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Sample records for barrett esophagus

  1. Barrett esophagus

    Science.gov (United States)

    ... eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 138. Ferri FF. Barrett esophagus. ... FF ed. Ferri's Clinical Advisor 2016 . Philadelphia, PA: Elsevier; 2016:202-203. Katz PO, Gerson LB, Vela ...

  2. Helicobacter pylori in Barrett's esophagus

    OpenAIRE

    Ferreres, Joan-Carles; Fernández, Fidel; Rodríguez Vives, Agustín; González-Rodilla, Irene; Ursúa, Inmaculada; Ramos, Rafael; Val-Bernal, José Fernando

    1991-01-01

    Barrett's esophagus is an anatomicoclinical state in which, due to the prolonged action of gastroesophageal reflux, the squamous epithelium is replaced by columnar epithelium. Helicobacter pylori has been implicated in the pathogenesis of various gastrointestinal disorders and has occasionally been observed in Barrett's esophagus. The aim of this study is to determine the incidence of H. pylori in Barrett's esophagus and try to establish its role in the pathoge...

  3. [Barrett's esophagus in children].

    Science.gov (United States)

    Ida, Shinobu

    2005-08-01

    Barrett's esophagus (BE) is a condition of esophageal dysplasia in which the tubular esophagus is lined with columnar instead of squamous mucosa--not with just any type of columnar mucosa, but with a specialized type with goblet cells. It is considered to be an acquired phenomenon secondary to acid exposure from gastro-esophageal reflux (GER). This report shows a review of BE of children and our data about BE from the study of 19 handicapped children with GER. 3 had intestinal dysplasia with goblet cells (BE). The % time of pH under 4 on 24-hour pH monitoring was significantly lower in the patients with esophagitis including BE than in them with normal esophagus. BE of our study seemed to be reversible after the surgery and anti-acid therapy. It is suggested that BE is not a rare condition even in children and biopsy specimens should be taken to establish the diagnosis. PMID:16101239

  4. Biomarkers in Barrett's esophagus.

    Science.gov (United States)

    Reid, Brian J; Blount, Patricia L; Rabinovitch, Peter S

    2003-04-01

    This article provides a framework for clinicians who are attempting the difficult task of interpreting the Barrett's biomarker literature with the goal of improving care for their patients. Although many articles. including more that 60 proposed biomarkers, have been published on this subject, only a few describe phase 3 and 4 studies that are of interest to the clinical gastroenterologist (Table 1). For year, dysplasia grade has been the sole means of risk stratification for patients with BE, and it likely will continue to be used in the foreseeable future. The current authors believe that dysplasia classification can be valuable using the team management approach and quality controls described previously. Significant problems, however, have emerged in phase 2 through 4 studies of dysplasia that make it imperative for the Barrett's field to incorporate additional biomarkers as they are validated. These problems include poor reproducibility of dysplasia interpretations, poor predictive value for negative, indefinite, and low-grade dysplasia, and inconsistent results for HGD in different centers, all of which makes it virtually impossible to develop national guidelines for surveillance. Some studies have even suggested that endoscopic biopsy surveillance using dysplasia may not be worthwhile. Currently, flow cytometric tetraploidy and aneuploidy have progressed furthest in biomarker validation (see Table 1). With proper handling, endoscopic biopsy specimens can be shipped to reference laboratories that have the instruments, computer analytic methods, and expertise to reproducibly detect tetraploidy and aneuploidy. The results of phase 4 studies indicate that flow cytometry appears to be useful in detecting a subset of patients who do not have HGD and yet have an increased risk of progression to cancer that cannot be identified by dysplasia grade. For many reasons, the authors anticipate that the number of validated biomarkers will increase substantially in the

  5. Barrett's esophagus: clinical features, obesity, and imaging.

    LENUS (Irish Health Repository)

    Quigley, Eamonn M M

    2011-09-01

    The following includes commentaries on clinical features and imaging of Barrett\\'s esophagus (BE); the clinical factors that influence the development of BE; the influence of body fat distribution and central obesity; the role of adipocytokines and proinflammatory markers in carcinogenesis; the role of body mass index (BMI) in healing of Barrett\\'s epithelium; the role of surgery in prevention of carcinogenesis in BE; the importance of double-contrast esophagography and cross-sectional images of the esophagus; and the value of positron emission tomography\\/computed tomography.

  6. Scintigraphic assessment of Barrett's esophagus

    International Nuclear Information System (INIS)

    Barrett's (B) esophagus is defined by the presence of columnar epithelium above the gastroesophageal junction. Patients with 5cm histologically proven B were evaluated for mucosal labeling (ML), esophageal motility (EM), gastroesophageal reflux (GER), and gastric emptying (GE) of solids and liquids with and without iv metaclopramide (MCP). ML, after premedication with cimetidine, was evaluated 20 and 40 min after injection of Tc-99m04 with ANT and RAO views. Eight of 11 B and 0 of 2 controls (C) labeled esophageal mucosa. EM was assessed in the supine position over one min after a 15 ml swallow Tc-99mSc-H2O. The normal pattern shows sequential, aboral, discreet peaks with no retrograde movement over one min in three computer derived regions over the esophagus. Five of 16 B and 1 of 6 C demonstrated abnormal pattern. GER was assessed in the supine position by serially increasing extrinsic binder pressures from 0 to 100 Torr after ingestion of 300 ml of Tc-99mSc-orange juice (OJ). GER was present in 13 of 15 B and 0 of 11 C. Reflux ranged from 5.1% to 30% at 100 Torr. Hiatal hernia (HH) was identified in 14 of 16 B by endoscopy and in 10 of 16 by scintigraphy. GE was evaluated after a liquid meal of 300 ml Tc-99mSc-OJ and a solid meal of Tc-99mSc-egg salad sandwich. The supine subject was imaged anteriorly for 30 min (liquid) or 60 min (solid). GE was assessed an additional 10 min after MCP. Clearance time (50%) for solid Ge was calculated from extrapolated linear fits of decay corrected data. There was no significant difference in liquid or solid GE between B and C. The authors conclude the following: 1) ML detects B with lower sensitivity than previously reported; 2) EM disorders are frequently found in B; 3) GER is frequently identified in B; 4) HH can be identified by nuclear technique; and 5) B shows normal GE and responds to MCP

  7. Scintigraphic investigation of Barrett esophagus patients

    International Nuclear Information System (INIS)

    The cylinder-cells metaplasia of the esophagus or Barrett esophagus (BE) is known as a high potent praecancerosis. The dimensions of the lesion are one of the most important prognostic criteria. The aim of the study is to evaluate the diagnostic possibilities of 99mTc-scintigraphy for both lesion size and localization determination. The study involved 11 patients with histological data for BE and 6 control persons. Single lesion was established at four patients; two or more lesions - at seven. The rest six persons examined did not show lesions at all. The study proved that the 99mTc-scintigraphy provided reliable imaging of the cylinder-cells metaplasia areas in the esophagus. It also gives an opportunity for BE mapping which is very important for disease control and prognosis. (author)

  8. GERD, Barrett's Esophagus and the Risk for Esophageal Cancer

    Science.gov (United States)

    ... Facts About Common Colon Cancer Screening Tests PATIENTS GERD, Barrett's Esophagus and the Risk for Esophageal Cancer ... commonly in Caucasians as well as people with gastroesophageal reflux disease (GERD). This cancer is increasing in frequency. ...

  9. Clinical Study of Ursodeoxycholic Acid in Barrett's Esophagus Patients.

    Science.gov (United States)

    Banerjee, Bhaskar; Shaheen, Nicholas J; Martinez, Jessica A; Hsu, Chiu-Hsieh; Trowers, Eugene; Gibson, Blake A; Della'Zanna, Gary; Richmond, Ellen; Chow, H-H Sherry

    2016-07-01

    Prior research strongly implicates gastric acid and bile acids, two major components of the gastroesophageal refluxate, in the development of Barrett's esophagus and its pathogenesis. Ursodeoxycholic acid (UDCA), a hydrophilic bile acid, has been shown to protect esophageal cells against oxidative stress induced by cytotoxic bile acids. We conducted a pilot clinical study to evaluate the clinical activity of UDCA in patients with Barrett's esophagus. Twenty-nine patients with Barrett's esophagus received UDCA treatment at a daily dose of 13 to 15 mg/kg/day for 6 months. The clinical activity of UDCA was assessed by evaluating changes in gastric bile acid composition and markers of oxidative DNA damage (8-hydroxydeoxyguanosine), cell proliferation (Ki67), and apoptosis (cleaved caspase-3) in Barrett's esophagus epithelium. The bile acid concentrations in gastric fluid were measured by liquid chromatography/mass spectrometry. At baseline, UDCA (sum of unchanged and glycine/taurine conjugates) accounted for 18.2% of total gastric bile acids. After UDCA intervention, UDCA increased significantly to account for 93.4% of total gastric bile acids (P < 0.0001). The expression of markers of oxidative DNA damage, cell proliferation, and apoptosis was assessed in the Barrett's esophagus biopsies by IHC. The selected tissue biomarkers were unchanged after 6 months of UDCA intervention. We conclude that high-dose UDCA supplementation for 6 months resulted in favorable changes in gastric bile acid composition but did not modulate selected markers of oxidative DNA damage, cell proliferation, and apoptosis in the Barrett's esophagus epithelium. Cancer Prev Res; 9(7); 528-33. ©2016 AACRSee related article by Brian J. Reid, p. 512. PMID:26908564

  10. Improved esophageal function in Barrett esophagus with intravenous metoclopramide

    International Nuclear Information System (INIS)

    A prospective study of the response in esophageal function to intravenous metaclopramide was performed in 16 patients with Barrett esophagus by means of radionuclide esophageal scintigraphy. Scintigraphy was performed before and after the intravenous administration of 10 mg of metoclopramide. Analysis of esophageal function included the percentage emptying at 30 seconds. The majority of patients (62.5%) showed clear improvement in esophageal function. The mean percentage of emptying improved from 59% to 75% (P = .03). This suggests an additional reason for metoclopramide therapy in Barrett esophagus beyond its present role in decreasing gastroesophageal reflux. Radionuclide esophageal scintigraphy is as rapid and sensitive test of esophageal function, including drug response

  11. Usefulness of Chromoendoscopy and Narrow Band Imaging in Barrett's Esophagus

    Directory of Open Access Journals (Sweden)

    Engy Yousry El Sayed

    2014-12-01

    Full Text Available Barrett's esophagus (BE is the most important risk factor for esophageal adenocarcinoma. High resolution magnification endoscopy with Narrow band imaging (NBI facilitates mucosal surface evaluation and may improve the endoscopic diagnosis of Barrett’s esophagus. The aim of this work was to study the diagnostic value of chromo endoscopy versus NBI in detection of Barrett’s esophagus. Patients and methods: Forty patients their conventional white light endoscopy revealed the diagnosis of GERD and showed findings suggestive of Barrett’s esophagus, they were divided into 20 patients underwent chromo endoscopy and 20 patients underwent Narrow band imaging (NBI, The endoscopic results of both groups were compared with the final histo pathological diagnosis. Results: NBI showed higher accuracy than chromo endoscopy 75 % which vs. 70 % P< 0.05 in detection of BE. NBI had an accuracy of 70 and 75 % in type A pattern (round pits with regular microvasculature to predict columnar mucosa without intestinal metaplasia and type B pattern (villous pits with regular microvasculature to predict specialized intestinal metaplasia respectively. Conclusion: NBI is not only helpful in detecting metaplasia but also in differentiating cardiac from intestinal metaplasia, as it allows clear visualization of micro structural and micro vascular patterns.

  12. Effects of telomerase expression on photodynamic therapy of Barrett's esophagus

    Science.gov (United States)

    Wang, Kenneth K.; Anderson, Marlys; Buttar, Navtej; WongKeeSong, Louis-Michel; Borkenhagen, Lynn; Lutzke, Lori

    2003-06-01

    Photodynamic therapy has been applied to Barrett's esophagus and has been shown in prospective randomized studies to eliminate dysplasia as well as decrease the occurrence of cancer. However, the therapy isnot always effective and there are issues with residual areas of Barrett's mucosa despite therapy. There has not been a good explanation for these residual areas and they seem to imply that there may exist a biological mechanisms by which these cells may be resistant to photodynamic therapy. It was our aim to determine if known abnormalities in Barrett's mucosa could be correlated with the lack of response of some of these tissues. We examined the tissue from mulitpel patients who had resonse to therapy as well as those who did not respond. We assessed the tissue for p53 mutations, inactivatino of p16, ploidy status, cell proliferation, telomerase activity, and degree of dysplasia. Interestingly, the only genetic marker than was found to be correlated with lack of reonse was p53 and telomerase activity. This suggests that cells that have lost mechanisms for cell death such as apoptosis or telomere shortengin may be more resistant to photodynamic therapy. In this study, we examined patients before and after PDT for telomerase activity.

  13. The Complex, Clonal, and Controversial Nature of Barrett's Esophagus.

    Science.gov (United States)

    Evans, James A; McDonald, Stuart A C

    2016-01-01

    Barrett's esophagus (BO) is a preneoplastic condition described as the replacement of the stratified squamous epithelium of the distal esophagus with one that histologically presents as a diverse mixture of metaplastic glands resembling gastric or intestinal-type columnar epithelium. The clonal origins of BO are still unclear. More recently, we have begun to investigate the relationship between the various metaplastic gland phenotypes observed in BO, how they evolve, and the cancer risk they bestow. Studies have revealed that glands along the BO segment are clonal units containing a single stem cell clone that can give rise to all the differentiated epithelial cell types in glands. Clonal lineage tracing analysis has revealed that Barrett's glands are capable of bifurcation and this facilitates clonal expansion and competition. In fact, BO in some patients appears to consist of multiple, independently initiated clones that compete with each other for space and possibly resources. This chapter discusses the concepts of clonal competition and expansion in BO and sets out to query what we know about the role of gland diversity and phenotypic evolution within this complex columnar metaplasia. PMID:27573766

  14. White Paper AGA: Advanced Imaging in Barrett's Esophagus.

    Science.gov (United States)

    Sharma, Prateek; Brill, Joel; Canto, Marcia; DeMarco, Daniel; Fennerty, Brian; Gupta, Neil; Laine, Loren; Lieberman, David; Lightdale, Charles; Montgomery, Elizabeth; Odze, Robert; Tokar, Jeffrey; Kochman, Michael

    2015-12-01

    Enhanced imaging technologies such as narrow band imaging, flexible spectral imaging color enhancement, i-Scan, confocal laser endomicroscopy, and optical coherence tomography are readily available for use by endoscopists in routine clinical practice. In November 2014, the American Gastroenterological Association's Center for GI Innovation and Technology conducted a 2-day workshop to discuss endoscopic image enhancement technologies, focusing on their role in 2 specific clinical conditions (colon polyps and Barrett's esophagus) and on issues relating to training and implementation of these technologies (white papers). Although the majority of the studies that use enhanced imaging technologies have been positive, these techniques ideally need to be validated in larger cohorts and in community centers. As it stands today, detailed endoscopic examination with high-definition white-light endoscopy and random 4-quadrant biopsy remains the standard of care. However, the workshop panelists agreed that in the hands of endoscopists who have met the preservation and incorporation of valuable endoscopic innovation thresholds (diagnostic accuracy) with enhanced imaging techniques (specific technologies), use of the technique in Barrett's esophagus patients is appropriate. PMID:26462567

  15. Potential Role of the Microbiome in Barrett's Esophagus and Esophageal Adenocarcinoma.

    Science.gov (United States)

    Snider, Erik J; Freedberg, Daniel E; Abrams, Julian A

    2016-08-01

    Esophageal adenocarcinoma and its precursor Barrett's esophagus have been rapidly increasing in incidence for half a century, for reasons not adequately explained by currently identified risk factors such as gastroesophageal reflux disease and obesity. The upper gastrointestinal microbiome may represent another potential cofactor. The distal esophagus has a distinct microbiome of predominantly oral-derived flora, which is altered in Barrett's esophagus and reflux esophagitis. Chronic low-grade inflammation or direct carcinogenesis from this altered microbiome may combine with known risk factors to promote Barrett's metaplasia and progression to adenocarcinoma. PMID:27068172

  16. Risk factors for neoplastic progression in Barrett's esophagus

    Institute of Scientific and Technical Information of China (English)

    Elizabeth F Wiseman; Yeng S Ang

    2011-01-01

    Barrett's esophagus (BE) confers a significant increasedrisk for development of esophageal adenocarcinoma (EAC), with the pathogenesis appearing to progress through a "metaplasia-dysplasia-carcinoma" (MDC) sequence. Many of the genetic insults driving this MDCsequence have recently been characterized, providing targets for candidate biomarkers with potential clinical utility to stratify risk in individual patients. Many clini-cal risk factors have been investigated, and associa-tions with a variety of genetic, specific gastrointestinaland other modifiable factors have been proposed in the literature. This review summarizes the current un-derstanding of the mechanisms involved in neoplastic progression of BE to EAC and critically appraises the relative roles and contributions of these putative risk factors from the published evidence currently available.

  17. Role of brush cytology in the diagnosis of Barrett's esophagus: an analysis of eight cases.

    Science.gov (United States)

    Padmavathy, Femila; Siddaraju, Neelaiah; Sistla, Sarath Chandra

    2011-01-01

    Although debatable, role of cytology in diagnosing Barrett's esophagus has been stressed by some authors. Our brief report analyses the role of brush cytology (BC) in its diagnosis. Eight patients who presented with upper gastrointestinal (GI) manifestations and subsequently diagnosed to have Barrett's esophagus with or without adenocarcinoma on brush cytology (BC) or, endoscopic biopsy (EB) or, a combination of both the techniques were included in the study. In all the cases routine cytologic smears and histologic sections with relevant special stains (when essential) were studied. On cytology, the diagnosis of "Barrett's esophagus" was made when the esophageal brushings obtained from a region beyond 3 cm from the gastroesophageal junction showed closely intermingled clusters of squamous and columnar cells, or when there was evidence of intestinal metaplasia. Adenocarcinoma in Barrett's esophagus was diagnosed by the usual criteria for malignancy with features of adenocarcinoma. Cytologic diagnoses were correlated with the histologic diagnoses. Of the eight cases, seven had histopathologic correlation of which six had evidence of BE on BC; four had cytohistologic concordance, of which three cases revealed adenocarcinoma arising in BE. Two endoscopic biopsies were nonrepresentative. In one case, cytology missed Barrett's esophagus. For two cases in which cytology detected Barrett's mucosa, biopsies were nonrepresentative. Our study showed brush cytology (BC) to be a fairly reliable test for detecting Barrett's esophagus. Owing to its inherent advantage of sampling a wider and circumferential area, a technically well performed brushing procedure is likely to be more representative and superior than multiple endoscopic biopsies. PMID:21162095

  18. Frequency, types and complications of barrett's esophagus in patients with symptoms of gastro-esophageal reflux

    International Nuclear Information System (INIS)

    Objective: This study was carried out to evaluate the frequency, types and complications of Barrett's esophagus in symptomatic gastro-esophageal reflux patients. Subjects: A total of 100 patients of gastro-esophageal reflux were studied to evaluate the frequency, types and complications of Barrett's esophagus. Endoscopic biopsies were taken and examined with H and E and various special stains like PAS, Alcian blue/PAS, high iron diamine/ Alcian blue and Giemsa stains. Results: Of 100 cases studied, 32 were found to have Barrett's esophagus on microscopy. The remaining 68 cases showed low and high grade changes of gastro-esophageal reflux. Conclusion: In comparison with studies from western countries, Barrett's esophagus was found to be relatively more common in our population. However, the frequency of complications like ulcer, stricture, dysplasia and adenocarcinoma was lesser. (author)

  19. Advances in endoscopic diagnosis and treatment of Barrett's esophagus.

    Science.gov (United States)

    Gaddam, Srinivas; Sharma, Prateek

    2010-12-01

    Barrett's esophagus (BE) is defined as abnormal specialized columnar metaplasia with intestinalization in place of the normal squamous esophageal epithelium. Gastroesophageal reflux disease is a known risk factor for BE; nonetheless BE is also detected in asymptomatic individuals. Other risk factors for BE include smoking, male gender, age over 50 and obesity. Patients diagnosed with BE (without dysplasia) are recommended to undergo endoscopic surveillance every 3-5 years. Advances in imaging techniques (such as narrow band imaging, autofluorescence imaging and confocal laser endomicroscopy) have the potential to improve the detection of dysplasia and early cancer, thus making surveillance a more cost-effective endeavor. Patients with high grade dysplasia (HGD) and early cancer have a high rate of progression to invasive adenocarcinoma and traditionally these patients were treated with esophagectomy. The rapid advancement of endoscopic therapeutic techniques along with a low risk of complications have made endoscopic therapy an acceptable alternative to an esophagectomy in patients with HGD and early cancer. Several endoscopic treatment techniques such as endoscopic mucosal resection, multipolar electrocoagulation, photodynamic therapy, argon plasma coagulation, cryotherapy, and radiofrequency ablation have been studied for endoscopic treatment. PMID:21091894

  20. Small cell carcinoma arising in Barrett's esophagus: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Markogiannakis Haridimos

    2008-01-01

    Full Text Available Abstract Introduction Gastrointestinal tract small cell carcinoma is an infrequent and aggressive neoplasm that represents 0.1–1% of gastrointestinal malignancies. Very few cases of small cell esophageal carcinoma arising in Barrett's esophagus have been reported in the literature. An extremely rare case of primary small cell carcinoma of the distal third of the esophagus arising from dysplastic Barrett's esophagus is herein presented. Case presentation A 62-year-old man with gastroesophageal reflux history presented with epigastric pain, epigastric fullness, dysphagia, anorexia, and weight loss. Esophagogastroscopy revealed an ulceroproliferative, intraluminar mass in the distal esophagus obstructing the esophageal lumen. Biopsy showed small cell esophageal carcinoma. Contrast-enhanced chest and abdominal computed tomography demonstrated a large tumor of the distal third of the esophagus without any lymphadenopathy or distant metastasis. Preoperative chemotherapy with cisplatine and etoposide for 3 months resulted in a significant reduction of the tumor. After en block esophagectomy with two field lymph node dissection, proximal gastrectomy, and cervical esophagogastric anastomosis, the patient was discharged on the 14th postoperative day. Histopathology revealed a primary small cell carcinoma of the distal third of the esophagus arising from dysplastic Barrett's esophagus. The patient received another 3 month course of postoperative chemotherapy with the same agents and remained free of disease at 12 month review. Conclusion Although small cell esophageal carcinoma is rare and its association with dysplastic Barrett's esophagus is extremely infrequent, the high carcinogenic risk of Barrett's epithelium should be kept in mind. Prognosis is quite unfavorable; a better prognosis might be possible with early diagnosis and treatment strategies incorporating chemotherapy along with oncological radical surgery and/or radiotherapy as part of a

  1. Three-tiered risk stratification model to predict progression in Barrett's esophagus using epigenetic and clinical features.

    Directory of Open Access Journals (Sweden)

    Fumiaki Sato

    Full Text Available Barrett's esophagus predisposes to esophageal adenocarcinoma. However, the value of endoscopic surveillance in Barrett's esophagus has been debated because of the low incidence of esophageal adenocarcinoma in Barrett's esophagus. Moreover, high inter-observer and sampling-dependent variation in the histologic staging of dysplasia make clinical risk assessment problematic. In this study, we developed a 3-tiered risk stratification strategy, based on systematically selected epigenetic and clinical parameters, to improve Barrett's esophagus surveillance efficiency.We defined high-grade dysplasia as endpoint of progression, and Barrett's esophagus progressor patients as Barrett's esophagus patients with either no dysplasia or low-grade dysplasia who later developed high-grade dysplasia or esophageal adenocarcinoma. We analyzed 4 epigenetic and 3 clinical parameters in 118 Barrett's esophagus tissues obtained from 35 progressor and 27 non-progressor Barrett's esophagus patients from Baltimore Veterans Affairs Maryland Health Care Systems and Mayo Clinic. Based on 2-year and 4-year prediction models using linear discriminant analysis (area under the receiver-operator characteristic (ROC curve: 0.8386 and 0.7910, respectively, Barrett's esophagus specimens were stratified into high-risk (HR, intermediate-risk (IR, or low-risk (LR groups. This 3-tiered stratification method retained both the high specificity of the 2-year model and the high sensitivity of the 4-year model. Progression-free survivals differed significantly among the 3 risk groups, with p = 0.0022 (HR vs. IR and p<0.0001 (HR or IR vs. LR. Incremental value analyses demonstrated that the number of methylated genes contributed most influentially to prediction accuracy.This 3-tiered risk stratification strategy has the potential to exert a profound impact on Barrett's esophagus surveillance accuracy and efficiency.

  2. Free radicals and antioxidant systems in reflux esophagitis and Barrett's esophagus

    Institute of Scientific and Technical Information of China (English)

    Pilar Jiménez; Elena Piazuelo; M. Teresa Sánchez; Javier Ortego; Fernando Soteras; Angel Lanas

    2005-01-01

    AIM: Experimental studies suggest that free radicals are involved in acid and pepsin-induced damage of esophageal mucosa. The profile and balance between free radicals and antioxidant systems in human esophagitis are unknown. METHODS: Superoxide anion and its powerful oxidant reaction with nitric oxide (peroxynitrite) generation were determined in esophageal mucosal biopsies from 101 patients with different gastro-esophageal reflux diseases and 28 controls. Activity of both superoxide dismutase (SOD) and catalase, and reduced glutathione (GSH) levels,were also assessed. Expression of Cu,ZnSOD, MnSOD and tyrosine-nitrated MnSOD were analyzed by Western blot and/or immunohistochemistry.RESULTS: The highest levels of superoxide anion generation were found in patients with severe lesions of esophagitis. Peroxynitrite generation was intense in Barrett's biopsies, weaker in esophagitis and absent/weak in normal mucosa. Expression of Cu,ZnSOD and MnSOD isoforms were present in normal mucosa and increased according to the severityof the lesion, reaching the highest level in Barrett's esophagus. However, SOD mucosal activity significantly decreased in patients with esophagitis and Barrett's esophagus, which was, at least in part, due to nitration of its tyrosine residues. Catalase activity and GSH levels were significanUy increased in mucosal specimens from patients with esophagitis and/or Barrett's esophagus.CONCLUSION: A decrease in SOD antioxidant activity leading to increased mucosal levels of superoxide anion and peroxynitrite radicals may contribute to the development of esophageal damage and Barrett's esophagus in patients with gastroesophageal reflux. Administration of SOD may be a therapeutic target in the treatment of patients with esophagitis and Barrett's esophagus.

  3. Post-ablation lymphocytic esophagitis in Barrett esophagus with high grade dysplasia or intramucosal carcinoma.

    Science.gov (United States)

    Kissiedu, Juliana; Thota, Prashanthi N; Gohel, Tushar; Lopez, Rocio; Gordon, Ilyssa O

    2016-06-01

    In patients who have undergone ablation therapy for treatment of Barrett's esophagus with dysplasia, histologic features of eosinophilic esophagitis, but not lymphocytic esophagitis, have been described. We evaluated for histologic evidence of eosinophilic esophagitis and lymphocytic esophagitis and correlated with endoscopic findings in this population. A single-institution Barrett's esophagus registry was searched for patients who had received radiofrequency ablation, cryotherapy, or both for treatment of Barrett's esophagus with dysplasia. Clinical and endoscopic data were collected and biopsies were reviewed for inflammation and reactive changes at three time points: pre-intervention, first surveillance after ablation therapy, and most recent surveillance. Of the 173 patients initially identified, 102 met the inclusion criteria. Intraepithelial eosinophils were increased at first surveillance (60%, P=0.096) and last surveillance (69%, P=0.048) compared with pre-intervention (50%), although histologic evidence of post-ablation eosinophilic esophagitis was not significant. Prevalence of lymphocytic esophagitis was significantly higher at first surveillance (17%, P=0.02) and at last surveillance (43%, Pcryotherapy were identified as independent risk factors for developing histologic lymphocytic esophagitis. This is the first report that histologic evidence of lymphocytic esophagitis increased over time in patients undergoing ablation for Barrett's esophagus with dysplasia. Though the pathophysiology of lymphocytic esophagitis remains unknown, patients in our study with a history of smoking, hyperlipidemia, or cryotherapy were more likely to develop post-ablation lymphocytic esophagitis. PMID:26965580

  4. Polymorphisms Near TBX5 and GDF7 Are Associated With Increased Risk for Barrett's Esophagus

    NARCIS (Netherlands)

    Palles, Claire; Chegwidden, Laura; Li, Xinzhong; Findlay, John M.; Farnham, Garry; Giner, Francesc Castro; Peppelenbosch, Maikel P.; Kovac, Michal; Adams, Claire L.; Prenen, Hans; Briggs, Sarah; Harrison, Rebecca; Sanders, Scott; MacDonald, David; Haigh, Chris; Tucker, Art; Love, Sharon; Nanji, Manoj; Decaestecker, John; Ferry, David; Rathbone, Barrie; Hapeshi, Julie; Barr, Hugh; Moayyedi, Paul; Watson, Peter; Zietek, Barbara; Maroo, Neera; Gay, Laura; Underwood, Tim; Boulter, Lisa; McMurtry, Hugh; Monk, David; Patel, Praful; Ragunath, Krish; Al Dulaimi, David; Murray, Iain; Koss, Konrad; Veitch, Andrew; Trudgill, Nigel; Nwokolo, Chuka; Rembacken, Bjorn; Atherfold, Paul; Green, Elaine; Ang, Yeng; Kuipers, Ernst J.; Chow, Wu; Paterson, Stuart; Kadri, Sudarshan; Beales, Ian; Grimley, Charles; Mullins, Paul; Beckett, Conrad; Farrant, Mark; Dixon, Andrew; Kelly, Sean; Johnson, Matthew; Wajed, Shahjehan; Dhar, Anjan; Sawyer, Elinor; Roylance, Rebecca; Onstad, Lynn; Gammon, Marilie D.; Corley, Douglas A.; Shaheen, Nicholas J.; Bird, Nigel C.; Hardie, Laura J.; Reid, Brian J.; Ye, Weimin; Liu, Geoffrey; Romero, Yvonne; Bernstein, Leslie; Wu, Anna H.; Casson, Alan G.; Fitzgerald, Rebecca; Whiteman, David C.; Risch, Harvey A.; Levine, David M.; Vaughan, Tom L.; Verhaar, Auke P.; van den Brande, Jan; Toxopeus, Eelke L.; Spaander, Manon C.; Wijnhoven, Bas P. L.; van der Laan, Luc J. W.; Krishnadath, Kausilia; Wijmenga, Cisca; Trynka, Gosia; McManus, Ross; Reynolds, John V.; O'Sullivan, Jacintha; MacMathuna, Padraic; McGarrigle, Sarah A.; Kelleher, Dermot; Vermeire, Severine; Cleynen, Isabelle; Bisschops, Raf; Tomlinson, Ian; Jankowski, Janusz

    2015-01-01

    BACKGROUND & AIMS: Barrett's esophagus (BE) increases the risk of esophageal adenocarcinoma (EAC). We found the risk to be BE has been associated with single nucleotide polymorphisms (SNPs) on chromosome 6p21 (within the HLA region) and on 16q23, where the closest protein-coding gene is FOXF1. Subse

  5. Polymorphisms near TBX5 and GDF7 are associated with increased risk for Barrett's esophagus

    NARCIS (Netherlands)

    C. Palles (Claire); L. Chegwidden (Laura); X. Li (Xinzhong); J.M. Findlay (John M.); G. Farnham (Garry); F. Castro Giner (Francesc); M.P. Peppelenbosch (Maikel); M. Kovac (Michal); C.L. Adams (Claire L.); H. Prenen (Hans); S. Briggs (Sarah); R. Harrison (Rebecca); S. Sanders (Scott); D. Macdonald (David); K. Haigh (Katharina); A.T. Tucker (Art); S. Love (Sharon); M. Nanji (Manoj); J. Decaestecker (John); D.R. Ferry (David); B. Rathbone (Barrie); J. Hapeshi (Julie); H. Barr (Hugh); P. Moayyedi (Paul); P. Watson (Peter); B. Zietek (Barbara); N. Maroo (Neera); L. Gay (Laura); T. Underwood (Tim); L. Boulter (Lisa); H. McMurtry (Hugh); A.B. Monk (Alastair); P. Patel (Poulam); K. Ragunath (Krish); D. Al Dulaimi (David); I. Murray (Iain); C. Koss (Clara); A. Veitch (Andrew); N. Trudgill (Nigel); C. Nwokolo (Chuka); B. Rembacken; P. Atherfold (Paul); E.K. Green (Elaine K); Y. Ang (Yeng); E.J. Kuipers (Ernst); W. Chow (Wu); S. Paterson (Stuart); S. Kadri (Sudarshan); I. Beales (Ian); C. Grimley (Charles); P. Mullins (Paul); C. Beckett (Conrad); M. Farrant (Mark); A. Dixon (Andrew); S. Kelly (Sean); M. Johnson (Matthew); S. Wajed (Shahjehan); A. Dhar (Archana); E.J. Sawyer (Elinor); R. Roylance (Rebecca); L. Onstad (Lynn); M.D. Gammon (Marilie); D.A. Corley (Douglas); N. Shaheen (Nazima); N.C. Bird (Nigel); B.G.S. Hardie (Bruce); B.J. Reid (Brian); W. Ye (Weimin); G. Liu (Geoffrey); Y. Romero (Yvonne); L. Bernstein (Leslie); A.H. Wu (Anna H.); A.G. Casson (Alan); R.C. Fitzgerald (Rebecca); D.C. Whiteman (David C.); H. Risch (Harvey); D.M. Levine (David M.); T.L. Vaughan (Thomas); A.P. Verhaar (Auke); J. Van Den Brande (Jan); E.L.A. Toxopeus (Eelke); V.M.C.W. Spaander (Manon); B.P.L. Wijnhoven (Bas); L.J.W. van der Laan (Luc); K.K. Krishnadath (Kausilia); C. Wijmenga (Cisca); G. Trynka (Gosia); R. McManus (Ross); J.V. Reynolds (John V.); J. O'Sullivan (Jacintha); P. Macmathuna (Padraic); S.A. McGarrigle (Sarah A.); D. Kelleher (Dermot); S. Vermeire (Séverine); I. Cleynen (Isabelle); R. Bisschops (Raf); I.P. Tomlinson (Ian); J.A. Jankowski (Janusz Antoni)

    2015-01-01

    textabstractBackground & Aims Barrett's esophagus (BE) increases the risk of esophageal adenocarcinoma (EAC). We found the risk to be BE has been associated with single nucleotide polymorphisms (SNPs) on chromosome 6p21 (within the HLA region) and on 16q23, where the closest protein-coding gene is F

  6. Transcribed ultraconserved noncoding RNAs (T-UCR) are involved in Barrett's esophagus carcinogenesis.

    Science.gov (United States)

    Fassan, Matteo; Dall'Olmo, Luigi; Galasso, Marco; Braconi, Chiara; Pizzi, Marco; Realdon, Stefano; Volinia, Stefano; Valeri, Nicola; Gasparini, Pierluigi; Baffa, Raffaele; Souza, Rhonda F; Vicentini, Caterina; D'Angelo, Edoardo; Bornschein, Jan; Nuovo, Gerard J; Zaninotto, Giovanni; Croce, Carlo M; Rugge, Massimo

    2014-08-30

    Barrett's esophagus (BE) involves a metaplastic replacement of native esophageal squamous epithelium (Sq) by columnar-intestinalized mucosa, and it is the main risk factor for Barrett-related adenocarcinoma (BAc). Ultra-conserved regions (UCRs) are a class non-coding sequences that are conserved in humans, mice and rats. More than 90% of UCRs are transcribed (T-UCRs) in normal tissues, and are altered at transcriptional level in tumorigenesis. To identify the T-UCR profiles that are dysregulated in Barrett's mucosa transformation, microarray analysis was performed on a discovery set of 51 macro-dissected samples obtained from 14 long-segment BE patients. Results were validated in an independent series of esophageal biopsy/surgery specimens and in two murine models of Barrett's esophagus (i.e. esophagogastric-duodenal anastomosis). Progression from normal to BE to adenocarcinoma was each associated with specific and mutually exclusive T-UCR signatures that included up-regulation of uc.58-, uc.202-, uc.207-, and uc.223- and down-regulation of uc.214+. A 9 T-UCR signature characterized BE versus Sq (with the down-regulation of uc.161-, uc.165-, and uc.327-, and the up-regulation of uc.153-, uc.158-, uc.206-, uc.274-, uc.472-, and uc.473-). Analogous BE-specific T-UCR profiles were shared by human and murine lesions. This study is the first demonstration of a role for T-UCRs in the transformation of Barrett's mucosa. PMID:25216530

  7. O esôfago de Barrett associado à estenose cáustica do esôfago Barrett's esophagus associated to caustic stenosis of the esophagus

    Directory of Open Access Journals (Sweden)

    Nelson Adami Andreollo

    2003-09-01

    Full Text Available RACIONAL: A estenose esofágica secundária à ingestão de produtos cáusticos é freqüente no Brasil, principalmente como tentativa de suicídio. O esôfago de Barrett surge como conseqüência do refluxo gastroesofágico crônico. A literatura pesquisada mostrou que esta associação é muito rara. CASUÍSTICA E MÉTODOS: De 1981 a 2000 foram admitidos e tratados no Gastrocentro-UNICAMP (Universidade Estadual de Campinas, SP. 120 doentes com estenose cáustica do esôfago e durante o seguimento destes, foram encontrados 9 casos associados com o esôfago de Barrett (7,5%. O tempo de ingestão do cáustico variou de 4 a 54 anos (média de 29 anos e eram quatro homens e cinco mulheres, oito brancos e um negro, com idade média de 57,7 anos (43 a 72 anos. RESULTADOS: Todos os casos apresentavam disfagia e a endoscopia digestiva alta flexível mostrou áreas de estenose e seqüelas de esofagite cáustica. Três pacientes referiram sintomas de refluxo gastroesofágico, mas hérnia de hiato foi encontrada em apenas um caso. O esôfago de Barrett foi encontrado no terço médio do esôfago em três casos, acima das áreas de estenose, e nos demais, no terço distal. A disfagia foi tratada com dilatações esofágicas periódicas. Dois pacientes apresentando sintomas de refluxo grave foram submetidos a fundoplicatura à Nissen modificado através de videolaparoscopia, com bons resultados. CONCLUSÕES: O esôfago de Barrett nesses doentes poderia estar associado com a ingestão de cáustico, porque nem sempre esteve associado à esofagite por refluxo. É muito importante o seguimento desses doentes e realização periódica de endoscopias digestivas com biopsias do esôfago de Barrett, devido à possibilidade de malignização.BACKGROUND: The esophageal stenosis secondary to the ingestion of caustic products is frequent in Brazil, mainly due to an attempt suicide. The Barrett's esophagus is consequence of the chronic gastroesophageal reflux. The

  8. Common variants at the MHC locus and at chromosome 16q24.1 predispose to Barrett's esophagus

    NARCIS (Netherlands)

    Su, Zhan; Gay, Laura J.; Strange, Amy; Palles, Claire; Band, Gavin; Whiteman, David C.; Lescai, Francesco; Langford, Cordelia; Nanji, Manoj; Edkins, Sarah; van der Winkel, Anouk; Levine, David; Sasieni, Peter; Bellenguez, Celine; Howarth, Kimberley; Freeman, Colin; Trudgill, Nigel; Tucker, Art T.; Pirinen, Matti; Peppelenbosch, Maikel P.; van der Laan, Luc J. W.; Kuipers, Ernst J.; Drenth, Joost P. H.; Peters, Wilbert H.; Reynolds, John V.; Kelleher, Dermot P.; McManus, Ross; Grabsch, Heike; Prenen, Hans; Bisschops, Raf; Krishnadath, Kausila; Siersema, Peter D.; van Baal, Jantine W. P. M.; Middleton, Mark; Petty, Russell; Gillies, Richard; Burch, Nicola; Bhandari, Pradeep; Paterson, Stuart; Edwards, Cathryn; Penman, Ian; Vaidya, Kishor; Ang, Yeng; Murray, Iain; Patel, Praful; Ye, Weimin; Mullins, Paul; Wu, Anna H.; Bird, Nigel C.; Dallal, Helen; Shaheen, Nicholas J.; Murray, Liam J.; Koss, Konrad; Bernstein, Leslie; Romero, Yvonne; Hardie, Laura J.; Zhang, Rui; Winter, Helen; Corley, Douglas A.; Panter, Simon; Risch, Harvey A.; Reid, Brian J.; Sargeant, Ian; Gammon, Marilie D.; Smart, Howard; Dhar, Anjan; McMurtry, Hugh; Ali, Haythem; Liu, Geoffrey; Casson, Alan G.; Chow, Wong-Ho; Rutter, Matt; Tawil, Ashref; Morris, Danielle; Nwokolo, Chuka; Isaacs, Peter; Rodgers, Colin; Ragunath, Krish; MacDonald, Chris; Haigh, Chris; Monk, David; Davies, Gareth; Wajed, Saj; Johnston, David; Gibbons, Michael; Cullen, Sue; Church, Nicholas; Langley, Ruth; Griffin, Michael; Alderson, Derek; Deloukas, Panos; Hunt, Sarah E.; Gray, Emma; Dronov, Serge; Potter, Simon C.; Tashakkori-Ghanbaria, Avazeh; Anderson, Mark; Brooks, Claire; Blackwell, Jenefer M.; Bramon, Elvira; Brown, Matthew A.; Casas, Juan P.; Corvin, Aiden; Duncanson, Audrey; Markus, Hugh S.; Mathew, Christopher G.; Palmer, Colin N. A.; Plomin, Robert; Rautanen, Anna; Sawcer, Stephen J.; Trembath, Richard C.; Viswanathan, Ananth C.; Wood, Nicholas; Trynka, Gosia; Wijmenga, Cisca; Cazier, Jean-Baptiste; Atherfold, Paul; Nicholson, Anna M.; Gellatly, Nichola L.; Glancy, Deborah; Cooper, Sheldon C.; Cunningham, David; Lind, Tore; Hapeshi, Julie; Ferry, David; Rathbone, Barrie; Brown, Julia; Love, Sharon; Attwood, Stephen; MacGregor, Stuart; Watson, Peter; Sanders, Scott; Ek, Weronica; Harrison, Rebecca F.; Moayyedi, Paul; de Caestecker, John; Barr, Hugh; Stupka, Elia; Vaughan, Thomas L.; Peltonen, Leena; Spencer, Chris C. A.; Tomlinson, Ian; Donnelly, Peter; Jankowski, Janusz A. Z.

    2012-01-01

    Barrett's esophagus is an increasingly common disease that is strongly associated with reflux of stomach acid and usually a hiatus hernia, and it strongly predisposes to esophageal adenocarcinoma (EAC), a tumor with a very poor prognosis. We report the first genome-wide association study on Barrett'

  9. Evaluation of a Minimally Invasive Cell Sampling Device Coupled with Assessment of Trefoil Factor 3 Expression for Diagnosing Barrett's Esophagus: A Multi-Center Case–Control Study

    OpenAIRE

    Ross-Innes, Caryn S.; Irene Debiram-Beecham; Maria O'Donovan; Elaine Walker; Sibu Varghese; Pierre Lao-Sirieix; Laurence Lovat; Michael Griffin; Krish Ragunath; Rehan Haidry; Sami, Sarmed S.; Philip Kaye; Marco Novelli; Babett Disep; Richard Ostler

    2015-01-01

    Editors' Summary Background Barrett's esophagus is a condition in which the cells lining the esophagus (the tube that transports food from the mouth to the stomach) change and begin to resemble the cells lining the intestines. Although some people with Barrett's esophagus complain of burning indigestion or acid reflux from the stomach into the esophagus, many people have no symptoms or do not seek medical advice, so the condition often remains undiagnosed. Long-term acid reflux (gastroesophag...

  10. Barrett's Esophagus Methylation Profiles — EDRN Public Portal

    Science.gov (United States)

    We propose a nested case-control study of biomarkers in the setting of BE. By bringing together research institutions with large populations of patients with BE, we will perform a multi-center study of FISH and hypermethylation markers as possible prognostic factors in BE. The centers will select from their cohorts who have progressed to HGD or to adenocarcinoma of the esophagus ("progressors"), and who also donated samples prior to the development of cancer, when their histology was felt to be benign. These subjects will be compared to individuals who have been under endoscopic surveillance, but who have not progressed to HGD or EAC ("non-progressors"). Using this approach, we hope to identify promising markers for risk stratification in BE. We expect to be able to make successful application for a prospective study of markers identified in this case-control study.

  11. Superoxide dismutase prevents development of adenocarcinoma in a rat model of Barrett's esophagus

    Institute of Scientific and Technical Information of China (English)

    Elena Piazuelo; Carmelo Cebrián; Alfredo Escartín; Pilar Jiménez; Fernando Soteras; Javier Ortego; Angel Lanas

    2005-01-01

    AIM: To test whether antioxidant treatment could prevent the progression of Barrett's esophagus to adenocarcinoma.METHODS: In a rat model of gastroduodenoesophageal reflux by esophagojejunal anastomosis with gastric preservation, groups of 6-10 rats were randomized to receive treatment with superoxide dismutase (SOD) or vehicle and followed up for 4 mo. Rat's esophagus was assessed by histological analysis, superoxide anion and peroxinitrite generation, SOD levels and DNA oxidative damage.RESULTS: All rats undergoing esophagojejunostomy developed extensive esophageal mucosal ulceration and inflammation by mo 4. The process was associated with a progressive presence of intestinal metaplasia beyondthe anastomotic area (9% 1st mo and 50% 4th mo) (94% at the anastomotic level) and adenocarcinoma(11% 1st mo and 60% 4th mo). These changes were associated with superoxide anion and peroxinitrite mucosal generation, an early and significant increase of DNA oxidative damage and a significant decrease in SOD levels (P<0.05). Exogenous administration of SOD decreased mucosal superoxide levels, increased mucosal SOD levels and reduced the risk of developing intestinal metaplasia beyond the anastomotic area (odds ratio = 0.326; 95%CI: 0.108-0.981; P = 0.046),and esophageal adenocarcinoma (odds ratio = 0.243;95%CI: 0.073-0.804; P = 0.021).CONCLUSION: Superoxide dismutase prevents the progression of esophagitis to Barrett's esophagus and adenocarcinoma in this rat model of gastrointestinal reflux, supporting a role of antioxidants in the chemoprevention of esophageal adenocarcinoma.

  12. Battling Barrett's esophagus: uncovering the genetics and epigenetics of Barrrett's esophagus and esophageal adenocarcinoma

    OpenAIRE

    Streppel, M.M.

    2014-01-01

    Barrett’s esophagus (BE) is a common premalignant condition of the distal esophagus with a high incidence among Caucasian males. It is an important risk factor for the development of esophageal adenocarcinoma (EAC). EACs arise in BE following a multistep sequence through low- and high-grade dysplasia, finally culminating in an invasive adenocarcinoma. Because of this increased risk of developing an EAC and poor prognosis of EAC patients, BE patients are offered endoscopic surveillance in orde...

  13. Acid suppression increases rates of Barrett's esophagus and esophageal injury in the presence of duodenal reflux.

    LENUS (Irish Health Repository)

    2012-01-31

    BACKGROUND: The contribution of gastric acid to the toxicity of alkaline duodenal refluxate on the esophageal mucosa is unclear. This study compared the effect of duodenal refluxate when acid was present, decreased by proton pump inhibitors (PPI), or absent. METHODS: We randomized 136 Sprague-Dawley rats into 4 groups: group 1 (n = 33) were controls; group 2 (n = 34) underwent esophagoduodenostomy promoting "combined reflux"; group 3 (n = 34) underwent esophagoduodenostomy and PPI treatment to decrease acid reflux; and group 4, the \\'gastrectomy\\' group (n = 35) underwent esophagoduodenostomy and total gastrectomy to eliminate acid in the refluxate. Esophaguses were examined for inflammatory, Barrett\\'s, and other histologic changes, and expression of proliferative markers Ki-67, proliferating cell nuclear antigen (PCNA), and epidermal growth factor receptor (EGFR). RESULTS: In all reflux groups, the incidence of Barrett\\'s mucosa was greater when acid was suppressed (group C, 62%; group D, 71%) than when not suppressed (group B, 27%; P = 0.004 and P < .001). Erosions were more frequent in the PPI and gastrectomy groups than in the combined reflux group. Edema (wet weight) and ulceration was more frequent in the gastrectomy than in the combined reflux group. Acute inflammatory changes were infrequent in the PPI group (8%) compared with the combined reflux (94%) or gastrectomy (100%) groups, but chronic inflammation persisted in 100% of the PPI group. EGFR levels were greater in the PPI compared with the combined reflux group (P = .04). Ki-67, PCNA, and combined marker scores were greater in the gastrectomy compared with the combined reflux group (P = .006, P = .14, and P < .001). CONCLUSION: Gastric acid suppression in the presence of duodenal refluxate caused increased rates of inflammatory changes, intestinal metaplasia, and molecular proliferative activity. PPIs suppressed acute inflammatory changes only, whereas chronic inflammatory changes persisted.

  14. Zoning of mucosal phenotype, dysplasia, and telomerase activity measured by telomerase repeat assay protocol in Barrett's esophagus

    NARCIS (Netherlands)

    Going, JJ; Fletcher-Monaghan, AJ; Neilson, L; Wisman, BA; van der Zee, A; Stuart, RC; Keith, WN

    2004-01-01

    Glandular dysplasia in Barrett's esophagus may regress spontaneously but can also progress to cancer. The human telomerase RNA template and the human telomerase reverse transcriptase enzyme which do not, of themselves, correlate strongly with telomerase activity, are too often overexpressed in Barre

  15. Barrett's Esophagus

    Science.gov (United States)

    ... Understanding how Crohn’s Disease treatments affect children’s gut microbiome Jun 10, 2016 See additional news » Related Conditions & Diseases Esophageal Cancer Gastroesophageal Reflux (GER), and Gastroesophageal Reflux ...

  16. Endoscopic treatments for Barrett's esophagus: a systematic review of safety and effectiveness compared to esophagectomy

    Directory of Open Access Journals (Sweden)

    Lau Darren

    2010-09-01

    Full Text Available Abstract Background Recently, several new endoscopic treatments have been used to treat patients with Barrett's esophagus with high grade dysplasia. This systematic review aimed to determine the safety and effectiveness of these treatments compared with esophagectomy. Methods A comprehensive literature search was undertaken to identify studies of endoscopic treatments for Barrett's esophagus or early stage esophageal cancer. Information from the selected studies was extracted by two independent reviewers. Study quality was assessed and information was tabulated to identify trends or patterns. Results were pooled across studies for each outcome. Safety (occurrence of adverse events and effectiveness (complete eradication of dysplasia were compared across different treatments. Results The 101 studies that met the selection criteria included 8 endoscopic techniques and esophagectomy; only 12 were comparative studies. The quality of evidence was generally low. Methods and outcomes were inconsistently reported. Protocols, outcomes measured, follow-up times and numbers of treatment sessions varied, making it difficult to calculate pooled estimates. The surgical mortality rate was 1.2%, compared to 0.04% in 2831 patients treated endoscopically (1 death. Adverse events were more severe and frequent with esophagectomy, and included anastomotic leaks (9.4%, wound infections (4.1% and pulmonary complications (4.1%. Four patients (0.1% treated endoscopically experienced bleeding requiring transfusions. The stricture rate with esophagectomy (5.3% was lower than with porfimer sodium photodynamic therapy (18.5%, but higher than aminolevulinic acid (ALA 60 mg/kg PDT (1.4%. Dysphagia and odynophagia varied in frequency across modalities, with the highest rates reported for multipolar electrocoagulation (MPEC. Photosensitivity, an adverse event that occurs only with photodynamic therapy, was experienced by 26.4% of patients who received porfimer sodium. Some

  17. Radionuclide esophageal scintigraphy in Barrett esophagus: Documentation of decreased esophageal clearance

    International Nuclear Information System (INIS)

    The authors prospectively studied radionuclide esophageal scintigraphy in 27 patients with histologically proved Barrett esophagus (BE) and 17 patients with reflux esophagitis (RE). Quantitative analysis of time-activity curves yielded esophageal transit times (ETT) and percent emptying at 30 seconds (normal ≥ 90%). The only quantitative parameter of radionuclide esophageal scintigraphy to show a significant difference between BE and RE was percent emptying. Percent emptying was abnormal in 48% of patients with BE, versus 31% of patients with RE. Mean percent emptying was decreased to 82.1% in patients with BE but was virtually normal (89.5%) in patients with RE. These data support the hypothesis of inherent esophageal dysmotility in patients with BE. They may benefit from therapy augmenting esophageal clearance

  18. Barrett's esophagus: Prevalence and risk factors in patients with chronic GERD in Upper Egypt

    Institute of Scientific and Technical Information of China (English)

    Yasser M Fouad; Madiha M Makhlouf; Heba M Tawfik; Hussein El Amin; Wael Abdel Ghany; Hisham R El-khayat

    2009-01-01

    AIM: To determine the prevalence and possible risk factors of Barrett's esophagus (BE) in patients with chronic gastroesophageal reflux disease (GERD) in El Minya and Assuit, Upper Egypt. METHODS: One thousand consecutive patients with chronic GERD symptoms were included in the study over 2 years. They were subjected to history taking including a questionnaire for GERD symptoms, clinical examination and upper digestive tract endoscopy. Endoscopic signs suggestive of columnar-lined esophagus (CLE) were defined as mucosal tongues or an upward shift of the squamocolumnar junction. BE was diagnosed by pathological examination when specialized intestinal metaplasia was detected histologically in suspected CLE. pH was monitored in 40 patients. RESULTS: BE was present in 7.3% of patients with chronic GERD symptoms, with a mean age of 48.3 ± 8.2 years, which was significantly higher than patients with GERD without BE (37.4 ± 13.6 years). Adenocarcinoma was detected in eight cases (0.8%), six of them in BE patients. There was no significant difference between patients with BE and GERD regarding sex, smoking, alcohol consumption or symptoms of GERD. Patients with BE had significantly longer esophageal acid exposure time in the supine position, measured by pH monitoring. CONCLUSION: The prevalence of BE in patients with GERD who were referred for endoscopy was 7.3%. BE seems to be associated with older age and more in patients with nocturnal gastroesophageal reflux.

  19. Case of Barrett's adenocarcinoma with marked endoscopic morphological changes in Barrett's esophagus over a long follow-up period of 15 years.

    Science.gov (United States)

    Iwaya, Yugo; Yamazaki, Tomoo; Watanabe, Takayuki; Seki, Ayako; Ochi, Yasuhide; Hara, Etsuo; Arakura, Norikazu; Tanaka, Eiji; Hasebe, Osamu

    2016-07-01

    The natural history of Barrett's esophagus (BE) is unclear. We herein describe a case of Barrett's adenocarcinoma (BAC) in which we could closely observe marked morphological changes in BE over a long follow-up period of 15 years. A man in his seventies received routine esophagogastroduodenoscopy (EGD) and was diagnosed as having reflux esophagitis and short-segment BE. The BE gradually became elongated, and BAC was detected 9 years following the initial EGD examination with continued administration of a proton pump inhibitor. We witnessed that BE elongated sporadically over time and mucosal breaks of reflux esophagitis were detectable several years before elongation. The patient underwent endoscopic submucosal dissection for BAC and has been monitored by EGD every year thereafter. These remarkable morphological changes may be representative of the natural history of BE and aid in deciding long-term disease management. PMID:26946036

  20. Endoscopic ablation of Barrett's esophagus using high power setting argon plasma coagulation: A prospective study

    Institute of Scientific and Technical Information of China (English)

    Corrado Pedrazzani; Filippo Catalano; Mara Festini; Germana Zerman; Anna Tomezzoli; Andrea Ruzzenente; Alfredo Guglielmi; Giovanni de Manzoni

    2005-01-01

    AIM: This prospective study evaluated the effectiveness of 90 W argon plasma coagulation (APC) for the ablation of Barrett's esophagus (BE) that is considered to be the main risk factor for the development of esophageal adenocarcinoma.METHODS: The results from 25 patients, observed at the First Department of General Surgery, University of Verona, Italy, from October 2000 to October 2003, who underwent APC for histologically proven BE were prospectively analyzed.RESULTS: The ablation treatment was completed in all the patients but one (96%). The mean number of APC sessions needed to complete ablation was 1.6 (total number: 40). The eradication was obtained in the majority of cases by one session only (60%), two sessions were required in 24% of the cases and three or more in 16%.About 43% of the sessions were complicated. Retrosternal pain (22.5%) and fever (17.5%) were the most frequent symptoms. Only one major complication occurred, it was an hemorrhage due to ulcer formation on the treated esophagus that required urgent endoscopic sclerosis and admission. The follow-up was accomplished in all the patients with a mean period of 26.3 mo and 20 patients (84%) with a follow-up period longer than 24 mo. Only one patient showed a relapse of metaplastic mucosa 12 mo after the completion of ablation. The patient was hence re-treated and now is free from recurrence 33 mo later.CONCLUSION: High power setting (90 W) APC showed to be safe and effective. The effects persist at a mean follow-up period of two years with a comparable cost in term of complications with respect to standard power settings. Further studies with greater number of patients are required to confirm these results and to assess if ablation reduces the incidence of malignant progression.

  1. Gene expression in rats with Barrett's esophagus and esophageal adenocarcinoma induced by gastroduodenoesophageal reflux

    Institute of Scientific and Technical Information of China (English)

    Peng Cheng; Jun Gong; Tao Wang; Jie Chen; Gui-Sheng Liu; Ru Zhang

    2005-01-01

    AIM: To study the different gene expression profiles in rats with Barrett's esophagus (BE) and esophageal adenocarcinoma (EA) induced by gastro-duodenoesophageal reflux.METHODS: Esophagoduodenostomy was performed in 8-wk old Sprague-Dawley rats to induce gastro-duodenoesophageal reflux, and a group of rats that received sham operation served as control. Esophageal epithelial pathological tissues were dissected and frozen in liquid nitrogen immediately. The expression profiles of 4 096genes in EA and BE tissues were compared to normal esophagus epithelium in normal control (NC) by cDNA microarray.RESULTS: Four hundred and forty-eight genes in BE were more than three times different from those in NC, including 312 upregulated and 136 downregulated genes. Three hundred and seventy-seven genes in EA were more than three times different from those in NC, including 255upregulated and 142 downregulated genes. Compared to BE, there were 122 upregulated and 156 downregulated genes in EA. In the present study, the interested genes were those involved in carcinogenesis. Among them, the upregulated genes included cathepsin C, aminopeptidase M, arachidonic acid epoxygenase, tryptophan-2,3-dioxygenase, ubiquitin-conjugating enzyme, cyclic GMP-stimulated phosphodiesterase, tissue inhibitor of metalloproteinase-1, betaine-homocysteine methyltransferase, lysozyme, complement 4b binding protein,complement 9 protein, insulin-like growth factor binding protein, UDP-glucuronosyltransferase, tissue inhibitor of metalloproteinase-3, aldolase B, retinoid X receptor gamma, carboxylesterase and testicular cell adhesion molecule 1. The downregulated genes included glutathione synthetase, lecithin-cholesterol acyltransferase, p55CDC,heart fatty acid binding protein, cell adhesion regulator and endothelial cell selectin ligand.CONCLUSION: Esophageal epithelium exposed excessively to harmful ingredients of duodenal and gastric reflux may develop into BE and even EA gradually. The gene

  2. Barrett's esophagus and cancer risk: how research advances can impact clinical practice.

    Science.gov (United States)

    di Pietro, Massimiliano; Alzoubaidi, Durayd; Fitzgerald, Rebecca C

    2014-07-01

    Barrett's esophagus (BE) is the only known precursor to esophageal adenocarcinoma (EAC), whose incidence has increased sharply in the last 4 decades. The annual conversion rate of BE to cancer is significant, but small. The identification of patients at a higher risk of cancer therefore poses a clinical conundrum. Currently, endoscopic surveillance is recommended in BE patients, with the aim of diagnosing either dysplasia or cancer at early stages, both of which are curable with minimally invasive endoscopic techniques. There is a large variation in clinical practice for endoscopic surveillance, and dysplasia as a marker of increased risk is affected by sampling error and high interobserver variability. Screening programs have not yet been formally accepted, mainly due to the economic burden that would be generated by upper gastrointestinal endoscopy. Screening programs have not yet been formally accepted, mainly due to the economic burden that would be generated by widespread indication to upper gastrointestinal endoscopy. In fact, it is currently difficult to formulate an accurate algorithm to confidently target the population at risk, based on the known clinical risk factors for BE and EAC. This review will focus on the clinical and molecular factors that are involved in the development of BE and its conversion to cancer and on how increased knowledge in these areas can improve the clinical management of the disease. PMID:25071900

  3. Tongue-like Barrett's esophagus is associated with gastroesophageal reflux disease

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    AIM: To test this hypothesis of barrett esophagus (BE) classified into two types and to further determine if there was any correlation between the shape of endoscopically suspected esophageal metaplasia (ESEM), prevalence of reflux esophagitis (RE) and heartburn. METHODS: A total of 6504 Japanese who underwent endoscopy for their annual stomach check-up were enrolled in this study. BE was detected without histological confirmation that is ESEH. We originally classified cases of ESEM into 3 types based on its shape: Tongue-like (T type), Dome-like (D type) and Wave-like (W type) ESEM. The respective subjects were prospectively asked to complete questionnaires concerning the symptoms of heartburn, dysphagia, and abdominal pain for a one-month period. RESULTS: ESEM was observed in 10.3% of 6504 subjects (ESEM < 1 an, 9.4%; 1 cm ≤ ESEM < 3 cm, 1.7%; ESEM ≥ 3 an, 0.5%). The frequency of ESEM was significantly higher in males compared with female subjects. Statistical analysis showed that the prevalence of heartburn and RE were significantly higher in the T type ESEM than in the W type ESEM (P<0.05). CONCLUSION: The T type ESEM was strongly asso- ciated with reflux symptoms and RE whereas the W type ESEM was not associated with GERD.

  4. Diagnostic Accuracy of Mucosal Biopsy versus Endoscopic Mucosal Resection in Barrett's Esophagus and Related Superficial Lesions.

    Science.gov (United States)

    Elsadek, Hany M; Radwan, Mamdouh M

    2015-01-01

    Background. Endoscopic surveillance for early detection of dysplastic or neoplastic changes in patients with Barrett's esophagus (BE) depends usually on biopsy. The diagnostic and therapeutic role of endoscopic mucosal resection (EMR) in BE is rapidly growing. Objective. The aim of this study was to check the accuracy of biopsy for precise histopathologic diagnosis of dysplasia and neoplasia, compared to EMR in patients having BE and related superficial esophageal lesions. Methods. A total of 48 patients with previously diagnosed BE (36 men, 12 women, mean age 49.75 ± 13.3 years) underwent routine surveillance endoscopic examination. Biopsies were taken from superficial lesions, if present, and otherwise from BE segments. Then, EMR was performed within three weeks. Results. Biopsy based histopathologic diagnoses were nondysplastic BE (NDBE), 22 cases; low-grade dysplasia (LGD), 14 cases; high-grade dysplasia (HGD), 8 cases; intramucosal carcinoma (IMC), two cases; and invasive adenocarcinoma (IAC), two cases. EMR based diagnosis differed from biopsy based diagnosis (either upgrading or downgrading) in 20 cases (41.67%), (Kappa = 0.43, 95% CI: 0.170-0.69). Conclusions. Biopsy is not a satisfactory method for accurate diagnosis of dysplastic or neoplastic changes in BE patients with or without suspicious superficial lesions. EMR should therefore be the preferred diagnostic method in such patients. PMID:27347544

  5. Coffee or Tea, Hot or Cold, Are Not Associated With Risk of Barrett's Esophagus.

    Science.gov (United States)

    Sajja, Krishna C; El-Serag, Hashem B; Thrift, Aaron P

    2016-05-01

    Epidemiologic data regarding coffee and tea consumption and risk of esophageal inflammation, Barrett's esophagus (BE), and adenocarcinoma are sparse and inconclusive. This study examined the association between consumption of tea or coffee with risk of BE. We conducted a cross-sectional study among US veterans, comparing 310 patients with histologically confirmed BE with 1728 individuals with no endoscopic or histopathologic features of BE (controls). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression models. In univariate models, we found a statistically significant association between risk of BE and consumption of coffee (OR, 1.41; 95% CI, 1.06-1.87) or tea (OR, 1.34; 95% CI, 1.05-1.71). However, in multivariate analysis, in which models were adjusted for confounders including sex and race, we found no association between risk of BE and consumption of coffee (adjusted OR, 1.04; 95% CI, 0.76-1.42) or tea (adjusted OR, 1.11; 95% CI, 0.85-1.44). These data do not support an association between consumption of coffee or tea and the risk of BE. It is unlikely that avoidance of coffee or tea will protect against BE. PMID:26681488

  6. Relationship of gastric Helicobacter pyloriinfection to Barrett's esophagus and gastro-esophageal reflux disease in Chinese

    Institute of Scientific and Technical Information of China (English)

    Jun Zhang; Xiao-Li Chen; Kang-Min Wang; Xiao-Dan Guo; Ai-Li Zuo; Jun Gong

    2004-01-01

    AIM: To evaluate the relationship of Helicobacter pylori infection to reflux esophagitis (RE), Barrett's esophagus (BE)and gastric intestinal metaplasia (IM).METHODS: RE, BE and gastric IM were determined by upper endoscopy. Patients were divided into 2 groups; those with squamocolumnar junction (SCJ) beyond gastroesophageal junction (GEJ) ≥3 cm (group A), and those with SCJ beyond GEJ <3 cm (group B). Biopsy specimens were obtained endoscopically from just below the SCJ, gastric antrum along the greater and lesser curvature. Pathological changes and H pylori infection were determined by HE staining, Alcian blue staining and Giemsa staining.RESULTS: The prevalence of H pylori infection was 46.93%.There was no difference in the prevalence between males and females. The prevalence of H pylori infection decreased stepwise significantly from RE grade I to Ⅲ. There was no difference in the prevalence between the two groups, and between long-segment and short-segment BE. In distal stomach, prevalence of H pylori infection was significantly higher in patients with IM than those without IM.CONCLUSION: There is a protective role of H tpylori infection to GERD. There may be no relationship between Hpylori infection of stomach and BE. H pylori infection is associated with the development of IM in the distal stomach.

  7. Difference of Gene Expression Profiles between Barrett's Esophagus and Cardia Intestinal Metaplasia by Gene Chip

    Institute of Scientific and Technical Information of China (English)

    CHANG Ying; LIU Bin

    2006-01-01

    The difference of gene expression profile changes in Barrettes esophagus (BE) and cardia intestinal metaplasia (CIM) epithelium was studied and the novel associated genes were screened in the early stage by cDNA microarray. The cDNA retro-transcribed from equal quantity mRNA from BE and CIM epithelial tissues were labeled with Cy3 and Cy5 fluorescence as probes. The mixed probe was hybridized with three pieces BiostarH-40s double dot human whole gene chip. The chips were scanned with a ScanArray 4000. The acquired images were analyzed using GenePix Pro 3.0 software. It was found a total of 141 genes were screened out that exhibited differentially expression more than 2 times in all three chips. It was identified that in gene expression profiles of BE, 74 genes were up-regulated and 67 down-regulated as compared with CIM. The comparison between the difference of gene expression profile changes in BE and CIM epithelia revealed that there existed the difference between BE and CIM at gene level. 141 genes with the expression more than two time were probably related to the occurrence and development of BE and the promotion or progress in adenocarcinoma.

  8. Bacterial Composition of the Human Upper Gastrointestinal Tract Microbiome Is Dynamic and Associated with Genomic Instability in a Barrett's Esophagus Cohort.

    Directory of Open Access Journals (Sweden)

    Alevtina Gall

    Full Text Available The incidence of esophageal adenocarcinoma (EAC has increased nearly five-fold over the last four decades in the United States. Barrett's esophagus, the replacement of the normal squamous epithelial lining with a mucus-secreting columnar epithelium, is the only known precursor to EAC. Like other parts of the gastrointestinal (GI tract, the esophagus hosts a variety of bacteria and comparisons among published studies suggest bacterial communities in the stomach and esophagus differ. Chronic infection with Helicobacter pylori in the stomach has been inversely associated with development of EAC, but the mechanisms underlying this association remain unclear.The bacterial composition in the upper GI tract was characterized in a subset of participants (n=12 of the Seattle Barrett's Esophagus Research cohort using broad-range 16S PCR and pyrosequencing of biopsy and brush samples collected from squamous esophagus, Barrett's esophagus, stomach corpus and stomach antrum. Three of the individuals were sampled at two separate time points. Prevalence of H. pylori infection and subsequent development of aneuploidy (n=339 and EAC (n=433 was examined in a larger subset of this cohort.Within individuals, bacterial communities of the stomach and esophagus showed overlapping community membership. Despite closer proximity, the stomach antrum and corpus communities were less similar than the antrum and esophageal samples. Re-sampling of study participants revealed similar upper GI community membership in two of three cases. In this Barrett's esophagus cohort, Streptococcus and Prevotella species dominate the upper GI and the ratio of these two species is associated with waist-to-hip ratio and hiatal hernia length, two known EAC risk factors in Barrett's esophagus. H. pylori-positive individuals had a significantly decreased incidence of aneuploidy and a non-significant trend toward lower incidence of EAC.

  9. Intestinal Stem Cell Markers in the Intestinal Metaplasia of Stomach and Barrett's Esophagus.

    Directory of Open Access Journals (Sweden)

    Bo Gun Jang

    Full Text Available Gastric intestinal metaplasia (IM is a highly prevalent preneoplastic lesion; however, the molecular mechanisms regulating its development remain unclear. We have previously shown that a population of cells expressing the intestinal stem cell (ISC marker LGR5 increases remarkably in IM. In this study, we further investigated the molecular characteristics of these LGR5+ cells in IM by examining the expression profile of several ISC markers. Notably, we found that ISC markers-including OLFM4 and EPHB2-are positively associated with the CDX2 expression in non-tumorous gastric tissues. This finding was confirmed in stomach lesions with or without metaplasia, which demonstrated that OLFM4 and EPHB2 expression gradually increased with metaplastic progression. Moreover, RNA in situ hybridization revealed that LGR5+ cells coexpress several ISC markers and remained confined to the base of metaplastic glands, reminiscent to that of normal intestinal crypts, whereas those in normal antral glands expressed none of these markers. Furthermore, a large number of ISC marker-expressing cells were diffusely distributed in gastric adenomas, suggesting that these markers may facilitate gastric tumorigenesis. In addition, Barrett's esophagus (BE-which is histologically similar to intestinal metaplasia-exhibited a similar distribution of ISC markers, indicating the presence of a stem cell population with intestinal differentiation potential. In conclusion, we identified that LGR5+ cells in gastric IM and BE coexpress ISC markers, and exhibit the same expression profile as those found in normal intestinal crypts. Taken together, these results implicate an intestinal-like stem cell population in the pathogenesis of IM, and provide an important basis for understanding the development and maintenance of this disease.

  10. Necrotizing sialometaplasia-like change of the esophageal submucosal glands is associated with Barrett's esophagus.

    Science.gov (United States)

    Braxton, David R; Nickleach, Dana C; Liu, Yuan; Farris, Alton B

    2014-08-01

    The esophageal submucosal glands (SMG) protect the squamous epithelium from insults such as gastroesophageal reflux disease by secreting mucins and bicarbonate. We have observed metaplastic changes within the SMG acini that we have termed oncocytic glandular metaplasia (OGM), and necrotizing sialometaplasia-like change (NSMLC). The aim of this study is to evaluate the associated clinicopathological parameters of, and to phenotypically characterize the SMG metaplasias. Esophagectomy specimens were retrospectively assessed on hematoxylin and eosin sections and assigned to either a Barrett's esophagus (BE) or non-BE control group. Clinicopathologic data was collected, and univariate analysis and multivariate logistic regression models were performed to assess the adjusted associations with NSMLC and OGM. Selected cases of SMG metaplasia were characterized. SMG were present in 82 esophagi that met inclusion criteria. On univariate analysis, NSMLC was associated with BE (p = 0.002). There was no relationship between NSMLC and patient age, sex, tumor size, or treatment history. OGM was associated with BE (p = 0.031). No relationship was found between OGM and patient age, sex, or tumor size. On multivariate analysis, BE was independently associated with NSMLC (odds ratio [OR] 4.95, p = 0.003). Treatment history was also independently associated with OGM (p = 0.029), but not NSMLC. Both NSMLC and OGM were non-mucinous ductal type epithelia retaining a p63-smooth muscle actin co-positive myoepithelial cell layer. NSMLC and OGM were present in endoscopic mucosal resection specimens. Our study suggests that SMG metaplasia is primarily a reflux-induced pathology. NSMLC may pose diagnostic dilemmas in resection specimens or when only partially represented in mucosal biopsies or endoscopic resection specimens. PMID:24863247

  11. Glyco-centric lectin magnetic bead array (LeMBA) - proteomics dataset of human serum samples from healthy, Barrett׳s esophagus and esophageal adenocarcinoma individuals.

    Science.gov (United States)

    Shah, Alok K; Lê Cao, Kim-Anh; Choi, Eunju; Chen, David; Gautier, Benoît; Nancarrow, Derek; Whiteman, David C; Baker, Peter R; Clauser, Karl R; Chalkley, Robert J; Saunders, Nicholas A; Barbour, Andrew P; Joshi, Virendra; Hill, Michelle M

    2016-06-01

    This data article describes serum glycoprotein biomarker discovery and qualification datasets generated using lectin magnetic bead array (LeMBA) - mass spectrometry techniques, "Serum glycoprotein biomarker discovery and qualification pipeline reveals novel diagnostic biomarker candidates for esophageal adenocarcinoma" [1]. Serum samples collected from healthy, metaplastic Barrett׳s esophagus (BE) and esophageal adenocarcinoma (EAC) individuals were profiled for glycoprotein subsets via differential lectin binding. The biomarker discovery proteomics dataset consisting of 20 individual lectin pull-downs for 29 serum samples with a spiked-in internal standard chicken ovalbumin protein has been deposited in the PRIDE partner repository of the ProteomeXchange Consortium with the data set identifier PRIDE: PXD002442. Annotated MS/MS spectra for the peptide identifications can be viewed using MS-Viewer (〈http://prospector2.ucsf.edu/prospector/cgi-bin/msform.cgi?form=msviewer〉) using search key "jn7qafftux". The qualification dataset contained 6-lectin pulldown-coupled multiple reaction monitoring-mass spectrometry (MRM-MS) data for 41 protein candidates, from 60 serum samples. This dataset is available as a supplemental files with the original publication [1]. PMID:27408916

  12. miR-200 family expression is downregulated upon neoplastic progression of Barrett's esophagus

    Institute of Scientific and Technical Information of China (English)

    Cameron M Smith; David I Watson; Mary P Leong; George C Mayne; Michael Z Michael; Bas PL Wijnhoven; Damian J Hussey

    2011-01-01

    AIM:To investigate miR-200 family expression in Barrett's epithelium,gastric and duodenal epithelia,and esophageal adenocarcinoma. METHODS:Real-time reverse transcriptase-polymerase chain reaction was used to measure miR-200,ZEB1 and ZEB2 expression.Ingenuity Pathway Analysis of miR-200 targets was used to predict biological outcomes. RESULTS:Barrett's epithelium expressed lower levels of miR-141 and miR-200c than did gastric and duodenal epithelia (P < 0.001).In silico analysis indicated roles for the miR-200 family in molecular pathways that distinguish Barrett's epithelium from gastric and duodenal epithelia,and which control apoptosis and proliferation. All miR-200 members were downregulated in adenocarcinoma (P < 0.02),and miR-200c expression was also downregulated in non-invasive epithelium adjacent to adenocarcinoma (P < 0.02).The expression of all miR-200 members was lower in Barrett's epithelium derived high-grade dysplastic cell lines than in a cell line derived from benign Barrett's epithelium.We observed significant inverse correlations between miR-200 family expression and ZEB1 and ZEB2 expression in Barrett's epithelium and esophageal adenocarcinoma (P < 0.05). CONCLUSION:miR-200 expression might contribute to the anti-apoptotic and proliferative phenotype of Barrett's epithelium and regulate key neoplastic processes in this epithelium.

  13. Lack of differential pattern in central adiposity and metabolic syndrome in Barrett's esophagus and gastroesophageal reflux disease.

    LENUS (Irish Health Repository)

    Healy, L A

    2012-02-01

    Obesity is an established risk factor for esophageal adenocarcinoma, although the mechanism is unclear. A pathway from reflux to inflammation through metaplasia is the dominant hypothesis, and an added role relating to visceral adiposity and the metabolic syndrome has been mooted in Barrett\\'s esophagus (BE) patients. Whether BE differs from gastroesophageal reflux disease (GERD) in obesity and metabolic syndrome profiles is unclear, and this was the focus of this study. Patients with proven BE or GERD were randomly selected from the unit data registry and invited to attend for metabolic syndrome screening, anthropometry studies including segmental body composition analysis, and laboratory tests including fasting lipids, insulin, and C-reactive protein. Metabolic syndrome was defined using the National Cholesterol Education Program (NCEP) and the International Diabetes Federation (IDF) criteria. One hundred and eighteen BE patients and 113 age- and sex-matched GERD controls were studied. The incidence of obesity (body mass index >30 kg\\/m(2)) was 36% and 38%, respectively, with the pattern of fat deposition predominantly central and an estimated trunk fat mass of 13 and 14 kg, respectively. Using the NCEP criteria, metabolic syndrome was significantly more common in the BE cohort (30% vs 20%, P < 0.05), but there was no significant difference using IDF criteria (42% vs 37%, P= 0.340). Central obesity and the metabolic syndrome are common in both Barrett\\'s and GERD cohorts, but not significantly different, suggesting that central obesity and the metabolic syndrome does not per se impact on the development of BE in a reflux population. In BE, the importance of obesity and the metabolic syndrome in disease progression merits further study.

  14. O esôfago de Barrett associado à estenose cáustica do esôfago Barrett's esophagus associated to caustic stenosis of the esophagus

    OpenAIRE

    Nelson Adami Andreollo; Luiz Roberto Lopes; Valdir Tercioti Jr; Nelson Ary Brandalise; Luiz Sérgio Leonardi

    2003-01-01

    RACIONAL: A estenose esofágica secundária à ingestão de produtos cáusticos é freqüente no Brasil, principalmente como tentativa de suicídio. O esôfago de Barrett surge como conseqüência do refluxo gastroesofágico crônico. A literatura pesquisada mostrou que esta associação é muito rara. CASUÍSTICA E MÉTODOS: De 1981 a 2000 foram admitidos e tratados no Gastrocentro-UNICAMP (Universidade Estadual de Campinas, SP.) 120 doentes com estenose cáustica do esôfago e durante o seguimento destes, fora...

  15. Real-time depth-resolved Raman endoscopy for in vivo diagnosis of dysplasia in Barrett's esophagus

    Science.gov (United States)

    Bergholt, Mads Sylvest; Zheng, Wei; Ho, Khek Yu; Yeoh, Khay Guan; Teh, Ming; So, Jimmy Bok Yan; Huang, Zhiwei

    2013-03-01

    Raman spectroscopy is a vibrational analytic technique sensitive to the changes in biomolecular composition and conformations occurring in tissue. With our most recent development of depth-resolved near-infrared (NIR) Raman endoscopy integrated with on-line diagnostic algorithms, in vivo real-time epithelial diagnostics has been realized under multimodal wide-field imaging (i.e., white- light reflectance (WLR), narrow-band imaging (NBI), autofluorescence imaging (AFI)) modalities. A selection of 43 patients who previously underwent Raman endoscopy (n=146 spectra) was used to render a robust model based on partial least squares - discriminant analysis (PLS-DA) for diagnosis of dysplasia in Barrett's esophagus. The Raman endoscopy technique was validated prospectively on 2 new esophageal patients for in vivo tissue diagnosis. The Raman endoscopic technique could identify esophageal high-grade dysplasia in vivo with an accuracy of 85.9% (sensitivity: 91.3% (21/23): specificity 83.3% (40/48)) on spectrum basis. This study realizes for the first time depth-resolved Raman endoscopy for real-time in vivo diagnosis of dysplasia in Barrett's epithelium at the biomolecular level.

  16. Os nitritos são importantes na gênese do adenocarcinoma associado ao esôfago de Barrett? Are the nitrites important in a genesis of the adenocarcinoma associated to the Barrett esophagus?

    Directory of Open Access Journals (Sweden)

    Sergio Ferreira Módena

    2008-09-01

    Full Text Available RACIONAL: O esôfago de Barrett é complicação do refluxo gastroesofágico e predispõe ao surgimento do adenocarcinoma, sendo que vários fatores têm sido relacionados à sua etiopatogenia. OBJETIVO: Analisar o modelo experimental de refluxo duodenogastroesofágico e a ingestão de solução de nitrito de sódio na gênese do adenocarcinoma associado ao esôfago de Barrett. MÉTODOS: Sessenta ratos machos Wistar foram divididos em quatro grupos, com 20 animais controles não operados (10 animais ingeriram somente água e 10 água mais solução de nitrito de sódio e 40 animais submetidos à anastomose duodenogastroesofágica látero-lateral (20 animais ingeriram somente água e 20 animais ingeriram água mais solução de nitrito de sódio. A ocorrência de esofagite, metaplasia, displasia, esôfago de Barrett e adenocarcinoma associado foram analisados. A classificação de Viena para displasia e adenocarcinoma foi empregada na análise dos resultados. RESULTADOS: Após 42 semanas de observação, nos animais operados sem ingestão de nitritos o esôfago de Barrett foi registrado em 26,3% (5/19, enquanto no grupo operado associado à ingestão de nitritos, foi encontrado em 72,3% (13/18 dos animais, sendo que neste grupo também foi encontrado seis adenocarcinomas (33,3%. Nenhum animal não operado apresentou o esôfago de Barrett. As categorias 2, 3 e 5 da classificação de Viena somente foram encontradas nos animais operados que ingeriram nitrito de sódio (66,7%. CONCLUSÃO: A ingestão de nitrito de sódio associado ao refluxo duodenogastroesofágico têm importante participação na gênese do adenocarcinoma associado ao esôfago de Barrett.BACKGROUND: Barrett's esophagus is a complication of gastroesophageal reflux and predisposes to adenocarcinoma of the esophagogastric transition and several factors have been related to its pathogenesis. AIM: To evaluated the genesis of adenocarcinoma associated with Barrett's esophagus in an

  17. Association of methylenetetrahydrofolate reductase C677T-A1298C polymorphisms with risk for esophageal adenocarcinoma, Barrett's esophagus, and reflux esophagitis.

    Science.gov (United States)

    Ekiz, F; Ormeci, N; Coban, S; Karabulut, H G; Aktas, B; Tukun, A; Tuncali, T; Yüksel, O; Alkış, N

    2012-07-01

    Incidence of the esophagus adenocarcinoma has been dramatically increasing in Western countries since the last decade. Gastroesophageal reflux disease and Barrett's esophagus are risk factors for adenocarcinoma. Methylenetetrahydrofolate reductase (MTHFR) genes play a key role not only in folate metabolism but also in esophagus, stomach, pancreatic carcinoma, and acute leukemias. Studies have suggested that genetic polymorphisms of MTHFR (C677T) may clarify the causes and events involved in esophageal carcinogenesis. In this study, we evaluated MTHFR C677T and A1298C polymorphisms, and vitamin B12, folate, and plasma homocystein levels in patients with esophageal adenocarcinoma (EAC), Barrett's esophagus (BE), chronic esophagitis, and healthy controls (n = 26, n = 14, n = 30, and n = 30, respectively). The mean age of patients in the EAC and BE groups was significantly higher compared with the control group (P homocystein, and B12 levels among the groups. MTHFR gene polymorphisms and folate deficiency are not predictors of early esophageal carcinoma. However, further studies using larger series of patients are needed to evaluate the effect of genetic polymorphisms in the folate metabolic pathway and to clarify the role of folate deficiency and folate metabolism in the development of esophagus adenocarcinoma. PMID:21951971

  18. Chromosomal gains and genomic loss of p53 and p16 genes in Barrett's esophagus detected by fluorescence in situ hybridization of cytology specimens.

