WorldWideScience

Sample records for evoked human oesophageal

  1. Swainsonine promotes apoptosis in human oesophageal squamous ...

    Indian Academy of Sciences (India)

    Swainsonine, a natural indolizidine alkaloid, has been reported to have antitumour effects, and can induce apoptosis in human gastric and lung cancer cells. In the present study, we evaluated the antitumour effects of swainsonine on several oesophageal squamous cell carcinoma cells and investigated relative molecular ...

  2. Oesophageal Ulceration in Human Immunodeficiency Virus Infected ...

    African Journals Online (AJOL)

    Objective. To determine the aetiology of oesophageal ulceration in HIV-infected patients. Design. A retrospective clinical, endoscopic and histopathological analysis of patients with confirmed HIV infection and an oesophageal ulcer diagnosed on endoscopy. Setting. A tertiary referral, gastrointestinal clinic in Cape Town.

  3. Identification and genetic manipulation of human and mouse oesophageal stem cells.

    Science.gov (United States)

    Jeong, Youngtae; Rhee, Horace; Martin, Shanique; Klass, Daniel; Lin, Yuan; Nguyen, Le Xuan Truong; Feng, Weiguo; Diehn, Maximilian

    2016-07-01

    Human oesophageal stem cell research is hampered by the lack of an optimal assay system to study self-renewal and differentiation. We aimed to identify and characterise human and mouse oesophageal stem/progenitor cells by establishing 3-dimensional organotypic sphere culture systems for both species. Primary oesophageal epithelial cells were freshly isolated and fluorescence-activated cell sorting (FACS)-sorted from human and mouse oesophagus and 3-dimensional organotypic sphere culture systems were developed. The self-renewing potential and differentiation status of novel subpopulations were assessed by sphere-forming ability, cell cycle analysis, immunostaining, qPCR and RNA-Seq. Primary human and mouse oesophageal epithelial cells clonally formed esophagospheres consisting of stratified squamous epithelium. Sphere-forming cells could self-renew and form esophagospheres for over 43 passages in vitro and generated stratified squamous epithelium when transplanted under the kidney capsule of immunodeficient mice. Sphere-forming cells were 10-15-fold enriched among human CD49f(hi)CD24(low) cells and murine CD49f(+)CD24(low)CD71(low) cells compared with the most differentiated cells. Genetic elimination of p63 in mouse and human oesophageal cells dramatically decreased esophagosphere formation and basal gene expression while increasing suprabasal gene expression. We developed clonogenic and organotypic culture systems for the quantitative analyses of human and mouse oesophageal stem/progenitor cells and identified novel cell surface marker combinations that enrich for these cells. Using this system, we demonstrate that elimination of p63 inhibits self-renewal of human oesophageal stem/progenitor cells. We anticipate that these esophagosphere culture systems will facilitate studies of oesophageal stem cell biology and may prove useful for ex vivo expansion of human oesophageal stem cells. Published by the BMJ Publishing Group Limited. For permission to use (where not

  4. Eosinophilic oesophagitis

    DEFF Research Database (Denmark)

    Nielsen, Rasmus Gaardskjær; Husby, Steffen

    2007-01-01

    Eosinophilic oesophagitis is characterised by age-dependent symptoms mimicking gastrooesophageal reflux disease, a distinct endoscopic appearance and a histological picture with extensive infiltration of eosinophils in the oesophageal mucosa. Eosinophilic oesophagitis is more frequently seen......, oral steroids, inhaled (swallowed) steroids, and leucotriene receptor antagonists. Detailed information on the eosinophilic inflammatory processes in the oesophageal mucosa was initially obtained from animal models, in particular with regard to the role of interleukin-5 and the chemokine eotaxin-1...

  5. Human auditory evoked potentials. II - Effects of attention

    Science.gov (United States)

    Picton, T. W.; Hillyard, S. A.

    1974-01-01

    Attention directed toward auditory stimuli, in order to detect an occasional fainter 'signal' stimulus, caused a substantial increase in the N1 (83 msec) and P2 (161 msec) components of the auditory evoked potential without any change in preceding components. This evidence shows that human auditory attention is not mediated by a peripheral gating mechanism. The evoked response to the detected signal stimulus also contained a large P3 (450 msec) wave that was topographically distinct from the preceding components. This late positive wave could also be recorded in response to a detected omitted stimulus in a regular train and therefore seemed to index a stimulus-independent perceptual decision process.