    Science.gov (United States)

    Fahmy, Mona; Skacel, Marek; Gramlich, Terry L; Brainard, Jennifer A; Rice, Thomas W; Goldblum, John R; Connor, Jason T; Casey, Graham; Legator, Mona S; Tubbs, Raymond R; Falk, Gary W

    2004-05-01

    Endoscopic brush cytology is a promising surveillance technique for Barrett's esophagus. Ancillary markers are sought to increase the sensitivity of cytology and allow identification of patients at increased risk for disease progression. To determine if there are specific genetic changes in Barrett's esophagus with associated high-grade dysplasia/intramucosal adenocarcinoma compared to those without dysplasia, we performed fluorescence in situ hybridization (FISH) on cytologic specimens using probes to chromosomes and genomic regions previously described as altered in this disease. We studied archival brush cytology slides from 40 Barrett's esophagus patients: 21 with biopsy-proven high-grade dysplasia/carcinoma and 19 with no dysplasia and a minimum 5 years of negative follow-up. Centromeric enumeration probes (CEP) for chromosomes 6, 7, 11, and 12, and locus-specific probes (LSI) for 9p21 (p16 gene), and 17p13.1 (p53 gene) loci along with their corresponding CEP (9 and 17, respectively) were used in this study. A positive FISH result was defined as the presence of cells with >2 CEP signals or with a loss of the LSI signals relative to their corresponding CEP. p53 locus loss and/or aneusomy of chromosomes 6, 7, 11, and 12 abnormalities could be detected by FISH in routinely processed endoscopic brush cytology specimens from 95% of biopsy-positive cases with a specificity of 100%. Interestingly, all five cases with cytologic changes classified as indefinite for dysplasia from patients with a positive biopsy showed changes by FISH. Loss of the p16 locus was seen commonly in patients both with and without dysplasia/carcinoma. Selected biomarkers from this study merit further investigation to determine their potential to detect genetic changes in patients with Barrett's esophagus prior to the development of high-grade dysplasia. PMID:15017433

  19. Nuclear translocation of glutathione transferase omega is a progression marker in Barrett's esophagus

    DEFF Research Database (Denmark)

    Piaggi, Simona; Marchi, Santino; Ciancia, Eugenio;

    2009-01-01

    fraction of BE patients. This study was aimed to investigate the possible role of glutathione-S-transferase-omega 1 (GSTO1), a recently discovered member of the glutathione-S-transferase family, as a progression marker in the Barrett's disease in order to improve the diagnosis of NiN in BE and to......N were equally divided between nuclear, cytoplasmic and diffuse staining (2 each, respectively). Experiments in vitro showed that in human HeLa cancer cells, GSTO1 translocates into the nucleus as a consequence of heath shock. These findings suggested that the nuclear translocation of glutathione...

  20. Esôfago de Barrett e displasia: critérios diagnósticos Barret's esophagus and dysplasia: diagnostic criteria

    Directory of Open Access Journals (Sweden)

    Maria Aparecida Marchesan Rodrigues

    2004-06-01

    Full Text Available A presente revisão focaliza aspectos conceituais e os principais problemas diagnósticos referentes ao esôfago de Barrett e à displasia. O esôfago de Barrett resulta de complicação da doença do refluxo gastroesofágico de longa duração. É identificado endoscopicamente pela presença de mucosa glandular no esôfago tubular acima da junção esofagogástrica. Histologicamente, é caracterizado pela substituição do epitélio estratificado pavimentoso por epitélio colunar especializado com células caliciformes, expresso como metaplasia intestinal. A importância biológica do esôfago de Barrett é o risco de progressão para câncer. A displasia é o principal marcador biológico preditivo de evolução para adenocarcinoma. Identificar e graduar a displasia constitui importante questão na prática diagnóstica. O diagnóstico patológico do esôfago de Barrett deve conter informações sobre a investigação de displasia. O principal diagnóstico diferencial da displasia é feito em relação a reatividade e regeneração epitelial no contexto de inflamação da mucosa. Como a variabilidade de interpretação é um dos principais problemas no diagnóstico da displasia, os casos de esôfago de Barrett devem ser enviados à consulta para segunda opinião diagnóstica. O exame anatomopatológico é fundamental para definir o diagnóstico de esôfago de Barrett e para rastrear a displasia, que é o principal marcador de risco para câncer nesta entidade.This review focuses on conceptual aspects of Barrett's esophagus and Barrett's related dysplasia and highlights current diagnostic problems on the interpretation of these lesions. Barrett's esophagus results from longstanding gastroesophageal reflux. Endoscopically it is recognized by the presence of glandular mucosa in the tubular esophagus above the esophagogastric junction at variable lenghts. Histologically it is characterized by the presence of specialized columnar epithelium with

  1. Computerized morphometry as an aid in determining the grade of dysplasia and progression to adenocarcinoma in Barrett's esophagus.

    Science.gov (United States)

    Sabo, Edmond; Beck, Andrew H; Montgomery, Elizabeth A; Bhattacharya, Baishali; Meitner, Patricia; Wang, Ji Yi; Resnick, Murray B

    2006-12-01

    The aims of this study were to use computerized morphometry in order to differentiate between the degree of dysplasia and to predict progression to invasive adenocarcinoma in Barrett's esophagus (BE). Biopsies from 97 patients with BE graded by a consensus forum of expert gastrointestinal pathologists were available for morphometrical analysis. The study group included 36 biopsies negative for dysplasia (ND), none of which progressed to carcinoma; 16 indefinite for dysplasia (IND) and 21 low-grade dysplasia (LGD), of which three progressed in each group and 24 high-grade dysplasia (HGD), of which 15 progressed to invasive carcinoma. Computerized morphometry was used for measuring indices of size, shape, texture, symmetry and architectural distribution of the epithelial nuclei. Low-grade dysplasia was best differentiated from the ND group by nuclear pseudostratification (P=0.036), pleomorphism (Pgroup by nuclear area (Psymmetry (Pgroups and 86% for differentiating between the LGD and HGD groups. Within the HGD group, univariate significant predictors of the progression interval to carcinoma were: indices of nuclear texture (heterogeneity: P=0.0019, s.d.-OD: P=0.005) and orientation: P=0.022. Nuclear texture (heterogeneity) was the only independent predictor of progression (P=0.004, hazard=11.54) by Cox's multivariate test. This study proposes that computerized morphometry is a valid tool for determining the grade of dysplasia in BE. Moreover, histomorphometric quantification of nuclear texture is a powerful tool for predicting progression to invasive adenocarcinoma in patients with HGD. PMID:17075582

  2. A labelled discrete choice experiment adds realism to the choices presented: preferences for surveillance tests for Barrett esophagus

    Directory of Open Access Journals (Sweden)

    Donkers Bas

    2009-05-01

    Full Text Available Abstract Background Discrete choice experiments (DCEs allow systematic assessment of preferences by asking respondents to choose between scenarios. We conducted a labelled discrete choice experiment with realistic choices to investigate patients' trade-offs between the expected health gains and the burden of testing in surveillance of Barrett esophagus (BE. Methods Fifteen choice scenarios were selected based on 2 attributes: 1 type of test (endoscopy and two less burdensome fictitious tests, 2 frequency of surveillance. Each test-frequency combination was associated with its own realistic decrease in risk of dying from esophageal adenocarcinoma. A conditional logit model was fitted. Results Of 297 eligible patients (155 BE and 142 with non-specific upper GI symptoms, 247 completed the questionnaire (84%. Patients preferred surveillance to no surveillance. Current surveillance schemes of once every 1–2 years were amongst the most preferred alternatives. Higher health gains were preferred over those with lower health gains, except when test frequencies exceeded once a year. For similar health gains, patients preferred video-capsule over saliva swab and least preferred endoscopy. Conclusion This first example of a labelled DCE using realistic scenarios in a healthcare context shows that such experiments are feasible. A comparison of labelled and unlabelled designs taking into account setting and research question is recommended.

  3. Gene expression profiling in Barrett's esophagus and cardia intestinal metaplasia:A comparative analysis using cDNA microarray

    Institute of Scientific and Technical Information of China (English)

    Ying Chang; Jun Gong; Bin Liu; Jun Zhang; Fei Dai

    2004-01-01

    AIM: To study the difference of gene expression profile changes in Barrett's esophagus (BE) and cardia intestinal metaplasia (CIM) and to screen the novel genes in the early stage by cDNA microarray.METHODS: cDNA retrotranscribed from an equal amount of mRNA from BE and CIM epithelial tissues was labeled with Cy3 and Cy5 fluorescence as probes. The mixed probe was hybridized with three pieces of BiostarH-40 s double dot human whole gene chip. The chips were scanned with a ScanArray 4000. The acquired images were analyzed using GenePix Pro 3.0 software.RESULTS: A total of 141 genes were screened out that exhibited different expression in all three chips. There were 74 upregulated and 67 downregulated genes in gene expression profiles of BE which were two times of that in CIM.CONCLUSION: There is a difference in gene expression level between BE and CIM epithelia. These 141 genes probably relate to the occurrence and development of BE and the progression to adenocarcinoma.

  4. Endoscopic mucosal resection for high-grade dysplasia and intramucosal carcinoma in Barrett's esophagus: An Italian experience

    Institute of Scientific and Technical Information of China (English)

    Massimo Conio; Rosangela Filiberti; Alessandro Repici; Renzo Cestari; Sabrina Blanchi; Gabriella Lapertosa; Guido Missale; Domenico Della Casa; Vincenzo Villanacci; Pier Gigi Calandri

    2005-01-01

    AIM: To evaluate endoscopic mucosal resection (EMR)in patients with high-grade dysplasia (HGD) and/or intramucosal cancer (IMC) in Barrett's esophagus (BE).METHODS: Between June 2000 and December 2003,39 consecutive patients with HGD (35) and/or IMC (4)underwent EMR. BE >30 mm was present in 27 patients.In three patients with short segment BE (25.0%), HGDwas detected in a normal appearing BE. Lesions had a mean diameter of 14.8±10.3 mm. Mucosal resection was carried out using the cap method.RESULTS: The average size of resections was 19.7±9.4×14.6±8.2 mm. Histopathologic assessment postresection revealed 5 low-grade dysplasia (LGD) (12.8%),27 HGD (69.2%), 2 IMC (5.1%), and 5 SMC (-12.8%).EMR changed the pre-treatment diagnosis in 10 patients (25.6%). Three patients with SMC underwehtsurgery.Histology of the surgical specimen revealed 1 T0N0 and 2 T1N0 lesions. The remaining two patients were cancer free at 32.5 and 45.6 mo, respectively. A metachronous lesion was detected after 25 mo in one patient with HGD. Intra-procedural bleeding, controlled at endoscopy,occurred in four patients (10.3%). After a median followup of 34.9 mo, all patients remained in remission.CONCLUSION: In the medium term, EMR is effective and safe to treat HGD and/or IMC within BE and is a valuable staging method. It could become an alternative to surgery.

  5. Predictors Of Treatment Failure After Radiofrequency Ablation For Intramucosal Adenocarcinoma in Barrett Esophagus: A Multi-institutional Retrospective Cohort Study.

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    Agoston, Agoston T; Strauss, Adam C; Dulai, Parambir S; Hagen, Catherine E; Muzikansky, Alona; Fudman, David I; Abrams, Julian A; Forcione, David G; Jajoo, Kunal; Saltzman, John R; Odze, Robert D; Lauwers, Gregory Y; Gordon, Stuart R; Lightdale, Charles J; Rothstein, Richard I; Srivastava, Amitabh

    2016-04-01

    Radiofrequency ablation (RFA), with or without endoscopic mucosal resection (EMR), is a safe, effective, and durable treatment option for Barrett esophagus (BE)-associated dysplasia (DYS), but few studies have identified predictors of treatment failure in BE-associated intramucosal adenocarcinoma (IMC). The aim of this study was to determine the rate of IMC eradication when using RFA±EMR and to identify clinical and pathologic predictors of treatment failure. A retrospective review of medical records and a central review of index histologic parameters were performed for 78 patients who underwent RFA±EMR as the primary treatment for biopsy-proven IMC at 4 academic tertiary medical centers. Complete eradication (CE) (absence of IMC/DYS on first follow-up endoscopy) was achieved in 86% of patients, and durable eradication (DE) (CE with no recurrence of IMC/DYS until last follow-up) was achieved in 78% of patients, with significant variation between the 4 study sites (P=0.03 and 0.09 by analysis of variance for DE and CE, respectively). Use of EMR before RFA significantly reduced the risk for treatment failure for IMC/DYS (hazard ratio, 0.15; 95% confidence interval, 0.05-0.48; P=0.001), whereas IMC involving ≥50% of the columnar metaplastic area on index examination significantly increased the risk for treatment failure (hazard ratio, 4.24; 95% confidence interval, 1.53-11.7; P=0.005). Endoscopic and pathologic factors associated with treatment failure in BE-associated IMC treated with RFA±EMR may help identify the subset of IMC patients for whom a more aggressive initial approach may be justified. PMID:26645729

  6. Genome-wide DNA Methylation Profiling of Cell-Free Serum DNA in Esophageal Adenocarcinoma and Barrett Esophagus

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    Rihong Zhai

    2012-01-01

    Full Text Available Aberrant DNA methylation (DNAm is a feature of most types of cancers. Genome-wide DNAm profiling has been performed successfully on tumor tissue DNA samples. However, the invasive procedure limits the utility of tumor tissue for epidemiological studies. While recent data indicate that cell-free circulating DNAm (cfDNAm profiles reflect DNAm status in corresponding tumor tissues, no studies have examined the association of cfDNAm with cancer or precursors on a genome-wide scale. The objective of this pilot study was to evaluate the putative significance of genome-wide cfDNAm profiles in esophageal adenocarcinoma (EA and Barrett esophagus (BE, EA precursor. We performed genome-wide DNAm profiling in EA tissue DNA (n = 8 and matched serum DNA (n = 8, in serum DNA of BE (n = 10, and in healthy controls (n = 10 using the Infinium HumanMethylation27 BeadChip that covers 27,578 CpG loci in 14,495 genes. We found that cfDNAm profiles were highly correlated to DNAm profiles in matched tumor tissue DNA (r = 0.92 in patients with EA. We selected the most differentially methylated loci to perform hierarchical clustering analysis. We found that 911 loci can discriminate perfectly between EA and control samples, 554 loci can separate EA from BE samples, and 46 loci can distinguish BE from control samples. These results suggest that genome-wide cfDNAm profiles are highly consistent with DNAm profiles detected in corresponding tumor tissues. Differential cfDNAm profiling may be a useful approach for the noninvasive screening of EA and EA premalignant lesions.

  7. Visceral obesity and the risk of Barrett's esophagus in Japanese patients with non-alcoholic fatty liver disease

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    Kirikoshi Hiroyuki

    2009-07-01

    Full Text Available Abstract Background The association between obesity and the risk of Barrett's esophagus (BE is unclear. Furthermore, the association between visceral obesity and the risk of BE is entirely unknown. Methods We conducted a retrospective study in 163 patients with non-alcoholic fatty liver disease (NAFLD who underwent both endoscopy and abdominal CT at an interval of less than a year at our institution. BE was endoscopically diagnosed based on the Prague C & M Criteria. The surface areas of visceral adipose tissue (VAT and subcutaneous adipose tissue (SAT were calculated from CT images at the level of the umbilicus. The correlations between the BMI, VAT, and SAT and the risk of BE were examined by univariate and multivariate analyses. Results Sixty-nine of the 163 study participants (42.3% were diagnosed to have endoscopic BE, which was classified as short-segment BE (SSBE in almost all of the cases. There were no significant differences in the age or gender distribution between the groups with and without BE. According to the results of the univariate analysis, VAT was significantly associated with the risk of BE; the BMI tended to be higher in the group with BE than in the group without BE, but this relation did not reach statistical significance. VAT was independently associated with the risk of BE even after adjustment for the BMI. Conclusion In Japanese patients with NAFLD, obesity tended to be associated with the risk of BE, and this risk appeared to be mediated for the most part by abdominal visceral adiposity.

  8. Displasia no esôfago de Barrett - concordância intra e interobservador no diagnóstico histopatológico Dysplasia in Barrett's esophagus - intra- and interobserver variability in histopathological diagnosis

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    César Vivian Lopes

    2004-06-01

    Full Text Available RACIONAL: O potencial maligno do esôfago de Barrett é bem reconhecido. A vigilância endoscópica e a abordagem terapêutica se baseiam na presença e graduação da displasia. Contudo, a validade do diagnóstico histopatológico pode ser questionada devido à precária reprodutibilidade tanto intra como interobservador. OBJETIVO: Avaliar a concordância intra e interobservador no diagnóstico de displasia no esôfago de Barrett. MATERIAL E MÉTODOS: O material foi constituído por 42 blocos de parafina contendo fragmentos de esôfago provenientes de biopsias endoscópicas de portadores de esôfago de Barrett. Cortes de 3 micrômetros foram corados pela hematoxilina-eosina e pelo PAS-alcian blue. A leitura das lâminas foi realizada de maneira cega, em microscópio óptico. A reprodutibilidade intra e interobservador utilizou o teste kappa. RESULTADOS: O número total de fragmentos foi de 229, com média de 5,45 (1 a 18 fragmentos por paciente. O diagnóstico de displasia de baixo grau firmado pelos diferentes patologistas variou de 21,4% a 52,4%. A concordância intra-observador para o diagnóstico de displasia de baixo grau foi fraca (kappa = 0,30. A concordância interobservador para o diagnóstico de displasia de baixo grau foi pobre, com escore kappa oscilando entre 0,05 e 0,16. O diagnóstico de displasia, firmado pela concordância entre todos os patologistas, foi de 14,3%. CONCLUSÕES: A concordância no diagnóstico histopatológico de displasia de baixo grau no esôfago de Barrett, tanto intra quanto interobservador, é ruim. Idealmente, à semelhança da displasia de alto grau, o diagnóstico de displasia de baixo grau no esôfago de Barrett também deveria ser confirmado por mais de um patologista.BACKGROUND: Barrett's esophagus is a well-known pre-malignant condition. Pathologic interpretation of biopsy specimens guides endoscopic surveillance as well as the therapeutic approach that will be carried out. However, the predictive

  9. THE REAL PREVALENCE OF EROSIVE ESOPHAGITIS AND BARRETT'S ESOPHAGUS IN SYSTEMIC SCLERODERMA: DATA FROM 12-MONTHS PROSPECTIVE STUDY

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    Andrey Evgenievich Karateev

    2012-01-01

    Full Text Available Complicated forms of reflux-esophagitis, i.e., erosive esophagitis and Barrett's esophagus (BE — are common types of visceral pathology in systemic scleroderma (SSD, which require adequate therapy and follow up. Although real prevalence of esophageal involvement in SSD in Russian patients remains uncertain. Objective — to identify prevalence of erosive esophagitis and BE, and to quantify gastro-intestinal (GI symptoms in patients with SSD. Material and methods. During 1 year (December 2009 — January 2011 all consecutive SSD patients, hospitalized to FSBI «SRIR» RAMS, after signing informed consent, were subjected to esophagogastroduodenoscopy with biopsy of esophageal mucosa in upper 1/3. Totally 123 patients were examined (96,8% females, 3,2% males, aged 50,5±13,1 years. Esophageal mucous was evaluated for presence of pathologic changes and BE (intestinal metaplasia in biopsy samples was a BE diagnostic criterion. SODA questionnaire was used to quantify GIT symptoms Results. Erosive esophagitis was detected in 30 (24,3% patients, BE — in 11 (8,9%. In 80% of patients marked changes in esophageal mucosa were associated with typical symptoms (heartburn, regurgitaion, dysphagia, while in some cases (in 3 patients erosive esophagitis and BE were asymptomatic. Quantitative evaluation of symptoms with SODA questionnaire demonstrated clear correlation between subjective assessment and severity of esophageal pathologic changes. In patients with erosive gastritis and BE the SODA «pain» and «non-pain» parameters scores were significantly higher and satisfaction in dyspepsia management was lower (p<0,05, then in individuals without erosions and mucosal inflammation. Here was no clear correlation between esophageal pathology and SSD type (limited, diffuse, age, duration of the disease, presence of pulmonary interstitial lesion and Sjogren's syndrome. Patients with erosive esophagitis were significantly more often (36,6% using proton pomp

  10. Proton pump inhibitors suppress iNOS-dependent DNA damage in Barrett's esophagus by increasing Mn-SOD expression

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    Thanan, Raynoo [Faculty of Pharmaceutical Sciences, Suzuka University of Medical Science, Suzuka, Mie 513-8670 (Japan); Department of Environmental and Molecular Medicine, Mie University Graduate School of Medicine, Tsu, Mie 514-8507 (Japan); Ma, Ning [Faculty of Health Science, Suzuka University of Medical Science, Suzuka, Mie 513-0293 (Japan); Iijima, Katsunori; Abe, Yasuhiko; Koike, Tomoyuki; Shimosegawa, Tooru [Division of Gastroenterology, Tohoku University Hospital, Sendai, Miyaki 980-8574 (Japan); Pinlaor, Somchai [Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002 (Thailand); Hiraku, Yusuke; Oikawa, Shinji; Murata, Mariko [Department of Environmental and Molecular Medicine, Mie University Graduate School of Medicine, Tsu, Mie 514-8507 (Japan); Kawanishi, Shosuke, E-mail: kawanisi@suzuka-u.ac.jp [Faculty of Pharmaceutical Sciences, Suzuka University of Medical Science, Suzuka, Mie 513-8670 (Japan)

    2012-05-04

    Highlights: Black-Right-Pointing-Pointer Inflammation by Barrett's esophagus (BE) is a risk factor of its adenocarcinoma (BEA). Black-Right-Pointing-Pointer 8-Nitroguanine and 8-oxodG are inflammation-related DNA lesions. Black-Right-Pointing-Pointer DNA lesions and iNOS expression were higher in the order, BEA > BE > normal tissues. Black-Right-Pointing-Pointer Proton pump inhibitors suppress DNA damage by increasing Mn-SOD via Nrf2 activation. Black-Right-Pointing-Pointer DNA lesions can be useful biomarkers to predict risk of BEA in BE patients. -- Abstract: Barrett's esophagus (BE), an inflammatory disease, is a risk factor for Barrett's esophageal adenocarcinoma (BEA). Treatment of BE patients with proton pump inhibitors (PPIs) is expected to reduce the risk of BEA. We performed an immunohistochemical study to examine the formation of nitrative and oxidative DNA lesions, 8-nitroguanine and 8-oxo-7,8-dihydro-2 Prime -deoxygaunosine (8-oxodG), in normal esophageal, BE with pre- and post-treatment by PPIs and BEA tissues. We also observed the expression of an oxidant-generating enzyme (iNOS) and its transcription factor NF-{kappa}B, an antioxidant enzyme (Mn-SOD), its transcription factor (Nrf2) and an Nrf2 inhibitor (Keap1). The immunoreactivity of DNA lesions was significantly higher in the order of BEA > BE > normal tissues. iNOS expression was significantly higher in the order of BEA > BE > normal tissues, while Mn-SOD expression was significantly lower in the order of BEA < BE < normal tissues. Interestingly, Mn-SOD expression and the nuclear localization of Nrf2 were significantly increased, and the formation of DNA lesions was significantly decreased in BE tissues after PPIs treatment for 3-6 months. Keap1 and iNOS expression was not significantly changed by the PPIs treatment in BE tissues. These results indicate that 8-nitroguanine and 8-oxodG play a role in BE-derived BEA. Additionally, PPIs treatment may trigger the activation and

  11. MiRNA-Related SNPs and Risk of Esophageal Adenocarcinoma and Barrett's Esophagus: Post Genome-Wide Association Analysis in the BEACON Consortium.

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    Matthew F Buas

    Full Text Available Incidence of esophageal adenocarcinoma (EA has increased substantially in recent decades. Multiple risk factors have been identified for EA and its precursor, Barrett's esophagus (BE, such as reflux, European ancestry, male sex, obesity, and tobacco smoking, and several germline genetic variants were recently associated with disease risk. Using data from the Barrett's and Esophageal Adenocarcinoma Consortium (BEACON genome-wide association study (GWAS of 2,515 EA cases, 3,295 BE cases, and 3,207 controls, we examined single nucleotide polymorphisms (SNPs that potentially affect the biogenesis or biological activity of microRNAs (miRNAs, small non-coding RNAs implicated in post-transcriptional gene regulation, and deregulated in many cancers, including EA. Polymorphisms in three classes of genes were examined for association with risk of EA or BE: miRNA biogenesis genes (157 SNPs, 21 genes; miRNA gene loci (234 SNPs, 210 genes; and miRNA-targeted mRNAs (177 SNPs, 158 genes. Nominal associations (P0.50, and we did not find evidence for interactions between variants analyzed and two risk factors for EA/BE (smoking and obesity. This analysis provides the most extensive assessment to date of miRNA-related SNPs in relation to risk of EA and BE. While common genetic variants within components of the miRNA biogenesis core pathway appear unlikely to modulate susceptibility to EA or BE, further studies may be warranted to examine potential associations between unassessed variants in miRNA genes and targets with disease risk.

  12. Origin of adenocarcinoma in Barrett's esophagus: P53 and Ki67 expression and histopathologic background Origem do adenocarcinoma no esôfago de Barrett: bases histopathológicas e expressão dos genes p53 e Ki67

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    Sergio Szachnowicz

    2005-04-01

    Full Text Available Barrett's esophagus is the substitution of squamous epithelium of the distal esophagus by columnar epithelium. Intestinal metaplasia in Barrett's esophagus is considered to be the main risk factor for the development of adenocarcinoma. Diffuse adenocarcinoma and Barrett's esophagus without intestinal metaplasia are rare, and reports on the subject are scarce. PURPOSE AND METHOD: To estimate the prevalence of adenocarcinoma in 297 patients with Barrett's esophagus, during the period of 1990 to 2002, and in 13 patients undergoing surgery, to conduct detailed macroscopic and microscopic analysis, with performance of immunohistochemical tests for p53 and Ki67, correlating the type of tumor with its adjacent epithelium. RESULTS: In our patients with Barrett's esophagus, there was a prevalence of 5.7% of adenocarcinoma. The tumors developed only when the Barrett's esophagus segment was long (>3.0 cm. Tumors were located close to the squamous-columnar junction. The histological study revealed 2 patients (15.4% with Barrett's esophagus adjacent to a tumor with gastric metaplasia without the presence of intestinal metaplasia. Tumors were classified according to Nakamura's classification (23% differentiated pattern, and 77% undifferentiated pattern and to Lauren's classification (61% intestinal and 39% diffuse. The difference is due to the migration of microtubular and foveolar tumors of undifferentiated (gastric pattern in Nakamuras classification to the Lauren's intestinal type. The immunohistochemical test for Ki67 was strongly positive in all the patients, thus evidencing intense cell proliferation in both the columnar epithelium and tumor. Expression of p53 was negative in 67% of the adjacent columnar epithelia and 42% of the tumors, without any correlation between the tissue types. CONCLUSION: Adenocarcinoma develops from mixed columnar epithelium, either intestinal or gastric, showing both the gastric and the intestinal patterns; thus, tumors can

  13. Dietary fruit, vegetable, fat, and red and processed meat intakes and Barrett's esophagus risk: a systematic review and meta-analysis.

    Science.gov (United States)

    Zhao, Zhanwei; Pu, Zhongshu; Yin, Zifang; Yu, Pengfei; Hao, Yiming; Wang, Qian; Guo, Min; Zhao, Qingchuan

    2016-01-01

    The relationships between dietary fruit, vegetable, fat, and red and processed meat intakes and Barrett's esophagus (BE) risk remain inconclusive. We conducted a systematic review and meta-analysis to summarize the available evidence on these issues. PubMed, EMBASE and the Cochrane Library were searched for studies published from inception through October 2015. A total of eight studies were included in this analysis. Fruit intake was not associated with BE risk (OR = 0.65, 95% CI = 0.37-1.13), but vegetable intake was strongly associated with BE risk (OR = 0.45, 95% CI = 0.29-0.71). Saturated fat, red meat and processed meat intakes were not associated with BE risk with OR = 1.25 (95% CI = 0.82-1.91), OR = 0.85 (95% CI = 0.61-1.17) and OR = 1.03 (95% CI = 0.73-1.46), respectively. Dietary vegetable not fruits intake may be associated with decreased BE risk. Fat and red and processed meat intakes may not contribute to an increased BE risk. Well-designed, large prospective studies with better established dose-response relationships are needed to further validate these issues. PMID:27256629

  14. Gastroesophageal reflux in relation to adenocarcinomas of the esophagus: a pooled analysis from the Barrett's and Esophageal Adenocarcinoma Consortium (BEACON.

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    Michael B Cook

    Full Text Available Previous studies have evidenced an association between gastroesophageal reflux and esophageal adenocarcinoma (EA. It is unknown to what extent these associations vary by population, age, sex, body mass index, and cigarette smoking, or whether duration and frequency of symptoms interact in predicting risk. The Barrett's and Esophageal Adenocarcinoma Consortium (BEACON allowed an in-depth assessment of these issues.Detailed information on heartburn and regurgitation symptoms and covariates were available from five BEACON case-control studies of EA and esophagogastric junction adenocarcinoma (EGJA. We conducted single-study multivariable logistic regressions followed by random-effects meta-analysis. Stratified analyses, meta-regressions, and sensitivity analyses were also conducted.Five studies provided 1,128 EA cases, 1,229 EGJA cases, and 4,057 controls for analysis. All summary estimates indicated positive, significant associations between heartburn/regurgitation symptoms and EA. Increasing heartburn duration was associated with increasing EA risk; odds ratios were 2.80, 3.85, and 6.24 for symptom durations of <10 years, 10 to <20 years, and ≥20 years. Associations with EGJA were slighter weaker, but still statistically significant for those with the highest exposure. Both frequency and duration of heartburn/regurgitation symptoms were independently associated with higher risk. We observed similar strengths of associations when stratified by age, sex, cigarette smoking, and body mass index.This analysis indicates that the association between heartburn/regurgitation symptoms and EA is strong, increases with increased duration and/or frequency, and is consistent across major risk factors. Weaker associations for EGJA suggest that this cancer site has a dissimilar pathogenesis or represents a mixed population of patients.

  15. Characteristics of patients with columnar-lined Barrett's esophagus and risk factors for progression to esophageal adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    Kamal E Bani-Hani; Bayan K Bani-Hani; Iain G Martin

    2005-01-01

    AIM: To determine the risk factors for the development of esophageal adenocarcinoma in these patients with columnar-lined esophagus (CLE).METHODS: Data collected retrospectively on 597consecutive patients diagnosed at endoscopy and histology to have CLE at Leeds General Infirmary between 1984 and 1995 were analyzed. Factors evaluated included age,sex, length of columnar segment, smoking, and drinking habits, history of non-steroidal ingestion, presence of endoscopic esophagitis, ulceration or benign strictures and presence of Helicobacter pylori in esophageal biopsies. Univariate and multivariate analyses were performed to identify risk factors for the development of adenocarcinoma.RESULTS: Forty-four patients presented or developed esophageal adenocarcinoma during follow-up.Independent risk factors for the development of adenocarcinoma in patients with CLE were males (OR 5.12,95%CI 2.04-12.84, P = 0.0005), and benign esophageal stricture (OR 4.37, 95%CI 2.02-9.45, P = 0.0002). Male subjects and patients who developed benign esophageal stricture constituted 86% (n = 38) of all patients who presented or developed esophageal adenocarcinoma.The presence of esophagitis was associated with a significant reduction in the development of esophageal carcinoma (OR 0.28, 95%CI 0.13-0.57, P = 0.0006). No other clinical characteristics differentiate between the non-malignant and malignant group.CONCLUSION: In patients with CLE, endoscopic surveillance for the early detection of adenocarcinoma may be restricted to male subjects, as well as patients who develop benign esophageal strictures.

  16. Expressão de sulfomucinas e de carboidratos de mucinas simples no esôfago de Barrett Expression of sulphomucins and simple-mucin type carbohydrate in Barrett's esophagus

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    Frederico Henrique C. Melo

    2007-04-01

    of malignant transformation in the gastrointestinal tract. OBJECTIVES: To evaluate the expression of sulphomucins and simple-mucin type carbohydrate antigens (Tn, sTn T and sT expression in Barrett's esophagus (BE in order to identify potential lesions of increased risk to malignant transformation. METHODS: Biopsies of 50 cases of BE processed routinely were studied; diagnosis was performed in hematoxylin and eosin (HE and periodic acid Schiff (PAS/alcian blue stained sections. Additional sections were stained by high iron diamine for subtype intestinal metaplasia and by immunohistochemistry for Tn, sTn, T and sT antigens, whose expression was analyzed in the columnar and goblet cells of BE. RESULTS: BE was detected in only 47 cases stained by histochemistry and all of them had sulphomucin expression. Type III intestinal metaplasia was detected in 44 cases (93.6%; three had only type II, and type I was not observed. Tn antigen was expressed in columnar cells in 94% of the cases and sTn was expressed in goblet cells in 88% of them. T and sT were negative in 82% and in 87.8% of the cases, respectively. CONCLUSIONS: BE showed a homogeneous pattern of expression of sulphomucins and simple-mucin type carbohydrate antigens. BE was characterized as incomplete-type intestinal metaplasia with type III component together with Tn and sTn expression. According to these data, these markers are not useful to discriminate lesions with different potential of malignant transformation.

  17. Prevalence of Barrett's esophagus in individuals without typical symptoms of gastroesophageal reflux disease Prevalência do esôfago de Barrett em indivíduos sem sintomas típicos da doença por refluxo gastroesofágico

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    Mauro Carneiro de Freitas

    2008-03-01

    Full Text Available BACKGROUND: Barrett’s esophagus, the major risk factor for esophageal adenocarcinoma, is detected in approximately 10%-14% of individuals submitted to upper endoscopy for the assessment of gastroesophageal reflux disease related symptoms. Prevalence studies of Barrett’s esophagus in individuals without typical symptoms of gastroesophageal reflux disease have reported rates ranging from 0.6% to 25%. AIM: To determine the prevalence of Barrett’s in a Brazilian population older than 50 years without typical symptoms of gastroesophageal reflux disease. METHODS: A total of 104 patients (51 men, mean age of 65 years, with an indication for upper endoscopy but without symptoms of heartburn and/or acid regurgitation (determined with a validated questionnaire were recruited. Subjects submitted to upper endoscopic examination in the last 10 years or using antisecretory medication (proton pump inhibitors during the last 6 months were not included. Methylene blue chromoscopy was performed during the endoscopic exam to facilitate identification of the metaplastic epithelium. RESULTS: Barrett’s esophagus was diagnosed endoscopically and confirmed by histology in four patients, all of them males. The metaplastic segment was short (less than 3 cm and free of dysplasia in all patients. The prevalence of Barrett’s esophagus was 7.75% in the male population and 3.8% in the general population studied. CONCLUSION: Due to the low prevalence of Barrett’s esophagus found in the present study, associated with the finding of short-segment Barrett’s esophagus in all cases diagnosed and the absence of dysplasia in the material analyzed, endoscopic screening for Barrett’s esophagus in patients above the age of 50 without the classical symptoms of gastroesophageal reflux disease is not indicated for the Brazilian population.RACIONAL: O esôfago de Barrett, principal fator de risco para o adenocarcinoma do esôfago, é uma complicação da doença por refluxo

  18. Esôfago de Barrett: aspectos fisiopatológicos e moleculares da seqüência metaplasia-displasia-adenocarcinoma - artigo de revisão Barrett's esophagus: physiopathological and molecular aspects of metaplasia-dysplasia-adenocarcinoma sequence - review article

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    Bernardo Silveira Volkweis

    2008-04-01

    Full Text Available The Barrett's esophagus (BE is defined as endoscopically visible columnar mucosa at the distal esophagus, of any extension, proved to harbor intestinal metaplasia on biopsy, highlighted by the presence of goblet cells. BE denotes long-standing gastroesophageal reflux disease (GERD and is an important risk factor for the development of esophageal adenocarcinoma (EAC. Therefore, these patients must be on follow-up, in order to diagnose cancer early. BE patients have frequent alterations in esophageal physiologyc studies. Alkaline duodenogastroesophageal reflux seems to have important role. The development BE occurs in steps, initially with formation of cardiac type mucosa subsequent intestinalization. Futher progression can follow a sequence, from low grade dysplasia, to high grade dysplasia and esophageal adenocarcinoma. Current follow-up is based on the presence of dysplasia. It has limitations, grouping patients heterogeneously. Different steps of carcinogenesis have been studied looking for an ideal prognostic marker. Uncontrolled proliferative activity, apoptosis inhibition, angiogenesis, tissue invasion and metastases formation are all implicated in cancer origin. Some cycle cell molecules have been studied in BE, such as retinoblastoma protein, ciclins, kinase dependent ciclins and cell cycle inhibitors. The P53 protein is one of the most investigated in the metaplasia-adenocarcinoma progression. Growth Factors, apoptotic proteins, telomers and DNA ploidy have also been searched. Increased proliferative activity has been implicated in Barrett's carcinogenesis and the Ki-67 antigen, through imunohistochemical analysis, has become the the method of choice. Present in the nucleus, it is found in proliferative cells only. Some studies suport association between Ki-67 activity and the metaplasia-dysplasia-adenocarcinoma sequence.The results, however, are inconclusive and research should follow this way.

  19. Esôfago de Barrett e displasia: critérios diagnósticos Barret's esophagus and dysplasia: diagnostic criteria

    OpenAIRE

    Maria Aparecida Marchesan Rodrigues

    2004-01-01

    A presente revisão focaliza aspectos conceituais e os principais problemas diagnósticos referentes ao esôfago de Barrett e à displasia. O esôfago de Barrett resulta de complicação da doença do refluxo gastroesofágico de longa duração. É identificado endoscopicamente pela presença de mucosa glandular no esôfago tubular acima da junção esofagogástrica. Histologicamente, é caracterizado pela substituição do epitélio estratificado pavimentoso por epitélio colunar especializado com células calicif...

  20. Primary adenocarcinoma of cervical esophagus.

    Science.gov (United States)

    Alrawi, S J; Winston, J; Tan, D; Gibbs, J; Loree, T R; Hicks, W; Rigual, N; Lorè, J M

    2005-06-01

    Most upper esophageal malignancies are squamous cell carcinomas, rarely adenocarcinomas arising from Barrett's esophagus and very rarely adenocarcinomas from heterotopic gastric mucosa without evidence of Barrett's especially in the cervical part of the esophagus. We report a case of adenocarcinoma of the polypoid type in the upper esophagus (cervical esophagus) arising from ectopic gastric mucosa, in a 60 year-old man who presented with progressive dysphagia. Accurate diagnosis by esophagogram revealed a large mass in the cervical esophagus; CAT scan showed intraluminal mass at the level of thoracic inlet, esophagogastroscopy showed a fleshy polyp (3.2cm x 3.0cm) at 20 cm from the incisors with a biopsy confirming moderately differentiated adenocarcinoma with no evidence of Barrett's esophagus. Through a left cervical approach and resection of medial third of clavicle, the tumor was removed by partial esophagectomy followed by lymph node dissection, and proved to be T1NOMO, stage I (AJCC staging 6th ed.). Post operatively, the patient received chemoradiation with no evidence of recurrence or metastasis in six years of follow up. It seems this tumor has a much better prognosis than adenocarcinomas arising from Barrett's. To our knowledge only 19 cases have been reported in literature so far. PMID:16110768

  1. Zollinger-Ellison syndrome with esophagitis and Barrett mucosa.

    Science.gov (United States)

    Karl, T R; Pindyck, F; Sicular, A

    1983-10-01

    Although esophageal disease in Zollinger-Ellison syndrome is being recognized with increasing frequency, Barrett esophagus is seen only rarely. Basal lower esophageal sphincter pressure is probably not different in Zollinger-Ellison syndrome and non-Zollinger-Ellison syndrome patients. Circulating gastrin, therefore, cannot be the major determinant of lower esophageal sphincter pressure in vivo. Total gastrectomy and resection of all metaplastic esophagus, when feasible, is the treatment of choice for patients with Zollinger-Ellison syndrome and Barrett mucosa. PMID:6624733

  2. Cigarette Smoking Increases Risk of Barrett’s Esophagus:An Analysis of the Barrett’s and Esophageal Adenocarcinoma Consortium

    OpenAIRE

    Cook, Michael B.; Shaheen, Nicholas J; Anderson, Lesley A; Giffen, Carol; Chow, Wong-Ho; Vaughan, Thomas L.; Whiteman, David C; Corley, Douglas A.

    2012-01-01

    Background & Aims: Cigarette smoking has been implicated in the etiology of esophageal adenocarcinoma, but it is not clear if smoking is a risk factor for Barrett's esophagus. We investigated whether tobacco smoking and other factors increase risk for Barrett's esophagus. Methods: We analyzed data from 5 case-control studies included in the international Barrett's and Esophageal Adenocarcinoma Consortium. We compared data from subjects with Barrett's esophagus (n = 1059) with those from s...

  3. Termocoagulação endoscópica do esôfago de Barrett com plasma de argônio sob diferentes potências: análise histopatológica e de sintomas pós-procedimento Endoscopic argon plasm thermo-coagulation of Barrett's esophagus using different powers: histopathological and post procedure symptons analysis

    Directory of Open Access Journals (Sweden)

    Vanessa Puccinelli Dotti

    2009-04-01

    Full Text Available OBJETIVO: Definir qual a melhor potência a ser empregada de forma a atingir a profundidade necessária para ablação com o menor número de sintomas pós-procedimento. MÉTODO: Foram estudados 28 pacientes com esôfago de Barrett, após tratamento cirúrgico do refluxo ou em uso de bloqueadores de bomba de prótons, submetidos à ablação endoscópica, randomizados em dois grupos com potências diferentes - 50 ou 70W. Imediatamente após, foram realizadas biópsias endoscópicas das áreas fulguradas. A sintomatologia foi avaliada por questionário telefônico. RESULTADOS: Não houve diferença entre os grupos quanto a idade, a extensão do esôfago de Barrett, a porcentagem da circunferência esofagiana coagulada e a duração dos sintomas. A dor foi o sintoma predominante e a disfagia ocorreu de forma transitória. Houve correlação negativa moderada entre número de sintomas e potência (potência mais baixa com maior número de sintomas, porém sem diferença significativa. Em 40% dos casos em que se utilizou menor potência obteve-se fragmentos que atingiram apenas a porção superficial da mucosa, o que só ocorreu em 10% dos casos no grupo de 70W. Não foi observada diferença significativa entre a potência utilizada ou o acometimento da muscular da mucosa e o número de sintomas. CONCLUSÕES: A utilização de potência de 70W durante a coagulação do esôfago de Barrett com plasma de argônio sugere associação com menor incidência de metaplasia colunar especializada residual abaixo do epitélio escamoso neoformado.OBJECTIVE: To establish the ideal power to be employed in order to get the effective ablation and the lowest rate of symptoms at argon plasma thermocoagulation in Barrett's esophagus (BE. METHODS: Twenty-eight asymptomatic patients with BE, were randomly divided in two groups of different ablation powers, 50W or 70W. After endoscopic ablation and biopsies from the treated area for histological analyses, symptoms were

  4. Resultados das cirurgias "floppy nissen rossetti" e "floppy nissen longa " realizadas por videolaparascopia em pacientes com esôfago de barrett: estudo prelimilar Results of laparoscopic " floppy nissen rossetti" and "long floppy nissen" surgeries in patients with barrett's esophagus: preliminary study

    Directory of Open Access Journals (Sweden)

    Delta Madureira Filho

    2003-12-01

    personal statistics about "Floppy Nissen Rossetti Fundoplication" without division of short gastric vessels(NRF for the sugical treatment of GERD patients, focusing those with Barrett' s esophagus(BE, we compared surgical results of this procedure to a "Floppy Long Nissen Fundoplication" with division of short gastric vessels(NLF, addressing pH measurement and clinical features. METHODS: From march 2000 to march 2003, 28 patients with GERD and BE, were assessed postoperatively, 12 for NRF and 16 for NLF. Assessment was performed considering the relief or persistence of symptoms, appearance of post operative dysphagia and persistence of acid reflux after surgery, detected by pH measurement. RESULTS: Both surgeries relief heart-burn symptoms, pirosis and regurgitation (overflow on the second postoperative day. Transitory dysphagia occurred more frequently after NRF surgery than with NLF (41% versus 6.25%. Permanent dysphagia has not been observed on either groups. Postoperative pH measurements six months after surgeries have shown that NRF group patients were not totally free of reflux, 25% of pH measurements presented positive results, while NLF group patients were almost totally protected, 6.25% with positive results. Although this is a preliminary study based on small sample size, authors advice about the risks that a constant reflux after surgery may pose to a patient with Barrett's esophagus and present a new proposal (floppy and long wrap, contrary to current trends (short and floppy wrap for the treatment of GERD patients with BE, that deserves a special consideration by surgeons and researchers.

  5. Expressão de CDX2 e mucinas (MUC1, MUC2, MUC5AC e MUC6 em esôfago de Barrett antes e após fundoplicatura de Nissen Expression of CDX2 and mucins (MUC1, MUC2, MUC5AC and MUC6 in Barrett's esophagus before and after Nissen fundoplication

    Directory of Open Access Journals (Sweden)

    Luciana Rodrigues de Meirelles

    2012-10-01

    Full Text Available INTRODUÇÃO: O esôfago de Barrett (EB corresponde à substituição do epitélio escamoso por um do tipo intestinal, em resposta ao refluxo crônico nos pacientes com doença do refluxo gastroesofágico (DRGE. É um importante precursor do adenocarcinoma esofágico. A fundoplicatura de Nissen (FN é uma cirurgia antirrefluxo que visa a reduzir a agressão à mucosa esofágica. Alterações no padrão de expressão imuno-histoquímica de mucinas e de CDX2 no EB antes e depois da FN podem ser úteis na identificação de um padrão de expressão desses marcadores e, eventualmente, na identificação de casos com risco de evolução para malignidade. OBJETIVOS: Avaliar e comparar a imunoexpressão de CDX2 e mucinas no EB de pacientes com DRGE submetidos à FN antes e após a cirurgia. MATERIAIS E MÉTODOS: Estudo retrospectivo de 25 pacientes com diagnóstico de DRGE e EB submetidos à FN, acompanhados por, pelo menos, três anos. Foram feitos análise histológica e estudo imuno-histoquímico das biópsias endoscópicas antes e após a cirurgia, comparando-se a inflamação e a imunoexpressão de MUC1, MUC2, MUC5AC, MUC6 e CDX2. Estimou-se a porcentagem de células com expressão para os marcadores estudados na mucosa de Barrett: 0%-25%, 25%-75% e 75%-100% das células positivas. Foram utilizados os testes de McNemar e Stuart-William e adotou-se o nível de 5% de significância estatística. RESULTADOS E CONCLUSÃO: Não houve diferenças significativas quanto a presença ou intensidade de inflamação, nem da imunoexpressão de mucinas e CDX2 no EB antes e após a FN. O tratamento cirúrgico não influenciou a mudança da expressão dessas glicoproteínas no EB.INTRODUCTION: Barrett´s esophagus (BE is characterized by the exchange of esophageal squamous epithelium for intestinal type in response to chronic reflux in patients with gastroesophageal reflux disease (GERD.It is an important precursor of esophageal adenocarcinoma. Nissen

  6. Esophagus Disorders

    Science.gov (United States)

    ... The most common problem with the esophagus is gastroesophageal reflux disease (GERD). It happens when a band of muscle at ... into the esophagus and irritate it. Over time, GERD can cause damage to the esophagus. Other problems ...

  7. Greater interobserver agreement by endoscopic mucosal resection than biopsy samples in Barrett's dysplasia

    NARCIS (Netherlands)

    S. Wani; S.C. Mathur; W.L. Curvers; V. Singh; L.A. Herrero; S.B. Hall; O. Ulusarac; R. Cherian; D.H. McGregor; A. Bansal; A. Rastogi; B. Ahmed; M. Singh; S. Gaddam; F.J. ten Kate; J. Bergman; P. Sharma

    2010-01-01

    BACKGROUND & AIMS: Endoscopic mucosal resection (EMR) is an important diagnostic, staging, and therapeutic tool for patients with Barrett's esophagus (BE)-associated neoplasia. We analyzed the histopathologic characteristics of specimens collected during EMR compared with biopsy specimens from patie

  8. Absence of Na +/sugar cotransport activity in Barrett's metaplasia

    Institute of Scientific and Technical Information of China (English)

    Lisa J Murray; Owen Tully; David S Rudolph; Marysue Whitby; Mary C Valenzano; Giancarlo Mercogliano; James J Thornton; James M Mullin

    2008-01-01

    AIM:To evaluate the presence of Na+-dependent,active,sugar transport in Barrett's epithelia as an intestinal biomarker,based on the well-documented,morphological intestinal phenotype of Barrett's esophagus (BE).METHODS:We examined uptake of the nonmeta-bolizable glucose analogue,alpha-methyl-D-glucoside (AMG),a substrate for the entire sodium glucose cotransporter (SGLT) family of transport proteins.During upper endoscopy,patients with BE or with uncomplicated gastroesophageal reflux disease (GERD)allowed for duodenal,gastric fundic,and esophageal mucosal biopsies to be taken.Biopsies were incubated in bicarbonate-buffered saline (KRB) containing 0.1 mmol/L 14C-AMG for 60 min at 20℃.Characterized by abundant SGLT,duodenum served as a positive control while gastric fundus and normal esophagus,known to lack SGLT,sewed as negative controls.RESULTS:Duodenal biopsies accumulated 249.84± 35.49 (SEM) picomoles AMG/μg DNA (n = 12),gastric fundus biopsies 36.20 ± 6.62 (n = 12),normal esophagus 12.10 ± 0.59 (n = 3) and Barrett's metaplasia 29.79 ± 5.77 (n = 8).There was a statistical difference (P<0.01) between biopsies from duodenum and each other biopsy site but there was no statistically significant difference between normal esophagus and BE biopsies.0.5 mmol/L phlorizin (PZ) inhibited AMG uptake into duodenal mucosa by over 89%,but had no significant effect on AMG uptake into gastric fundus,normal esophagus,or Barrett's tissue.In the absence of Na+ (all Na+ salts replaced by Li+ salts),AMG uptake in duodenum was decreased by over 90%,while uptake into gastric,esophageal or Barrett's tissue was statistically unaffected.CONCLUSION:Despite the intestinal enterocyte phenotype of BE,Na+-dependent,sugar transport activity is not present in bhese cells.

  9. Heterotopic Gastric Mucosa in the Distal Part of Esophagus in a Teenager: Case Report.

    Science.gov (United States)

    Lupu, Vasile Valeriu; Ignat, Ancuta; Paduraru, Gabriela; Mihaila, Doina; Burlea, Marin; Ciubara, Anamaria

    2015-10-01

    Heterotopic gastric mucosa (HGM) of the esophagus is a congenital anomaly consisting of ectopic gastric mucosa. It may be connected with disorders of the upper gastrointestinal tract, exacerbated by Helicobacter pylori. The diagnosis of HGM is confirmed via endoscopy with biopsy. Histopathology provides the definitive diagnosis by demonstrating gastric mucosa adjacent to normal esophageal mucosa. HGM located in the distal esophagus needs differentiation from Barrett's esophagus. Barrett's esophagus is a well-known premalignant injury for adenocarcinoma of the esophagus. Malignant progression of HGM occurs in a stepwise pattern, following the metaplasia-dysplasia-adenocarcinoma sequence.We present a rare case of a teenage girl with HGM located in the distal esophagus, associated with chronic gastritis and biliary duodenogastric reflux. Endoscopy combined with biopsies is a mandatory method in clinical evaluation of metaplastic and nonmetaplastic changes within HGM of the esophagus. PMID:26496283

  10. Signaling in H2O2-Induced Increase in Cell Proliferation in Barrett's Esophageal Adenocarcinoma Cells

    OpenAIRE

    Zhou, Xiaoxu; Li, Dan; Resnick, Murray B.; Behar, Jose; Wands, Jack; Cao, Weibiao

    2011-01-01

    Mechanisms whereby acid reflux may accelerate the progression from Barrett's esophagus (BE) to esophageal adenocarcinoma (EA) are not fully understood. We have previously shown that NADPH oxidase NOX5-S generates reactive oxygen species (ROS) when Barrett's metaplastic cells are exposed to acid. Besides metaplastic cells, other H2O2-producing cells (e.g., inflammatory cells) present in BE mucosa may produce additional ROS, which may also affect metaplastic cells contributing to esophageal tum...

  11. A clinical study on treating Barrett’s esophagus with argon plasma coagulation plus esomeprazole%氩离子凝固术配合埃索美拉唑治疗 Barrett 食管临床研究

    Institute of Scientific and Technical Information of China (English)

    钱鑫

    2014-01-01

    目的:探讨内镜下氩离子凝固术(Argon Plasma Coagulation,APC)配合抑酸治疗Barrett食管(Barrett’s Esophagus, BE)的临床疗效。方法:在内镜下以APC对40例经病理证实为肠上皮化生的BE完全损毁化生黏膜,再配合埃索美拉唑抑酸治疗,术后再进行内镜、病理随访12个月。结果:40例均完成治疗,其中需要1次治疗者28例,2次治疗者11例,3次治疗者1例。37例达到完全的鳞状上皮再生(92.5%),3例再生的鳞状上皮间混有岛状的柱状上皮(7.5%),12个月后共有4例出现内镜下可见的复发。结论:内镜下APC配合抑酸治疗BE安全、有效,但有一定比例的复发和残留。%Objective: To study clinical effects of the argon plasma coagulation (APC) plus esomeprazole on Barrett’s esophagus(BE). Methods: 40 patients with Barrett’s esophagus confirmed by endoscope were treated with APC and successively acid suppression therapy. All the patients were rechecked by endoscope and pathology method on 12 months after treatment. Results: All patients were accomplished treatment. The eradication was obtained in 28 cases by only one session and 11 cases two session, 1 cases three sessions. The complete squamous reepithelialization was observed in 37 patients (92.5%), and remnant islands of columnar epithelium mixed with squamous reepithelialization in the original places were observed in 3 patients (7.5%). The reappearance of columnar epithelium was observed in 4 patients in 12 months. Conclusion: APC plus esomeprazole in Barrett’s esophagus’ endepidermis show obvious reversal function, however, recurrences and residual of BE are present in minority of patients.

  12. Cytochromes P450 are Expressed in Proliferating Cells in Barrett's Metaplasia

    Directory of Open Access Journals (Sweden)

    Steven J. Hughes

    1999-06-01

    Full Text Available The expression of cytochromes P450 (CYP in Barrett's esophagus and esophageal squamous mucosa was investigated. Esophagectomy specimens from 23 patients were examined for CYP expression of CYP1A2, CYP3A4, CYP2C9/10, and CYP2E1 by immunohistochemical analysis, and the expression of CYP1A1, CYP3A4, CYP1B1, CYP2E1, and CYP2C9/10 in these tissues was further confirmed by reverse transcription polymerase chain reaction. Immunohistochemical analysis of esophageal squamous mucosa (n = 12 showed expression of CYP1A2, CYP3A4, CYP2E1, and CYP2C9/10 proteins, but it was noted that cells within the basal proliferative zone did not express CYPs. Immunohistochemical analysis of Barrett's esophagus (n = 13 showed expression of CYP1A2, CYP3A4, CYP2E1, and CYP2C9/10 that was prominent in the basal glandular regions, which are areas containing a high percentage of actively proliferating cells. Immunohistochemical staining for both proliferating cell nuclear antigen and the CYPs further supported the colocalization of CYP expression to areas of active cell proliferation in Barrett's esophagus, whereas in the esophageal squamous epithelium, CYP expression is limited to cells that are not proliferating. RT-PCR with amplification product sequence analysis confirmed CYP1A1, CYP3A4, CYP1B1, CYP2E1, and CYP2C9/10 mRNA expression in Barrett's esophagus. These data suggest that the potential ability of cells in Barrett's esophagus to both activate carcinogens and proliferate may be important risk factors affecting carcinogenesis in this metaplastic tissue.

  13. Barrett's esophagus. Diagnosis, follow-up and treatment

    DEFF Research Database (Denmark)

    Bremholm, Lasse; Funch-Jensen, Peter; Eriksen, Jan;

    2012-01-01

    should include evaluation of dysplasia, and if present it should be classified as low or high grade dysplasia. All patients are offered relevant antireflux treatment with PPI or surgery. Ablation or mucosal resection of metaplastic epithelia with or without low grade dysplasia is experimental and it is...... not recommended outside controlled studies. Treatment of high grade dysplasia and carcinoma in situ is handled in departments treating esophageal cancer. Follow-up with endoscopy and biopsy can be offered. Follow-up endoscopy with biopsy can only be recommended after thorough information to the...

  14. Barrett's esophagus. Diagnosis, follow-up and treatment

    DEFF Research Database (Denmark)

    Bremholm, Lasse; Funch-Jensen, Peter; Eriksen, Jan;

    2012-01-01

    should include evaluation of dysplasia, and if present it should be classified as low or high grade dysplasia. All patients are offered relevant antireflux treatment with PPI or surgery. Ablation or mucosal resection of metaplastic epithelia with or without low grade dysplasia is experimental and it is...... not recommended outside controlled studies. Treatment of high grade dysplasia and carcinoma in situ is handledin departments treating esophageal cancer. Follow-up with endoscopy and biopsy can be offered. Follow-up endoscopy with biopsy can only be recommended after thorough information to the...

  15. Barrett’s esophagus: review of diagnosis and treatment

    OpenAIRE

    Sappati Biyyani, Raja Shekhar; Chak, Amithab

    2013-01-01

    Barrett's esophagus (BE) is an acquired condition characterized by replacement of stratified squamous epithelium by a cancer predisposing metaplastic columnar epithelium. Endoscopy with systemic biopsy protocols plays a vital role in diagnosis. Technological advancements in dysplasia detection improves outcomes in surveillance and treatment of patients with BE and dysplasia. These advances in endoscopic technology radically changed the treatment for dysplastic BE and early cancer from being s...

  16. Overview of the Esophagus

    Science.gov (United States)

    ... Content Medical News Overview of the Esophagus By Michael C. DiMarino, MD NOTE: This is the Consumer ... the esophagus become dilated and bleed easily (see Portal Hypertension ). Resources In This Article Animation 1 How ...

  17. Treatment of squamous cell and adenocarcinoma of the esophagus

    Directory of Open Access Journals (Sweden)

    Rathbone B

    2012-11-01

    Full Text Available Barrie Rathbone,1 Janusz Jankowski,2 Michael Rathbone31University Hospitals of Leicester, Leicester, 2Sir James Black Professor Queen Mary University of London, 3St George's University of London, London, United KingdomAbstract: Esophageal cancer is the sixth commonest cause of cancer death worldwide. It predominantly occurs in two histological types, ie, squamous cell carcinoma and adenocarcinoma, each with its own distinct geographical distribution and natural history. The incidence of esophageal adenocarcinoma is rising, as is that of its precursor lesion, Barrett's esophagus, which consists of metaplastic change in the squamous mucosa of the esophagus in response to damage by gastroesophageal reflux disease. The principal risk factors for esophageal cancer are cigarette smoking and alcohol consumption, reflux disease, and obesity. In tumors without local invasion or distant metastases, surgery remains the treatment option of choice, although there are considerable differences of opinion regarding the roles of chemotherapy and radiotherapy. A wide variety of endoscopic treatments are available for dysplastic lesions and palliation. Despite the availability of increasingly complex imaging modalities and expensive and possibly ineffective attempts at screening, the evidence base is conflicted and the prognosis remains poor. However, from a recent large systematic review, three clear recommendations can be made, ie, use of endoscopic resection for high grade dysplasia, use of radiofrequency ablation for residual premalignant lesions, and, finally, prevention of risk factors for cancer, such as smoking, alcohol consumption, and obesity.Keywords: cancer, Barrett's, esophagus, squamous cell carcinoma, adenocarcinoma

  18. Esophagus Cancer: Palliative Therapy

    Science.gov (United States)

    ... in our document Guide to Controlling Cancer Pain . Nutritional support Nutrition is another concern for many patients with esophagus cancer. The cancer or its treatment might affect how you swallow ... supplements and information about your individual nutritional needs. ...

  19. [Gastroesophageal reflux disease and Barrett's dysplasia].

    Science.gov (United States)

    Pech, Oliver

    2015-10-01

    The new guideline for reflux disease and Barrett's oesophagus offers some news in diagnosis and therapy. Especially in the endoscopic treatment of early neoplasia in Barrett's oesophagus the combination of endoscopic resection and ablation (e. g. radiofrequency ablation) has now been established. PMID:26445259

  20. Adiponectin multimers in patients with Barrett's Oesophagus

    Directory of Open Access Journals (Sweden)

    Mohammed Fakhraldeen*, Huseen Saad Mostafa**, Ghada Ali Abdulwahab

    2010-06-01

    Full Text Available Barrett's oesophagus is associated with abdominal obesity. Adiponectin is a peptide that is secreted from adipocytes and circulates in three multimeric forms: low molecular weight (LMW, middle molecular weight (MMW, and high molecular weight (HMW. The anti-inflammatory effects of adiponectin are specific to individual multimers, with the LMW being most anti-inflammatory. We investigated the possibility that circulating levels of adiponectin and its multimers would be associated with the risk of Barrett's oesophagus. Subjects and methods This study comprised patients diagnosed to have Barrett's oesophagus, and control subjects diagnosed to have gastrooesophageal reflux disease (GORD, all were diagnosed in the gastroenterology and endoscopy unit, King Fahd hospital, Riyadh, Saudi Arabia. Plasma adiponectin levels and its multimers were evaluated for patients with Barrett's oesophagus and controls with GORD. Results There were 120 cases of Barrett's oesophagus and 250 GORD controls. Total adiponectin was not significantly associated with Barrett's oesophagus; low levels of LMW adiponectin and low LMW/total ratio were significantly present in patients with Barrett's oesophagus. Conclusion Low levels of LMW adiponectin are significantly associated with Barrett's oesophagus.

  1. Vida y pensamiento de Rafael Barrett

    OpenAIRE

    Corral Sánchez-Cabezudo, Francisco

    1991-01-01

    La trayectoria intelectual de Rafael Barrett representa el caso particular de un "joven del 98" trasplantado a América. Con el inicio del siglo, Barrett abandona la bohemia madrileña en la que consta su relación personal con valle, Maeztu, Baroja, Bueno y Fuente. En América produce una notable obra intelectual, a pesar de su corta vida. Desde unos inicios filosóficos Nietzscheanos, muy identificados con el tono y la temática del joven 98, Barrett va evolucionando (como consecuencia de su prop...

  2. Swallowable capsule with air channel for improved image-guided cancer detection in the esophagus

    Science.gov (United States)

    Seibel, Eric J.; Melville, C. David; Lung, Jonathan K. C.; Babchanik, Alexander P.; Lee, Cameron M.; Johnston, Richard S.; Dominitz, Jason A.

    2009-02-01

    A new type of endoscope has been developed and tested in the human esophagus, a tethered-capsule endoscope (TCE) that requires no sedation for oral ingestion and esophageal inspection. The TCE uses scanned red, green, and blue laser light to image the upper digestive tract using a swallowable capsule of 6.4mm in diameter and 18mm in length on a 1.4mm diameter tether. The TCE has been modified for image-guided interventions in the lower esophagus, specifically for more effective detection and measurement of the extent of Barrett's esophagus, a precursor to esophageal cancer. Three modifications have been tested in vivo: (1) weighting the capsule so it is negatively buoyant in water, (2) increasing the frame rate of 500-line images to 30 Hz (video rate), and (3) adding a 1.0mm inner diameter working channel alongside the tether for distending the lower esophagus with air pressure during endoscopy. All three modifications proved effective for more clearly visualizing the lower esophagus in the first few human subjects. The air channel was especially useful because it did not change tolerability in the first subject for unsedated endoscopy and the air easily removed bubbles obscuring tissue from the field of view. The air provided a non-invasive intervention by stimulating the mechanosensor of the lower esophageal sphincter at the precise time that the TCE was positioned for most informative imaging. All three TCE modifications proved successful for improved visualization of esophageal pathology, such as suspected Barrett's esophagus, without the use of sedation.

  3. Ballmer, Barrett weigh in on security

    CERN Multimedia

    Sullivan, T

    2003-01-01

    ORLANDO, Fla. - Speaking in separate sessions Tuesday at the Gartner Symposium/ITxpo, Microsoft CEO Steve Ballmer and Intel's chief Craig Barrett discussed the problems of computer/network security (1/2 page).

  4. Leiomyosarcoma of the esophagus.

    Science.gov (United States)

    Pramesh, C S; Pantvaidya, G H; Moonim, M T; Jambhekar, N A; Sharma, S; Deshpande, R K

    2003-01-01

    Leiomyosarcomas of the esophagus are rare, malignant, smooth-muscle tumors. The presenting symptoms are indistinguishable from other esophageal neoplasms, though the history may be longer due to the slow growth of these tumors. Barium studies may show large intramural masses with ulceration or tracking, expansile intraluminal masses or areas of luminal narrowing. Endoscopic biopsies may give a high false negative rate especially in cases where the mucosa is intact. The treatment of choice is surgical excision. Synchronous and metachronous metastases do not preclude surgery, provided the metastases are also resectable. Prognosis is better than in patients with squamous esophageal cancer. The role of adjuvant radiotherapy and chemotherapy is controversial. We report a 40-year-old man who presented to us with dysphagia and was found to have a leiomyosarcoma of the esophagus. He was treated successfully with esophagectomy and is disease-free after 7 years. We review the literature on esophageal leiomyosarcomas and their management. PMID:12823215

  5. Radiology of the esophagus

    International Nuclear Information System (INIS)

    Before the radiologist can decide on his approach to the examination, he needs clinical information and a short relevant medical history of the patient. These aspects are considered in Chapter 1. Chapter 2 covers the 'standard' examination of the esophagus, the contrast media, the relative values of the single contrast, mucosal relief and double contrast studies, the various techniques used to obtain double contrast films and, finally, several of the drugs administered during the examination. Since in cases of aspecific dysphagia the entire esophagus - including the pharynx - must be examined, this stepchild of the radiological examination is the focus of attention in Chapter 3 while an overview of the anatomy, physiology, roentgen anatomy and roentgen physiology of the esophageal body is presented in Chapter 4. Congenital abnormalities, displacement and impressions, diverticula, foreign bodies, perforation and tumors are considered in more detail in Chapters 5 to 10, respectively. The value of computed tomography for the staging of esophageal cancer is discussed in Chapter 11. Chapter 12 is devoted to the highly diversified spectrum of abnormalities of the esophageal wall. Disturbed motility is the subject of Chapter 13. In Chapter 14 the hiatal hernia, gastroesophageal reflux and its results are discussed in a somewhat broader context. In Chapter 15 the radiological aspects of the postoperative esophagus are described. (orig./MG)

  6. Barrett's ulcer: cause of spontaneous oesophageal perforation.

    OpenAIRE

    Limburg, A. J.; Hesselink, E. J.; Kleibeuker, J H

    1989-01-01

    We report two patients, who presented within six months with the classic clinical picture of 'spontaneous' oesophageal perforation, which was caused by a perforated Barrett's ulcer. These two cases underline the importance of postoperative endoscopy in ruling out intrinsic oesophageal disease as the cause of the rupture in every patient, who survives this life threatening condition.

  7. Does Impaired Gallbladder Function Contribute to the Development of Barrett's Esophagus and Esophageal Adenocarcinoma?

    LENUS (Irish Health Repository)

    Nassr, Ayman O

    2011-06-01

    Esophageal adenocarcinoma is aetiologically associated with gastro-esophageal reflux, but the mechanisms responsible for the metaplasia-dysplasia sequence are unknown. Bile components are implicated. Impaired gallbladder function may contribute to duodenogastric reflux (DGR) and harmful GERD.

  8. The Barrett-Crane model: measure factor

    CERN Document Server

    Kaminski, Wojciech

    2013-01-01

    The original spin foam model construction for 4D gravity by Barrett and Crane suffers from several fatal issues. In the simple examples of the vertex amplitude they can be summarized as the existence of contributions to the asymptotics from non geometric configurations. Even restricted to geometric contributions the amplitude is not completely worked out. While the phase is known to be the Regge action, the so called measure factor has remained mysterious for a decade. In the toy model case of the 6j symbol this measure factor has a nice geometric interpretation of V^{-1/2} leading to speculations that a similar interpretation should be possible also in the 4D case. In this paper we provide the first geometric interpretation of the geometric part of the asymptotic for the spin foam consisting of two glued 4-simplices (decomposition of the 4-sphere) in the Barrett-Crane model in the large internal spin regime.

  9. O critério de positividade para a análise imunoistoquímica da p53 na confirmação da displasia do esôfago de Barrett faz diferença? Does positive criterium for p53 immunohistochemical analysis in the confirmation of Barrett's dysplasia make difference?

    Directory of Open Access Journals (Sweden)

    César Vivian Lopes

    2005-12-01

    Full Text Available RACIONAL: O esôfago de Barrett é uma complicação da doença do refluxo gastroesofágico com importante potencial de malignização. Relata-se que a expressão do marcador tumoral p53 se acentua com a progressão displasia-adenocarcinoma. OBJETIVO: Avaliar a expressão da p53 no epitélio de Barrett com presença ou não de displasia conforme dois critérios de positividade. MATERIAL E MÉTODOS: O material foi constituído por biopsias endoscópicas de 42 doentes com esôfago de Barrett. Cortes histológicos foram corados pela hematoxilina-eosina, pelo PAS-alcian blue e avaliados quanto à expressão imunoistoquímica da p53. O diagnóstico de displasia foi firmado pela concordância entre três patologistas. Foram utilizados dois critérios de positividade para a p53: 1. a coloração de, pelo menos, metade dos núcleos e 2. o encontro de qualquer núcleo corado. RESULTADOS: O número total de fragmentos foi de 229, com média de 5,4 por paciente. A displasia foi detectada em seis (14,3% casos. Para diferentes critérios de positividade, a p53 foi detectada, respectivamente, em 5 (13,9% e 14 (38,9% com epitélio metaplásico não-displásico. Especificamente nos seis casos displásicos, a p53 foi detectada, conforme o critério de positividade, em um (16,7% e quatro (66,7% casos, respectivamente. CONCLUSÕES: Nesta pequena série, a expressão imunoistoquímica da p53, independente do critério de positividade, não foi de auxílio para a confirmação de alterações displásicas no esôfago de Barrett.BACKGROUND: Barrett's esophagus is the most serious complication of the gastroesophageal reflux disease and presents a malignant potential. The expression of the tumoral marker p53 increases with the dysplasia-adenocarcinoma sequence. AIMS: To evaluate the p53 expression in Barrett's esophagus with or without dysplasia according to the two positive immunostaining criteria. MATERIALS AND METHODS: The material was constituted by endoscopic

  10. Radiosensitivity of carcinoma of esophagus

    International Nuclear Information System (INIS)

    With a detailed graphic reconstruction of radiation effects shown in 11 operation materials of carcinoma of esophagus with preoperative irradiation, histologic analysis of the radiosensitivity was made. Residual cancer lesions in 11 operation specimens contained adenocarcinoma elements. Carcinoma of esophagus belonged to mixed carcinoma (syn. metaplastic cancer). Radioresistant nature resulted from the remnant adenocarcinoma elements. Protruded type (3 cases) showed about 60 % of residual cancer after preoperative irradiation of 40 Gy (Lineac or 60Co.). The residual cancer nests histologically revealed well-differentiated squamous cell carcinoma with a few signet-ring cells, compatible with mucoepidermoid carcinoma. In protruded type, the mixed carcinoma was composed of segmental, disproportioned zonal squamous metaplasia. As its histogenetic origin, a main duct of esophageal gland was suggested. In 9 autopsy cases of esophageal cancer, recurrent lesion within the field of irradiation failed to respond to radiotherapy. In recurrent residual lesions, a higher proportion of adenocarcinoma elements was noticed. Therefore, the cancer part formed by a high rate of metaplasia was markedly responsive to irradiation, whereas increased residue of adenocarcinoma elements was enhanced the radioresistant property. In a middle thoracic esophagus (Im) corresponding to the commonest site of esophageal cancer, the distribution of esohageal glands was in a high density with a constant ratio of density in each age group particularly in male. In age groups with higher incidence of carcinoma of esophagus, esophageal glands markedly increased especially in male, in contrast with the indefinite number and density ratio in female cases. A high density of esophageal glands was noticed in the upper (Iu) and lower (Im) parts of the 2nd physiologic constriction, in proportion to the commonest site of carcinoma of esophagus. (J.P.N.)

  11. Influence of Life Style Factors on Barrett's Oesophagus.

    Science.gov (United States)

    Horna Strand, A; Franzén, T

    2014-01-01

    Background. Since the incidence of adenocarcinoma of the oesophagus is rising, the prognosis is poor, and surveillance programs are expensive and mostly cost ineffective, there is a need to increase the knowledge of risk factors in Barrett's oesophagus and oesophageal cancer in order to be able to give attention to medical prevention and/or surveillance programs. Aim. To study if there is a correlation between the development of Barrett's oesophagus and GOR (gastro oesophageal reflux), family history of GOR, and life style factors, such as alcohol, smoking habits, and mental stress. Methods. Fifty-five consecutively selected patients with Barrett's oesophagus (BO) examined at Linköping University Hospital's Oesophageal Laboratory were matched by sex, age, and duration of reflux symptoms with 55 GOR patients without Barrett's oesophagus at the Oesophageal Laboratory. The medical charts in respective groups were examined for comparison of life style factors, mental stress, medication, duration of gastroesophageal acid reflux at 24 hr-pH-metry, and incidence of antireflux surgery and of adenocarcinoma of the oesophagus (ACO). Also, potential gender differences and diagnosis of ACO were studied. Results. Mean percentage reflux time on 24 hr-pH-metry was higher for the Barrett's oesophagus group, 18% for women and 17% for men compared to 4% for women and 4% for men in the control group (P < 0.05). Family history of GOR was more frequent in Barrett's oesophagus patients (62%) than in the control group (35%) (P < 0.05). Male patients with Barrett's oesophagus had medical therapy for their GOR symptoms to a higher extent (38%) than male controls (65%) (P < 0.05). No difference was found in the number of tobacco users or former tobacco users between Barrett's oesophagus patients and controls. Barrett's oesophagus patients had the same level of alcohol consumption and the same average BMI as the control subjects. Female patients with Barrett's oesophagus rated

  12. Safety and efficacy of endoscopic spray cryotherapy for Barrett's dysplasia: results of the National Cryospray Registry.

    Science.gov (United States)

    Ghorbani, S; Tsai, F C; Greenwald, B D; Jang, S; Dumot, J A; McKinley, M J; Shaheen, N J; Habr, F; Coyle, W J

    2016-04-01

    Retrospective series have shown the efficacy of endoscopic spray cryotherapy in eradicating high-grade dysplasia (HGD) in Barrett's esophagus (BE); however, prospective data are lacking, and efficacy for low-grade dysplasia (LGD) is unclear. The aim of this study was to assess the efficacy and safety of spray cryotherapy in patients with LGD or HGD. A multicenter, prospective open-label registry enrolled patients with dysplastic BE. Spray cryotherapy was performed every 2-3 months until there was no endoscopic evidence of BE and no histological evidence of dysplasia, followed by surveillance endoscopies up to 2 years. Primary outcome measures were complete eradication of dysplasia (CE-D) and complete eradication of all intestinal metaplasia (CE-IM). Ninety-six subjects with Barrett's dysplasia (67% HGD; 65% long-segment BE; mean length 4.5 cm) underwent 321 treatments (mean 3.3 per subject). Mean age was 67 years, 83% were male. Eighty patients (83%) completed treatment with follow-up endoscopy (mean duration 21 months). In patients with LGD, rate of CE-D was 91% (21/23) and rate of CE-IM was 61% (14/23). In HGD, CE-D rate was 81% (46/57) and CE-IM was 65% (37/57). In patients with short-segment BE (SSBE) with any dysplasia, CE-D was achieved in 97% (30/31) and CE-IM in 77% (24/31). There were no esophageal perforations or related deaths. One subject developed a stricture, which did not require dilation. One patient was hospitalized for bleeding in the setting of non-steroidal anti-inflammatory drug use. In the largest prospective cohort to date, data suggest endoscopic spray cryotherapy is a safe and effective modality for eradication of BE with LGD or HGD, particularly with SSBE. PMID:25708903

  13. Dynamic clonal equilibrium and predetermined cancer risk in Barrett's oesophagus.

    Science.gov (United States)

    Martinez, Pierre; Timmer, Margriet R; Lau, Chiu T; Calpe, Silvia; Sancho-Serra, Maria Del Carmen; Straub, Danielle; Baker, Ann-Marie; Meijer, Sybren L; Kate, Fiebo J W Ten; Mallant-Hent, Rosalie C; Naber, Anton H J; van Oijen, Arnoud H A M; Baak, Lubbertus C; Scholten, Pieter; Böhmer, Clarisse J M; Fockens, Paul; Bergman, Jacques J G H M; Maley, Carlo C; Graham, Trevor A; Krishnadath, Kausilia K

    2016-01-01

    Surveillance of Barrett's oesophagus allows us to study the evolutionary dynamics of a human neoplasm over time. Here we use multicolour fluorescence in situ hybridization on brush cytology specimens, from two time points with a median interval of 37 months in 195 non-dysplastic Barrett's patients, and a third time point in a subset of 90 patients at a median interval of 36 months, to study clonal evolution at single-cell resolution. Baseline genetic diversity predicts progression and remains in a stable dynamic equilibrium over time. Clonal expansions are rare, being detected once every 36.8 patient years, and growing at an average rate of 1.58 cm(2) (95% CI: 0.09-4.06) per year, often involving the p16 locus. This suggests a lack of strong clonal selection in Barrett's and that the malignant potential of 'benign' Barrett's lesions is predetermined, with important implications for surveillance programs. PMID:27538785

  14. Clinico-roentgenological diagnosis of esophagus dyskinesia

    International Nuclear Information System (INIS)

    Modern data on clinico-roentgenological manifestations of esophagus dyskinesia are generalized. Using experience gained for many years in the examination of numerous patients and critical analysis of domestic and foreign literature, the classification of dyskinesia types is suggested. Part of the material is studied, using the most recent methods - roentgenocinematography and roentgenotonometry of esophagus. The description of cardiospasm, esophagospasm, esophagus, hypokinesia, achalasia and chalasia of cardia is given. Problems of differential diagnosis both of intragroup and similar to the clinical manifestations of esophagus diseases, are considered

  15. Non-neoplastic disorders of the esophagus

    International Nuclear Information System (INIS)

    Non-neoplastic disorders of the esophagus include esophagitis, esophageal diverticulum, esophageal injury, foreign body, fistulous formation between the esophagus and the surrounding structures and mucocele. Since these disorders have variable symptoms and radiologic findings, it needs to differentiated from other disorders other than esophageal diseases. Being knowledgeable of CT findings suggest that these disorders can help diagnose non-neoplastic disorders of the esophagus. The purpose of this pictorial essay is to review the CT appearance of non-neoplastic disorders of the esophagus.

  16. Non-neoplastic disorders of the esophagus

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Min Ji; Kim, Young Tong [Dept. of Radiology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan (Korea, Republic of)

    2013-07-15

    Non-neoplastic disorders of the esophagus include esophagitis, esophageal diverticulum, esophageal injury, foreign body, fistulous formation between the esophagus and the surrounding structures and mucocele. Since these disorders have variable symptoms and radiologic findings, it needs to differentiated from other disorders other than esophageal diseases. Being knowledgeable of CT findings suggest that these disorders can help diagnose non-neoplastic disorders of the esophagus. The purpose of this pictorial essay is to review the CT appearance of non-neoplastic disorders of the esophagus.

  17. A Critical Review Syd Barrett: A Very Irregular Head

    OpenAIRE

    Chapman, Rob

    2011-01-01

    This Literature Review contextualises the work I undertook for „Syd Barrett: A Very Irregular Head,‟ (1) a 140,000 word biography based on the life of the musician Syd Barrett, lead guitarist, vocalist, and principal songwriter in the original line up of Pink Floyd. The book is based on two and a half years of focussed research, carried out between January 1997 and August 2009. During this time I interviewed family, friends, schoolmates, fellow college students, musicians, a...

  18. Foreign bodies in the esophagus

    International Nuclear Information System (INIS)

    Foreign bodies (FB) in the esophagus (FBE) is one of the most frequent emergency consultations in the gastroenterology service and involves in its management specialties such as: surgery, otolaryngology and radiology. The type of foreign body and its incidence varies according to the geographical region and the age of the patients. there is controversy on the predictive value of the symptoms and the final finding of a foreign body. Likewise, the initial management protocol and the endoscopic intervention vary. Descriptive observational case-series study. Study performed from July 2004 to January 2006, patients more than one year of age were included in the study, with clinical suspicion of foreign body, attended at el Tunal hospital, be it because they consulted to this institution or because they wear referred from other centers belonging to the health district network, covering patient population of the socioeconomic layers 1 to 3. Suspicion of impaction less than seven days of evolution. Exclusion criteria. Patients less than one year old, and those not accepting to participate in the study. All of the patients were filled out a form including the target measurement variables. The objectives were as follows: 1. to determine the clinical useful parameters to predict if a foreign body is found during the higher digestive endoscopy. 2. Establish the frequency and location of the various foreign bodies. 3. Determine the efficacy of flexible endoscopy for extracting foreign bodies lodged in the esophagus. Results. 110 patients were included in the study, 50% of them male. Age span ranged from 1 to 79 o seven years old. 15% were less than 10 years old. In 60 of them a foreign body was found. The patients presented to the hospital 2 to 72 hours after initiation and upper gi tract endoscopy was performed within 12 hours after admission. The most frequent site of impaction was the upper esophagus, 58% (35/60), followed by the hypopharynx in 22% of cases (13/60). Fish

  19. Comparative Multi-Epitope-Ligand-Cartography reveals essential immunological alterations in Barrett's metaplasia and esophageal adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Bertram Wiedenmann

    2010-07-01

    Full Text Available Abstract Background Barrett's esophagus (BE is caused by gastroesophageal reflux with consecutive mucosal inflammation, predisposing patients to the development of esophageal adenocarcinoma (EAC. We investigated changes in T cell-related mucosal combinatorial molecular protein patterns in both diseases using the novel Multi-Epitope-Ligand-Cartography, a unique robotic whole-cell imaging technology that simultaneously visualizes dozens of proteins in structurally intact tissues and correlates cellular localization of proteins with function. Results Biopsies were taken during endoscopy from BE, EAC, and normal control tissue, and proteomic microscopy was performed on 32 different epitopes. When the significance level was set to p For example, the number of activated apoptotic naïve and memory T cells was significantly increased only in BE, whereas the number of activated apoptotic helper and regulatory T cells was significantly elevated in BE and EAC. In contrast, the number of activated apoptotic cytotoxic T cells was significantly elevated only in EAC. Confirming different pathways in BE and EAC, the number of T lymphocytes with p53 expression and downregulation of bcl2 expression (CD3+p53+Bcl2-NfkB- was significantly increased in EAC compared to BE and controls. Interestingly, the number of precursor T cells (CD7+ was significantly elevated only in EAC. These cells lack Bax and caspase-8, suggesting impaired apoptosis in the early stages of T cell differentiation. Conclusion Proteomic analysis showed for the first time that proteins, which are critically involved in the mucosal immune system of the esophagus, are distinctly expressed in BE and EAC, whereas others are comparably altered in both diseases, suggesting that many pathogenic events might be shared by both diseases. Topological proteomic analysis, therefore, helps us to understand the different pathogenic events in the underlying disease pathways.