  6. The ultrastructure of the muscle coat of human gastro-oesophageal junction, with special reference to interstitial cells of Cajal

    Directory of Open Access Journals (Sweden)

    Faussone-Pellegrini eMaria-Simonetta

    2013-04-01

    Full Text Available The muscle coat of the human lower oesophageal sphincter and stomach was studied 5 cm above and 4 cm below the gastro-oesophageal junction. Four subjects were operated on for motility disorders of the oesophagus, two for a hypertensive lower oesophageal sphincter and two for an epiphrenic diverticulum; six subjects were operated on for oesophageal or gastric carcinomas. Specimens were fixed in phosphate-buffered OsO4, embedded in Epon, contrasted with uranyl acetate and lead citrate and observed under a Siemens Elmiskop Ia electron microscope. Both the oesophageal and gastric muscle cells, which showed features typical of this cell type, were innervated by multiple varicosities that were rich in synaptic vesicles; these varicosities were generally rarely encountered at distances less than 1000 Å from muscle cells. Only a very few, close neuromuscular junctions were detected. Special cells, which correspond to the interstitial cells of Cajal as reported by other authors, were discerned at the periphery of muscle cell bundles. These cells were characterized by an elongated cell body with many thin branches and an oval, sometimes indented nucleus. Some pinocytotic vesicles were located at the cell periphery. These cells were surrounded by a discontinuous basal lamina and were seen in close contact with each other and with muscle cells; the close contact areas were often very wide. The cytoplasm contained variable amounts of mitochondria, a well-developed smooth endoplasmic reticulum and a Golgi complex. As a characteristic feature, bundles of thin filaments were located at the cell periphery and were attached to electron-dense areas of the cell membrane. Morphologically, these filaments resembled myofilaments; they were present in variable amounts and were sometimes very numerous. The observation that the cytoplasmic organelles and filaments varied in number, is probably related to the different functional properties of these cells

  7. Recurrent laryngeal papillomatosis with oesophageal involvement in a 2 year old boy: successful treatment with the quadrivalent human papillomatosis vaccine.

    Science.gov (United States)

    Mészner, Zsófia; Jankovics, István; Nagy, Anikó; Gerlinger, Imre; Katona, Gábor

    2015-02-01

    Authors present a case report of a 2-year-old boy with recurrent laryngeal papillomatosis with oesophageal involvement due to human papilloma virus types 6 and 11, who needed surgical treatment every 4-6 weeks, altogether 11 times. After detailed immunological evaluation of basic immunological parameters, and in vitro detection of good responses to routine childhood immunization, a therapeutic vaccination has been decided with a 4-valent HPV vaccine. Following the third vaccine dose both laryngeal and oesophageal lesions disappeared completely, and for 2 years follow-up no papillomas could be detected. Vaccination could be a promising method in the treatment of RRP in children. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  8. The aetiological role of human papillomavirus in oesophageal squamous cell carcinoma: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Surabhi S Liyanage

    Full Text Available BACKGROUND: The aetiological role of human papillomavirus (HPV in oesophageal squamous cell carcinoma (OSCC has been widely researched for more than three decades, with conflicting findings. In the absence of a large, adequately powered single case-control study, a meta-analysis of all available case-control studies is the most rigorous way of identifying any potential association between HPV and OSCC. We present the first global meta-analysis of case-control studies investigating the role of HPV in OSCC. METHODS: Case-control studies investigating OSCC tissue for presence of HPV DNA were identified. 21 case-control studies analyzing a total of 1223 cases and 1415 controls, met our inclusion criteria. HPV detection rates were tabulated for each study and all studies were assessed for quality. The random effects method was used to pool the odds ratios (OR. RESULTS: From all OSCC specimens included in this meta-analysis, 35% (426/1223 were positive for HPV DNA. The pooled OR for an HPV-OSCC association was 3.04 (95% CI 2.20 to 4.20. Meta-regression analysis did not find a significant association between OR and any of the quality domains. Influence analysis was non-significant for the effect of individual studies on the pooled estimate. Studies conducted in countries with low to medium OSCC incidence showed a stronger relationship (OR 4.65, 95% CI 2.47 to 8.76 than regions of high OSCC incidence (OR 2.65, 95% CI 1.80 to 3.91. CONCLUSIONS: Uncertainty around the aetiological role of HPV in OSCC is due largely to the small number and scale of appropriately designed studies. Our meta-analysis of these studies suggests that HPV increases the risk of OSCC three-fold. This study provides the strongest evidence to date of an HPV-OSCC association. The importance of these findings is that prophylactic vaccination could be of public health benefit in prevention of OSCC in countries with high OSCC incidence.

  9. A Case-Control Study of the Role of Human Papillomavirus in Oesophageal Squamous Cell Carcinoma in Australia

    Directory of Open Access Journals (Sweden)

    Surabhi S. Liyanage

    2014-01-01

    Full Text Available Objective. We investigate the prevalence of human papillomavirus (HPV in oesophageal squamous cell carcinoma (OSCC tissues compared to oesophageal tissue from healthy controls, in an Australian cohort. Methods. We conducted a hospital-based case-control study of 99 patients with OSCC and 100 healthy controls to examine the presence of HPV DNA. Paraffin tissues were tested using the PapType high-risk HPV detection and genotyping kit and with INNO-LiPA HPV Genotyping Extra. The biopsy samples were tested for HPV using a PCR-ELISA method based on the L1 consensus primer set PGMY09-PGMY11. Results. HPV DNA of the oncogenic genotype 16 was detected in 1/99 case specimens, a rate of 1010 per 100,000 (95% CI: 30–5500. All control specimens were negative for HPV. Significantly higher rates of smoking, other aerodigestive cancers, and mortality were seen among cases than controls. A pooled analysis of this study and the only other Australian case-control study found that 9/321 cases and 0/155 controls were positive for HPV. The pooled odds ratio for HPV being a risk factor for OSCC was 9.35 (95% CI: 0.47–190.33. Conclusion. Our results suggest that in this multifactorial cancer HPV may be an additional risk factor; although a larger, better powered study is needed.

  10. Potential diagnostic implications of miR-144 overexpression in human oesophageal cancer

    Directory of Open Access Journals (Sweden)

    Priyanka Sharma

    2016-01-01

    Full Text Available Background & objectives: Insidious symptomatology, late clinical presentation and poor prognosis of oesophageal cancer (EC highlight the pressing need for novel non-invasive biomarkers for early tumour diagnosis and better prognosis. The present study was carried out to evaluate the clinical significance of circulating and tissue miR-144 expression in oesophageal cancer. Methods: Clinical significance of miR-144 expression was evaluated in preneoplastic (12 and neoplastic (35 oesophageal cancer tissues as well as matched distant non-malignant tissues using real-time PCR (qPCR. Circulating levels of miR-144 were also analyzed in serum samples of EC patients as well as normal individuals to determine the diagnostic potential of miR-144. Further, targets of miR-144 were predicted using bioinformatic tools and their gene ontology (GO terms were assigned. Results: Real-time PCR analysis revealed significant upregulation of miR-144 in 29 of 35 (83% EC tissues as compared to matched distant non-malignant tissues (P=0.010. a0 ll the dysplastic tissues showed upregulation of miR-144 as compared to their matched distant non-malignant tissues. Relative levels of circulating miR-144 in serum significantly distinguished EC patients from normal controls (P=0.015; AUC = 0.731 with high sensitivity of 94.7 per cent. Bioinformatically predicted target, PUR-aplha (PURA was found to be significantly (P=0.018 downregulated in 81 per cent (26/32 EC patients and its expression was found to be significantly and negatively correlated with miR-144 expression at mRNA level. Interpretation & conclusions: Our findings showed significant upregulation of miR-144 in serum samples of EC patients indicating its potential as minimally invasive marker. Further studies need to be done to understand the role of miR-144 in the pathogenesis of EC.

  11. Oesophageal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Cole, A. [Westmead Hospital, Westmead, NSW, (Australia). Department of Radiology