  20. Esophagus

    Institute of Scientific and Technical Information of China (English)

    1997-01-01

    970336 The significance of microbloodvessel quanti-tation in gastric cancer. TAO Houquan(陶厚权), et al.Surg Dept Ruijin Hosp, Shanghai 2nd Med Univ,Shanghai, 200025. Chin J Dig, 1997; 17(1): 20-22 Objectives: To investigate the correlationship be-tween microvessel quantitation, various clinicopatho-logic factors and prognosis of gastric carcinoma using

  1. Metaplasia intestinal especializada de esôfago distal na doença do refluxo gastroesofágico: prevalência e aspectos clínico-epidemiológicos Specialized intestinal metaplasia of distal esophagus in the gastroesophageal reflux disease: prevalence and clinical-demographic features

    Directory of Open Access Journals (Sweden)

    Leiber C. Caum

    2003-12-01

    , esofagite mais intensa e sem associação com tabaco ou álcool.BACKGROUND: Specialized intestinal metaplasia can be categorized according endoscopic and histological findings in long segment Barrett, short segment Barrett and specialized intestinal metaplasia of cardia. Barrett's esophagus is an acquired disease that is found in about 10%-13% of patients undergoing endoscopy for symptoms of gastroesophageal reflux disease and it is well established as predisposing to esophageal adenocarcinoma. The columnar epithelium with goblet cells replaces the normal squamous epithelium. OBJECTIVE: To determine the prevalence and clinical-demographic characteristics of specialized intestinal metaplasia of distal esophagus in the gastroesophageal reflux disease. METHODS: From April to October 2002, 402 patients referred to upper endoscopy due gastroesophageal reflux disease were evaluated through of a symptom questionnaire about clinical and demographic features and submitted to upper endoscopy with four-quadrant biopsies 1 cm below escamocolumnar junction. RESULTS: Eighteen point four percent of patients had specialized intestinal metaplasia, 0.5% long segment Barrett esophagus, 3.2% short segment Barrett's esophagus and 14.7% specialized intestinal metaplasia of cardia. Patients with Barrett's esophagus showed a tendency to be male and specialized metaplasia of cardia to be female. All patients with Barrett's esophagus were white. There was not association between symptoms of gastroesophageal reflux disease and specialized intestinal metaplasia, but patients with Barrett's esophagus showed a tendency to have symptoms over 5 years and had more hiatal hernia and esophagitis. The use of alcohol and tobacco was not related to the presence of specialized intestinal metaplasia. CONCLUSIONS: Barrett's esophagus was more related to the male gender, gastroesophageal reflux disease symptoms for 5 years or longer, more intense esophagitis and hiatal hernia, but was not related to the use of

  2. Sonographic findings of Juxta- and subdiaphragmatic esophagus

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kwang Sul; Hwang, Dae Hyun; Kim, Ho Kyun; Shim, Jae Chan; Jeon, Woo Ki; Kim, Jung Suk; Lee, Ghi Jai; Jeon, Jung Dong; Han, Chang Yul; Song, Mun Gap [Inje University Paik Hospital, Busan (Korea, Republic of)

    1990-12-15

    During two months from May, 1989, sonographic findings of Juxta- and subdiaphragmatic esophagus were obtained in 120 cases (88%) among 137 cases of normal patients. The esophageal wall is seen as three different echoic layers; hyperechoic mucosa, hypoechoic intervening layers, hyperechoic adventitia. The esophageal image is truncated horn shape (66%) and tubular shape (34%) on longitudinal section, and oval shape (97%) on cross section. The quality of esophageal image is intimately proportionate to the degree of the development of left lobe of liver. On abdominal ultrasonogram, the normal esophageal image of Juxta- and subdiaphragmatic esophagus will be used for evaluation of the pathology of the esophagus.

  3. Esofagectomia transiatal para o tratamento do adenocarcinoma do esôfago Transhiatal esofagectomy for adenocarcinoma of the esophagus

    Directory of Open Access Journals (Sweden)

    Dino Antonio Oswaldo Altmann

    1999-10-01

    Full Text Available A esofagite de refluxo associada ao epitélio de colunar do esôfago predispõe ao adenocarcinoma, cuja incidência vem aumentando nos últimos anos. Entre 1976 e 1993, os autores trataram 11 pacientes com adenocarcinoma primário do esôfago. Em dois casos, a neoplasia desenvolveu-se em epitélio colunar ectópico no esôfago cervical e torácico. Nos demais casos, ocorreu no terço distal do esôfago em epitélio colunar de Barrett, em pacientes com sintomas clínicos de esofagite de refluxo, dos quais sete eram portadores de hérnia de hiato e refluxo gastroesofágico previamente documentados. Nove pacientes foram submetidos a esofagectomia transiatal com esofagogastroplastia, um foi submetido a esofagectomia distal com interposição de jejuno e o último a esofagogastroplastia retroestemal sem esofagectomia. A exceção de três pacientes, os demais tiveram operações consideradas curativas. Cinco doentes encontravam-se em estádios mais iniciais, ainda sem comprometimento linfonodal. Não houve mortalidade operatória, sendo que as principais complicações foram a fístula da anastomose esofagogástrica e a abertura da cavidade pleural, ambas ocorrendo em dois pacientes. A sobrevida média dos pacientes foi de 40,5 meses. Três pacientes permanecem vivos e sem evidência de doença (estádio 0, I e IIA com 64, 94 e 117 meses de seguimento. Concluiu-se que a esofagectomia neste tipo de tumor é um procedimento seguro e que a sobrevida a longo prazo é possível quando os tumores em estadio inicial são tratados adequadamente.Esophagitis associated with Barretts esophagus is a recognized predisponent factor for the development of adenocarcinoma. its incidence has been raising through the last years. Between 1976 and 1993, eleven patients with primary adenocarcinoma of the esophagus were treated. In two cases, the neoplasia occurred in an aberrant gastric mucosa in the cervical and thoracic esophagus. in the remaining cases, the tumor

  4. How Is Cancer of the Esophagus Diagnosed?

    Science.gov (United States)

    ... have spread outside of the esophagus. Computed tomography (CT or CAT) scan The CT scan uses x- ... medicine to help prevent and treat allergic reactions. CT-guided needle biopsy: CT scans can also be ...

  5. Foreign Body Esophagus: When Endoscopic Removal Fails…

    OpenAIRE

    Shreshtha, Diva; Sikka, Kapil; Singh, Chirom Amit; Thakar, Alok

    2013-01-01

    Aspiration or ingestion of a foreign body has frequently been reported in the pediatric and in the adult population. Among many foreign bodies to be ingested, artificial denture is one to be impacted in the esophagus, especially among the elderly. Radiolucency of dental prosthesis complicates early diagnosis of an impacted or ingested dental prosthesis. Rigid and flexible esophagoscopes have been used to retrieve the foreign body from the esophagus but the need for open surgery to remove the ...

  6. Antiinflammatory agents protect opossum esophagus during radiotherapy

    International Nuclear Information System (INIS)

    Eighteen opossums received 2250 rad 60Co to the entire esophagus and lower esophageal sphincter. Animals received treatment with 600 mg aspirin, 25 mg/kg hydrocortisone, or saline before irradiation and twice daily for 1 week after irradiation. At 10 days postirradiation, animals were evaluated for signs of acute esophagitis by esophagoscopy and barium esophagram. Each animal was then killed and the esophagus removed and evaluated histologically. Animals treated with either aspirin or hydrocortisone had significantly milder esophagitis than control irradiated animals

  7. Barrett's oesophagus: Evidence from the current meta-analyses.

    Science.gov (United States)

    Gatenby, Piers; Soon, Yuen

    2014-08-15

    Guidelines have been published regarding the management of Barrett's oesophagus (columnar-lined oesophagus). These have examined the role of surveillance in an effort to detect dysplasia and early cancer. The guidelines have provided criteria for enrolment into surveillance and some risk stratification with regard to surveillance interval. The research basis for the decisions reached with regard to cancer risk is weak and this manuscript has examined the available data published from meta-analyses up to 25(th) April 2013 (much of which has been published since the guidelines and their most recent updates have been written). There were 9 meta-analyses comparing patients with Barrett's oesophagus to control populations. These have demonstrated that Barrett's oesophagus is more common in males than females, in subjects who have ever smoked, in subjects with obesity, in subjects with prolonged symptoms of gastro-oesophageal reflux disease, in subjects who do not have infection with Helicobacter pylori and in subjects with hiatus hernia. These findings should inform public health measures in reducing the risk of Barrett's oesophagus and subsequent surveillance burden and cancer risk. There were 8 meta-analyses comparing different groups of patients with Barrett's oesophagus with regard to cancer risk. These have demonstrated that there was no statistically significant benefit of antireflux surgery over medical therapy, that endoscopic ablative therapy was effective in reducing cancer risk that there was similar cancer risk in patients with Barrett's oesophagus independent of geographic origin, that the adenocarcinoma incidence in males is twice the rate in females, that the cancer risk in long segment disease showed a trend to be higher than in short segment disease, that there was a trend for higher cancer risk in low-grade dysplasia over non-dysplastic Barrett's oesophagus, that there is a lower risk in patients with Helicobacter pylori infection and that there is a

  8. Latest developments in the endoscopic management of gastroesophageal reflux disease and Barrett's esophagus: An overview of the year's literature

    NARCIS (Netherlands)

    J.J.G.H.M. Bergman

    2006-01-01

    The development of endoscopic techniques for the treatment of gastroesophageal reflux disease has come to an abrupt halt after some of the most widely disseminated and best evaluated techniques were withdrawn from the market. This underlines the importance of conducting high-quality endoscopic resea

  9. Fibrovascular polyp of the hypopharynx and esophagus

    Institute of Scientific and Technical Information of China (English)

    WANG Jun; HAN De-min; NI Xin; MA Li-jing; YE Jing-ying; XIAO Yang

    2011-01-01

    Fibrovascular polyp of the hypopharynx and esophagus, a rare, benign, intraluminal and submucosal tumor, is most commonly originated from the proximal esophagus. We discussed four cases with regurgitation, respiratory symptom or the feeling of a mass in the throat. All the patients were examined with laryngoscope under general anesthesia. A transverse cervical incision was performed in one patient and the polyps were excised under laryngoscope with CO2 laser in the other three patients. All the lesions were removed successfully. Diagnostic and therapeutic principles involved in these cases are presented and discussed. The recognition of fibrovascular polyp of the hypopharynx and esophagus as a potential cause of regurgitation is paramount. Surgical excision is recommended because of the satisfactory outcome.

  10. Granular cell tumor of the esophagus.

    Science.gov (United States)

    Patel, R M; DeSota-LaPaix, F; Sika, J V; Mallaiah, L R; Purow, E

    1981-12-01

    Two cases of granular cell tumor of the esophagus are reported and the main features of the previously reported cases are summarized. Dysphagia and substernal discomfort or pain are the most common symptoms seen and are likely to occur with lesions greater than 1 cm. in diameter. The diagnosis should be considered in adult females with an intramural mass of the esophagus. The cell of origin is still disputed. The treatment of choice, when the patient is symptomatic or the lesion greater than 1 cm. in size, is local resection. The tumor, when incidentally discovered in an asymptomatic patient, may safely be followed endoscopically. PMID:6277183

  11. The Barrett-Crane model: asymptotic measure factor

    Science.gov (United States)

    Kamiński, Wojciech; Steinhaus, Sebastian

    2014-04-01

    The original spin foam model construction for 4D gravity by Barrett and Crane suffers from a few troubling issues. In the simple examples of the vertex amplitude they can be summarized as the existence of contributions to the asymptotics from non-geometric configurations. Even restricted to geometric contributions the amplitude is not completely worked out. While the phase is known to be the Regge action, the so-called measure factor has remained mysterious for a decade. In the toy model case of the 6j symbol this measure factor has a nice geometric interpretation of V-1/2 leading to speculations that a similar interpretation should be possible also in the 4D case. In this paper we provide the first geometric interpretation of the geometric part of the asymptotic for the spin foam consisting of two glued 4-simplices (decomposition of the 4-sphere) in the Barrett-Crane model in the large internal spin regime.

  12. Medical image of the week: massive esophagus

    Directory of Open Access Journals (Sweden)

    Young JR

    2013-10-01

    Full Text Available No abstract available. Article truncated at 150 words. A 34 year-old male inmate presents with chest pain 10 years prior to admission. His prior chest x-ray shows only mild thickening of the right paraspinal stripe (Figure 1. Chest x-ray on admission 10 years later shows a large right mixed density paramediastinal mass silhouetting the right pulmonary artery and right paratracheal stripe (Figure 2. This was confirmed to be a massive esophagus on thoracic CT scan (Figure 3. The patient was eventually diagnosed with achalasia. A number of disorders can present with a massive esophagus including achalasia, esophagectomy with colonic interposition, scleroderma, esophageal carcinoma with stricture, and esophagitis with stricture (1. Diagnostic imaging findings using fluroscopy, CT and X-ray can help differentiate these disorders. A massive esophagus due to achalasia is smooth walled with symmetric tapering to a "bird-beak" deformity and a chest x-ray may initially be normal. Colonic interposition is evident by colonic haustra. A dilated esophagus due …

  13. Crohn's disease masquerading carcinoma of the esophagus

    International Nuclear Information System (INIS)

    We present a 47-year-old patient with progressive dysphagia. Upper gastrointestinal endoscopy revealed middle third esophageal ulcer, the histology of which was moderately differentiated carcinoma. The patient underwent 3-stage esophagectomy with cervical gastro esophageal anastomosis. The histopathology revealed Crohn's disease of the esophagus. The clinical features and diagnosis of this rare condition are described, the review of the literature. (author)

  14. Lagrangian approach to the Barrett-Crane spin foam model

    International Nuclear Information System (INIS)

    We provide the Barrett-Crane spin foam model for quantum gravity with a discrete action principle, consisting in the usual BF term with discretized simplicity constraints which in the continuum turn topological BF theory into gravity. The setting is the same as usually considered in the literature: space-time is cut into 4-simplices, the connection describes how to glue these 4-simplices together and the action is a sum of terms depending on the holonomies around each triangle. We impose the discretized simplicity constraints on disjoint tetrahedra and we show how the Lagrange multipliers distort the parallel transport and the correlations between neighboring simplices. We then construct the discretized BF action using a noncommutative * product between SU(2) plane waves. We show how this naturally leads to the Barrett-Crane model. This clears up the geometrical meaning of the model. We discuss the natural generalization of this action principle and the spin foam models it leads to. We show how the recently introduced spin foam fusion coefficients emerge with a nontrivial measure. In particular, we recover the Engle-Pereira-Rovelli spin foam model by weakening the discretized simplicity constraints. Finally, we identify the two sectors of Plebanski's theory and we give the analog of the Barrett-Crane model in the nongeometric sector.

  15. Automatic classification of endoscopic images for premalignant conditions of the esophagus

    Science.gov (United States)

    Boschetto, Davide; Gambaretto, Gloria; Grisan, Enrico

    2016-03-01

    Barrett's esophagus (BE) is a precancerous complication of gastroesophageal reflux disease in which normal stratified squamous epithelium lining the esophagus is replaced by intestinal metaplastic columnar epithelium. Repeated endoscopies and multiple biopsies are often necessary to establish the presence of intestinal metaplasia. Narrow Band Imaging (NBI) is an imaging technique commonly used with endoscopies that enhances the contrast of vascular pattern on the mucosa. We present a computer-based method for the automatic normal/metaplastic classification of endoscopic NBI images. Superpixel segmentation is used to identify and cluster pixels belonging to uniform regions. From each uniform clustered region of pixels, eight features maximizing differences among normal and metaplastic epithelium are extracted for the classification step. For each superpixel, the three mean intensities of each color channel are firstly selected as features. Three added features are the mean intensities for each superpixel after separately applying to the red-channel image three different morphological filters (top-hat filtering, entropy filtering and range filtering). The last two features require the computation of the Grey-Level Co-Occurrence Matrix (GLCM), and are reflective of the contrast and the homogeneity of each superpixel. The classification step is performed using an ensemble of 50 classification trees, with a 10-fold cross-validation scheme by training the classifier at each step on a random 70% of the images and testing on the remaining 30% of the dataset. Sensitivity and Specificity are respectively of 79.2% and 87.3%, with an overall accuracy of 83.9%.

  16. Another View of Dynamic Criteria: A Critical Reanalysis of Barrett, Caldwell, and Alexander.

    Science.gov (United States)

    Austin, James T.; And Others

    1989-01-01

    A critical reanalysis of Barrett, Caldwell, and Alexander's (1985) critique of dynamic criteria. Summarizes and questions Barrett, et al.'s three definitions of dynamic criteria and their conclusion that reported temporal changes in criteria could be explained by methodological artifacts. A greater focus on dynamic criteria as constructs is…

  17. An unusual foreign body of esophagus

    Directory of Open Access Journals (Sweden)

    Surinder K Singhal

    2010-07-01

    Full Text Available We report a rare case of an unusually long foreign body (Datun impacted in the esophagus of a 56 year-old gentleman. He was literate, without any psychiatric illness and had been using “Neem” (Azadirachta indica stick for cleaning his teeth for the past twenty years. Neem sticks are used for brushing teeth, perhaps one of the earliest and very effective dental care. On closer questioning he revealed his habit of passing the Neem stick into his throat with the aim of cleaning it too while cleaning his teeth. He presented to our emergency early in the morning with this strange long foreign body impacted in his esophagus which was removed successfully using a Jackson’s adult rigid oesophagoscope. We believe this to be the first case of such an unusually long foreign body to be reported in the literature.

  18. Primary malignant melanoma of the esophagus.

    Science.gov (United States)

    Jora, Charu; Pankaj, Promila; Verma, Ritu; Jain, Anjali; Belho, Ethel S

    2015-01-01

    Primary malignant melanoma most commonly originates from the skin; other less common extra cutaneous sites include squamous mucous membranes, uvea, retina, leptomeninges, genitourinary tract, digestive tract, biliary tract, and upper respiratory tract. Primary melanoma of the gastrointestinal tract is exceedingly rare. We are reporting a histo-pathologically proven rare case of primary malignant melanoma of the esophagus and its findings on fluorodeoxyglucose positron emission tomography and computed tomography. PMID:25829739

  19. Primary malignant melanoma of the esophagus

    International Nuclear Information System (INIS)

    Primary malignant melanoma most commonly originates from the skin; other less common extra cutaneous sites include squamous mucous membranes, uvea, retina, leptomeninges, genitourinary tract, digestive tract, biliary tract, and upper respiratory tract. Primary melanoma of the gastrointestinal tract is exceedingly rare. We are reporting a histo-pathologically proven rare case of primary malignant melanoma of the esophagus and its findings on fluorodeoxyglucose positron emission tomography and computed tomography

  20. Chemotherapy in cancer of the esophagus

    OpenAIRE

    Kok, Tjebbe

    1997-01-01

    textabstractAl though cancer of the esophagus has been recogni zed as a fatal disease as long ago as the start of the Christian era, the present outlook remains dismal. Less than 10 percent of patients with seemingly localized disease, surgically treated with curative intent, will survive five years or more. Dysphagia, the initial symptom in most patients, usually occurs late in the course of the disease, when the esophageal wall has been infiltrated or penetrated. At this time, in the majori...

  1. Eosinophilic esophagitis: asthma of the esophagus?

    Science.gov (United States)

    Arora, Amindra S; Yamazaki, Kiyoshi

    2004-07-01

    Eosinophilic esophagitis (EE) is rapidly emerging as a distinct disease entity in both pediatric and adult gastroenterology. The typical clinical presentation includes solid food dysphagia in young men who have an atopic predisposition. Food impaction necessitating endoscopic intervention is common. EE should be suspected, in particular, in patients with unexplained dysphagia or those with no response to antacid or anti-acid secretory therapy. Careful endoscopic and radiographic examinations reveal furrows, corrugations, rings, whitish plaques, fragile crêpe paper-like appearance, and a small-caliber esophagus. Mucosal erosion in the distal esophagus, characteristic to reflux esophagitis, is absent in EE. Marked eosinophil infiltration in the esophageal epithelia (>20 eosinophils per high-power field) is the diagnostic hallmark. Food antigens and aeroallergens may play a role in the pathogenesis of EE. The mechanisms may be dependent or independent of immunoglobulin E. Elimination diets, systemic and topical corticosteroids, leukotriene receptor antagonists, and, most recently, an anti-interleukin-5 monoclonal antibody have been used to treat EE. EE likely represents another example of eosinophil-associated inflammation of epithelia at the interface between external and internal milieu, similar to bronchial asthma and atopic dermatitis. This review summarizes recent progress in the diagnosis and management of EE and discusses future research directions. PMID:15224275

  2. Endoscopic regression of Barrett's oesophagus during omeprazole treatment; a randomised double blind study

    OpenAIRE

    Peters, F.; Ganesh, S.; Kuipers, E.; Sluiter, W; Klinkenberg-Knol, E; Lamers, C; Kleibeuker, J

    1999-01-01

    BACKGROUND—Barrett's oesophagus, columnar metaplasia of the epithelium, is a premalignant condition with a 50-100-fold increased risk of cancer. The condition is caused by chronic gastro-oesophageal reflux. Regression of metaplasia may decrease the cancer risk.
AIMS—To determine whether elimination of acid gastro-oesophageal reflux induces a regression of metaplastic epithelium.
METHODS—Sixty eight patients with acid reflux and proven Barrett's oesophagus were included in a prospective, rando...

  3. Staging by tomography: Lung, esophagus, mama and pleural cancer

    International Nuclear Information System (INIS)

    This presentation shows images of different types of cancer in the lung, esophagus, mama and pleura. The chest radiography, computed tomography, magnetic resonance and PET CT contribute to detect the morphology, size, location, metastasize, malignant and benign nodules, lymph glands.

  4. Difficult factors in Management of Impacted Dental Prosthesis in Esophagus

    OpenAIRE

    Efiaty A. Soepardi

    2005-01-01

    A dental prosthesis which ingested and impacted in esophagus, is an emergency case and life threatening, so require immediate esophagoscopy intervention for removing. The objective of this study is to assess some factors can caused dtfficulties in diagnosing and treating the ingested and impacted dental prosthesis in the esophagus and their complications. This retrospective study analyzed patient’s chart whose underwent esophagoscopy for removing the impacted dental prosthesis in Dr. Cipto Ma...

  5. Longitudinal Muscle Dysfunction in Achalasia Esophagus and Its Relevance

    OpenAIRE

    Mittal, Ravinder K.; Hong, Su Jin; Bhargava, Valmik

    2013-01-01

    Muscularis propria of the esophagus is organized into circular and longitudinal muscle layers. Goal of this review is to summarize the role of longitudinal muscle in physiology and pathophysiology of esophageal sensory and motor function. Simultaneous manometry and ultrasound imaging that measure circular and longitudinal muscle contraction respectively reveal that during peristalsis 2 layers of the esophagus contract in perfect synchrony. On the other hand, during transient relaxation of the...

  6. Trimodal therapy in squamous cell carcinoma of the esophagus

    OpenAIRE

    Matuschek C; Bölke E; Zahra T; Knoefel WT; Peiper M; Budach W; Erhardt A; Scherer A; Baldus SE; Gerber PA; Buhren BA; Schauer M; Hoff N-Ph; Gattermann N; Orth K

    2011-01-01

    Abstract Patients with ESCC (squamous cell carcinoma of the esophagus) are most commonly diagnosed with locally advanced tumor stages. Early metastatic disease and late diagnosis are common reasons responsible for this tumor's poor clinical outcome. The prognosis of esophageal cancer is very poor because patients usually do not have symptoms in early disease stages. Squamous cell carcinoma of the esophagus frequently complicates patients with multiple co-morbidities and these patients often r...

  7. Risk factors for Barrett's oesophagus and oesophageal adenocarcinoma: Results from the FINBAR study

    Institute of Scientific and Technical Information of China (English)

    Lesley A Anderson; RG Peter Watson; Seamus J Murphy; Brian T Johnston; Harry Comber; Jim Mc Guigan; John V Reynolds; Liam J Murray

    2007-01-01

    AIM: To investigate risk factors associated with Barrett's oesophagus and oesophageal adenocarcinoma.METHODS: This all-Ireland population-based case-control study recruited 224 Barrett's oesophagus patients, 227 oesophageal adenocarcinoma patients and 260 controls. All participants underwent a structured interview with information obtained about potential lifestyle and environmental risk factors.RESULTS: Gastro-oesophageal reflux was associated with Barrett's [OR 12.0 (95% CI 7.64-18.7)] and oesophageal adenocarcinoma [OR 3.48 (95% CI 2.25-5.41)]. Oesophageal adenocarcinoma patients were more likely than controls to be ex- or current smokers [OR 1.72 (95% CI 1.06-2.81) and OR 4.84 (95% CI 2.72-8.61) respectively] and to have a high body mass index [OR 2.69 (95% CI 1.62-4.46)]. No significant associations were observed between these risk factors and Barrett's oesophagus. Fruit but not vegetables were negatively associated with oesophageal adenocarcinoma [OR 0.50 (95% CI 0.30-0.86)].CONCLUSION: A high body mass index, a diet low in fruit and cigarette smoking may be involved in the progression from Barrett's oesophagus to oesophageal adenocarcinoma.

  8. Diagnostic ability of Barrett's index to detect dysthyroid optic neuropathy using multidetector computed tomography

    International Nuclear Information System (INIS)

    Objectives: The objective of this study was to evaluate the ability of a muscular index (Barrett's Index), calculated with multidetector computed tomography, to detect dysthyroid optic neuropathy in patients with Graves' orbitopathy. Methods: Thirty-six patients with Graves' orbitopathy were prospectively studied and submitted to neuro-ophthalmic evaluation and multidetector computed tomography scans of the orbits. Orbits were divided into two groups: those with and without dysthyroid optic neuropathy. Barrett's index was calculated as the percentage of the orbit occupied by muscles. Sensitivity and specificity were determined for several index values. Results: Sixty-four orbits (19 with and 45 without dysthyroid optic neuropathy) met the inclusion criteria for the study. The mean Barrett's index values (±SD) were 64.47% ± 6.06% and 49.44% ± 10.94% in the groups with and without dysthyroid optic neuropathy, respectively (p60% should be carefully examined and followed for the development of dysthyroid optic neuropathy. (author)

  9. Role of gastrin-peptides in Barrett's and colorectal carcinogenesis

    Institute of Scientific and Technical Information of China (English)

    Eduardo Chueca; Angel Lanas; Elena Piazuelo

    2012-01-01

    Gastrin is the main hormone responsible for the stimulation of gastric acid secretion; in addition,gastrin and its derivatives exert proliferative and antiapoptotic effects on several cell types.Gastrin synthesis and secretion are increased in certain situations,for example,when proton pump inhibitors are used.The impact of sustained hypergastrinemia is currently being investigated.In vitro experiments and animal models have shown that prolonged hypergastrinemia may be related with higher cancer rates; although,this relationship is less clear in human beings.Higher gastrin levels have been shown to cause hyperplasia of several cell types; yet,the risk for developing cancer seems to be the same in normo-and hypergastrinemic patients.Some tumors also produce their own gastrin,which can act in an autocrine manner promoting tumor growth.Certain cancers are extremely dependent on gastrin to proliferate.Initial research focused only on the effects of amidated gastrins,but there has been an interest in intermediates of gastrin in the last few decades.These intermediates aren't biologically inactive;in fact,they may exert greater effects on proliferation and apoptosis than the completely processed forms.In certain gastrin overproduction states,they are the most abundant gastrin peptides secreted.The purpose of this review is to examine the gastrin biosynthesis process and to summarize the results from different studies evaluating the production,levels,and effects of the main forms of gastrin in different overexpression states and their possible relationship with Barrett's and colorectal carcinogenesis.

  10. Detection of Helicobacter pylori in saliva and esophagus.

    Science.gov (United States)

    Cellini, Luigina; Grande, Rossella; Artese, Luciano; Marzio, Leonardo

    2010-10-01

    The route of Helicobacter pylori transmission remains unclear and the currently suggested route is person-to-person transfer by faecal-oral and oral-oral mode. The aim of this study was to verify the presence of H. pylori in esophagus and saliva of humans. Saliva samples, mucosal biopsies from esophagus, gastric antrum and fundus were collected from 19 patients with positive Urea Breath Test (UBT). Gastric biopsies were used for H. pylori colture and antimicrobial susceptibility tests whereas saliva samples were collected to detect H. pylori with a Nested-PCR targeting 16S rRNA gene as well as esophagus biopsies which were also investigated with immunohistochemical staining. Helicobacter pylori was isolated in 18 patients both in gastric antrum and fundus. The molecular analysis, confirmed by comparative sequences evaluation, gave positive results in all saliva and esophageal samples whereas the immunohistochemistry revealed the presence of H. pylori in 15.8% (3/19) of the esophagus samples. Our data suggest that saliva and esophagus may be considered reservoirs for H. pylori in humans and emphasize the need to use more susceptible techniques for H. pylori detection, in particular in over-crowded sites. Identification of the transmission route of H. pylori is crucial in developing an effective plan of surveillance by finding new means of disease management. PMID:21213594

  11. Polymorphisms Near TBX5 and GDF7 Are Associated With Increased Risk for Barrett’s Esophagus

    Science.gov (United States)

    Palles, Claire; Chegwidden, Laura; Li, Xinzhong; Findlay, John M.; Farnham, Garry; Castro Giner, Francesc; Peppelenbosch, Maikel P.; Kovac, Michal; Adams, Claire L.; Prenen, Hans; Briggs, Sarah; Harrison, Rebecca; Sanders, Scott; MacDonald, David; Haigh, Chris; Tucker, Art; Love, Sharon; Nanji, Manoj; deCaestecker, John; Ferry, David; Rathbone, Barrie; Hapeshi, Julie; Barr, Hugh; Moayyedi, Paul; Watson, Peter; Zietek, Barbara; Maroo, Neera; Gay, Laura; Underwood, Tim; Boulter, Lisa; McMurtry, Hugh; Monk, David; Patel, Praful; Ragunath, Krish; Al Dulaimi, David; Murray, Iain; Koss, Konrad; Veitch, Andrew; Trudgill, Nigel; Nwokolo, Chuka; Rembacken, Bjorn; Atherfold, Paul; Green, Elaine; Ang, Yeng; Kuipers, Ernst J.; Chow, Wu; Paterson, Stuart; Kadri, Sudarshan; Beales, Ian; Grimley, Charles; Mullins, Paul; Beckett, Conrad; Farrant, Mark; Dixon, Andrew; Kelly, Sean; Johnson, Matthew; Wajed, Shahjehan; Dhar, Anjan; Sawyer, Elinor; Roylance, Rebecca; Onstad, Lynn; Gammon, Marilie D.; Corley, Douglas A.; Shaheen, Nicholas J.; Bird, Nigel C.; Hardie, Laura J.; Reid, Brian J.; Ye, Weimin; Liu, Geoffrey; Romero, Yvonne; Bernstein, Leslie; Wu, Anna H.; Casson, Alan G.; Fitzgerald, Rebecca; Whiteman, David C.; Risch, Harvey A.; Levine, David M.; Vaughan, Tom L.; Verhaar, Auke P.; van den Brande, Jan; Toxopeus, Eelke L.; Spaander, Manon C.; Wijnhoven, Bas P.L.; van der Laan, Luc J.W.; Krishnadath, Kausilia; Wijmenga, Cisca; Trynka, Gosia; McManus, Ross; Reynolds, John V.; O’Sullivan, Jacintha; MacMathuna, Padraic; McGarrigle, Sarah A.; Kelleher, Dermot; Vermeire, Severine; Cleynen, Isabelle; Bisschops, Raf; Tomlinson, Ian; Jankowski, Janusz

    2015-01-01

    Background & Aims Barrett's esophagus (BE) increases the risk of esophageal adenocarcinoma (EAC). We found the risk to be BE has been associated with single nucleotide polymorphisms (SNPs) on chromosome 6p21 (within the HLA region) and on 16q23, where the closest protein-coding gene is FOXF1. Subsequently, the Barrett's and Esophageal Adenocarcinoma Consortium (BEACON) identified risk loci for BE and esophageal adenocarcinoma near CRTC1 and BARX1, and within 100 kb of FOXP1. We aimed to identify further SNPs that increased BE risk and to validate previously reported associations. Methods We performed a genome-wide association study (GWAS) to identify variants associated with BE and further analyzed promising variants identified by BEACON by genotyping 10,158 patients with BE and 21,062 controls. Results We identified 2 SNPs not previously associated with BE: rs3072 (2p24.1; odds ratio [OR] = 1.14; 95% CI: 1.09–1.18; P = 1.8 × 10−11) and rs2701108 (12q24.21; OR = 0.90; 95% CI: 0.86–0.93; P = 7.5 × 10−9). The closest protein-coding genes were respectively GDF7 (rs3072), which encodes a ligand in the bone morphogenetic protein pathway, and TBX5 (rs2701108), which encodes a transcription factor that regulates esophageal and cardiac development. Our data also supported in BE cases 3 risk SNPs identified by BEACON (rs2687201, rs11789015, and rs10423674). Meta-analysis of all data identified another SNP associated with BE and esophageal adenocarcinoma: rs3784262, within ALDH1A2 (OR = 0.90; 95% CI: 0.87–0.93; P = 3.72 × 10−9). Conclusions We identified 2 loci associated with risk of BE and provided data to support a further locus. The genes we found to be associated with risk for BE encode transcription factors involved in thoracic, diaphragmatic, and esophageal development or proteins involved in the inflammatory response. PMID:25447851

  12. New method of double contrast examination of the esophagus

    International Nuclear Information System (INIS)

    Many different methods of double contrast esophagus examination exist, e.g. the air swallowing, tube inflation, gas producing or hypotonizing agent administration techniques. However, to swallow an adequate size air bubble is difficult, the insertion of an esophageal tube is inconvenient for the patient and time consuming to a certain extent, and the use of gas producing or hypotonizing compositions has some disadvantages too. Our method employs foam (whipped cream) instead of the air or carbon dioxide generally used. After consuming one tablespoonful good-quality barium sulfate esophagus paste, the patient swallows one or two tablespoonfuls whipped cream to distend the barium coated walls. Owing to the nearly airequivalent density of the foam, highquality double contrast spots can be obtained. This technique films in different obliques as well. The foam contrasting is effective even distally to a narrowed part, so the distensibility can be analyzed at full length of the esophagus. (orig.)

  13. The epidemiology of hypopharynx and cervical esophagus cancer.

    Science.gov (United States)

    Popescu, C R; Bertesteanu, S V G; Mirea, D; Grigore, Raluca; lonescu, Diana; Popescu, B

    2010-01-01

    At the beginning of the 21st century the hypopharynx and the cervical esophagus cancer represents a major issue for all countries of the world. The epidemiology of the hypopharynx and cervical esophagus cancer deals with the spread of the disease in the human population with regard to sex, age, profession, time and space, as well as risk factors that contribute to these phenomena. The main goal is to investigate the causes and the factors involved in the development of the tumors at the pharyngoesophageal junction, knowledge that contributes to the latest therapeutic assessment through interdisciplinary collaboration (E.N.T. surgeon, general surgeon, radiation oncologist, chemotherapist, and nutritionist). The epidemiology of the hypopharynx and cervical esophagus cancer includes three major areas of interest: descriptive (the study of the spread in mass population), analytical (the study of causal risk factors on the disease) and experimental (that verifies by experiments on animals the prior identified hypothesis). PMID:21254737

  14. Barrett-Crane spin foam model from generalized BF-type action for gravity

    International Nuclear Information System (INIS)

    We study a generalized action for gravity as a constrained BF theory, and its relationship with the Plebanski action. We analyze the discretization of the constraints and the spin foam quantization of the theory, showing that it leads naturally to the Barrett-Crane spin foam model for quantum gravity. Our analysis holds true in both the Euclidean and Lorentzian formulations

  15. The geometrization of matter proposal in the Barrett-Crane model and resolution of cosmological problems

    OpenAIRE

    Alexander, S.; Crane, L.; Sheppeard, M. D.

    2003-01-01

    We give an overview of the current issues in early universe cosmology and consider the potential resolution of these issues in an as yet nascent spin foam cosmology. The model is the Barrett-Crane Model for quantum gravity along with a generalization of manifold complexes to complexes including conical singularities.

  16. Janie Porter Barrett (1865-1948): Exemplary African American Correctional Educator

    Science.gov (United States)

    Muth, Bill; Gehring, Thom; Puffer, Margaret; Mayers, Camille; Kamusikiri, Sandra; Pressley, Glenda

    2009-01-01

    One problem with the literature of correctional education (CE) and prison reform is that the contributions of African Americans have been generally neglected. This is the first of three essays that will begin to fill that gap. Janie Porter Barrett was an important Virginia leader in the period before and after the turn of the 20th century. She…

  17. Norman Barrett (1903-1979): Unorthodox pioneer of thoracic and oesophageal surgery.

    Science.gov (United States)

    Edison, E; Agha, R; Camm, C

    2016-05-01

    It is an interesting quirk of medical history that the legacy of Norman Barrett most ostensibly lies in the name of a disease the he was quite emphatically wrong about, at least when he first described it. Indeed, there are those who argue to remove the eponym in favour of the title 'Columnar Lined Epithelium', in part because of what little Barrett actually had to do with the correct initial characterisation of this disease. Yet the sum of Norman Barrett's contributions to modern medicine is much more than a mistaken characterisation of a pathological process. Barrett was truly a pioneer of chest surgery in the UK - a speciality in its embryonic stages when he first qualified. He was also renowned as a teacher and academic of the highest calibre. In tracing the story of his life we can see how his natural attributes, life experiences and keen appreciation of the arts (especially history) facilitated personal success and such sharp insight into the vagaries of modern academic medicine. PMID:24802356

  18. Antiinflammatory agents protect opossum esophagus during radiotherapy. [Cobalt 60

    Energy Technology Data Exchange (ETDEWEB)

    Northway, M.G.; Eastwood, G.L.; Libshitz, H.I.; Feldman, M.S.; Mamel, J.J.; Szwarc, I.A.

    1982-10-01

    Eighteen opossums received 2250 rad /sup 60/Co to the entire esophagus and lower esophageal sphincter. Animals received treatment with 600 mg aspirin, 25 mg/kg hydrocortisone, or saline before irradiation and twice daily for 1 week after irradiation. At 10 days postirradiation, animals were evaluated for signs of acute esophagitis by esophagoscopy and barium esophagram. Each animal was then killed and the esophagus removed and evaluated histologically. Animals treated with either aspirin or hydrocortisone had significantly milder esophagitis than control irradiated animals.

  19. Malignant Schwannoma of the Esophagus: A Rare Case Report

    Science.gov (United States)

    Mishra, Biswajit; Madhusudhan, Kumble Seetharama; Kilambi, Ragini; Das, Prasenjit; Pal, Sujoy; Srivastava, Deep Narayan

    2016-01-01

    Neurogenic tumors are the most prevalent tumors of the mediastinum, and schwannomas are the most common type of neurogenic tumor. Primary neurogenic neoplasm of the esophagus is uncommon and malignant schwannoma of the esophagus is extremely rare. We report a case of a 27-year-old female presenting with dysphagia and palpitations who was found to have a lobulated tumor in the mediastinum that was compressing the esophageal lumen. The tumor was successfully treated surgically without recurrence. The final diagnosis, on histopathological examination of the specimen, was malignant schwannoma. PMID:26889451

  20. The epidemiology of hypopharynx and cervical esophagus cancer

    OpenAIRE

    Popescu, CR; Bertesteanu, SVG; Mirea, D; Grigore, R; Ionescu, D.; Popescu, B

    2010-01-01

    At the beginning of the 21st century hypopharynx and cervical esophagus cancer represents a major issue for all countries of the world. The epidemiology of the hypopharynx and cervical esophagus cancer deals with the spread of the disease in human population in regards to sex, age, profession, time and space, as well as risk factors that contribute to these phenomena. The main goal is to investigate the causes and the factors involved in the development of the tumors at the pharyngo–esophagea...

  1. Esophagectomy - minimally invasive

    Science.gov (United States)

    ... Robotic esophagectomy; Removal of the esophagus - minimally invasive; Achalasia - esophagectomy; Barrett esophagus - esophagectomy; Esophageal cancer - esophagectomy - laparoscopic; Cancer of the esophagus -esophagectomy - ...

  2. Oat cell carcinoma of the esophagus: Unusual radiological appearances

    International Nuclear Information System (INIS)

    Primary oat cell carcinoma of the esophagus is a very rare tumour. The radiographic appearance of the three cases described in this paper are unusual because they resemble benign lesions such as leiomyoma, fibrous polyp and candidiasis. It would be interesting to investigate whether such an unusual appearance is common for this neoplasm. (orig.)

  3. Oat cell carcinoma of the esophagus: Unusual radiological appearances

    Energy Technology Data Exchange (ETDEWEB)

    Bedi, D.G.; Shaw, M.T.

    1986-08-01

    Primary oat cell carcinoma of the esophagus is a very rare tumour. The radiographic appearance of the three cases described in this paper are unusual because they resemble benign lesions such as leiomyoma, fibrous polyp and candidiasis. It would be interesting to investigate whether such an unusual appearance is common for this neoplasm.

  4. Difficult factors in Management of Impacted Dental Prosthesis in Esophagus

    Directory of Open Access Journals (Sweden)

    Efiaty A. Soepardi

    2005-03-01

    Full Text Available A dental prosthesis which ingested and impacted in esophagus, is an emergency case and life threatening, so require immediate esophagoscopy intervention for removing. The objective of this study is to assess some factors can caused dtfficulties in diagnosing and treating the ingested and impacted dental prosthesis in the esophagus and their complications. This retrospective study analyzed patient’s chart whose underwent esophagoscopy for removing the impacted dental prosthesis in Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia during a period between January 1997 and December 2003. Neck-chest X-ray and esophagoscopy were performed in all patients to identify the existence of the dental prosthesis as a diagnostic and treatment procedure. The length of time for removing the dental prosthesis was recorded and stated as a less difficult esophagoscopy when it takes time less than 60 minutes and as a difficult  esophagoscopy takes 60 minutes or longer. Some risk difficulties factors were statistically analyzed. There were 53 patients of ingested dental prosthesis in esophagus. Only 51 cases were analyzed According to the length of time for removing the dental prosthesis by esophagoscopy, 22 patients were recorded as less difficult cases and 29 patients as difficult cases. Two cases among the cases needed cervicotomy after unsuccessful esophagoscopy removal. The difficulties to diagnose an impacted dental prosthesis in the esophagus caused by unreliable clinical history, unclear signs and symptoms, unable to be detected by X-ray and was not found during esophagoscopy. The difficulties in treating due to mucosal laceration, edema, bleeding, failure of the first extraction and conformity with the size and shape, the wire outside the dental prosthesis and the length of time stayed in the esophagus. (Med J Indones 2005; 14: 33-6Keywords: ingested dental prosthesis, radioluscent foreign body, length of time of esophagoscopy

  5. SYD BARRETT: WAS HE SUFFERING FROM SCHIZOPHRENIA OR ASPERGER’S SYNDROME?

    Directory of Open Access Journals (Sweden)

    Mario Campanella

    2015-06-01

    Full Text Available Roger Keith “Syd” Barrett (Cambridge, January 6, 1946 - Cambridge, July 7, 2006 was a British singer, guitarist, composer and painter, founder and leader of Pink Floyd from 1965 to 1968, when he left the group. Before retiring to private life, he recorded two solo albums, “The Madcap Laughs” and “Barrett”, published in 1970. His experience and skills strongly influenced the subsequent production of the group, especially albums like “Dark Side of the Moon”, “Wish You Were Here” and “The Wall”. The innovative guitar style of Barrett and his propensity to exploration of new experimental techniques, like the use of dissonance, distortion and feedback, had an enormous impact on several musicians, from David Bowie to Brian Eno to Jimmy Page. After his retirement, Barrett led a secluded life painting and devoted to gardening, completely ignoring all the popularity and by losing his own tracks fueling even more his legend. A series of biographies were written about him since the eighties. In any case, the Pink Floyd composed and recorded several musical tributes dedicated to him after his departure from the band. The use of synthetic drugs of any kind and social withdrawal fostered the clinical impression that Barrett was suffering from schizophrenia. Recent studies, however, would suggest the hypothesis that he was suffering from a low-functioning Asperger’s syndrome. The aim of this paper is to review Barrett’s data that would indicate that this was actually his diagnosis.

  6. Book review: Food security and sociopolitical stability edited by Christopher B. Barrett

    OpenAIRE

    Singh, Chandni

    2014-01-01

    "Food Security and Sociopolitical Stability." Christopher B. Barrett (ed). Oxford University Press. September 2013. --- Global food price spikes in 2008 and again in 2011 coincided with a surge of political unrest in low- and middle-income countries. In some places, food riots turned violent, pressuring governments and in a few cases contributed to their overthrow. Foreign investors sparked a new global land rush, adding a different set of pressures, and the spectre of widespread food insecur...

  7. Dual variables and a connection picture for the Euclidean Barrett-Crane model

    International Nuclear Information System (INIS)

    The partition function of the SO(4)- or Spin(4)-symmetric Euclidean Barrett-Crane model can be understood as the sum over all quantized geometries of a given triangulation of a four-manifold. In the original formulation, the variables of the model are balanced representations of SO(4) which describe the quantized areas of the triangles. We present an exact duality transformation for the full quantum theory and reformulate the model in terms of new variables which can be understood as variables conjugate to the quantized areas. The new variables are pairs of S3-values associated with the tetrahedra. These S3-variables parametrize the hyperplanes spanned by the tetrahedra (locally embedded in R4), and the fact that there is a pair of variables for each tetrahedron can be viewed as a consequence of an SO(4)-valued parallel transport along the edges dual to the tetrahedra. We reconstruct the parallel transport of which only the action of SO(4) on S3 is physically relevant and rewrite the Barrett-Crane model as an SO(4) lattice BF-theory living on the 2-complex dual to the triangulation subject to suitable constraints whose form we derive at the quantum level. Our reformulation of the Barrett-Crane model in terms of continuous variables is suitable for the application of various analytical and numerical techniques familiar from statistical mechanics

  8. Diagnostic ability of barrett's index to detect dysthyroid optic neuropathy using multidetector computed tomography

    Directory of Open Access Journals (Sweden)

    Mário L. R. Monteiro

    2008-01-01

    Full Text Available OBJECTIVES: The objective of this study was to evaluate the ability of a muscular index (Barrett's Index, calculated with multidetector computed tomography, to detect dysthyroid optic neuropathy in patients with Graves' orbitopathy. METHODS: Thirty-six patients with Graves' orbitopathy were prospectively studied and submitted to neuro-ophthalmic evaluation and multidetector computed tomography scans of the orbits. Orbits were divided into two groups: those with and without dysthyroid optic neuropathy. Barrett's index was calculated as the percentage of the orbit occupied by muscles. Sensitivity and specificity were determined for several index values. RESULTS: Sixty-four orbits (19 with and 45 without dysthyroid optic neuropathy met the inclusion criteria for the study. The mean Barrett's index values (± SD were 64.47% ± 6.06% and 49.44% ± 10.94%in the groups with and without dysthyroid optic neuropathy, respectively (p60% should be carefully examined and followed for the development of dysthyroid optic neuropathy.

  9. Progression of Jackhammer Esophagus to Type II Achalasia.

    Science.gov (United States)

    Abdallah, Jason; Fass, Ronnie

    2016-01-31

    It has been suggested that patients with certain motility disorders may progress overtime to develop achalasia. We describe a 66 year-old woman who presented with dysphagia for solids and liquids for a period of 18 months. Her initial workup showed normal endoscopy and non-specific esophageal motility disorder on conventional manometry. Six months later, due to persistence of symptoms, the patient underwent a high resolution esophageal manometry (HREM) demonstrating jackhammer esophagus. The patient was treated with a high dose proton pump inhibitor but without resolution of her symptoms. During the last year, the patient reported repeated episodes of food regurgitation and a significant weight loss. A repeat HREM revealed type II achalasia. Multiple case reports, and only a few prospective studies have demonstrated progression from certain esophageal motility disorders to achalasia. However, this report is the first to describe a case of jackhammer esophagus progressing to type II achalasia. PMID:26717932

  10. Role of XPC, XPD, XRCC1, GSTP genetic polymorphisms and Barrett’s esophagus in a cohort of Italian subjects. A neural network analysis

    Directory of Open Access Journals (Sweden)

    Tarlarini C

    2012-08-01

    Full Text Available Claudia Tarlarini,1 Silvana Penco,1 Massimo Conio,2 Enzo Grossi3 On behalf of the Barrett Italian Study Group 1Department of Laboratory Medicine, Medical Genetics, Niguarda Ca’ Granda Hospital, Milan, Italy; 2Department of Gastroenterology, General Hospital, San Remo, Italy; 3Medical Department, Bracco Imaging SpA, Milan, ItalyBackground: Barrett’s esophagus (BE, a metaplastic premalignant disorder, represents the primary risk factor for the development of esophageal adenocarcinoma. Chronic gastroesophageal reflux disease and central obesity have been associated with BE and esophageal adenocarcinoma, but relatively little is known about the specific genes that confer susceptibility to BE carcinogenesis.Methods: A total of 74 patients with BE and 67 controls coming from six gastrointestinal Italian units were evaluated for six polymorphisms in four genes: XPC, XPD nucleotide excision repair (NER genes, XRCC1 (BER gene, and glutathione S-transferase P1. Smoking status was analyzed together with the genetic data. Statistical analysis was performed through Artificial Neural Networks.Results: Distributions of sex, smoking history, and polymorphisms among BE cases and controls did not show statistically significant differences. The r-value from linear correlation allowed us to identify possible protective factors as well as possible risk factors. The application of advanced intelligent systems allowed for the selection of a subgroup of nine variables. Artificial Neural Networks applied on the final data set reached mean global accuracy of 60%, reaching as high as 65.88%.Conclusion: We report here results from an exploratory study. Results from this study failed to find an association among the tested single nucleotide polymorphisms and BE phenotype through classical statistical methods. On the contrary, advanced intelligent systems are really able to handle the disease complexity, not treating the data with reductionist approaches unable to detect

  11. Liposarcoma Arising in a Giant Lipomatous Polyp of the Esophagus

    OpenAIRE

    Bak, Young-Tae; Kim, Jin Ho; Kim, Jong Guk; Lee, Chang Hong; Lee, Kap No; Choi, Young Ho; Kim, Hark Jei

    1989-01-01

    A case of liposarcoma in a giant pedunculated lipoma of the esophagus in a 49-year-old Korean woman who presented intermittent swallowing difficulty for 3 years is reported. Endoscopy and esophagography revealed that a giant smooth longitudinal tumor mass almost entirely occupied the esophageal lumen. A total esohagectomy was done. The tumor was 20 cm in length and 7 cm in average diameter with an obvious stalk measuring 3 cm in length and 1 cm in diameter. Microscopic examination disclosed a...

  12. DISK BATTERIES IN THE ESOPHAGUS OF NIGERIAN CHILDREN: CASE SERIES

    OpenAIRE

    LUCKY OBUKOWHO ONOTAI; ADAOBI ELIZABETH OSUJI

    2015-01-01

    Foreign body (FB) ingestion is common in clinical practice especially in children. Its impaction in the esophagus constitutes an important cause of morbidity and mortality in our environment. Due to technological advancement and increase use of disk batteries to power children toys and remote control gadgets, ingestion of disk batteries is now commonplace. In our environment there is paucity of information on disk batteries hence we decided to present case series of disk batteries in the esop...

  13. A case of radiation induced carcinoma of the cervical esophagus

    International Nuclear Information System (INIS)

    A patient with carcinoma of the cervical esophagus who visited a hospital with a complaint of difficulty in swallowing was reported. This patient was a 50 year old woman. It was 32 years since she had had external irradiation with x- ray over the neck for Basedow's disease at the age of 18. From the age of 30, she had had hypothyroidism and had used thyroid. She became aware of difficulty in swallowing in October, 1976. Then this symptom progressed gradually, and she also had hoarseness. She visited a hospital in August, 1977. At the first medical examination, pigmentation and atrophic changes in the neck induced by radiation were observed, and some lymphnodes with the size of a red bean were palpated. Esophageal roentogenography revealed circular and spiral type lesion in the cervical esophagus, which was 4 cm in length and had a clear boundary. Endoscopic examination revealed circular stenotic lesion. This lesion was diagnosed as squamous cell carcinoma by biopsy. Total of 3,000 rad of Linac x-ray was irradiated over the neck and the clavicle before operation. Operation findings revealed fibrosis, atrophy, and hardening of the thyroid gland caused by radiation. Carcinoma with the size 35 mm x 18 mm was limited to the cervical esophagus, and the degree of the progress was A2, N2, M0 (Pl0). Histological findings revealed moderately differentiated squamous cell carcinoma and its metastases to the right supraclaviclar lymphnodes. This carcinoma was diagnosed as radiation-induced carcinoma of the cervical esophagus, because this patient had had irradiation over the neck, locally marked atrophic changes and scar remained, and carcinoma occurred in the area which had been irradiated with x-ray. (Tsunoda, M.)

  14. Barrett’s esophagus in 2016: From pathophysiology to treatment

    OpenAIRE

    Martinucci, Irene; de Bortoli, Nicola; Russo, Salvatore; Bertani, Lorenzo; Furnari, Manuele; Mokrowiecka, Anna; Malecka-Panas, Ewa; Savarino, Vincenzo; Savarino, Edoardo; Marchi, Santino

    2016-01-01

    Esophageal complications caused by gastroesophageal reflux disease (GERD) include reflux esophagitis and Barrett’s esophagus (BE). BE is a premalignant condition with an increased risk of developing esophageal adenocarcinoma (EAC). The carcinogenic sequence may progress through several steps, from normal esophageal mucosa through BE to EAC. A recent advent of functional esophageal testing (particularly multichannel intraluminal impedance and pH monitoring) has helped to improve our knowledge ...

  15. A manometric study of the esophagus in adult patients

    International Nuclear Information System (INIS)

    112 patients over 65 with an average age of 71.6 years old were studied. 65 of them were females and 47 were males. A manometric study of the esophagus was conducted in all cases and the results were compared with those of a groups of 48 sound individuals, 38 males and 10 females with an average age of 28.7 years old. The manometric diagnosis in 61.6 % of the cases was unspecific motor disorder; in 31.2 %, hiatus hernia; in 26.7 %, esophageal achalasia; and only 5.3 % presented a normal manometric study. It was proved that the resting pressure of the upper esophageal sphincter, the intensity and duration of the primary wave in the upper esophagus, and the lenght and percentage of relaxation of the lower esophageal sphincter were significantly inferior, for a p < 0.05 in elderly patients compared with the control group. The duration of the primary wave in the middle and lower esophagus was augmented, for a p < 0.05 in our studied group. Morphological alterations of the primary wave were found, where as tertiary and non-peristaltic waves were also observed, which is attributed to the progressive deterioration of the esophageal function with aging. These results confirm the presence of specific manometric alterations in the third age that must be known in order to improve the attention and treatment of these patients

  16. El fenotipo de las mucinas en el esófago de Barrett

    Science.gov (United States)

    Torrado, Julio; Piazuelo, María Blanca; Ruiz, Irune; Izarzugaza, María Isabel; Camargo, María Constanza; Delgado, Alberto; Abdirad, Afshin; Correa, Pelayo

    2011-01-01

    Antecedentes El esófago de Barrett es una reconocida lesión precursora de adenocarcinoma esofágico. Aunque generalmente asociada al reflujo gastroesofágico, los mecanismos patogénicos de la enfermedad no son bien conocidos. El objetivo del presente estudio es explorar la historia natural e identificar marcadores de progreso del proceso precanceroso. Material y métodos Se utilizaron cortes histológicos de 67 especímenes de esófago correspondientes a 14 pacientes con esófago de Barrett, a los que se siguió entre 1 – 9 años. Se clasificaron las lesiones en: esófago de Barrett sin displasia, indefinido para displasia o con displasia. Se evaluó la expresión de diferentes mucinas en las células caliciformes y en las columnares usando técnicas de histoquímica e inmunohistoquímica. Resultados En todos los casos se comprobó la presencia de metaplasia intestinal incompleta. Las células columnares dentro del epitelio metaplásico contenían mucinas neutras. A mayor severidad de la lesión se encontró significativamente menor expresión de sialomucinas en las células columnares (p de tendencia igual a 0,03). En sujetos con lesiones indefinidas para displasia se observó un mayor contenido de sulfomucinas en las células caliciformes (p=0,034) y de MUC2 en las células columnares (p=0,029) que en sujetos con esófago de Barrett sin displasia. Se observó expresión de la mucina intestinal MUC2 y de la mucina gástrica MUC5AC en todas las muestras. MUC6, una mucina de las glándulas profundas gástricas, se presentó ocasionalmente. Conclusión La evaluación de los perfiles de mucinas en el esófago de Barrett sugiere una transición gradual del fenotipo del epitelio metaplásico a medida que la lesión avanza en el tiempo. PMID:21804831

  17. MicroRNA-196a & microRNA-101 expression in Barrett's oesophagus in patients with medically and surgically treated gastro-oesophageal reflux

    Directory of Open Access Journals (Sweden)

    Bright Tim

    2011-02-01

    Full Text Available Abstract Background Proton pump inhibitor (PPI medication and surgical fundoplication are used for the control of gastro-oesophageal reflux in patients with Barrett's oesophagus, but differ in their effectiveness for both acid and bile reflux. This might impact on the inflammatory processes that are associated with progression of Barrett's oesophagus to cancer, and this may be evident in the gene expression profile and microRNA expression pattern in Barrett's oesophagus mucosa. We hypothesised that two miRNAs with inflammatory and oncogenic roles, miR-101 and miR-196a, are differentially expressed in Barrett's oesophagus epithelium in patients with reflux treated medically vs. surgically. Findings Mucosal tissue was obtained at endoscopy from patients with Barrett's oesophagus whose reflux was controlled by proton pump inhibitor (PPI therapy (n = 20 or by fundoplication (n = 19. RNA was extracted and the expression of miR-101 and miR-196a was measured using real-time reverse transcription - polymerase chain reaction. There were no significant differences in miR-101 and miR-196a expression in Barrett's oesophagus epithelium in patients treated by PPI vs. fundoplication (p = 0.768 and 0.211 respectively. Secondary analysis showed a correlation between miR-196a expression and Barrett's oesophagus segment length (p = 0.014. Conclusion The method of reflux treatment did not influence the expression of miR-101 and miR-196a in Barrett's oesophagus. This data does not provide support to the hypothesis that surgical treatment of reflux better prevents cancer development in Barrett's oesophagus. The association between miR-196a expression and Barrett's oesophagus length is consistent with a tumour promoting role for miR-196a in Barrett's oesophagus.

  18. Increased Production of Lysozyme Associated with Bacterial Proliferation in Barrett's Esophagitis, Chronic Gastritis, Gluten-induced Atrophic Duodenitis (Celiac Disease), Lymphocytic Colitis, Collagenous Colitis, Ulcerative Colitis and Crohn's Colitis.

    Science.gov (United States)

    Rubio, Carlos A

    2015-12-01

    The mucosa of the esophagus, the stomach, the small intestine, the large intestine and rectum are unremittingly challenged by adverse micro-environmental factors, such as ingested pathogenic and non-pathogenic bacteria, and harsh secretions with digestive properties with disparate pH, as well as bacteria and secretions from upstream GI organs. Despite the apparently inauspicious mixture of secretions and bacteria, the normal GI mucosa retains a healthy state of cell renewal. To by-pass the tough microenvironment, the epithelia of the GI react by speeding-up cell exfoliation, by increasing peristalsis, eliminating bacteria through secretion of plasma cell-immunoglobulins and by increasing production of natural antibacterial enzymes (lysozyme) and host defense peptides (defensin-5). Lysozyme was recently found up-regulated in Barrett's esophagitis, in chronic gastritis, in gluten-induced atrophic duodenitis (celiac disease), in collagenous colitis, in lymphocytic colitis and in Crohn's colitis. This up-regulation is a response directed towards the special types of bacteria thriving in the microenvironment in each of the aforementioned clinical inflammatory maladies. The purpose of that up-regulation is to protect the mucosa affected by the ongoing chronic inflammation. Bacterial antibiotic resistance continues to exhaust our supply of effective antibiotics. The future challenge is how to solve the increasing menace of bacterial resistance to anti-bacterial drugs. Further research on natural anti-bacterial enzymes such as lysozyme, appears mandatory. PMID:26637845

  19. A case of primary isolated non-Hodgkin's lymphoma of the esophagus in an immunocompetent patient

    Institute of Scientific and Technical Information of China (English)

    Ioannis V Kalogeropoulos; Athanasios N Chalazonitis; Sofia Tsolaki; Fotios Laspas; Nikolaos Ptohis; Ioannis Neofytou; Dimitra Rontogianni

    2009-01-01

    Primary non-Hodgkin's lymphoma of the esophagus is a rare disease. A case of primary isolated non- Hodgkin's lymphoma of the esophagus in a 77-yearold man without acquired immunodeficiency syndrome is presented. We describe the clinical features and the imaging findings (barium swallow, endoscopic ultrasonography and CT) of a biopsy proven B-cell lymphoma with diffuse transmural involvement of the esophagus wall, which was discovered incidentally. We also briefly review the literature.

  20. Breast Metastasis in Esophagus Cancer: Literature Review and Report on a Case

    Science.gov (United States)

    2016-01-01

    Esophagus cancer metastases often involve locoregional lymph nodes, lung, bone, liver, and brain. Metastatic involvement of the breast from esophagus cancer is uncommon, but if it happened, it usually presents as a part of multiple organ distal metastases. Here we report a case of the largest metastatic esophagus cancer of the breast and the chest wall, and we review the similar reported cases. PMID:27340587

  1. Esophageal contractions in type 3 achalasia esophagus: simultaneous or peristaltic?

    Science.gov (United States)

    Kim, Tae Ho; Patel, Nirali; Ledgerwood-Lee, Melissa; Mittal, Ravinder K

    2016-05-01

    Absence of peristalsis and impaired relaxation of lower esophageal sphincter are the hallmarks of achalasia esophagus. Based on the pressurization patterns, achalasia has been subdivided into three subtypes. The goal of our study was to evaluate the esophageal contraction pattern and bolus clearance in type 3 achalasia esophagus. High-resolution manometry (HRM) recordings of all patients diagnosed with achalasia esophagus in our center between the years 2011 and 2013 were reviewed. Recordings of 36 patients with type 3 achalasia were analyzed for the characteristics of swallow-induced "simultaneous esophageal contraction." The HRM impedance recordings of 14 additional patients with type 3 achalasia were analyzed for bolus clearance from the impedance recording. Finally, the HRM impedance along with intraluminal ultrasound imaging was conducted in six patients to further characterize the simultaneous esophageal contractions. Among 187 achalasia patients, 30 were type 1, 121 type 2, and 36 type 3. A total of 434 swallows evaluated in type 3 achalasia patients revealed that 95% of the swallow-induced contractions met criteria for simultaneous esophageal contraction, based on the onset of contraction. Interestingly, the peak and termination of the majority of simultaneous esophageal contractions were sequential. The HRM impedance revealed that 94% of the "simultaneous contractions" were associated with complete bolus clearance. Ultrasound image analysis revealed that baseline muscle thickness of patients in type 3 achalasia is larger than normal but the pattern of axial shortening is similar to that in normal subjects. The majority of esophageal contractions in type 3 achalasia are not true simultaneous contractions because the peak and termination of contraction are sequential and they are associated with complete bolus clearance. PMID:26950858

  2. Webs of the lower esophagus: a complication of gastroesophageal reflux?

    Science.gov (United States)

    Weaver, J W; Kaude, J V; Hamlin, D J

    1984-02-01

    Seven patients with webs within 6 cm of the gastroesophageal junction were identified from 5109 barium studies of the esophagus covering a 10-year period (incidence, 0.14%). These webs were clearly distinct from the B-ring at the gastroesophageal junction itself. Demographic, social, and clinical factors for these patients are reviewed and compared with those of 26 cervical-web patients diagnosed in the same 10-year period, 26 control thoracic esophagogram patients and 26 control cervical esophagogram patients. Five of the seven patients with lower esophageal webs had gastroesophageal reflux. PMID:6607592

  3. The sub-leading asymptotic behaviour of area correlations in the Barrett-Crane model

    International Nuclear Information System (INIS)

    The Barrett-Crane spin foam model for quantum gravity provides an excellent setting for testing analytical and numerical tools used to probe spin foam models. Here, we complete the report on the numerical analysis of the single 4-simplex area correlations begun in (2009 Phys. Lett. B 670 403-6), discussing the next-to-leading order corrections ('one-loop' corrections) with particular attention to their measure dependence, and the difference between the Gaussian and Bessel ansatz for the boundary state.

  4. SYD BARRETT: WAS HE SUFFERING FROM SCHIZOPHRENIA OR ASPERGER’S SYNDROME?

    OpenAIRE

    Mario Campanella

    2015-01-01

    Roger Keith “Syd” Barrett (Cambridge, January 6, 1946 - Cambridge, July 7, 2006) was a British singer, guitarist, composer and painter, founder and leader of Pink Floyd from 1965 to 1968, when he left the group. Before retiring to private life, he recorded two solo albums, “The Madcap Laughs” and “Barrett”, published in 1970. His experience and skills strongly influenced the subsequent production of the group, especially albums like “Dark Side of the Moon”, “Wish You Were Here” and “The Wa...

  5. Esófago de Barrett: da molécula ao cancro

    OpenAIRE

    Ormonde, Carolina Câmara

    2014-01-01

    O Esófago de Barrett (EB) consiste numa metaplasia, na qual o epitélio escamoso estratificado do esófago é substituído por epitélio colunar simples. Este constitui o principal fator de risco para o desenvolvimento de adenocarcinoma do esófago (ACE), uma neoplasia que tem vindo a crescer em incidência, em particular, nos países ocidentais. Este aumento tem originado uma onda de preocupação, por não se conseguir predizer quais os doentes com EB que progredirão para ACE. A vigilân...

  6. Trimodal therapy in squamous cell carcinoma of the esophagus

    Directory of Open Access Journals (Sweden)

    Matuschek C

    2011-10-01

    Full Text Available Abstract Patients with ESCC (squamous cell carcinoma of the esophagus are most commonly diagnosed with locally advanced tumor stages. Early metastatic disease and late diagnosis are common reasons responsible for this tumor's poor clinical outcome. The prognosis of esophageal cancer is very poor because patients usually do not have symptoms in early disease stages. Squamous cell carcinoma of the esophagus frequently complicates patients with multiple co-morbidities and these patients often require interdisciplinary diagnosis and treatment procedures. At present time, neoadjuvant radiation therapy and chemotherapy followed by surgery are regarded as the international standard of care. Meta-analyses have confirmed that this approach provides the patient with better local tumor control and an increased overall survival rate. It is recommended that patients with positive tumor response to neoadjuvant therapy and who are poor surgical candidates should consider definitive radiochemotherapy without surgery as a treatment option. In future, EGFR antibodies may also be administered to patients during therapy to improve the current treatment effectiveness. Positron-emission tomography proves to be an early response-imaging tool used to evaluate the effect of the neoadjuvant therapy and could be used as a predictive factor for the survival rate in ESCC. The percentage proportions of residual tumor cells in the histopathological analyses represent a gold standard for evaluating the response rate to radiochemotherapy. In the future, early response evaluation and molecular biological tests could be important diagnostic tools in influencing the treatment decisions of ESCC patients.

  7. Atresia in the esophagus Atresia Esofágica.

    Directory of Open Access Journals (Sweden)

    Narciso Hernández Rodríguez

    2005-12-01

    Full Text Available Esophageal atresia is the congenital lack of continuity of the esophagus with or without communication to the airway. Incidence is estimateed in 1 by 3000 to 4500 alive newborns. Cases in brothers are found and children of parents with atresia esophagus, nevertheless not a hereditary is recognized; also there is a greater frequency in twins. We presented the Good Clinical Practices Guideline for Esophageal atresia, approved by consensus in the 2nd National Good Clinical Practices Workshop in Pediatric Surgery (Manzanillo, Cuba, September 31 - October 3, 2002.
    La atresia esofágica es la falta congénita de continuidad del esófago con o sin comunicación a la vía aérea. Se estima una incidencia de 1 cada 3000 a 4 500 neonatos vivos. Se encuentran casos en hermanos e hijos de padres con atresia de esófago, sin embargo no existe un patrón hereditario establecido, también hay una mayor frecuencia en gemelos. Se presenta la Guía de Buenas Prácticas Clínicas para Atresia esofágica, aprobada por consenso en el 2º Taller Nacional de Buenas Prácticas Clínicas en Cirugía Pediátrica (Manzanillo, 31 de septiembre al 3 de octubre del 2002.

  8. Giant fibrovascular polyp of the esophagus: report of a case.

    Science.gov (United States)

    Goenka, Ajit Harishkumar; Sharma, Sanjay; Ramachandran, Vijay; Chattopadhyay, Tushar K; Ray, Ruma

    2011-01-01

    A fibrovascular polyp is a peculiar nonepithelial tumor of the esophagus that invariably arises in the cervical esophagus at the level of the thoracic inlet and grows distally into a massive elongated, pedunculated, intraluminal lesion. Although it is a benign lesion that is eminently resectable, it is a dramatic entity owing to its tendency to cause bizarre complications such as asphyxia and sudden death when it regurgitates into the pharynx and causes laryngeal impaction. This report describes the multimodality imaging appearance of an archetypal case of a giant fibrovascular polyp in a patient with a seemingly innocuous presentation for the size of the lesion. The essential role of cross-sectional imaging in establishing a prompt diagnosis, defining the tissue elements of the mass, and delineation of the exact extent of the lesion in guiding the treatment approach is highlighted. The appearance of fibrovascular polyp in a single patient with a combination of barium swallow, multidetector computed tomography, and high-resolution contrast-enhanced magnetic resonance imaging has not been reported previously. PMID:21191703

  9. Transabdominal sonographic findings of the distal esophagus in esophageal varices

    International Nuclear Information System (INIS)

    To assess transabdominal sonographic findings of the distal esophagus in the patients with esophageal varices. Transabdominal sonography was performed on two groups which considered of 42 normal subjects (25 males and 17 female, age: 20-65) and 45 cirrhotic patients (34 males and 11 females, age: 30-70) with esophageal varices. The thickness of the anterior wall of the distal esophagus (AWDE) was measured and the shape of its surface was observed. Then these findings were compared between the two groups. The mean thickness of the AWDE in the 42 normal subjects was 2.4 ± 0.62 mm (2-4 mm), while that of the 45 cirrhotic patients was 6.0 ± 1.27 mm (3-10 mm). Whereas the irregular surface of the AWDE was observed in 4 of the 42 normal subjects (9.5%), it was seen in 30 of the 45 cirrhotic patients with esophageal varices (66.7%). When as AWDE having more than 5 mm in thickness was used as a diagnostic criterion for the esophageal varices, the sensitivity, specificity, and accuracy was 89%, 100% and 94% respectively. When an irregular wall surface was used as a diagnostic standard, the results were 67%, 90% and 70% respectively. In the cirrhotic patients, esophageal varix can be presumed with reasons of the thickening AWDE (more than 5 mm) and irregularity of its surface in the transabdominal sonography.

  10. Trimodal therapy in squamous cell carcinoma of the esophagus.

    Science.gov (United States)

    Matuschek, C; Bölke, E; Zahra, T; Knoefel, W T; Peiper, M; Budach, W; Erhardt, A; Scherer, A; Baldus, S E; Gerber, P A; Buhren, B A; Schauer, M; Hoff, N-Ph; Gattermann, N; Orth, K

    2011-10-10

    Patients with ESCC (squamous cell carcinoma of the esophagus) are most commonly diagnosed with locally advanced tumor stages. Early metastatic disease and late diagnosis are common reasons responsible for this tumor's poor clinical outcome. The prognosis of esophageal cancer is very poor because patients usually do not have symptoms in early disease stages. Squamous cell carcinoma of the esophagus frequently complicates patients with multiple co-morbidities and these patients often require interdisciplinary diagnosis and treatment procedures. At present time, neoadjuvant radiation therapy and chemotherapy followed by surgery are regarded as the international standard of care. Meta-analyses have confirmed that this approach provides the patient with better local tumor control and an increased overall survival rate. It is recommended that patients with positive tumor response to neoadjuvant therapy and who are poor surgical candidates should consider definitive radiochemotherapy without surgery as a treatment option. In future, EGFR antibodies may also be administered to patients during therapy to improve the current treatment effectiveness. Positron-emission tomography proves to be an early response-imaging tool used to evaluate the effect of the neoadjuvant therapy and could be used as a predictive factor for the survival rate in ESCC. The percentage proportions of residual tumor cells in the histopathological analyses represent a gold standard for evaluating the response rate to radiochemotherapy. In the future, early response evaluation and molecular biological tests could be important diagnostic tools in influencing the treatment decisions of ESCC patients. PMID:22024422

  11. Quantum simplicial geometry in the group field theory formalism: reconsidering the Barrett-Crane model

    International Nuclear Information System (INIS)

    A dual formulation of group field theories, obtained by a Fourier transform mapping functions on a group to functions on its Lie algebra, has recently been proposed. In the case of the Ooguri model for SO(4) BF theory, the variables of the dual field variables are thus so(4) bivectors, which have a direct interpretation as the discrete B variables. Here we study a modification of the model by means of a constraint operator implementing the simplicity of the bivectors in such a way that projected fields describe metric tetrahedra. This involves an extension of the usual group field theory (GFT) framework, where boundary operators are labeled by projected spin network states. By construction, the Feynman amplitudes are simplicial path integrals for constrained BF theory. We show that the spin foam formulation of these amplitudes corresponds to a variant of the Barrett-Crane model for quantum gravity. We then re-examine the arguments against the Barrett-Crane model(s) in light of our construction. (paper)

  12. Preliminary findings from tests of a microwave applicator designed to treat Barrett's oesophagus

    International Nuclear Information System (INIS)

    Barrett's oesophagus is considered to increase the risk of cancer 30-fold. Helical microwave antennas have been developed for ablative treatment of Barrett's. A microwave balloon applicator was tested in an initial animal study using adult white pigs. For treatment, a balloon filled with tissue-equivalent material encapsulated the antenna. A range of different treatment temperatures and durations was used to investigate a range of thermal ablations of the oesophageal epithelium. Eight animals were investigated, five non-survival and three with a 1-week survival period. The balloon was fitted with an array of temperature sensors, which gave an indication of the treatment in situ and allowed modifications to be performed in real time. Temperature data were recorded from all four quadrants of the balloon throughout and test sites were collected and analysed histologically. All experiments were successfully completed without perforation, serious adverse effects or death. Sites of discrete ulceration were induced in the survival tests, whereas the non-survival tests yielded little reproducible tissue modification. Results suggested that an activation temperature of ∼55 deg. C needed to be reached during the treatment for tissue damage to be induced. Once damage had been triggered the severity was related to the mean temperature attained during the treatment period. A mean temperature of 52 deg. C or more resulted in substantial damage, whilst a mean temperature of ∼50 deg. C resulted in the desired surface damage with sparing of subjacent tissues

  13. Observation of dislocation by synchrotron Berg-Barrett X-ray topography

    International Nuclear Information System (INIS)

    Efficient utilization of electric energy is sought, and as one of the methods, a process to replace Si with 4H-SiC as a power converter is being studied. However, the current 4H-SiC wafer includes lattice defect, which incurs the changes of lattice defect texture during device process, and sometimes introduces new lattice defect. Accordingly, it is important to investigate the changes in lattice defect texture due to the device process, as well as the effects of the changes on device characteristics. The authors used the X-ray topography of the black case of oblique incidence using monochromatized X-ray, so-called Berg-Barrett method, and examined the following items: (1) vicinity of the surface of 4H-SiC wafer, (2) changes of defect structure associated with epitaxial film growth, and (3) relationship of the dislocation and stacking faults of device inside with the characteristics of device. The authors arranged the contrast of dislocation observed in Berg-Barrett method, and summarized the rules on dislocation contrast. (A.O.)

  14. Squamous cell carcinoma of esophagus masquerading as solitary thyroid nodule

    Directory of Open Access Journals (Sweden)

    Basu S

    2005-01-01

    Full Text Available Secondary neoplasm of the thyroid mimicking a primary thyroid lesion is a rare finding, especially in an individual without a past history of malignancy. A case of squamous cell carcinoma metastatic to the thyroid (presenting as a solitary thyroid nodule, who had an unsuspected primary in the esophagus is described. Usually, multiple areas of the gland are involved in the secondary involvement of the thyroid. The clinical presentation of an apparently asymptomatic mass with neck lymphadenopathy, normal thyroid functions, and a cold nodule on 99mTcO4- thyroid scan can often lead to a misdiagnosis as primary thyroid neoplasm. The present case underscores the fact that due importance to the subtle signs and symptoms and a high degree of suspicion, whenever the histology is unusual for a thyroid primary, is needed and the workup should include ruling out other primary malignancies.

  15. Investigations in the functional scintiscanning of the esophagus

    International Nuclear Information System (INIS)

    For a dynamic, scintigraphic investigation of the esophagus the radio-esopagogram (REG) according to Kazem (1971) is modified: the passage of a pudding bolus labelled with 0.5 to 1 mCi sup(99m)technetium through the esophagus is observed in patients who are sitting. The results are evaluated by means of a summation picture and time/activity diagrams over 3 regions. For each region, the time of passage and retention quotient are established. From investigations on 7 persons without esophageal affections normal values were determined; in all, 31 patients were examined by this technique. As a variation, 16 investigations were carried through with an equally labelled mouthful of water and the results compared with those of the pudding bolus REG. In different stenosing and more functional affections the pudding bolus REG regularly showed pathological results. The alterations seen in the REGs after swallowing labelled water were mostly less distinct; false negative findings did occur. Investigations on patients who were lying showed no prolonged passage time but did show increased retention quotients. When using other test meals, complete retentions were frequently observed. In 26 cases transport velocities could be established. They are in good correspondence with those reported in the literature on the basis of physiological investigations. In 10 patients suffering from reflux esophagitis the REG was combined with reflux scintiscanning using controlled abdominal compression. While passage disturbances of a functional nature could mostly be confirmed, reflux was successfully demonstrated only in 4 cases. All considered, the pudding bolus REG proved to be a sensitive investigation procedure permitting a differentiated quantitative assessment of esophageal passage disturbances. (orig./MG)

  16. Esophagectomy - minimally invasive

    Science.gov (United States)

    Minimally invasive esophagectomy; Robotic esophagectomy; Removal of the esophagus - minimally invasive; Achalasia - esophagectomy; Barrett esophagus - esophagectomy; Esophageal cancer - esophagectomy - laparoscopic; Cancer of the ...

  17. Endoscopic mucosal resection with a multiband ligator for the treatment of Barrett's high-grade dysplasia and early gastric cancer Resección endoscópica de la mucosa con un ligador multibanda para el tratamiento de la displasia de Barret de alto grado y el cáncer gástrico precoz

    Directory of Open Access Journals (Sweden)

    J Espinel

    2009-06-01

    Full Text Available Aim: due to surgery's high mortality and morbidity, local therapeutic techniques are required for Barrett's high-grade dysplasia (BHGD and early gastric cancer (EGC. Various techniques are available for endoscopic mucosal resection (EMR in the GI tract. The "suck and cut" technique, which uses a transparent cap or modified multiband variceal ligator, is usually the most practiced method. A multiband ligator (ML allows sequential resection without the need for submucosal injection and endoscope withdrawal. The objective of this study was to evaluate the efficacy and safety of EMR with a ML device in the treatment of Barrett's high-grade dysplasia and early gastric cancer. Patients and methods: prospective study. Eight consecutive patients (4 men; median age, 62 years; range 38-89 years with BHGD (4 or EGC (4 were treated. EMR was performed with a multiband ligator in order to create a pseudopolyp and then permit snare polypectomy of flat mucosal lesions. The pseudopolyp was resected by using pure coagulating current. No submucosal saline injection was administered before resection. Results: a total of 8 consecutive patients were treated with the multiband ligator (ML technique. Barrett's esophagus (BE: one patient with long BE received 3 EMR sessions. Three patients presented with short BE and received 1 EMR session each. The histology of the EMR specimens confirmed a moderately differentiated adenocarcinoma with submucosal infiltration (1 patient and BHGD (3 patients. Early gastric cancer (EGC: 3 patients had EGC (type IIa and 1 patient had high-grade dysplasia. EMR was accomplished in 1 session for each patient. The histology of EMR specimens confirmed a mucinous adenocarcinoma with submucosal infiltration (1 patient, EGC (2 patients, and HGD (1 patient. Complications (mild esophageal stenosis, minor bleeding occurred in 2 patients. Conclusions: EMR has diagnostic and therapeutic implications, and represents a superior diagnostic modality as

  18. Barrett-Crane model from a Boulatov-Ooguri field theory over a homogeneous space

    International Nuclear Information System (INIS)

    Boulatov and Ooguri have generalized the matrix models of 2d quantum gravity to 3d and 4d, in the form of field theories over group manifolds. We show that the Barrett-Crane quantum gravity model arises naturally from a theory of this type, but restricted to the homogeneous space S3=SO(4)/SO(3), as a term in its Feynman expansion. From such a perspective, 4d quantum space-time emerges as a Feynman graph, in the manner of the 2d matrix models. This formalism provides a precise meaning to the 'sum over triangulations', which is presumably necessary for a physical interpretation of a spin-foam model as a theory of gravity. In addition, this formalism leads us to introduce a natural alternative model, which might have relevance for quantum gravity

  19. Modified Barrett formula near the neutral-ionic quantum phase transition

    International Nuclear Information System (INIS)

    A quantum version of the Blume-Emery-Griffiths (BEG) model is investigated by mean-field theory in order to characterize the newly-found neutral-ionic (NI) quantum phase transition in pressured-DMTTF-QBr4 (4,4'-dimethyltetrathiafulvalene-p-bromanil). In the quantum BEG model, a finite tunneling between neutral and ionic states changes the quantum NI transition of first order in the BEG model into that of second order. In the vicinity of this continuous NI quantum critical point, the dielectric permittivity in the neutral phase is shown to follow the Barrett formula characteristic of quantum paraelectricity. These features in the quantum BEG model are in good agreement with the experimental results, which suggests the importance of quantum NI fluctuations in DMTTF-QBr4.