    1997-08-01

    Oesophageal carcinoma is an aggressive malignant tumour, and in Western countries accounts for only about 3 per cent of all malignancies. In other countries, such as China, this rate can be as high as 25 per cent, and as a result, is responsible for many deaths from malignancy. Despite this fairly low presentation rate in Westernised countries, the survival rate for sufferers beyond five years is dismal. This is also reflected in other parts of the world. Even with complex surgical techniques and Radiation Therapy, the survival rate has not improved markedly with these advanced techniques. This article gives a broad overview of Oesophageal Carcinoma, with a Westmead influence in reference to diagnosis, treatment and prognosis. The assessment of the tumour is done in a number of different ways. Barium Swallow is useful in assessing the length of the tumour. Endoscopy is also used to assess tumour length, this method being more sensitive than Barium Swallow. A CT of the Chest, Abdomen and Pelvis is performed to assess local spread, distant metastases and is also used for planning. The CT may be done as an Angio CT. Other methods of assessment used in a lesser extent, due to the technology being new, or from lack of experienced operators is MRI, endoscopic ultrasound and laparoscopic ultrasound. There are a number of different forms of treatment that may be considered, dependant upon the condition of the patient, and whether or not the tumour is considered `curable`. At Westmead Hospital, the considerations for treatment are: radiation therapy (as palliative therapy), surgery, combined radiation and chemotherapy and palliative therapy. 1 refs., 9 figs.

  12. Oesophageal atresia

    Directory of Open Access Journals (Sweden)

    Spitz Lewis

    2007-05-01

    Full Text Available Abstract Oesophageal atresia (OA encompasses a group of congenital anomalies comprising of an interruption of the continuity of the oesophagus with or without a persistent communication with the trachea. In 86% of cases there is a distal tracheooesophageal fistula, in 7% there is no fistulous connection, while in 4% there is a tracheooesophageal fistula without atresia. OA occurs in 1 in 2500 live births. Infants with OA are unable to swallow saliva and are noted to have excessive salivation requiring repeated suctioning. Associated anomalies occur in 50% of cases, the majority involving one or more of the VACTERL association (vertebral, anorectal, cardiac, tracheooesophageal, renal and limb defects. The aetiology is largely unknown and is likely to be multifactorial, however, various clues have been uncovered in animal experiments particularly defects in the expression of the gene Sonic hedgehog (Shh. The vast majority of cases are sporadic and the recurrence risk for siblings is 1%. The diagnosis may be suspected prenatally by a small or absent stomach bubble on antenatal ultrasound scan at around 18 weeks gestation. The likelihood of an atresia is increased by the presence of polyhydramnios. A nasogastric tube should be passed at birth in all infants born to a mother with polyhydramnios as well as to infants who are excessively mucusy soon after delivery to establish or refute the diagnosis. In OA the tube will not progress beyond 10 cm from the mouth (confirmation is by plain X-ray of the chest and abdomen. Definitive management comprises disconnection of the tracheooesophageal fistula, closure of the tracheal defect and primary anastomosis of the oesophagus. Where there is a "long gap" between the ends of the oesophagus, delayed primary repair should be attempted. Only very rarely will an oesophageal replacement be required. Survival is directly related to birth weight and to the presence of a major cardiac defect. Infants weighing over

  13. Swainsonine promotes apoptosis in human oesophageal squamous cell carcinoma cells in vitro and in vivo through activation of mitochondrial pathway.

    Science.gov (United States)

    Li, Zhaocal; Huang, Yong; Dong, Feng; Li, Wei; Ding, Li; Yu, Gaoshui; Xu, Dan; Yang, Yuanyuan; Xu, Xingang; Tong, Dewen

    2012-12-01

    Swainsonine, a natural indolizidine alkaloid, has been reported to have antitumour effects, and can induce apoptosis in human gastric and lung cancer cells. In the present study, we evaluated the antitumour effects of swainsonine on several oesophageal squamous cell carcinoma cells and investigated relative molecular mechanisms. Swainsonine treatment inhibited the growth of Eca-109, TE-1 and TE-10 cells in a concentration-dependent manner as measured by MTT assay. Morphological observation, DNA laddering detection and flow cytometry analysis demonstrated that swainsonine treatment induced Eca-109 cell apoptosis in vitro. Further results showed that swainsonine treatment up-regulated Bax, downregulated Bcl-2 expression, triggered Bax translocation to mitochondria, destructed mitochondria integrity and activated mitochondria-mediated apoptotic pathway, followed by the release of cytochrome c, which in turn activated caspase-9 and caspase-3, promoted the cleavage of PARP, resulting in Eca-109 cell apoptosis. Moreover, swainsonine treatment inhibited Bcl-2 expression, promoted Bax translocation, cytochrome c release and caspase-3 activation in xenograft tumour cells, resulting in a significant decrease of tumour volume and tumour weight in the swainsoninetreated xenograft mice groups compared with that in the control group. Taken together, this study demonstrated that swainsonine inhibited Eca-109 cells growth through activation of mitochondria-mediated caspase-dependent pathway.