  20. Examination of tissue distribution of Helicobacter pylori within columnar-lined esophagus.

    Science.gov (United States)

    Sharma, V K; Demian, S E; Taillon, D; Vasudeva, R; Howden, C W

    1999-06-01

    H. pylori may colonize columnar-lined esophagus, although an etiologic role in esophageal adenocarcinoma is unproven. H. pylori can adhere to intestinal metaplasia in the stomach. This study was designed to examine if H. pylori adheres to specialized intestinal metaplasia in columnar-lined esophagus. Esophageal biopsies from patients with columnar-lined esophagus were reviewed. Patients with only gastric metaplasia were excluded. Sections with specialized intestinal metaplasia in at least one third of at least one gland were recut, stained using the Giemsa stain, and reexamined by two independent pathologists using strict criteria for adherence by H. pylori. The 209 esophageal biopsies with adequate specialized intestinal metaplasia from 58 patients were examined: H. pylori was only seen on gastric metaplasia in three patients-and never on specialized intestinal metaplasia. Within the esophagus, H. pylori adheres only to gastric metaplasia, which is not considered premalignant for esophageal adenocarcinoma. PMID:10389690

  1. Obstruction of the esophagus 5 months after radiotherapy for a central lung cancer

    International Nuclear Information System (INIS)

    Dysphagia after radiotherapy of thoracic tumors may be caused by recurrences or by radiation damage to the esophagus. Case Report: A 75-year-old patient presented with a complete obstruction of the esophagus 5 months after CHARTWEL radiotherapy for a non-small cell lung cancer. During the last week of radiotherapy mild dysphagia (Grade 1 EORTC/RTOG, Grade 2 MRC-CHART-Score) occurred that persisted over the following months. X-ray and endoscopic investigations revealed an easily removable food bolus without evidence of esophageal stricture or ulceration. Conclusion: The case report describes a mild but prolonged early radiation reaction of the esophagus. In comparison with conventional fractionation the incidence of dysphagia is higher after accelerated fractionation schedules. The pathophysiologic mechanisms underlying persistent dysphagia are currently unknown. Beside of recurrences, radiation effects to the esophagus should be considered if dysphagia after irradiation of thoracic tumors occurs, because, as in this case, therapy may rapidly improve the symptoms. (orig.)

  2. Mucoepidermoid carcinoma of esophagus combined with squamous carcinoma of lung: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Chaoxing Liu

    2015-01-01

    Full Text Available Mucoepidermoid carcinoma (MEC is typically located in the salivary, lacrimal, and tracheobronchial glands and rarely presents in the esophagus. MEC is commonly characterized by squamous cells, mucus-secreting cells, and intermediate cells. This report presents the case of a 57-years-old male with a three months history of cough and shortness of breath. Computer tomography (CT scans revealed a tumor locating in the left hilar. The histological report was squamous carcinoma. After three circles of chemotherapy, the patient complained of dysphagia. The electronic gastroscope showed a protrusion which 30-34 cm from the incisors. The tumor was histopathologically determined to be MEC of esophagus. The patient refused to surgery and concurrent chemoradiotheray; so, radiotherapy and sequential chemotherapy were performed, and after one year of follow up, the disease of esophagus recurrence; the patient was died of hemorrhage of esophagus for tumor progression. The literatures of MEC are also reviewed in this study.

  3. Detection of telomerase activity in malignant neoplasms and nonmalignantepithelial tissues of human esophagus

    Institute of Scientific and Technical Information of China (English)

    Shah Min Yang; Tian Jiao Wang; Bao Yu Li; Yuan Huan Wu

    2000-01-01

    AIM To study the expression of telomerase activity in malignant esophageal neoplasms and normal humanesophageal epithelia.METHODS Telomerase activity was assayed by the telomere repeat amplification protocol (TRAP)method. All the neoplasms and epithelia of esophagus were confirmed by routine pathological diagnosis.RESULTS Telomerase activity was assayed in 18 normal esophageal epithelial tissues and in 35 malignantneoplasms of esophagus, including 27 cases of esophageal carcinoma and 8 cases of cardiac carcinoma.Telomerase activity was detected in most of malignant neoplasms of esophagus (91.4%, 32/35) and in allthe normal esophageal epithelial tissues except one (18/19).CONCLUSION The results suggest that in addition to contributing to proliferation of immortal blast cellsand neoplastic cells, telomerase activity may also play a similar role in regeneration of normal epithelia ofhuman esophagus. The potential use of telomerase activity as a diagnostic marker in human esophagealneoplasm might not be suitable.

  4. Recurrent massive bleeding due to dissecting intramural hematoma of the esophagus: Treatment with therapeutic angiography

    Institute of Scientific and Technical Information of China (English)

    Jaejun Shim; Jae Young Jang; Young Hwangbo; Seok Ho Dong; Joo Hyeong Oh; Hyo Jong Kim; Byung-Ho Kim; Young Woon Chang; Rin Chang

    2009-01-01

    Spontaneous or traumatic intramural bleeding of the esophagus, which is often associated with overlying mucosal dissection, constitutes a rare spectrum of esophageal injury called dissecting intramural hematoma of the esophagus (DIHE). Chest pain, swallowing difficulty, and minor hematemesis are common, which resolve spontaneously in most cases. This case report describes a patient with spontaneous DIHE with recurrent massive bleeding which required critical management and highlights a potential role for therapeutic angiography as an alternative to surgery.

  5. Ectopic sebaceous glands in the esophagus: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Bhat Ramachandra

    2008-01-01

    Full Text Available Ectopic sebaceous glands occur rarely in the esophagus. A 65-year-old man presented with a history of discomfort during swallowing since the last 4 months. On upper gastrointestinal endoscopy, multiple wart-like grayish-yellow projections were detected and two of them were biopsied. Microscopically, they proved to be sebaceous glands in the esophagus. Histogenesis of this rare lesion is discussed in this case report.

  6. Successful Surgical Treatment of a Spontaneous Rupture of the Esophagus Diagnosed Two Days after Onset

    OpenAIRE

    Ando, Hiroyuki; Shitara, Yoshinori; Hagiwara, Kei; Hara, Keigo; Mogami, Yasushi; Kobayashi, Tsutomu; Yajima, Toshiki; Tani, Masachika; Morinaga, Nobuhiro; Ishizaki, Masatoshi; Kuwano, Hiroyuki

    2012-01-01

    Esophageal perforation is a relatively uncommon disease with a high rate of mortality and morbidity. Delay in the diagnosis and treatment occurs in more than 50% of cases, leading to a mortality rate of 40–60%. Primary repair is generally considered the gold standard for patients who present within the first 24 h following perforation of the esophagus. In this paper, we present a case of successful surgical treatment of spontaneous rupture of the esophagus that was diagnosed 2 days after onse...

  7. Carcinoma of the cervical esophagus treated with radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Mendenhall, W.M.; Parsons, J.T.; Vogel, S.B.; Cassisi, N.J.; Million, R.R.

    1988-07-01

    This is an analysis of 34 patients with carcinoma of the cervical esophagus treated with radiation therapy with curative intent at the University of Florida between September 1966 and May 1985. All patients have a minimum 2-year follow-up and 28 (82%) have at least 5 years of follow-up. Patients were staged according to the recommendations of the AJCC. Patients who died within 2 years of treatment with the primary site continuously disease-free were excluded from the local control analysis; all patients were included in the analysis of complications and survival. Irradiation resulted in control of the primary lesion in 1 of 2 patients who presented with T1 lesions, in 4 of the 12 patients with T2 lesions, and 3 of 17 patients who presented with T3 lesions. One patient with a T3 lesion that recurred locally was successfully salvaged by an operation. The 5-year absolute survival rates by stage were as follows: no patients with stage I lesions survived; of 11 stage II patients, one survived; and of 16 stage III patients, three survived. Interestingly, all four of the 5-year survivors were women.

  8. Carcinoma of the cervical esophagus treated with radiation therapy

    International Nuclear Information System (INIS)

    This is an analysis of 34 patients with carcinoma of the cervical esophagus treated with radiation therapy with curative intent at the University of Florida between September 1966 and May 1985. All patients have a minimum 2-year follow-up and 28 (82%) have at least 5 years of follow-up. Patients were staged according to the recommendations of the AJCC. Patients who died within 2 years of treatment with the primary site continuously disease-free were excluded from the local control analysis; all patients were included in the analysis of complications and survival. Irradiation resulted in control of the primary lesion in 1 of 2 patients who presented with T1 lesions, in 4 of the 12 patients with T2 lesions, and 3 of 17 patients who presented with T3 lesions. One patient with a T3 lesion that recurred locally was successfully salvaged by an operation. The 5-year absolute survival rates by stage were as follows: no patients with stage I lesions survived; of 11 stage II patients, one survived; and of 16 stage III patients, three survived. Interestingly, all four of the 5-year survivors were women

  9. Swallowing performance after radiation therapy for carcinoma of the esophagus

    Energy Technology Data Exchange (ETDEWEB)

    O' Rourke, I.C.; Tiver, K.; Bull, C.; Gebski, V.; Langlands, A.O.

    1988-05-15

    The purpose of the study reported in this article was to tabulate the incidence and etiologic factors of importance in the development of strictures after radiotherapy for carcinoma of the esophagus and to analyze the outcome of patients who develop such strictures. Eighty patients were treated with radiotherapy, 50 having radical and 30 having palliative treatment. Sixty-nine patients had squamous cell carcinoma, four had adenocarcinoma, one had sarcoma, one had mucoepidermoid carcinoma, and five had undifferentiated tumors. Forty percent developed no stricture, 30% had benign fibrotic stricture, and 28% developed malignant stricture. The etiologic factors analysed included age, pretreatment swallowing score, histology and length (size) of tumor; stage of disease, dose of radiotherapy, and use of chemotherapy. None of these factors were shown to be of etiologic importance. The survival of patients who developed benign strictures was found to be significantly longer (1-year survival 88%) than those who developed no stricture (50%) or malignant stricture (19%). Using a success score for palliation of dysphagia, it was found that the majority of patients (71%) who developed a benign stricture had a moderately successful outcome--they were able to tolerate a full or soft diet and required dilatation with a median duration between dilatations of 5 months. Patients who developed a malignant stricture were palliated poorly by dilatation alone, and most required esophageal intubation.

  10. Swallowing performance after radiation therapy for carcinoma of the esophagus

    International Nuclear Information System (INIS)

    The purpose of the study reported in this article was to tabulate the incidence and etiologic factors of importance in the development of strictures after radiotherapy for carcinoma of the esophagus and to analyze the outcome of patients who develop such strictures. Eighty patients were treated with radiotherapy, 50 having radical and 30 having palliative treatment. Sixty-nine patients had squamous cell carcinoma, four had adenocarcinoma, one had sarcoma, one had mucoepidermoid carcinoma, and five had undifferentiated tumors. Forty percent developed no stricture, 30% had benign fibrotic stricture, and 28% developed malignant stricture. The etiologic factors analysed included age, pretreatment swallowing score, histology and length (size) of tumor; stage of disease, dose of radiotherapy, and use of chemotherapy. None of these factors were shown to be of etiologic importance. The survival of patients who developed benign strictures was found to be significantly longer (1-year survival 88%) than those who developed no stricture (50%) or malignant stricture (19%). Using a success score for palliation of dysphagia, it was found that the majority of patients (71%) who developed a benign stricture had a moderately successful outcome--they were able to tolerate a full or soft diet and required dilatation with a median duration between dilatations of 5 months. Patients who developed a malignant stricture were palliated poorly by dilatation alone, and most required esophageal intubation

  11. Paired Exome Analysis of Barrett’s Esophagus and Adenocarcinoma

    Science.gov (United States)

    Stachler, Matthew D.; Taylor-Weiner, Amaro; Peng, Shouyong; McKenna, Aaron; Agoston, Agoston T.; Odze, Robert D.; Davison, Jon M.; Nason, Katie S.; Loda, Massimo; Leshchiner, Ignaty; Stewart, Chip; Stojanov, Petar; Seepo, Sara; Lawrence, Michael S.; Ferrer-Torres, Daysha; Lin, Jules; Chang, Andrew C.; Gabriel, Stacey B.; Lander, Eric S.; Beer, David G.; Getz, Gad; Carter, Scott L.; Bass, Adam J.

    2015-01-01

    Barrett’s esophagus, is thought to progress to esophageal adenocarcinoma (EAC) through a step-wise progression with loss of CDKN2A followed by p53 inactivation and aneuploidy. Here, we present whole exome sequencing from 25 pairs of EAC and Barrett’s and five patients whose Barrett’s and tumor were extensively sampled. Our analysis revealed that oncogene amplification typically occurred as a late event and that TP53 mutations often occur early in Barrett’s progression, including in non-dysplastic epithelium. Reanalysis of additional EAC exome data revealed that the majority (62.5%) of EACs emerged following genome doubling and that tumors with genomic doubling had different patterns of genomic alterations with more frequent oncogenic amplifications and less frequent inactivation of tumor suppressors, including CDKN2A. These data suggest that many EACs emerge not through gradual accumulation of tumor suppressor alterations but rather through a more direct path whereby a TP53-mutant cell undergoes genome doubling, followed by acquisition of oncogenic amplifications. PMID:26192918

  12. Barrett’s esophagus in 2016: From pathophysiology to treatment

    Science.gov (United States)

    Martinucci, Irene; de Bortoli, Nicola; Russo, Salvatore; Bertani, Lorenzo; Furnari, Manuele; Mokrowiecka, Anna; Malecka-Panas, Ewa; Savarino, Vincenzo; Savarino, Edoardo; Marchi, Santino

    2016-01-01

    Esophageal complications caused by gastroesophageal reflux disease (GERD) include reflux esophagitis and Barrett’s esophagus (BE). BE is a premalignant condition with an increased risk of developing esophageal adenocarcinoma (EAC). The carcinogenic sequence may progress through several steps, from normal esophageal mucosa through BE to EAC. A recent advent of functional esophageal testing (particularly multichannel intraluminal impedance and pH monitoring) has helped to improve our knowledge about GERD pathophysiology, including its complications. Those findings (when properly confirmed) might help to predict BE neoplastic progression. Over the last few decades, the incidence of EAC has continued to rise in Western populations. However, only a minority of BE patients develop EAC, opening the debate regarding the cost-effectiveness of current screening/surveillance strategies. Thus, major efforts in clinical and research practice are focused on new methods for optimal risk assessment that can stratify BE patients at low or high risk of developing EAC, which should improve the cost effectiveness of screening/surveillance programs and consequently significantly affect health-care costs. Furthermore, the area of BE therapeutic management is rapidly evolving. Endoscopic eradication therapies have been shown to be effective, and new therapeutic options for BE and EAC have emerged. The aim of the present review article is to highlight the status of screening/surveillance programs and the current progress of BE therapy. Moreover, we discuss the recent introduction of novel esophageal pathophysiological exams that have improved the knowledge of the mechanisms linking GERD to BE. PMID:27158534

  13. Power, trust, and Science of Unitary Human Beings influence political leadership: a celebration of Barrett's power theory.

    Science.gov (United States)

    Wright, Barbara W

    2010-01-01

    The importance of nurses' participation in health policy leadership is discussed within the context of Rogers' science of unitary human beings, Barrett's power theory, and one nurse-politician's experience. Nurses have a major role to play in resolving public policy issues that influence the health of people. A brief review of the history of nurses in the political arena is presented. Research related to power and trust is reviewed. Suggested strategies for success in political situations are offered. PMID:20026730

  14. Neuromedin B receptor in esophagus: evidence for subtypes of bombesin receptors

    Energy Technology Data Exchange (ETDEWEB)

    Von Schrenck, T.; Heinz-Erian, P.; Moran, T.; Mantey, S.A.; Gardner, J.D.; Jensen, R.T.

    1989-04-01

    To identify receptors for bombesin-related peptides in the rat esophagus, we measured binding of 125I-Bolton-Hunter neuromedin B (125I-BH-neuromedin B) and 125I-(Tyr4)bombesin to tissue sections from the rat esophagus and compared the results with those for rat pancreas. Esophagus bound both tracers, whereas pancreas bound only 125I-(Tyr4)bombesin. In each tissue binding was saturable, dependent on pH, on time, and on temperature, reversible, and specific. Autoradiography demonstrated binding of both tracers only to the muscularis mucosae of the esophagus and binding of 125I-(Tyr4)bombesin diffusely over pancreatic acini. In the esophagus, the relative potencies for inhibition of binding of both tracers were as follows: neuromedin B greater than bombesin greater than GRP = neuromedin C; similar relative potencies were found for causing contraction of muscle strips from whole esophagus and from the isolated muscularis mucosae. In pancreas tissue sections and dispersed acini, the relative potencies for inhibition of binding of 125I-(Tyr4)bombesin were as follows: bombesin greater than GRP = neuromedin C much greater than neuromedin B. Similar relative potencies were found for stimulation of enzyme secretion from dispersed pancreatic acini. Computer analysis in both tissues demonstrated only a single binding site. The present study demonstrates that rat esophagus muscle possesses specific receptors for bombesin-related peptides. Furthermore, this study shows that the esophageal bombesin receptors represent a previously unidentified class of bombesin receptors in that they have a higher affinity for neuromedin B than for bombesin. In contrast, the pancreatic bombesin receptors have, like all other bombesin receptors described to date, a high affinity for bombesin, but low affinity for neuromedin B.

  15. Cromoendoscopia com azul de metileno para diagnóstico de esôfago de Barrett

    Directory of Open Access Journals (Sweden)

    Saporiti Marcela Rocha Loures

    2003-01-01

    Full Text Available RACIONAL: O esôfago de Barrett é uma condição na qual a mucosa escamosa esofágica é substituída por metaplasia intestinal especializada, que predispõe o paciente ao desenvolvimento de adenocarcinoma esofágico. Este é precedido por displasia e carcinoma precoce; o rastreamento dessas lesões faz-se através de endoscopias digestivas periódicas com biopsias randomizadas. A incidência aumentada desse, tem despertado interesse no desenvolvimento de novas técnicas endoscópicas, como a cromoendoscopia com azul de metileno, para melhorar a identificação do esôfago de Barrett e suas complicações. OBJETIVO: Determinar se as biopsias dirigidas pela cromoendoscopia com azul de metileno oferecem vantagem em relação ao método convencional na detecção do esôfago de Barrett. MATERIAL E MÉTODO: Estudaram-se 45 pacientes com diagnóstico prévio de esôfago de Barrett, todos submetidos a dois exames de endoscopia digestiva alta com biopsias, em intervalo de 4 semanas, um convencional e outro com aplicação do corante, no período entre abril e outubro de 2002. RESULTADOS: Os resultados histológicos das biopsias de todos os exames foram comparados. Observou-se sensibilidade de 62,5%, especificidade de 15,4%, valor preditivo positivo de 57,7% e valor preditivo negativo de 18,2%. Não houve diferença significativa quanto ao número de biopsias. O tempo de duração da técnica de cromoendoscopia foi significativamente maior quando comparado ao da técnica convencional. CONCLUSÃO: Não se observou vantagem na utilização da cromoendoscopia em relação à técnica randomizada no diagnóstico do esôfago de Barrett.

  16. Histochemical and ultrastructural characterization of the posterior esophagus of Bulla striata (Mollusca, Opisthobranchia).

    Science.gov (United States)

    Lobo-da-Cunha, Alexandre; Oliveira, Elsa; Ferreira, Iris; Coelho, Rita; Calado, Gonçalo

    2010-12-01

    The posterior esophagus of Bulla striata, running from the gizzard to the stomach, was investigated with light and electron microscopy to obtain new data for a comparative analysis of the digestive system in cephalaspidean opisthobranchs. In this species, the posterior esophagus can be divided into two regions. In the first, the epithelium is formed by columnar cells with apical microvilli embedded in a cuticle. Many epithelial and subepithelial secretory cells are present in this region. In both, electron-lucent secretory vesicles containing filaments and a peripheral round mass of secretory material fill the cytoplasm. These acid mucus-secreting cells may also contain a few dense secretory vesicles. In the second part of the posterior esophagus, the cuticle is absent and the epithelium is ciliated. In this region, epithelial cells may contain larger lipid droplets and glycogen reserves. Subepithelial secretory cells are not present, and in epithelial secretory cells the number of dense vesicles increases, but most secretory cells still contain some electron-lucent vesicles. These cells secrete a mixture of proteins and acid polysaccharides and should be considered seromucous. The secretory cells of the posterior esophagus are significantly different from those previously reported in the anterior esophagus of this herbivorous species. PMID:20883598

  17. Improvement over time in outcomes for patients undergoing endoscopic therapy for Barrett's oesophagus-related neoplasia: 6-year experience from the first 500 patients treated in the UK patient registry.

    LENUS (Irish Health Repository)

    Haidry, R J

    2015-08-01

    Barrett\\'s oesophagus (BE) is a pre-malignant condition leading to oesophageal adenocarcinoma (OAC). Treatment of neoplasia at an early stage is desirable. Combined endoscopic mucosal resection (EMR) followed by radiofrequency ablation (RFA) is an alternative to surgery for patients with BE-related neoplasia.

  18. The simultaneous expression of both ephrin B3 receptor and E-cadherin in Barrett`s adenocarcinoma is associated with favorable clinical staging

    Directory of Open Access Journals (Sweden)

    Schauer Matthias C

    2012-05-01

    Full Text Available Abstract Background In intestinal epithelium, tyrosine kinase receptor Ephrin B3 (Eph B3 maintains the architecture of the crypt-villus axis by repulsive interaction with its ligand ephrin-B1. While loss of Eph B3 is linked to colorectal cancer initiation, overexpression of Eph B3 in cancer cell lines inhibits growth and induces functional changes with decreased mesenchymal and increased epithelial markers. In order to study this tumor suppressor activity of Eph B3 in esophageal adenocarcinoma we analyzed the simultaneous expression of Eph B3 and E-cadherin in both the healthy esophagus and in Barrett’s carcinoma. Methods Simultaneous expression of Eph B3 and E-cadherin was investigated in samples from 141 patients with Barrett’s carcinoma and from 20 healthy esophagi using immunhistology and quantitative PCR. Results from healthy squamous epithelium, Barrett’s metaplasia and staging-specific esophageal adenocarcinoma were correlated. Results A significantly reduced E-cadherin mRNA expression could be detected in adenocarcinoma compared to dysplasia. The immunhistological activity of E-cadherin and Eph B3 was reduced in adenocarcinoma compared to dysplasia or healthy esophageal mucosa. The intracellular E-cadherin distribution changed significantly from the cytoplasm to the membrane, when the Eph receptor was simultaneously expressed. Simultaneous expression of E-cadherin and Eph B3 showed a significant inverse correlation to tumor stage. Conclusions We present novel evidence of the tumor suppressor activity of Eph B3 in esophageal adenocarcinoma possibly due to the impact on redistribution of cellular E-cadherin to the membrane. Our results suggest that this effect might play a role in the dysplasia-adenocarcinoma sequence, the infiltrative growth pattern and the development of lymph node metastases.

  19. Propulsion Velocity and ETT on Biomagnetic Assessment of the Human Esophagus

    International Nuclear Information System (INIS)

    Esophagus transit time measurement is a common clinical practical. Biomagnetic techniques and modern instrumentation can perform non invasive and functional assessments of the gastrointestinal tract. This study presents the evaluation of the esophagus transit time and propulsion velocity of a magnetic marker from the mouth to stomach using water vs. a swallow easy substance recently patented. A group of ten healthy subjects from 45 to 55 years, were evaluated in identical conditions for two times, they ingested randomly a magnetic marker in an anatomical body position of 45 deg., one times with water and the other one with a patented substance developed in order to help the subjects to swallow pills. The esophagus transit time was shorter when the subjects ingested the magnetic marker with the swallow easy substance than they ingested the magnetic marker with same quantity of water

  20. The tube esophagram: a technique for obtaining a detailed double-contrast examination of the esophagus.

    Science.gov (United States)

    Levine, M S; Kressel, H Y; Laufer, I; Herlinger, H; Goren, R

    1984-02-01

    Although double-contrast esophagography is capable of delineating fine surface morphologic detail in the esophagus, it is not possible to obtain an optimal examination on all patients. Tube esophagography is a complementary technique that can provide a more detailed double-contrast examination of the esophagus. This procedure was performed on 45 patients in whom the routine double-contrast study was inconclusive. The tube esophagram contributed significantly to the radiologic evaluation in 33 cases, providing additional information in 23 and actually altering the final radiologic diagnosis in 10. The tube esophagram was particularly useful in depicting the distal esophagus when the initial double-contrast study was suboptimal due to inadequate distension and/or barium pooling that obscured mucosal detail in this region. The tube esophagram is a valuable adjunctive procedure that can lead to a more definitive radiologic diagnosis when the routine double-contrast examination is inconclusive. PMID:6607593

  1. The surgical treatment of cancer of the esophagus. Summary of replies to a questionnaire.

    Science.gov (United States)

    París, F; Casillas, M; Zarza, A G; Padilla, J

    1979-03-01

    In an attempt to assess the different methods of treatment of tumors of the esophagus we contacted 170 surgeons (in 1975-1976). Seventy-six (45%) answered a questionnaire concerning the surgical management of esophageal tumors, the reasons for non operability and non resectability, the place of radiotherapy, the validity of palliative procedures, the exposure and type of resection for tumors at various levels in the esophagus, the technical details of the operations, the resectability and mortality rate, the anastomotic leak rate and its treatment, and the five-year survival rate after operation. The replies to the questionnaire are summarized. PMID:94320

  2. Dynamic, diagnostic, and pharmacological radionuclide studies of the esophagus in achalasia

    Energy Technology Data Exchange (ETDEWEB)

    Rozen, P.; Gelfond, M.; Zaltzman, S.; Baron, J.; Gilat, T.

    1982-08-01

    The esophagus was evaluated in 15 patients with achalasia by continuous gamma camera imaging following ingestion of a semi-solid meal labeled with /sup 99m/Tc. The images were displayed and recorded on a simple computerized data processing/display system. Subsequent cine mode images of esophageal emptying demonstrated abnormalities of the body of the esophagus not reflected by the manometric examination. Computer-generated time-activity curves representing specific regions of interest were better than manometry in evaluating the results of myotomy, dilatation, and drug therapy. Isosorbide dinitrate significantly improved esophageal emptying.

  3. Dynamic, diagnostic, and pharmacological radionuclide studies of the esophagus in achalasia: correlation with manometric measurements

    International Nuclear Information System (INIS)

    The esophagus was evaluated in 15 patients with achalasia by continuous gamma camera imaging following ingestion of a semi-solid meal labeled with 99/sup m/Tc. The images were displayed and recorded on a simple computerized data processing/display system. Subsequent cine' mode images of esophagela emptying demonstrated abnormalities of the body of the esophagus not reflected by the manometric examination. Computer-generated time-activity curves representing specific regions of interest were better than manometry in evaluating the results of myotomy, dilatation, and drug therapy. Isosorbide dinitrate significantly improved esophageal emptying

  4. Dynamic, diagnostic, and pharmacological radionuclide studies of the esophagus in achalasia

    International Nuclear Information System (INIS)

    The esophagus was evaluated in 15 patients with achalasia by continuous gamma camera imaging following ingestion of a semi-solid meal labeled with /sup 99m/Tc. The images were displayed and recorded on a simple computerized data processing/display system. Subsequent cine mode images of esophageal emptying demonstrated abnormalities of the body of the esophagus not reflected by the manometric examination. Computer-generated time-activity curves representing specific regions of interest were better than manometry in evaluating the results of myotomy, dilatation, and drug therapy. Isosorbide dinitrate significantly improved esophageal emptying

  5. Dynamic, diagnostic, and pharmacological radionuclide studies of the esophagus in achalasia: correlation with manometric measurements

    Energy Technology Data Exchange (ETDEWEB)

    Rozen, P.; Gelfond, M.; Zaltzman, S.; Baron, J.; Gilat, T.

    1982-08-01

    The esophagus was evaluated in 15 patients with achalasia by continuous gamma camera imaging following ingestion of a semi-solid meal labeled with /sup 99//sup m/Tc. The images were displayed and recorded on a simple computerized data processing/display system. Subsequent cine' mode images of esophagela emptying demonstrated abnormalities of the body of the esophagus not reflected by the manometric examination. Computer-generated time-activity curves representing specific regions of interest were better than manometry in evaluating the results of myotomy, dilatation, and drug therapy. Isosorbide dinitrate significantly improved esophageal emptying.

  6. Scientific attitude towards the interventional treatment of the lesions of esophagus and esophagogastric junction

    International Nuclear Information System (INIS)

    The diseases of esophagus and stomach possess highest morbidity in China. For decades the interventional radiology has effectively solved a lot of clinical puzzles upon the lesions of esophagus and esophagogastric junction. Rapid development and extensive application often induce the exaggeration of indication and improper choice of the procedure, resulting in clinical disposal for various complications. Scientific attitude should be taken on the utilization of interventional method: possessing rich imaging and clinical knowledge; understanding the property of various interventional instruments; strictly grasping indications of arterial infusion chemotherapy, balloon catheter dilation and stent placement; perfectly mastering the operation technology; well controlling complications. (authors)

  7. alpha. sub 2 -mediated effect of dopamine on the motility of the chicken esophagus

    Energy Technology Data Exchange (ETDEWEB)

    Sanchez, J.; Costa, G.; Benedito, S.; Garcia-Sacristan, L.R.A.; Orensanz, L. M. (Univ. Complutense de Madrid (Spain))

    1990-01-01

    Dopamine (DA), apomorphine and B-HT 933 produced dose related contractions on isolated longitudinal strips of chicken esophagus, whereas phenylephrine elicited no effect. DA induced contractions of myogenic origin, these contractions were insensitive to DA antagonists and were partially suppressed by yohimbine, which suggested an {alpha}{sub 2}-adrenergic implication in this DA effect. This hypothesis was further investigated by performing binding experiments, in which B-HT 933 displaced the binding of ({sup 3}H) DA to esophageal homogenates. The results suggest the participation of an {alpha}{sub 2} - adrenergic receptor in the contractile response elicited by DA in the isolated chicken esophagus.

  8. Cromoendoscopia com azul de metileno para diagnóstico de esôfago de Barrett

    OpenAIRE

    Saporiti Marcela Rocha Loures; Souza Raquel Canzi de Almada e; Pisani Júlio César; Amarante Heda Maria Barska dos Santos; Carmes Eliane Ribeiro; Sakamoto Danielle Giacometti

    2003-01-01

    RACIONAL: O esôfago de Barrett é uma condição na qual a mucosa escamosa esofágica é substituída por metaplasia intestinal especializada, que predispõe o paciente ao desenvolvimento de adenocarcinoma esofágico. Este é precedido por displasia e carcinoma precoce; o rastreamento dessas lesões faz-se através de endoscopias digestivas periódicas com biopsias randomizadas. A incidência aumentada desse, tem despertado interesse no desenvolvimento de novas técnicas endoscópicas, como a cromoendoscopi...

  9. Studies on the regulation of transient lower esophageal sphincter relaxations (TLESRs) by acid in the esophagus and stomach.

    Science.gov (United States)

    Banovcin, P; Halicka, J; Halickova, M; Duricek, M; Hyrdel, R; Tatar, M; Kollarik, M

    2016-07-01

    Transient lower esophageal sphincter relaxation (TLESR) is the major mechanism of gastroesophageal reflux, but the regulation of TLESR by stimuli in the esophagus is incompletely understood. We have recently reported that acid infusion in the esophagus substantially (by 75%) increased the number of meal-induced TLESR in healthy subjects. We concluded that the TLESR reflex triggered by gastric distention with meal was enhanced by the stimulation of esophageal nerves by acid. However, the possibilities that the acid infused into the esophagus acts after passing though lower esophageal sphincter in stomach to enhance TLESR, or that the acid directly initiates TLESR from the esophagus were not addressed. Here, we evaluated the effect of acid infusion into the proximal stomach on meal-induced TLESR (study 1) and the ability of acid infusion into the esophagus to initiate TLESR without prior meal (study 2). We analyzed TLESRs by using high-resolution manometry in healthy subjects in paired randomized studies. In study 1, we found that acid infusion into the proximal stomach did not affect TLESRs induced by standard meal. The number of meal-induced TLESRs following the acid infusion into the proximal stomach was similar to the number of meal-induced TLESRs following the control infusion. In study 2, we found that acid infusion into the esophagus without prior meal did not initiate TLESRs. We conclude that the increase in the meal-induced TLESRs by acid in the esophagus demonstrated in our previous study is not attributable to the action of acid in the stomach or to direct initiation of TLESR from the esophagus by acid. Our studies are consistent with the concept that the stimuli in the esophagus can influence TLESRs. The enhancement of TLESR by acid in the esophagus may contribute to pathogenesis of gastroesophageal reflux in some patients. PMID:25873206

  10. Effect of esophageal emptying and saliva on clearance of acid from the esophagus

    International Nuclear Information System (INIS)

    The clearance of acid from the esophagus and esophageal emptying in normal subjects was studied. A 15-ml bolus of 0.1 N hydrochloric acid (pH 1.2) radiolabeled with [/sup 99m/Tc]sulfur colloid was injected into the esophagus, and the subject swallowed every 30 seconds. Concurrent manometry and radionuclide imaging showed nearly complete emptying of acid from the esophagus by an immediate secondary peristaltic sequence, although esophageal pH did not rise until the first swallow 30 seconds later. Esophageal pH then returned to normal by a series of step increases, each associated with a swallow-induced peristaltic sequence. Saliva stimulation by an oral lozenge shortened the time required for acid clearance, whereas aspiration of saliva from the mouth abolished acid clearance. Saliva stimulation or aspiration did not affect the virtually complete emptying of acid volume by the initial peristaltic sequence. It was concluded that esophageal acid clearance normally occurs as a two-step process: (1) Virtually all acid volume is emptied from the esophagus by one or two peristaltic sequences, leaving a minimal residual amount that sustains a low pH, and (2) residual acid is neutralized by swallowed saliva

  11. Intrathoracic esophagojejunostomy using OrVilTM for gastric adenocarcinoma involving the esophagus

    Institute of Scientific and Technical Information of China (English)

    Kazuhito; Yajima; Tatsuo; Ka; Shin-ichi; Kosugi; Yosuke; Kano; Takashi; Ishikawa; Hiroshi; Ichikawa; Takaaki; Hanyu; Toshifumi; Wakai

    2014-01-01

    AIM: To demonstrate a new surgical technique of lower mediastinal lymphadenectomy and intrathoracic anastomosis of esophagojejunostomy using OrV ilTM. METHODS: After a total median phrenotomy, the supradiaphragmatic and lower thoracic paraesophageal lymph nodes were transhiatally dissected. The esophagus was cut off using a liner stapler and OrV ilTMwas inserted. Finally, end-to-side esophagojejunostomy was created by using a circular stapler. From July 2009,we adopted this surgical technique for five patients with gastric cancer involving the lower esophagus. RESULTS: The median operation time was 314 min(range; 210-367 min), and median blood loss was 210 mL(range; 100-838 mL). The median numbers of dissected lower mediastinal nodes were 3(range; 1-10). None of the patients had postoperative complications including anastomotic leakage and stenosis. Themedian hospital stay was 16 d(range: 15-20 d). The median length of esophageal involvement was 14 mm(range: 6-48 mm) and that of the resected esophagus was 40 mm(range: 35-55 mm); all resected specimens had tumor-free margins.CONCLUSION: This surgical technique is easy and safe intrathoracic anastomosis for the patients with gastric adenocarcinoma involving the lower esophagus.

  12. ESOPHAGUS-STOMACH-ABDOMINAL WALL DRAINAGE FOR DELAYED INTRATHORACIC ESOHPAGEAL PERFORATIONLI

    Institute of Scientific and Technical Information of China (English)

    李国庆; 单根法; 张辅贤; 钟竑

    2003-01-01

    Objective To design a technique of esophagus stomach abdominal wall drainage for the delayed intrathoracic esophageal perforation and to improve the therapeutic results.MethodsFour patients were treated by this simplified technique. There were 1 case of lower intrathoracic esophageal perforation to the left thorax, 1 high and 2 middle perforation to the right. This technique used two plastic tubes (chest tube) in a diameter about 1.2cm. One tube served as an intercostal drainage tube to drain purulent effusion, the other was inserted abdominally through stomach to the esophagus about 10cm above the esophageal perforation.ResultsThe four patients were treated successfully by the esophagus stomach abdominal wall drainage. There was no mortality or severe morbidity or complication. Hospitalizations were shortened. ConclusionThis technique is simple, safe and effective. It may provide a more promising alternative method of treatment for delayed esophageal perforation, especially in the critically ill patients. The procedure can also be extended to deal with esophagus stomach anastomotic leak.

  13. Immunolocalization of succinate dehydrogenase in the esophagus epithelium of domesticated mammals

    OpenAIRE

    Meyer, W.; Kacza, J.; I. N. Hornickel; Schoennagel, B.

    2013-01-01

    Using immunohistochemistry and transmission electron microscopy (TEM), the esophagus epithelia of seven domesticated mammals (horse, cattle, goat, pig, dog, laboratory rat, cat) of three nutrition groups (herbivorous, omnivorous, carnivorous) were studied to get first information about energy generation, as demonstrated by succinate dehydrogenase (SDH) activities. Distinct reaction intensities could be observed in all esophageal cell layers of the different species studied reflecting moderate...

  14. Spontaneous rupture of the esophagus associated with intramural rupture caused by ingestion of weeding medicine (Lasso)

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Keon; Park, Heung Il; Kwun, Chung Sik [Chun Nam University College of Medicine, Kwangju (Korea, Republic of)

    1975-06-15

    This is a report of a case of spontaneous rupture of the esophagus associated with intramural rupture caused by ingestion of weeding medicine for the purpose of suicide in a 27 year old Korean male whose chief complaints were dyspnea, epigastric pain, swallowing disturbance, and hoarseness for 3 days prior to admission. A review of literature is submitted.

  15. Current relevance of cervical ultrasonography in staging cancer of the esophagus and gastroesophageal junction

    NARCIS (Netherlands)

    Schreurs, Liesbeth; Verhoef, C.C.; van der Jagt, E.J.; van Dam, G.M.; Groen, H.; Plukker, J.T.

    2008-01-01

    Purpose: To evaluate the value of external ultrasonography (US) of the neck in current dedicated preoperative staging of patients with cancer of the esophagus and gastroesophageal junction (GEJ). Materials and methods: We analyzed 180 consecutive patients (154 men, 26 women, and mean age 63 (38-84)

  16. Spontaneous rupture of the esophagus associated with intramural rupture caused by ingestion of weeding medicine (Lasso)

    International Nuclear Information System (INIS)

    This is a report of a case of spontaneous rupture of the esophagus associated with intramural rupture caused by ingestion of weeding medicine for the purpose of suicide in a 27 year old Korean male whose chief complaints were dyspnea, epigastric pain, swallowing disturbance, and hoarseness for 3 days prior to admission. A review of literature is submitted.

  17. Interstitial cells of Cajal in the striated musculature of the mouse esophagus

    DEFF Research Database (Denmark)

    Rumessen, J J; de Kerchove d'Exaerde, A; Mignon, S; Bernex, F; Timmermans, J P; Schiffmann, S N; Panthier, J J; Vanderwinden, J M

    2001-01-01

    Interstitial cells of Cajal (ICC) are important regulatory cells in the smooth muscle coats of the digestive tract. Expression of the Kit receptor tyrosine kinase was used in this study as a marker to study their distribution and development in the striated musculature of the mouse esophagus. Sec...

  18. Strategies and therapeutic opportunities for the delivery of drugs to the esophagus.

    Science.gov (United States)

    Zhang, Liang; Russell, Danielle; Conway, Barbara R; Batchelor, Hannah

    2008-01-01

    Targeting of drugs and therapies locally to the esophagus is an important objective in the development of new and more effective dosage forms. Therapies that are retained within the oral cavity for both local and systemic action have been utilized for many years, although delivery to the esophagus has been far less reported. Esophageal disease states, including infections, motility disorders, gastric reflux, and cancers, would all benefit from localized drug delivery. Therefore, research in this area provides significant opportunities. The key limitation to effective drug delivery within the esophagus is sufficient retention at this site coupled with activity profiles to correspond with these retention times; therefore, a suitable formulation needs to provide the drug in a ready-to-work form at the site of action during the rapid transit through this organ. A successfully designed esophageal-targeted system can overcome these obstacles. This review presents a range of dosage form approaches for targeting the esophagus, including bioadhesive liquids and orally retained lozenges, chewing gums, gels, and films, as well as endoscopically delivered therapeutics. The techniques used to measure efficacy both in vitro and in vivo are also discussed. Drug delivery is a growing driver within the pharmaceutical industry and offers benefits both in terms of clinical efficacy, as well as in market positioning, as a means of extending a drug's exclusivity and profitability. Emerging systems that can be used to target the esophagus are reported within this review, as well as the potential of alternative formulations that offer benefits in this exciting area. PMID:18540840

  19. Sensory-motor responses to mechanical stimulation of the esophagus after sensitization with acid

    Institute of Scientific and Technical Information of China (English)

    Asbj(ф)rn Mlohr Drewes; Hariprasad Reddy; Camilla Staahl; Jan Pedersen; Peter Funch-Jensen; Lars Arendt-Nielsen; Hans Gregersen

    2005-01-01

    AIM: Sensitization most likely plays an important role in chronic pain disorders, and such sensitization can be mimicked by experimental acid perfusion of the esophagus.The current study systematically investigated the sensory and motor responses of the esophagus to controlled mechanical stimuli before and after sensitization.METHODS: Thirty healthy subjects were included.Distension of the distal esophagus with a balloon was performed before and after perfusion with 0.1 mol/L hydrochloric acid for 30 min. An impedance planimetry system was used to measure cross-sectional area,volume, pressure, and tension during the distensions. A new model allowed evaluation of the phasic contractions by the tension during contractions as a function of the initial muscle length before the contraction (comparable to the Frank-Starling law for the heart). Length-tension diagrams were used to evaluate the muscle tone before and after relaxation of the smooth muscle with butylscopolamine.RESULTS: The sensitization resulted in allodynia and hyperalgesia to the distension volumes, and the degree of sensitization was related to the infused volume of acid. Furthermore, a nearly 50% increase in the evoked referred pain was seen after sensitization. The mechanical analysis demonstrated hyper-reactivity of the esophagus following acid perfusion, with an increased number and force of the phasic contractions, but the muscle tone did not change.CONCLUSION: Acid perfusion of the esophagus sensitizes the sensory pathways and facilitates secondary contractions.The new model can be used to study abnormal sensorymotor mechanisms in visceral organs.

  20. Early Involvement of Death-Associated Protein Kinase Promoter Hypermethylation in the Carcinogenesis of Barrett's Esophageal Adenocarcinoma and Its Association with Clinical Progression

    Directory of Open Access Journals (Sweden)

    Doerthe Kuester

    2007-03-01

    Full Text Available Esophageal Barrett's adenocarcinoma (BA develops through a multistage process, which is associated with the transcriptional silencing of tumor-suppressor genes by promoter CpG island hypermethylation. In this study, we explored the promoter hypermethylation and protein expression of proapoptotic deathassociated protein kinase (DAPK during the multistep Barrett's carcinogenesis cascade. Early BA and paired samples of premalignant lesions of 61 patients were analyzed by methylation-specific polymerase chain reaction and immunohistochemistry. For the association of clinicopathological markers and protein expression, an immunohistochemical tissue microarray analysis of 66 additional BAs of advanced tumor stages was performed. Hypermethylation of DAPK promoter was detected in 20% of normal mucosa, 50% of Barrett's metaplasia, 53% of dysplasia, and 60% of adenocarcinomas, and resulted in a marked decrease in DAPK protein expression (P < .01. The loss of DAPK protein was significantly associated with advanced depth of tumor invasion and advanced tumor stages (P < .001. Moreover, the severity of reflux esophagitis correlated significantly with the hypermethylation rate of the DAPK promoter (P < .003. Thus, we consider DAPK inactivation by promoter hypermethylation as an early event in Barrett's carcinogenesis and suggest that a decreased protein expression of DAPK likely plays a role in the development and progression of BA.

  1. Barrett's oesophagus patients with low-grade dysplasia can be accurately risk-stratified after histological review by an expert pathology panel

    NARCIS (Netherlands)

    Duits, Lucas C.; Phoa, K. Nadine; Curvers, Wouter L.; Ten Kate, Fiebo J W; Meijer, Gerrit A.; Seldenrijk, Cees A.; Offerhaus, G. Johan; Visser, Mike; Meijer, Sybren L.; Krishnadath, Kausilia K.; Tijssen, Jan G P; Mallant-Hent, Rosalie C.; Bergman, Jacques J G H M

    2015-01-01

    Objective Reported malignant progression rates for low-grade dysplasia (LGD) in Barrett's oesophagus (BO) vary widely. Expert histological review of LGD is advised, but limited data are available on its clinical value. This retrospective cohort study aimed to determine the value of an expert patholo

  2. Esophagus sparing with IMRT in lung tumor irradiation: An EUD-based optimization technique

    International Nuclear Information System (INIS)

    Purpose: The aim of this study was to evaluate (1) the use of generalized equivalent uniform dose (gEUD) to optimize dose escalation of lung tumors when the esophagus overlaps the planning target volume (PTV) and (2) the potential benefit of further dose escalation in only the part of the PTV that does not overlap the esophagus. Methods and Materials: The treatment-planning computed tomography (CT) scans of patients with primary lung tumors located in different regions of the left and right lung were used for the optimization of beamlet intensity modulated radiation therapy (IMRT) plans. In all cases, the PTV overlapped part of the esophagus. The dose in the PTV was maximized according to 7 different primary cost functions: 2 plans that made use of mean dose (MD) (the reference plan, in which the 95% isodose surface covered the PTV and a second plan that had no constraint on the minimum isodose), 3 plans based on maximizing gEUD for the whole PTV with ever increasing assumptions for tumor aggressiveness, and 2 plans that used different gEUD values in 2 simultaneous, overlapping target volumes (the whole PTV and the PTV minus esophagus). Beam arrangements and NTCP-based costlets for the organs at risk (OARs) were kept identical to the original conformal plan for each case. Regardless of optimization method, the relative ranking of the resulting plans was evaluated in terms of the absence of cold spots within the PTV and the final gEUD computed for the whole PTV. Results: Because the MD-optimized plans lacked a constraint on minimum PTV coverage, they resulted in cold spots that affected approximately 5% of the PTV volume. When optimizing over the whole PTV volume, gEUD-optimized plans resulted in higher equivalent uniform PTV doses than did the reference plan while still maintaining normal-tissue constraints. However, only under the assumption of extremely aggressive tumors could cold spots in the PTV be avoided. Generally, high-level overall results are obtained

  3. Expression of Sex Steroid Hormone Receptors in Vagal Motor Neurons Innervating the Trachea and Esophagus in Mouse

    Science.gov (United States)

    Mukudai, Shigeyuki; Ichi Matsuda, Ken; Bando, Hideki; Takanami, Keiko; Nishio, Takeshi; Sugiyama, Yoichiro; Hisa, Yasuo; Kawata, Mitsuhiro

    2016-01-01

    The medullary vagal motor nuclei, the nucleus ambiguus (NA) and dorsal motor nucleus of the vagus (DMV), innervate the respiratory and gastrointestinal tracts. We conducted immunohistochemical analysis of expression of the androgen receptor (AR) and estrogen receptor α (ERα), in relation to innervation of the trachea and esophagus via vagal motor nuclei in mice. AR and ERα were expressed in the rostral NA and in part of the DMV. Tracing experiments using cholera toxin B subunit demonstrated that neurons of vagal motor nuclei that innervate the trachea and esophagus express AR and ERα. There was no difference in expression of sex steroid hormone receptors between trachea- and esophagus-innervating neurons. These results suggest that sex steroid hormones may act on vagal motor nuclei via their receptors, thereby regulating functions of the trachea and esophagus. PMID:27006520

  4. The Effects of Environmental Factors on Smooth Muscle Cells Differentiation from Adipose-Derived Stem Cells and Esophagus Tissues Engineering

    OpenAIRE

    Wang, Fang

    2015-01-01

    Adipose-derived stem cells (ASCs) are increasingly being used for regenerative medicine and tissue engineering. Smooth muscle cells (SMCs) can be differentiated from ASCs. Oxygen is a key factor influencing the stem cell differentiation. Tissue engineered esophagus has been a preferred solution for diseased esophagus replacement. The first part involved the effect of hypoxia on differentiation. The results showed 5% hypoxia to be the optimal condition for differentiation of ASCs into contract...

  5. Heterogeneous vesicles in mucous epithelial cells of posterior esophagus of Chinese giant salamander (Andrias davidianus).

    Science.gov (United States)

    Zhang, H; Guo, X; Zhong, S; Ge, T; Peng, S; Yu, P; Zhou, Z

    2015-01-01

    The Chinese giant salamander belongs to an old lineage of salamanders and endangered species. Many studies of breeding and disease regarding this amphibian had been implemented. However, the studies on the ultrastructure of this amphibian are rare. In this work, we provide a histological and ultrastructural investigation on posterior esophagus of Chinese giant salamander. The sections of amphibian esophagus were stained by hematoxylin & eosin (H&E). Moreover, the esophageal epithelium was observed by transmission electron microscopy (TEM). The results showed that esophageal epithelium was a single layer epithelium, which consisted of mucous cells and columnar cells. The esophageal glands were present in submucosa. The columnar cells were ciliated. According to the diverging ultrastructure of mucous vesicles, three types of mucous cells could be identified in the esophageal mucosa: i) electron-lucent vesicles mucous cell (ELV-MC); ii) electron-dense vesicles mucous cell (EDV-MC); and iii) mixed vesicles mucous cell (MV-MC). PMID:26428885

  6. Heterogeneous vesicles in mucous epithelial cells of posterior esophagus of Chinese giant salamander (Andrias davidianus

    Directory of Open Access Journals (Sweden)

    H. Zhang

    2015-08-01

    Full Text Available The Chinese giant salamander belongs to an old lineage of salamanders and endangered species. Many studies of breeding and disease regarding this amphibian had been implemented. However, the studies on the ultrastructure of this amphibian are rare. In this work, we provide a histological and ultrastructural investigation on posterior esophagus of Chinese giant salamander. The sections of amphibian esophagus were stained by hematoxylin & eosin (H&E. Moreover, the esophageal epithelium was observed by transmission electron microscopy (TEM. The results showed that esophageal epithelium was a single layer epithelium, which consisted of mucous cells and columnar cells. The esophageal glands were present in submucosa. The columnar cells were ciliated. According to the diverging ultrastructure of mucous vesicles, three types of mucous cells could be identified in the esophageal mucosa: i electron-lucent vesicles mucous cell (ELV-MC; ii electron-dense vesicles mucous cell (EDV-MC; and iii mixed vesicles mucous cell (MV-MC.

  7. Cases of Swallow Syncope Induced by the Activation of Mechanorecepters in the Lower Esophagus

    OpenAIRE

    Kang, Ki Hoon; Cho, Wook Hyun; Kim, Myung Chan; Chang, Hee Jong; Chung, Jae Il; Won, Dong Jun

    2005-01-01

    Swallowing is a rare cause of neurally mediated syncope. The mechanism of swallow syncope that contributes to hypotension, bradycardia, or to both is complex. A 59-year-old man had experienced a recurrent loss of consciousness during swallowing of carbonated beverages or sticky foods. Another 59-year-old man had complained of intermittent syncope just after eating foods. These two patients had no significant structural or functional abnormalities in the esophagus or heart. Both cases showed b...

  8. Relationship between ABO blood groups and carcinoma of esophagus and cardia in Chaoshan inhabitants of China

    Institute of Scientific and Technical Information of China (English)

    Min Su; Shan-Ming Lu; Dong-Ping Tian; Hu Zhao; Xiao-Yun Li; DeRui Li; Zhi-Chao Zheng

    2001-01-01

    AIM To study the relationship between ABO blood groups and carcinoma of esophagus and cardia in Chaoshan inhebitants of China, which is a unique Littoral high-risk area of esophageal carcinoma in China. The poor communication and transportation in the psst has made Cheoshan a relatively closed area and kept its culture and costure of old China thousend years ago.``METHODS Data on age, sex, ABO blood type and X-rayor psthological diagnose of the pstients with carcinoma of esophagus or cardia were collected from the Tumor Hospital. First Affiliated Hospital, Second Affiliated Hospital of Shantou University Medical College; and the Central Hospital of Shantou and the Central Hospital of Jieyang. A total of 6685 pstients with esophageal carcinoma (EC) and 2 955 patients with cardiac cancer (CC) in Chaoshen district were retrospectively assessed for their association with ABO blood groups.``RESULTS The distribution of ABO blood groups in patients with EC or CC was similar to the norrnal local population in Chaoshen. However, blood group B in male patients with CC and in the pstients with carcinoma in the upper third esophagus was 2.3% and 4.7% higher than the corresponding controls. The relative risk B: O was 1. 1415 (P<0.05)and 1 .2696 (P<0.05), respectively. No relationship was found between ABO blood groups and tumor differentiation.``CONCLTUSION ABO blood group B is associated with the incidence of CC in male individuals and carcinona in the upper third esophagus. The distribution of ABO blood groups varies in the different geographical and ethnic groups. As a result, proper controls are very important for such studies.``

  9. Barrett’s Esophagus and Cancer Risk: How Research Advances Can Impact Clinical Practice

    OpenAIRE

    di Pietro, Massimiliano; Alzoubaidi, Durayd; Fitzgerald, Rebecca C.

    2014-01-01

    Barrett’s esophagus (BE) is the only known precursor to esophageal adenocarcinoma (EAC), whose incidence has increased sharply in the last 4 decades. The annual conversion rate of BE to cancer is significant, but small. The identification of patients at a higher risk of cancer therefore poses a clinical conundrum. Currently, endoscopic surveillance is recommended in BE patients, with the aim of diagnosing either dysplasia or cancer at early stages, both of which are curable with minimally inv...

  10. Duplication of the cervical esophagus: a case report and review of the literature

    International Nuclear Information System (INIS)

    This report describes a newborn with a cervical esophageal duplication cyst, a rare developmental anomaly of the neck. Only a few cases of this cystic entity have been described in the literature to date. This case is unique in that the patient had an air-fluid level within the lesion as a result of communication of the duplication cyst with the native esophagus. (orig.)

  11. Ultrastructure of striated muscle fibers in the middle third of the human esophagus

    OpenAIRE

    Faussone-Pellegrini, M.S; Cortesini, C.

    1986-01-01

    Striated muscle fibers and .their spatial relationship to smooth muscle cells have been studied in the middle third of human esophagus. Biopsies were obtained from 3 patients during surgery. In both the circular and longitudinal layers, the muscle coat of this transition zone was composed of fascicles of uniform dimensioi~ (100-200 pm of diameter); some of these bundles were made up of striated muscle fibers, others were pure bundles of smooth muscle cells and ...

  12. The effect on esophagus after different radiotherapy techniques for early stage Hodgkin's lymphoma

    DEFF Research Database (Denmark)

    Jørgensen, Anni; Maraldo, M.; Brodin, Nils Patrik; Aznar, Marianne Camille; Voglius, I.R.; Petersen, Peter Meidahl; Munck af Rosenschöld, Per Martin; Specht, Lena

    2013-01-01

    The cure rate of early stage Hodgkin's lymphoma (HL) is excellent; investigating the late effects of treatment is thus important. Esophageal toxicity is a known side effect in patients receiving radiotherapy (RT) to the mediastinum, although little is known of this in HL survivors. This study...... investigates the dose to the esophagus in the treatment of early stage HL using different RT techniques. Estimated risks of early esophagitis, esophageal stricture and cancer are compared between treatments....

  13. Expression of TP53, BCL-2, and VEGFA Genes in Esophagus Carcinoma and its Biological Significance

    OpenAIRE

    Wei, Wei; Wang, Yanqin; YU, XIAOMING; Ye, Lan; Jiang, Yuhua; Cheng, Yufeng

    2015-01-01

    Background The pathogenesis of esophagus carcinoma involves a cascade process consisting of multiple factors and accumulation of gene mutations. It is known that vascular endothelial growth factor (VEGF) mainly regulates de novo vascular formation while B-cell lymphoma-2 (BCL-2) gene exerts a tumor-suppressing effect. The prominent expression of VEGFA and BCL-2 genes, along with the most famous tumor-suppressor gene, TP53, raise the possibly of gene interaction. This study therefore investiga...

  14. Caustic Injury and Stricture of the Esophagus After Long-Term Phenytoin Use

    Science.gov (United States)

    Clayton, Steven B.; Champeaux, Anne L.; Feldman, John C.; Richter, Joel E.

    2015-01-01

    A 50-year-old man with a history of epilepsy controlled with phenytoin presented for evaluation of dysphagia. History revealed the patient was taking his phenytoin daily without water. Barium esophagram showed severe stricturing of the mid-esophagus. Upper endoscopy revealed diffuse gross mucosal abnormality with a thick stricture and occasional exudate. Biopsies were consistent with a drug-induced injury with lymphocytic infiltration and epithelial cell necrosis. PMID:26157921

  15. Role of chemoprophylaxis with either NSAIDs or statins in patients with Barrett’s esophagus

    OpenAIRE

    Tsibouris, Panagiotis; Vlachou, Erasmia; Isaacs, Peter Edward Thomas

    2014-01-01

    The incidence of esophageal adenocarcinoma, a poor prognosis neoplasia, has risen dramatically in recent decades. Barrett’s esophagus represents the best-known risk factor for esophageal adenocarcinoma development. Non-steroidal anti-inflammatory drugs through cyclooxygenase-2 inhibition and prostaglandin metabolism regulation could control cell proliferation, increase cell apoptosis and regulate the expression of growth and angiogenic factors. Statins can achieve equivalent effects through p...

  16. Dosimetric study of a brachytherapy treatment of esophagus with Brazilian 192Ir sources using an anthropomorphic phantom

    International Nuclear Information System (INIS)

    Several radioisotopes are produced at Instituto de Pesquisas Energéticas e Nucleares for the use in medical treatments, including the activation of 192Ir sources. These sources are suitable for brachytherapy treatments, due to their low or high activity, depending on the concentration of 192Ir, easiness to manufacture, small size, stable daughter products and the possibility of re-utilization. They may be used for the treatment of prostate, cervix, head and neck, skin, breast, gallbladder, uterus, vagina, lung, rectum, and eye cancer treatment. In this work, the use of some 192Ir sources was studied for the treatment of esophagus cancer, especially the dose determination of important structures, such as those on the mediastinum. This was carried out utilizing a FASH anthropomorphic phantom and the MCNP5 Monte Carlo code to transport the radiation through matter. It was possible to observe that the doses at lungs, breast, esophagus, thyroid and heart were the highest, which was expected due to their proximity to the source. Therefore, the data are useful to assess the representative dose specific to brachytherapy treatments on the esophagus for radiation protection purposes. - Author-Highlights: • The use of brachytherapy sources was studied for the treatment of esophagus cancer. • FASH anthropomorphic phantom and MCNP5 Monte Carlo code were employed. • The doses at lungs, breast, esophagus, thyroid and heart were the highest. • The data is useful to assess the representative doses of treatments on the esophagus

  17. Some aspects of оesophagus morphogenesis at the early stages of prenatal ontogenesis in human being

    Directory of Open Access Journals (Sweden)

    Marchuk O.F.

    2008-01-01

    Full Text Available The peculiarities of esophagus morphogenesis and topography formation in embryos and prefetuses of human being by the complex of morphological methods hаve been studied. Topographical differences in germ of esophagus and respiratory tube was set. In embryos of 4.5-5.0 mm PCL the process of diaphragm formation was observed, which was complete in prefetuses of 18.0-19.0 mm PCL. In embryos of 9.0-9.5 mm PCL the enlarge of circular layer of esophagus muscular membrane was observed; in embryos of 18.0-19.0 mm PCL the longitudinal layer was enlarged. In further development a circular layer thickness was in prevalence due to the thickness of longitudinal layer along all length of esophagus. As a result of condensing interorganic layers of mesenchyma more close correlative intercommunications between esophagus, trachea, thoracic aorta, vagus nerves and serous membranes was set. At the end of prefetuses period the process of recanalisation of esophagus was completed.

  18. 25. Clinicopathologic analysis on 13 823 carcinomas of esophagus and cardia in Chaoshan littoral of China

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Background: Chaoshan is the close region and Chaoshan people who came from old Changan and Henan thousands years ago are relative isolation population with high-risk of esophageal carcinoma (EC) and cardiac carcinoma(CC) in China. However there were no report about detail clinicopathologic data of cancer of esophagus and cardia in Chaoshan district before. Methods: The data of age, sex. ABO blood type and X-ray or pathological diagnosis of the patients with carcinoma of esophagus or cardia were collected from The tumor hospital. The First affiliated hospital, The Second affiliated hospital of Shantou University Medical College, the Center hospital of Shantou and the populalion hospital of Jieyang. In this study. Clinicopathologic data of 9 650 patients with EC and 4 173 patients with CC in Chaoshan population were analyzed. Results and Conclusion: The male to female ratio was 3∶1 in EC and 4.75∶1 in CC, indicating EC and CC was more common in the male than in the female. The average affected age of EC was 54.61 year old. CC was 58.14 year old. The most common affected site of esophageal carcinoma was the middle third of esophagus(72.00%); the second was the lower third (15.30%). The main gross type of esophageal carcinoma was ulcerative type (41.50%); the medullary type ranks second (39.60%). In histological types of EC, squamous cell carcinoma accounted for overwhelming majority(96.44%).

  19. Investigations of disorders of motility of the esophagus in chronic diseases. 14

    International Nuclear Information System (INIS)

    Chronic diseases of the esophagus impair the transport function of this organ. Esophageal scintigraphy investigates the transport function under physiological circumstances. Various test meals are radioactively labelled and swallowed by the patient. depending on the cause of a transport disorder the investigation lasts only 60s up to half an hour. Parametric imaging techniques like the so called condensed pictures give information about extent and peristalsis of transport disorders. The determination of transit times and/or percent of residuum in the eso-phagus allows for quantitating functional disorders. The use of multiple swallow technique or of various tracers during one investigation leads to high sensitivity in the detection of esophageal transport disorders, even in an early stage of a chronic disease, like morphea or sclero-derma. The documentation of successful therapeutical interventions is possible, for example in achalasia. In obscure complaints or in thoracic pain without coronary heart disease esophageal scintigraphy may confirm or exclude a disease of the esophagus. (author). 40 refs.; 5 figs

  20. Somatically Acquired LINE-1 Insertions in Normal Esophagus Undergo Clonal Expansion in Esophageal Squamous Cell Carcinoma.

    Science.gov (United States)

    Doucet-O'Hare, Tara T; Sharma, Reema; Rodić, Nemanja; Anders, Robert A; Burns, Kathleen H; Kazazian, Haig H

    2016-09-01

    Squamous cell carcinoma of the esophagus (SCC) is the most common form of esophageal cancer in the world and is typically diagnosed at an advanced stage when successful treatment is challenging. Understanding the mutational profile of this cancer may identify new treatment strategies. Because somatic retrotransposition has been shown in tumors of the gastrointestinal system, we focused on LINE-1 (L1) mobilization as a source of genetic instability in this cancer. We hypothesized that retrotransposition is ongoing in SCC patients. The expression of L1 encoded proteins is necessary for retrotransposition to occur; therefore, we evaluated the expression of L1 open reading frame 1 protein (ORF1p). Using immunohistochemistry, we detected ORF1p expression in all four SCC cases evaluated. Using L1-seq, we identified and validated 74 somatic insertions in eight tumors of the nine evaluated. Of these, 12 insertions appeared to be somatic, not genetically inherited, and sub-clonal (i.e., present in less than one copy per genome equivalent) in the adjacent normal esophagus (NE), while clonal in the tumor. Our results indicate that L1 retrotransposition is active in SCC of the esophagus and that insertion events are present in histologically NE that expands clonally in the subsequent tumor. PMID:27319353

  1. Distribution of Interstitial Cells of Cajal in the Esophagus of Fetal Rats with Esophageal Atresia

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    Caner Isbir

    2016-04-01

    Full Text Available Aim: Scarcity of the interstitial cells of Cajal (ICC is related to motility disorders. In the study, we aimed to evaluate the number and density of ICCs in the fetal rat esophagus in the adriamycin - esophageal atresia (EA model. Material and Method: Rat fetuses were divided into three groups as a control, adriamycin group without EA and adriamycin group with EA. Four doses of adriamycin, 2 mg/kg each, were injected intraperitoneally to the adriamycin group rats between on 6 and 9 days of gestation. The presence of ICCs in the esophagus of the rat fetuses was determined by using an immunohistochemistry technique (c-kit, CD117. The average numbers of ICCs were calculated with microscopic evaluation by using a visual scoring system (range1 to 3. Results: Seven fetuses were included in each group. The ICCs score 3 distributions of fetuses were 5 (72% fetuses in the control group, 3 (43% fetuses in the adriamycin group without EA, 1 (14% fetus in the adriamycin group with EA. It have been found that there was a marked reduction of ICCs distribution in the adriamycin group with EA compared to control group (p 0.05. Discussion: ICCs density was significantly decreased in the rat fetuses with EA compared to the fetuses without EA. These findings support the idea that ICCs density may be congenitally abnormal in EA. This may be led to dismotility seen in the operated esophagus due to EA.

  2. A comparison of results by sequential and concurrent chemo radiotherapy in locally advanced carcinoma esophagus

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    V Bhandari

    2013-01-01

    Full Text Available Aim: Many Trials using sequential and concurrent chemo radiotherapy have been done so far and has established the role of concurrent chemo radiotherapy in treatment of inoperable carcinoma esophagus. In this study, we have compared the results of concurrent chemo radiotherapy with sequential chemo radiotherapy. We have treated inoperable carcinoma esophagus in both the settings and present here the comparison of results in the two settings. Materials and Methods: There were 26 patients of carcinoma esophagus in sequential and 31 in concurrent chemo radiotherapy arm. In sequential arm methotrexate and Cisplatin followed by radiotherapy was given whereas in concurrent arm, Cisplatin was given once weekly along with radiotherapy. Results: The 2 year survival was 38% in sequential and35.5% in the concurrent setting and the median survival was 19.5 and 18 months respectively in the two arms.The toxicities in both the arms were comparable. P value of 0.4774 with confidence interval of 95% was obtained, which is not significant. Dysphagia was improved earlier in sequential than in the concurrent arm. Conclusion: As the results and toxicities in both the arms are almost similar with better symptom control, so larger randomized trials are required to assess the response and the use of methotrexate in sequential chemo radiotherapy can be further explored.

  3. Peristaltic Transport of a Rheological Fluid: Model for Movement of Food Bolus Through Esophagus

    CERN Document Server

    Misra, J C

    2011-01-01

    Fluid mechanical peristaltic transport through esophagus has been of concern in the paper. A mathematical model has been developed with an aim to study the peristaltic transport of a rheological fluid for arbitrary wave shapes and tube lengths. The Ostwald-de Waele power law of viscous fluid is considered here to depict the non-Newtonian behaviour of the fluid. The model is formulated and analyzed with the specific aim of exploring some important information concerning the movement of food bolus through the esophagus. The analysis has been carried out by using lubrication theory. The study is particularly suitable for cases where the Reynolds number is small. The esophagus is treated as a circular tube through which the transport of food bolus takes places by periodic contraction of the esophageal wall. Variation of different variables concerned with the transport phenomena such as pressure, flow velocity, particle trajectory and reflux are investigated for a single wave as well as for a train of periodic per...

  4. Mechanism for esophagus-jejunum stent bypass in the treatment of type 2 diabetes mellitus

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    Suo-lin FU

    2012-09-01

    Full Text Available Objective To observe the effect of endoscopic esophagus-jejunum covered stent bypass on the treatment of type 2 diabetes mellitus (T2DM, and analyze the mechanism thereof. Methods Five obese Beagle dog models of T2DM underwent endoscopic esophagus-jejunum covered stent bypass to serve as operation group, and five normal Beagle dogs as control group receive endoscopy and exploratory laparotomy. The T2DM indices of both groups, including fast plasma glucose (FPG level, fast insulin (FINS level, intravenous glucose tolerance test-2h plasma glucose (IVGTT-2h PG and IVGTT-2h FINS, were determined regularly before operation and 4, 8 and 12 weeks after operation. The insulin resistance index (HOMA-IR and the function of islet β-cell (HOMA-β were calculated with Homeostasis Model Assessment. The levels of gastric inhibitory polypeptide (GIP and glucagon-like peptide-1(GLP-1 were also determined. Results Four weeks after operation, FPG, FINS, IVGTT-2h PG, and IVGTT-2h FINS all decreased significantly in operation group (P 0.05. The HOMA-IR index declined distinctly and HOMA-β index ascended obviously in operation group 4 weeks after operation (P 0.05. The level of GIP lowered significantly (P 0.05. Conclusion T2DM may be treated with esophagus-jejunum covered stent bypass effectively and safely, and the mechanism thereof might be related to the changes in gastrointestinal hormones.

  5. Telomerase inhibition by siRNA causes senescence and apoptosis in Barrett's adenocarcinoma cells: mechanism and therapeutic potential

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    Batchu Ramesh B

    2005-07-01

    Full Text Available Abstract Background In cancer cells, telomerase induction helps maintain telomere length and thereby bypasses senescence and provides enhanced replicative potential. Chemical inhibitors of telomerase have been shown to reactivate telomere shortening and cause replicative senescence and apoptotic cell death of tumor cells while having little or no effect on normal diploid cells. Results We designed siRNAs against two different regions of telomerase gene and evaluated their effect on telomere length, proliferative potential, and gene expression in Barrett's adenocarcinoma SEG-1 cells. The mixture of siRNAs in nanomolar concentrations caused a loss of telomerase activity that appeared as early as day 1 and was essentially complete at day 3. Inhibition of telomerase activity was associated with marked reduction in median telomere length and complete loss of detectable telomeres in more than 50% of the treated cells. Telomere loss caused senescence in 40% and apoptosis in 86% of the treated cells. These responses appeared to be associated with activation of DNA sensor HR23B and subsequent activation of p53 homolog p73 and p63 and E2F1. Changes in these gene regulators were probably the source of observed up-regulation of cell cycle inhibitors, p16 and GADD45. Elevated transcript levels of FasL, Fas and caspase 8 that activate death receptors and CARD 9 that interacts with Bcl10 and NFKB to enhance mitochondrial translocation and activation of caspase 9 were also observed. Conclusion These studies show that telomerase siRNAs can cause effective suppression of telomerase and telomere shortening leading to both cell cycle arrest and apoptosis via mechanisms that include up-regulation of several genes involved in cell cycle arrest and apoptosis. Telomerase siRNAs may therefore be strong candidates for highly selective therapy for chemoprevention and treatment of Barrett's adenocarcinoma.

  6. Primary small cell carcinoma of esophagus:Report of 9 cases and review of literature

    Institute of Scientific and Technical Information of China (English)

    Zhu Wu; Jian-Yang Ma; Jun-Jie Yang; Yong-Fan Zhao; Shang-Fu Zhang

    2004-01-01

    AIM: To analyze the clinical manifestations, pathological features and treatment of primary small cell carcinoma (SCC)of the esophagus and to review the literature on this entity.METHODS: The records of 9 patients with primary esophageal small cell carcinoma were examined and the demographic data, presenting symptoms, methods of tumor diagnosis, and types of treatment given, response to treatment, pathologic findings, and clinical outcome were reviewed. Features of mixed patterns of histological differentiation and lymph node metastases were specifically sought.RESULTS: All the patients reported dysphagia, weight loss and chest pain as the initial symptoms. In 5 cases the tumors were located in the mid-esophagus, 3 cases in the lower third of the esophagus and 1 case in the upper third.The average length of esophageal involvement was 5 cm.They underwent radical resection, regional lymph node clearance and esophageal-stomach anastomosis in thorax or at neck. Two patients had a stage Ⅱa disease, five had a stage Ⅱb disease, and the other two had a stage Ⅲdisease of International Union Contrele Cancer (UICC). All of them were histologically and immunohistochemically confirmed SCC of esophagus. Immunohistochemical staining for neuron-specific enolase (NSE), synaptophsin (Syn) and chromogranin A exhibited strong immunoreactivity in all specimens. Three of the nine resected specimens showed foci of squamous cell carcinoma in situ. Metastasis was present in 7 of 9 adjacent lymph nodes. All the patients survived the operations and made an uneventful postoperative recovery. They received adjuvant systemic chemotherapy and local radiation therapy after discharge. During followup, three patients developed multiple liver, brain, lung and bone metastases and died between 5 and 18 mo after the diagnosis. Three patients developed widespread metastasis disease and died between 18 and 37 mo after the diagnosis.There was no local tumor recurrence in these 6 patients.The other

  7. X-ray Berg-Barrett topography of the deformation substructure of stabilized zirconium oxide single crystals deformed at 1673 K

    International Nuclear Information System (INIS)

    X-ray Berg-Barrett topography has been used to check the nature of the slip systems that are activated during high-temperature plastic deformation of single crystals and to follow the evolution of the microstructure with the strain. A study has been made of yttria fully stabilized zirconium oxide deformed by compression along the left angle 001 right angle direction at 1673 K. The {110} left angle 1 anti 10 right angle slip system was activated. (orig.)

  8. Current Evidence to Justify, and the Methodological Considerations for a Randomised Controlled Trial Testing the Hypothesis that Statins Prevent the Malignant Progression of Barrett's Oesophagus

    Institute of Scientific and Technical Information of China (English)

    David Thurtle; Leo Alexandre; Yoon K Loke; Ed Cheong; Andrew Hart

    2014-01-01

    Barrett's oesophagus is the predominant risk factor for oesophageal adenocarcinoma, a cancer whose incidence is increasing and which has a poor prognosis. This article reviews the latest experimental and epidemiological evidence justifying the development of a randomised controlled trial investigating the hypothesis that statins prevent the malignant progression of Barrett's oesophagus, and explores the methodological considerations for such a trial. The experimental evidence suggests anti-carcinogenic properties of statins on oesophageal cancer cell lines, based on the inhibition of the mevalonate pathway and the production of pro-apoptotic proteins. The epidemiological evidence reports inverse associations between statin use and the incidence of oesophageal carcinoma in both general population and Barrett's oesophagus cohorts. Such a randomised controlled trial would be a large multi-centre trial, probably investigating simvastatin, given the wide clinical experience with this drug, relatively low side-effect profile and low ifnancial cost. As with any clinical trial, high adherence is important, which could be increased with therapy, patient, doctor and system-focussed interventions. We would suggest there is now sufifcient evidence to justify a full clinical trial that attempts to prevent this aggressive cancer in a high-risk population.

  9. Diagnosis of Neoplasia in Barrett’s Esophagus using Vital-dye Enhanced Fluorescence Imaging

    Science.gov (United States)

    Perl, Daniel P.; Parikh, Neil; Chang, Shannon; Peng, Paul; Thekkek, Nadhi; Lee, Michelle H.; Polydorides, Alexandros D.; Mitcham, Josephine; Richards-Kortum, Rebecca; Anandasabapathy, Sharmila

    2014-01-01

    The ability to differentiate benign metaplasia in Barrett’s Esophagus (BE) from neoplasia in vivo remains difficult as both tissue types can be flat and indistinguishable with white light imaging alone. As a result, a modality that highlights glandular architecture would be useful to discriminate neoplasia from benign epithelium in the distal esophagus. VFI is a novel technique that uses an exogenous topical fluorescent contrast agent to delineate high grade dysplasia and cancer from benign epithelium. Specifically, the fluorescent images provide spatial resolution of 50 to 100 μm and a field of view up to 2.5 cm, allowing endoscopists to visualize glandular morphology. Upon excitation, classic Barrett’s metaplasia appears as continuous, evenly-spaced glands and an overall homogenous morphology; in contrast, neoplastic tissue appears crowded with complete obliteration of the glandular framework. Here we provide an overview of the instrumentation and enumerate the protocol of this new technique. While VFI affords a gastroenterologist with the glandular architecture of suspicious tissue, cellular dysplasia cannot be resolved with this modality. As such, one cannot morphologically distinguish Barrett’s metaplasia from BE with Low-Grade Dysplasia via this imaging modality. By trading off a decrease in resolution with a greater field of view, this imaging system can be used at the very least as a red-flag imaging device to target and biopsy suspicious lesions; yet, if the accuracy measures are promising, VFI may become the standard imaging technique for the diagnosis of neoplasia (defined as either high grade dysplasia or cancer) in the distal esophagus. PMID:24893592

  10. Tissue damage in the canine normal esophagus by photoactivation with talaporfin sodium (laserphyrin: a preclinical study.

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    Takahiro Horimatsu

    Full Text Available BACKGROUND: Treatment failure at the primary site after chemoradiotherapy is a major problem in achieving a complete response. Photodynamic therapy (PDT with porfimer sodium (Photofrin® has some problems such as the requirement for shielding from light for several weeks and a high incidence of skin phototoxicity. PDT with talaporfin sodium (Laserphyrin is less toxic and is expected to have a better effect compared with Photofrin PDT. However, Laserphyrin PDT is not approved for use in the esophagus. In this preclinical study, we investigated tissue damage of the canine normal esophagus caused by photoactivation with Laserphyrin. METHODOLOGY/PRINCIPAL FINDINGS: Diode laser irradiation was performed at 60 min after administration. An area 5 cm oral to the esophagogastric junction was irradiated at 25 J/cm(2, 50 J/cm(2, and 100 J/cm(2 using a three-step escalation. The irradiated areas were evaluated endoscopically on postirradiation days 1 and 7, and were subjected to histological examination after autopsy. The areas injured by photoactivation were 52 mm(2, 498 mm(2, and 831 mm(2 after irradiation at 25 J/cm(2, 50 J/cm(2, and 100 J/cm(2, respectively. Tissue injury was observed in the muscle layer or even deeper at any irradiation level and became more severe as the irradiation dose increased. At 100 J/cm(2 both inflammatory changes and necrosis were seen histologically in extra-adventitial tissue. CONCLUSIONS/SIGNIFICANCE: To minimize injury of the normal esophagus by photoactivation with Laserphyrin, diode laser irradiation at 25 J/cm(2 appears to be safe. For human application, it would be desirable to investigate the optimal laser dose starting from this level.

  11. Involvement of catecholaminergic neurons in motor innervation of striated muscle in the mouse esophagus.

    Science.gov (United States)

    van der Keylen, Piet; Garreis, Fabian; Steigleder, Ruth; Sommer, Daniel; Neuhuber, Winfried L; Wörl, Jürgen

    2016-05-01

    Enteric co-innervation is a peculiar innervation pattern of striated esophageal musculature. Both anatomical and functional data on enteric co-innervation related to various transmitters have been collected in different species, although its function remains enigmatic. However, it is unclear whether catecholaminergic components are involved in such a co-innervation. Thus, we examined to identify catecholaminergic neuronal elements and clarify their relationship to other innervation components in the esophagus, using immunohistochemistry with antibodies against tyrosine hydroxylase (TH), vesicular acetylcholine transporter (VAChT), choline acetyltransferase (ChAT) and protein gene product 9.5 (PGP 9.5), α-bungarotoxin (α-BT) and PCR with primers for amplification of cDNA encoding TH and dopamine-β-hydroxylase (DBH). TH-positive nerve fibers were abundant throughout the myenteric plexus and localized on about 14% of α-BT-labelled motor endplates differing from VAChT-positive vagal nerve terminals. TH-positive perikarya represented a subpopulation of only about 2.8% of all PGP 9.5-positive myenteric neurons. Analysis of mRNA showed both TH and DBH transcripts in the mouse esophagus. As ChAT-positive neurons in the compact formation of the nucleus ambiguus were negative for TH, the TH-positive nerve varicosities on motor endplates are presumably of enteric origin, although a sympathetic origin cannot be excluded. In the medulla oblongata, the cholinergic ambiguus neurons were densely supplied with TH-positive varicosities. Thus, catecholamines may modulate vagal motor innervation of esophageal-striated muscles not only at the peripheral level via enteric co-innervation but also at the central level via projections to the nucleus ambiguus. As Parkinson's disease, with a loss of central dopaminergic neurons, also affects the enteric nervous system and dysphagia is prevalent in patients with this disease, investigation of intrinsic catecholamines in the esophagus may

  12. Activation of Akt is increased in the dysplasia-carcinoma sequence in Barrett's oesophagus and contributes to increased proliferation and inhibition of apoptosis: a histopathological and functional study

    International Nuclear Information System (INIS)

    The incidence of oesophageal adenocarcinoma is increasing rapidly in the developed world. The serine-threonine protein kinase and proto-oncogene Akt has been reported to regulate proliferation and apoptosis in several tissues but there are no data on the involvement of Akt in oesophageal carcinogenesis. Therefore we have examined the activation of Akt in Barrett's oesophagus and oesophageal adenocarcinoma and the functional effects of Akt activation in vitro. Expression of total and active (phosphorylated) Akt were determined in endoscopic biopsies and surgical resection specimens using immunohistochemistry. The functional effects of Akt were examined using Barrett's adenocarcinoma cells in culture. In normal squamous oesophagus, erosive oesophagitis and non-dysplastic Barrett's oesophagus, phospho-Akt was limited to the basal 1/3 of the mucosa. Image analysis confirmed that Akt activation was significantly increased in non-dysplastic Barrett's oesophagus compared to squamous epithelium and further significantly increased in high-grade dysplasia and adenocarcinoma. In all cases of high grade dysplasia and adenocarcinoma Akt was activated in the luminal 1/3 of the epithelium. Transient acid exposure and the obesity hormone leptin activated Akt, stimulated proliferation and inhibited apoptosis: the combination of acid and leptin was synergistic. Inhibition of Akt phosphorylation with LY294002 increased apoptosis and blocked the effects of acid and leptin both alone and in combination. Activation of Akt was associated with downstream phosphorylation and deactivation of the pro-apoptotic protein Bad and phosphorylation of the Forkhead family transcription factor FOXO1. Akt is abnormally activated in Barrett's oesophagus, high grade dysplasia and adenocarcinoma. Akt activation promotes proliferation and inhibits apoptosis in Barrett's adenocarcinoma cells and both transient acid exposure and leptin stimulate Akt phosphorylation. Downstream

  13. Radionuclide examination of motility disorders of the esophagus: a comparative study with manometry

    International Nuclear Information System (INIS)

    The primary aim of this investigation is to determine the value of radionuclide studies for clinical diagnostics in the light of its advantages over the manometric examination by means of available casuistics. A general review of the development of the examinations for assessment of the motility of the esophagus is given and both normal and disturbed motor function are described. The details of the patient groups and the techniques used in this study are presented. The results obtained for normal subjects and patients with achalasia, diffuse esophageal spasm, systemic connective tissue diseases with esophageal involvement and reflux esophagitis are reported and discussed. (Auth.)