  14. Human auditory evoked potentials. I - Evaluation of components

    Science.gov (United States)

    Picton, T. W.; Hillyard, S. A.; Krausz, H. I.; Galambos, R.

    1974-01-01

    Fifteen distinct components can be identified in the scalp recorded average evoked potential to an abrupt auditory stimulus. The early components occurring in the first 8 msec after a stimulus represent the activation of the cochlea and the auditory nuclei of the brainstem. The middle latency components occurring between 8 and 50 msec after the stimulus probably represent activation of both auditory thalamus and cortex but can be seriously contaminated by concurrent scalp muscle reflex potentials. The longer latency components occurring between 50 and 300 msec after the stimulus are maximally recorded over fronto-central scalp regions and seem to represent widespread activation of frontal cortex.

  15. The division of attention and the human auditory evoked potential

    Science.gov (United States)

    Hink, R. F.; Van Voorhis, S. T.; Hillyard, S. A.; Smith, T. S.

    1977-01-01

    The sensitivity of the scalp-recorded, auditory evoked potential to selective attention was examined while subjects responded to stimuli presented to one ear (focused attention) and to both ears (divided attention). The amplitude of the N1 component was found to be largest to stimuli in the ear upon which attention was to be focused, smallest to stimuli in the ear to be ignored, and intermediate to stimuli in both ears when attention was divided. The results are interpreted as supporting a capacity model of attention.

  16. Brain stem auditory evoked responses in human infants and adults

    Science.gov (United States)

    Hecox, K.; Galambos, R.

    1974-01-01

    Brain stem evoked potentials were recorded by conventional scalp electrodes in infants (3 weeks to 3 years of age) and adults. The latency of one of the major response components (wave V) is shown to be a function both of click intensity and the age of the subject; this latency at a given signal strength shortens postnatally to reach the adult value (about 6 msec) by 12 to 18 months of age. The demonstrated reliability and limited variability of these brain stem electrophysiological responses provide the basis for an optimistic estimate of their usefulness as an objective method for assessing hearing in infants and adults.

  17. Auditory evoked responses upon awakening from sleep in human subjects.

    Science.gov (United States)

    Ferrara, M; De Gennaro, L; Ferlazzo, F; Curcio, G; Barattucci, M; Bertini, M

    2001-09-14

    The hypothesis that a state of hypoarousal upon awakening should lead to a decrease in amplitude and an increase in latency of the N1-P2 components of the Auditory Evoked Potentials (AEPs) as compared to presleep wakefulness levels, was evaluated after two nocturnal awakenings and after the final morning awakening from a 7.5-h night of sleep. The amplitude of the N1-P2 complex was reduced upon awakening as compared to presleep wakefulness levels, but only following the first nocturnal awakening, scheduled after the first 2 h of sleep. This result is interpreted as indicating a link between slow wave sleep amount, mainly present during the first part of the night, and lowered levels of brain activation upon awakening. The reaction times, recorded concomitantly to AEPs, were more sensitive to the negative effects of sleep inertia.

  18. Effect of Delta-tetrahydrocannabinol, a cannabinoid receptor agonist, on the triggering of transient lower oesophageal sphincter relaxations in dogs and humans

    NARCIS (Netherlands)

    Beaumont, H.; Jensen, J.; Carlsson, A.; Ruth, M.; Lehmann, A.; Boeckxstaens, G. E.

    2009-01-01

    Background and purpose: Transient lower oesophageal sphincter relaxations (TLESRs) are the main mechanism underlying gastro-oesophageal reflux and are a potential pharmacological treatment target. We evaluated the effect of the CB(1)/CB(2) receptor agonist Delta(9)-tetrahydrocannabinol

  19. Management of oesophageal cancer

    OpenAIRE

    Tong, Daniel K. H.; Law, Simon

    2009-01-01

    Oesophageal cancer is a disease of dismal prognosis. There are variations of epidemiology among different ethnic groups and geographic regions. India is a country with high incidence. This can be attributed to the interplay between environmental, dietary factors and life-style of the population of the country. Optimal therapeutic strategy for patients with oesophageal cancer demands individual consideration.

  20. Mapping human brain networks with cortico-cortical evoked potentials

    National Research Council Canada - National Science Library

    Keller, Corey J; Honey, Christopher J; Mégevand, Pierre; Entz, Laszlo; Ulbert, Istvan; Mehta, Ashesh D

    2014-01-01

    The cerebral cortex forms a sheet of neurons organized into a network of interconnected modules that is highly expanded in humans and presumably enables our most refined sensory and cognitive abilities...

  1. Spontaneous and Evoked Contractility of Human Intestinal Lymphatic Vessels.

    Science.gov (United States)

    Telinius, Niklas; Majgaard, Jens; Mohanakumar, Sheyanth; Pahle, Einar; Nielsen, Jørn; Hjortdal, Vibeke; Aalkjær, Christian; Boedtkjer, Donna Briggs

    2017-03-01

    Mesenteric lymphatic vessels (MLVs) from various animal species have been intensively studied. We aimed to establish the viability and basic contractile characteristics of human MLVs maintained in vitro and to determine the reactivity of MLVs with norepinephrine (NE) and substance P (SP) and to compare with the thoracic duct (TD). Isolated human lymphatic vessels were mounted on a wire myograph under isometric conditions and tension was recorded. The diameter-tension characteristics for MLVs were generated by stretching the vessels and stimulating with a 125 mM K+ solution containing 10 μM NE. The diameter-tension data generated for MLVs from two separate surgical patient groups were found to be similar: maximum active tension for MLVs occurred when the passive stretch corresponded to a transmural pressure of 22 mmHg. Subsequent experiments on human MLVs were performed by normalization with 22 mmHg as the equivalent target pressure. The majority of MLVs were responders (spontaneous activity and/or reactivity with 10 μM NE or 125 mM K+ solution). Nonresponders (16% of vessel segments) had significantly smaller inner diameters. MLVs responded consistently to NE (1 nM-10 μM) but the responsiveness of MLVs and TD to SP (0.1 nM-10 μM) was poor: TD reacted only with 10 μM SP, whereas MLVs were sensitive to nanomolar concentrations and the contractile response declined with higher concentrations. Under in vitro isometric conditions, human MLVs generate maximum tension when stretched to a passive level corresponding to 22 mmHg, and the majority of MLVs are responsive when normalized to this pressure. MLVs respond to NE and SP though NE produces a more consistent response in the concentration range tested.

  2. Auditory evoked fields elicited by spectral, temporal, and spectral-temporal changes in human cerebral cortex

    Directory of Open Access Journals (Sweden)

    Hidehiko eOkamoto

    2012-05-01

    Full Text Available Natural sounds contain complex spectral components, which are temporally modulated as time-varying signals. Recent studies have suggested that the auditory system encodes spectral and temporal sound information differently. However, it remains unresolved how the human brain processes sounds containing both spectral and temporal changes. In the present study, we investigated human auditory evoked responses elicited by spectral, temporal, and spectral-temporal sound changes by means of magnetoencephalography (MEG. The auditory evoked responses elicited by the spectral-temporal change were very similar to those elicited by the spectral change, but those elicited by the temporal change were delayed by 30 – 50 ms and differed from the others in morphology. The results suggest that human brain responses corresponding to spectral sound changes precede those corresponding to temporal sound changes, even when the spectral and temporal changes occur simultaneously.

  3. Evoked corticospinal output to the human scalene muscles is altered by lung volume.

    Science.gov (United States)

    Hudson, Anna L; Taylor, Janet L; Anand, Ashima; Gandevia, Simon C; Butler, Jane E

    2012-03-15

    Increases in lung volume inhibit the inspiratory output from the medulla, but the effect of lung inflation on the voluntary control of breathing in humans is not known. We tested corticospinal excitability using transcranial magnetic stimulation (TMS) to evoke a response in the scalene muscles. TMS was delivered at rest at three different lung volumes between functional residual capacity (FRC) and total lung capacity (TLC) during incremental inspiratory and incremental expiratory manoeuvres. Motor evoked potentials (MEPs) in scalenes were ∼50% larger at a high lung volume (FRC+∼90% inspiratory capacity [IC]) compared to lower lung volumes (FRC and FRC+∼40% IC) in both inspiratory and expiratory manoeuvres (plung inflation on the automatic and voluntary control of breathing in humans. Copyright © 2011 Elsevier B.V. All rights reserved.