  14. Mucosal bridges of the upper esophagus after radiotherapy for Hodgkin's disease

    International Nuclear Information System (INIS)

    A 47-yr-old man developed dysphagia 4 yr after mediastinal radiotherapy for Hodgkin's disease. X-ray series, fiberoptic endoscopy, and computerized transverse tomography showed mucosal bridges in the upper esophagus. Histologically, these bridges were constituted from normal epithelium overlying a chronic inflammatory lamina propria, without evidence of Hodgkin's disease recurrence or of squamous cell carcinoma. Swallowing was improved by endoscopic electrocoagulation and Eder-Puestow dilatations. Several arguments favor the hypothesis that these mucosal bridges were the late sequelae of radiation esophagitis

  15. The effect on esophagus after different radiotherapy techniques for early stage Hodgkin's lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Joergensen, Anni Y. S. [Dept. of Radiation Oncology, Rigshospitalet, Univ. of Copenhagen, Copenhagen (Denmark); Dept. of Oncology, Rigshospitalet, Univ. of Copenhagen, Copenhagen (Denmark)], e-mail: an9dk@hotmail.com; Maraldo, Maja V.; Vogelius, Ivan R. [Dept. of Radiation Oncology, Rigshospitalet, Univ. of Copenhagen, Copenhagen (Denmark); Brodin, Nils Patrik; Aznar, Marianne C; Af Rosenschoeld, Per Munck [Dept. of Radiation Oncology, Rigshospitalet, Univ. of Copenhagen, Copenhagen (Denmark); Niels Bohr Inst., Univ. of Copenhagen, Copenhagen (Denmark); Petersen, Peter M.; Specht, Lena [Dept. of Radiation Oncology, Rigshospitalet, Univ. of Copenhagen, Copenhagen (Denmark); Dept. of Oncology, Rigshospitalet, Univ. of Copenhagen, Copenhagen (Denmark); Dept. of Hematology, Rigshospitalet, Univ. of Copenhagen, Copenhagen (Denmark)

    2013-10-15

    Introduction: The cure rate of early stage Hodgkin's lymphoma (HL) is excellent; investigating the late effects of treatment is thus important. Esophageal toxicity is a known side effect in patients receiving radiotherapy (RT) to the mediastinum, although little is known of this in HL survivors. This study investigates the dose to the esophagus in the treatment of early stage HL using different RT techniques. Estimated risks of early esophagitis, esophageal stricture and cancer are compared between treatments. Material and methods: We included 46 patients {>=}15 years with supra diaphragmatic, clinical stage I-II HL, who received chemotherapy followed by involved node RT (INRT) to 30.6 Gy at our institution. INRT was planned with three-dimensional conformal RT (3DCRT). For each patient a volumetric modulated arc therapy (VMAT), proton therapy (PT) and mantle field (MF) treatment plan was simulated. Mean, maximum and minimum dose to the esophagus were extracted from the treatment plans. Risk estimates were based on dose-response models from clinical series with long-term follow-up. Statistical analyses were performed with repeated measures ANOVA using Bonferroni corrections. Results: Mean dose to the esophagus was 16.4, 16.4, 14.7 and 34.2 Gy (p < 0.001) with 3DCRT, VMAT, PT and MF treatment, respectively. No differences were seen in the estimated risk of developing esophagitis, stricture or cancer with 3DCRT compared to VMAT (p = 1.000, p = 1.000, p = 0.356). PT performed significantly better with the lowest risk estimates on all parameters compared to the photon treatments, except compared to 3DCRT for stricture (p = 0.066). On all parameters the modern techniques were superior to MF treatment (p < 0.001). Conclusions: The estimated dose to the esophagus and the corresponding estimated risks of esophageal complications are decreased significantly with highly conformal RT compared to MF treatment. The number of patients presenting with late esophageal side

  16. Echography in the esophagus perforation for strange body: Preoperative and intraoperative use

    International Nuclear Information System (INIS)

    In order to discover foreign bodies, which have perforated the esophagus and are located in the soft tissues of the neck; preoperative ultrasonography was performed on five patients with visualization, and intraoperative ultrasonography was performed on three of them. All the foreign bodies were fishbone and their image is typically linear and hyperchoic, with subsequent reinforcement of echoes. ultrasonography proved most useful in all cases for the satisfactory extraction of the foreign body. There are no reports in literature of the use of this technique

  17. Distribution of Interstitial Cells of Cajal in the Esophagus of Fetal Rats with Esophageal Atresia

    OpenAIRE

    Caner Isbir

    2016-01-01

    Aim: Scarcity of the interstitial cells of Cajal (ICC) is related to motility disorders. In the study, we aimed to evaluate the number and density of ICCs in the fetal rat esophagus in the adriamycin - esophageal atresia (EA) model. Material and Method: Rat fetuses were divided into three groups as a control, adriamycin group without EA and adriamycin group with EA. Four doses of adriamycin, 2 mg/kg each, were injected intraperitoneally to the adriamycin group rats between on 6 and 9 days of ...

  18. The effect on esophagus after different radiotherapy techniques for early stage Hodgkin's lymphoma

    International Nuclear Information System (INIS)

    Introduction: The cure rate of early stage Hodgkin's lymphoma (HL) is excellent; investigating the late effects of treatment is thus important. Esophageal toxicity is a known side effect in patients receiving radiotherapy (RT) to the mediastinum, although little is known of this in HL survivors. This study investigates the dose to the esophagus in the treatment of early stage HL using different RT techniques. Estimated risks of early esophagitis, esophageal stricture and cancer are compared between treatments. Material and methods: We included 46 patients ≥15 years with supra diaphragmatic, clinical stage I-II HL, who received chemotherapy followed by involved node RT (INRT) to 30.6 Gy at our institution. INRT was planned with three-dimensional conformal RT (3DCRT). For each patient a volumetric modulated arc therapy (VMAT), proton therapy (PT) and mantle field (MF) treatment plan was simulated. Mean, maximum and minimum dose to the esophagus were extracted from the treatment plans. Risk estimates were based on dose-response models from clinical series with long-term follow-up. Statistical analyses were performed with repeated measures ANOVA using Bonferroni corrections. Results: Mean dose to the esophagus was 16.4, 16.4, 14.7 and 34.2 Gy (p < 0.001) with 3DCRT, VMAT, PT and MF treatment, respectively. No differences were seen in the estimated risk of developing esophagitis, stricture or cancer with 3DCRT compared to VMAT (p = 1.000, p = 1.000, p = 0.356). PT performed significantly better with the lowest risk estimates on all parameters compared to the photon treatments, except compared to 3DCRT for stricture (p = 0.066). On all parameters the modern techniques were superior to MF treatment (p < 0.001). Conclusions: The estimated dose to the esophagus and the corresponding estimated risks of esophageal complications are decreased significantly with highly conformal RT compared to MF treatment. The number of patients presenting with late esophageal side effects

  19. Demonstration of vascular abnormalities compressing esophagus by MDCT: Special focus on dysphagia lusoria

    Energy Technology Data Exchange (ETDEWEB)

    Alper, Fatih [Department of Radiology, Medical Faculty, Atatuerk University, Erzurum (Turkey)]. E-mail: fatihrad@yahoo.com; Akgun, Metin [Department of Chest Diseases, Medical Faculty, Atatuerk University, Erzurum (Turkey); Kantarci, Mecit [Department of Radiology, Medical Faculty, Atatuerk University, Erzurum (Turkey); Eroglu, Atilla [Department of Thoracic Surgery, Medical Faculty, Atatuerk University, Erzurum (Turkey); Ceyhan, Elvan [Department of Mathematics, College of Arts and Sciences, Koc University, Istanbul (Turkey); Onbas, Omer [Department of Radiology, Medical Faculty, Atatuerk University, Erzurum (Turkey); Duran, Cihan [Department of Radiology, Florence Nightingale Hospital, Istanbul (Turkey); Okur, Adnan [Department of Radiology, Medical Faculty, Atatuerk University, Erzurum (Turkey)

    2006-07-15

    Purpose: Dysphagia lusoria (DL) is described in the literature as difficulty in swallowing caused by vascular abnormalities. The most common cause is an aberrant right subclavian artery (SCA) which passes behind the esophagus and is also called arteria lusoria (AL). Our aim was to demonstrate the use of multidetector computed tomography (MDCT) in the diagnosis of AL, as there is no comprehensive study investigating the role of MDCT in such cases. Material and methods: A total of 38 consecutive patients, comprising of 23 females (61%) and 15 males (39%), who had extrinsic compression were included in the study. These patients are selected from the cases who were admitted due to their gastrointestinal symptoms, such as dysphagia, epigastric pain, chronic nausea, vomiting, etc. The mean age of patients was 40 {+-} 25 years (range 15-65). Following barium esophagogram and then endoscopy performed, MDCT angiography was carried out on the same or the following few days. MDCT sections were examined to determine the following: presence of vascular abnormality; the diameter and angle of that vascular structure; and the compressed area of esophagus. Radiological findings and dysphagia scores were also compared. Results: In each of 15 cases, there was a compression due to vascular abnormality which were all located between the esophagus and the spine. There was an esophageal compression in each of 12 cases, due to right aberrant SCA, in one case due to right superior aortic arch and in two cases due to both right aortic arch and left SCA with Kommerell's diverticulum. The mean diameter and the angle of AL were 16.4 mm and 48.8{sup o}, respectively, and the mean area of pressured esophagus was 194.7 mm{sup 2}. Dysphagia scores of the cases was 1 in thirteen cases and 2 in two cases. However, dysphagia scores were not correlated with these parameters. Conclusions: MDCT angiography is a useful diagnostic tool for evaluation of patients with dysphagia, especially caused by a

  20. Dermatan sulfate is involved in the tumorigenic properties of esophagus squamous cell carcinoma

    DEFF Research Database (Denmark)

    Thelin, Martin A; Svensson, Katrin J; Shi, Xiaofeng;

    2012-01-01

    unique feature that distinguishes DS from CS is the presence of iduronic acid (IdoA) in DS. Here, we report that CS/DS is increased five-fold in human biopsies of esophagus squamous cell carcinoma (ESCC), an aggressive tumor with poor prognosis, as compared with normal tissue. The main Ido....../2 signaling, and deregulated actin cytoskeleton dynamics and focal adhesion formation. Our findings show that IdoA in DS influences tumorigenesis by affecting cancer cell behavior. Therefore, downregulation of IdoA by DS-epi1 inhibitors may represent a new anticancer therapy....

  1. Tension Pneumoperitoneum Following Instrumental Perforation of an Obstructed Esophagus in an Infant.

    Directory of Open Access Journals (Sweden)

    Chih-Cheng Luo

    2003-10-01

    Full Text Available A 4-month-old infant was diagnosed with esophageal atresia and tracheoesophageal fistula.He was admitted to our hospital because of progressive poor findings and repeatedaspiration pneumonia after surgical repair. An esophagogram demonstrated severeesophageal stricture. Flexible endoscopic dilatation was performed under general anesthesia,but sudden onset respiratory distress and progressive abdominal distention were noted duringthe procedure. Abdominal radiographic study revealed severe pneumoperitoneum.Tension pneumoperitoneum after perforation of the obstructed esophagus is extremely rarebut life threatening. We herein report our experience with the successful management of thiscomplication in an infant.

  2. Statistical modeling of the response characteristics of mechanosensitive stimuli in the human esophagus

    DEFF Research Database (Denmark)

    Drewes, Asbjørn Mohr; Reddy, Hari Prasad; Ståhl, Camilla; Funch-Jensen, Peter; Arendt-Nielsen, Lars; Gregersen, Hans; Lundbye-Christensen, Søren

    2005-01-01

    using a statistical model based on correlation analysis. The esophagus was distended with a bag in 32 healthy subjects by using an inflation rate of 25 mL/min. The luminal cross-sectional areas and sensory ratings were determined during the distentions. The stimuli were repeated after relaxation of the...... smooth muscle with butylscopolamine and after sensitization with hydrochloride acid. A positive correlation between the sensory responses to distention was found in the nonpainful and painful ranges, respectively, but correlations between nonpainful and painful ratings were nonsignificant. Relaxation of...

  3. Squamous Cell Carcinoma and Adenocarcinoma of the Esophagus-Differences in Etiology, Epidemiology and Prevention

    Institute of Scientific and Technical Information of China (English)

    ElfriedeBollschweiler; EvaWolfgarten

    2004-01-01

    In Germany, esophageal carcinoma is one of the ten most frequent causes of death. Normally the disease is found in men over the age of 50. Although squamous cell carcinoma (SCC) of the esophagus has been more commonly diagnosed over the past 30 years, there is increasing incidence of esophageal adenocarcinoma (AC) in Western industrialized countries. For SCC the known etiological risk factors are nicotine and alcohol abuse. For AC, they are moderate nicotine and alcohol consumption as well as gastro-esophageal reflux and obesity.

  4. Array-based comparative genomic hybridization for the detection of DNA sequence copy number changes in Barrett's adenocarcinoma.

    Science.gov (United States)

    Albrecht, Bettina; Hausmann, Michael; Zitzelsberger, Horst; Stein, Hubert; Siewert, Jörg Rüdiger; Hopt, Ulrich; Langer, Rupert; Höfler, Heinz; Werner, Martin; Walch, Axel

    2004-07-01

    Array-based comparative genomic hybridization (aCGH) allows the identification of DNA sequence copy number changes at high resolution by co-hybridizing differentially labelled test and control DNAs to a micro-array of genomic clones. The present study has analysed a series of 23 formalin-fixed, paraffin wax-embedded tissue samples of Barrett's adenocarcinoma (BCA, n = 18) and non-neoplastic squamous oesophageal (n = 2) and gastric cardia mucosa (n = 3) by aCGH. The micro-arrays used contained 287 genomic targets covering oncogenes, tumour suppressor genes, and DNA sequences localized within chromosomal regions previously reported to be altered in BCA. DNA sequence copy number changes for a panel of approximately 50 genes were identified, most of which have not been previously described in BCA. DNA sequence copy number gains (mean 41 +/- 25/BCA) were more frequent than DNA sequence copy number losses (mean 20 +/- 15/BCA). The highest frequencies for DNA sequence copy number gains were detected for SNRPN (61%); GNLY (44%); NME1 (44%); DDX15, ABCB1 (MDR), ATM, LAMA3, MYBL2, ZNF217, and TNFRSF6B (39% each); and MSH2, TERC, SERPINE1, AFM137XA11, IGF1R, and PTPN1 (33% each). DNA sequence copy number losses were identified for PDGFB (44%); D17S125 (39%); AKT3 (28%); and RASSFI, FHIT, CDKN2A (p16), and SAS (CDK4) (28% each). In all non-neoplastic tissue samples of squamous oesophageal and gastric cardia mucosa, the measured mean ratios were 1.00 (squamous oesophageal mucosa) or 1.01 (gastric mucosa), indicating that no DNA sequence copy number chances were present. For validation, the DNA sequence copy number changes of selected clones (SNRPN, CMYC, HER2, ZNF217) detected by aCGH were confirmed by fluorescence in situ hybridization (FISH). These data show the sensitivity of aCGH for the identification of DNA sequence copy number changes at high resolution in BCA. The newly identified genes may include so far unknown biomarkers in BCA and are therefore a starting point for

  5. Exercise and the Prevention of Oesophageal Cancer (EPOC) study protocol: a randomized controlled trial of exercise versus stretching in males with Barrett's oesophagus

    International Nuclear Information System (INIS)

    Chronic gastro-oesophageal reflux disease and excessive body fat are considered principal causes of Barrett's oesophagus (a metaplastic change in the cells lining the oesophagus) and its neoplastic progression, oesophageal adenocarcinoma. Metabolic disturbances including altered levels of obesity-related cytokines, chronic inflammation and insulin resistance have also been associated with oesophageal cancer development, especially in males. Physical activity may have the potential to abrogate metabolic disturbances in males with Barrett's oesophagus and elicit beneficial reductions in body fat and gastro-oesophageal reflux symptoms. Thus, exercise may be an effective intervention in reducing oesophageal adenocarcinoma risk. However, to date this hypothesis remains untested. The 'Exercise and the Prevention of Oesophageal Cancer Study' will determine whether 24 weeks of exercise training will lead to alterations in risk factors or biomarkers for oesophageal adenocarcinoma in males with Barrett's oesophagus. Our primary outcomes are serum concentrations of leptin, adiponectin, tumour necrosis factor-alpha, C-reactive protein and interleukin-6 as well as insulin resistance. Body composition, gastro-oesophageal reflux disease symptoms, cardiovascular fitness and muscular strength will also be assessed as secondary outcomes. A randomized controlled trial of 80 overweight or obese, inactive males with Barrett's oesophagus will be conducted in Brisbane, Australia. Participants will be randomized to an intervention arm (60 minutes of moderate-intensity aerobic and resistance training, five days per week) or a control arm (45 minutes of stretching, five days per week) for 24 weeks. Primary and secondary endpoints will be measured at baseline (week 0), midpoint (week 12) and at the end of the intervention (week 24). Due to the increasing incidence and very high mortality associated with oesophageal adenocarcinoma, interventions effective in

  6. Exercise and the Prevention of Oesophageal Cancer (EPOC study protocol: a randomized controlled trial of exercise versus stretching in males with Barrett's oesophagus

    Directory of Open Access Journals (Sweden)

    Reeves Marina M

    2010-06-01

    Full Text Available Abstract Background Chronic gastro-oesophageal reflux disease and excessive body fat are considered principal causes of Barrett's oesophagus (a metaplastic change in the cells lining the oesophagus and its neoplastic progression, oesophageal adenocarcinoma. Metabolic disturbances including altered levels of obesity-related cytokines, chronic inflammation and insulin resistance have also been associated with oesophageal cancer development, especially in males. Physical activity may have the potential to abrogate metabolic disturbances in males with Barrett's oesophagus and elicit beneficial reductions in body fat and gastro-oesophageal reflux symptoms. Thus, exercise may be an effective intervention in reducing oesophageal adenocarcinoma risk. However, to date this hypothesis remains untested. The 'Exercise and the Prevention of Oesophageal Cancer Study' will determine whether 24 weeks of exercise training will lead to alterations in risk factors or biomarkers for oesophageal adenocarcinoma in males with Barrett's oesophagus. Our primary outcomes are serum concentrations of leptin, adiponectin, tumour necrosis factor-alpha, C-reactive protein and interleukin-6 as well as insulin resistance. Body composition, gastro-oesophageal reflux disease symptoms, cardiovascular fitness and muscular strength will also be assessed as secondary outcomes. Methods/Design A randomized controlled trial of 80 overweight or obese, inactive males with Barrett's oesophagus will be conducted in Brisbane, Australia. Participants will be randomized to an intervention arm (60 minutes of moderate-intensity aerobic and resistance training, five days per week or a control arm (45 minutes of stretching, five days per week for 24 weeks. Primary and secondary endpoints will be measured at baseline (week 0, midpoint (week 12 and at the end of the intervention (week 24. Discussion Due to the increasing incidence and very high mortality associated with oesophageal adenocarcinoma

  7. Removal of Foreign Body (Glass of Mirror in Esophagus with Direct Laryngoscope

    Directory of Open Access Journals (Sweden)

    Fachzi Fitri

    2015-01-01

    Full Text Available AbstractLiterature contains fewer reports discussing the use of direct laryngoscope in esophageal foreign body extraction. Foreign bodies in esophagus was diagnosed based on anamnesis, physical examination, radiological finding. The choice of treatment influenced by many factors, such as the patient’s age and clinical condition, the size and shape of the ingested foreign body, the anatomic location and the skills of the physician. A case of impacted glass of mirror in esophagus and mental disorder in a 38 years old male was reported, which had been perfomed direct laryngoscope and an extraction with Magill forcep.Keywords: Foreign body, glass of mirror, direct laryngoscope, Magill forcepAbstrakSedikit sekali kepustakaan yang membahas mengenai penggunaan laringoskopi langsung pada pengangkatan benda asing esofagus. Benda asing esofagus didiagnosis berdasarkan anamnesis, pemeriksaan fisik, radiologi. Pilihan penatalaksanaan dipengaruhi oleh usia pasien dan kondisi klinis, ukuran dan bentuk benda asing, lokasi anatomi dan kemampuan dokter.Dilaporkan satu kasus kaca cermin di esofagus pada laki-laki usia 38 tahun dengan gangguan mental, yang telah dilakukan laringoskopi langsung dan ekstraksi dengan forsep Magill.Kata kunci: Benda asing, kaca cermin, laringoskopi langsung, Forsep Magill

  8. Ultrasonographic study of mechanosensory properties in human esophagus during mechanical distension

    Institute of Scientific and Technical Information of China (English)

    Ejnar Larsen; Hariprasad Reddy; Asbjφrn Mohr Drewes; Lars Arendt-Nielsen; Hans Gregersen

    2006-01-01

    AIM: To study the esophageal geometry and mechanosensation using endoscopic ultrasonography during volume-controlled ramp distensions in the distal esophagus.METHODS: Twelve healthy volunteers underwent distension of a bag. During distension up to moderate pain the sensory intensity was assessed on a visual analogue scale (VAS). The esophageal deformation in terms of multidimensional stretch ratios and strains was calculated at different volumes and VAS levels. Distensions were done before and during administration of the anticholinergic drug butylscopolamine.RESULTS: The stimulus-response (volume-VAS) curve did not differ without or with the administration of butylscopolamine. Analysis of stretch ratios demonstrated tensile stretch in circumferential direction, compression in radial direction and a small tensile stretch in longitudinal direction. A strain gradient existed throughout the esophageal wall with the largest circumferential deformarion at the mucosal surface. The sensation intensity increased exponentially as function of the strains.CONCLUSION: The method provides information of esophageal deformation gradients that correlate to the sensation intensity. Hence, it can be used to study mechanosensation in the human esophagus. Further studies are needed to determine the exact deformation stimulus for the esophageal mechanoreceptors.

  9. Aneurisma de aorta com ruptura para esôfago Aortic aneurysm rupture into the esophagus

    Directory of Open Access Journals (Sweden)

    Christiano da Silveira de Barcellos

    2008-12-01

    Full Text Available Apresentamos o caso de uma paciente portadora de aneurisma de aorta descendente com ruptura para o esôfago que, após aortoplastia com interposição de tubo de dacron e rafia da laceração esofágica, evoluiu com fístula esôfago pleural no terceiro dia pós-operatório. A paciente necessitou de reintervenção e cuidados intensivos, reabilitando-se adequadamente. A propósito deste caso incomum e do aprendizado adquirido no seu manejo, revisamos a literatura a fim de discutir a melhor alternativa de correção desta rara e, freqüentemente, fatal forma de apresentação das doenças da aorta.We present the case of a patient with a descending aorta aneurysm rupture into the esophagus, which, after aortoplasty with Dacron tube interposition and suture of esophageal laceration, developed a pleural-esophagus fistula on the 3rd postoperative day. She needed re-intervention and intensive care, followed by adequate recovery. Considering this unusual case and the knowledge acquired through its management, we reviewed the literature in order to discuss the best alternative for the correction of this rare and often fatal form of presentation of aortic diseases.

  10. Proton therapy radiation pneumonitis local dose–response in esophagus cancer patients

    International Nuclear Information System (INIS)

    Purpose: This study quantifies pulmonary radiation toxicity in patients who received proton therapy for esophagus cancer. Materials/methods: We retrospectively studied 100 esophagus cancer patients treated with proton therapy. The linearity of the enhanced FDG uptake vs. proton dose was evaluated using the Akaike Information Criterion (AIC). Pneumonitis symptoms (RP) were assessed using the Common Toxicity Criteria for Adverse Events version 4.0 (CTCAEv4). The interaction of the imaging response with dosimetric parameters and symptoms was evaluated. Results: The RP scores were: 0 grade 4/5, 7 grade 3, 20 grade 2, 37 grade 1, and 36 grade 0. Each dosimetric parameter was significantly higher for the symptomatic group. The AIC winning models were 30 linear, 52 linear quadratic, and 18 linear logarithmic. There was no significant difference in the linear coefficient between models. The slope of the FDG vs. proton dose response was 0.022 for the symptomatic and 0.012 for the asymptomatic (p = 0.014). Combining dosimetric parameters with the slope did not improve the sensitivity or accuracy in identifying symptomatic cases. Conclusions: The proton radiation dose response on FDG PET/CT imaging exhibited a predominantly linear dose response on modeling. Symptomatic patients had a higher dose response slope

  11. Design of a protocol for combined laser hyperthermia-photodynamic therapy in the esophagus

    Science.gov (United States)

    London, Richard A.; Eichler, Juergen P.; Liebetruth, Jochen; Ziegenhagen, L.

    2000-05-01

    Photodynamic laser therapy (PDT) for esophageal cancer has recently been studied in animal and clinical trials. In several animal experiments a synergetic effect was found by simultaneously applying PDT and hyperthermia (HT). In this paper an optical fiber system is described which can be used in the esophagus for combined PDT with a 1 W dye laser and HT with a 15 - 40 W Nd-YAG laser. Phantoms were developed to simulate the geometry of the esophagus using cow muscle. The spatial-temporal temperature field during HT was measured. The results were compared with calculations using a coupled Monte Carlo laser transport/finite difference heat transport model using the LATIS computer program. Measurements and calculations yield a realistic description of the temperature distribution during HT under various experimental conditions. The LATIS program allows the prediction of the effects of blood perfusion for in-vivo situations. The results show that the perfusion has considerable influence on the temperature field, which must be considered for in-vivo applications.

  12. 食管支架对食管癌性狭窄患者吞咽障碍的改善%Improvement of dysphagia in patients with esophagus stenosis following carcinoma of esophagus

    Institute of Scientific and Technical Information of China (English)

    李明; 甘少光; 黄仕州; 陈容芳

    2002-01-01

    Objective To investigate the intervention ways of endoscopes in the treatment of esophagus stenosis due to carcinoma of esophagus and improvement of quality. Method 11 cases of advanced carcinoma of esophagus were included in this study. Operation and chemical therapy were unavailable for these patients. Memory trestle with membrane and made of alloy of Nickel- titanium was inserted under intervention of endoscope. Trestle was posed in stenosis part of esophagus under direction of X- ray. Trestle could be dilated 3- 7 days after operation due to its reaction characteristics to temperature. So, redilated therapy was unnecessary. Trestle could reconstruct swallowing tract and made feeding through mouth become available during limited survival time.Results All trestles were successfully inserted.Half- fluid feeding was available after operation. Obstruction was removed in all patients(100% ).Conclusion Method described in this study was safe and effective .Effective swallowing tracts were reconstructed in all patients after trestle was planted and quality of life and survival time were both improved.

  13. Role of retinoic acid receptors in squamous-cell carcinoma in human esophagus

    Directory of Open Access Journals (Sweden)

    Wolfgarten E

    2005-01-01

    Full Text Available Abstract Background Worldwide, cancer in the esophagus ranks among the 10 most common cancers. Alterations of retinoic acid receptors (e.g. RARα, β, γ, and RXRα, β, γ expression is considered to play an important role in development of squamous-cell carcinoma (SCC, which is the most common esophageal cancer. Alcohol consumption and smoking, which can alter retinoic acid receptor levels, have been identified as key risk factors in the development of carcinoma in the aero-digestive tract. Therefore, the aim of the present study was to evaluate protein levels of retinoic acid receptors (i.e. RARα, β, γ, and RXRβ in esophageal SCC and surrounding normal tissue of patients with untreated SCC and controls. Methods All study participants completed a questionnaire concerning smoking and alcohol drinking habits as well as anthropometrical parameters. Protein levels of RARα, β, γ, and RXRβ were determined by Western Blot in normal esophageal tissue and tissue obtained from SCC of 21 patients with newly diagnosed esophageal SCC and normal esophageal tissue of 10 controls. Results Protein levels of RARγ were significantly lower by ~68% in SCC compared to normal surrounding tissue in patients with SCC that smoked and/or consumed elevated amounts of alcohol. Furthermore, RARα protein levels were significantly lower (~- 45% in SCC in comparison to normal esophageal mucosa in patients with elevated alcohol intake. When comparing protein levels of retinoic acid receptors between normal tissue of patients with SCC and controls, RARγ protein levels were found to be significantly higher (~2.7-fold in normal esophageal tissue of SCC patients than in esophageal tissue obtained from controls. No differences were found for RARα, β, and RXRβ protein levels between normal esophageal tissue of patients and that of controls. Conclusion In conclusion, results of the present study suggest that alterations of retinoic acid receptors protein may contribute

  14. New and Safe Treatment of Food Impacted in the Esophagus: A Single Center Experience of 100 Consecutive Cases

    Directory of Open Access Journals (Sweden)

    Muhammad Shafique

    2013-01-01

    Full Text Available Aim. Large food bits can get stuck in the esophagus and must be removed by endoscopy. In some cases, this can be difficult or unsafe. We describe a new and safe treatment for such patients. Materials and Methods. 100 consecutive patients were referred to Akershus University Hospital with impacted food in the esophagus. In 36 patients (36%, the food passed spontaneously. In 59 (92% of the remaining 64 patients, the food was removed by endoscopic intervention. In the last five patients, endoscopic removal was judged difficult or unsafe. These patients received the new treatment: one capsule Creon 10000 IU dissolved in 30 mL of Coca-Cola administered by a nasooesophageal tube four times daily for 2-3 days. Results. Of the 59 patients treated with endoscopic procedure, complications occurred in four (7%: three bleedings and one perforation of the esophagus. In five patients treated with Coca-Cola and Creon, the food had either passed or was soft after 2-3 days and could easily be removed. Conclusion. The treatment of choice of impacted food in the esophagus is endoscopic removal. In cases where this is difficult, we recommend treatment with Coca-Cola and Creon for 2-3 days before complications occur.

  15. BLOOD VESSELS IN GANGLIA IN HUMAN ESOPHAGUS MIGHT EXPLAIN THE HIGHER FREQUENCY OF MEGAESOPHAGUS COMPARED WITH MEGACOLON

    Directory of Open Access Journals (Sweden)

    Sheila Jorge Adad

    2014-12-01

    Full Text Available This study aimed to determine the existence of blood vessels within ganglia of the myenteric plexus of the human esophagus and colon. At necropsy, 15 stillborns, newborns and children up to two years of age, with no gastrointestinal disorders, were examined. Rings of the esophagus and colon were analyzed and then fixed in formalin and processed for paraffin. Histological sections were stained by hematoxylin-eosin, Giemsa and immunohistochemistry for the characterization of endothelial cells, using antibodies for anti-factor VIII and CD31. Blood vessels were identified within the ganglia of the myenteric plexus of the esophagus, and no blood vessels were found in any ganglia of the colon. It was concluded that the ganglia of the myenteric plexus of the esophagus are vascularized, while the ganglia of the colon are avascular. Vascularization within the esophageal ganglia could facilitate the entrance of infectious agents, as well as the development of inflammatory responses (ganglionitis and denervation, as found in Chagas disease and idiopathic achalasia. This could explain the higher frequency of megaesophagus compared with megacolon.

  16. Multiple fields may offer better esophagus sparing without increased probability of lung toxicity in optimized IMRT of lung tumors

    International Nuclear Information System (INIS)

    Purpose: To evaluate whether increasing numbers of intensity-modulated radiation therapy (IMRT) fields enhance lung-tumor dose without additional predicted toxicity for difficult planning geometries. Methods and Materials: Data from 8 previous three dimensional conformal radiation therapy (3D-CRT) patients with tumors located in various regions of each lung, but with planning target volumes (PTVs) overlapping part of the esophagus, were used as input. Four optimized-beamlet IMRT plans (1 plan that used the 3D-CRT beam arrangement and 3 plans with 3, 5, or 7 axial, but predominantly one-sided, fields) were compared. For IMRT, the equivalent uniform dose (EUD) in the whole PTV was optimized simultaneously with that in a reduced PTV exclusive of the esophagus. Normal-tissue complication probability-based costlets were used for the esophagus, heart, and lung. Results: Overall, IMRT plans (optimized by use of EUD to judiciously allow relaxed PTV dose homogeneity) result in better minimum PTV isodose surface coverage and better average EUD values than does conformal planning; dose generally increases with the number of fields. Even 7-field plans do not significantly alter normal-lung mean-dose values or lung volumes that receive more than 13, 20, or 30 Gy. Conclusion: Optimized many-field IMRT plans can lead to escalated lung-tumor dose in the special case of esophagus overlapping PTV, without unacceptable alteration in the dose distribution to normal lung

  17. Adenocarcinoma of the cervical esophagus arising from ectopic gastric mucosa: report of two cases and review of the literature.

    Science.gov (United States)

    Nomura, Kosuke; Iizuka, Toshiro; Inoshita, Naoko; Kuribayashi, Yasutaka; Toba, Takahito; Yamada, Akihiro; Yamashita, Satoshi; Furuhata, Tsukasa; Kikuchi, Daisuke; Matsui, Akira; Mitani, Toshifumi; Ogawa, Osamu; Hoteya, Shu; Ueno, Masaki; Udagawa, Harushi; Kaise, Mitsuru

    2015-12-01

    Esophageal adenocarcinoma arising from ectopic gastric mucosa (EGM) is extremely rare. We describe here two Japanese patients with adenocarcinoma of the cervical esophagus arising from EGM. Case 1 is a 62-year-old man who had slightly red EGM in the cervical esophagus on upper gastrointestinal endoscopy (UGE). Because the biopsy showed atypical glands that were suspicious for adenocarcinoma, endoscopic submucosal dissection was performed. Histopathological examination revealed that the lesion was a well-differentiated adenocarcinoma (pT1a MM). Lymphovascular invasion was absent, and the margins were free from carcinoma. Case 2 is a 57-year-old man who had an elevated lesion with a bleeding tendency in an area of EGM in the cervical esophagus on UGE. Adenocarcinoma was diagnosed in the biopsy. Because of the presence of enlarged lymph nodes (#106recL), preoperative chemoradiotherapy was performed to reduce the size of the adenocarcinoma and lymph nodes prior to resection of the cervical esophagus and reconstruction with free jejunal grafts. Histopathological examination revealed moderately differentiated adenocarcinoma (0-I, pT2N1M0, pStage II). In both cases, adenocarcinoma was surrounded by EGM, which led to the diagnosis of EGM-derived esophageal adenocarcinoma. Here, we report its immunohistochemical characteristics in the present cases and discuss the histogenesis. PMID:26476962

  18. Intramural Injection with Botulinum Toxin Type A in Piglet Esophagus. The Influencer on Maximum Load and Elongation

    DEFF Research Database (Denmark)

    Pedersen, Mark Ellebæk; Qvist, Niels; Schrøder, Henrik Daa;

    2015-01-01

    Introduction The treatment of esophageal atresia (OA) is challenging. The main goal is to achieve primary anastomosis. We have previously demonstrated in a pig model that intramural injection of botulinum toxin type A (BTX-A) resulted in significant elongation of the esophagus during tensioning...

  19. Quantifying glucose permeability and enhanced light penetration in ex vivo human normal and cancerous esophagus tissues with optical coherence tomography

    International Nuclear Information System (INIS)

    We report our pilot results on quantification of glucose (G) diffusion permeability in human normal esophagus and ESCC tissues in vitro by using OCT technique. The permeability coefficient of 40% aqueous solution of G was found to be (1.74±0.04)×10-5 cm/s in normal esophagus and (2.45±0.06)×10-5 cm/s in ESCC tissues. The results from this study indicate that ESCC tissues had a higher permeability coefficient compared to normal esophageal tissues, and the light penetration depths gradually increase with the increase of applied topically with G time for the normal esophageal and ESCC tissues. The results indicate that the permeability coefficient of G in cancer tissues was 1.41-fold than that in normal tissues, and the light penetration depth for the ESCC tissues is significantly smaller than that of normal esophagus tissues in the same time range. These results demonstrate that the optical clearing of normal and cancer esophagus tissues are improved after application of G

  20. Role of retinoic acid receptors in squamous-cell carcinoma in human esophagus

    DEFF Research Database (Denmark)

    Bergheim, I.; Wolfgarten, E.; Bollschweiler, E.;

    2005-01-01

    BACKGROUND: Worldwide, cancer in the esophagus ranks among the 10 most common cancers. Alterations of retinoic acid receptors (e.g. RARalpha, beta, gamma, and RXRalpha, beta, gamma) expression is considered to play an important role in development of squamous-cell carcinoma (SCC), which is the most...... common esophageal cancer. Alcohol consumption and smoking, which can alter retinoic acid receptor levels, have been identified as key risk factors in the development of carcinoma in the aero-digestive tract. Therefore, the aim of the present study was to evaluate protein levels of retinoic acid receptors...... comparing protein levels of retinoic acid receptors between normal tissue of patients with SCC and controls, RARgamma protein levels were found to be significantly higher (approximately 2.7-fold) in normal esophageal tissue of SCC patients than in esophageal tissue obtained from controls. No differences...

  1. Transient mega-esophagus in a neonate with congenital diaphragmatic hernia

    International Nuclear Information System (INIS)

    Esophageal dilatation (ED) in neonates is rare. In the present case, ED was detected in a chest radiograph following repair of congenital diaphragmatic hernia (CDH) in a term neonate. A roentgenographic swallow study on the seventh day of life demonstrated ED and a sub-diaphragmatic stomach. The infant thrived adequately on enteral feeding. A swallow study on the twentieth day of life showed a normal-width esophagus with gastroesophageal reflux and small hiatus hernia. The longstanding herniated stomach in the fetus apparently caused kinking, edema, and obstruction of the gastroesophageal junction. This led to a significant ED and concealment of gastroesophageal reflux. We aim to arouse awareness about the occurrence of ED with CDH, and about its benign course under conservative management. (orig.)

  2. Role of radiotherapy in the pre-operative management ofcarcinoma of the esophagus

    Institute of Scientific and Technical Information of China (English)

    Bryan H Burmeister

    2015-01-01

    The use of radiotherapy in the management ofcarcinoma of the esophagus and gastro-esophagealjunction has undergone much evolution over the past2 decades. Advances to define its role have been slowwith meta-analyses often providing the most usefuldata. In spite of this many institutions around the worldare divided about the role of radiotherapy in this diseaseand attribute different roles to radiotherapy based onclinical stage, tumor site and histology. The purpose ofthis review is to try to define the role of radiotherapygiven our current knowledge base and to reviewwhich current and future trials may fill the gaps ofknowledge that we currently have. It will also highlightthe difficulties in making firm recommendations aboutthe use of radiotherapy especially in a time whentechnology and treatments are rapidly evolving.

  3. Role of scintiscan studies of the esophagus in the diagnosis of related functional disorders

    International Nuclear Information System (INIS)

    Radionuclide studies of the esophagus (by measuring the passage of a bolus of 99m-Tc DTPA and subsequent reflux tests) were carried out in a cohort of 248 patients, where the underlying pathological changes varied between individuals. In terms of sensitivity, this method was superior to mere reflux measurements and long-term pH determinations - just as well as to histological, endoscopic and simple X-ray examinations. Disorders of the esophageal function can mostly not be predicted from the clinical symptoms and signs alone. if esophageal function studies are combined with radionuclide examinations of gastric emptying, esophageal disorders are revealed in about 50% of cases showing deviations of the gastric emptying rate in either direction. It deserves to be mentioned here that this is quite independent of the level of gastric secretion. The results obtained have shown that esophageal function studies in combination with reflux tests are an invaluable technique of screening for esophageal function disorders. (TRV)

  4. Immunolocalization of succinate dehydrogenase in the esophagus epithelium of domesticated mammals

    Directory of Open Access Journals (Sweden)

    W. Meyer

    2013-05-01

    Full Text Available Using immunohistochemistry and transmission electron microscopy (TEM, the esophagus epithelia of seven domesticated mammals (horse, cattle, goat, pig, dog, laboratory rat, cat of three nutrition groups (herbivorous, omnivorous, carnivorous were studied to get first information about energy generation, as demonstrated by succinate dehydrogenase (SDH activities. Distinct reaction intensities could be observed in all esophageal cell layers of the different species studied reflecting moderate to strong metabolic activities. The generally strong staining in the stratum basale indicated that new cells are continuously produced. The latter feature was confirmed by a thick, and in the horse generally highly active stratum spinosum. Only in the pig, reaction intensity variations occurred, obviously related to differences in physical feed quality or restricted feed allocation. The immunohistochemical results were corroborated by the presence of intact mitochondria in the esophageal cells of all species and nutrition types studied, except for the horse. Possible relationships between SDH reaction intensities and feed structure, mass or consistency are discussed.

  5. Distinguishing human normal or cancerous esophagus tissue ex vivo using multiphoton microscopy

    International Nuclear Information System (INIS)

    Application of multiphoton microscopy (MPM) to clinical cancer research has greatly developed over the last few years. In this paper, we mainly focus on two-photon excitation fluorescence (TPEF) and second harmonic generation (SHG) for investigating esophageal cancer. We chiefly discuss the SHG/TPEF image and spectral characteristics of normal and cancerous esophagus submucosa with the combined multi-channel imaging mode and Lambda mode of a multiphoton microscope (LSM 510 META). Great differences can be detected, such as collagen content and morphology, glandular-shaped cancer cells, TPEF/SHG intensity ratio, and so on, which demonstrate that the multiphoton imaging technique has the potential ability for minimally-invasive early cancer diagnosis. (paper)

  6. Incidencia de adenocarcinoma de esófago y displasia de alto grado en pacientes con esófago de Barrett largo sin displasia

    OpenAIRE

    Fernández Cadenas, Fernando

    2014-01-01

    Introducción: El esófago de Barrett (EB) es una entidad adquirida y principal factor de riesgo para el adenocarcinoma esofágico (ACE). Los pacientes con EB son incluidos en programas de seguimiento endoscópico para diagnosticar ACE en fases precoces con mejor pronóstico o se les propone la ablación endoscópica del tejido metaplásico. Para valorar la eficacia de las actuaciones propuestas es esencial establecer el riesgo real de degeneración del EB. Con la información disponible las tasas pued...

  7. Role of chemoprophylaxis with either NSAIDs or statins in patients with Barrett’s esophagus

    Institute of Scientific and Technical Information of China (English)

    Panagiotis; Tsibouris; Erasmia; Vlachou; Peter; Edward; Thomas; Isaacs

    2014-01-01

    The incidence of esophageal adenocarcinoma,a poor prognosis neoplasia,has risen dramatically in recent decades.Barrett’s esophagus represents the best-known risk factor for esophageal adenocarcinoma development.Non-steroidal anti-inflammatory drugs through cyclooxygenase-2 inhibition and prostaglandin metabolism regulation could control cell proliferation,increase cell apoptosis and regulate the expression of growth and angiogenic factors.Statins can achieve equivalent effects through prenylation and subsequently control of cellular signaling cascades.At present,epidemiological studies are small and underpowered.Their data could not justify either medication as a chemo-preventive agent.Population based studies have shown a 43%reduction of the odds of developing an esophageal adenocarcinoma,leaving out or stating a 25%reduction in patients consuming non-aspirin nonsteroidal antiinflammatory drugs and a 50%reduction in those patients consuming aspirin.They have also stated a 19%reduction of esophageal cancer incidence when statins have been used.Observational studies have shown that non-steroidal anti-inflammatory drugs could reduce theadenocarcinoma incidence in patients with Barrett’s esophagus by 41%,while statins could reduce the risk by 43%.The cancer preventive effect has been enhanced in those patients taking a combination of non-steroidal anti-inflammatory drugs and statins(a 74%decrease).Observational data are equivocal concerning the efficacy of non-steroidal anti-inflammatory drug subclasses.Non-steroidal anti-inflammatory drugs clearly have substantial potential for toxicity,while statins are rather safe drugs.In conclusion,both non-steroidal anti-inflammatory drugs and statins are promising chemopreventive agents and deserve further exploration with interventional studies.In the meanwhile,their use is justified only in patients with cardiovascular disease.

  8. Effects of acid on vagal nociceptive afferent subtypes in guinea pig esophagus.

    Science.gov (United States)

    Yu, Xiaoyun; Hu, Youtian; Yu, Shaoyong

    2014-08-15

    Acid reflux-induced heartburn and noncardiac chest pain are processed peripherally by sensory nerve endings in the wall of the esophagus, but the underlying mechanism is still unclear. This study aims to determine the effects of acid on esophageal vagal nociceptive afferent subtypes. Extracellular single-unit recordings were performed in guinea pig vagal nodose or jugular C fiber neurons by using ex vivo esophageal-vagal preparations with intact nerve endings in the esophagus. We recorded action potentials (AP) of esophageal nodose or jugular C fibers evoked by acid perfusion and compared esophageal distension-evoked AP before and after acid perfusion. Acid perfusion for 30 min (pH range 7.4 to 5.8) did not evoke AP in nodose C fibers but significantly decreased their responses to esophageal distension, which could be recovered after washing out acid for 90 min. In jugular C fibers, acid perfusion not only evoked AP but also inhibited their responses to esophageal distension, which were not recovered after washing out acid for 120 min. Lower concentration of capsaicin perfusion mimicked acid-induced effects in nodose and jugular C fibers. Pretreatment with TRPV1 antagonist AMG9810, but not acid-sensing ion channel (ASIC) inhibitor amiloride, significantly inhibited acid-induced effects in nodose and jugular C fiber. These results demonstrate that esophageal vagal nociceptive afferent nerve subtypes display distinctive responses to acid. Acid activates jugular, but not nodose, C fibers and inhibits both of their responses to esophageal distension. These effects are mediated mainly through TRPV1. This inhibitory effect is a novel finding and may contribute to esophageal sensory/motor dysfunction in acid reflux diseases. PMID:24994852

  9. Effect of synthetic cationic protein on mechanoexcitability of vagal afferent nerve subtypes in guinea pig esophagus.

    Science.gov (United States)

    Yu, Shaoyong; Ouyang, Ann

    2011-12-01

    Eosinophilic esophagitis is characterized by increased infiltration and degranulation of eosinophils in the esophagus. Whether eosinophil-derived cationic proteins regulate esophageal sensory nerve function is still unknown. Using synthetic cationic protein to investigate such effect, we performed extracellular recordings from vagal nodose or jugular neurons in ex vivo esophageal-vagal preparations with intact nerve endings in the esophagus. Nerve excitabilities were determined by comparing action potentials evoked by esophageal distensions before and after perfusion of synthetic cationic protein poly-L-lysine (PLL) with or without pretreatment with poly-L-glutamic acid (PLGA), which neutralized cationic charges of PLL. Perfusion with PLL did not evoke action potentials in esophageal nodose C fibers but increased their responses to esophageal distension. This potentiation effect lasted for 30 min after washing out of PLL. Pretreatment with PLGA significantly inhibited PLL-induced mechanohyperexcitability of esophageal nodose C fibers. In esophageal nodose Aδ fibers, perfusion with PLL did not evoke action potentials. In contrast to nodose C fibers, both the spontaneous discharges and the responses to esophageal distension in nodose Aδ fibers were decreased by perfusion with PLL, which can be restored after washing out PLL for 30-60 min. Pretreatment with PLGA attenuated PLL-induced decrease in spontaneous discharge and mechanoexcitability of esophageal nodose Aδ fibers. In esophageal jugular C fibers, PLL neither evoked action potentials nor changed their responses to esophageal distension. Collectively, these data demonstrated that synthetic cationic protein did not evoke action potential discharges of esophageal vagal afferents but had distinctive sensitization effects on their responses to esophageal distension. PMID:21960520

  10. Huntingtons anvendelse af Barretts religionsstatistik. I Margit Warburg og Brian Jacobsen (red.): Tørre tal om troen. Religionsdemografi i det 21. århundrede. Højbjerg: Univers, s. 76-92

    DEFF Research Database (Denmark)

    Iversen, Hans Raun

    Artiklen dokumenterer og diskuterer de forskellige interesser, der er på spil i international religionsstatistik. Den fokuserer dernæst på den fatale skævvridning af de religionsstatistiske opgørelser i Barretts World Christian Encyklopedia, der er sket i Huntingtons The Clash of Civilizations....

  11. Relief of dysphagia during neoadjuvant treatment for cancer of the esophagus or gastroesophageal junction.

    Science.gov (United States)

    Sunde, B; Ericson, J; Kumagai, K; Lundell, L; Tsai, J A; Lindblad, M; Rouvelas, I; Friesland, S; Wang, N; Nilsson, M

    2016-07-01

    Dysphagia is the main symptom of cancer of the esophagus and gastroesophageal junction and causing nutritional problems and weight loss, often counteracted by insertion of self-expandable metal stents or nutrition via an enteral route. Clinical observations indicate that neoadjuvant therapy may effectively and promptly alleviate dysphagia, making such nutrition supportive interventions redundant before surgical resection. The objective of the current study was to carefully study the effects of induction neoadjuvant therapy on dysphagia and its subsequent course and thereby investigate the actual need for alimentary gateways for nutritional support. Thirty-five consecutive patients scheduled for neoadjuvant therapy were recruited and assessed regarding dysphagia and appetite at baseline, after the first cycle of preoperative treatment with either chemotherapy alone or with chemoradiotherapy and before surgery. Platinum-based therapy in combination with 5-fluorouracil was administered intravenously days 1-5 every 3 weeks and consisted of three treatments. Patients receiving combined chemoradiotherapy started radiotherapy on day one of second chemotherapy cycle. They received fractions of 2 Gy/day each up to a total dose of 40 Gy. Watson and Ogilvie dysphagia scores were used to assess dysphagia, while appetite was assessed by the Edmonton Assessment System Visual analogue scale-appetite questionnaire. Patients were evaluated at regular outpatient clinic visits or by telephone. The histological tumor response in the surgical specimen was assessed using the Chirieac scale. Ten patients scheduled for neoadjuvant chemotherapy and 25 patients scheduled for chemoradiotherapy were included in the analysis. There was a significant improvement in dysphagia in both treatment groups, according to both scales, already from baseline to the completion of the first chemotherapy cycle which remained to the end of the neoadjuvant treatment (P < 0.001). Appetite also improved

  12. Application of the adductome approach to assess intertissue DNA damage variations in human lung and esophagus

    International Nuclear Information System (INIS)

    Methods for determining the differential susceptibility of human organs to DNA damage have not yet been explored to any large extent due to technical constraints. The development of comprehensive analytical approaches by which to detect intertissue variations in DNA damage susceptibility may advance our understanding of the roles of DNA adducts in cancer etiology and as exposure biomarkers at least. A strategy designed for the detection and comparison of multiple DNA adducts from different tissue samples was applied to assess esophageal and peripherally- and centrally-located lung tissue DNA obtained from the same person. This adductome approach utilized LC/ESI-MS/MS analysis methods designed to detect the neutral loss of 2'-deoxyribose from positively ionized 2'-deoxynucleoside adducts transmitting the [M+H]+ > [M+H-116]+ transition over 374 transitions. In the final analyses, adductome maps were produced which facilitated the visualization of putative DNA adducts and their relative levels of occurrence and allowed for comprehensive comparisons between samples, including a calf thymus DNA negative control. The largest putative adducts were distributed similarly across the samples, however, differences in the relative amounts of putative adducts in lung and esophagus tissue were also revealed. The largest-occurring lung tissue DNA putative adducts were 90% similar (n = 50), while putative adducts in esophagus tissue DNA were shown to be 80 and 84% similar to central and peripheral lung tissue DNA respectively. Seven DNA adducts, N2-ethyl-2'-deoxyguanosine (N2-ethyl-dG), 1,N6-etheno-2'-deoxyadenosine (εdA), α-S- and α-R-methyl-γ-hydroxy-1,N2-propano-2'-deoxyguanosine (1,N2-PdG1, 1,N2-PdG2), 3-(2'-deoxyribosyl)-5,6,7,8-tetrahydro-8-hydroxy-pyrimido[1,2-a] purine-(3H)-one (8-OH-PdG) and the two stereoisomers of 3-(2'-deoxyribosyl)-5,6,7,8-tetrahydro-6-hydroxypyrimido[1,2-a] purine-(3H)-one (6-OH-PdG) were unambiguously detected in all tissue DNA samples by

  13. The Outcome of Conventional External Beam Radiotherapy for Patients with Squamous Cell Carcinoma of the Esophagus

    International Nuclear Information System (INIS)

    The best treatment for advanced esophageal cancer is chemoradiotherapy followed by surgery. In spite of the advance of multimodality therapy, most patients with esophageal cancer are treated with radiation therapy alone. This study reports the outcome of the use of conventional external beam radiotherapy alone for the treatment of esophageal cancer. Between January 1998 and December 2005, 30 patients with squamous cell carcinoma of the esophagus were treated with external beam radiotherapy using a total dose exceeding 40 Gy. Radiotherapy was delivered with a total dose of 44-60 Gy (median dose, 57.2 Gy) over 36 ∼115 days (median time, 45 days). Thirteen patients (43.3%) had a history of disorders such as diabetes, hypertension, tuberculosis, lye stricture, asthma, cerebral infarct, and cancers. Four patients metachronously had double primary cancers. The most common location of a tumor was the mid-thoracic portion of the esophagus (56.7%). Tumor lengths ranged from 2 cm to 11 cm, with a median length of 6 cm. For AJCC staging, stage III was the most common (63.3%). Five patients had metastases at diagnosis. The median overall survival was 8.3 months. The survival rates at 1-year and 2-years were 33.3% and 18.7%, respectively. The complete response rate 1∼3 months after radiotherapy was 20% (6/30) and the partial response rate was 70% (21/30). Sixteen patients (53.3%) had an improved symptom of dysphagia. Significant prognostic factors were age, tumor length, stage, degree of dysphagia at the time of diagnosis and tumor response. Cox regression analysis revealed the aim of treatment, clinical tumor response and tumor length as independent prognostic factors for overall survival. Twenty-eight patients had local failure and another four patients had metastases. Three patients were detected with double primary cancers in this analysis. A complication of esophageal stricture was observed in three patients (10%), and radiation pneumonitis occurred in two patients (6

  14. Esophagus and contralateral lung-sparing IMRT for locally advanced lung cancer in the community hospital setting

    Directory of Open Access Journals (Sweden)

    Johnny eKao

    2015-06-01

    Full Text Available Background: The optimal technique for performing lung IMRT remains poorly defined. We hypothesize that improved dose distributions associated with normal tissue sparing IMRT can allow for safe dose escalation resulting in decreased acute and late toxicity. Methods: We performed a retrospective analysis of 82 consecutive lung cancer patients treated with curative intent from 1/10 to 9/14. From 1/10 to 4/12, 44 patients were treated with the community standard of 3-dimensional conformal radiotherapy or IMRT without specific esophagus or contralateral lung constraints (standard RT. From 5/12 to 9/14, 38 patients were treated with normal tissue-sparing IMRT with selective sparing of contralateral lung and esophagus. The study endpoints were dosimetry, toxicity and overall survival.Results: Despite higher mean prescribed radiation doses in the normal tissue-sparing IMRT cohort (64.5 Gy vs. 60.8 Gy, p=0.04, patients treated with normal tissue-sparing IMRT had significantly lower lung V20, V10, V5, mean lung, maximum esophagus and mean esophagus doses compared to patients treated with standard RT (p≤0.001. Patients in the normal tissue-sparing IMRT group had reduced acute grade ≥3 esophagitis (0% vs. 11%, p<0.001, acute grade ≥2 weight loss (2% vs. 16%, p=0.04, late grade ≥2 pneumonitis (7% vs. 21%, p=0.02. The 2-year overall survival was 52% with normal tissue-sparing IMRT arm compared to 28% for standard RT (p=0.015.Conclusion: These data provide proof of principle that suboptimal radiation dose distributions are associated with significant acute and late lung and esophageal toxicity that may result in hospitalization or even premature mortality. Strict attention to contralateral lung and esophageal dose volume constraints are feasible in the community hospital setting without sacrificing disease control.

  15. 26. Relationship between ABO Blood Groups and Carcinoma of Esophagus and Cardia in Chaoshan Littoral of China

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Abstract: Background. Chaoshan is the only littoral among the six high-risk areas of esophageal carcinoma (EC) in China and the relatively isolatal society for the inconvenient transport gives an opportunity to study the genetics of carcinoma of esophagus and cardia. Some reports had suggested that ABO blood groups were associated with tumors, but their relation remained controversial. Methods: The data of age, sex, ABO blood type and X-ray or pathological diagnosis of the patients with carcinoma of esophagus or cardia were collected from The tumor hospital, First affiliated hospital, Second affiliated hospital of Shantou University Medical College; the Center hospital of Shantou and the Center hospital of Jieyang. In this study, 6 685 patients with EC and 2 955 patients with cardiac cancer(CC) in Chaoshan district were retrospectively assessed the association with ABO blood groups. Results: The distribution of ABO blood groups in patients with EC or CC was similar to the normal local population in Chaoshan. However, there was 2.3% excess of blood group B in male patients with CC and 4.7% excess in the patients with carcinoma in the upper third esophagus, compared with the corresponding controls. The relative risk B:O was 1.1415 (P<0.05) and 1.2696 (P<0.05), respectively No relationship between ABO blood groups and tumor differentiation was found. Conclusion: ABO blood group B was associated with the incidence of CC in male individuals and carcinoma in the upper third esophagus. The distribution of ABO blood groups varied in the different geographical and ethnic groups, as a result, proper controls were very important for such study.

  16. Gastro-Esophageal Reflux Disease Symptoms and Demographic Factors as a Pre-Screening Tool for Barrett’s Esophagus

    OpenAIRE

    Liu, Xinxue; Wong, Angela; Kadri, Sudarshan R.; Corovic, Andrej; O’Donovan, Maria; Lao-Sirieix, Pierre; Lovat, Laurence B.; Burnham, Rodney W.; Fitzgerald, Rebecca C

    2014-01-01

    Background Barrett’s esophagus (BE) occurs as consequence of reflux and is a risk factor for esophageal adenocarcinoma. The current “gold-standard” for diagnosing BE is endoscopy which remains prohibitively expensive and impractical as a population screening tool. We aimed to develop a pre-screening tool to aid decision making for diagnostic referrals. Methodology/Principal Findings A prospective (training) cohort of 1603 patients attending for endoscopy was used for identification of risk fa...

  17. Transcutaneous cervical esophagus ultrasound in adults: Relation with ambulatory 24-h pH-monitoring and esophageal manometry

    OpenAIRE

    Kacar, Sabite; Uysal, Selma; Kuran, Sedef; Dagli, Ulku; Ozin, Yasemin; Karabulut, Erdem; Sasmaz, Nurgul

    2007-01-01

    AIM: To determine the gastroesophageal refluxate in the cervical esophagus (CE) and measure transcutaneous cervical esophageal ultrasound (TCEUS) findings [anterior wall thickness (WT) of CE, esophageal luminal diameter (ELD), esophageal diameter (ED)]; to compare TCEUS findings in the patient subgroups divided according to 24-h esophageal pH monitoring and manometry; and to investigate possible cut-off values according to the TCEUS findings as a predictor of gastroesophageal reflux (GER).

  18. Amelanotic malignant melanoma of the esophagus: Report of two cases with immunohistochemical and molecular genetic study of KIT and PDGFRA

    Institute of Scientific and Technical Information of China (English)

    Tadashi Terada

    2009-01-01

    The author reports herein two cases of amelanotic malignant melanoma of the esophagus. Case 1 is an 87-year-old woman who was admitted to our hospital because of nausea and vomiting. Endoscopic examination revealed an ulcerated tumor of the distal esophagus,and a biopsy was taken. The biopsy showed malignant polygonal and spindle cells. No melanin pigment was recognized. Immunohistochemically, the tumor cells were positive for melanosome (HMB45), S100 protein,KIT and Platelet derived growth factor receptor-α (PDGFRA).The patient was treated by chemotherapy and radiation, but died of systemic metastasis 12 mo after the presentation. Case 2 is a 56-year-old man presenting with dysphagia. Endoscopic examination revealed a polypoid tumor in the middle esophagus, and a biopsy was obtained. The biopsy showed malignant spindle cells without melanin pigment. Immunohistochemically,the tumor cells were positively labeled for melanosome,S100 protein, KIT and PDGFRA. The patient refused operation,and was treated by palliative chemotherapy and radiation. He died of metastasis 7 mo after the admission. In both cases, molecular genetic analyses of KIT gene (exons 9, 11, 13 and 17) and PDGFRA gene (exons 12 and 18) were performed by the PCR direct sequencing method, which showed no mutations of KIT and PDGFRA genes. This is the first report of esophageal malignant melanoma with an examination of the expression of KIT and PDGFRA and the mutational status of KIT and PDGFRA genes.

  19. Colon-interposition as replacement for the esophagus. A follow-up study.

    Science.gov (United States)

    van der Zee, D C; Zwierstra, R P; Kootstra, G; Edens, E T; van der Wagen, A; Bijleveld, C; Jonkers, A

    1981-08-01

    The longterm results of the use of colon-interposition as a substitution for the esophagus have been studied. Colon-interposition was carried out in eleven patients. There was one operative death. A second child died of an unknown cause nine years and eight months after operation. Nine patients could be studied from sixteen years and nine months to thirteen months after the operation. In six patients a satisfactory result has been achieved. One child is staying in a psychiatric infirmary. Feeding problems due to recurrent fistulae have led to growth retardation in another patient, while a third patient has regurgitation symptoms. A study of the case histories gives insight into the many early and late complications which occur in this operative procedure. The colon-interposition is a complicated procedure and should only be carried out in centers for pediatric surgery, because of its specific indication, its technique and the occurrence of complications afterwards. The development of alternative, less complicated, methods leaves a restricted indication for colon-interposition. PMID:7324572

  20. A Swedish study of chemoradiation in squamous cell carcinoma of the esophagus

    Energy Technology Data Exchange (ETDEWEB)

    Stockeld, D.; Tennvall, J.; Wagenius, G.; Albertsson, Maria; Backman, L.; Brodin, O.; Cwikiel, M.; Granstroem, L.; Gustafsson, Gunnar; Gustavsson, Sven; Hambraeus, G.; Lewensohn, Rolf; Sjoestedt, S.; Strander, H.; Aaberg, B.; Fagerberg, J. [Danderyd Hospital, Stockholm (Sweden). Dept. of Surgery

    2001-07-01

    This multicenter study describes the development of a chemoradiation protocol for the treatment of non-metastatic squamous cell carcinoma of the esophagus. Eighty patients were treated with three courses of chemotherapy (cisplatinum and 5-fluorouracil) with concomitant radiotherapy (40 Gy) during the last two courses of chemotherapy. Esophagectomy was performed, when feasible. If no operation was performed, patients were planned to receive a target dose of 64 Gy. Toxicity was mainly attributable to hematological impairment and led to two adjustments of the treatment protocol (addition of filgrastim and lowering of the 5-fluorouracil dose). These changes made it possible to administer the planned treatment in a gradually higher proportion of patients (13/23 [57%] before changes of treatment compared with 30/36 [83%] after changes). Treatment-related mortality was 3.75% (3 patients, associated with leucopenic septicemia after chemotherapy). Fifty-four patients were resected. No per- or postoperative mortality was encountered. The complete response (pathological CR) rate in operated patients was 46% (27/59 patients) after chemoradiation. In the whole series the CR rate (including clinical CR for non-resected patients) was 44%. With a minimum follow-up of 37 months, the 3-year survival for the whole group was 31% compared with 57% for the CR patients. Total 5-year survival thus far (July 1999) is 26%.

  1. Role of PET-CT in cancers around the esophagus and the bronchus

    International Nuclear Information System (INIS)

    Fluorodeoxyglucose-positron emission tomography (FDG-PET) is a useful modality for cancer diagnosis. It, however, often needs assistance from morphological imaging modalities such as CT or MRI for accurate diagnosis. PET-CT is a combination of a functional imaging tool. PET, and a morphological imaging tool, CT. The areas around the esophagus and bronchi contain complicated anatomical structures and display many variations of physiological uptake of FDG, which makes PET interpretation difficult. PET-CT solves this problem and allows easier and more confident interpretations. Though MRI may be superior to FDG-PET in diagnosis of primary cancer, FDG-PET is very useful in detecting unknown primary cancers which are negative on CT or MRI. In staging, it is possible to accurately localize nodal or other metastases, which has a bearing on surgical or radiation treatment planning. There are some issues in determining therapeutic efficacy, such as optimal timing of evaluation and avoiding false positive findings due to postradiation inflammation. Nonetheless, there is a report recommending evaluation using the change of standardized uptake value (SUV) of FDG uptake in the tumor. Radiation therapy planning using PET-CT has been tried in several institutes and new challenges using PET-CT are to be expected. (author)

  2. Outcome of superficial squamous cell carcinoma of the esophagus: a clinicopathological study

    Directory of Open Access Journals (Sweden)

    Maria Aparecida Coelho de Arruda Henry

    2013-05-01

    Full Text Available PURPOSE: To analyze the clinicopathological features and outcome of patients with pathologically proven superficial squamous cell carcinoma of the esophagus. METHODS: A total of 234 consecutive cases of esophageal carcinoma in a 15-year period were reviewed. RESULTS: Superficial esophageal cancer was found in five patients (2.1%. They were four men and one woman and the mean age was 52.5 years. Smoking and alcohol were the main risk factors. Achalasia due to Chagas disease occurred in one patient and a second primary tumor developed in the larynx in another patient. Four patients underwent esophagectomy and one patient received chemoradiotherapy. The histopathologic diagnosis was of squamous cell carcinoma in all cases. Intramucosal tumor (Tis was identified in three cases and superficially invasive carcinoma in two cases. Four patients are free of disease with survival times of two, four, six and nine years. The patient who developed laryngeal cancer died six years after esophagectomy. CONCLUSION: Long-term survival in patients with esophageal cancer is related to early diagnosis. Therefore, a less aggressive surgical approach, such as endoscopic resection, may be a good option for these patients, if depth of tumor invasion can be accurately predicted by the new imaging tools.

  3. Primary small cell carcinoma of the esophagus: clinicopathological study of 44 cases

    International Nuclear Information System (INIS)

    Primary small cell carcinoma of the esophagus (SCCE) is a highly aggressive disease characterized by early dissemination and poor prognosis. Because of the rarity of this disease, few previous studies have investigated the biomarkers associated with its prognosis. Leucine-rich repeat-containing G-protein coupled receptor 5 (Lgr5) is a stem cell marker and a member of the canonical Wnt-signaling cascade. However, the clinical role of Lgr5 in SCCE remains unknown. Tissue sections were obtained from 44 patients diagnosed with SCCE and expression of Lgr5 was examined by immunohistochemistry. The correlations between Lgr5 expression, and clinical parameters and prognostic significance were evaluated. Lgr5 was expressed in SCCE cancer tissues. High Lgr5 expression was significantly correlated with lymph node metastasis (p = 0.003), late stage (p = 0.003) and unfavorable response to chemotherapy (p = 0.013) according to RECIST 1.0 criteria. Patients with higher Lgr5 expression levels had shorter overall survival times than those with lower expression levels. These results demonstrated that overexpression of Lgr5 was significantly correlated with lymph node metastasis, tumor stage, and response to chemotherapy. Furthermore, high levels of Lgr5 expression appeared to be associated with poorer survival in patients with SCCE

  4. Acute secondary effects in the esophagus in patients undergoing radiotherapy for carcinoma of the lung

    Energy Technology Data Exchange (ETDEWEB)

    Mascarenhas, F.; Silvestre, M.E.; Sa da Costa, M.; Grima, N.; Campos, C.; Chaves, P.

    1989-02-01

    The incidence and nature of acute secondary irradiation esophagitis was studied in a series of 38 patients undergoing 60Co teletherapy for carcinoma of the lung. Thirty-four patients were male and four female, with ages ranging from 38 to 78 years. The mediastinum being irradiated in the process, all the patients underwent endoscopy for signs of esophagitis and/or gastritis after a dose of 30-40 Gy was delivered to the esophagus. Eighteen patients complained of dysphagia, but only in 12 of them did endoscopy show esophagitis. Of the remaining patients without complaints five had endoscopic signs of esophagitis. Gastritis was found in 18 cases and confirmed histologically in 14. In 17 cases, esophagitis and/or gastritis were confirmed histologically. It is believed that there is a fairly close correlation among clinical, endoscopic, and histological findings to support the claim that esophagitis in these patients is radiation induced. However, the cause of gastritis is not well understood. Data in the literature suggest that nonsteroid anti-inflammatory agents can act as prophylactic means of preventing radiation esophagitis.

  5. Endoscopic mucosal resection of Barrett’s esophagus detects high prevalence of subsquamous intestinal metaplasia

    Institute of Scientific and Technical Information of China (English)

    Patrick; Yachimski; Chanjuan; Shi; James; C; Slaughter; Mary; Kay; Washington

    2013-01-01

    AIM:To report the prevalence of Subsquamous intestinal metaplasia(SSIM)in patients undergoing endoscopic mucosal resection(EMR)for staging of Barrett’s esophagus(BE).METHODS:Thirty-three patients with BE associated neoplasia underwent EMR at our institution between September 2009 and September 2011;22 of these patients met study inclusion criteria.EMR was targeted at focal abnormalities within the BE segment.EMR was performed in standardized fashion using a cap-assisted band ligation technique,and resection specimens were assessed for the presence of SSIM.Demographic and clinical data were analyzed to determine predictors of SSIM.RESULTS:SSIM was detected in 59%of patients.SSIM was detected in 73%of patients with short segment(<3 cm)BE,and in 45%of patients with longsegment(≥3 cm)BE(P=NS).There was no association between presence/absence of SSIM and age,gender,or stage of BE-associated neoplasia.CONCLUSION:EMR detects SSIM in a majority of patients with BE-associated neoplasia.While the longterm clinical significance of SSIM remains uncertain,these results highlight the importance of EMR as an optimal diagnostic tool for staging of BE and detection of SSIM,and should further limit concerns that SSIM is purely a post-ablation phenomenon.

  6. DNMT3B 579 G>T promoter polymorphism and risk of esophagus carcinoma in Chinese

    Institute of Scientific and Technical Information of China (English)

    Hong Fan; Dong-Sheng Liu; Shu-Hong Zhang; Jia-Bo Hu; Feng Zhang; Zhu-Jiang Zhao

    2008-01-01

    AIM: To investigate the relationship between 579 G>T polymorphisms in the DNMT3B gene, which is involved in de novo methylation and associated with the risk of esophagus cancer (EC) in Chinese.METHODS: DNMT3B 579 G>T genotypes were determined by PCR-RFLP in 194 EC patients and 210 healthy controls matched for age and sex, who did not receive radiotherapy or chemotherapy for newly diagnosed and histopathologically confirmed EC.RESULTS: In control subjects, the frequency of T/T and G/T genotypes, and T and G alleles was 81.4%, 18.1%,90.05% and 9.55%, respectively. The distribution of genotypes and allelotypes in the EC patients was not significantly different from that in the controls.When stratified by sex and age, there was still no significant association between the risks of EC and GT and GG genotypes. This study also showed a distinct difference in the distribution of DNMT3B and single nucleotide polymorphism (SNP) between Chinese and Koreans.CONCLUSION: DNMT3B 579 G>T polymorphism may not be a stratification marker to predict the susceptibility to EC, at least in Chinese. DNMT3B promoter SNP is diverse in ethnic populations.

  7. Acute secondary effects in the esophagus in patients undergoing radiotherapy for carcinoma of the lung

    International Nuclear Information System (INIS)

    The incidence and nature of acute secondary irradiation esophagitis was studied in a series of 38 patients undergoing 60Co teletherapy for carcinoma of the lung. Thirty-four patients were male and four female, with ages ranging from 38 to 78 years. The mediastinum being irradiated in the process, all the patients underwent endoscopy for signs of esophagitis and/or gastritis after a dose of 30-40 Gy was delivered to the esophagus. Eighteen patients complained of dysphagia, but only in 12 of them did endoscopy show esophagitis. Of the remaining patients without complaints five had endoscopic signs of esophagitis. Gastritis was found in 18 cases and confirmed histologically in 14. In 17 cases, esophagitis and/or gastritis were confirmed histologically. It is believed that there is a fairly close correlation among clinical, endoscopic, and histological findings to support the claim that esophagitis in these patients is radiation induced. However, the cause of gastritis is not well understood. Data in the literature suggest that nonsteroid anti-inflammatory agents can act as prophylactic means of preventing radiation esophagitis

  8. Therapy and prophylaxis of acute and late radiation-induced sequelae of the esophagus

    International Nuclear Information System (INIS)

    Background: Radiation-induced esophagitis is a frequent acute side effect in curative and palliative radiotherapy of thoracal and cervical tumors. Late reactions are rare but might be severe. Methods: A resarch for reports on prophylactic and supportive therapies of radiation-induced esophagitis was performed (Medline, Cancerlit, and others). Results: Nutrition must be ensured and symptomatic relief of sequelae is important, especially in the case of dysphagia. The latter can be improved by topic or systemic analgetics. If esophageal spasm occurs, calcium antagonists might help. In case of gastro-esophageal reflux proton pump inhibitors should be used. There is no effective prophylactic measure for radiation esophagitis. Late side effects with clinical relevance are rare in conventional radiotherapy. Chronic ulcera, fistula or stenosis may develop. Before any treatment, a tumor infiltration of the esophagus should be excluded by biopsy. This can lead more often to late complications than radiation therapy itself. Nutrition should be ensured by endoscopic dilation, stent-implantation, or endoscopic percutaneous gastrostomy. Local injection of steroids might be used to avoid an early restenosis. Conclusions: An intensive symptomatic therapy of acute esophagitis is reasonable. Effective prophylaxis do not exist. Late radiation induced sequelae is rare. Therefore, a tumor recurrence should be excluded in cases of dysphagia. Securing nutrition by PEG, stent, or port is well in the fore. (orig.)

  9. Identification of early cancerous lesion of esophagus with endoscopic images by hyperspectral image technique (Conference Presentation)

    Science.gov (United States)

    Huang, Shih-Wei; Chen, Shih-Hua; Chen, Weichung; Wu, I.-Chen; Wu, Ming Tsang; Kuo, Chie-Tong; Wang, Hsiang-Chen

    2016-03-01

    This study presents a method to identify early esophageal cancer within endoscope using hyperspectral imaging technology. The research samples are three kinds of endoscopic images including white light endoscopic, chromoendoscopic, and narrow-band endoscopic images with different stages of pathological changes (normal, dysplasia, dysplasia - esophageal cancer, and esophageal cancer). Research is divided into two parts: first, we analysis the reflectance spectra of endoscopic images with different stages to know the spectral responses by pathological changes. Second, we identified early cancerous lesion of esophagus by principal component analysis (PCA) of the reflectance spectra of endoscopic images. The results of this study show that the identification of early cancerous lesion is possible achieve from three kinds of images. In which the spectral characteristics of NBI endoscopy images of a gray area than those without the existence of the problem the first two, and the trend is very clear. Therefore, if simply to reflect differences in the degree of spectral identification, chromoendoscopic images are suitable samples. The best identification of early esophageal cancer is using the NBI endoscopic images. Based on the results, the use of hyperspectral imaging technology in the early endoscopic esophageal cancer lesion image recognition helps clinicians quickly diagnose. We hope for the future to have a relatively large amount of endoscopic image by establishing a hyperspectral imaging database system developed in this study, so the clinician can take this repository more efficiently preliminary diagnosis.

  10. Current relevance of cervical ultrasonography in staging cancer of the esophagus and gastroesophageal junction

    International Nuclear Information System (INIS)

    Purpose: To evaluate the value of external ultrasonography (US) of the neck in current dedicated preoperative staging of patients with cancer of the esophagus and gastroesophageal junction (GEJ). Materials and methods: We analyzed 180 consecutive patients (154 men, 26 women, and mean age 63 (38-84) years) without palpable cervical lymphadenopathy, treated between January 2001 and March 2006. Suspicious lesions were confirmed by cytological examination. All first 125 consecutive patients (group A) were staged by standard endoscopic ultrasonography (EUS), multidetector computed tomography (md-CT), positron emission tomography with 18F-fluorodeoxyglucose (FDG-PET) and external US. The other 55 patients (group B) were prospectively staged according to a revised protocol consisting of routine EUS and md-CT, while PET was only performed in subjects with T3-T4 and/or N1 disease and external US solely on indication. Results: Cervical metastases were found in seven patients from group A (6%) and in five from group B (9%). Twenty percent (4/20) of the tumors above the carina and 5% (8/160) of the distal tumors presented with cervical metastases. All were diagnosed as T3 and T4 tumors on EUS. Eleven of these metastases were detected by external US and nine on md-CT. All nodal metastases were detected by the combination of PET and md-CT. No cervical metastases were missed by the diagnostic algorithm in group B. Conclusion: In present staging procedures for esophageal cancer, routine external US seems to have no additional value in detecting cervical metastases. It is still indicated to obtain cytological proof of suspected cervical lesions

  11. Current relevance of cervical ultrasonography in staging cancer of the esophagus and gastroesophageal junction

    Energy Technology Data Exchange (ETDEWEB)

    Schreurs, Liesbeth M.A. [Department of Surgical Oncology/Abdominal Surgery, University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, 9700 RB Groningen (Netherlands)], E-mail: l.m.a.schreurs@chir.umcg.nl; Verhoef, Christian C.P.M. [Department of Surgical Oncology/Abdominal Surgery, University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, 9700 RB Groningen (Netherlands)], E-mail: c.c.p.m.verhoef@chir.umcg.nl; Jagt, Erik J. van der [Department of Radiology, University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, 9700 RB Groningen (Netherlands)], E-mail: e.j.van.der.jagt@rad.umcg.nl; Dam, Gooitzen M. van [Department of Surgical Oncology/Abdominal Surgery, University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, 9700 RB Groningen (Netherlands)], E-mail: g.m.van.dam@chir.umcg.nl; Groen, Henk [Department of Epidemiology, University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, 9700 RB Groningen (Netherlands)], E-mail: h.groen@mta.umcg.nl; Plukker, John Th.M. [Department of Surgical Oncology/Abdominal Surgery, University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, 9700 RB Groningen (Netherlands)], E-mail: j.th.plukker@chir.umcg.nl

    2008-07-15

    Purpose: To evaluate the value of external ultrasonography (US) of the neck in current dedicated preoperative staging of patients with cancer of the esophagus and gastroesophageal junction (GEJ). Materials and methods: We analyzed 180 consecutive patients (154 men, 26 women, and mean age 63 (38-84) years) without palpable cervical lymphadenopathy, treated between January 2001 and March 2006. Suspicious lesions were confirmed by cytological examination. All first 125 consecutive patients (group A) were staged by standard endoscopic ultrasonography (EUS), multidetector computed tomography (md-CT), positron emission tomography with {sup 18}F-fluorodeoxyglucose (FDG-PET) and external US. The other 55 patients (group B) were prospectively staged according to a revised protocol consisting of routine EUS and md-CT, while PET was only performed in subjects with T3-T4 and/or N1 disease and external US solely on indication. Results: Cervical metastases were found in seven patients from group A (6%) and in five from group B (9%). Twenty percent (4/20) of the tumors above the carina and 5% (8/160) of the distal tumors presented with cervical metastases. All were diagnosed as T3 and T4 tumors on EUS. Eleven of these metastases were detected by external US and nine on md-CT. All nodal metastases were detected by the combination of PET and md-CT. No cervical metastases were missed by the diagnostic algorithm in group B. Conclusion: In present staging procedures for esophageal cancer, routine external US seems to have no additional value in detecting cervical metastases. It is still indicated to obtain cytological proof of suspected cervical lesions.

  12. Expense and benefit of neoadjuvant treatment in squamous cell carcinoma of the esophagus

    International Nuclear Information System (INIS)

    The effectiveness of neoadjuvant treatment (NT) prior to resection of squamous cell carcinoma of the esophagus (SCCE) in terms of prolonged survival has not been proven by randomized trials. Facing considerable financial expenses and with concerns regarding the consumption of the patient's remaining survival time, this study aims to provide rationales for pretreating resection candidates. From March 1986 to March 1999, patients undergoing resection for SCCE were documented prospectively. Since 1989, NT was offered to patients with mainly upper and middle third T3 or T4 tumors or T2 N1 stage who were fit for esophagectomy. Until 1993, NT consisted of chemotherapy. Since that time chemoradiation has also been applied. The parameters for expense and benefit of NT are costs, pretreatment time required, postoperative morbidity and mortality, clinical and histopathological response, and actuarial survival. Two hundred and three patients were treated, 170 by surgery alone and 33 by NT + surgery. Postoperative morbidity and mortality were 52% to 30% and 12% to 6%, respectively (p = n.s.). The response to NT was detected in 23 patients (70%). In 11 instances (33%), the primary tumor lesion was histopathologically eradicated. Survival following NT + surgery was significantly prolonged in node-positive patients with a median survival of 12 months to 19 months (p = 0.0193). The average pretreatment time was 113 ± 43 days, and reimbursement for NT to the hospital amounted to Euro 9.834. NT did not increase morbidity and mortality. Expenses for pretreatment, particularly time and costs, are considerable. However, taking into account that the results are derived from a non-randomized study, patients with regionally advanced tumor stages seem to benefit, as seen by their prolonged survival

  13. TRPM8 function and expression in vagal sensory neurons and afferent nerves innervating guinea pig esophagus.

    Science.gov (United States)

    Yu, Xiaoyun; Hu, Youtian; Ru, Fei; Kollarik, Marian; Undem, Bradley J; Yu, Shaoyong

    2015-03-15

    Sensory transduction in esophageal afferents requires specific ion channels and receptors. TRPM8 is a new member of the transient receptor potential (TRP) channel family and participates in cold- and menthol-induced sensory transduction, but its role in visceral sensory transduction is still less clear. This study aims to determine TRPM8 function and expression in esophageal vagal afferent subtypes. TRPM8 agonist WS-12-induced responses were first determined in nodose and jugular neurons by calcium imaging and then investigated by whole cell patch-clamp recordings in Dil-labeled esophageal nodose and jugular neurons. Extracellular single-unit recordings were performed in nodose and jugular C fiber neurons using ex vivo esophageal-vagal preparations with intact nerve endings in the esophagus. TRPM8 mRNA expression was determined by single neuron RT-PCR in Dil-labeled esophageal nodose and jugular neurons. The TRPM8 agonist WS-12 elicited calcium influx in a subpopulation of jugular but not nodose neurons. WS-12 activated outwardly rectifying currents in esophageal Dil-labeled jugular but not nodose neurons in a dose-dependent manner, which could be inhibited by the TRPM8 inhibitor AMTB. WS-12 selectively evoked action potential discharges in esophageal jugular but not nodose C fibers. Consistently, TRPM8 transcripts were highly expressed in esophageal Dil-labeled TRPV1-positive jugular neurons. In summary, the present study demonstrated a preferential expression and function of TRPM8 in esophageal vagal jugular but not nodose neurons and C fiber subtypes. This provides a distinctive role of TRPM8 in esophageal sensory transduction and may lead to a better understanding of the mechanisms of esophageal sensation and nociception. PMID:25591866

  14. Expense and benefit of neoadjuvant treatment in squamous cell carcinoma of the esophagus

    Directory of Open Access Journals (Sweden)

    Hartmann Karl A

    2001-11-01

    Full Text Available Abstract Background The effectiveness of neoadjuvant treatment (NT prior to resection of squamous cell carcinoma of the esophagus (SCCE in terms of prolonged survival has not been proven by randomized trials. Facing considerable financial expenses and with concerns regarding the consumption of the patient's remaining survival time, this study aims to provide rationales for pretreating resection candidates. Methods From March 1986 to March 1999, patients undergoing resection for SCCE were documented prospectively. Since 1989, NT was offered to patients with mainly upper and middle third T3 or T4 tumors or T2 N1 stage who were fit for esophagectomy. Until 1993, NT consisted of chemotherapy. Since that time chemoradiation has also been applied. The parameters for expense and benefit of NT are costs, pretreatment time required, postoperative morbidity and mortality, clinical and histopathological response, and actuarial survival. Results Two hundred and three patients were treated, 170 by surgery alone and 33 by NT + surgery. Postoperative morbidity and mortality were 52% to 30% and 12% to 6%, respectively (p = n.s.. The response to NT was detected in 23 patients (70%. In 11 instances (33%, the primary tumor lesion was histopathologically eradicated. Survival following NT + surgery was significantly prolonged in node-positive patients with a median survival of 12 months to 19 months (p = 0.0193. The average pretreatment time was 113 ± 43 days, and reimbursement for NT to the hospital amounted to Euro 9.834. Conclusions NT did not increase morbidity and mortality. Expenses for pretreatment, particularly time and costs, are considerable. However, taking into account that the results are derived from a non-randomized study, patients with regionally advanced tumor stages seem to benefit, as seen by their prolonged survival.

  15. Computer-aided detection of early cancer in the esophagus using HD endoscopy images

    Science.gov (United States)

    van der Sommen, Fons; Zinger, Svitlana; Schoon, Erik J.; de With, Peter H. N.

    2013-02-01

    Esophageal cancer is the fastest rising type of cancer in the Western world. The recent development of High-Definition (HD) endoscopy has enabled the specialist physician to identify cancer at an early stage. Nevertheless, it still requires considerable effort and training to be able to recognize these irregularities associated with early cancer. As a first step towards a Computer-Aided Detection (CAD) system that supports the physician in finding these early stages of cancer, we propose an algorithm that is able to identify irregularities in the esophagus automatically, based on HD endoscopic images. The concept employs tile-based processing, so our system is not only able to identify that an endoscopic image contains early cancer, but it can also locate it. The identification is based on the following steps: (1) preprocessing, (2) feature extraction with dimensionality reduction, (3) classification. We evaluate the detection performance in RGB, HSI and YCbCr color space using the Color Histogram (CH) and Gabor features and we compare with other well-known features to describe texture. For classification, we employ a Support Vector Machine (SVM) and evaluate its performance using different parameters and kernel functions. In experiments, our system achieves a classification accuracy of 95.9% on 50×50 pixel tiles of tumorous and normal tissue and reaches an Area Under the Curve (AUC) of 0.990. In 22 clinical examples our algorithm was able to identify all (pre-)cancerous regions and annotate those regions reasonably well. The experimental and clinical validation are considered promising for a CAD system that supports the physician in finding early stage cancer.

  16. Use of sting-response techniques for simulate diagnostics in human esophagus

    International Nuclear Information System (INIS)

    In this work a study of simulation of the gamma graphic studies that are carried out in human esophagus in the Dept. of Nuclear Medicine of the 'Celestino Hernandez Robau Hospital of Santa Clara is presented. For the investigation tubular reactors were used and sting-response techniques with radioactive tracer of Technetium 99 metastable to a concentration of 1 mCi and several flows were applied. The distribution curves of residences times were obtained, those that respond to an equation of the type: Y = A + B exp (- exp((x-C)/D)) - ((x-C/D)+1). They were also carried out, optimizations studies of the doses of the radioactive to give to the patients from 1 mCi (that is the one used in studies) up to 0,5 mCi, and the influences on the obtained distributions of residence time were analyzed. It was confirmed the possibility to lower the doses with clear information of the signal. It was also carried out a simulation of the attenuation of the radiations that takes place in the patients by the interposition of tissues among the analyzed organ, and the detection equipment. It was used paraffin for tissue simulation. It was found the almost independence of the intensity of the radiations with the thickness, for the assayed doses. Lastly it was found a complex mathematical model that responds to the diagnostic curves obtained in these studies, being correlated the coefficients of the pattern with the most important physical parameters of the system, giving it a practical and useful value, all time that the error among the values that this it predicts and the experimental ones do not surpass of 5%. (Author)

  17. Tissue engineered esophagus scaffold constructed with porcine small intestinal submucosa and synthetic polymers.

    Science.gov (United States)

    Fan, Mei-Rong; Gong, Mei; Da, Lin-Cui; Bai, Lin; Li, Xiu-Qun; Chen, Ke-Fei; Li-Ling, Jesse; Yang, Zhi-Ming; Xie, Hui-Qi

    2014-02-01

    Acellular porcine small intestinal submucosa (SIS) has been successfully used for reconstructing esophagus with half circumferential defects. However, repairing full circumferential esophageal defects with SIS has been restricted due to the latter's poor mechanical properties. In the present study, synthetic polyesters biomaterial poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) (PHBHHx) and poly(lactide-co-glycolide) (PLGA) have been used to improve the mechanical properties of SIS. Feasibility of SIS/PHBHHx-PLGA composite material scaffold for esophageal tissue engineering has been assessed through a series of testing. The appropriate mixing ratio of PHBHHx and PLGA polymers has been determined as 5:5 by mechanical testing and in vitro degradation experiment. The morphology of constructed membranous and tubular scaffolds was also characterized. As confirmed by enzyme-linked immunosorbent assay, the contents of VEGF and TGF-β have respectively reached 657 ± 18 ng mL(-1) and 130 ± 4 pg mL(-1) within the SIS/PHBHHx-PLGA specimens. Biocompatibility of the SIS/PHBHHx-PLGA specimens with rat bone marrow mesenchymal stem cells (MSCs) was also evaluated by scanning electron microscopy and a live-dead cell viability assay. Actin filaments of MSCs on the composite materials were labeled. Biological safety of the extract from SIS/PHBHHx-PLGA specimens, measured as hemolysis rate, was all lower than 5%. Compared with SIS and SIS/PHBHHx-PLGA specimens, inflammatory reaction provoked by the PHBHHx-PLGA specimens in rats was however more severe. Our results have suggested that SIS/PHBHHx-PLGA composite material can offer a new approach for esophageal tissue engineering. PMID:24457267

  18. Tissue engineered esophagus scaffold constructed with porcine small intestinal submucosa and synthetic polymers

    International Nuclear Information System (INIS)

    Acellular porcine small intestinal submucosa (SIS) has been successfully used for reconstructing esophagus with half circumferential defects. However, repairing full circumferential esophageal defects with SIS has been restricted due to the latter's poor mechanical properties. In the present study, synthetic polyesters biomaterial poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) (PHBHHx) and poly(lactide-co-glycolide) (PLGA) have been used to improve the mechanical properties of SIS. Feasibility of SIS/PHBHHx-PLGA composite material scaffold for esophageal tissue engineering has been assessed through a series of testing. The appropriate mixing ratio of PHBHHx and PLGA polymers has been determined as 5:5 by mechanical testing and in vitro degradation experiment. The morphology of constructed membranous and tubular scaffolds was also characterized. As confirmed by enzyme-linked immunosorbent assay, the contents of VEGF and TGF-β have respectively reached 657 ± 18 ng mL−1 and 130 ± 4 pg mL−1 within the SIS/PHBHHx-PLGA specimens. Biocompatibility of the SIS/PHBHHx-PLGA specimens with rat bone marrow mesenchymal stem cells (MSCs) was also evaluated by scanning electron microscopy and a live–dead cell viability assay. Actin filaments of MSCs on the composite materials were labeled. Biological safety of the extract from SIS/PHBHHx-PLGA specimens, measured as hemolysis rate, was all lower than 5%. Compared with SIS and SIS/PHBHHx-PLGA specimens, inflammatory reaction provoked by the PHBHHx-PLGA specimens in rats was however more severe. Our results have suggested that SIS/PHBHHx-PLGA composite material can offer a new approach for esophageal tissue engineering. (paper)

  19. Different types of spinal afferent nerve endings in stomach and esophagus identified by anterograde tracing from dorsal root ganglia.

    Science.gov (United States)

    Spencer, Nick J; Kyloh, Melinda; Beckett, Elizabeth A; Brookes, Simon; Hibberd, Tim

    2016-10-15

    In visceral organs of mammals, most noxious (painful) stimuli as well as innocuous stimuli are detected by spinal afferent neurons, whose cell bodies lie in dorsal root ganglia (DRGs). One of the major unresolved questions is the location, morphology, and neurochemistry of the nerve endings of spinal afferents that actually detect these stimuli in the viscera. In the upper gastrointestinal (GI) tract, there have been many anterograde tracing studies of vagal afferent endings, but none on spinal afferent endings. Recently, we developed a technique that now provides selective labeling of only spinal afferents. We used this approach to identify spinal afferent nerve endings in the upper GI tract of mice. Animals were anesthetized, and injections of dextran-amine were made into thoracic DRGs (T8-T12). Seven days post surgery, mice were euthanized, and the stomach and esophagus were removed, fixed, and stained for calcitonin gene-related peptide (CGRP). Spinal afferent axons were identified that ramified extensively through many rows of myenteric ganglia and formed nerve endings in discrete anatomical layers. Most commonly, intraganglionic varicose endings (IGVEs) were identified in myenteric ganglia of the stomach and varicose simple-type endings in the circular muscle and mucosa. Less commonly, nerve endings were identified in internodal strands, blood vessels, submucosal ganglia, and longitudinal muscle. In the esophagus, only IGVEs were identified in myenteric ganglia. No intraganglionic lamellar endings (IGLEs) were identified in the stomach or esophagus. We present the first identification of spinal afferent endings in the upper GI tract. Eight distinct types of spinal afferent endings were identified in the stomach, and most of them were CGRP immunoreactive. J. Comp. Neurol. 524:3064-3083, 2016. © 2016 Wiley Periodicals, Inc. PMID:27019197

  20. Prevention and therapy of squamous cell carcinoma of the rodent esophagus using freeze-dried black raspberries

    Institute of Scientific and Technical Information of China (English)

    Gary D STONER; Robeena M AZIZ

    2007-01-01

    Aim: This study was conducted to determine if short-term treatment of N-nitrosomethylbenzylamine (NMBA)-induced tumors in the rat esophagus with dietary freeze-dried black raspberries (FBR) would result in tumor regression and enhanced survival of the animals. Methods: Four-week-old male Fisher-344 ratswere administered an AIN-76A control diet and injected subcutaneously with 0.5 mg/kg NMBA once per week for 15 weeks. At 19 weeks, when rats had an average of 5-6 tumors (papillomas) per esophagus, they were given a control diet contain-ing either 5%, 10%, or 20% FBR. After 7 weeks of berry treatment, all surviving rats were killed and tumor incidence, number and volume were determined. Results:Esophageal tumor incidences, numbers and volumes in NMBA-treated rats were not influenced by any of the berry treatments. There were progressive increases in the survival of NMBA-treated rats fed 5%-20% FBR diets; however, these increases were not significant. Conclusion: FBR at 5%, 10%, and 20% of the diet had no effect on the development of NMBA-induced tumors in the rat esophagus or on animal survival when administered for 7 weeks beginning at the papilloma stage of tumor development. Thus, FBR appear to have no therapeutic value in the treatment of esophageal tumors. In contrast, dietary FBR are highly effectivein preventing the development of NMBA-induced esophageal tumors in rats when administered before and during NMBA treatment or shortly after NMBA treat-ment when the esophagi contain preneoplastic (dysplastic) lesions of varyingdegrees of severity.

  1. The Effects of Environmental Factors on Smooth Muscle Cells Differentiation from Adipose-Derived Stem Cells and Esophagus Tissues Engineering

    DEFF Research Database (Denmark)

    Wang, Fang

    for diseased esophagus replacement. The first part involved the effect of hypoxia on differentiation. The results showed 5% hypoxia to be the optimal condition for differentiation of ASCs into contractile SMCs. In the second part, the combined effects of mechanical strain (10% cyclic tensile strain......) and biochemical factor stimulation on SMCs differentiation were studied. The results showed that combined treatments promoted the late SMC-specific marker smooth muscle myosin heavy chain (MHC) expression. In the third part, the potential for using ASCs to replace SMCs to regenerate the smooth muscle layer...

  2. Research on Trypanosoma cruzi and Analysis of Inflammatory Infiltrate in Esophagus and Colon from Chronic Chagasic Patients with and without Mega

    Directory of Open Access Journals (Sweden)

    Eliângela de Castro Côbo

    2012-01-01

    Full Text Available To compare parasitism and inflammatory process in esophagus and colon from chronic chagasic patients, immunohistochemistry was carried out to research for T. cruzi and to evaluate the inflammatory infiltrate in the muscular and myenteric plexus in 39 esophagi (20 with and 19 without megaesophagus and 50 colons (25 with and 25 without megacolon. The frequency of T. cruzi in megaesophagus was 20%, and in megacolon it was 4%. No amastigotes were found in organs without mega; considering the total of esophagi (with and without mega, the frequency of T. cruzi would be 10% and 2% in the colon. Myositis and ganglionitis were more frequent and intense in organs with mega compared to those without mega, and in esophagus compared to colon. Qualitatively, inflammatory infiltration in esophagus and colon, with or without mega, was similar, consisting predominantly of T lymphocytes (CD3+, scarce macrophages (CD68+, and rare B lymphocytes (CD20+.

  3. Radiation Dose to the Esophagus From Breast Cancer Radiation Therapy, 1943-1996: An International Population-Based Study of 414 Patients

    International Nuclear Information System (INIS)

    Purpose: To provide dosimetric data for an epidemiologic study on the risk of second primary esophageal cancer among breast cancer survivors, by reconstructing the radiation dose incidentally delivered to the esophagus of 414 women treated with radiation therapy for breast cancer during 1943-1996 in North America and Europe. Methods and Materials: We abstracted the radiation therapy treatment parameters from each patient’s radiation therapy record. Treatment fields included direct chest wall (37% of patients), medial and lateral tangentials (45%), supraclavicular (SCV, 64%), internal mammary (IM, 44%), SCV and IM together (16%), axillary (52%), and breast/chest wall boosts (7%). The beam types used were 60Co (45% of fields), orthovoltage (33%), megavoltage photons (11%), and electrons (10%). The population median prescribed dose to the target volume ranged from 21 Gy to 40 Gy. We reconstructed the doses over the length of the esophagus using abstracted patient data, water phantom measurements, and a computational model of the human body. Results: Fields that treated the SCV and/or IM lymph nodes were used for 85% of the patients and delivered the highest doses within 3 regions of the esophagus: cervical (population median 38 Gy), upper thoracic (32 Gy), and middle thoracic (25 Gy). Other fields (direct chest wall, tangential, and axillary) contributed substantially lower doses (approximately 2 Gy). The cervical to middle thoracic esophagus received the highest dose because of its close proximity to the SCV and IM fields and less overlying tissue in that part of the chest. The location of the SCV field border relative to the midline was one of the most important determinants of the dose to the esophagus. Conclusions: Breast cancer patients in this study received relatively high incidental radiation therapy doses to the esophagus when the SCV and/or IM lymph nodes were treated, whereas direct chest wall, tangentials, and axillary fields contributed lower doses

  4. Quality of life assessment with different radiotherapy schedules in palliative management of advanced carcinoma esophagus: A prospective randomized study

    Directory of Open Access Journals (Sweden)

    Shaveta Mehta

    2008-01-01

    Full Text Available Aim: To investigate the quality of life (QOL of patients with advanced carcinoma esophagus treated with different palliative radiation schedules. Methods: Sixty-two consecutive patients with inoperable, non-metastatic carcinoma of the esophagus were randomly allocated to Arm-A (external radiotherapy 30 Gy/10 fractions + brachytherapy 12 Gy/two sessions, Arm-B (external radiotherapy 30 Gy /10 fractions and Arm-C (external radiotherapy 20Gy /five fractions. The QOL was assessed using the European Organization for Research and Treatment of Cancer questionnaire at presentation, after treatment and at 3 months follow-up. Results: The mean QOL score improved, in arm-A from 38 to 52 after treatment and 56 at 3 months, in arm-B from 30 to 44 after treatment and 55 at 3 months and in arm-C from 24 to 40 after treatment but decreased to 37 at 3 months. Improvement in dysphagia scores at the first follow-up was 46.1% in arm-A, 25.0% in arm-B and 22.6% in arm-C. The difference was maintained at 3 months, with maximum improvement in arm-A (57.6%. No significant differences were found between the three arms with regard to complications and additional procedures needed for relief of dysphagia. Conclusion: In comparison with external radiotherapy alone, external radiotherapy with intraluminal brachytherapy has shown a trend toward better QOL and consistent dysphagia relief without significant difference in adverse effects.

  5. Clinicopathological significance of KI-67 antibody labeling index for patients with squamous cell carcinoma of the esophagus

    International Nuclear Information System (INIS)

    Ki-67 antibody labeling index (MIB-1) is an indicator of cell proliferation, and has been investigated in carcinoma of the lung and breast. However, its correlation with clinicopathological significance and prognosis in squamous cell carcinoma (SCC) of the esophagus has not been determined. Twenty-five patients who underwent potentially curative resection for SCC of the esophagus in the hospital between 2006 and 2008 were enrolled in this study. Patients who had preoperative radio-and/or chemotherapy were excluded. Clinicopathological factors, prognosis of the patients and correlation between the MIB-1 of the primary tumors and the maximum standardized uptake values (max-SUV) in fluorodeoxyglucose positron emission tomography (FDG-PET) were investigated. The mean MIB-1 was 42.3% (range, 13.0-73.2%), and it was significantly correlated with lymph node metastasis (p=0.002) and pathological stage (p=0.007). Patients with high MIB-1 (more than 40%) showed a significantly poor disease-free survival compared with those with low MIB-1 (less than 40%) (p=0.035). Weak correlation was found between the MIB-1 and max-SUV (p=0.051). The MIB-1 has a significant correlation with lymphatic extension and pathological stage, and can be a prognostic parameter. MaxSUV might be a predictive factor of prognosis. (author)

  6. Metaplasia intestinal especializada de esôfago distal na doença do refluxo gastroesofágico: prevalência e aspectos clínico-epidemiológicos Specialized intestinal metaplasia of distal esophagus in the gastroesophageal reflux disease: prevalence and clinical-demographic features

    OpenAIRE

    Leiber C. Caum; Sérgio L. Bizinelli; Júlio César Pisani; Heda Maria Barska dos Santos Amarantes; Sérgio O. IOSHII; Eliane R. Carmes

    2003-01-01

    RACIONAL: A metaplasia intestinal especializada pode ser classificada, de acordo com os achados endoscópicos e histológicos, em Barrett longo, Barrett curto e metaplasia intestinal da cárdia. O esôfago de Barrett é doença adquirida que ocorre em aproximadamente 10% a 13% dos indivíduos com doença do refluxo gastroesofágico e representa uma condição pré-neoplásica. É caracterizado por substituição do epitélio escamoso estratificado pelo metaplásico colunar especializado, contendo células calic...

  7. Simplified method for esophagus protection during radiofrequency catheter ablation of atrial fibrillation - prospective study of 704 cases

    Directory of Open Access Journals (Sweden)

    José Carlos Pachón Mateos

    2015-04-01

    Full Text Available AbstractIntroduction:Although rare, the atrioesophageal fistula is one of the most feared complications in radiofrequency catheter ablation of atrial fibrillation due to the high risk of mortality.Objective:This is a prospective controlled study, performed during regular radiofrequency catheter ablation of atrial fibrillation, to test whether esophageal displacement by handling the transesophageal echocardiography transducer could be used for esophageal protection.Methods:Seven hundred and four patients (158 F/546M [22.4%/77.6%]; 52.8±14 [17-84] years old, with mean EF of 0.66±0.8 and drug-refractory atrial fibrillation were submitted to hybrid radiofrequency catheter ablation (conventional pulmonary vein isolation plus AF-Nests and background tachycardia ablation with displacement of the esophagus as far as possible from the radiofrequency target by transesophageal echocardiography transducer handling. The esophageal luminal temperature was monitored without and with displacement in 25 patients.Results:The mean esophageal displacement was 4 to 9.1cm (5.9±0.8 cm. In 680 of the 704 patients (96.6%, it was enough to allow complete and safe radiofrequency delivery (30W/40ºC/irrigated catheter or 50W/60ºC/8 mm catheter without esophagus overlapping. The mean esophageal luminal temperature changes with versus without esophageal displacement were 0.11±0.13ºC versus 1.1±0.4ºC respectively, P<0.01. The radiofrequency had to be halted in 68% of the patients without esophageal displacement because of esophageal luminal temperature increase. There was no incidence of atrioesophageal fistula suspected or confirmed. Only two superficial bleeding caused by transesophageal echocardiography transducer insertion were observed.Conclusion:Mechanical esophageal displacement by transesophageal echocardiography transducer during radiofrequency catheter ablation was able to prevent a rise in esophageal luminal temperature, helping to avoid esophageal thermal

  8. The Frequencies of Gastroesophageal and Extragastroesophageal Symptoms in Patients with Mild Erosive Esophagitis, Severe Erosive Esophagitis, and Barrett’s Esophagus in Taiwan

    OpenAIRE

    Sung-Shuo Kao; Wen-Chih Chen; Ping-I Hsu; Seng-Kee Chuah; Ching-Liang Lu; Kwok-Hung Lai; Feng-Woei Tsai; Chun-Chao Chang; Wei-Chen Tai

    2013-01-01

    Background. Gastroesophageal reflux disease (GERD) may present with gastroesophageal and extraesophageal symptoms. Currently, the frequencies of gastroesophageal and extragastroesophageal symptoms in Asian patients with different categories of GERD remain unclear. Aim. To investigate the frequencies of gastroesophageal and extragastroesophageal symptoms in patients with mild erosive esophagitis, severe erosive esophagitis, and Barrett’s esophagus of GERD. Methods. The symptoms of symptomatic ...

  9. Comparison of treatment using teletherapy (external beam radiation) alone versus teletherapy combined with brachytherapy for advanced squamous cell carcinoma of the esophagus

    Energy Technology Data Exchange (ETDEWEB)

    Samea, Renato; Lourenco, Laercio Gomes, E-mail: renatosamea@globo.com [Department of Surgical Oncology of Dr. Arnaldo Vieira de Carvalho Hospital, Sao Paulo, SP (Brazil)

    2011-10-15

    Background - Squamous cell carcinoma of the esophagus is still a difficult tumor to treat with very poor prognosis. Aim - To compare the response to teletherapy treatment (external beam radiotherapy) alone versus teletherapy combined with brachytherapy for patients with advanced squamous cell carcinoma of the esophagus. Methods - Were studied 49 patients with advanced squamous cell carcinoma of the esophagus on clinical stage III (TNM-1999). They were separated into two groups. The first, underwent radiation therapy alone with linear accelerator of particles, average dose of 6000 cGy and the second to external beam radiation therapy at a dose of 5040 cGy combined with brachytherapy with Iridium 192 at a dose of 1500 cGy. Brachytherapy started one to two weeks after the end of teletherapy, and it was divided into three weekly applications of 500 cGy. Age, gender, race, habits (smoking and drinking), body mass index (BMI), complications with treatment benefits (pain relief and food satisfaction) and survival were analyzed. Results - The quality of life (food satisfaction, and pain palliation of dysphagia) were better in the group treated with external beam radiation therapy combined with brachytherapy. Survival was higher in the brachytherapy combined with external beam radiation therapy alone. Conclusion - Although the cure rate of squamous cell cancer of the esophagus is almost nil when treated with irradiation alone, this therapy is a form of palliative treatment for most patients in whom surgical contraindication exists. (author)

  10. Polymorphisms in Genes of Relevance for Oestrogen and Oxytocin Pathways and Risk of Barrett's Oesophagus and Oesophageal Adenocarcinoma: A Pooled Analysis from the BEACON Consortium.

    Directory of Open Access Journals (Sweden)

    Katarina Lagergren

    Full Text Available The strong male predominance in oesophageal adenocarcinoma (OAC and Barrett's oesophagus (BO continues to puzzle. Hormonal influence, e.g. oestrogen or oxytocin, might contribute.This genetic-epidemiological study pooled 14 studies from three continents, Australia, Europe, and North America. Polymorphisms in 3 key genes coding for the oestrogen pathway (receptor alpha (ESR1, receptor beta (ESR2, and aromatase (CYP19A1, and 3 key genes of the oxytocin pathway (the oxytocin receptor (OXTR, oxytocin protein (OXT, and cyclic ADP ribose hydrolase glycoprotein (CD38, were analysed using a gene-based approach, versatile gene-based test association study (VEGAS.Among 1508 OAC patients, 2383 BO patients, and 2170 controls, genetic variants within ESR1 were associated with BO in males (p = 0.0058 and an increased risk of OAC and BO combined in males (p = 0.0023. Genetic variants within OXTR were associated with an increased risk of BO in both sexes combined (p = 0.0035 and in males (p = 0.0012. We followed up these suggestive findings in a further smaller data set, but found no replication. There were no significant associations between the other 4 genes studied and risk of OAC, BO, separately on in combination, in males and females combined or in males only.Genetic variants in the oestrogen receptor alpha and the oxytocin receptor may be associated with an increased risk of BO or OAC, but replication in other large samples are needed.

  11. 山西省食管癌患者出生顺序研究%Study on the birth order of patients with esophagus cancer in Shanxi province

    Institute of Scientific and Technical Information of China (English)

    韩斐; 范亚峰; 王国平; 丁悌; 李建民; 苏文; 高泽锋; 韩小友

    2012-01-01

    Objective To explore the relationship between esophagus cancer patients and both environmental and genetic factors,through analyzing the data on birth orders from esophagus cancer patients of Shanxi province.Methods Both Greenwood and Haldane methods on birth order were used to study the 1101 cases with esophagus cancer from Shanxi province.All the patients had received surgery and were diagnosed,by pathological evidence.First certificates of the patients were confirmed through the standard genetic epidemiologic investigation.Birth order was investigated on probands of the 1101 cases with esophagus cancer and their 44 siblings.Results Results form the Greenwood method showed that there was a tendency for cases with esophagus cancer in birth orders First to Third.However,the Haldane method showed that the results were quite different between actual value and the average theory value of 6A (6A(actual value)=17 118,(X)6A(average theory value) =19 290,X=∣6A-(X)6A∣/√V6A =7.63,X > 2) which suggested that the birth order had some effects on the occurrence of esophagus cancer.In addition,the actual value of 6A was lower than the theoretic average value,and the parents at younger productive age or baby at the first birth was easy to develop esophagus cancer.Conclusion Esophagus cancer was related with the birth order,especially at early order,which was not consistent with the national reports on esophagus cancer.Results from this study suggested that there were certain effects of environmental risk factors on esophagus cancer patients.%目的 分析山西省食管癌患者的出生顺序,探讨环境因素、遗传因素与食管癌的关系.方法 采用Greenwood和Haldane的出生顺序方法,以山西省肿瘤医院1101例住院食管癌手术患者为先证者进行遗传流行病学调查,并对1101例先证者及44例食管癌患病同胞进行出生顺序研究.结果 Greenwood法分析结果显示,食管癌患者较多发生在出生顺序1~3

  12. Use of a video laryngoscope to facilitate removal of a long, sharp-pointed blade from the esophagus.

    Science.gov (United States)

    Hiller, Kenneth N; Hagberg, Carin A

    2016-08-01

    Initial management of ingested esophageal foreign bodies involves airway assessment, determination of the requirement for and timing of therapeutic intervention, risk mitigation during removal, and identification of all indicated equipment for retrieval. Long, sharp-pointed objects lodged in the esophagus require emergent attention and should be retrieved endoscopically, if perforation has not occurred. Inducing general anesthesia and rapidly securing the airway can minimize the risk of aspiration, mitigate any effects of tracheal compression, avoid the potential of exacerbating existing trauma, and provide optimal conditions for removal of long, sharp-pointed esophageal foreign bodies. Video laryngoscopy provides improved recognition of anatomical structures in both normal and difficult airways, enabling assessment for hypopharyngeal and glottic trauma resulting from foreign body ingestion. The indirect view of video laryngoscopy also facilitates the coordinated manipulation of the airway by both the anesthesiologist and the surgeon as they visualize the anatomy together while securing the airway and removing the foreign body. PMID:27290934

  13. A fístula esôfago-gástrica cervical Cervical esophagus-gastric fistula

    Directory of Open Access Journals (Sweden)

    Fausto Orsi

    2003-02-01

    patients at Hospital Geral de Nova Iguaçu and at Hospital EMCOR, that had squamous cell esophagus cancer. The cervical esophagus gastric fistula was studied. METHODS: The treatment was essentially surgical, through transhiatal and transpleural esophagectomy. In the reconstruction of the digestive transit three approaches were used: pre-esternal, retro-esternal and posterior mediastinum, with their positives aspects and complications. RESULTS: The number of leaks was reduced to 7,69% when the posterior gastric wall was used. The postoperative mortality was 15,71% and respiratory insufficiency was the main cause. The five-year survival rate was 13,5%. CONCLUSIONS: Cervical esophagus-gastric anastomosis was the procedure used in all cases, firstly in the anterior wall and finally in the posterior wall. The best results were obtained with cervical esophagus-gastric anastomosis in the posterior wall.

  14. Stress Softening Behavior in the Mucosa-Submucosa and Muscle Layers in Normal and Diabetic Rat Esophagus

    DEFF Research Database (Denmark)

    Jiang, Hongbo; Liao, Donghua; Zhao, Jingbo;

    2015-01-01

    stress softening behavior in these layers in normal and diabetic rat esophagus and how diabetes affect the reversibility of esophageal stress softening.Methods: Ten Wistar rats were injected with STZ and the average blood glucose level reached 25 mmol/L after 8 weeks. Ten rats were used as the normal......M KCl was added for maximum contraction for 3min. KCl was washed out to permit relaxation and contractions were eliminated by immersion into Ca2+-free solution. After 1h rest, the tubes were exposed to five repeated ramp distensions conformed to the aforesaid two series. Stress-strain curves were used...... softer even after KCl treatment.Conclusion: The stress softening behavior in normal and diabetic esophageal tissue is different. We demonstrated reversible mechanical properties in the normal muscle layer after KCl activation. These adjustable passive mechanical properties may serve as a kind of 'self...

  15. Gaseous distention of the hypopharynx and cervical esophagus with nasal CPAP: a mimicker of pharyngeal perforation and esophageal atresia

    Energy Technology Data Exchange (ETDEWEB)

    Walor, David; Berdon, Walter; Holt, Peter D.; Fox, Matthew [Columbia University Medical Center, Department of Radiology, New York, NY (United States); Children' s Hospital of New York, New York, NY (United States); Anderson, Nicole [Columbia University Medical Center, Department of Neonatology, New York, NY (United States); Children' s Hospital of New York, New York, NY (United States)

    2005-12-01

    Nasal continuous positive airway pressure (CPAP) has been used since 1975 as the initial treatment for respiratory distress syndrome (RDS) in very premature infants. Gaseous distention of the abdomen (CPAP belly) is a common secondary effect of CPAP. Gaseous distention of the hypopharynx is also common. To determine the incidence of hypopharyngeal distention in infants on CPAP. We performed a retrospective review of the chest radiographs of 57 premature infants treated with CPAP during a 4-week period to find the presence and degree of hypopharyngeal distention. Of the 57 radiographs, 14 (25%) revealed gaseous distention of the hypopharynx and/or cervical esophagus. On occasion, this raised concern for pharyngeal perforation or esophageal atresia. Awareness that CPAP-related hypopharyngeal distention is common should help radiologists avoid erroneous consideration of esophageal atresia or hypopharyngeal perforation. (orig.)

  16. Gaseous distention of the hypopharynx and cervical esophagus with nasal CPAP: a mimicker of pharyngeal perforation and esophageal atresia

    International Nuclear Information System (INIS)

    Nasal continuous positive airway pressure (CPAP) has been used since 1975 as the initial treatment for respiratory distress syndrome (RDS) in very premature infants. Gaseous distention of the abdomen (CPAP belly) is a common secondary effect of CPAP. Gaseous distention of the hypopharynx is also common. To determine the incidence of hypopharyngeal distention in infants on CPAP. We performed a retrospective review of the chest radiographs of 57 premature infants treated with CPAP during a 4-week period to find the presence and degree of hypopharyngeal distention. Of the 57 radiographs, 14 (25%) revealed gaseous distention of the hypopharynx and/or cervical esophagus. On occasion, this raised concern for pharyngeal perforation or esophageal atresia. Awareness that CPAP-related hypopharyngeal distention is common should help radiologists avoid erroneous consideration of esophageal atresia or hypopharyngeal perforation. (orig.)

  17. Frequencies of poor metabolizers of cytochrome P450 2C19 in esophagus cancer, stomach cancer, lung cancer and bladder cancer in Chinese population

    Institute of Scientific and Technical Information of China (English)

    Wei-Xing Shi; Shu-Qing Chen

    2004-01-01

    AIM: To investigate the association between cytochrome P450 2C19 (CYP2C19) gene polymorphism and cancer susceptibility by genotyping of CYP2C19 poor metabolizers (PMs) in cancer patients.METHODS: One hundred and thirty-five cases of esophagus cancer, 148 cases of stomach cancer, 212 cases of lung cancer, 112 cases of bladder cancer and 372 controls were genotyped by allele specific amplification-polymerase chain reaction (ASA-PCR) for CYP2C19 PMs. The frequencies of PMs in cancer groups and control group were compared.RESULTS: The frequencies of PMs of CYP2C19 were 34.1%(46/135) in the group of esophagus cancer patients, 31.8%(47/148) in the stomach cancer patients, 34.4%(73/212) in the group of lung cancer patients, only 4.5% (5/112) in the bladder cancer patients and 14.0%(52/372) in control group.There were statistical differences between the cancer groups and control group (esophagus cancer, x2=25.65, P<0.005,OR=3.18, 95% CI=2.005-5.042; stomach cancer, x2=21.70,P<0.005, OR=2.86, 95%CI=1.820-4.501; lung cancer,x2=33.58, P<0.005, OR=3.23, 95%CI=1.503-6.906; bladder cancer, x2=7.50, P<0.01, OR=0.288, 95%CI=0.112-0.740).CONCLUSION: CYP2C19 PMs have a high incidence of esophagus cancer, stomach cancer and lung cancer, conversely they have a low incidence of bladder cancer. It suggests that CYP2C19 may participate in the activation of procarcinogen of esophagus cancer, stomach cancer and lung cancer, but may involve in the detoxification of carcinogens of bladder cancer.

  18. Mast cell-mediated long-lasting increases in excitability of vagal C fibers in guinea pig esophagus.

    Science.gov (United States)

    Yu, Shaoyong; Kollarik, Marian; Ouyang, Ann; Myers, Allen C; Undem, Bradley J

    2007-10-01

    Several esophageal pathologies are associated with an increased number of mast cells in the esophageal wall. We addressed the hypothesis that activation of esophageal mast cells leads to an increase in the excitability of local sensory C fibers. Guinea pigs were actively sensitized to ovalbumin. The mast cells in the esophagus were selectively activated ex vivo by superfusion with ovalbumin. Action potential discharge in guinea pig vagal nodose esophageal C-fiber nerve endings was monitored in the isolated (ex vivo) vagally innervated esophagus by extracellular recordings. Ovalbumin activated esophageal mast cells, leading to the rapid release of approximately 20% of the tissue histamine stores. This was associated with a consistent and significant increase in excitability of the nodose C fibers as reflected in a two- to threefold increase in action potential discharge frequency evoked by mechanical (increases in intraluminal pressure) stimulation. The increase in excitability persisted unchanged for at least 90 min (longest time period tested) after ovalbumin was washed from the tissue. This effect could be prevented by the histamine H1 receptor antagonist pyrilamine, but once the increase in excitability occurred, it persisted in the nominal absence of histamine and could not be reversed even with large concentrations of the histamine receptor antagonist. In conclusion, activation of esophageal mast cells leads to a pronounced and long-lived increase in nociceptive C-fiber excitability such that any sensation or reflex evoked via the vagal nociceptors will likely be enhanced. The effect is initiated by histamine acting via H1 receptor activation and maintained in the absence of the initiating stimulus. PMID:17702952

  19. Evaluation of docetaxel, CDDP and 5-FU combined therapy as second-line chemotherapy for esophagus cancer

    International Nuclear Information System (INIS)

    The combined therapy of docetaxel (70 mg/m2, day 1) cisplatin (CDDP) (80 mg/m2, day 1) and 5- fluorouracil (FU) (800 mg/m2, day 1-5) is used as second-line chemotherapy for esophagus cancer. First-line chemotherapy for 32 advanced squamous cell carcinomas of the esophagus is not effective, and early recurrences after chemotherapy were examined. Pretreatment surgery was used in 20 cases, radiation therapy in 19 and chemotherapy by 3.1 courses (1-9) on average. PR was found in 16 patients (response rate 50%) in the first course, MR in 2, NC in 6, and PD in 7 cases. Among 16 patients, one was of HCM patients. (auaspiration pneumonia and two by leukopenia. Thirteen patients received 3-5 courses. The operation was continuously enforced in three patients among 13, radiation therapy was added in three, and they survived for one year or more. Five for whom imaging became virtually impossible lived for six months or more. Additional treatment proved ineffective in 2, so it was discontinued. There were 18 lymph node examples of lesions effectively treated, 6 main lesions, 1 pulmonary metastasis and 1 bone metastasis. As for deleterious events, leukopenia was admitted in 95%. Granulocyte-colony stimulating factor (G-CSF) was needed by 68% during use and 3 days on average. The CDDP+5-FU+docetaxel therapy was comparatively safe in patients with much pre-treatment and demonstrated a maximum effect at more than the expected rate. (author)

  20. On the origin of rhythmic contractile activity of the esophagus in early achalasia, a clinical case study

    Directory of Open Access Journals (Sweden)

    JanD.Huizinga

    2013-05-01

    Full Text Available A patient with early achalasia presented spontaneous strong rhythmic non-propulsive contractions at ~ 7/min, independent of swallows. Our aim was to evaluate characteristics of the rhythmic contractions, provide data on the structure of pacemaker cells in the esophagus and discuss a potential role for interstitial cells of Cajal (ICC in the origin of rhythmicity. We hypothesize that intramuscular ICC (ICC-IM are the primary pacemaker cells. The frequency but not the amplitude of the rhythmic contractions was inhibited by the phosphodiesterase inhibitor drotaverine consistent with cAMP inhibiting pacemaker currents in ICC-IM. The frequency increased by wet swallows but not dry swallows, consistent with stretch causing increase in slow wave frequency in ICC-IM. New studies on archival material showed that ICC-IM were present throughout the human esophageal musculature and were not diminished in early achalasia. Although ICC-IM exhibited a low density, they were connected to PDGFRα-positive fibroblast-like cells with whom they formed a dense gap junction coupled network. Nitrergic innervation of ICC was strongly diminished in early achalasia because of the loss of nitrergic nerves. It therefore appears possibly that ICC-IM function as pacemaker cells in the esophagus and that the network of ICC and PDGFRα-positive cells allows for coupling and propagation of the pacemaker activity. Loss of nitrergic innervation to ICC in achalasia may render them more excitable such that its pacemaker activity is more easily expressed. Loss of propagation in achalasia may be due to loss of contraction-induced aboral nitrergic inhibition.

  1. TU-C-17A-10: Patient Features Based Dosimetric Pareto Front Prediction In Esophagus Cancer Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Wang, J; Zhao, K; Peng, J; Hu, W [Fudan University Shanghai Cancer Center, Shanghai, Shanghai (China); Jin, X [1st Affiliated Hospital of Wenzhou Medical College, Wenzhou (China)

    2014-06-15

    Purpose: The purpose of this study is to study the feasibility of the dosimetric pareto front (PF) prediction based on patient anatomic and dosimetric parameters for esophagus cancer patients. Methods: Sixty esophagus patients in our institution were enrolled in this study. A total 2920 IMRT plans were created to generated PF for each patient. On average, each patient had 48 plans. The anatomic and dosimetric features were extracted from those plans. The mean lung dose (MLD), mean heart dose (MHD), spinal cord max dose and PTV homogeneous index (PTVHI) were recorded for each plan. The principal component analysis (PCA) was used to extract overlap volume histogram (OVH) features between PTV and other critical organs. The full dataset was separated into two parts include the training dataset and the validation dataset. The prediction outcomes were the MHD and MLD for the current study. The spearman rank correlation coefficient was used to evaluate the correlation between the anatomical features and dosimetric features. The PF was fit by the the stepwise multiple regression method. The cross-validation method was used to evaluation the model. Results: The mean prediction error of the MHD was 465 cGy with 100 repetitions. The most correlated factors were the first principal components of the OVH between heart and PTV, and the overlap between heart and PTV in Z-axis. The mean prediction error of the MLD was 195 cGy. The most correlated factors were the first principal components of the OVH between lung and PTV, and the overlap between lung and PTV in Z-axis. Conclusion: It is feasible to use patients anatomic and dosimetric features to generate a predicted PF. Additional samples and further studies were required to get a better prediction model.

  2. Allergen challenge sensitizes TRPA1 in vagal sensory neurons and afferent C-fiber subtypes in guinea pig esophagus.

    Science.gov (United States)

    Liu, Zhenyu; Hu, Youtian; Yu, Xiaoyun; Xi, Jiefeng; Fan, Xiaoming; Tse, Chung-Ming; Myers, Allen C; Pasricha, Pankaj J; Li, Xingde; Yu, Shaoyong

    2015-03-15

    Transient receptor potential A1 (TRPA1) is a newly defined cationic ion channel, which selectively expresses in primary sensory afferent nerve, and is essential in mediating inflammatory nociception. Our previous study demonstrated that TRPA1 plays an important role in tissue mast cell activation-induced increase in the excitability of esophageal vagal nodose C fibers. The present study aims to determine whether prolonged antigen exposure in vivo sensitizes TRPA1 in a guinea pig model of eosinophilic esophagitis (EoE). Antigen challenge-induced responses in esophageal mucosa were first assessed by histological stains and Ussing chamber studies. TRPA1 function in vagal sensory neurons was then studied by calcium imaging and by whole cell patch-clamp recordings in 1,1'-dioctadecyl-3,3,3',3'-tetramethylindocarbocyanine perchlorate (DiI)-labeled esophageal vagal nodose and jugular neurons. Extracellular single-unit recordings were performed in vagal nodose and jugular C-fiber neuron subtypes using ex vivo esophageal-vagal preparations with intact nerve endings in the esophagus. Antigen challenge significantly increased infiltrations of eosinophils and mast cells in the esophagus. TRPA1 agonist allyl isothiocyanate (AITC)-induced calcium influx in nodose and jugular neurons was significantly increased, and current densities in esophageal DiI-labeled nodose and jugular neurons were also significantly increased in antigen-challenged animals. Prolonged antigen challenge decreased esophageal epithelial barrier resistance, which allowed intraesophageal-infused AITC-activating nodose and jugular C fibers at their nerve endings. Collectively, these results demonstrated that prolonged antigen challenge sensitized TRPA1 in esophageal sensory neurons and afferent C fibers. This novel finding will help us to better understand the molecular mechanism underlying esophageal sensory and motor dysfunctions in EoE. PMID:25591867

  3. The influence of distal colon irritation on the changes of cystometry parameters to esophagus and colon distentions.

    Science.gov (United States)

    Kaddumi, Ezidin G

    2016-01-01

    The co-occurrence of multiple pathologies in the pelvic viscera in the same patient, such as, irritable bowel syndrome and interstitial cystitis, indicates the complexity of viscero-visceral interactions and the necessity to study these interactions under multiple pathological conditions. In the present study, the effect of distal colon irritation (DCI) on the urinary bladder interaction with distal esophagus distention (DED), distal colon distention (DCD), and electrical stimulation of the abdominal branches of vagus nerve (abd-vagus) were investigated using cystometry parameters. The DCI significantly decreased the intercontraction time (ICT) by decreasing the storage time (ST); nonetheless, DED and Abd-vagus were still able to significantly decrease the ICT and ST following DCI. However, DCD had no effect on ICT following the DCI. The DCI, also, significantly decreased the Intravesical pressure amplitude (P-amplitude) by increasing the resting pressure (RP). Although DED has no effect on the P-amplitude, both in the intact and the irritated animals, the abd-vagus significantly increased the P-amplitude following DCI by increasing the maximum pressure (MP). In the contrary, 3mL DCD significantly increased the P-amplitude by increasing the MP and lost that effect following the DCI. Concerning the pressure threshold (PT), none of the stimuli had any significant changes in the intact animals. However, DCI significantly decreased the PT, also, the abd-vagus and 3mL DCD significantly decreased the PT. The results of this study indicate that chemical irritation of colon complicates the effects of mechanical irritation of esophagus and colon on urinary bladder function. PMID:27286126

  4. Age-specific risk factor profiles of adenocarcinomas of the esophagus: A pooled analysis from the international BEACON consortium.

    Science.gov (United States)

    Drahos, Jennifer; Xiao, Qian; Risch, Harvey A; Freedman, Neal D; Abnet, Christian C; Anderson, Lesley A; Bernstein, Leslie; Brown, Linda; Chow, Wong-Ho; Gammon, Marilie D; Kamangar, Farin; Liao, Linda M; Murray, Liam J; Ward, Mary H; Ye, Weimin; Wu, Anna H; Vaughan, Thomas L; Whiteman, David C; Cook, Michael B

    2016-01-01

    Esophageal (EA) and esophagogastric junction (EGJA) adenocarcinoma have been steadily increasing in frequency in younger people; however, the etiology of these cancers is poorly understood. We therefore investigated associations of body mass index (BMI), cigarette smoking, alcohol consumption, gastroesophageal reflux and use of nonsteroidal anti-inflammatory drugs (NSAIDs) in relation to age-specific risks of EA and EGJA. We pooled individual participant data from eight population-based, case-control studies within the international Barrett's and Esophageal Adenocarcinoma Consortium (BEACON). The analysis included 1,363 EA patients, 1,472 EGJA patients and 5,728 control participants. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for age-specific (<50, 50-59, 60-69, ≥70 years) cancer outcomes, as well as interactions by age. BMI, smoking status and pack-years, recurrent gastroesophageal reflux and frequency of gastroesophageal reflux were positively associated with EA and EGJA in each age group. Early-onset EA (<50 years) had stronger associations with recurrent gastroesophageal reflux (OR = 8.06, 95% CI: 4.52, 14.37; peffect modification  = 0.01) and BMI (ORBMI ≥ 30 vs . <25  = 4.19, 95% CI: 2.23, 7.87; peffect modification  = 0.04), relative to older age groups. In contrast, inverse associations of NSAID use were strongest in the oldest age group (≥70 years), although this apparent difference was not statistically significant. Age-specific associations with EGJA showed similar, but slightly weaker patterns and no statistically significant differences by age were observed. Our study provides evidence that associations between obesity and gastroesophageal reflux are stronger among earlier onset EA cancers. PMID:26175109

  5. A Contralateral Esophagus-Sparing Technique to Limit Severe Esophagitis Associated With Concurrent High-Dose Radiation and Chemotherapy in Patients With Thoracic Malignancies

    Energy Technology Data Exchange (ETDEWEB)

    Al-Halabi, Hani; Paetzold, Peter; Sharp, Gregory C.; Olsen, Christine; Willers, Henning, E-mail: hwillers@mgh.harvard.edu

    2015-07-15

    Purpose: Severe (Radiation Therapy Oncology Group [RTOG] grade 3 or greater) esophagitis generally occurs in 15% to 25% of non–small cell lung cancer (NSCLC) patients undergoing concurrent chemotherapy and radiation therapy (CCRT), which may result in treatment breaks that compromise local tumor control and pose a barrier to dose escalation. Here, we report a novel contralateral esophagus-sparing technique (CEST) that uses intensity modulated radiation therapy (IMRT) to reduce the incidence of severe esophagitis. Methods and Materials: We reviewed consecutive patients with thoracic malignancies undergoing curative CCRT in whom CEST was used. The esophageal wall contralateral (CE) to the tumor was contoured as an avoidance structure, and IMRT was used to guide a rapid dose falloff gradient beyond the target volume in close proximity to the esophagus. Esophagitis was recorded based on the RTOG acute toxicity grading system. Results: We identified 20 consecutive patients treated with CCRT of at least 63 Gy in whom there was gross tumor within 1 cm of the esophagus. The median radiation dose was 70.2 Gy (range, 63-72.15 Gy). In all patients, ≥99% of the planning and internal target volumes was covered by ≥90% and 100% of prescription dose, respectively. Strikingly, no patient experienced grade ≥3 esophagitis (95% confidence limits, 0%-16%) despite the high total doses delivered. The median maximum dose, V45, and V55 of the CE were 60.7 Gy, 2.1 cc, and 0.4 cc, respectively, indicating effective esophagus cross-section sparing by CEST. Conclusion: We report a simple yet effective method to avoid exposing the entire esophagus cross-section to high doses. By using proposed CE dose constraints of V45 <2.5 cc and V55 <0.5 cc, CEST may improve the esophagus toxicity profile in thoracic cancer patients receiving CCRT even at doses above the standard 60- to 63-Gy levels. Prospective testing of CEST is warranted.

  6. Spleen and pancreatic tail thorax translocation facilitating residual stomach esophagus anastomosis%胰脾胸腔易位在残胃食管吻合术中的应用

    Institute of Scientific and Technical Information of China (English)

    Haizhou Guo; Fuyou Zhou; Weijie Wang; Jianyun Guan; Weimin Zhang

    2007-01-01

    Objective: To investigate the value of spleen and pancreatic tail thorax translocation on the residual stomach esophagus anastomosis. Methods: 10 patients with esophageal carcinoma after gastrectomy were enrolled in this study.Lesions were removed through left thoracotomy and residual stomach was fully mobilized, with short gastric artery being reserved. Spleen and pancreatic tail were dissected from the back of peritoneum and transposed into thorax. Residual stomach esophagus anastomosis was performed. Results: All the operation went favorably. Patients were recovered rapidly and a relatively good prognosis was acquired. Late leakage and pleural effusion happened in one case respectively, but these complications were cured through conservative management without operation death. Conclusion: Residual stomach is an ideal candidate for the replacement of esophagus and residual stomach esophagus anastomosis is a simple operative alternative with few trauma and good results for the treatment of esophageal carcinoma after gastrectomy.

  7. Transcutaneous cervical esophagus ultrasound in adults: Relation with ambulatory 24-h pH-monitoring and esophageal manometry

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To determine the gastroesophageal refluxate in the cervical esophagus (CE) and measure transcutaneous cervical esophageal ultrasound (TCEUS) findings [anterior wall thickness (WT) of CE, esophageal luminal diameter (ELD), esophageal diameter (ED)]; to compare TCEUS findings in the patient subgroups divided according to 24-h esophageal pH monitoring and manometry; and to investigate possible cut-off values according to the TCEUS findings as a predictor of gastroesophageal reflux (GER).METHODS: In 45/500 patients, refluxate was visualized in TCEUS. 38/45 patients underwent esophagogastroduo denoscopy (EGD), 24-h pH monitoring and manometry.RESULTS: The 38 patients were grouped according to 24-h pH monitoring as follows: Group A: GER-positive (n = 20) [Includes Group B: isolated proximal reflux (PR) (n = 6), Group C: isolated distal reflux (DR) (n = 6),and Group D: both PR/DR (n = 8)]; Group E: no reflux (n = 13); and Group F: hypersensitive esophagus (HSE) (n= 5). Groups B + D indicated total PR patients (n = 14),Groups E + F reflux-negatives with HSE (n = 18), and Groups A + F reflux-positives with HSE (n = 25). When the 38 patients were grouped according to manometry findings, 24 had normal esophageal manometry; 7 had hypotensive and 2 had hypertensive lower esophageal sphincter (LES); and 5 had ineffective esophageal motility disorder (IEM). The ELD measurement was greater in group A + F than group E (P = 0.023, 5.0 ± 1.3 vs 3.9 ± 1.4 mm). In 27/38 patients, there was at least one pathologic acid reflux and/or pathologic manometry finding. The cut-off value for ELD of 4.83 mm had 79% sensitivity and 61% specificity in predicting the PR between Groups B + D and E (AUC = 0.775, P = 0.015).CONCLUSION: Visualizing refluxate in TCEUS was useful as a pre-diagnostic tool for estimating GER or manometric pathology in 71.1% of adults in our study,but it was not diagnostic for CE WT.

  8. Endoscopic ablation is a cost-effective cancer preventative therapy in patients with Barrett’s esophagus who have elevated genomic instability

    OpenAIRE

    Das, Ananya; Callenberg, Keith M.; Styn, Mindi A.; Jackson, Sara A.

    2016-01-01

    Background: The surveillance of patients with nondysplastic Barrett’s esophagus (NDBE) has a high cost and is of limited effectiveness in preventing esophageal adenocarcinoma (EAC). Ablation for NDBE remains expensive and controversial. Biomarkers of genomic instability have shown promise in identifying patients with NDBE at high risk for progression to EAC. Here, we evaluate the cost-effectiveness of using such biomarkers to stratify patients with NDBE by risk for EAC and, subsequently, the ...

  9. Comparison of three IMRT inverse planning techniques that allow for partial esophagus sparing in patients receiving thoracic radiation therapy for lung cancer.

    Science.gov (United States)

    Xiao, Ying; Werner-Wasik, Maria; Michalski, D; Houser, C; Bednarz, G; Curran, W; Galvin, James

    2004-01-01

    The purpose of this study is to compare 3 intensity-modulated radiation therapy (IMRT) inverse treatment planning techniques as applied to locally-advanced lung cancer. This study evaluates whether sufficient radiotherapy (RT) dose is given for durable control of tumors while sparing a portion of the esophagus, and whether large number of segments and monitor units are required. We selected 5 cases of locally-advanced lung cancer with large central tumor, abutting the esophagus. To ensure that no more than half of the esophagus circumference at any level received the specified dose limit, it was divided into disk-like sections and dose limits were imposed on each. Two sets of dose objectives were specified for tumor and other critical structures for standard dose RT and for dose escalation RT. Plans were generated using an aperture-based inverse planning (ABIP) technique with the Cimmino algorithm for optimization. Beamlet-based inverse treatment planning was carried out with a commercial simulated annealing package (CORVUS) and with an in-house system that used the Cimmino projection algorithm (CIMM). For 3 of the 5 cases, results met all of the constraints from the 3 techniques for the 2 sets of dose objectives. The CORVUS system without delivery efficiency consideration required the most segments and monitor units. The CIMM system reduced the number while the ABIP techniques showed a further reduction, although for one of the cases, a solution was not readily obtained using the ABIP technique for dose escalation objectives. PMID:15324918

  10. A patient with spontaneous rupture of the esophagus and concomitant gastric cancer whose life was saved: case of report and review of the literature in Japan

    Directory of Open Access Journals (Sweden)

    Matsuhashi Nobuhisa

    2011-12-01

    Full Text Available Abstract A 71-year-old man suddenly developed abdominal pain and vomiting on drinking soda after a meal, and visited a physician. Cervical subcutaneous and mediastinal emphysemas were observed on CT, and the patient was transferred to the emergency medical center of our hospital on the same day. Esophagography was performed at our department. A ruptured region was identified on the left side of the lower thoracic esophagus, and surgery was emergently performed employing sequential left thoracoabdominal incision. The chest wall was adhered due to inflammation, and large amounts of residual food and sloughing were present in the thoracic cavity and mediastinum. Moreover, necrotic changes were noted in the superior through inferior mediastinum. An about 2-cm rupture site was confirmed on the left side of the lower thoracic esophagus and closed by suture and filling with pediculate omentum. The presence of a tumorous lesion located mainly in the body of the stomach and lymph node enlargement were also diagnosed before surgery, for which gastric and intestinal fistulae were inserted to prepare for the second-stage surgery. The patient was admitted to an ICU after surgery. ARDS and MRSA-induced pneumonia and enteritis concomitantly developed but remitted. Curative surgery for gastric cancer was performed at 40 POD. Spontaneous rupture of the esophagus is relatively rare and that complicated by gastric caner is very rare, with only six cases being reported in Japan. Herein, we report the case.

  11. High-incidence of PTEN mutations in Chinese patients with primary small cell carcinoma of the esophagus

    International Nuclear Information System (INIS)

    Primary small cell carcinoma of the esophagus (PSCCE) is a rare and aggressive tumor with poor prognosis. The aim of this study was to investigate the existence of EGFR, KRAS, PIK3CA and PTEN mutations in PSCCE. Clinical–pathological data and paraffin-embedded specimens were collected from 38 patients. Exons 18 to 21 of EGFR, KRAS and PIK3CA status were analyzed by real-time PCR based on ARMS and Scorpion technology in all patients, and the PTEN gene was also screened using real-time PCR and high-resolution melting curve analysis (HRMA). Only 1 (2.63%) out of 38 patients had EGFR mutations in L858R missense, and KRAS and PIK3CA were not found in the mutational spot in all patients. However, PTEN mutations presented in 14 (36.84%) out of 38 patients, including exon 5 coding for PTEN missense mutation (n =4, 10.53%), exon 6 (n =7, 18.42%), concurrent exon 5 and exon 6 (n =2, 5.26%), and exon 8 (n =1, 2.63%). Concurrent mutations of these genes were not detected in all samples. No statistically significant associations were found between the clinicopathological features and the mutation status of PTEN. The incidence of PTEN mutations in Chinese patients with PSCCE was higher than that of previous reports in other histological subtypes of esophageal cancer

  12. Risk of esophagus cancer in diabetes mellitus: a population-based case-control study in Taiwan

    Directory of Open Access Journals (Sweden)

    Cheng Kao-Chi

    2012-12-01

    Full Text Available Abstract Background Diabetes mellitus (DM has been associated with the cancer risk. This study investigated relationship between DM and esophageal cancer using Taiwan’s insurance data. Methods We identified 549 patients with esophageal cancer newly diagnosed in 2000-2009 and randomly selected 2196 controls without any cancer, frequency matched by sex, age and diagnosis year of cases. Logistic regression model estimated odds ratios (ORs and 95% confidence intervals (CI of esophageal cancer associated with DM, sex, age. co-morbidities and medications. Results Cases were more prevalent than controls for alcoholism and esophageal disorders and using nonsteroidal anti-inflammatory drugs (NSAIDs and cyclooxygenase-2 inhibitors but not DM. Esophageal cancer had no association with DM (OR 0.99, 95% CI 0.71-1.37, but significantly associated with alcoholism (OR 14.1, 95% CI 7.87-25.4, esophageal ulcer (OR 10.1, 95% CI 5.70-17.9, esophageal reflux (OR 3.47, 95% CI 2.14-5.26 and uses of NSAIDs (OR 2.73, 95% CI 1.80-4.13. An elevated risk of esophageal cancer appeared in DM patients taking insulin (OR 2.57, 95% CI 1.08-6.15 or sulfonyurea (OR 3.80, 95% CI 1.16-12.5. Conclusions Patients with DM are not at higher risk for esophagus cancer. However, esophageal disorders and anti-diabetic drugs are associated with the risk of the disease.

  13. pRB expression in esophageal mucosa of individuals at high risk for squamous cell carcinoma of the esophagus

    Institute of Scientific and Technical Information of China (English)

    Simone S Contu; Paulo C Contu; Daniel C Damin; Renato B Fagundes; Fabiano Bevilacqua; Aline S Rosa; Jo(a)o C Prolla; Luis F Moreira

    2007-01-01

    AIM: To investigate the pRb expression in a large group of patients with history of chronic exposure to the main risk factors for development of squamous cell carcinoma of the esophagus.METHODS: One hundred and seventy asympto matic individuals at high risk for esophageal squamous cell carcinoma (consumption of more than 80 g of ethanol and 10 cigarettes/d for at least 10 years) underwent upper gastrointestinal endoscopy with biopsies of the esophageal mucosa. As a control group, specimens of esophageal mucosa obtained from 20 healthy subjects were also studied. Immunohistochemical assessment of the tissues was performed using a monoclonal antibody anti-pRB protein.RESULTS: Absence of the pRB staining, indicating loss of RB function, was observed in 33 (19.4%) of the individuals at risk for esophageal cancer, but in none of the healthy controls (P < 0.02). Loss of pRb expression increased in a stepwise fashion according to the severity of the histological findings (P < 0.005): normal mucosa (11/97 or 11.3%), chronic esophagitis (17/60 or 28.3%), low-grade dysplasia (3/10 or 30%), high-grade dysplasia 1/2 or 50%) and squamous cell carcinoma (1/1 or 100%).CONCLUSION: Our findings suggest that abnormal expression of the pRB protein may be implicated in the process of esophageal carcinogenesis. Additional studies are warranted to define the role of the pRBprotein as a biomarker for development of esophageal squamous cell carcinoma in individuals at high risk for this malignancy.

  14. Necrotizing Sialometaplasia-Like Change of the Esophageal Submucosal Glands is Associated with Barrett’s Esophagus

    Science.gov (United States)

    Braxton, David R.; Nickleach, Dana C.; Liu, Yuan; Farris, Alton B.

    2014-01-01

    The esophageal submucosal glands (SMG) protect the squamous epithelium from insults such as gastroesophageal reflux disease by secreting mucins and bicarbonate. We have observed metaplastic changes within the SMG acini that we have termed oncocytic glandular metaplasia (OGM), and necrotizing sialometaplasia-like change (NSMLC). The aim of this study is to evaluate the associated clinicopathological parameters of, and to phenotypically characterize the SMG metaplasias. Esophagectomy specimens were retrospectively assessed on hematoxylin and eosin sections and assigned to either a Barrett’s esophagus (BE) or non-BE control group. Clinicopathologic data was collected, and univariate analysis and multivariate logistic regression models were performed to assess the adjusted associations with NSMLC and OGM. Selected cases of SMG metaplasia were characterized. SMG were present in 82 esophagi that met inclusion criteria. On univariate analysis, NSMLC was associated with BE (p=0.002). There was no relationship between NSMLC and patient age, sex, tumor size, or treatment history. OGM was associated with BE (p=0.031). No relationship was found between OGM and patient age, sex, or tumor size. On multivariate analysis, BE was independently associated with NSMLC (odds ratio [OR] 4.95, p =0.003). Treatment history was also independently associated with OGM (p =0.029), but not NSMLC. Both NSMLC and OGM were non-mucinous ductal type epithelia retaining a p63-smooth muscle actin co-positive myoepithelial cell layer. NSMLC and OGM were present in endoscopic mucosal resection specimens. Our study suggests that SMG metaplasia is primarily a reflux-induced pathology. NSMLC may pose diagnostic dilemmas in resection specimens or when only partially represented in mucosal biopsies or endoscopic resection specimens. PMID:24863247

  15. 75 FR 8085 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meetings

    Science.gov (United States)

    2010-02-23

    ... Kidney Diseases Special Emphasis Panel; Barrett's Esophagus. Date: March 12, 2010. Time: 3:30 p.m. to 5 p...: Maria E. Davila-Bloom, PhD, Scientific Review Officer, Review Branch, DEA, NIDDK, National Institutes...

  16. Gastroesophageal Reflux in Children and Adolescents

    Science.gov (United States)

    ... Understanding how Crohn’s Disease treatments affect children’s gut microbiome Jun 10, 2016 See additional news » Related Conditions & Diseases Barrett's Esophagus Gastroesophageal Reflux (GER) and Gastroesophageal Reflux ...

  17. Analysis of the grade of esophagitis, chromendoscopical and histological findings of esophagus in patients with gastroesophageal reflux disease before and after the therapy

    Directory of Open Access Journals (Sweden)

    Brzački Vesna

    2010-01-01

    Full Text Available Background/Aim. The symptoms of gastroesophageal reflux desease (GERD are among the most common complaints for which patients are indicated for visiting gastroenterologist. It occurs as a result of the effect made by gastric reflux contents that moves into the esophagus. The prevalence of all forms of GERD is 40%. The aim of this study was to analyze the grade of esophagitis, chromendoscopical and histological findings of esophagus in patients with GERD before and after the therapy. Methods. A prospective study included 90 patients with symptoms of GERD, divided into 2 groups depending on whether they had endoscopic signs of gastroezophageal reflux (group ERD, or not (group NERD. All the patients had esophagogastroduodenoscopy, chromoendoscopy staining, test for Helicobacter pylori and histological findings of the esophagus. In the patients with Helicobacter pylori infection eradication therapy was done. Results. Esophagitis-B level was present in most of the patients. Among the groups, roughly the same number responded to positive findings on chromoendoscopy. After the therapy, chromoendoscopy was significantly negative in both groups of the patients comparing to chromoendoscopy before the therapy (p = 0.00001. Multiplication and elongation of papilla, basal cell hyperplasia, vascular dilatation, increasing of mitotic activity and the presence of polymorphonuclear leukocyte cells were statistically more frequent histological findings in the group ERB compared to the group NERB. After the therapy, the patients in both groups had statistically less histological findings of appropriate esophageal parameters. Conclusion. Chromoendoscopy combined with the standard endoscopy increases the sensitivity and specificity for reflux disease. Histology in the reflux disease is associated with endoscopic and clinical findings so that the localization of taking biopsies and histological criteria of pathohistological changes must be clearly defined

  18. Prognosis of patients with advanced carcinoma of the esophagus with complete response to chemotherapy and/or radiation therapy. A questionnaire survey in Japan

    International Nuclear Information System (INIS)

    We estimated the survival of patients with advanced carcinoma of the esophagus in Japan who achieved complete response (CR) with chemotherapy and/or radiation therapy. A questionnaire was designed for patients with cancer of the esophagus with pretreatment stage II-IV (excluding organ metastasis [M1]), who were treated with chemotherapy and/or radiation therapy and achieved either a clinical CR continuing for more than 1 year, or a pathological CR in surgical specimens. All patients were treated between January 1, 1990, and December 31, 1997, in Japan. Of the 169 eligible patients for whom adequate data were available, 106 patients with continuing clinical CR were defined as group A and 63 with pathological CR as group B. The overall survival rates at 5 years were 62.4% in group A and 64.8% in group B. In each of groups A and B, there was no significant difference in overall survival among subgroups of patients classified by initial pretreatment clinical stage. In group A, the survival rate of patients with concurrent chemotherapy and radiation therapy was significantly better than the rates for patients with chemotherapy alone or radiotherapy alone. In group A, the frequency of first failure at the local site of esophageal carcinoma was 7.7%. Of the 12 patients in group B (19%) who died less than 1 year postoperatively, 6 died of postoperative complications. The effect of CR to chemotherapy and/or radiation therapy for carcinoma of the esophagus on survival was marked. In patients with esophageal carcinoma who achieve CR, the prognosis may be independent of the initial pretreatment stage. Local failure in group A patients remains a problem, however. (author)

  19. Recent advances in oesophageal diseases

    OpenAIRE

    Al Dulaimi, David

    2014-01-01

    Abstract Dong Y, Qi B, Feng XY, Jiang CM. Meta-analysis of Barrett's esophagus in China. World J Gastroenterol 2013;19(46):8770-8779 The disease pattern of Barrett's esophagus (BE) in China is poorly characterised particularly in comparison with other developed countries. This meta-analysis of 3873 cases of BE collated from 69 clinical studies conducted in 25 provinces between 2000 and 2011 investigated the epidemiology and characteristics of BE in China compared to Western countries. The tot...

  20. A detailed analysis of next generation sequencing reads of microRNA expression in Barrett’s Esophagus: absolute versus relative quantification

    OpenAIRE

    Lee, In-Hee; Hong, Xiaoman; Mathur, Sharad C; Sharma, Mukut; Rastogi, Amit; Sharma, Prateek; Christenson, Lane K.; Bansal, Ajay

    2014-01-01

    Background Next generation sequencing (NGS) is a state of the art technology for microRNA (miRNA) analysis. The quantitative interpretation of the primary output of NGS i.e. the read counts for a miRNA sequence that can vary by several orders of magnitude (1 to 107) remains incompletely understood. Findings NGS (SOLiD 3 technology) was performed on biopsies from 6 Barrett’s esophagus (BE) and 5 Gastroesophageal Reflux Disease (GERD) patients. Read sequences were aligned to miRBase 18.0. Diffe...

  1. SU-E-P-47: Evaluation of Improvement of Esophagus Sparing in SBRT Lung Patients with Biologically Based IMRT Optimization

    Energy Technology Data Exchange (ETDEWEB)

    Liang, X; Penagaricano, J; Paudel, N; Zhang, X; Morrill, S; Corry, P; Han, E; Hardee, M; Ratanatharathorn, V [University of Arkansas Medical Science, Little Rock, AR (United States)

    2015-06-15

    Purpose: To study the potential of improving esophageal sparing for stereotactic body radiation therapy (SBRT) lung cancer patients by using biological optimization (BO) compared to conventional dose-volume based optimization (DVO) in treatment planning. Methods: Three NSCLC patients (PTV (62.3cc, 65.1cc, and 125.1cc) adjacent to the heart) previously treated with SBRT were re-planned using Varian Eclipse TPS (V11) using DVO and BO. The prescription dose was 60 Gy in 5 fractions normalized to 95% of the PTV volume. Plans were evaluated by comparing esophageal maximum doses, PTV heterogeneity (HI= D5%/D95%), and Paddick’s conformity (CI) indices. Quality of the plans was assessed by clinically-used IMRT QA procedures. Results: By using BO, the maximum dose to the esophagus was decreased 1384 cGy (34.6%), 502 cGy (16.5%) and 532 cGy (16.2%) in patient 1, 2 and 3 respectively. The maximum doses to spinal cord and the doses to 1000 cc and 1500 cc of normal lung were comparable in both plans. The mean doses (Dmean-hrt) and doses to 15cc of the heart (V15-hrt) were comparable for patient 1 and 2. However for patient 3, with the largest PTV, Dmean-hrt and V15-hrt increased by 62.2 cGy (18.3%) and 549.9 cGy (24.9%) respectively for the BO plans. The mean target HI of BO plans (1.13) was inferior to the DVO plans (1.07). The same trend was also observed for mean CI in BO plans (0.77) versus DVO plans (0.83). The QA pass rates (3%, 3mm) were comparable for both plans. Conclusion: This study demonstrated that the use of biological models in treatment planning optimization can substantially improve esophageal sparing without compromising spinal cord and normal lung doses. However, for the large PTV case (125.1cc) we studied here, Dmean-hrt and V15-hrt increased substantially. The target HI and CI were inferior in the BO plans.

  2. SU-E-P-47: Evaluation of Improvement of Esophagus Sparing in SBRT Lung Patients with Biologically Based IMRT Optimization

    International Nuclear Information System (INIS)

    Purpose: To study the potential of improving esophageal sparing for stereotactic body radiation therapy (SBRT) lung cancer patients by using biological optimization (BO) compared to conventional dose-volume based optimization (DVO) in treatment planning. Methods: Three NSCLC patients (PTV (62.3cc, 65.1cc, and 125.1cc) adjacent to the heart) previously treated with SBRT were re-planned using Varian Eclipse TPS (V11) using DVO and BO. The prescription dose was 60 Gy in 5 fractions normalized to 95% of the PTV volume. Plans were evaluated by comparing esophageal maximum doses, PTV heterogeneity (HI= D5%/D95%), and Paddick’s conformity (CI) indices. Quality of the plans was assessed by clinically-used IMRT QA procedures. Results: By using BO, the maximum dose to the esophagus was decreased 1384 cGy (34.6%), 502 cGy (16.5%) and 532 cGy (16.2%) in patient 1, 2 and 3 respectively. The maximum doses to spinal cord and the doses to 1000 cc and 1500 cc of normal lung were comparable in both plans. The mean doses (Dmean-hrt) and doses to 15cc of the heart (V15-hrt) were comparable for patient 1 and 2. However for patient 3, with the largest PTV, Dmean-hrt and V15-hrt increased by 62.2 cGy (18.3%) and 549.9 cGy (24.9%) respectively for the BO plans. The mean target HI of BO plans (1.13) was inferior to the DVO plans (1.07). The same trend was also observed for mean CI in BO plans (0.77) versus DVO plans (0.83). The QA pass rates (3%, 3mm) were comparable for both plans. Conclusion: This study demonstrated that the use of biological models in treatment planning optimization can substantially improve esophageal sparing without compromising spinal cord and normal lung doses. However, for the large PTV case (125.1cc) we studied here, Dmean-hrt and V15-hrt increased substantially. The target HI and CI were inferior in the BO plans

  3. WHAT IS THE REAL IMPAIRMENT ON ESOPHAGEAL MOTILITY IN PATIENTS WITH GASTROESOPHAGEAL REFLUX DISEASE?

    Directory of Open Access Journals (Sweden)

    Angela FALCÃO

    2013-04-01

    Full Text Available Context Impairment of esophageal motility is a common finding in patients with gastroesophageal reflux disease (GERD as reduced lower esophageal sphincter (LES basal pressure. A very low LES pressure might facilitate the occurrence of more gastroesophageal reflux whereas abnormal esophageal peristalsis may contribute to impaired esophageal clearance after reflux. Objective Evaluate the esophageal motor function of the lower esophageal sphincter and esophageal body in the various forms of gastroesophageal reflux disease. Methods The manometrics records of 268 patients, who had evaluation of the esophageal motility as part of the diagnostic gastroesophageal reflux disease were split into four groups, as follows: 33 patients who had no esophagitis; 92 patients who had erosive esophagitis; 101 patients who had short Barrett's esophagus and 42 patients who had long Barrett's esophagus. Results The group who had long Barrett's esophagus showed smaller mean LES pressure and higher percentage of marked LES hypotonia; in the distal segment of the esophageal body the this group showed higher percentage of marked hypocontractility of the distal segment (<30 mm Hg; this same group showed higher percentage of esophageal motility disorders. Conclusions The most intense esophageal motility disorders and lower pressure of lower esophageal sphincter were noted in the group with long Barrett's esophagus. Those with reflux esophagitis and short Barrett's esophagus had esophageal motility impairment, intermediate among patients with esophagitis and long Barrett's esophagus. Patients with typical symptoms of gastroesophageal reflux but without esophagitis by endoscopy study showed no impairment of esophageal motility.

  4. 食管、胃和结肠浅表性瘤变的巴黎分型%The Paris endoscopic classification of superficial neoplastic lesions: esophagus, stomach, and colon

    Institute of Scientific and Technical Information of China (English)

    Participants in the Paris Workshop

    2011-01-01

    An international group of endoscopists,surgeons,and pathologists gathered in Paris for an intensive workshop designed to explore the utility and clinical relevance of the Japanese endoscopic classification of superficial neoplastic lesions of the GI tract.This report summarizes the conclusions of the workshop and proposes a general framework for the endoscopic classification of superficial lesions of the esophagus,stomach,and colon.The clinical relevance of this classification is demonstrated in tables that show the relative proportion of each subtype in the esophagus,stomach,and colon,assessing the risk of submucosal invasion and the risk of lymph node metastases.

  5. Histopathologic features of esophageal glands in the region of the gastroesophageal junction in Chinese patients with gastric cardiac cancer involving the esophagus

    Directory of Open Access Journals (Sweden)

    Qin Huang

    2010-05-01

    Full Text Available Qin Huang1,2,3, Lihua Zhang11Department of Pathology of the Nanjing Drum Tower Hospital, Nanjing, China; 2Department of Pathology and Laboratory Medicine, Veterans Affairs, Boston Healthcare System, West Roxbury, MA, USA; 3Harvard Medical School, Boston, MA, USAAbstract: Esophageal glands (EGs were implicated previously as a potential origin of carcinomas of the gastroesophageal junction (GEJ. The studies of histopathology on diseases in EGs, however, are scarce. In the present study, we systematically investigated EGs in 36 resection cases of gastric cardiac carcinomas involving the esophagus (GCE in Chinese patients. All cases showed chronic inflammation in EGs and 14 (39% with Helicobacter pylori infection. Hyperplasia, atrophy, and dysplasia were common in EGs and observed in 21 (58%, 14 (39%, and 28 (78% cases, respectively. These changes were associated with various types of metaplasia, including intestinal (6, 17%, oncocytic (26, 72%, pancreatic acinar (11, 30%, and squamoid metaplasia (8, 22%. Oncocytic metaplasia was patchy, frequently replaced the entire lobule with dysplastic features. Pancreatic acinar metaplasia was present in superficial EGs as small acinar patches. Squamoid metaplasia was limited to the EG drainage ductile epithelium without keratin pearls or intercellular bridges; however, cytoplasmic vesicles and secretory vacuoles were common, suggesting dual differentiation. Dysplastic EGs featured architectural disarray with fused acini, cribriforming, abortive growth, and nuclear hyperchromasia, enlargement, and overlapping. The results demonstrate a spectrum of histopathologic changes in EGs and ductile epithelium, which is similar to those observed in GCE in Chinese patients.Keywords: esophageal glands, esophagus, stomach, cancer, Chinese

  6. Cancer of the Esophagus

    Science.gov (United States)

    ... see tailored statistics, browse the SEER Cancer Statistics Review . To see statistics for a specific state, go to the State ... which can be found in the SEER Cancer Statistics Review . In some cases, different year spans may be ...

  7. Consideration of Dose Limits for Organs at Risk of Thoracic Radiotherapy: Atlas for Lung, Proximal Bronchial Tree, Esophagus, Spinal Cord, Ribs, and Brachial Plexus

    International Nuclear Information System (INIS)

    Purpose: To review the dose limits and standardize the three-dimenional (3D) radiographic definition for the organs at risk (OARs) for thoracic radiotherapy (RT), including the lung, proximal bronchial tree, esophagus, spinal cord, ribs, and brachial plexus. Methods and Materials: The present study was performed by representatives from the Radiation Therapy Oncology Group, European Organization for Research and Treatment of Cancer, and Soutwestern Oncology Group lung cancer committees. The dosimetric constraints of major multicenter trials of 3D-conformal RT and stereotactic body RT were reviewed and the challenges of 3D delineation of these OARs described. Using knowledge of the human anatomy and 3D radiographic correlation, draft atlases were generated by a radiation oncologist, medical physicist, dosimetrist, and radiologist from the United States and reviewed by a radiation oncologist and medical physicist from Europe. The atlases were then critically reviewed, discussed, and edited by another 10 radiation oncologists. Results: Three-dimensional descriptions of the lung, proximal bronchial tree, esophagus, spinal cord, ribs, and brachial plexus are presented. Two computed tomography atlases were developed: one for the middle and lower thoracic OARs (except for the heart) and one focusing on the brachial plexus for a patient positioned supine with their arms up for thoracic RT. The dosimetric limits of the key OARs are discussed. Conclusions: We believe these atlases will allow us to define OARs with less variation and generate dosimetric data in a more consistent manner. This could help us study the effect of radiation on these OARs and guide high-quality clinical trials and individualized practice in 3D-conformal RT and stereotactic body RT.

  8. Consideration of Dose Limits for Organs at Risk of Thoracic Radiotherapy: Atlas for Lung, Proximal Bronchial Tree, Esophagus, Spinal Cord, Ribs, and Brachial Plexus

    Energy Technology Data Exchange (ETDEWEB)

    Kong, Feng-Ming, E-mail: fengkong@med.umich.edu [Department of Radiation Oncology, University of Michigan and Ann Arbor Veteran Affairs Medical System, Ann Arbor, MI (United States); Ritter, Timothy [Department of Radiation Oncology, University of Michigan and Ann Arbor Veteran Affairs Medical System, Ann Arbor, MI (United States); Quint, Douglas J. [Department of Radiology, University of Michigan, Ann Arbor, MI (United States); Senan, Suresh [Department of Radiation Oncology, VU University Medical Center, Amsterdam (Netherlands); Gaspar, Laurie E. [Department of Radiation Oncology, University of Colorado Denver, Denver, CO (United States); Komaki, Ritsuko U. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Hurkmans, Coen W. [Department of Radiation Oncology, Catharina Hospital, Eindhoven (Netherlands); Timmerman, Robert [Department of Radiation Oncology, University of Texas Southwestern Medical Center at Dallas, Dallas, TX (United States); Bezjak, Andrea [Department of Radiation Oncology, Princess Margaret Hospital, Toronto, ON (Canada); Bradley, Jeffrey D. [Department of Radiation Oncology, Washington University, St. Louis, MO (United States); Movsas, Benjamin [Department of Radiation Oncology, Henry Ford Hospital, Detroit, MI (United States); Marsh, Lon [Department of Radiation Oncology, University of Michigan and Ann Arbor Veteran Affairs Medical System, Ann Arbor, MI (United States); Okunieff, Paul [Department of Radiation Oncology, University of Florida, Gainesville, FL (United States); Choy, Hak [Department of Radiation Oncology, University of Texas Southwestern Medical Center at Dallas, Dallas, TX (United States); Curran, Walter J. [Department of Radiation Oncology, Emory University Cancer Center, and Winship Cancer institute, Atlanta, GA (United States)

    2011-12-01

    Purpose: To review the dose limits and standardize the three-dimenional (3D) radiographic definition for the organs at risk (OARs) for thoracic radiotherapy (RT), including the lung, proximal bronchial tree, esophagus, spinal cord, ribs, and brachial plexus. Methods and Materials: The present study was performed by representatives from the Radiation Therapy Oncology Group, European Organization for Research and Treatment of Cancer, and Soutwestern Oncology Group lung cancer committees. The dosimetric constraints of major multicenter trials of 3D-conformal RT and stereotactic body RT were reviewed and the challenges of 3D delineation of these OARs described. Using knowledge of the human anatomy and 3D radiographic correlation, draft atlases were generated by a radiation oncologist, medical physicist, dosimetrist, and radiologist from the United States and reviewed by a radiation oncologist and medical physicist from Europe. The atlases were then critically reviewed, discussed, and edited by another 10 radiation oncologists. Results: Three-dimensional descriptions of the lung, proximal bronchial tree, esophagus, spinal cord, ribs, and brachial plexus are presented. Two computed tomography atlases were developed: one for the middle and lower thoracic OARs (except for the heart) and one focusing on the brachial plexus for a patient positioned supine with their arms up for thoracic RT. The dosimetric limits of the key OARs are discussed. Conclusions: We believe these atlases will allow us to define OARs with less variation and generate dosimetric data in a more consistent manner. This could help us study the effect of radiation on these OARs and guide high-quality clinical trials and individualized practice in 3D-conformal RT and stereotactic body RT.

  9. Effects of combined pre-and post-natal protein deprivation on the myenteric plexus of the esophagus of weanling rats:A histochemical, quantitative and ultrastructural study

    Institute of Scientific and Technical Information of China (English)

    Edson A Liberti; Ricardo BV Fontes; Verginia M Fuggi; Laura BM Maifrino; Romeu R Souza

    2007-01-01

    AIM: To evaluate the effects of protein deprivation on the myenteric plexus of the esophagus of weanling rats.METHODS: Pregnant female Wistar rats were divided into 2 groups: nourished (N), receiving normal diet,and undernourished (D), receiving a protein-deprived diet, which continued after birth. At twenty-one days of age, 13 esophagi from each group were submitted to light microscopy and morphometrical analysis employing the NADH diaphorase, NADPH diaphorase and acetylcholinesterase techniques. Three other esophagi from each group were evaluated with transmission electron microscopy (TEM).RESULTS: In both the NADH- and the NADPH-reactive mounts, the neurons of the N mounts were more intensely stained, while in the D esophagi only the larger neurons were reactive. Many myenteric neurons of N were intensely reactive for AChE activity but only a few neurons of D exhibited these aspects. Ultrastructural analysis revealed that the granular reticulum of N showed large numbers of ribosomes aligned on the outer surface of its regularly arranged membrane while the ribosomes of D were disposed in clusters. The chromatin was more homogeneously scattered inside the neuron nucleus of N as well as the granular component of the nucleolus was evidently more developed in this group.Statistically significant differences between N and D groups were detected in the total estimated number of neurons stained by the NADPH technique.CONCLUSION: The morphological and quantitative data shows that feeding with protein-deprived diet in 21-d old rats induces a delay in the development of the myenteric neurons of the esophagus.