  4. Human cerebrocortical potentials evoked by stimulation of the dorsal nerve of the penis.

    Science.gov (United States)

    Bradley, W E; Farrell, D F; Ojemann, G A

    1998-01-01

    Cortical evoked potentials resulting from stimulation of the dorsal nerve of the penis (DNP) provide a unique opportunity to document the cortical localization of sexual sensory representation in man. The DNP supplies sensory axons to the major portion of the human phallus, including the penile shaft and glans. Animal and human studies indicate that this nerve plays a crucial role in erection and ejaculation. Direct cortical evoked responses to DNP electrical stimulation were recorded in patients undergoing preoperative evaluation for resection of epileptic foci. These studies provided evidence that the primary sensory cortex contains a large area of cortex devoted to the afferent fibers of the DNP and that the sensory field is in a different location than previously described. The location and distribution of this response indicated the need for revision of the traditional concept of the sensory cortical homunculus.

  5. Fast detection of unexpected sound intensity decrements as revealed by human evoked potentials.

    Directory of Open Access Journals (Sweden)

    Heike Althen

    Full Text Available The detection of deviant sounds is a crucial function of the auditory system and is reflected by the automatically elicited mismatch negativity (MMN, an auditory evoked potential at 100 to 250 ms from stimulus onset. It has recently been shown that rarely occurring frequency and location deviants in an oddball paradigm trigger a more negative response than standard sounds at very early latencies in the middle latency response of the human auditory evoked potential. This fast and early ability of the auditory system is corroborated by the finding of neurons in the animal auditory cortex and subcortical structures, which restore their adapted responsiveness to standard sounds, when a rare change in a sound feature occurs. In this study, we investigated whether the detection of intensity deviants is also reflected at shorter latencies than those of the MMN. Auditory evoked potentials in response to click sounds were analyzed regarding the auditory brain stem response, the middle latency response (MLR and the MMN. Rare stimuli with a lower intensity level than standard stimuli elicited (in addition to an MMN a more negative potential in the MLR at the transition from the Na to the Pa component at circa 24 ms from stimulus onset. This finding, together with the studies about frequency and location changes, suggests that the early automatic detection of deviant sounds in an oddball paradigm is a general property of the auditory system.

  6. The N2-P3 complex of the evoked potential and human performance

    Science.gov (United States)

    Odonnell, Brian F.; Cohen, Ronald A.

    1988-01-01

    The N2-P3 complex and other endogenous components of human evoked potential provide a set of tools for the investigation of human perceptual and cognitive processes. These multidimensional measures of central nervous system bioelectrical activity respond to a variety of environmental and internal factors which have been experimentally characterized. Their application to the analysis of human performance in naturalistic task environments is just beginning. Converging evidence suggests that the N2-P3 complex reflects processes of stimulus evaluation, perceptual resource allocation, and decision making that proceed in parallel, rather than in series, with response generation. Utilization of these EP components may provide insights into the central nervous system mechanisms modulating task performance unavailable from behavioral measures alone. The sensitivity of the N2-P3 complex to neuropathology, psychopathology, and pharmacological manipulation suggests that these components might provide sensitive markers for the effects of environmental stressors on the human central nervous system.

  7. Olfactory Cerebral Evoked Potentials for Pleasant and Unpleasant Smells in Humans

    Directory of Open Access Journals (Sweden)

    Tomohiko Igasaki

    2011-10-01

    Full Text Available The relationship between sensory estimation and evoked potential when pleasant or unpleasant smell delivered to human nose was investigated. Ten healthy men participated. First, the subject was presented gamma-undecalactone (pleasant smell or isovaleric acid (unpleasant smell, and instructed to estimate the odor magnitude and pleasantness/unpleasantness (sensory test session. Then, evoked potentials of the subject were measured from 19 scalp electrodes when pleasant or unpleasant smell were delivered 100 times to the subject, respectively (EEG measurement session. In the sensory test session, both the evaluation of odor magnitude and pleasantness/unpleasantness were significantly changed according to the concentration of smells. On the Pz scalp electrode, the positive potentials at the latency of 610 ms and 450 ms were observed in the pleasant and unpleasant stimulation, respectively. Statistically, it was found that the variance of the positive potential latency in unpleasant stimulation was significantly smaller than that in pleasant stimulation. It was also found that the positive potential latency in unpleasant stimulation was significantly earlier than that in pleasant stimulation. The small variance of latency and the earlier latency for unpleasant smell could be considered to reflect human behavior, such as quick reaction for avoiding dangerous odor to save one's life.