  10. Management of adenocarcinoma of the esophagus with chemoradiation alone or chemoradiation followed by esophagectomy: results of sequential nonrandomized phase II studies

    International Nuclear Information System (INIS)

    Purpose: The incidence of adenocarcinoma of the esophagus is increasing, but the optimal treatment for this disease is unknown. We evaluated the efficacy of chemoradiation and chemoradiation followed by esophagectomy as treatment for adenocarcinoma of the esophagus in sequential prospective nonrandomized phase II studies. Methods and Materials: Between May 1981 and June 1992, all previously untreated patients (N = 35) with potentially resectable adenocarcinoma of the esophagus (clinical Stage I or II) were treated with curative intent in sequential prospective Phase II studies. From May 1981 to August 1987, 11 patients (median age 66) were treated with concurrent chemotherapy [mitomycin C, and 5-fluorouracil (5-FU)] and radiotherapy to a median dose of 60 Gy (CRT group). From September 1987 to June 1992, 24 patients (median age 65) were treated with the same regimen of chemoradiation followed by planned esophagectomy (CRT + PE group). Of these, 12 patients (median age 62) actually underwent esophagectomy (CRT + E subgroup). Results: The median overall survival was 19 months for the CRT group and 15 months for the CRT + PE group. For the CRT + E subgroup, the median overall survival was 33 months. The 3-year actuarial overall survival for the CRT and the CRT + PE groups were 36 and 28% (p = 0.949). The subset of patients treated with chemoradiation followed by esophagectomy had a 3-year actuarial overall survival of 33% (p = 0.274). The 3-year actuarial freedom from local failure rates were similar: 62% in the CRT group vs. 58% in the CRT + PE group. Of the 12 patients who underwent esophagectomy (CRT + E group), 9 (75%) were free of local failure. Four of 12 (33%) patients had no pathologic evidence of malignancy in their surgical specimen. Six of 11 patients (55%) in the CRT group were free of local failure at the time of analysis. Two of five patients in this group who had local recurrence at 2 and 10 months underwent surgical salvage with subsequent survivals of

  11. Proton pump inhibitors suppress iNOS-dependent DNA damage in Barrett’s esophagus by increasing Mn-SOD expression

    International Nuclear Information System (INIS)

    Highlights: ► Inflammation by Barrett’s esophagus (BE) is a risk factor of its adenocarcinoma (BEA). ► 8-Nitroguanine and 8-oxodG are inflammation-related DNA lesions. ► DNA lesions and iNOS expression were higher in the order, BEA > BE > normal tissues. ► Proton pump inhibitors suppress DNA damage by increasing Mn-SOD via Nrf2 activation. ► DNA lesions can be useful biomarkers to predict risk of BEA in BE patients. -- Abstract: Barrett’s esophagus (BE), an inflammatory disease, is a risk factor for Barrett’s esophageal adenocarcinoma (BEA). Treatment of BE patients with proton pump inhibitors (PPIs) is expected to reduce the risk of BEA. We performed an immunohistochemical study to examine the formation of nitrative and oxidative DNA lesions, 8-nitroguanine and 8-oxo-7,8-dihydro-2′-deoxygaunosine (8-oxodG), in normal esophageal, BE with pre- and post-treatment by PPIs and BEA tissues. We also observed the expression of an oxidant-generating enzyme (iNOS) and its transcription factor NF-κB, an antioxidant enzyme (Mn-SOD), its transcription factor (Nrf2) and an Nrf2 inhibitor (Keap1). The immunoreactivity of DNA lesions was significantly higher in the order of BEA > BE > normal tissues. iNOS expression was significantly higher in the order of BEA > BE > normal tissues, while Mn-SOD expression was significantly lower in the order of BEA < BE < normal tissues. Interestingly, Mn-SOD expression and the nuclear localization of Nrf2 were significantly increased, and the formation of DNA lesions was significantly decreased in BE tissues after PPIs treatment for 3–6 months. Keap1 and iNOS expression was not significantly changed by the PPIs treatment in BE tissues. These results indicate that 8-nitroguanine and 8-oxodG play a role in BE-derived BEA. Additionally, PPIs treatment may trigger the activation and nuclear translocation of Nrf2 resulting in the expression of antioxidant genes, leading to DNA damage suppression. These DNA lesions can be useful

  12. Factors influencing the development of ulcers and strictures in carcinoma of the esophagus treated with radiotherapy with or without concurrent chemotherapy

    Directory of Open Access Journals (Sweden)

    Khurana Rohini

    2007-01-01

    Full Text Available Purpose: To ascertain factors that could influence the development of ulcers and strictures in the definitive management of squamous cell carcinoma (SCC of esophagus treated with external beam radiotherapy (EBRT, high-dose-rate (HDR intralumenal radiotherapy (ILRT with or without concurrent weekly cisplatin (CDDP @ 35 mg/m2 chemotherapy (CT. Materials and Methods: Between 1990-2005, 244 patients with inoperable SCC of esophagus were identified from our database and grouped into one of the following: those receiving at least 60Gy EBRT (Gp E, n=44; EBRT followed by HDR-ILRT (Gp E+I, n=98; at least 50Gy EBRT with CT (Gp E+C, n=68; EBRT+HDR-ILRT + CT (Gp E+I+C, n=34. Ulcers (discovered on endoscopy and strictures evident on a barium swallow (which needed dilatations were scored as treatment induced, if the biopsy was negative. Factors likely to influence their outcome were analyzed. Results: The groups were matched for all patient and disease characteristics except pretreatment hemoglobin and Karnofsky performance score (KPS, which were lower in Gp E. The incidence of ulcers was 7%, 8%, 6% and 21% ( P =0.08 while that of strictures was 14%, 9%, 21% and 41% ( P =0.00 for the groups E, E+I, E+C and E+I+C respectively. On univariate analysis, patients with better KPS ( P =0.03, treated with narrow applicators (6 mm vs. 10 mm, P =0.00, received CT ( P =0.00 or assigned to Gp E+I+C ( P =0.00 were more likely to develop strictures, with a trend for development of ulcers in Gp. E+I+C ( P =0.08. Logistic regression retained only Gp E+I+C for development of ulcers (OR 10.36, 95% CI 1.2-89.1, P =0.03 and strictures (OR 4.2, 95% CI 1.4-12.6, P =0.00. Conclusion: Treatment intensification as in Gp E+I+C results in about a three-fold increase in treatment induced late morbidity which can adversely impact on swallowing function and therefore emphasizes the need for optimisation of HDR-ILRT when used in a CT+RT protocol.

  13. Significance and prognostic value of lysosomal enzyme activities measured in surgically operated adenocarcinomas of the gastroesophageal junction and squamous cell carcinomas of the lower third of esophagus

    Institute of Scientific and Technical Information of China (English)

    Aron Altorjay; Balazs Paal; Nicolette Sohar; Janos Kiss; Imre Szanto; Istvan Sohar

    2005-01-01

    AIM: To establish whether there are fundamental differences in the biochemistries of adenocarcinomas of the gastroesophageal junction (GEJ) and the squamous cell carcinomas of the lower third of the esophagus (LTE).METHODS: Between February 1, 1997 and February 1,2000, we obtained tissue samples at the moment of resection from 54 patients for biochemical analysis. The full set of data could be comprehensively analyzed in 47 of 54 patients' samples (81%). Of these, 29 were adenocarcinomas of the GEJ Siewert type Ⅰ (n = 8), type Ⅱ (n = 12), type Ⅲ (n = 9), and 18 presented as squamous cell carcinomas of the LTE. We evaluated the mean values of 11-lysosomal enzyme and 1-cytosol protease activities of the tumorous and surrounding mucosae as well as their relative activities, measured as the ratio of activity in tumor and normal tissues from the same patient.These data were further analyzed to establish the correlation with tumor localization, TNM stage (lymph-node involvement), histological type (papillary, signet-ring cell,tubular), state of differentiation (good, moderate, poor),and survival (≤24 or ≥24 mo).RESULTS: In adenocarcinomas, the activity of α-mannosidase (AMAN), cathepsin B (CB) and dipeptidyl-peptidase Ⅰ (DPP Ⅰ) increased significantly as compared to the normal gastric mucosa. In squamous cell carcinomas of the esophagus, we also found a significant difference in the activity of cathepsin L and tripeptidyl-peptidase I in addition to these three. There was a statistical correlation of AMAN,CB, and DPP Ⅰ activity between the level of differentiation of adenocarcinomas of the GEJ and lymph node involvement,because tumors with no lymph node metastases histologically confirmed as well-differentiated, showed a significantly lower activity. The differences in CB and DPP Ⅰ activity correlated well with the differences in survival rates, since the CB and DPP Ⅰ values of those who died within 24 mo following surgical intervention were

  14. The zinc-finger transcription factor SALL4 is frequently expressed in human cancers: association with clinical outcome in squamous cell carcinoma but not in adenocarcinoma of the esophagus.

    Science.gov (United States)

    Kilic, Ergin; Tennstedt, Pierre; Högner, Anica; Lebok, Patrick; Sauter, Guido; Bokemeyer, Carsten; Izbicki, Jakob R; Wilczak, Waldemar

    2016-04-01

    SALL4 is a transcription factor originally identified as a homeotic gene essential for organ development. Early studies suggested that SALL4 is a useful marker to identify testicular and ovarian germ cell tumors. The aim of the study was to evaluate the diagnostic potential of SALL4 immunohistochemistry. Immunohistochemical staining was performed on a tissue microarray (TMA) with 3966 samples from 94 different tumor types and on a further TMA with 492 esophagus carcinomas. SALL4 immunostaining was by far most prevalent and most intensive in testicular tumors with a positivity rate of 93.1 % in seminomas, 80 % in mixed germ cell tumors (embryonic carcinomas/yolk sac tumors), and 18.5 % in teratomas, respectively. However, SALL4 expression is not specific to germ cell tumors. We observed SALL4 positivity in non-germ cell tumors as carcinomas of the kidney (28.9 % of chromophobe, 34.4 % of clear cell carcinoma), in intestinal type adenocarcinoma of the stomach (10.9 %), in adenocarcinoma (10.5 %) and squamous cell carcinoma (7.2 %) of the esophagus, and in malignant melanoma (8.1 %) and invasive urothelial bladder carcinoma (20 %). SALL4 expression was not found in lymphomas, in soft tissue tumors or breast tumors. At analysis of esophagus carcinoma TMA, no significant association was seen between SALL4 expression and overall survival in adenocarcinoma. However, SALL4 expression was strongly associated with worse overall survival in squamous cell carcinoma. SALL4 expression can be found at relevant frequencies in various tumors of different primary sites. SALL4 expression in squamous cell carcinoma of the esophagus may constitute a sign of dedifferentiation leading to poor patient prognosis. PMID:26818834

  15. Síndrome tilose hereditária e câncer de esôfago Hereditary tylosis syndrome and esophagus cancer

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    Camila Alves de Souza

    2009-10-01

    Full Text Available A tilose palmo-plantar é um distúrbio autossômico dominante caracterizado por uma hiperceratose palmo-plantar. Em geral, desenvolve-se na segunda infância e se acentua em áreas de pressão. Existem duas formas familiares de tilose palmo-plantar: a não epidermolítica e a epidermolítica. Os pacientes com tilose palmo-plantar forma epidermolítica apresentam uma chance até 40% maior de desenvolver carcinoma de células escamosas do esôfago. A associação de tilose palmo-plantar com neoplasia esofágica é denominada síndrome de Howel-Evans.Tylosis palmoplantaris is an autosomal dominant disorder characterized by hyperkeratosis of palms and soles. Lesions start during childhood and are more evident in areas of pressure. Familial tylosis palmoplantaris comprises two forms: epidermolytic and non-epidermolytic. Patients with the epidermolytic variant have up to 40% higher chance of developing squamous cell carcinoma of the esophagus. The association of tylosis palmoplantaris with esophageal cancer is called Howel-Evans syndrome.

  16. Ulceração de anastomose esôfago-entérica causada por alendronato Esophagus-enteric anastomosis ulceration caused by alendronate

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    Pedro DUQUES

    2001-04-01

    could be present. Objective — Report a case of a patient who underwent total gastrectomy with Y-en-Roux anastomosis for a gastric carcinoid tumor and developed an esophagus-enteric anastomosis ulceration after the use of alendronate. Patient and Method — A 63-year-old woman started medical therapy with alendronate in a dose of 10 mg daily. After a period of one month of medical treatment with this drug she began to complain of dysphagic symptoms and abdominal pain. She was submitted to endoscopic examination that showed an esophageal ulceration, an enteric ulceration of the anastomosis and an esophageal stenosis. Results - Medical treatment with alendronate was discontinued and the symptom of abdominal pain desapeared. The intensity of dysphagia has decreased. The ulcerated lesion remitted although esophageal stenosis did not. The patient was subsequently treated with esophagus-enteric anastomosis dilation. She improved in her general state and nowadays she is free of symptoms. Conclusion — Alendronate sodium could cause lesions of the inferior esophageal portion or in distal segments of the gastrointestinal tube, in patients with a fast gastrointestinal transit. Special attention must be given to gastrectomized patients that use this drug because of the possibility to develop mucosal lesions in the enteric anastomosed part and its fearfull complications as stenosis.

  17. The role of neoadjuvant radiochemotherapy using low-dose fraction cisplatin and 5-fluorouracil in patients with carcinoma of the esophagus

    International Nuclear Information System (INIS)

    We clarified the role of neoadjuvant radiochemotherapy in patients with carcinoma of the esophagus and compared it to neoadjuvant chemotherapy. We retrospectively examined 40 patients diagnosed with advanced thoracic esophageal carcinoma who underwent neoadjuvant therapy followed by esophagectomy between 1993 and 1999. We divided them into 2 groups: radiochemotherapy (17) and chemotherapy (23). Radiochemotherapy patients underwent 40 Gy radiation and low-dose fraction cisplatin (7 mg/body/day, 5 days a week x 4 weeks) and 5-fluorouracil (350 mg/body/day x 28 days). Chemotherapy patients received high-dose fraction cisplatin/5-fluorouracil involving 2 courses of cisplatin (70 mg/m2/day on day1) and 5-fluorouracil (700 mg/m2/day on days 1-5). Complete pathological response was 17.6% in the radiochemotherapy group and 0% in the chemotherapy group respectively. No hospital mortality occurred in the radiochemotherapy group, and 1 of the 23 chemotherapy patients died in the hospital due to postoperative complications. The incidence of residual tumors was significantly higher in the chemotherapy group (34.8%) than in the radiochemotherapy group (0%). Actuarial survival in the radiochemotherapy group at 1 year was 80.2% and at 3 years 53.5%. Actuarial survival in the chemotherapy group at 1 year was 56.5% and at 3 years 30.4%. Histological effectiveness was greater in patients treated with preoperative radiochemotherapy than those treated with preoperative chemotherapy. The combination of radiation and low-dose fraction CDDP/5-FU thus is first choice in neoadjuvant radiochemotherapy for the advanced esophageal carcinoma. (author)

  18. MicroRNA alterations in Barrett′s esophagus, esophageal adenocarcinoma, and esophageal adenocarcinoma cell lines following cranberry extract treatment: Insights for chemoprevention

    Directory of Open Access Journals (Sweden)

    Laura A Kresty

    2011-01-01

    Full Text Available Background: Aberrant expression of small noncoding endogenous RNA molecules known as microRNAs (miRNAs is documented to occur in multiple cancer types including esophageal adencarcinoma (EAC and its only known precursor, Barrett′s esophagus (BE. Recent studies have linked dysregulation of specific miRNAs to histological grade, neoplastic progression and metastatic potential. Materials and Methods: Herein, we present a summary of previously reported dysregulated miRNAs in BE and EAC tissues as well as EAC cell lines and evaluate a cranberry proanthocyanidin rich extract′s (C-PAC ability to modulate miRNA expression patterns of three human EAC cell lines (JHEso-Ad-1, OE33 and OE19. Results: A review of 13 published studies revealed dysregulation of 87 miRNAs in BE and EAC tissues, whereas 52 miRNAs have been reported to be altered in BE or EAC cell lines, with 48% overlap with miRNA changes reported in tissues. We report for the first time C-PAC-induced modulation of five miRNAs in three EAC cell lines resulting in 26 validated gene targets and identification of key signaling pathways including p53, angiogenesis, T-cell activation and apoptosis. Additionally, mutiple cancer related networks were ideintified as modulated by C-PAC utilizing Kyoto Encyclopedia of Genes and Genomes (KEGG, Protein Analysis Through Evolutionary Relationships (PANTHER, and MetaCore analysis tools. Conclusions: Study results support the cancer inhibitory potential of C-PAC is in part attributable to C-PAC′s ability to modify miRNA profiles within EAC cells. A number of C-PAC-modulated miRNAs have been been identified as dysregulated in BE and EAC. Further insights into miRNA dysregulation and modulation by select cancer preventive agents will support improved targeted interventions in high-risk cohorts.

  19. 食管上段胃黏膜异位症的研究近况%Advances in the study on heterotopic gastric mucosa in upper esophagus

    Institute of Scientific and Technical Information of China (English)

    朱海杭; 陈洁; 卜平

    2011-01-01

    食管上段胃黏膜异住,又称食管入口黏膜斑,常在内镜检查时被发现,内镜检出率0.1%~ 10.0%.病变与先天发育异常相关;黏膜具有酸分泌作用;幽门螺杆菌可定植于黏膜.多数无临床表现,症状轻而无特征性;胃食管反流和幽门螺杆菌与并发症产生有关,个案报告并发有溃疡出血、穿孔、瘘及腺癌等.无症状者无需治疗;内镜随访仍很重要.有症状者需要治疗,推荐抑酸和抗反流药或局部用氩气刀消融治疗可改善反流症状.%Heterotopic gastric mucosa in the upper esophagus (HGMUE), referred as inlet patch, is frequently found during endoscopic examination. The endoscopic prevalence varies from 0.1% to 10%. The lesion is thought to be of congenital origin anomaly. It has the function of acid secretion. Helicobacter pylori (H. Pylori) may colonize in the mucosa. Most patients are asymptomatic. The symptom is no special and mild. In patients of large HGMUE, acid secretion capacity and H. Pylori may cause upper esophageal disorders. The complications resulting from the ectopic mucosa, such as bleeding, perforation, fistula, and stricture formation, and adenocarcinoma, have also been reported in individual. Asymptomatic patients do not require specific therapy, but endoscopic surveillance is still important. Only in the treatment of the symptomatic cases, acid suppression and ablation by argon plasma coagulation (APC) for reflux symptoms can be recommended.

  20. TRPA1 in mast cell activation-induced long-lasting mechanical hypersensitivity of vagal afferent C-fibers in guinea pig esophagus.

    Science.gov (United States)

    Yu, Shaoyong; Gao, Guofeng; Peterson, Blaise Z; Ouyang, Ann

    2009-07-01

    Sensitization of esophageal sensory afferents by inflammatory mediators plays an important role in esophageal nociception. We have shown esophageal mast cell activation induces long-lasting mechanical hypersensitivity in vagal nodose C-fibers. However, the roles of mast cell mediators and downstream ion channels in this process are unclear. Mast cell tryptase via protease-activated receptor 2 (PAR2)-mediated pathways sensitizes sensory nerves and induces hyperalgesia. Transient receptor potential A1 (TRPA1) plays an important role in mechanosensory transduction and nociception. Here we tested the hypothesis that mast cell activation via a PAR2-dependent mechanism sensitizes TRPA1 to induce mechanical hypersensitivity in esophageal vagal C-fibers. The expression profiles of PAR2 and TRPA1 in vagal nodose ganglia were determined by immunostaining, Western blot, and RT-PCR. Extracellular recordings from esophageal nodose neurons were performed in ex vivo guinea pig esophageal-vagal preparations. Action potentials evoked by esophageal distention and chemical perfusion were compared. Both PAR2 and TRPA1 expressions were identified in vagal nodose neurons by immunostaining, Western blot, and RT-PCR. Ninety-one percent of TRPA1-positive neurons were of small and medium diameters, and 80% coexpressed PAR2. Esophageal mast cell activation significantly enhanced the response of nodose C-fibers to esophageal distension (mechanical hypersensitivity). This was mimicked by PAR2-activating peptide, which sustained for 90 min after wash, but not by PAR2 reverse peptide. TRPA1 inhibitor HC-030031 pretreatment significantly inhibited mechanical hypersensitivity induced by either mast cell activation or PAR2 agonist. Collectively, our data provide new evidence that sensitizing TRPA1 via a PAR2-dependent mechanism plays an important role in mast cell activation-induced mechanical hypersensitivity of vagal nodose C-fibers in guinea pig esophagus. PMID:19423751

  1. BOB CAT: A Large-Scale Review and Delphi Consensus for Management of Barrett’s Esophagus With No Dysplasia, Indefinite for, or Low-Grade Dysplasia

    Science.gov (United States)

    Bennett, Cathy; Moayyedi, Paul; Corley, Douglas A.; DeCaestecker, John; Falck-Ytter, Yngve; Falk, Gary; Vakil, Nimish; Sanders, Scott; Vieth, Michael; Inadomi, John; Aldulaimi, David; Ho, Khek-Yu; Odze, Robert; Meltzer, Stephen J.; Quigley, Eamonn; Gittens, Stuart; Watson, Peter; Zaninotto, Giovanni; Iyer, Prasad G.; Alexandre, Leo; Ang, Yeng; Callaghan, James; Harrison, Rebecca; Singh, Rajvinder; Bhandari, Pradeep; Bisschops, Raf; Geramizadeh, Bita; Kaye, Philip; Krishnadath, Sheila; Fennerty, M. Brian; Manner, Hendrik; Nason, Katie S.; Pech, Oliver; Konda, Vani; Ragunath, Krish; Rahman, Imdadur; Romero, Yvonne; Sampliner, Richard; Siersema, Peter D.; Tack, Jan; Tham, Tony C.K.; Trudgill, Nigel; Weinberg, David S.; Wang, Jean; Wang, Kenneth; Wong, Jennie Y.Y.; Attwood, Stephen; Malfertheiner, Peter; MacDonald, David; Barr, Hugh; Ferguson, Mark K.; Jankowski, Janusz

    2015-01-01

    OBJECTIVES Barrett’s esophagus (BE) is a common premalignant lesion for which surveillance is recommended. This strategy is limited by considerable variations in clinical practice. We conducted an international, multidisciplinary, systematic search and evidence-based review of BE and provided consensus recommendations for clinical use in patients with nondysplastic, indefinite, and low-grade dysplasia (LGD). METHODS We defined the scope, proposed statements, and searched electronic databases, yielding 20,558 publications that were screened, selected online, and formed the evidence base. We used a Delphi consensus process, with an 80% agreement threshold, using GRADE (Grading of Recommendations Assessment, Development and Evaluation) to categorize the quality of evidence and strength of recommendations. RESULTS In total, 80% of respondents agreed with 55 of 127 statements in the final voting rounds. Population endoscopic screening is not recommended and screening should target only very high-risk cases of males aged over 60 years with chronic uncontrolled reflux. A new international definition of BE was agreed upon. For any degree of dysplasia, at least two specialist gastrointestinal (GI) pathologists are required. Risk factors for cancer include male gender, length of BE, and central obesity. Endoscopic resection should be used for visible, nodular areas. Surveillance is not recommended for Management strategies for indefinite dysplasia (IND) and LGD were identified, including a de-escalation strategy for lower-risk patients and escalation to intervention with follow-up for higher-risk patients. CONCLUSIONS In this uniquely large consensus process in gastroenterology, we made key clinical recommendations for the escalation/de-escalation of BE in clinical practice. We made strong recommendations for the prioritization of future research. PMID:25869390

  2. Wnt/β-Catenin Signaling Activation beyond Robust Nuclear β-Catenin Accumulation in Nondysplastic Barrett’s Esophagus: Regulation via Dickkopf-1

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    Orestis Lyros

    2015-07-01

    Full Text Available INTRODUCTION: Wnt/β-catenin signaling activation has been reported only during the late steps of Barrett’s esophagus (BE neoplastic progression, but not in BE metaplasia, based on the absence of nuclear β-catenin. However, β-catenin transcriptional activity has been recorded in absence of robust nuclear accumulation. Thus, we aimed to investigate the Wnt/β-catenin signaling in nondysplastic BE. METHODS: Esophageal tissues from healthy and BE patients without dysplasia were analyzed for Wnt target gene expression by quantitative reverse transcription polymerase chain reaction (qRT-PCR and immunohistochemistry. Esophageal squamous (EPC1-& EPC2-hTERT, BE metaplastic (CP-A, and adenocarcinoma (OE33 cell lines were characterized for Wnt activation by qRT-PCR, Western blot, and luciferase assay. Wnt activity regulation was examined by using recombinant Wnt3a and Dickkopf-1 (Dkk1 as well as Dkk1 short interfering RNA. RESULTS: Wnt target genes (AXIN2, c-MYC, Cyclin D1, Dkk1 and Wnt3a were significantly upregulated in nondysplastic BE compared with squamous mucosa. Elevated levels of dephosphorylated β-catenin were detected in nondysplastic BE. Nuclear active β-catenin and TOPflash activity were increased in CP-A and OE33 cells compared with squamous cells. Wnt3a-mediated β-catenin signaling activation was abolished by Dkk1 in CP-A cells. TOPFlash activity was elevated following Dkk1 silencing in CP-A but not in OE33 cells. Dysplastic and esophageal adenocarcinoma tissues demonstrated further Dkk1 and AXIN2 overexpression. CONCLUSIONS: Despite the absence of robust nuclear accumulation, β-catenin is transcriptionally active in nondysplastic BE. Dkk1 overexpression regulates β-catenin signaling in BE metaplastic but not in adenocarcinoma cells, suggesting that early perturbation of Dkk1-mediated signaling suppression may contribute to BE malignant transformation.

  3. A phase I/II study of external beam radiation, brachytherapy and concurrent chemotherapy in localized cancer of the esophagus (RTOG 9207)

    International Nuclear Information System (INIS)

    Introduction: A multi-institutional, prospective study was designed to determine the feasibility and toxicity of chemotherapy, external beam irradiation and esophageal brachytherapy (EB) in a potentially curable group of patients with adenocarcinoma or squamous cell carcinoma of the esophagus. Methods: Planned treatment was 50 Gy external beam radiation (25 fractions/5 wks) followed 2 weeks later by EB (either HDR 5 Gy wks 8,9 and 10 for a total of 15 Gy or LDR 20 Gy wk 8). The protocol was later revised to delete the LDR alternative due to poor accrual and decrease the HDR dose to 10 Gy, ie 5 Gy wks 8 and 9. Chemotherapy was given wks 1,5,8 and 11 with DDP 75 mg/m2 and 5-FU 1000 mg/m2/24 hrs, 96 hour infusion. Data is available on 50 patients (46 squamous, 3 adenocarcinoma) treated on the HDR alternative (EB dose 15 Gy and 10 Gy in 40 and 10 patients, respectively. Results: Thirty-five patients (70%) were able to complete external beam, EB and at least 2 courses of chemotherapy. Estimated survival rate at 12 months is 48%. Life-threatening toxicity or death occurred in 13 (26%) and 4 (8%) patients, respectively. Treatment-related esophageal fistulas occurred in 6 patients (12%) at 0.5 to 6.2 months from the first day of brachytherapy, leading to death in 3. So far all treatment-related fistulas occurred in the 15 Gy EB group. Conclusions: Survival following this combination of chemotherapy, external beam radiation and EB does not appear to be different from survival seen following chemotherapy and external beam radiation only. Based on the high incidence of fistulas, we urge extreme caution in employing EB as a boost following concurrent chemotherapy and external beam radiation with the schema utilized in this prospective study

  4. Use of sting-response techniques for simulate diagnostics in human esophagus; Uso de tecnicas estimulo-respuesta para simular diagnosticos en esofago humano

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez, I.; Gonzalez, Y.; Valdes, L.; Alfonso, J.A.; Estevez, E. [Facultad de Quimica Farmacia, Universidad Central de Las Villas (Cuba)

    2003-07-01

    In this work a study of simulation of the gamma graphic studies that are carried out in human esophagus in the Dept. of Nuclear Medicine of the 'Celestino Hernandez Robau Hospital of Santa Clara is presented. For the investigation tubular reactors were used and sting-response techniques with radioactive tracer of Technetium 99 metastable to a concentration of 1 mCi and several flows were applied. The distribution curves of residences times were obtained, those that respond to an equation of the type: Y = A + B exp (- exp((x-C)/D)) - ((x-C/D)+1). They were also carried out, optimizations studies of the doses of the radioactive to give to the patients from 1 mCi (that is the one used in studies) up to 0,5 mCi, and the influences on the obtained distributions of residence time were analyzed. It was confirmed the possibility to lower the doses with clear information of the signal. It was also carried out a simulation of the attenuation of the radiations that takes place in the patients by the interposition of tissues among the analyzed organ, and the detection equipment. It was used paraffin for tissue simulation. It was found the almost independence of the intensity of the radiations with the thickness, for the assayed doses. Lastly it was found a complex mathematical model that responds to the diagnostic curves obtained in these studies, being correlated the coefficients of the pattern with the most important physical parameters of the system, giving it a practical and useful value, all time that the error among the values that this it predicts and the experimental ones do not surpass of 5%. (Author)

  5. Prognostic parameters for acute esophagus toxicity in Intensity Modulated Radiotherapy and concurrent chemotherapy for locally advanced non-small cell lung cancer

    International Nuclear Information System (INIS)

    Background and purpose: The aim of this study was to correlate clinical and dosimetric variables with acute esophageal toxicity (AET) following Intensity Modulated Radiotherapy (IMRT) with concurrent chemotherapy for locally advanced non-small cell lung cancer (NSCLC). In addition, timeline of AET was reported. Material and methods: 153 patients with locally advanced NSCLC treated with 66 Gy/2.75 Gy/24 fractions of radiotherapy and concurrent daily low dose cisplatin were selected. Medical records and treatments of these patients were retrospectively reviewed. Maximum AET grade ⩾2 and maximum grade 3 were the endpoints of this study. Dates for onset, maximum and recovery (to baseline) of AET were reported. Univariate and multivariate analysis were applied to correlate clinical, tumor, dosimetric and chemotherapy dose variables to AET grade ⩾2 and grade 3. Results: AET grade 2 occurred in 37% and grade 3 in 20% of the patients. The median onset of AET was around day 15 for all grades. The median onset of the maximum grade was day 30 for both grades 2 and 3. The median duration was 43 days for grade 1, 50 days for grade 2 and >80 days for grade 3. Of the grade 3 AET patients, 48% recovered within 3 months. Esophagus V50, ethnic background, and the number of cisplatin administrations were significantly correlated with grade 3 AET. Conclusions: For NSCLC patients treated with concurrent chemotherapy and IMRT A higher number of cisplatin administrations, non-Caucasian background and higher V50oes were associated with grade 3 AET. The median onset of AET grade 3 is 15 days after the start of treatment, maximized at day 30, with a median duration of >80 days

  6. Tratamento do câncer de esôfago: ensaio clinico controlado Treatment of cancer of the esophagus: clinical trial

    Directory of Open Access Journals (Sweden)

    Antonio Pedro Mirra

    1998-04-01

    Full Text Available Realização de ensaio clínico controlado em câncer de esôfago, com uma casuística de 65 casos, no Hospital A.C. Camargo, no período de 1986 a 1990. O ensaio clínico controlado estudou três grupos terapêuticos: grupo I - cirurgia exclusiva (20 casos; grupo 2 - cirurgia + radioterapia pós-operatória (27 casos; grupo 3 - quimioterapia pré-operatória + cirurgia + radioterapia e quimioterapia pós-operatória (18 casos. O tempo cirúrgico foi único, com ressecção ampla do esôfago, utilizando-se como vias de acesso, preferentemente, a transpleural para os tumores localizados no terço médio do esôfago e a transmediastinal para o terço inferior e segmento abdominal. A retirada dos gânglios linfáticos regionais fez parte deste tempo cirúrgico, bem como a técnica de plastia padronizada com o estômago, com anastomose extratorácica cervical e posição do estômago no mediastino posterior. A radioterapia foi aplicada no leito esofágico, com dose total de 4.500 a 5.000 cGY em cinco sessões semanais. Foram utilizadas as drogas cisplatina (80 mg/m², vincristina (1,5 mg/m² e bleomicina (10mg/m² na quimioterapia pré e pós-operatórias. A sobrevida de cinco anos, segundo os grupos terapêuticos, foi de: grupo I - 61,9% , grupo 2 - 52,6 % e grupo 3 - 68,7%. Esta sobrevida, segundo o estadiamento clínico, foi de: EC I+II A - 52,0% e EC II B + III- 45,5%. Esses resultados estatisticamente não foram significativos. Os índices de sobrevida de cinco anos para os grupos terapêuticos 1 e 2 variaram de 40,4 a 60,6% quando os EC foram I + II A; para os demais EC não houve sobrevida de cinco anos. Para uma melhor avaliação, a inclusão de maior número de casos em pesquisas desse tipo poderia ser obtida pela participação de vários centros de tratamento do câncer de esôfago.A 65-case-clinical trial on esophagus cancer was conducted at the Hospital A.C. Camargo between 1986 and 1990. A controlled clinical trial studied three

  7. The Association between the Clinical Symptoms of Heterotopic Gastric Mucosa in the upper Esophagus and its Pathologic Types%上食管胃黏膜异位症的临床与病理分析

    Institute of Scientific and Technical Information of China (English)

    张春芬; 陈宏伟; 李延伟

    2011-01-01

    Objective To investigate the association between the clinical symptoms of heterotopic gastric mucosa in the upper esophagus and its pathologic types. Methods The biopsies were taken from red mucosa for pathological examination when upper esophagus was observed by endoscope in 15 713 cases. Results 14 eases of cardia gastric mucosa and 3 cases of fundic gastric mucosa were detected in 18 patients with unfavorable gulping. 1 case of cardia gastric mucosa and 9 cases of fundic gastric mucosa were detected in 11 patients with local burning sensation or pain. The pathologic types were significantly different. Conclusion The symptoms of heterotopic gastric mucosa in the upper esophagus are closely related with pathologic types.%目的 研究上食管胃黏膜异位症的临床症状与病理特征的关系.方法以在某医院进行胃镜检查的15 713人为研究对象,在常规内镜操作中经食管上段时,观察到边界清楚的红色黏膜,取检进行病理学检查.结果症状表现为下咽不利的患者有18例,其中贲门型胃黏膜有14例,胃底型黏膜3例;局部烧灼感或者疼痛的患者有11例,其中贲门型胃黏膜有1例,胃底型黏膜有9例;其病理学类型存在明显差异.结论 上食管胃黏膜异位症的症状与病理学类型相关.

  8. Esophagectomy with gastroplasty in advanced megaesophagus: late results of omeprazole use

    Directory of Open Access Journals (Sweden)

    Celso de Castro Pochini

    2015-10-01

    Full Text Available Objective: To analyze the late results of advanced Chagasic megaesophagus treatment by esophagectomy associated with the use of proton pump inhibitor (omeprazole as for the incidence of esophagitis and Barrett's esophagus in the remaining stump. Methods : We studied patients with advanced megaesophagus undergoing esophagectomy and transmediastinal esophagogastroplasty. Patients were divided into three groups: A (20 with esophageal replacement by full stomach, without the use of omeprazole; B (20 with esophageal replacement by full stomach, with omeprazole 40 mg/day introduced after the first postoperative endoscopy and maintained for six years; and C (30 with esophageal replacement by gastric tube with use of omeprazole. Dysphagia, weight loss and BMI were clinical parameters we analyzed. Upper gastrointestinal endoscopy was performed in all patients, and determined the height of the anastomosis, the aspect of the mucosa, with special attention to possible injuries arising from gastroesophageal reflux, and the patency of the esophagogastric anastomosis. Results : We studied 50 patients, 28 males (56% and 22 (44% females. All underwent endoscopy every year. In the first endoscopy, erosive esophagitis was present in nine patients (18% and Barrett's esophagus, in four (8%; in the last endoscopy, erosive esophagitis was present in five patients (8% and Barrett's esophagus in one (2%. When comparing groups B and C, there was no evidence that the manufacturing of a gastric tube reduced esophagitis and Barrett's esophagus. However, when comparing groups A and C, omeprazole use was correlated with reduction of reflux complications such as esophagitis and Barrett's esophagus (p <0.005. Conclusion : The use of omeprazole (40 mg/day reduced the onset of erosive esophagitis and Barrett's esophagus during the late postoperative period.

  9. Endoscopic ultrasound via the esophagus

    DEFF Research Database (Denmark)

    Bødtger, Uffe; Clementsen, Paul; Annema, Jouke;

    2010-01-01

    "endoscopic ultrasound (EUS) and lung cancer" in PubMed was conducted. Invasive procedures (mediastinoscopy, thoracoscopy/-tomy) are the gold standard. The specificity of EUS was between 97 and 100%, and sensitivity 90 to 92%. The sensitivity was lower in studies published before 2000, and in computed...

  10. Achalasia of esophagus - case report

    International Nuclear Information System (INIS)

    The author presents the characteristic features in the radiologic of the achalasia on a case of a 67 year old patient. The patient had a long - standing dysphagia and odynophagia, which had progressed gradually during 21 years to the third stage of the disease with atonic oesophagus. The most important problem still remains the differentiating from the cardia - type gastric carcinoma and fibroendoscopy with/or without biopsy is an inevitable supplementary diagnostic method in differential diagnostic procedure. (authors)

  11. Primary Tuberculosis of the Esophagus

    OpenAIRE

    2012-01-01

    Os autores reportam o caso de uma doente de 38 anos de idade com um quadro clínico de odinofagia, dor retroesternal e emagrecimento. Os exames complementares de diagnóstico revelaram a presença de uma lesão ulcerada no esófago, como forma de manifestação de tuberculose primária do esófago. A Tuberculose esofágica é uma doença pouco frequente, sendo responsável por 0,15% da mortalidade por tuberculose. A Tuberculose primária do esófago, sem envolvimento de outros órgãos, como o nosso caso c...

  12. Mediastinite por perfuração e ruptura do esôfago torácico Mediastinitis from perfuration and rupture of the thoracic esophagus

    Directory of Open Access Journals (Sweden)

    Geraldo Roger Normando Jr.

    2006-12-01

    Full Text Available OBJETIVO: Avaliar a mortalidade por mediastinite e sepse originadas por perfuração e ruptura do esôfago torácico, de acordo o tempo de evolução da doença. MÉTODO: Estudo retrospectivo de 14 anos (1992 a 2006, com pacientes portadores de ruptura e perfuração do esôfago. Foi avaliado sexo, idade, mecanismo de lesão, evolução ( 24 horas e tratamento. RESULTADOS: Foram analisados 44 pacientes, sendo 10 do sexo feminino (22,73% e 34 do sexo masculino (77,27%. A variação da idade foi de dois meses a 77 anos e a média de 33,2. Os ferimentos estiveram presentes em 19 casos (43,18%: Arma branca em cinco e projétil de arma de fogo 14. A instrumentação endoscópica foi detectada em nove casos (20,45%. Nos pacientes submetidos à esofagorrafia (diagnóstico precoce, menos de 24 horas a mortalidade esteve presente três casos (20%. Em pacientes submetidos à esofagectomia (diagnóstico tardio, mais de 24 horas a mortalidade ocorreu em oito casos (36,36%, e essa diferença não foi estatisticamente significante (p 0,05. No tratamento conservador, a mortalidade foi em cinco de sete casos a a diferença foi estatisticamente significativa quando comparado com o tratamento cirúrgico. CONCLUSÕES: O tratamento conservador para mediastinite por ruptura e perfuração do esôfago mostrou mortalidade alta quando comparada com tratamento cirúrgico. Entre os pacientes operados, a diferença não foi estatisticamente significante, confirmando a indicação de esofagectomia para casos de infecção avançada e a esofagorrafia para casos precoces.BACKGROUND: To evaluate the mortality by mediastinitis and sepsis originated from ruptures and perfurations of the thoracic esophagus, according to length of diagnosis. METHODS: A retrospective study of 14 years (1992 to 2006 was carried out including patients with thoracic esophageal ruptures and perforations, stratified according to sex, age, mechanism of injury, evolution and treatment ( 24 hours. RESULTS

  13. Quality control for thermoluminescent dosemeters TLD-100 de Li F: Mg, Ti for high dose rate treatments using Ir-192 sources in breast, esophagus and bronchus; Control de calidad con dosimetros thermoluminiscentes TLD-100 de Li F: Mg, Ti para tratamientos de alta tasa de dosis com fuentes de Ir-192 en canceres de seno, esofago y bronchio

    Energy Technology Data Exchange (ETDEWEB)

    Torres, F. [Universidad Nacional de Colombia, Bogota (Colombia)]. E-mail: franciscotorreshoyos@yahoo.com; Plazas, M.C. [Instituto Nacional de Cancerologia, Bogota (Colombia); Cavadia, W. [Universidad de Cordoba (Colombia)

    2004-07-01

    Rods - shaped, TLD - 100, LiF: Mg,Ti thermoluminescence dosimeters are used to check duality control during breast, esophagus and bronchus cancer treatments with high rate dose and Ir -192 source. We conclude that the specificity dose in prescription points is in agreement with parameters given in international protocols. (author)

  14. 流变学流体的蠕动传输:食道中食物块的运动模型%Peristaltic Transport of a Rheological Fluid:Model for Movement of Food Bolus Through Esophagus

    Institute of Scientific and Technical Information of China (English)

    J·C·密斯拉; S·麦蒂; 海治

    2012-01-01

    研究食道中蠕动传输的流体力学.对任意的波形和任意的管道长度,建立起流变学流体蠕动传输的数学模型.用粘性流体的Ostwald-de Waele幂定律,描述非Newton流体的流动特性.解析公式化模型,详细且精确地给出食物块在食道中蠕动传输相关的一些重要性质.分析中应用了润滑理论,本研究特别适合于Reynolds数不大的情况.将食道看作环形的管道,通过食道壁周期性的收缩来传输食物块.就单个波和周期性收缩一组波的传播,研究与传输过程有关变量的变化,如压力、流速、食物颗粒轨迹以及流量等.局部压力的变化,对流变指数n有着高度的敏感性.研究结果清晰地表明,食物块在食道中蠕动传输时,Newton流体或流变学流体构成的连续流体,以组合波传播比大间隔单波传播,传输效率要高得多.%Fluid mechanical peristaltic transport through esophagus had been of concern. A mathematical model had been developed with an aim to study the peristaltic transport of a rheo-logical fluid for arbitrary wave shapes and tube lengths. The Ostwald-de Waele power law of viscous fluid was considered here to depict the non-Newtonian behaviour of the fluid. The model was formulated and analyzed with the specific aim of exploring some important information concerning the movement of food bolus through the esophagus. The analysis had been carried out by using lubrication theory. The study was particularly suitable for cases where the Reynolds number was small. The esophagus was treated as a circular tube through which the transport of food bolus takes places by periodic contraction of the esophageal wall. Variation of different variables concerned with the transport phenomena such as pressure, flow velocity, particle trajectory and reflux were investigated for a single wave as well as for a train of periodic peristaltic waves. Locally variable pressure was seen to be highly sensitive to the flow index n

  15. Squamous cell carcinoma of the esophagus and multiple primary tumors of the upper aerodigestive tract Carcinoma epidermoide do esôfago e múltiplos tumores primários do trato aerodigestivo alto

    Directory of Open Access Journals (Sweden)

    Ulysses RIBEIRO Jr.

    1999-12-01

    Full Text Available Squamous cell carcinoma of the esophagus is frequently associated with other, synchronous or metachronous tumors, in the upper aerodigestive tract. All 264 patients with squamous cell carcinoma of the esophagus, treated in the Gastrointestinal Surgery, Esophagus section, of the "Hospital das Clínicas" (São Paulo University Medical School, Brazil, between 1979 and 1989 were analyzed retrospectively with regards to the occurrence of multiple primary tumors in the upper aerodigestive tract. Multiple primary tumors were encountered in 10 (3.8% patients. All patients were male and the mean age at the time of the first primary was 52.2 years. Tobacco smoke and alcohol were the principal carcinogens in these patients (n = 10. The sites of the tumors were: larynx (n = 4, tongue (n = 4, lung (n = 2, and oral cavity (n = 1. Two simultaneous, three synchronous and five metachronous multiple primary carcinomas were detected. The esophagus was the second primary tumor in nine patients. The mean overall survival after the diagnosis of the second primary was 2.8 months (SD = 0.89. Inquiry regarding other malignancies, associated with panendoscopy should be carry out prior to the treatment of the first primary to diagnose simultaneous or synchronous primary tumors, and careful follow-up should be performed after treatment of the first primary to detect new tumors in these high-risk patients.Carcinoma epidermóide do esôfago está freqüentemente associado a outros, sincrônicos ou metacrônicos tumores do trato aerodigestivo alto. Foram analisados, retrospectivamente, 264 pacientes com carcinoma de esôfago tratados na Disciplina de Cirurgia do Aparelho Digestivo, Divisão de Cirurgia do Esôfago, do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, entre 1979 e 1989, com o intuito de se observar a ocorrência de múltiplos tumores primários do trato aerodigestivo alto. Observaram-se 10 (3.8% pacientes com múltiplos tumores

  16. Experimental model for learning in vascular surgery and microsurgery: esophagus and trachea of chicken Modelo para o aprendizado experimental em cirurgia e microcirurgia vascular: esôfago e traquéia de frango

    Directory of Open Access Journals (Sweden)

    Rosi Aparecida Nunes Achar

    2011-04-01

    Full Text Available PURPOSE: This paper proposes a model of training surgical skills using vascular anastomosis in an animal model that simulates the size, consistency and resistance arteries and veins, to use it to chicken trachea and esophagus, respectively. METHODS: We used chicken necks where the esophagus and trachea were dissected and after preparation were followed every step of the procedure of vascular anastomosis. The flow of the anastomosis was confirmed by direct observation and testing of filling (empty-and-refill test immediately after the anastomosis. RESULTS: All samples proved to be viable by the criteria described above. CONCLUSION: For the first time presents an interesting experimental model used to train vascular sutures, because it is endowed with all the necessary requirements for the learning of experimental vascular surgery.OBJETIVO: O presente trabalho propõe um modelo de treinamento de habilidades cirúrgicas em anastomoses vasculares utilizando um modelo que simula o calibre, a consistência e a resistência arterial e venosa, utilizando-se para isto a traquéia e esôfago de frango, respectivamente. MÉTODOS: Foram utilizados pescoços de frango, onde foram dissecados esôfago e traquéia e após preparo foram seguidos todos os passos do procedimento da anastomose vascular. O fluxo das anastomoses foi comprovado por observação direta e teste de enchimento imediatamente após as anastomoses. RESULTADOS: Todas as amostras mostraram-se viáveis pelos critérios acima descritos. CONCLUSÃO: Pela primeira vez apresenta-se um modelo experimental interessante que serve para treinar suturas vasculares, pois é dotado de todos os requisitos necessários para o aprendizado da cirurgia vascular experimental.

  17. Cisplatin- vs. oxaliplatin-based radiosensitizing chemotherapy for squamous cell carcinoma of the esophagus. A comparison of two preoperative radiochemotherapy regimens

    Energy Technology Data Exchange (ETDEWEB)

    Fakhrian, K. [University Clinic of the Ruhr University Bochum, Department of Radiation Oncology, Marien Hospital Herne, Herne (Germany); University of Bochum, Department of Radiation Oncology, Bochum (Germany); Technische Universitaet Muenchen, Department of Radiation Oncology, Klinikum rechts der Isar, Munich (Germany); Ordu, A.D.; Molls, M. [Technische Universitaet Muenchen, Department of Radiation Oncology, Klinikum rechts der Isar, Munich (Germany); Haller, B. [Technische Universitaet Muenchen, Department of Epidemiology and Medical Statistics, Klinikum rechts der Isar, Munich (Germany); Theisen, J. [Technische Universitaet Muenchen, Department of Surgery, Klinikum rechts der Isar, Munich (Germany); Lordick, F. [University Clinic Leipzig, University Cancer Center Leipzig (UCCL), Leipzig (Germany); Technische Universitaet Muenchen, Department of Internal Medicine III (Hematology/Oncology), Klinikum rechts der Isar, Munich (Germany); Bisof, V. [Clinical Hospital Centre Zagreb, Department of Oncology, Zagreb (Croatia); Geinitz, H. [Technische Universitaet Muenchen, Department of Radiation Oncology, Klinikum rechts der Isar, Munich (Germany); Krankenhaus der Barmherzigen Schwestern Linz, Department of Radiation Oncology, Linz (Austria)

    2014-11-15

    To compare the outcomes of two neoadjuvant radiochemotherapy (N-RCT) regimens for squamous cell carcinoma of the esophagus (ESCC). The standard N-RCT regimen for ESCC at our institution between 2002 and 2011 was a total dose of 45 Gy (1.8-Gy fractions) with concomitant cisplatin (20 mg/m{sup 2}, days 1-5 and 29-33) and 5-fluorouracil (5-FU; 225 mg/m{sup 2}, 24 h continuous infusion on days 1-33). During the same period, a phase I/II study comparing the standard ESCC N-RCT protocol with a regimen identical except for the replacement of cisplatin with weekly oxaliplatin (40-50 mg/m{sup 2}) was performed at our center. The standard regimen was used to treat 40 patients; 37 received the oxaliplatin regimen. All patients subsequently underwent radical resection with reconstruction according to tumor location and two-field lymph node dissection. Median follow-up time from the start of N-RCT was 74 months (range 3-116 months). The two patient groups were comparable in terms of demographic and baseline tumor characteristics. R0 resection was achieved in 37/39 patients (95 %) in the cisplatin-based N-RCT group, compared to 24/37 (65 %) in the oxaliplatin-based group (p = 0.002). A pathological complete response (pCR) was seen in the resection specimens from 18/39 patients (46 %) in the cisplatin-based N-RCT group and in 8/37 (22 %) oxaliplatin-group patients. In the cisplatin group, 2- and 5-year overall survival (OS) rates were 67 ± 8 % and 60 ± 8 %, respectively (median OS 103 months), compared to 38 ± 8 % and 32 ± 8 %, respectively, for the oxaliplatin group (median OS 17 months; hazard ratio, HR 0.452; 95 % confidence interval, CI 0.244-0.839; p = 0.012). Oxaliplatin-based N-RCT resulted in poorer outcomes in ESCC patients and should not routinely replace cisplatin-based N-RCT. (orig.) [German] Unser Ziel war es, die Ergebnisse zweier neoadjuvanter Radiochemotherapie- (N-RCT-) Konzepte mit nachfolgender Resektion beim fortgeschrittenen Plattenepithelzellkarzinom des

  18. Expressão citofotométrica do marcador CD34 no carcinoma epidermóide de esôfago Citophotometric expression of CD34 in squamous cell carcinoma of the esophagus

    Directory of Open Access Journals (Sweden)

    Olímpia Alves Teixeira Lima

    2007-12-01

    Full Text Available RACIONAL: O câncer de esôfago está entre as seis neoplasias malignas mais comuns do mundo. Devido à sua grande agressividade clínica, o subtipo carcinoma epidermóide constitui um dos tumores de pior prognóstico, com alto índice de morbi-mortalidade. Marcadores de biologia molecular tem sido apontados como forte coadjuvante no diagnóstico e graduação de tumores. A angiogênese, evento essencial para a progressão tumoral, pode ser estudada pelo marcador CD34. OBJETIVO: Determinar por citofotometria, usando o sistema SAMBA 4000, a expressão do marcador CD34 no carcinoma epidermóide de esôfago e, correlacioná-los com dados clínico-patológicos (idade, sexo, grau de diferenciação do tumor, estadio, tamanho, localização, profundidade e acometimento de linfonodos. MÉTODOS: Avaliaram-se 29 amostras teciduais de carcinoma epidermóide de esôfago utilizando-se coloração imunoistoquímica com marcador anti-CD34. A quantificação da expressão deste marcador foi realizada por citometria de imagem, pelo sistema SAMBA 4000 nas variáveis índice de marcagem e densidade óptica. A correlação entre subgrupos e análise estatística dos resultados foi realizada com o programa SPSS. RESULTADOS: A expressão média do marcador CD34 foi de 73,40% + 15,20 no índice de marcagem e 56,10 + 23,54 na densidae óptica. O CD34 não apresenta correlação estatisticamente significativa com as características clínico-histopatológicas estudadas (idade, sexo, grau de diferenciação do tumor, estadio, tamanho, localização, profundidade e acometimento de linfonodos. CONCLUSÃO: O marcador CD34 apresenta expressão no carcinoma epidermóide de esôfago, com maior valor no índice de marcagem em relação à densidade óptica. Ele4 não apresenta correlação com as características clínico-histopatológicas estudadas.BACKGROUND: Esophagus carcinoma is rated among the six more common malignant neoplasias in the world. Due to its aggressive

  19. Primary Care Evaluation and Management of Gastroenterologic Issues in Women.

    Science.gov (United States)

    Rao, Vijaya L; Micic, Dejan; Kim, Karen E

    2016-06-01

    Gastrointestinal disorders often present to the primary care setting where initial preventive, diagnostic, and treatment strategies are implemented. This article reviews the presentation and diagnosis of common gastrointestinal disorders, including colorectal cancer, irritable bowel syndrome, peptic ulcer disease, gallbladder disorders, inflammatory bowel disease, gastroesophageal reflux, and Barrett's esophagus. We focus on the evaluation and management of these diseases in women. PMID:27212096

  20. Interventional Endoscopy Database for Pancreatico-biliary, Gastrointestinal and Esophageal Disorders

    Science.gov (United States)

    2015-06-01

    Ampullary Cancer; Duodenal Cancer; Bile Duct Cancer; Bile Duct Disorders; Gallstones; Obstructive Jaundice; Pancreatic Disorders (Noncancerous); Colorectal Cancer; Esophageal Cancer; Barrett's Esophagus; Gastric Malignancies; Pancreatic Cancer; Pediatric Gastroenterology; Cholangiocarcinoma; Pancreatic Pseudocysts; Acute and Chronic Pancreatitis; Recurrent Pancreatitis; Cholangitis; Bile Leak; Biliary Strictures; Pancreatic Divisum; Biliary and Pancreatic Stones; Choledocholithiasis

  1. Comparisons of different methods of anesthesia and analgesia on the levels of glycometabolism rate-limiting enzymes in erythrocytes and plasma glucose and stress hormones in patients undergoing esophagus surgery

    Institute of Scientific and Technical Information of China (English)

    Xiaokun Zhan; Xiongxiong Pan; Yinbin Pan; Jie Sun; Yanning Qian

    2008-01-01

    Objective: To compare the effects of different methods of anesthesia and analgesia on the activities of phosphofmctokinase(PFK), glucose-6-phosphate dehydrogenase(G-tPD) and aldose reductase(AR) in erythrocytes and levels of plasma glucose and stress hormones in patients undergoing esophagus surgery. Methods: Sixty-two patients scheduled for esophagus surgery were randomly divided into three groups: group I (n = 20) receiving only general anesthesia(GA) followed by intravenous patient controlled analgesia(PCA) with fentanyl 15 μg/kg. The other two groups receiving both general anesthesia combined with thoracic epidural anesthesia (GEA) and either intravenous PCA with fentanyl 15 μg/kg (group Ⅱ, n = 21) or thoracic epidurai analgesia(TEA) with 0.125% ropivaeaine and 0.0002% fentanyl mixture(group Ⅲ, n = 21) after the operation. Venous blood samples were collected for measurements of PFK, G-tPD and AR activities in erythrocytes and plasma glucose, conisol, epinephrine and norepinephrine before induction (T,1), 60 rain following the incision (T,2), 60 min(T,3) after operation, on the lst(T,4) and 2nd postoperative day(T5). Results: The activities of PFK decreased(P<0.01 or P=0.004) and the activities of G-tPD and AR increased(P<0.01) in groups Ⅰ and Ⅱ on T,4 compared with those on T,1. Between the two groups, the activities of these enzymes in group Ⅱ changed less than those of group Ⅰ (P<0.01 or P<0.05). These enzymes activities changed slightly in group Ⅲ on T,4(P>0.05). There were significant differences between group Ⅲ and the other two groups(P<0.01 or P<0.05). The levels of plasma glucose increased significantly on T,2(P<0.01), reached peak values on T,4(P<0.01) and fell on T,5 in the three groups. Compared to those of groups Ⅰ and Ⅱ, the values of plasma glucose in group Ⅲ were lower on T,4 and T,5(P<0.05 or P<0.01). The cortisol concentration in each group increased significantly at T,2(P<0.01 or P<0.05), and

  2. 早期食管癌的低张双对比造影检查的X线诊断价值%X-ray diagnostic value of hypotonic double contrast examination in early esophagus cancer

    Institute of Scientific and Technical Information of China (English)

    陈斌

    2014-01-01

    目的:研究对于早期食管癌实施低双张对比的造影检查的X线有关诊断价值。方法:对73例早期食管癌患者实施3种造影方式,对比该病X线的表现以及3种X线方式检查对该病的检出率。结果:黏膜破坏60例(82.2%),小充盈缺损18例(24.7%),管壁扩张受限34例(46.6%),小龛影25例(34.2%)。其中糜烂型以及乳头型在X线的表现,相对于平坦型和斑块型而言,差异具有统计学意义(P<0.05)。3种方式中,准确诊断病变最多的为低张双对比的造影方式(以下简称为低双造影),以总计93.2%的检出率显著高于其他两种方式。差异统计学意义(P<0.05)。结论:早期食管癌的X线检出率主要是低双造影的检出率为最高,具有临床推荐价值。%Objective:To study the X-ray related diagnostic value of implement of hypotonic double contrast examination in early esophagus cancer.Methods:73 cases with early esophagus cancer were given three kinds of imaging modes.The X-ray performances of this disease were compared.The detection rates of three kinds of X-ray examination way for this disease were compared.Results:60 cases(82.2%) were mucosal damage;18 cases(24.7%) were small filling defect;34 cases(46.6%) were wall expansion limited;25 cases(34.2% ) were small niche.The X-ray performances of the erosive type and papillary type were compared with that of the flat type and plaque type,and there were differences with statistical significance(P<0.05).In 3 kinds of ways,the hypotonic double contrast examination(hereinafter referred to as the low double contrast) was the most accurate diagnosis of lesions.The detection rate of 93.2% was significantly higher than that of other two methods.The difference was statistically significant(P<0.05).Conclusion:The detection rate of hypotonic double contrast examination is the highest in X-ray detection rate of early esophagus cancer.It has clinical recommendation value.

  3. Prognosis value of the active tumoral volume in {sup 18}F-F.D.G. for the esophagus cancer and influence of the tumor delimitation methodology; Valeur pronostique du volume tumoral actif en {sup 18}F-FDG pour le cancer de l'oesophage et influence de la methodologie de contourage de la tumeur

    Energy Technology Data Exchange (ETDEWEB)

    Hatt, M. [LaTIM Inserm U650, 29 - Brest (France); Cheze Le Rest, C. [CHU Morvan, departement de medecine nucleaire, 29 - Brest (France); Albarghach, M.N. [CHU Morvan, departement de radiotherapie, 29 - Brest (France)

    2010-07-01

    Purpose: compare the predictive value for survival and response to the treatment of the active tumor volume automatically measured on the PET with {sup 18}F-F.D.G. images by different methods to this one of S.U.V., in the esophagus cancer. Conclusions: Our results suggest that the tumor volume is a pertinent information of which prognosis value in the esophagus cancer is clearly superior to this one of S.U.V. (maximum or average), at the condition to be measured with accuracy, what Fuzzy locally adaptive Bayesian (F.L.A.B.) allows contrary to the thresholding methods. The predictive value of total glycolysis volume (T.G.V.) is still superior and it is less influenced by the method used, F.L.A.B. offering a better differentiation, for the different responses to the treatment or for survival. (N.C.)

  4. 窄带成像内镜诊断食管上段胃黏膜异位症的临床分析%Clinical analysis of heterotopic gastric mucosa in the upper esophagus diagnosed by narrow band imaging endoscopy

    Institute of Scientific and Technical Information of China (English)

    宋敏; 吴杰; 王萍; 黄晓东

    2015-01-01

    Objective]To investigate the clinical features of heterotopic gastric mucosa in the upper esophagus(HGMUE)diagnosed by narrow band imaging(NBI)endoscopy.[Methods]The clinical manifesta‐tions ,endoscopic features and the histological characteristics of HGM UE patients in the Wuhan central hospital from 2013 to 2014 were retrospectively analyzed.[Results]Total 113 cases were diagnosed HG‐MUE by NBI endoscopy in 4 719 patients.The detection rate of HGMUE was 2.39%.Some patients had the clinical symptoms of retrosternal pain ,heartburn ,dysphagia ,globus sensation ,hoarseness ,et al.The pa‐thology of tissues was gastric epithelium.Fundic‐type gastric mucosa(68.14% )constituted the most com‐mon histology.[Conclusion]The use of NBI endoscopy can improve the detection rate of HGMUE which may help the secondary step of clinical treatment.%[目的]探讨窄带成像(narrow band imaging ,NBI)内镜诊断的食管上段胃黏膜异位症(heterotopic gastric mucosa in the upper esophagus ,HGMUE)的临床特点,以提高HGMUE的检出率。[方法]回顾性分析NBI内镜诊断为HGMUE的113例患者临床、内镜、病理表现。[结果]4719例患者中发现HGMUE患者113例,内镜检出率为2.39%。NBI内镜下,病变区域为棕褐色斑块,与周围正常食管上皮界限清晰,小凹形态以管状(93.81%)为主,未发现表面微血管扩张变异。部分患者临床表现为胸骨后疼痛、烧灼感、吞咽困难、咽部异物感等,病理为胃上皮组织,胃底型(68.14%)居多。[结论] NBI内镜可提高 HGMUE的检出率,从而为临床治疗提供帮助。

  5. Effects on heart function of neoadjuvant chemotherapy and chemoradiotherapy in patients with cancer in the esophagus or gastroesophageal junction – a prospective cohort pilot study within a randomized clinical trial

    International Nuclear Information System (INIS)

    Neoadjuvant therapy for cancer of the esophagus or gastroesophageal (GE)-junction is well established. The pros and cons of chemoradiotherapy and chemotherapy are debated. Chemoradiotherapy might impair cardiac function eliciting postoperative morbidity. The aim of this pilot study was to describe acute changes in left ventricular function following chemoradiotherapy or chemotherapy. Patients with esophageal and (GE)-junction cancer enrolled at our center into a multicenter trial comparing neoadjuvant chemoradiotherapy and chemotherapy were eligible. Patients were randomized to receive cisplatin and 5-fluorouracil with or without the addition of 40 Gy radiotherapy prior to surgery. Left ventricular function was evaluated using echocardiography and plasma N-Terminal Pro-B-Type Natriuretic Peptide (NT-proBNP) before and after neoadjuvant treatment. The primary outcome measure was left ventricular global strain (GS). Clinical effects were assessed using repeated exercise tests. Linear mixed models were used to analyze the effects of treatment group, and the interaction between groups. 40 patients participated (chemoradiotherapy, n = 17; chemotherapy, n = 23). In the chemoradiotherapy group there was no change in left ventricular global strain but mitral annular plane systolic excursion (MAPSE) of the ventricular septum, early diastolic filling velocity (E-velocity), and the ratio of early to late ventricular filling velocities (E/A ratio) decreased significantly (p = 0.02, p = 0.01, and p = 0.03, respectively). No changes were observed in the chemotherapy group. There was a trend towards an interaction effect for MAPSE sept and E (p = 0.09 and p = 0.09). NT-proBNP increased following chemoradiotherapy (p = 0.05) but not after chemotherapy (p > 0.99), and there was a trend towards an interaction effect (p = 0.07). Working capacity decreased following neoadjuvant treatment (chemoradiotherapy p = 0.001, chemotherapy p = 0.03) and was more pronounced after

  6. Esophageal papilloma: Flexible endoscopic ablation byradiofrequency

    Institute of Scientific and Technical Information of China (English)

    Gianmattia del Genio; Federica del Genio; Pietro Schettino; Paolo Limongelli; Salvatore Tolone; Luigi Brusciano; Manuela Avellino; Chiara Vitiello; Giovanni Docimo; Angelo Pezzullo; Ludovico Docimo

    2015-01-01

    Squamous papilloma of the esophagus is a rare benignlesion of the esophagus. Radiofrequency ablation is anestablished endoscopic technique for the eradication ofBarrett esophagus. No cases of endoscopic ablation ofesophageal papilloma by radiofrequency ablation (RFA)have been reported. We report a case of esophagealpapilloma successfully treated with a single sessionof radiofrequency ablation. Endoscopic ablation ofthe lesion was achieved by radiofrequency using anew catheter inserted through the working channelof endoscope. The esophageal ablated tissue wasremoved by a specifically designed cup. Completeablation was confirmed at 3 mo by endoscopy withbiopsies. This case supports feasibility and safety of asa new potential indication for BarrxTM RFA in patientswith esophageal papilloma.

  7. In vitro construction of tissue-engineered esophagus A preliminary test%体外构建犬组织工程化食管的初步试验

    Institute of Scientific and Technical Information of China (English)

    张哲; 张璐; 牛晓光; 尹志伊; 何宝亮; 王伦青

    2008-01-01

    背景:近年来组织工程技术的发展为人工食管的研究开辟了新的思路,有研究者应用体外培养的食管黏膜上皮细胞接种于复合高分子材料上,构建组织工程食管获得成功.目的:探讨应用体外培养的犬食管黏膜上皮细胞种植于猪的主动脉脱细胞基质支架上,构建组织工程化人工食管的可行性.设计:观察实验.单位:泰山医学院中心实验室.材料:实验于2004-06/2004-12在泰山医学院中心实验室完成,选用3只出生24 h内杂种犬,由泰山医学院动物园提供. 实验过程中对动物的处置过程符合动物伦理学标准.二氧化碳培养箱MCO-15AC(SANYO),RC-26低温高速离心机(杜邦).胰蛋白酶、转铁蛋白、Ⅱ型胶原酶(GIBCO);DMEM、DispaseⅡ分离酶、鼠抗人角蛋白单克隆抗体(Sigma).方法:用酶-去污剂法对猪主动脉进行脱细胞处理,体外分离、培养、扩增新生杂种犬的食管黏膜上皮细胞,接种于去细胞基质支架体外培养,种植后3天、1周通过组织学及电镜观察食管黏膜上皮细胞在脱细胞基质支架上的生长情况.主要观察指标:体外培养的食管黏膜上皮细胞的形态;脱细胞基质与犬食管上皮细胞的生物相容性.结果:酶化学除垢剂法能使猪主动脉细胞脱落,基质三维结构变疏松.体外扩增的犬食管黏膜上皮细胞可以种植在脱细胞基质上并能生长,增殖.结论:脱细胞的基质与犬食管上皮细胞具有良好的生物相容性,能结合在一起并形成人工食管移植体.%BACKGROUND:Recently,the development of tissue-engineered technique lms broadened the study of artificial esophagus.Some investigators have inoculated esophageal epithelial cells cultured in vitro onto compound polymer material and successfully constructed tissue-engineered esophagus.OBJECTIVE:To investigate the feasibility of tissue-engineered artificial esophagus by combining dog esophageal epithelail cells and an acelhilarized

  8. Final report of Intergroup Trial 0122 (ECOG PE-289, RTOG 90-12): Phase II trial of neoadjuvant chemotherapy plus concurrent chemotherapy and high-dose radiation for squamous cell carcinoma of the esophagus

    International Nuclear Information System (INIS)

    Purpose: To determine the outcome of neoadjuvant chemotherapy followed by concurrent chemotherapy plus high-dose radiation therapy in patients with local/regional squamous cell carcinoma of the esophagus. Methods and Materials: Forty-five patients with clinical Stage T1-4N0-1M0 squamous cell carcinoma were entered on a prospective single-arm study, of which 38 were eligible. Patients received 3 monthly cycles of 5-FU (1000 mg/m2/24 h x 5 days) and cisplatin (100 mg/m2 day 1; neoadjuvant segment) followed by 2 additional monthly cycles of 5-FU (1000 mg/m2/24 h x 5 days) and cisplatin (75 mg/m2 day 1) plus concurrent 6480 cGy (combined modality segment). The median follow-up in surviving patients was 59 months. Results: For the 38 eligible patients, the primary tumor response rate was 47% complete, 8% partial, and 3% stable disease. The first site of clinical failure was 39% local/regional and 24% distant. For the total patient group, there were 6 deaths during treatment, of which 9% (4/45) were treatment related. The median survival was 20 months. Actuarial survival at 3 years was 30%, and at 5 years, 20%. Conclusion: This intensive neoadjuvant approach does not appear to offer a benefit compared with conventional doses and techniques of combined modality therapy. However, high dose radiation (6480 cGy) appears to be tolerable, and is being tested further in Intergroup Trial INT 0123

  9. Narrow-band imaging and white-light endoscopy with optical magnification in the diagnosis of dysplasia in Barrett’s esophagus: results of the Asia-Pacific Barrett’s Consortium

    Science.gov (United States)

    Singh, Rajvinder; Jayanna, Mahesh; Wong, Jennie; Lim, Lee Guan; Zhang, Jun; Lv, Jing; Liu, Dong; Lee, Yi-Chia; Han, Ming-Lun; Tseng, Ping-Huei; Namasivayam, Vikneswaran; Banerjee, Rupa; Uedo, Noriya; Chan, Wah Kheong; Ho, Shiaw Hooi; Chen, Shi-yao; Bhatia, Shobna; Funasaka, Kohei; Ando, Takafumi; Wu, Justin; Lesmana, Cosmas; Tam, William; Wang, Wen-Lun; Chang, Chi-Yang; Jung, Hwoon-Yong; Jung, Kee Wook; Bestari, Muhammad Begawan; Yao, Kenshi; Chong, Vui Heng; Sharma, Prateek; Ho, Khek-Yu

    2015-01-01

    Objective: The advent and utility of new endoscopic imaging modalities for predicting the histology of Barrett’s esophagus (BE) in real time with high accuracy appear promising and could potentially obviate the need to perform random biopsies where guidelines are poorly adhered to. We embarked on evaluating the performance characteristics of white-light endoscopy with magnification (WLE-z), narrow-band imaging with magnification (NBI-z) and a combination of both modalities. Design: This was a prospective online study with 28 endoscopists from 11 countries (Asia-Pacific region) participating as assessors. In total, 35 patients with BE were assessed using 150 slides from WLE-z and NBI-z randomly arranged using a simple classification with corresponding histology. The overall Accuracy (Acc), Sensitivity (Sn), Specificity (Sp), Positive Predictive Value (PPV), and Negative Predictive Value (NPV) of WLE-z, NBI-z and a combination of both were calculated. Results: The overall Acc for WLE-z and NBI-z images was 87.1 % and 88.7 %, respectively. When images from the two modalities were placed side by side, the Acc increased to 90.3 %. The Sn, Sp, PPV, and NPV of WLE-z were 48 %, 92 %, 45 %, and 93 % while with NBI-z, these improved to 89 %, 89 %, 56 %, and 98 %, respectively. When both imaging modalities were viewed together, they improved further to 93 %, 90 %, 61 %, and 99 %. Conclusion: The high NPV (99 %) when both WLE-z and NBI-z were used simultaneously indicates that areas with regular appearance that are diagnosed with confidence can effectively be left alone and not biopsied when performed at a skilled resourced center. This approach could potentially lead to a paradigm shift of how patients with BE are assessed. PMID:26134765

  10. Bruising of the esophagus as a cause of gastrointestinal bleeding in a case of heatstroke Hematomas esofágicos como causa de hemorragia digestiva en un caso de golpe de calor

    Directory of Open Access Journals (Sweden)

    A. J. Lucendo Villarín

    2005-08-01

    Full Text Available Alterations in blood clotting are a frequent complication of serious heatstroke and may result in gastrointestinal bleeding. We report the case of a 26-year-old man who was admitted to our hospital with symptoms of hyperthermia associated with encephalopathy and disseminated intravascular coagulation (DIC after prolonged exposure to sunlight. He presented hematemesis, after which he was diagnosed with having a bruising of the esophagus that took up the upper and lower thirds, there being no other lesions in the stomach or duodenum. After supportive treatment and following the resolution of the underlying pathology, the endoscopy-revealed injuries healed with a complete normalization of the esophageal mucosa. Esophageal submucosal bruising is an exceptional cause of hematemesis in serious heatstroke not previously described in the literature.Las alteraciones de la coagulación son una complicación frecuente en el golpe de calor grave, y pueden ser causa de hemorragia digestiva. Presentamos el caso de un varón de 26 años que fue admitido en nuestro hospital por un cuadro de hipertermia, asociado con encefalopatía y coagulación intravascular diseminada tras exposición solar prolongada. Presentó hematemesis por la que fue diagnosticado de múltiples hematomas esofágicos que ocupaban los tercios superior e inferior del órgano, en ausencia de otras lesiones en estómago y duodeno. Tras el tratamiento de soporte y la resolución de la patología subyacente, desaparecieron las lesiones endoscópicas, normalizándose la mucosa esofágica.

  11. Injury of ~(125)Ⅰ seeds implants to trachea and esophagus of rabbits%放射性~(125)Ⅰ粒子植入对家兔正常气管、食管损伤初探

    Institute of Scientific and Technical Information of China (English)

    李运; 李剑锋; 杨帆; 周足力; 王俊

    2010-01-01

    Objective To evaluate the impact of 1125 seeds para-tracheal braehytherapy on regional tissue injury in rab-bit models. Methods 42 rabbits were randomized into 7 groups. Group 1 to 6 belong to study groups (in which 1,4,5 and 6 belong to "dose gradient" subgroup, while 2,3 and 4 to "chronologic" subgroup) , while the last group acts as negative con-trol. The activity of seeds in study group were 0.3 mCi in group 1, 0.5 mCi in group 2 to 5, 0.7 mCi in group 5, and 0.9mCi in group 6. False seeds (0 mCi) were used for the negative control. 4 seeds with equal dosage were implanted between trachea and esophagus in each rabbit under general anesthesia. Seeds arrangement was made according to Paris principle. For the tissue injury evaluation, group 2 was sacrificed by the end of first month post-operatively, group 3 at the end of the second month, and group 4 end of the third month. The rest of rabbits were also sacrificed at the end of the third month. Pieces of adjacent e-sophagus and trachea were sampled from each rabbit. Tissue injury features such as inflammation, edema, congestion or fibrosis as evaluated histologically. Results All rabbits were healthy during study period except 5. Histological analysis revealed that trachea samples from all groups had lymphocytas and plasma cells infiltration as signs of chronic inflammation, hut fibrosis was nut clearly visible. There were no differences between study and control groups with respect to inflammation, edema and con-gestion scores. But in groups which received the highest doses of radiation or sacrificed at 60 d showed more eosinophil infiltra-tion and epithelum degeneration, and statistical significance was reached between these groups and control. Esophageal samples had less histological changes compared with trachea. Conclusion Para-tracheal implantation of ~(125)Ⅰ seeds with therapeutic or higher dosage only induce minor and reversible damage to the regional tissue. This implies that ~(125)Ⅰ implants

  12. Carcinoma basalóide escamoso: uma forma rara e agressiva de câncer do esôfago e revisão da literatura Basaloid squamous carcinoma of the esophagus: a rare and aggressive form of esophageal cancer and literature review

    Directory of Open Access Journals (Sweden)

    Maria Aparecida Coelho de Arruda Henry

    2007-03-01

    Full Text Available RACIONAL: O carcinoma basalóide escamoso ocorre com maior freqüência no trato aerodigestivo superior e raramente acomete o esôfago. OBJETIVO: Apresentar os aspectos clínico-patológicos e os atributos imunoistoquímicos de um paciente com carcinoma basalóide escamoso do esôfago. RELATO DO CASO: Dos 134 pacientes com câncer do esôfago atendidos no Hospital Universitário de Botucatu-Unesp, São Paulo, de 1990 a 1999, somente um paciente (0,74% apresentou carcinoma basalóide escamoso do esôfago. Tratava-se de paciente masculino, 41 anos, branco, lavrador com disfagia, regurgitação e emagrecimento há três meses. Referia tabagismo e etilismo há muitos anos. O esofagograma e o exame endoscópico revelaram lesão vegetante no terço distal do esôfago. A biópsia demonstrou neoplasia intraepitelial de alto grau associada a blocos de células basalóides que infiltravam o cório da mucosa, caracterizando o carcinoma basalóide escamoso. Os marcadores imunoistoquímicos foram positivos para o antígeno carcinoembriônico e para citoceratinas de alto peso molecular. A tomografia computadorizada revelou múltiplas metástases nos pulmões, fígado, e nódulos linfáticos regionais, documentando a fase avançada de evolução da doença. O tratamento consistiu apenas na realização de gastrostomia. O paciente apresentou queda acentuada do estado geral e evoluiu para óbito com quadro de melena quatro meses após o diagnóstico. CONCLUSÃO: O carcinoma basalóide escamoso é uma forma rara e agressiva de câncer do esôfago e o prognóstico depende do estadiamento da lesão e das condições clínicas do paciente no momento do diagnóstico.BACKGROUND: Basaloid squamous carcinoma is more frequently found in the upper aerodigestive tract, being rarely found in the esophagus. AIM: To present the pathological and clinical aspects, as well as immunhistochemical attributes of a basaloid squamous carcinoma of the esophagus patient. CASE REPORT: Of

  13. Primary small cell carcinoma of the esophagus: patient data metaanalysis and review of the literature [Primäres kleinzelliges Ösophaguskarzinom: Patientendaten-Metaanalyse und Review der Literatur

    Directory of Open Access Journals (Sweden)

    Schmidt-Wolf, Ingo G.H.

    2013-08-01

    Full Text Available [english] We analysed the typical features of primary small cell carcinoma of the esophagus (SCCE with emphasis on occurrence, behaviour, outcome and treatment options. This metaanalysis was aimed at collecting and analyzing information from international studies about handling this disease. This seems necessary due to the rarity of this disease. Studies were acquired from electronic databases and reference lists. We finally analysed 313 patient cases from the literature with oesophageal SCC. A data extraction was accomplished referring to 13 evaluable features that are described in the “methods”, whereof 7 were analyzed with univariate and multivariate tests. Three hundred thirteen cases were analyzed, 109 patients (35% had limited stage (LS, whereas 167 (54% had extensive stage (ES. There is no information about the remaining 35 patients concerning the stage. Univariate and multivariate analysis showed only age (50 years, HR 1.024; 95% CI 1.000–1.041, 50 years and therapy are independent significant predictors of prognosis.[german] Gegenstand unserer Untersuchungen war die Erhebung typischer Eigenschaften des kleinzelligen Ösophaguskarzinoms mit Berücksichtigung des Auftretens, des Verlaufs, der Auswirkung und der Behandlungsoptionen. Ziel unserer Metaanalyse bestand darin, Informationen aus internationalen Studien, die sich mit dieser Krankheit befassten, zu sammeln und auszuwerten. Dies scheint notwendig aufgrund der Seltenheit der Krankheit. Die verwendeten Studien wurden von elektronischen Datenbanken und Referenzlisten ermittelt. Insgesamt wurden 313 Patientenfälle mit einem kleinzelligen Ösophaguskarzinom aus der Literatur ausgewertet. Die erhobenen Daten beziehen sich auf 13 auswertbare Kriterien, die in den „Methoden“ beschrieben sind, wovon sieben Kriterien mit univariaten und multivariaten Tests untersucht worden sind. Von 313 analysierten Patientenfällen waren 109 (35% Patienten im limitierten Stadium der Erkrankung

  14. Cx43和Pax3在人胚胎食管肌层组织中的表达及意义%Expression and Significance of Cx43 and Pax3 in the Esophagus of a Human Embryo

    Institute of Scientific and Technical Information of China (English)

    张剑; 刘学红

    2009-01-01

    应用免疫组织化学SABC法检测第2,3,4三个月胎龄段,Cx43和Pax3蛋白在人胚胎食管组织中的表达.结果表明:第2个月胚龄时,Cx43和Pax3在食管肌层肌细胞中呈阳性表达,在肌间神经丛处神经细胞呈阴性表达;第3个月胎龄段,Cx43和Pax3在食管肌层肌细胞阳性表达与第2个月胚龄相似,在肌间神经丛处大部分神经细胞呈阳性表达;第4个月胎龄段,Cx43和Pax3在食管肌层神经细胞和肌细胞均呈弱阳性表达.因此,Cx43和Pax3蛋白与人胚胎早期食管肌层组织细胞的生长发育关系密切.%The objective of the paper is to explore the patterns of Connexin43 (Cx43) and Pairedbox3 (Pax3) protein expressions in the esophageal muscular layers of a human embryo.The SABC method in Immunohistochemistry has been employed to examine the expressions of Cx43 and Pax3 proteins in the muscular layers of the esophagus in human embryos from the second to fourth months of gestation.The following are the results:In the second month of gestation,their muscle cells of the esophageal muscular layers are positive while the nerve cells in the myenteric plexus are negative;In the third month,the Cx43 and Pax3 expressions in the muscle cells in the esophageal muscular layers are similar to those of the second month,with most nerve cells positive in the myenteric plexus;In the fourth month,the Cx43 and Pax3 protein expressions are weakly positive both in the muscle cells and nerve cells of the esophageal muscular layers.A conclusion is reached:Their Cx43 and Pax3 proteins are closely related to the growth and development of the cells and tissues in the esophageal muscular layers in human embryos.

  15. Níveis plasmáticos de taurina e de seus precursores em pacientes com câncer de esôfago Plasma taurine levels in patients with esophagus cancer

    Directory of Open Access Journals (Sweden)

    Vânia Cristina Lamônica-Garcia

    2008-09-01

    e da mortalidade sugerem participação efetiva da taurina na sobrevida dos pacientes e, portanto, os cuidados nutricionais específicos com a sua via geradora (cisteína, metionina e vitaminas do complexo B.BACKGROUND: The esophagus cancer-host has a two way close relationship as seen in its sulphur-amino acid metabolism. Taurine one of these compounds has ubiquous role in host defense and other physiological mechanisms related to survival. AIM: To study the plasma levels of taurine and its precursors in patients with esophagus cancer. METHODS: In a sectional design both groups, patients (n = 16, 43-73 yrs old and healthy controls (n = 20, 27-65 yrs old were assessed for anthropometry, body-weight lost, hematology (Hb, Ht, total leukocytes and lymphocyte counts, general biochemistry (albumin, glucose, lipids and aminotransferases and chromatographic analysis for taurine, cysteine, and homocysteine. The survival time was registered there since from the clinical-histopathological diagnosis. All participants had a written ethical consent for the research. RESULTS: The cancer patients were predominantly, white males of low social economic class, with spinocellular carcinoma stage IV located at upper 3rd half of them presented hypoalbuminemia and 16% referred significant body-weight loss. The patients showed statistically lower values of Hb, Ht, total and HDL cholesterol and cysteine and significantly higher values of taurine, homocysteine and aminotransferases than healthy controls. A positive relationship was found between taurine and either TLC (r = 0.50 and survival (r = 0.81. CONCLUSIONS: Lower plasma cysteine along with higher levels of taurine and homocysteine and the positive direct association of taurine with indications of survival suggest an effective role of this compound and therefore a prospective special nutritional care in its precursors (cysteine, methionine and B vitamins of these patients.

  16. Primary liposarcoma of esophagus: A case report

    Institute of Scientific and Technical Information of China (English)

    Theodore D Liakakos; Theodore G Troupis; Charalambos Tzathas; Konstantina Spirou; Irene Nikolaou; Spiridon Ladas; Gabriel M Karatzas

    2006-01-01

    Liposarcoma is the most common soft tissue sarcoma in adult life while esophageal liposarcoma is an extremely rare tumor. In the world literature, only :14 cases of esophageal liposarcomas have been described. We report a 72-year old male patient who was urgently admitted to our hospital for acute epigastric pain with a burning retrosternal sensation, persistent nausea, vomiting and dysphagia. Barium swallow, upper gastrointestinal (GI)endoscopy, esophageal manometry and CT scan, failed to accurately diagnose the lesion. After surgical resection of an esophageal polypoid tumor, the histological examination revealed a well-differentiated grade Ⅰliposarcoma. Diagnostic and therapeutic tools were discussed and the results of literature were reviewed.

  17. [Acute obstruction of the esophagus by mucilage].

    Science.gov (United States)

    Laroche, C; Caquet, R; Remy, R; Duflo, B

    1975-10-23

    The authors present the case of an 84 year-old woman with chronic constipation who suddenly developed acute obstruction of the lower oesophagus on taking a tablespoonful of mucilage without water. The obstruction was relieved by fiber endoscopy. There was no other previous lesion which might explain this complication. The patient was seen again later in good general health. The authors recall the clinical and radiological signs of acute obstruction of the oesophagus and discuss the physiopathology. They propose treating them exclusively by oesophageal fiber endoscopy. PMID:175497

  18. Polymeric Biodegradable Stent Insertion in the Esophagus

    Directory of Open Access Journals (Sweden)

    Kai Yang

    2016-04-01

    Full Text Available Esophageal stent insertion has been used as a well-accepted and effective alternative to manage and improve the quality of life for patients diagnosed with esophageal diseases and disorders. Current stents are either permanent or temporary and are fabricated from either metal or plastic. The partially covered self-expanding metal stent (SEMS has a firm anchoring effect and prevent stent migration, however, the hyperplastic tissue reaction cause stent restenosis and make it difficult to remove. A fully covered SEMS and self-expanding plastic stent (SEPS reduced reactive hyperplasia but has a high migration rate. The main advantage that polymeric biodegradable stents (BDSs have over metal or plastic stents is that removal is not require and reduce the need for repeated stent insertion. But the slightly lower radial force of BDS may be its main shortcoming and a post-implant problem. Thus, strengthening support of BDS is a content of the research in the future. BDSs are often temporarily effective in esophageal stricture to relieve dysphagia. In the future, it can be expect that biodegradable drug-eluting stents (DES will be available to treat benign esophageal stricture, perforations or leaks with additional use as palliative modalities for treating malignant esophageal stricture, as the bridge to surgery or to maintain luminal patency during neoadjuvant chemoradiation.

  19. MRI of esophagus. N staging and more.

    International Nuclear Information System (INIS)

    Esophageal disease is common. Fluoroscopy with or without fast cine-sequences is able to depict swallowing dynamics precisely and therefore is used in cases with swallowing disturbance, achalasia or diverticula etc. It is performed in addition to primary endoscopy. There is no evidence based indication for MRI in these settings as it is not to rule out postsurgical fistula and incompetence. Endoscopy and endosonography are gold standard for the depiction as well as staging of esophageal tumors hence differentiation of the esophageal wall layers and detection of suspicious lymph nodes is possible. And from both, biopsies may be taken. New techniques as OCT (optical coherence tomography) can demonstrate in situ carcinoma and therefore helps to decide for limited treatments as mucosectomy. For today multimodular treatment strategies in esophageal carcinoma the T-stage will lead to the treatment decision whereas the nodal-stage will give information about the prognosis. As a matter of fact endoscopy is unable to pass a stenosis esophageal tumor in up to 50% of the cases and will therefore not be able to give precise information on both T- and N-stage resulting in a good indication for MRI. Fetal MRI of the chest is a new topic in which MRI seems to be superior to ultrasonography. (orig.)

  20. Upper abdominal malignancies (not including esophagus)

    International Nuclear Information System (INIS)

    Objective: This course will give an overview of the role of radiation therapy in the treatment of gastrointestinal malignancies in the upper abdomen, with an emphasis on carcinomas of the stomach, pancreas and biliary tract. For each site, information will be presented related to failure patterns with conventional surgical treatment and the indications for surgery for different stages of disease. The possible uses of radiation therapy as an adjuvant to surgical resection will be discussed as well as the use of radiation therapy alone. In addition, the combination of radiation therapy with chemotherapy will be discussed for each of these sites, as well as the information available at present as to the optimal way to combine chemotherapy with radiation therapy. Radiation therapy is not generally accepted to have a role in the treatment of patients with adenocarcinomas of the stomach. This is related to the fact that gastric cancer has been standardly treated with surgical resection alone, and delivery of high dose radiation therapy to the upper abdomen can be difficult because of the sensitivity of nearby normal tissues. Nonetheless, data on failure patterns suggest that local recurrence is common in patients with disease through the gastric wall and with positive nodes. Although there is some suggestive data to indicate that radiation therapy is effective as an adjuvant, results of an ongoing trial will be necessary for determination of the exact role of radiation therapy. Possible uses of radiation therapy as preoperative therapy or given alone will also be briefly discussed. Radiation therapy has been often used in the treatment of pancreatic adenocarcinomas, either alone or combined with surgical resection. Its use is more common for this site both because of the extremely poor prognosis of standard therapies, and because of the difficulty in performing an adequate surgical resection. Data will be reviewed suggesting that radiation therapy has a role when combined with chemotherapy in patients with unresectable disease, and that radiation therapy and chemotherapy is of value as an adjuvant therapy in patients who have had a potentially curative surgical resection. There is relatively little information on the treatment of cancers of the biliary tract with radiation therapy. However, the existing data on recurrence patterns and therapy will be reviewed. The use of brachytherapy for patients with biliary obstruction will be discussed. In most tumors of the GI tract, the combination of radiation therapy with 5-FU chemotherapy seems to be more effective than radiation therapy alone. Newer information suggests that modulators of 5-FU effect such as leucovorin, or altered modes of administration such as continuous infusion, may be beneficial. These issues will be discussed as they relate to the upper abdominal malignancies

  1. Changes of pH in the lower part of esophagus in the ship crew with motion sickness and effects of drug intervention%晕船情况下食管下端pH值的变化及药物干预探讨

    Institute of Scientific and Technical Information of China (English)

    吕礁; 余理红; 施云星; 周国中; 钱慧; 曾晓虹; 刘长云; 覃林花; 刘曼娇

    2014-01-01

    目的 实时监测和观察晕船人员食管下端pH值的变化以及药物的干预作用,为运动病的防治提供理论依据.方法 健康志愿者36例,均为男性.采用瑞典Medtronic Synectics公司生产的DigitrapperMKⅢ型便携式pH监测仪,动态监测航行前、航行期间及口服法莫替丁后食管下端pH各参数的变化.结果 (1)航行中食管下端pH三项监测指标较航行前差异均有统计学意义(P<0.05);(2)口服法莫替丁后,除pH <4的反流次数与航行中相比差异无统计学意义(P>0.05)外,pH <4的总时间百分数及反流持续>5 min次数与航行中相比差异均有统计学意义(P<0.05).结论 晕船人员在较大风浪中航行时,食管下端酸反流较航行前明显增加,口服法莫替丁可明显抑制航行时的食管酸反流.食管下端pH监测可用于晕船情况下防治食管酸反流的药物筛选及疗效评价.%Objective To monitor changes of pH in the lower part of esophagus in the ship crew with motion sickness and effects of drug intervention,so as to provide theoretical evidence for the prevention and treatment of motion sickness.Methods Thirty-six male healthy volunteers were involved in the study.Portable pH monitoring system (Digitrapper MK Ⅲ,Medtronic Synectics Corporation,Sweden) was used to dynamically monitor pH changes before and during deployment,and also to observe pH changes in the lower part of esophagus in the subjects following oral administration of famotidine.Results (1) Statistical significance could all be seen in the 3 pH indexes in the lower part of esophagus monitored during deployment among the ship crew with motion sickness (P < 0.05).(2) Following oral administration of famotidine,there was statistical significance in the percentage of total time (pH < 4) and the frequency of sustained reflux (> 5 min),as compared with those during deployment,but the frequency of sustained reflux (pH < 4) was an exception,when it was compared

  2. Influence of Glutamine Addition on Nutritional Status in Nutritional Therapy of Patients with Esophagus Canc-er:a Meta Analysis%添加谷氨酰胺营养治疗对食管癌患者营养状况影响的meta分析

    Institute of Scientific and Technical Information of China (English)

    滑丽美; 刘晓军; 赵青兰; 于建敏

    2014-01-01

    目的:评价添加谷氨酰胺营养治疗对食管癌患者营养状况的影响。方法计算机检索1994-2012年中国知网(CNKI)全文期刊数据库、万方数据库、Pubmed数据库、Cochrane Central Register of Controlled Trials(The Co-chrane Library),纳入添加谷氨酰胺营养治疗食管癌患者的随机对照研究,采用RevMan 5.2统计软件进行分析。结果最终纳入的5项研究,包括284例研究对象,其中4项研究属于高质量等级研究。 meta分析结果显示,谷氨酰胺组白蛋白、前白蛋白、IgG水平高于常规营养支持组,C反应蛋白水平低于常规营养支持组(P0.05)。结论添加谷氨酰胺营养支持治疗可以明显改善食管癌患者营养不良状况,提高免疫力,减少氧化应激损伤,其效果优于常规营养支持。%Objective To evaluate the influence of Glutamine addition on nutrition status in nutritional therapy of patients with esophagus cancer. Methods Clinical data of Glutamine addition in nutritional therapy of patients with e-sophagus cancer was retrieved from electronic database:CNKI, Wanfang Data,Pubmed and Cochrane Central Register of Controlled Trials (the Cochrane Library) for randomized control trials, and data was analyzed with RevMan 5. 2 software. Results Five study items were recruited including 284 cases and 4 high quality grade studies. Meta analysis results showed that the levels of albumin, prealbumin and IgG were significantly higher, while the C-reactive protein ( CRP) lev-el was significantly lower in Glutamine addition group than those in ordinary nutrition support group (P0. 05). Conclusion Glutamine addition in nu-tritional therapy of patients with esophagus cancer can significantly improve poor nutritional status, enhance the immunity and reduce damage of the oxidative stress with better effect than that of the ordinary nutrition support.

  3. An animal model of photodynamic-therapy-induced esophageal stricture: preliminary report

    Science.gov (United States)

    Perry, Yaron; Epperly, Michael W.; Finkelstein, Sydney; Klein, Edwin; Greenberger, Joel; Luketich, James

    2003-06-01

    Photodynamic Therapy (PDT) using Photofrin has been recently approved by the FDA for the treatment of esophageal cancer and Barrett's esophagus. A major limitation of PDT for Barrett's esophagus is the development of esophageal stricture in up to 53% of patients. Mechanisms of PDT stricture formation have not been elucidated. The major difficulty is the lack of an animal model for PDT-induced stricture. We have used a pig model in which the esophagus is very similar to that of the human esophagus. Two (Scrofa) domestic pigs were injected with Photofrin at dosage of 2 mg/kg 48 hours prior to photoactivation with 630 nm light. Following anesthesia, a laser probe (2.5 cm in length) was passed through the oral cavity to approximately the mid-point of the esophagus via an endoscope. Light energy (400 Joules (J)/cm) was delivered as a single dose in one pig or repeated at 72 hours in the second pig. In this pig model, upper endoscopy, Barium swallow and pathological studies confirmed stricture formation following esophageal PDT exposure of 400 J as one or two fractions. We believe that this is the first animal model created to study esophageal strictures resulting from PDT.

  4. Obesity and gastrointestinal diseases.

    Science.gov (United States)

    Fujimoto, Ai; Hoteya, Shu; Iizuka, Toshiro; Ogawa, Osamu; Mitani, Toshifumi; Kuroki, Yuichiro; Matsui, Akira; Nakamura, Masanori; Kikuchi, Daisuke; Yamashita, Satoshi; Furuhata, Tsukasa; Yamada, Akihiro; Nishida, Noriko; Arase, Koji; Hashimoto, Mitsuyo; Igarashi, Yoshinori; Kaise, Mitsuru

    2013-01-01

    The prevalence of obesity in the Japanese population has been increasing dramatically in step with the Westernization of lifestyles and food ways. Our study demonstrated significant associations between obesity and a number of gastrointestinal disorders in a large sample population in Japan. We demonstrated that reflux esophagitis and hiatal hernia were strongly related to obesity (BMI > 25) in the Japanese. In particular, obesity with young male was a high risk for these diseases. On the other hand, it has been reported that obesity is also associated with Barrett's esophagus and colorectal adenoma; however, obesity was not a risk factor for these diseases in our study. The difference of ethnicity of our subjects may partly explain why we found no data to implicate obesity as a risk factor for Barrett's esophagus. Arterial sclerosis associated with advanced age and hyperglycemia was accompanied by an increased risk of colorectal adenoma. PMID:23781242

  5. CDX1 is an important molecular mediator of Barrett's metaplasia

    DEFF Research Database (Denmark)

    Wong, N A C S; Wilding, J; Bartlett, S; Liu, Y; Warren, B F; Piris, J; Maynard, N; Marshall, R; Bodmer, W F

    2005-01-01

    molecule in the pathogenesis of BM. CDX1 mRNA and protein were universally expressed in all samples of BM tested but not in normal esophageal squamous or gastric body epithelia. This tissue-specific expression was attributable to the methylation status of the CDX1 promoter. Conjugated bile salts and the...

  6. Comparação dos tratamentos do carcinoma espinocelular avançado do esofago pela teleterapia exclusiva e pela teleterapia associada à braquiterapia Comparison of treatment using teletherapy (external beam radiation alone versus teletherapy combined with brachytherapy for advanced squamous cell carcinoma of the esophagus

    Directory of Open Access Journals (Sweden)

    Renato Samea

    2011-12-01

    Full Text Available RACIONAL: O câncer do esôfago ainda constitui neoplasia de difícil tratamento e de prognóstico muito ruim. OBJETIVO: Comparar a resposta do tratamento exclusivo com teleterapia isolada versus teleterapia associada à braquiterapia endoluminal de doentes portadores de carcinoma espinocelular avançado do esôfago. MÉTODO: Foram estudados 49 doentes portadores de carcinoma espinocelular avançado do esôfago médio em estádio clínico III (TNM. Os doentes foram divididos em dois grupos de doentes. O primeiro grupo foi submetido à teleterapia exclusiva com acelerador linear de partículas, dose média de 6000 cGy e o segundo à teleterapia na dose de 5040 cGy associada à braquiterapia endoluminal com Iridium 192 na dose de 1500 cGy. A braquiterapia foi iniciada uma a duas semanas após o término da teleterapia e dividida em três aplicações semanais de 500 cGy. Foram avaliadas as variáveis idade, sexo, raça, hábitos (tabagismo e etilismo, índice de massa corpórea (IMC, complicações com o tratamento, benefícios (melhora da dor e satisfação alimentar e sobrevivência. RESULTADOS: Os resultados quanto a qualidade de vida (satisfação alimentar, paliação da disfagia e dor foram melhores no grupo submetido à teleterapia associada a braquiterapia. A sobrevivência foi maior no grupo de teleterapia associada a braquiterapia. CONCLUSÃO: Apesar do índice de cura do câncer espinocelular do esôfago ser quase nulo quando tratado com irradiação isolada, esta terapêutica constitui-se em uma forma de tratamento paliativo para grande parte dos doentes em que existe contra-indicação cirúrgica.BACKGROUND: Squamous cell carcinoma of the esophagus is still a difficult tumor to treat with very poor prognosis. AIM: To compare the response to teletherapy treatment (external beam radiotherapy alone versus teletherapy combined with brachytherapy for patients with advanced squamous cell carcinoma of the esophagus. METHODS: Were studied 49

  7. Assessment of Gastroesophageal Reflux in Children(2-12 Month) Based on Clinical Findings and Ultrasonography

    OpenAIRE

    F Jassemi Zergani; R Farahi Rostami; F Hakim; Z Jannat Alipour; Karimi, K.; Z Fotokian

    2012-01-01

    Introduction: Gastroesophageal reflux is a common gastrointestinal disorder among infants, which can cause complications, such as esophagitis and Barrett's esophagus if its diagnosis and treatment are delayed. On the other hand, similarity of Gastro esophageal Reflux symptoms with symptoms of other childhood diseases makes its diagnosis and treatment difficult. So a proper tool for early screening and diagnostic test is essential. Methods: This study was conducted on 221 infants(2 to 12 month...

  8. Have patients with esophagitis got an increased risk of adenocarcinoma? Results from a population-based study

    Institute of Scientific and Technical Information of China (English)

    Seamus J Murphy; Lesley A Anderson; Brian T Johnston; Deirdre A Fitzpatrick; Peter RG Watson; Pauline Monaghan; Liam J Murray

    2005-01-01

    AIM: To examine an increased risk of esophageal adenocarcinoma is restricted to patients who develop Barrett's esophagus or whether esophagitis per se is a risk factor for adenocarcinoma.METHODS: A population-based cohort of patients with histological evidence of esophagitis without Barrett's esophagus was constructed using electronic pathology reports relating to all esophageal biopsies in Northern Ireland between 1993 and 1996. Person-years of followup and incident cases of esophageal cancer were calculated by linking the cohort to death files and the Northern Ireland Cancer Registry records. Standardized incidence ratios (SIR) were calculated for esophageal cancers (adenocarcinoma, squamous cell carcinoma (SCC), and histologically unspecified cancers).RESULTS: A total of 2 013 patients in the cohort provided 13 559 patient-years of follow-up (mean follow-up 6.7 years). None of the patients developed adenocarcinoma. Three patients developed SCC, and six developed histologically unspecified cancers. The SIR for all esophageal cancers and for SCC were 2.73 (95%CI 1.25-5.19) and 2.93 (95%CI 0.61-8.59), respectively. In a sensitivity analysis in which all unspecified esophageal cancers were treated as adenocarcinomas, the SIR for adenocarcinoma was 2.64 (0.97-5.75).CONCLUSION: The risk of adenocarcinoma is not elevated in patients with histological evidence of esophagitis without Barrett's esophagus; however, these patients may have a moderately increased risk of SCC.Further studies are required to confirm these findings,which suggest that Barrett's esophagus, not esophagitis,is the key precursor lesion in the development of adenocarcinoma.

  9. Decreased expression of GST pi is correlated with a poor prognosis in human esophageal squamous carcinoma

    OpenAIRE

    Wang Junsheng; Yang Guanrui; He Wei; Wang Zhihui; Wang Zhong; Nesland Jahn M; Holm Ruth; Suo Zhenhe

    2010-01-01

    Background Glutathione S-transferase pi (GST pi) is a subgroup of GST family, which provides cellular protection against free radical and carcinogenic compounds due to its detoxifying function. Expression patterns of GST pi have been studied in several carcinomas and its down-regulation was implicated to be involved in malignant transformation in patients with Barrett's esophagus. However, neither the exact role of GST pi in the pathogenesis nor its prognostic impact in squ...

  10. Long-term outcomes of trimodality treatment for squamous cell carcinoma of the esophagus with cisplatin and/or 5-FU. More than 20 years' experience at a single institution

    Energy Technology Data Exchange (ETDEWEB)

    Fakhrian, Khashayar [Ruhr-Universitaet Bochum, Department of Radiation Oncology, Marien Hospital Herne and Sankt Josef Hospital Bochum, Bochum (Germany); Technische Universitaet Muenchen, Department of Radiation Oncology, Klinikum rechts der Isar, Munich (Germany); Universitaetsklinikum der Ruhr-Universitaet Bochum, Klinik fuer Strahlentherapie und Radio-Onkologie, Marienhospital Herne, Herne (Germany); Ordu, Arif Deniz; Molls, Michael [Technische Universitaet Muenchen, Department of Radiation Oncology, Klinikum rechts der Isar, Munich (Germany); Lordick, Florian [University Clinic Leipzig, University Cancer Center Leipzig (UCCL), Leipzig (Germany); Technische Universitaet Muenchen, Department of Internal Medicine III (Hematology/Oncology), Munich (Germany); Theisen, Joerg [Technische Universitaet Muenchen, Department of Surgery, Klinikum rechts der Isar, Munich (Germany); Haller, Bernhard [Technische Universitaet Muenchen, Institute for Medical Statistics and Epidemiology, Klinikum rechts der Isar, Munich (Germany); Omrcen, Tomislav [Technische Universitaet Muenchen, Department of Radiation Oncology, Klinikum rechts der Isar, Munich (Germany); University Hospital Split, Center of Oncology and Radiotherapy, Split (Croatia); Nieder, Carsten [Department of Oncology and Palliative Medicine, Nordland Hospital Trust, Bodoe (Norway); University of Tromsoe, Institute of Clinical Medicine, Faculty of Health Sciences, Tromsoe (Norway); Geinitz, Hans [Technische Universitaet Muenchen, Department of Radiation Oncology, Klinikum rechts der Isar, Munich (Germany); Krankenhaus der Barmherzigen Schwestern Linz, Department of Radiation Oncology, Linz (Austria)

    2014-12-15

    The purpose of this article is to report the outcome of neoadjuvant radiochemotherapy (N-RCT) + surgery in patients with squamous cell carcinoma of the esophagus at a single institution. We retrospectively reviewed data from patients who were referred to our department for N-RCT. From 1988-2011, 103 patients were treated with N-RCT with cisplatin and/or 5-fluorouracil (5-FU). Group 1: (n = 55) from 1988-2006 with 39.6-40 Gy and 5-FU with (n = 17) or without cisplatin (n = 38). Group 2: from 2003-2010 with 44-45 Gy and 5-FU with (n = 40) or without cisplatin (n = 8). All patients underwent radical resection with reconstruction according to tumor location and 2-field lymph node dissection. The degree of histomorphologic regression was defined as grade 1a (pCR, 0 % residual tumor), grade 1b (pSTR, < 10 % residual tumor), grade 2 (10-50 % residual tumor), and grade 3 (> 50 % residual tumor). Median follow-up time from the start of N-RCT was 100 months (range 2-213 months). The median overall survival (OS) for the whole cohort was 42 months and the 5-year OS was 45 ± 5 %. In the multivariate analysis, worse ECOG performance status (p < 0.001), weight loss > 10 % before the start of the N-RCT (p = 0.025), higher pT category (p = 0.001), and grade 2/3 pathologic remission (p < 0.001) were significantly associated with a poor OS. PCR and pSTR rates for group 1 were 36 % and 18 % compared to 53 % and 22 % for group 2 (p = 0.011). There was a tendency for a better outcome in group 2 patients without statistical significance. The 5-year OS, disease-free survival and recurrent-free survival were 36 ± 7 %, 35 ± 6, and 36 ± 7 % for group 1 and 55 ± 7, 49 ± 7, and 53 ± 7 in group 2 (p = 0.117, p = 0.124, and p = 0.087). There was no significant difference between the two groups considering the postoperative morbidity and mortality. Higher radiation doses and more use of simultaneous cisplatin lead to higher pathologic response rates to N-RCT and may be associated with

  11. O esôfago curto e o refluxo distal são fatores de risco para o refluxo proximal? Short length of the esophagus and distal reflux are risk factors for proximal esophageal reflux?

    Directory of Open Access Journals (Sweden)

    Humberto Oliveira Serra

    2010-12-01

    Full Text Available RACIONAL: Não está claro se pacientes que apresentam refluxo gastroesofágico distal têm maior risco de apresentar também refluxo proximal. O senso comum sugere que um episódio de refluxo poderia chegar mais facilmente à faringe em pacientes que tivessem menor distância a percorrer entre o esfíncter inferior do esôfago e o superior. OBJETIVO: Investigar se o esôfago curto e a presença de refluxo esofágico distal são fatores de risco para refluxo proximal nos pacientes com sintomas respiratórios. MÉTODO: Cento e sete pacientes foram avaliados prospectivamente por meio de entrevista, esofagoscopia, manometria e pHmetria. Utilizaram-se o teste t de Student, o de correlação de Spearman, o do Qui-quadrado e odds-ratio. O nível de significância foi 0,05. RESULTADOS: Os sintomas que motivaram a investigação da doença do refluxo gastroesofágico foram: tosse 43 (40,2%; pigarro 25 (23,4%, globo faríngeo 23 (21,5% e rouquidão 16 (14,9%. No estudo endoscópico 22 apresentaram esofagite e 14 hérnia de hiato. Na avaliação manométrica 11 (10,8% apresentaram hipotonia do esfíncter inferior. A média do comprimento do esôfago foi 24,3 (± 1,9 cm, variando de 20 a 30 cm. Na avaliação pHmétrica 23 (21,5% apresentaram refluxo distal patológico e 12 (11,2% refluxo proximal. CONCLUSÕES: O comprimento do esôfago não esteve associado com a presença de refluxo proximal. Pacientes que apresentaram refluxo gatroesofágico distal, independente do comprimento do esôfago, tiveram risco aumentado de 4,6 vezes para apresentarem refluxo proximal.BACKGROUND: It is not clear whether patients suffering from distal esophageal reflux also present high risk to proximal esophageal reflux. Common sense suggests that reflux would more easily reach the pharynx in patients who have a smaller distance between the lower esophageal sphincter and the upper one and, thus, short esophagus. AIM: To Investigate if short esophageal length and presence of

  12. Design and validation of a near-infrared fluorescence endoscope for detection of early esophageal malignancy using a targeted imaging probe

    Science.gov (United States)

    Waterhouse, Dale J.; Joseph, James; Neves, Andre A.; di Pietro, Massimiliano; Brindle, Kevin M.; Fitzgerald, Rebecca C.; Bohndiek, Sarah E.

    2016-03-01

    Barrett's esophagus is a condition that predisposes patients to esophageal cancer. Early detection of cancer in these patients can be curative, but is confounded by a lack of contrast in white light endoscopy (WLE). Application of fluorescently-labeled lectins to the esophagus during endoscopy can more accurately delineate dysplasia emerging within Barrett's than WLE1, but strong tissue autofluorescence has limited sensitivity and dynamic range of this approach. To overcome this challenge, we synthesized a near-infrared (NIR) fluorescent lectin and have constructed a clinically translatable endoscope for simultaneous WLE and NIR imaging. An imaging fiber bundle, shielded from patient contact using a disposable catheter, relays collected light into an optical path that splits the WL reflectance and NIR emission onto two cameras for simultaneous video-rate recording. The captured images are co-registered and the honeycomb artifact arising from the fiber bundle is removed using interpolation between image points derived from individual fibers. A minimum detectable concentration of 110 nM was determined using a dilution series of IRDye800CW-lectin in black well plates. We have demonstrated the ability to use our endoscope to distinguish between different tissue types in ex vivo mouse stomachs. Future work using human ex vivo tissue specimens will determine safe illumination limits and sensitivity for dysplasia and adenocarcinoma in Barrett's esophagus, prior to commencing clinical trials.

  13. 放疗联合卡培他滨或顺铂治疗局部晚期食管癌临床研究%Clinical study on radiotherapy combined with xeloda or carboplatin in the treatment of locally advanced esophagus carcinoma

    Institute of Scientific and Technical Information of China (English)

    黄河澄; 林连兴; 罗何三; 吴盛喜

    2012-01-01

    目的 比较放疗联合卡培他滨与联合顺铂治疗局部晚期食管癌的疗效和毒副反应.方法 74例晚期食管癌患者随机分为两组,卡培他滨组(放疗联合卡培他滨)35例,于放疗开始时口服卡培他滨,500 mg/次,2次/d,至放疗结束;顺铂组(放疗联合顺铂)39例,于放疗开始第1天,每周静脉滴注顺铂20 mg/m2,共6次.分析比较两组疗效及毒副反应.结果 治疗结束后2个月时,卡培他滨组总有效率为91.4%,顺铂组总有效率为89.7%,两组差异无统计学意义(P>0.05);生存分析两组患者总生存率差异无统计学意义(P>0.05);卡培他滨组胃肠道反应、骨髓抑制及晚期放疗反应均较顺铂组轻(均P<0.05).结论 卡培他滨联合放疗和顺铂联合放疗治疗局部晚期食管癌疗效相当,但卡培他滨联合放疗毒副反应较轻,治疗耐受性较好,值得临床推广.%Objective To evaluate the effects and toxic side-effects of radiotherapy combined with xeloda or carboplatin respectively for locally advanced esophagus carcinoma.Methods 74 cases with locally advanced esophagus carcinoma were randomly allocated into two groups.One group received radiotherapy combined with Xeloda,500mg at a time,twice a day,taken orally from the beginning of radiotherapy till end of treatment.The second group received radiotherapy combined with Carboplatin by intravenous drip at 100mg a day,for 5 days,from the first week of radiotherapy.Results The overall response rate in the radiotherapy combined with Xeloda group was 91.4% and 89.7% in the radiotherapy combined with Carboplatin group.The difference between the two groups was not statistically significant(P >0.05 ).Kaplan-Meier survival analysis showed no statistically significant differences in survival between the two groups.The toxic side-effects of gastrointestinal tract,reaction myelosuppression and late radiation reaction were notably alleviated in the Xeloda group compared with the

  14. Inflammation-Related Carcinogenesis and Prevention in Esophageal Adenocarcinoma Using Rat Duodenoesophageal Reflux Models

    Energy Technology Data Exchange (ETDEWEB)

    Fujimura, Takashi, E-mail: tphuji@staff.kanazawa-u.ac.jp; Oyama, Katsunobu; Sasaki, Shozo; Nishijima, Koji; Miyashita, Tomoharu; Ohta, Tetsuo [Gastroenterologic Surgery, Kanazawa University Hospital, Kanazawa, Japan, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8641 (Japan); Koichi, Miwa [Houju Memorial Hospital, Nomi, Japan, 11-71 Midorigaoka, Nomi, Ishikawa 923-1226 (Japan); Takanori, Hattori [Division of Molecular and Diagnostic Pathology, Shiga University of Medical Science, Otsu, Japan, Seta Tsukinowa-cho, Otsu, Shiga 520-2192 (Japan)

    2011-08-10

    Development from chronic inflammation to Barrett's adenocarcinoma is known as one of the inflammation-related carcinogenesis routes. Gastroesophageal reflux disease induces regurgitant esophagitis, and esophageal mucosa is usually regenerated by squamous epithelium, but sometimes and somewhere replaced with metaplastic columnar epithelium. Specialized columnar epithelium, so-called Barrett's epithelium (BE), is a risk factor for dysplasia and adenocarcinoma in esophagus. Several experiments using rodent model inducing duodenogastroesophageal reflux or duodenoesophageal reflux revealed that columnar epithelium, first emerging at the proliferative zone, progresses to dysplasia and finally adenocarcinoma, and exogenous carcinogen is not necessary for cancer development. It is demonstrated that duodenal juice rather than gastric juice is essential to develop esophageal adenocarcinoma in not only rodent experiments, but also clinical studies. Antireflux surgery and chemoprevention by proton pump inhibitors, nonsteroidal anti-inflammatory drugs, selective cyclooxygenase-2 inhibitors, green tea, retinoic acid and thioproline showed preventive effects on the development of Barrett's adenocarcinoma in rodent models, but it remains controversial whether antireflux surgery could regress BE and prevent esophageal cancer in clinical observation. The Chemoprevention for Barrett's Esophagus Trial (CBET), a phase IIb, multicenter, randomized, double-masked study using celecoxib in patients with Barrett's dysplasia failed to prove to prevent progression of dysplasia to cancer. The AspECT (Aspirin Esomeprazole Chemoprevention Trial), a large multicenter phase III randomized trial to evaluate the effects of esomeprazole and/or aspirin on the rate of progression to high-grade dysplasia or adenocarcinoma in patients with BE is now ongoing.

  15. Ligation of the abdominal esophagus decreases scorpion toxin-induced gastric secretion in rats Ligadura do esôfago abdominal diminui a secreção gástrica induzida por toxina de escorpião em ratos

    Directory of Open Access Journals (Sweden)

    Claudia S. Vidal

    2004-06-01

    Full Text Available PURPOSE: Scorpion toxin purified from Tityus serrulatus venom (Tx induces an increase in volume, acidity and pepsin secretion in the gastric juice of rats. Ligation of oesophagus has been shown to reduce the acid gastric secretion in rats. The aim of this paper was to determine the influence of the esophageal ligation on gastric secretion induced by Tx in rats METHODS: Forty-four male albino rats were given water ad libitum, but no food for 20 to 24 hours, anesthetized with urethane and the trachea and jugular vein cannulated. Cervical or abdominal esophageal ligation or sham-operations were performed before and after the injection of 0.25 mg/kg of scorpion toxin (fraction T1 into the jugular vein. One hour later, the volume, acidity, pH and peptic activity of gastric juice were determined. RESULTS: The scorpion toxin induced an increase in gastric juice volume, acidity and pepsin output and a decrease in pH when injected into the vein of intact animals or in sham-operated animals. Cervical esophagus ligation did not interfere with the effects of toxin, however, ligation of the abdominal esophageal decreased the toxin effect on the rat stomach. CONCLUSION: Ligation of the abdominal esophagus decreases the gastric secretion induced by scorpion toxin.OBJETIVO: A toxina de escorpião purificada do veneno do escorpião Tityus serrulatus (Tx induz um aumento no volume, acidez e secreção de pepsina no suco gástrico de ratos. A ligadura do esôfago diminui a secreção ácida do estômago em ratos. O objetivo deste trabalho foi determinar a influência da ligadura do esôfago sobre a secreção gástrica induzida pela Tx em ratos. MÉTODOS: 44 ratos machos, brancos foram administrados água ad libitum, mas não alimentados por 20 a 24 horas, anestesiados com uretana e canulados a traquéia e a veia jugular. Foram realizadas as ligaduras do esôfago cervical ou abdominal ou operações simuladas antes e após a administração na veia jugular de 0

  16. Modelo experimental de fundoplicatura gastroesofágica em ratos: estudo manométrico e histológico do esôfago Experimental model of gastric-esophageal fundoplication in rats: manometric and histological study of the esophagus

    Directory of Open Access Journals (Sweden)

    Sérgio Luis Rocha

    2004-04-01

    Full Text Available OBJETIVO: O presente estudo objetiva avaliar alguns aspectos decorrentes da fundoplicatura em ratos, com técnica de Nissen, através da análise histológica do esôfago distal e estudo manométrico do esfíncter esofágico inferior (EEI, bem como da avaliação da variação do peso dos ratos submetidos ao procedimento, com diferentes dias de evolução. MÉTODOS: Utilizaram-se 70 ratos Wistar, machos, com idade entre 100 e 130 dias e peso entre 250 e 300 g, divididos em dois grupos. O grupo experimento foi composto por 60 ratos, subdivididos em 6 subgrupos de acordo com o tempo de aferição manométrica pós-operatória: 02, 07, 14, 21, 28 e 40 dias, e submetido a fundoplicatura com posterior análise manométrica do EEI e histológica do esôfago distal. O grupo controle foi composto pelos 10 animais restantes, submetido apenas a laparotomia com manipulação da região es��fago-gástrica, e realizaram-se as mesmas análises. RESULTADOS: Evidenciou-se na análise histológica, edema estatisticamente significativo (p=0,0000 nos subgrupos 02 e 07 dias, acompanhado de perda de peso. Observou-se significância estatística no estudo manométrico em todos os subgrupos comparados ao controle (p t c=+2,132. CONCLUSÃO: Após fundoplicatura de Nissen em ratos, a pressão no EEI não retorna aos níveis do controle até o 40º pós-operatório. O edema correlacionado à perda de peso e ao aumento da pressão no EEI pode ser a principal variável relacionada à possível disfagia.PURPOSE: The aim of this experimental study is to evaluate the outcomes of having Nissen fundoplication done on rats through the histological analysis of the distal esophagus and manometric study of the lower esophageal sphincter (LES, as well as the evaluation of weight variation of the rats subjected to this procedure, in distinct days after surgery. METHODS: Have been used 70 male Wistar rats, at the ages of 100 to 130 days , weighing from 250 to 300 grams and divided

  17. 充气毯术中保温对食管癌根治术患者细胞免疫功能的影响%Effect of forced-air warming system on cellular immune function during radical esophagus cancer resection

    Institute of Scientific and Technical Information of China (English)

    邱郁薇; 徐美英

    2011-01-01

    Objective To investigate the effect of forced-air warming system on the cellular immune function during radical esophagus cancer resection. Methods Thirty-six ASA Ⅰ or Ⅱ patients of both sexes, aged ≤ 64 yr, with body mass index < 30 kg/m2 , scheduled for elective radical esophagus cancer resection, were randomized to 2 groups ( n = 18 each): normal temperature care group (group C) and forced-air wanning group (group T) . Anesthesia was induced with midazolam, sufentanil, propofol and vecuronium. The patients were tracheal intubated and mechanically ventilated. The patients were not warmed intraoperatively in group C. In group T, the patients were prewarmed for 20 min at 43℃, using forced-air warming system before induction and then kept warm until the end of operation. The nasopharyngeal temperature was measured at 0, 30, 60, 120 and 180 min after anesthesia induction and at the end of operation (T1-6 ) to reflect the body temperature. Venous blood samples were taken at T1,6 for analysis of T-lymphocyte subsets (CD3+ , CD4+ , CD8+ , CD4+ /CD8+ ) and NK cells (by flow cytometry) and determination of the plasma concentrations of noradrenaline and adrenaline (by ELISA) . Results Compared with T1 , the body temperature was significantly decreased at T2-6 in group C, and the percentage of CD4+ cells and CD4+ /CD8+ ratio were significantly decreased and the percentage of CD8+ and plasma concentrations of noradrenaline and adrenaline increased at T6 in both groups ( P < 0.05). Compared with group C, the body temperature was significantly increased at T2-6, plasma concentrations of noradrenaline and adrenaline were significantly increased at T, , while the change rate of concentrations was significantly decreased in group T ( P < 0.05) . ConclusionThe efficiency of forced-air warming system in maintaining perioperative normothermia is good and it reduces the stress response, but it exerts no influence on the cellular immune function in patients undergoing

  18. Dilated intercellular spaces in subtypes of gastroesophagic reflux disease Dilatación de los espacios intercelulares en los subtipos de la enfermedad por reflujo gastroesofágico

    Directory of Open Access Journals (Sweden)

    J. C. Álvaro-Villegas

    2010-05-01

    Full Text Available Background: dilatation of the intercellular spaces by electron microscopy has been considered as an early morphological marker of tissue injury in gastroesophageal reflux disease. The degree of dilatation in Barrett's esophagus is currently unknown. Objectives: to determine the frequency of dilated intercellular spaces in Barrett's esophagus. Material and methods: cross-sectional and prospective analysis of consecutive patients with gastroesophageal reflux disease. We selected symptomatic patients > 18 years and both sexes. Patients with recent PPI use (Introducción: la dilatación de los espacios intercelulares mediante microscopia electrónica se considera un marcador morfológico temprano de daño tisular en la enfermedad por reflujo gastroesofágico. El grado de dilatación en el esófago de Barrett se desconoce actualmente. Objetivos: determinar la frecuencia y grado de la dilatación de los espacios intercelulares en el esófago de Barrett. Material y métodos: series de casos consecutivos con análisis transversal y prospectivo de pacientes con reflujo gastroesofágico. Criterios de selección: > 18 años, sintomáticos, ambos sexos. Se excluyeron aquellos con ingesta de IBP, antagonistas H-2, AINE y cirugía previa. Tomamos datos clínicos, cuestionario de Carlsson-Dent, endoscopia, pH-metría (no erosivos, y biopsias de la mucosa normal a 2 y 5 cm por encima de la unión escamo-columnar. La medición de la dilatación de los espacios intercelulares fue por microscopia electrónica. Estadística: descriptiva. Prueba de Chi-cuadrado con nivel de significancia de 0,05. Se compararon 4 grupos: a enfermedad por reflujo no erosiva (n = 14; b esofagitis erosiva (n = 5; c esófago de Barrett (n = 13; y d controles sanos (n = 5. Resultados: hubo mayor dilatación de los espacios intercelulares en el esófago de Barrett (5 cm, 2,72 ± 1,3 μm vs. 2 cm, 1,7 ± 0,48 μm (p = 0,001. Los otros grupos mostraron menor dilatación y sin diferencias

  19. Esophageal replacement in children: Challenges and long-term outcomes

    Science.gov (United States)

    Soccorso, Giampiero; Parikh, Dakshesh H.

    2016-01-01

    Replacement of a nonexistent or damaged esophagus continues to pose a significant challenge to pediatric surgeons. Various esophageal replacement grafts and techniques have not produced consistently good outcomes to emulate normal esophagus. Therefore, many techniques are still being practiced and recommended with no clear consensus. We present a concise literature review of the currently used techniques and with discussions on the advantages and anticipated morbidity. There are no randomized controlled pediatric studies to compare different types of esophageal replacements. Management and graft choice are based on geographical and personal predilections rather than on any discernible objective data. The biggest series with long-term outcome are reported for gastric transposition and colonic replacement. Comparison of different studies shows no significant difference in early (graft necrosis and anastomotic leaks) or late complications (strictures, poor feeding, gastro-esophageal reflux, tortuosity of the graft, and Barrett's esophagus). The biggest series seem to have lower complications than small series reflecting the decennials experience in their respective centers. Long-term follow-up is recommended following esophageal replacement for the development of late strictures, excessive tortuosity, and Barrett's changes within the graft. Once child overcomes initial morbidity and establishes oral feeding, long-term consequences and complications of pediatric esophageal replacement should be monitored and managed in adult life. PMID:27365900

  20. Endoscopic mucosal resection for proximal superficial lesions: efficacy and safety study in 59 consecutive resections Resección endoscópica mucosa de lesiones superficiales altas: estudio de su eficacia y seguridad en 59 resecciones consecutivas

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    Eduardo Albéniz-Arbizu

    2012-09-01

    Full Text Available Introduction: endoscopic mucosal resection is an accepted technique for the treatment of proximal gastrointestinal tract superficial lesions. Objectives: to evaluate the efficacy and safety of this procedure in the proximal gastrointestinal tract. Material and methods: forty one consecutive patients (23 males and 18 females, mean age of 61 ± 11.5 years were included in our study. Fifty nine resections were performed in these patients in 69 sessions. Lesions treated consisted of elevated lesions with high grade dysplasia in the context of Barrett's esophagus (group A, high grade dysplasia appearing in random biopsies taken during the follow-up of Barrett's esophagus (group B and superficial gastroduodenal lesions (group C. Snare resection after submucosal injection, band ligator-assisted or cap-assisted mucosal resection were the chosen techniques. Results: we resected 7 elevated lesions with high grade dysplasia in the context of Barrett's esophagus, 6 complete Barrett's esophagus with high grade dysplasia in 16 sequential sessions and 46 gastroduodenal superficial lesions (10 adenomas, 9 gastric superficial carcinomas, 18 carcinoid tumours and 9 lesions of different histological nature. Resections in the two first groups were complete in 100% of the cases, and in 97.9% of the cases in group C. Complications included 2 cases of limited deferred bleeding (groups A and B and another two cases of stenosis with little clinical relevance in Group B. Conclusions: a endoscopic mucosal resection is an efficient technique for the treatment of proximal gastrointestinal tract superficial lesions; b it is a safe procedure with a low percentage of complications, which can generally be managed endoscopically; and c in contrast with other ablative techniques, endoscopic mucosal resection offers the possibility of a pathologic analysis of the samples.Introducción: la resección endoscópica mucosa es una técnica aceptada en el tratamiento de lesiones

  1. Radiation Dose-Volume Effects in the Esophagus

    International Nuclear Information System (INIS)

    Publications relating esophageal radiation toxicity to clinical variables and to quantitative dose and dose-volume measures derived from three-dimensional conformal radiotherapy for non-small-cell lung cancer are reviewed. A variety of clinical and dosimetric parameters have been associated with acute and late toxicity. Suggestions for future studies are presented.

  2. Gastric and esophagus events before and during treatment of osteoporosis

    DEFF Research Database (Denmark)

    Vestergaard, Peter; Schwartz, Kristoffer; Pinholt, Else Marie;

    2009-01-01

    patients on a wide range of drugs against osteoporosis both before and after initiation of these drugs. We studied a nationwide register-based cohort from Denmark with all users of drugs against osteoporosis between 1996 and 2006 (n = 103,562) as cases and three age- and sex-matched controls from the...... against osteoporosis are associated with an increased risk of esophagitis, esophageal ulcers, esophageal perforation, and gastroduodenal ulcers. However, the increase was already present before initiation of the drug for several types of drugs against osteoporosis. This points at an effect of the...... underlying condition being treated or comorbid conditions and drugs being provided in patients with osteoporosis, such as nonsteroidal anti-inflammatory drugs and corticosteroids....

  3. Radionuclide examination of motility disorders of the esophagus

    International Nuclear Information System (INIS)

    The scintigraphic results in relation to manometry obtained for normal subjects and patients with achalasia, diffuse esophageal spasm, systemic connective tissue diseases with esophageal involvement and reflux esophagitis are reported and discussed. In 17 patients with reflux esophagitis no relation could be found between the endoscopic grading and the persistence of activity in one or more regions of interest. Four out of 23 patients with abnormal results of a 24-h pH study and a normal manometry had abnormal results of a radionuclide study. This supports but does not prove the view of Russell et al. that radionuclide studies are more sensitive than manometry. A plea is made to study a larger group of patients using the same definitions and methods. 13 refs.; 5 figs.; 3 tabs

  4. Laryngopharyngeal reflux COPD to uncover reflux and columnar lined esophagus

    OpenAIRE

    Kristo I; Riegler M; Schoppmann SF

    2015-01-01

    Ivan Kristo, Martin Riegler, Sebastian F Schoppmann Upper-GI-Service, Gastroesophageal Tumor Unit, Department of Surgery, Comprehensive Cancer Center, Medical University of Vienna, Vienna, AustriaWith interest we read the article by Jung et al1 published in the recent issue of the International Journal of Chronic Obstructive Pulmonary Disease. An important finding of the study was the positive correlation between symptoms of gastroesophageal reflux disease (GERD), endoscopic signs for laryng...

  5. Standardized pathologic evaluation of the esophagus after neoadjuvant chemoradiation

    NARCIS (Netherlands)

    Muijs, Christina T.; Smit, Justin K.; Karrenbeld, Arend; Beukema, Jannet C.; Langendijk, Johannes A.; Plukker, John Theodorus

    2012-01-01

    Background: The main objective of this study was to develop and validate a method to reconstruct the gross and clinical tumor volume (GTV and CTV) on the esophageal specimen in order to facilitate a good pathologic examination of the original tumor area after neo-adjuvant chemoradiation (CRT). Metho

  6. Foriegn Bodies of the Tracheobronchial tree and Esophagus

    Directory of Open Access Journals (Sweden)

    A. DALIL-TOJARI

    1975-01-01

    Full Text Available Report of 850 cases of foreign bodies in the air and food passages is presented. The incidence of the accident was more in children between the age of 1-6 years than others. No sex difference was noted for the incidence of the accident The presence of leech as a foreign body in this report is of interest General anesthesia is recommended in the case that foreign bodies are present in the air way of children. In these cases bronchoscopy, with oxygenation by insuflation in brochoscope or Ventury 50 or other similar techniques is recommended.

  7. Intramural injection with botulinum toxin significantly elongates the pig esophagus

    DEFF Research Database (Denmark)

    Larsen, Heidi Fhær; Jensen, Thorbjørn Søren Rønn; Rasmussen, Lars;

    2013-01-01

    Surgical treatment of long-gap esophageal atresia (LGEA) is challenging. Methods which facilitate stretching of the esophageal pouches may allow primary anastomosis. Botulinum toxin type A (BTX-A) blocks acetylcholine release in neuromuscular junctions, thereby causing muscle relaxation. We...

  8. Neurologic and neuromuscular functional disorders of the pharynx and esophagus

    International Nuclear Information System (INIS)

    Neurologic swallowing disorders are an increasing diagnostic problem in our overaged population. Undiagnosed chronic aspiration pneumonia is the cause of death in 20-40% of all inhabitants of nursing homes. In neurologic diseases of the pharynx, the physiologic interaction of pharyngeal contraction, closure of the pharynx, and esophageal motility are frequently disturbed. This may be due to cortical, bulbar, or cerebellar brain damage of ischemic or traumatic origin. Furthermore diseases or peripheral nerves, muscles, and synapses cause disturbances. The most life-threatening complication of these disturbances is tracheal aspiration, which requires an iso-osmolar contrast medium for imaging studies that cause no or minimal pulmonary problems. Utilizing fast dynamic documentation we can analyze the swallowing act in 35 images within the passage time of 0.7 s. This requires digital frame sequences from 15-50 images/s, which can be provided by DSI or videofluoroscopy. Neurologic and neuromuscular patterns are demonstrated with and without tracheal aspiration. The differentiation of aspiration in a so-called pre-, intra-, and postdeglutitive form is possible. We distinguish four grades of severity of aspiration, which is also of great clinical impact for the differential rehabilitation therapy. The efficiency of the rehabilitation protocol can be assessed by the dynamic swallowing studies. (orig.)

  9. What You Need to Know about Cancer of the Esophagus

    Science.gov (United States)

    ... type Progress Annual Report to the Nation Cancer Portfolio Snapshots Milestones in Cancer Research & Discovery Stories of ... Editorial Board Integrative Therapies Editorial Board Levels of Evidence Levels of Evidence: Treatment Levels of Evidence: Supportive & ...

  10. A Rare Case of Malignant Glomus Tumor of the Esophagus

    Directory of Open Access Journals (Sweden)

    Gurvinder Singh Bali

    2013-01-01

    Full Text Available Glomus tumors are rare neoplasms that usually occur on the hands in a subungual location, or sometimes in palms, wrists or soles of the feet. They are described as purple/pink tiny painful lesions with a triad of pain, local point tenderness, and cold hypersensitivity. They are almost always benign, but rare malignant variants have been reported. They have also been reported to be present at unusual locations, like the lung, stomach, or liver. Gastrointestinal glomus tumors are extremely rare tumors and very few cases have been reported in the literature. Most that have been reported were usually benign in nature. A rare esophageal glomangioma, mimicking a papilloma, was reported in 2006. We report a case of glomangiosarcoma (malignant glomus tumor in a 49-year-old female, who presented with symptoms of dysphagia including some spasm and hoarseness and subjective unintentional weight loss. On endoscopic exam, she was found to have a distal esophageal mass with malignant features. Radiologically, the mass had a size of about 8 cm on the CT scan without evidence of metastases. Pathology and immunostaining of the biopsy showed features resembling a malignant glomus tumor. She underwent an endoscopic and laparoscopic staging of the tumor along with ultrasound. Based on the laparoscopic findings, which were consistent with the preoperative diagnosis, she was scheduled for an esophagectomy. Histopathology and immunophenotypic features of the excised mass were consistent with a diagnosis of malignant glomus tumor.

  11. THE ROLE OF ANTS ESOPHAGUS IN THE TROPHALLAXIS (FORMICIDAE

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    FLAVIO HENRIQUE CAETANO

    2006-01-01

    Full Text Available Trophallaxis is widely disseminated among social Hymenoptera and the crop is considered to be the region of the digestive tract responsible for food pumping from one insect to another. In the present study, however, the crop has been found to be a simple reservoir since its musculture does not correspond the function attributed to the structure. The behaviour of the digestive tract on the basis of ultramorphology has been dealt with in detail.

  12. Real time video processing software for the analysis of endoscopic guided-biopsies

    Science.gov (United States)

    Ordoñez, C.; Bouchet, A.; Pastore, J.; Blotta, E.

    2011-12-01

    The severity in Barrett esophagus disease is, undoubtedly, the possibility of its malignization. To make an early diagnosis in order to avoid possible complications, it is absolutely necessary collect biopsies to make a histological analysis. This should be done under endoscopic control to avoid mucus areas that may co-exist within the columnar epithelial, which could lead to a false diagnosis. This paper presents a video processing software in real-time in order to delineate and enhance areas of interest to facilitate the work of the expert.

  13. Metanálise sobre o uso de glicocorticóides pré-operatório para redução do risco de complicações após esofagectomia por carcinoma do esôfago Use of preoperative glucocorticoid to risk reduction of complications after esophagectomy by esophagus carcinoma: meta-analysis

    Directory of Open Access Journals (Sweden)

    Antônio Marcos Raimondi

    2006-12-01

    of incomplete knowledge regarding its effectiveness. The aim here was to assess the effects of preoperative glucocorticoid administration in adults undergoing esophageal resection for esophageal carcinoma. METHODS: Studies were identified by searching the Cochrane Controlled Trials Register, MEDLINE, EMBASE, CancerLit, SCIELO and Cochrane Library, and by manual searching from relevant articles. The last search for clinical trials for this systematic review was performed in December 2005. This review included randomized studies of patients with potentially resectable carcinomas of the esophagus that compared preoperative glucocorticoid administration with placebo. Data were extracted by the reviewer, and the trial quality was assessed using Jadad scoring. Odds ratio with 95% confidence limits and bayesian relative risk were used to assess the significance of the difference between the treatment arms. RESULTS: Four randomized trials involving 169 patients were found. There were no differences in postoperative mortality, anastomotic leakage, hepatic and renal failure between the glucocorticoid and placebo groups. There were fewer postoperative respiratory complications (95% CI = 0.09-0.46, sepsis (95% CI = 0.10-0.81, and total postoperative complications (95% CI = 0.06-0.23 with preoperative glucocorticoid administration. CONCLUSIONS: Prophylactic administration of glucocorticoids is associated with decreased postoperative complications.

  14. Metanálise sobre o uso de glicocorticóide pré-operatório para redução do risco de complicações após esofagectomia por carcinoma do esôfago Use of preoperative glucocorticoid to reduce risk of complications after esophagectomy for carcinoma of the esophagus: meta-analysis

    Directory of Open Access Journals (Sweden)

    Antônio Marcos Raimondi

    2007-04-01

    systematic review, the last search for clinical trials was performed in December 2005. This review included randomized studies of patients with potentially resectable carcinomas of the esophagus that compared preoperative glucocorticoid administration with placebo. Data were collected by the reviewer, and quality of the trial was assessed using Jadad scoring. Odds ratio with 95% confidence intervals was used to assess the significance of the difference between treatment arms. RESULTS. Four randomized trials involving 169 patients were found. There were no differences in postoperative mortality, anastomotic leakage, hepatic and renal failure between the glucocorticoid and placebo groups. There were fewer postoperative respiratory complications (95% CI= 0.09-0.46, sepsis (95% CI= 0.10-0.81, and total postoperative complications (95% CI=0.06-0.23 with preoperative glucocorticoid administration. CONCLUSION. Prophylactic administration of glucocorticoids is associated with decreased postoperative complications.

  15. 整合素受体和细胞穿膜肽共修饰紫杉醇脂质体抑制食管癌Ec9706细胞的研究%The Inhibition Effect of RGD and R8 Co-modified Paclitaxel Loaded Liposome on the Esophagus Carcinoma EC9706 Cells

    Institute of Scientific and Technical Information of China (English)

    吕行; 印滇

    2014-01-01

    RGD/R8-LP-PTX was evaluated by MTT assay. Tumor spheroids were used to evaluate anti-tumor ability of RGD/R8-LP-PTX in vitro. Results:The particle diameter of the co-modified liposome was 124. 8 ± 9. 4 nm with the Zeta potential of 21. 35 ± 3. 55mV. The uptake of the RGD/R8-LP by Ec9706 cells and the prolif-eration inhibition rate of RGD/R8-LP-PTX to Ec9706 cells were both found in a time-dependent manner. The result demon-strated that the co-modified liposome uptaken by EC9706 were 2. 1, 2. 6 times higher than that of R8-LP and RGD-LP, re-spectively. The MTT assay demonstrated the cell viability of R8-LP-PTX,RGD-LP-PTX and LP-PTX were 1. 6, 1. 7 and 2. 2 times higher than that of RGD/R8-LP-PTX respectively. Tumor spheroids continued to grow in size and volume in saline 148% of the primary volume while the tumor spheroid volumes changed into nearly 36%, 59% and 64% of the original volumes when treated with R8-LP-PTX,RGD-LP-PTX and LP-PTX respectively(P<0. 01). Conclusion: The RGD/R8-LP-PTX can penetrate the tumor cell membrane effectively ,it might serve as a promising delivery system of antitumor drugs against esophagus carcinoma.

  16. Description of the technique of upper gastrointestinal series radiological examination for the evaluation of the esophagus, stomach and duodenum of Wistar female rats Descrição de técnica radiológica contrastada de esôfago, estômago e duodeno em ratas Wistar

    Directory of Open Access Journals (Sweden)

    João Vicente Machado Grossi

    2009-12-01

    Full Text Available PURPOSE: To evaluate the anatomy of female Wistar rats and the workability of contrast radiography as a technique to investigate the gastrointestinal series. METHODS: Eight adult female Wistar rats were undergone to the contrast radiography as anteroposterior incidence and as posterior incidence in profile. The radiological examination was conducted at a 45° angle to the radiological table. Film-focus distance (FFD was 100 cm, film-object distance (FOD was 0 cm, and object-focus distance (OFD was 100 cm. An orogastric probe was used to inject barium contrast at 5-min intervals, for a total of four applications. After the radiological examination, animals were necropsy for confirmation of the radiological findings, and the radiographs were the absence of the normal anatomy variations inspected and described by an experienced radiologist. RESULTS: All the radiographs produced achieved satisfactory results in terms of position, exposure, location and quality. The upper esophageal sphincter (UES was identified in the esophagus at the nerve C2, the lower esophageal sphincter (LES was identified between spinal cord segments L1 and L2, the thoracic-abdominal junction was observed at T10, the esophageal-gastric junction (EGJ at T13-L1, with the abdominal portion in the epigastric region. The stomach was observed mostly in the epigastric region, left hypochondrium, left and mesogastric flank. The duodenum findings presented higher variation, with most findings identified in the epigastric region, right hypochondrium, right flank and mesogastric ileal fossa at T13-L5. CONCLUSION: Contrast radiology is useful and may be employed to assess the anatomy of the animal being studied. The experimental model described afforded to fully identify all organs investigated, as well as other occasional relevant findings. No anatomical anomalies in the subsequent necropsy, confirming the radiographic findings.OBJETIVO: Avaliar a anatomia normal de ratas Wistar e a

  17. Downregulation of p63 upon exposure to bile salts and acid in normal and cancer esophageal cells in culture.

    Science.gov (United States)

    Roman, Sabine; Pétré, Aurélia; Thépot, Amélie; Hautefeuille, Agnès; Scoazec, Jean-Yves; Mion, François; Hainaut, Pierre

    2007-07-01

    p63 is a member of the p53 protein family that regulates differentiation and morphogenesis in epithelial tissues and is required for the formation of squamous epithelia. Barrett's mucosa is a glandular metaplasia of the squamous epithelium that develops in the lower esophagus in the context of chronic, gastroesophageal reflux and is considered as a precursor for adenocarcinoma. Normal or squamous cancer esophageal cells were exposed to deoxycholic acid (DCA, 50, 100, or 200 microM) and chenodeoxycholic and taurochenodeoxycholic acid at pH 5. p63 and cyclooxygenase-2 (COX-2) expressions were studied by Western blot and RT-PCR. DCA exposure at pH 5 led to a spectacular decrease in the levels of all isoforms of the p63 proteins. This decrease was observed within minutes of exposure, with a synergistic effect between DCA and acid. Within the same time frame, levels of p63 mRNA were relatively unaffected, whereas levels of COX-2, a marker of stress responses often induced in Barrett's mucosa, were increased. Similar results were obtained with chenodeoxycholic acid but not its taurine conjugate at pH 5. Proteasome inhibition by lactacystin or MG-132 partially blocked the decrease in p63, suggesting a posttranslational degradation mechanism. These results show that combined exposure to bile salt and acid downregulates a critical regulator of squamous differentiation, providing a mechanism to explain the replacement of squamous epithelium by a glandular metaplasia upon exposure of the lower esophagus to gastric reflux. PMID:17615180

  18. Photodynamic therapy--1994: treatment of benign and malignant upper aerodigestive tract disease

    Science.gov (United States)

    Schweitzer, Vanessa G.

    1995-03-01

    From 1983 to 1994 Phase II and III clinical studies at Henry Ford Hospital demonstrated complete or partial responses in 46 of 47 patients treated with hematoporphyrin-derivative photodynamic therapy (HPD-PDT) for a variety of benign and malignant upper aerodigestive tract disease: (1) superficial `condemned mucosa' or `field cancerization' of the oral cavity; (2) stage III/IV head and neck cancer; (3) mucocutaneous AIDS-related Kaposi's sarcoma of the upper aerodigestive tract; (4) recurrent laryngotracheal papillomatosis; (5) severe dysplasia/adenocarcinoma in situ in Barrett's esophagus; (6) partial or completely obstructing terminal esophageal cancer. HPD-PDT produced complete responses in 19 patients (follow up 6 months to 8 years) with `field cancerization' (CIS, T1) of the oral cavity and larynx (6), adenocarcinoma in situ in Barrett's esophagus (2), mucocutaneous Kaposi's sarcoma (9), obstructing esophageal carcinoma (1), and stage IV squamous cell carcinoma of the nasopharynx (1). PDT treatment protocols, results, complications, and application as adjunct or primary oncologic therapy for head and neck disease are reviewed.

  19. Hematoporphyrin-mediated photodynamic therapy for treatment of head and neck cancer: clinical update 1996

    Science.gov (United States)

    Schweitzer, Vanessa G.

    1996-04-01

    From 1983 to 1996 Phase II and III clinical studies at Henry Ford Hospital demonstrated complete or partial responses in 55 of 56 patients treated with hematoporphyrin-derivative or PHOTOFRIN-mediated photodynamic therapy (HPD-PDT) for a variety of benign and malignant upper aerodigestive tract disease: (1) superficial 'condemned mucosa' or 'field cancerization' of the oral cavity and larynx (7 cases); (2) Stage III/IV head and neck cancer (25 cases); (3) mucocutaneous AIDS-associated Kaposi's sarcoma of the upper aerodigestive tract and non AIDS-related Kaposi's sarcoma of the lower extremity (15 cases); (4) recurrent laryngotracheal papillomatosis (3 cases); (5) severe dysplasia/adenocarcinoma or squamous cell carcinoma in situ in Barrett's esophagus (4 cases); (6) partial or completely obstructing terminal esophageal cancer (9 cases). At the time of this report, HPD-PDT produced complete responses in 24 patients (follow up 6 months to 9 years) with 'field cancerization' (CIS, T1N0M0) of the oral cavity and larynx (6 cases), adenocarcinoma in situ in Barrett's esophagus (3 cases), mucocutaneous Kaposi's sarcoma (12 cases), obstructing esophageal carcinoma (1 case), and stage IV squamous cell carcinoma of the nasopharynx (1 case), and radiation therapy or solar-induced basal cell/squamous cell carcinomas (2 cases). PDT treatment protocols, results, complications, and application as adjunct or primary oncologic therapy for head and neck cancer are reviewed in this article.

  20. One hundred years of electricity supply - from Calder and Barrett to Calder Hall

    International Nuclear Information System (INIS)

    A history of electricity supply is presented. The first supply being from a hydroelectric station in Godalming, followed by a few months later in January 1882 by the first steam generating plant at Holborn Viaduct. The choice of AC over DC is discussed. Mention is made of the generation of electricity from nuclear sources by EPRI and by the first commercial nuclear station Calder Hall. (author)

  1. Preliminary Image Map of the 2007 Harris Fire Perimeter, Barrett Lake Quadrangle, San Diego County, California

    Science.gov (United States)

    Clark, Perry S.; Scratch, Wendy S.; Bias, Gaylord W.; Stander, Gregory B.; Sexton, Jenne L.; Krawczak, Bridgette J.

    2008-01-01

    In the fall of 2007, wildfires burned out of control in southern California. The extent of these fires encompassed large geographic areas that included a variety of landscapes from urban to wilderness. The U.S. Geological Survey National Geospatial Technical Operations Center (NGTOC) is currently (2008) developing a quadrangle-based 1:24,000-scale image map product. One of the concepts behind the image map product is to provide an updated map in electronic format to assist with emergency response. This image map is one of 55 preliminary image map quadrangles covering the areas burned by the southern California wildfires. Each map is a layered, geo-registered Portable Document Format (.pdf) file. For more information about the layered geo-registered .pdf, see the readme file (http://pubs.usgs.gov/of/2008/1029/downloads/CA_Agua_Dulce_of2008-1029_README.txt). To view the areas affected and the quadrangles mapped in this preliminary project, see the map index (http://pubs.usgs.gov/of/2008/1029/downloads/CA_of2008_1029-1083_index.pdf) provided with this report.

  2. Endoscopic Ablation Therapy for Barrett's Oesophagus. A Clinicopathologic Study on Efficacy

    NARCIS (Netherlands)

    M. Hage (Mariska)

    2005-01-01

    textabstractSince Barrett’s oesophagus is a major risk factor for developing oesophageal adenocarcinoma, most centres have implemented endosocopic biopsy surveillance programs to detect precursor stages of adenocarcinoma (i.e. low grade dysplasia (LGD) and high grade dysplasia (HGD)). There is mu

  3. Endoscopic Ablation Therapy for Barrett's Oesophagus. A Clinicopathologic Study on Efficacy

    OpenAIRE

    Hage, Mariska

    2005-01-01

    textabstractSince Barrett’s oesophagus is a major risk factor for developing oesophageal adenocarcinoma, most centres have implemented endosocopic biopsy surveillance programs to detect precursor stages of adenocarcinoma (i.e. low grade dysplasia (LGD) and high grade dysplasia (HGD)). There is much interest in non-invasive, low-risk, ablative techniques that can eliminate precursor stages or early invasive cancer, since oesophagectomy, mostly performed once HGD or invasive cancer has develope...

  4. Association of esophageal inflammation, obesity and gastroesophageal reflux disease: from FDG PET/CT perspective.

    Directory of Open Access Journals (Sweden)

    Yen-Wen Wu

    Full Text Available OBJECTIVE: Gastroesophageal reflux disease (GERD is associated with bothersome symptoms and neoplastic progression into Barrett's esophagus and esophageal adenocarcinoma. We aim to determine the correlation between GERD, esophageal inflammation and obesity with 18F-Fluorodeoxyglucose (FDG positron emission tomography/computed tomography (PET/CT. METHODS: We studied 458 subjects who underwent a comprehensive health check-up, which included an upper gastrointestinal endoscopy, FDG PET/CT and complete anthropometric measures. GERD symptoms were evaluated with Reflux Disease Questionnaire. Endoscopically erosive esophagitis was scored using the Los Angeles classification system. Inflammatory activity, represented by standardized uptake values (SUVmax of FDG at pre-determined locations of esophagus, stomach and duodenum, were compared. Association between erosive esophagitis, FDG activity and anthropometric evaluation, including body mass index (BMI, waist circumference, visceral and subcutaneous adipose tissue volumes were analyzed. RESULTS: Subjects with erosive esophagitis (n = 178, 38.9% had significantly higher SUVmax at middle esophagus (2.69±0.74 vs. 2.41±0.57, P<.001 and esophagogastric junction (3.10±0.89 vs. 2.38±0.57, P<.001, marginally higher at upper esophageal sphincter (2.29±0.42 vs. 2.21±0.48, P = .062, but not in stomach or duodenum. The severity of erosive esophagitis correlated with SUVmax and subjects with Barrett's esophagus had the highest SUVmax at middle esophagus and esophagogastric junction. Heartburn positively correlated with higher SUVmax at middle oesophagus (r = .262, P = .003. Using multivariate regression analyses, age (P = .027, total cholesterol level (P = .003, alcohol drinking (P = .03, subcutaneous adipose tissue (P<.001, BMI (P<.001 and waist circumference (P<.001 were independently associated with higher SUVmax at respective esophageal locations. CONCLUSIONS: Esophageal

  5. Automated segmentation and characterization of esophageal wall in vivo by tethered capsule optical coherence tomography endomicroscopy.

    Science.gov (United States)

    Ughi, Giovanni J; Gora, Michalina J; Swager, Anne-Fré; Soomro, Amna; Grant, Catriona; Tiernan, Aubrey; Rosenberg, Mireille; Sauk, Jenny S; Nishioka, Norman S; Tearney, Guillermo J

    2016-02-01

    Optical coherence tomography (OCT) is an optical diagnostic modality that can acquire cross-sectional images of the microscopic structure of the esophagus, including Barrett's esophagus (BE) and associated dysplasia. We developed a swallowable tethered capsule OCT endomicroscopy (TCE) device that acquires high-resolution images of entire gastrointestinal (GI) tract luminal organs. This device has a potential to become a screening method that identifies patients with an abnormal esophagus that should be further referred for upper endoscopy. Currently, the characterization of the OCT-TCE esophageal wall data set is performed manually, which is time-consuming and inefficient. Additionally, since the capsule optics optimally focus light approximately 500 µm outside the capsule wall and the best quality images are obtained when the tissue is in full contact with the capsule, it is crucial to provide feedback for the operator about tissue contact during the imaging procedure. In this study, we developed a fully automated algorithm for the segmentation of in vivo OCT-TCE data sets and characterization of the esophageal wall. The algorithm provides a two-dimensional representation of both the contact map from the data collected in human clinical studies as well as a tissue map depicting areas of BE with or without dysplasia. Results suggest that these techniques can potentially improve the current TCE data acquisition procedure and provide an efficient characterization of the diseased esophageal wall. PMID:26977350

  6. Prevention of PDT-induced esophageal stricture by MnSOD-PL gene therapy

    International Nuclear Information System (INIS)

    Photodynamic Therapy (PDT) is currently being used to treat esophageal cancer and Barrett's esophagus. PDT is very promising except that it results in a high rate of esophageal stricture. The clinical protocol involves the injection of Photofrin into the patient followed 48 hours later with a laser treatment of 630 nm of light. At this wavelength Photofrin reacts with the light and results in production of reactive oxygen species (ROS) in the mitochondria. To determine if MnSOD-PL prevents esophageal stricture we developed a pig model. Pigs (20 kg outbred female) were injected intravenously with Photofrin (2 mg/kg) and an endoscope was placed into the esophagus where MnSOD-PL (10 mg plasmid DNA) was administered at the site of PDT treatment. Control pigs received Photofrin only. Twenty-four hours later an endoscope was placed into the esophagus and the laser inserted through the endoscope to 10 cm above the GE junction where 400 Joules of light were administered to the esophagus. A second PDT treatment of 400 Joules was given 48 hours later. The pigs were followed for development of esophageal stricture as determined by a 10% weight loss, an endoscopic exam demonstrating esophageal stricture, and an x-ray following barium swallow. Upon detection of esophageal stricture, the pigs were sacrificed. The esophagus was removed and pathological examination performed. By 14-21 days all control pigs developed esophageal stricture while pigs receiving MnSOD-PL had a prolonged survival for at least 6 weeks after injection of MnSOD-PL. At this time, the MnSOD-PL-injected pigs were sacrificed. The esophagus was removed from each animal and examined for the development of esophageal stricture. No esophageal stricture was detected by x-ray following barium swallow, endoscopic exam or pathological examination in esophagus samples from MnSOD-PL treated pigs. Results of these experiments demonstrate that MnSOD-PL may be effective in preventing normal esophageal tissue damage by PDT

  7. Esophageal scintigraphy: Applications and limitations in the study of esophageal disorders

    Energy Technology Data Exchange (ETDEWEB)

    O' Connor, M.K.; Byrne, P.J.; Keeling, P.; Hennessy, T.P.

    1988-06-01

    This study examines the scintigraphic transit pattern in a variety of esophageal disorders. Scintigraphy was performed with a semi solid bolus and the patient in an upright position. Condensed esophageal images were obtained from which we derived the esophageal transit time. The pattern of bolus transit was graded by the duration of transit and by the presence of hold up or retrograde motion. Scintigrams were performed in 11 volunteers and 88 patients whose esophageal function had been confirmed by conventional gastroesophageal techniques. Esophageal disorders examined included achalasia, scleroderma, esophageal carcinoma, Barrett esophagus, and reflux esophagitis. We also examined the effects of gastroesophageal surgery on esophageal function. Transit times distinguished grossly abnormal esophageal function from normal but did not distinguish between different esophageal disorders. Graded transit patterns were a more sensitive indicator of esophageal function and permitted some differentiation between esophageal disorders and allowed evaluation of the effects of gastroesophageal surgery.

  8. Esophageal scintigraphy: Applications and limitations in the study of esophageal disorders

    International Nuclear Information System (INIS)

    This study examines the scintigraphic transit pattern in a variety of esophageal disorders. Scintigraphy was performed with a semi solid bolus and the patient in an upright position. Condensed esophageal images were obtained from which we derived the esophageal transit time. The pattern of bolus transit was graded by the duration of transit and by the presence of hold up or retrograde motion. Scintigrams were performed in 11 volunteers and 88 patients whose esophageal function had been confirmed by conventional gastroesophageal techniques. Esophageal disorders examined included achalasia, scleroderma, esophageal carcinoma, Barrett esophagus, and reflux esophagitis. We also examined the effects of gastroesophageal surgery on esophageal function. Transit times distinguished grossly abnormal esophageal function from normal but did not distinguish between different esophageal disorders. Graded transit patterns were a more sensitive indicator of esophageal function and permitted some differentiation between esophageal disorders and allowed evaluation of the effects of gastroesophageal surgery. (orig.)

  9. Russell Body Gastroenteritis: An Aberrant Manifestation of Chronic Inflammation in Gastrointestinal Mucosa

    Directory of Open Access Journals (Sweden)

    Feriyl Bhaijee

    2013-01-01

    Full Text Available First described in 1998, Russell body gastritis is a rare chronic inflammatory condition characterized by abundant intramucosal polyclonal plasma cells, which contain intracytoplasmic eosinophilic globules of immunoglobulins (Russell bodies that displace the nucleus, with an accompanying chronic inflammatory infiltrate. Russell bodies represent a cellular response to overstimulation of plasma cells, leading to the accumulation of abundant, nondegradable, condensed immunoglobulin in dilated rough endoplasmic reticulum cisternae. Russell body gastritis usually occurs in the gastric antrum, but two cases of Russell body duodenitis have been recently described. Herein, we report an unusual case of Barrett esophagus with prominent lymphoplasmacytic infiltration and Russell bodies, which expands the current spectrum of Russell body gastritis/duodenitis. Given the various anatomic locations in which Russell body gastritis may arise, we suggest that “Russell body gastroenteritis” may be a more appropriate designation for this uncommon reactive condition.

  10. Widespread hypomethylation occurs early and synergizes with gene amplification during esophageal carcinogenesis

    DEFF Research Database (Denmark)

    Alvarez, Hector; Opalinska, Joanna; Zhou, Li; Sohal, Davendra; Fazzari, Melissa J; Yu, Yiting; Montagna, Christina; Montgomery, Elizabeth A; Canto, Marcia; Dunbar, Kerry B; Wang, Jean; Roa, Juan Carlos; Mo, Yongkai; Bhagat, Tushar; Ramesh, Hemalata; Cannizzaro, Linda; Mollenhauer, J; Thompson, Reid F; Suzuki, Masako; Meltzer, Stephen J; Meltzer, Stephen; Melnick, Ari; Greally, John M; Maitra, Anirban; Verma, Amit

    2011-01-01

    Although a combination of genomic and epigenetic alterations are implicated in the multistep transformation of normal squamous esophageal epithelium to Barrett esophagus, dysplasia, and adenocarcinoma, the combinatorial effect of these changes is unknown. By integrating genome-wide DNA methylation...... observed at a restricted number of loci and, in combination with hemi-allelic deletions, leads to downregulatation of selected transcripts during multistep progression. We also observe that epigenetic regulation during epithelial carcinogenesis is not restricted to traditionally defined "CpG islands," but...... may also occur through a mechanism of differential methylation outside of these regions. Finally, validation of novel upregulated targets (CXCL1 and 3, GATA6, and DMBT1) in a larger independent panel of samples confirms the utility of integrative analysis in cancer biomarker discovery....

  11. Factors that influence therapeutic outcomes in symptomatic gastroesophageal reflux disease.

    LENUS (Irish Health Repository)

    Quigley, Eamonn M M

    2012-02-03

    The term "symptomatic gastroesophageal reflux disease" (GERD) refers to those patients who present with the typical GERD symptoms of heartburn and regurgitation, yet do not have endoscopic evidence of esophagitis. The primary goals of managing symptomatic GERD are to control symptoms and improve quality of life. A clinical assessment of the GERD patient can identify important clinical features, such as atypical and extraesophageal symptoms for which acid-suppressive agents tend to be less effective. Performing an endoscopy can further identify the patient as having nonerosive reflux disease, erosive esophagitis, or Barrett\\'s esophagus-diagnoses which can help determine treatment but may not prove predictive of therapeutic response. Determining acid exposure through pH testing can predict therapeutic response, with those revealing an abnormal acid exposure time being more responsive to acid-suppressive therapy. However, the performance of an endoscopy and pH testing on each patient is clearly not practical. Whereas the natural history of symptomatic GERD is still largely undefined, acid-suppressive therapy appears to be the best approach available for both the short-term and long-term management of this disease.

  12. The Assessment of Turkish Written Examination Questions Based on the Text in Accordance with the Barrett's Taxonomy

    Science.gov (United States)

    Göçer, Ali

    2014-01-01

    In this study, Turkish text-based written examination questions posed to students in secondary schools were examined. In this research, document analysis method within the framework of the qualitative research approach was used. The data obtained from the documents consisting of written examination papers were analyzed with content analysis…

  13. Book Review on: Patrick Barrett, Daniel Chavez and Cesar Rodriguez Garavito. The New Latin American Left. Utopia Reborn?

    OpenAIRE

    Icaza Garza, Rosalba

    2010-01-01

    textabstractBarret, Chavez and Rodriguez main task in The New Latin American Left. Utopia Reborn?, is that of identifying what are the factors that can explain the emergence of a new left in Latin America. The result is a nicely edited collection of expert voices on leftist politics in the region that reflect around the obstacles, dilemmas and future of this ongoing and interesting ‘turn to the left’ in the Latin American contemporary landscape

  14. Book Review on: Patrick Barrett, Daniel Chavez and Cesar Rodriguez Garavito. The New Latin American Left. Utopia Reborn?

    NARCIS (Netherlands)

    R.A. Icaza Garza (Rosalba)

    2010-01-01

    textabstractBarret, Chavez and Rodriguez main task in The New Latin American Left. Utopia Reborn?, is that of identifying what are the factors that can explain the emergence of a new left in Latin America. The result is a nicely edited collection of expert voices on leftist politics in the region th

  15. Thoracoscopic removal of dental prosthesis impacted in the upper thoracic esophagus

    OpenAIRE

    Bonavina, L; A. Aiolfi; Siboni, S.; E. Rausa

    2014-01-01

    Dental appliances are the most common cause of accidental foreign body esophageal impaction, especially in the elderly population with decreased oral sensory perception. A 47-year-old man with history of oligophrenia and recurrent epileptic seizures was referred to our hospital following dislocation and ingestion of his upper dental prosthesis. Endoscopic removal and clipping of an esophageal tear had been unsuccessfully attempted. A chest CT scan confirmed entrapment of the dental prosthesis...

  16. A new experimental model to study preneoplastic lesions in achalasia of the esophagus

    Directory of Open Access Journals (Sweden)

    Vespúcio Marcelo Vinícius Oliveira

    2005-01-01

    Full Text Available PURPOSE: Develop an experimental model to study esophageal preneoplastic lesions induced by diethylnitrosamine in rats with achalasia. METHODS: Male Wistar rats were divided into four groups: control - C (n=8; rats with megaesophagus - B (n=8; rats treated with DEN - D (n=15 and rats with megaesophagus plus DEN - BD (n=15. Megaesophagus can be experimentally obtained in rats by topical application of benzalkonium choride. The morphology and PCNA labeling index of the epithelium were evaluated. RESULTS: The morphometric analysis showed an increase in epithelial thickness in the animals of group BD (2166?1012mm² when compared to the other groups (C = 878?278mm²; B = 1746?144mm² and D = 1691?697mm², mainly due to basal layer hyperplasia, besides an increase in the keratin of the superficial layer. The PCNA labeling index in the basal layer was significantly higher in the group BD (0,695?0,111 when compared to the other groups (C = 0,490?0,132; B = 0,512?0,215 and D = 0,477?0,198. CONCLUSIONS: Our data confirm in an experimental model the previous observation in humans of increased epithelial cell proliferation during the esophageal carcinogenic process in achalasia and may be useful to further studies on the mechanisms of the esophageal carcinogenesis and the the design of follow-up endoscopic studies for patients with achalasia.

  17. Ximedon Administration in Complex Treatment of Chemical Burns of Esophagus and Stomach in Experiment

    Directory of Open Access Journals (Sweden)

    Rukevich S.G.

    2014-03-01

    Full Text Available The aim of the investigation was to study in experiment the morphological changes in rat esophageal and gastric tissues after chemical burn using a regeneration enhancing agent (Ximedon against the background of medical treatment. Materials and Methods. Esophageal and gastric chemical burns were modeled on Wistar white rats (n=70 by 30% acetic acid. The survivors were divided into three groups: a control group (without therapy, a standard treatment group (the rats were administered cefotaxime and prednisolone intraperitoneally and an experimental group (cefotaxime, prednisolone, Ximedon intraperitoneally. The results were assessed morphologically and morphometrically on day 13, 19 and 40. Conclusion. Esophageal and gastric mucosa thickness after chemical burn does not recover under any treatment. Antibiotics and corticosteroids taken after burn inhibit inflammation in tissues, but do not prevent scar tissue development in muscularis mucosae. A long term (6 weeks of Ximedon therapy along with standard therapy results in complete recovery of esophageal and gastric mucous structure and significantly suppresses a scarring process in muscular elements.

  18. Heat Shock Protein 90 (HSP90 and Her2 in Adenocarcinomas of the Esophagus

    Directory of Open Access Journals (Sweden)

    Julia Slotta-Huspenina

    2014-06-01

    Full Text Available Her2 overexpression and amplification can be found in a significant subset of esophageal adenocarcinomas. The activity of Her2 has been shown to be modulated by molecular chaperones such as HSP90. We analyzed expression/amplification data for HSP90 and Her2 on 127 primary resected esophageal adenocarcinomas in order to evaluate a possible relationship between these two molecules. HSP90 expression determined by immunohistochemistry was observed in various levels. Thirty nine (39 tumors (30.7% were classified as Her2-positive according to their immunoreactivity and amplification status. There was a significant correlation between HSP90 expression and Her2-status (p = 0.008. This could also be demonstrated by quantitative protein expression analysis with reverse phase protein arrays (r = 0.9; p < 0.001. Her2-status was associated withpT-category (p = 0.041, lymph node metastases (p = 0.049 and tumor differentiation (p = 0.036 with a higher percentage of cases with negative Her2 status in lower tumor stagesA negative Her2-status was also associated with better survival in univariate and multivariate analysis (p = 0.001 and p = 0.014. For HSP90, no associations between clinical and pathological parameters were found. The observed association between HSP90 expression and Her2 suggests a co-regulation of these molecules in at least a subset of esophageal adenocarcinomas. Anti-HSP90 drugs, which recently have been introduced in cancer treatment, may also be an option for these tumors by targeting HSP90 alone or in combination with Her2.

  19. TRPA1 in bradykinin-induced mechanical hypersensitivity of vagal C fibers in guinea pig esophagus.

    Science.gov (United States)

    Yu, Shaoyong; Ouyang, Ann

    2009-02-01

    Bradykinin (BK) activates sensory nerves and causes hyperalgesia. Transient receptor potential A1 (TRPA1) is expressed in sensory nerves and mediates cold, mechanical, and chemical nociception. TRPA1 can be activated by BK. TRPA1 knockout mice show impaired responses to BK and mechanical nociception. However, direct evidence from sensory nerve terminals is lacking. This study aims to determine the role of TRPA1 in BK-induced visceral mechanical hypersensitivity. Extracellular recordings of action potentials from vagal nodose and jugular neurons are performed in an ex vivo guinea pig esophageal-vagal preparation. Peak frequencies of action potentials of afferent nerves evoked by esophageal distension and chemical perfusion are recorded and compared. BK activates most nodose and all jugular C fibers. This activation is repeatable and associated with a significant increase in response to esophageal distension, which can be prevented by the B2 receptor antagonist WIN64338. TRPA1 agonist allyl isothiocyanate (AITC) activates most BK-positive nodose and jugular C fibers. This is associated with a transient loss of response to mechanical distensions and desensitization to a second AITC perfusion. Desensitization with AITC and pretreatment with TRPA1 inhibitor HC-030031 both inhibit BK-induced mechanical hypersensitivity but do not affect BK-evoked activation in nodose and jugular C fibers. In contrast, esophageal vagal afferent Adelta fibers do not respond to BK or AITC and fail to show mechanical hypersensitivity after BK perfusion. This provides the first evidence directly from visceral sensory afferent nerve terminals that TRPA1 mediates BK-induced mechanical hypersensitivity. This reveals a novel mechanism of visceral peripheral sensitization. PMID:19033534

  20. Using the methylome to identify aggressive Barrett’s esophagus — EDRN Public Portal

    Science.gov (United States)

    OVERALL STRATEGY: Our strategy will consist of using HumanMethylation450 arrays to identify methylation profiles and/or candidate methylated genes that distinguish BE from BE+LGD, BE+HGD and EAC (Aim 1). We will then assess whether these genes are predictive markers for aggressive BE (Aim 2)