  8. Human Evoked Cortical Activity to Signal-to-Noise Ratio and Absolute Signal Level

    Science.gov (United States)

    Billings, Curtis J.; Tremblay, Kelly L.; Stecker, G. Christopher; Tolin, Wendy M.

    2009-01-01

    The purpose of this study was to determine the effect of signal level and signal-to-noise ratio (SNR) on the latency and amplitude of evoked cortical activity to further our understanding of how the human central auditory system encodes signals in noise. Cortical auditory evoked potentials (CAEPs) were recorded from 15 young normal-hearing adults in response to a 1000 Hz tone presented at two tone levels in quiet and while continuous background noise levels were varied in five equivalent SNR steps. These 12 conditions were used to determine the effects of signal level and SNR level on CAEP components P1, N1, P2, and N2. Based on prior signal-in-noise experiments conducted in animals, we hypothesized that SNR, would be a key contributor to human CAEP characteristics. As hypothesized, amplitude increased and latency decreased with increasing SNR; in addition, there was no main effect of tone level across the two signal levels tested (60 and 75 dB SPL). Morphology of the P1-N1-P2 complex was driven primarily by SNR, highlighting the importance of noise when recording CAEPs. Results are discussed in terms of the current interest in recording CAEPs in hearing aid users. PMID:19364526

  9. Long-Term Visuo-Gustatory Appetitive and Aversive Conditioning Potentiate Human Visual Evoked Potentials.

    Science.gov (United States)

    Christoffersen, Gert R J; Laugesen, Jakob L; Møller, Per; Bredie, Wender L P; Schachtman, Todd R; Liljendahl, Christina; Viemose, Ida

    2017-01-01

    Human recognition of foods and beverages are often based on visual cues associated with flavors. The dynamics of neurophysiological plasticity related to acquisition of such long-term associations has only recently become the target of investigation. In the present work, the effects of appetitive and aversive visuo-gustatory conditioning were studied with high density EEG-recordings focusing on late components in the visual evoked potentials (VEPs), specifically the N2-P3 waves. Unfamiliar images were paired with either a pleasant or an unpleasant juice and VEPs evoked by the images were compared before and 1 day after the pairings. In electrodes located over posterior visual cortex areas, the following changes were observed after conditioning: the amplitude from the N2-peak to the P3-peak increased and the N2 peak delay was reduced. The percentage increase of N2-to-P3 amplitudes was asymmetrically distributed over the posterior hemispheres despite the fact that the images were bilaterally symmetrical across the two visual hemifields. The percentage increases of N2-to-P3 amplitudes in each experimental subject correlated with the subject's evaluation of positive or negative hedonic valences of the two juices. The results from 118 scalp electrodes gave surface maps of theta power distributions showing increased power over posterior visual areas after the pairings. Source current distributions calculated from swLORETA revealed that visual evoked currents rose as a result of conditioning in five cortical regions-from primary visual areas and into the inferior temporal gyrus (ITG). These learning-induced changes were seen after both appetitive and aversive training while a sham trained control group showed no changes. It is concluded that long-term visuo-gustatory conditioning potentiated the N2-P3 complex, and it is suggested that the changes are regulated by the perceived hedonic valence of the US.

  10. Impact of gastro-oesophageal reflux on microRNA expression, location and function

    Directory of Open Access Journals (Sweden)

    Smith Cameron M

    2013-01-01

    Full Text Available Abstract Background Ulceration of the oesophageal squamous mucosa (ulcerative oesophagitis is a pathological manifestation of gastro-oesophageal reflux disease, and is a major risk factor for the development of Barrett’s oesophagus. Barrett’s oesophagus is characterised by replacement of reflux-damaged oesophageal squamous epithelium with a columnar intestinal-like epithelium. We previously reported discovery of microRNAs that are differentially expressed between oesophageal squamous mucosa and Barrett’s oesophagus mucosa. Now, to better understand early steps in the initiation of Barrett’s oesophagus, we assessed the expression, location and function of these microRNAs in oesophageal squamous mucosa from individuals with ulcerative oesophagitis. Methods Quantitative real-time PCR was used to compare miR-21, 143, 145, 194, 203, 205 and 215 expression levels in oesophageal mucosa from individuals without pathological gastro-oesophageal reflux to individuals with ulcerative oesophagitis. Correlations between microRNA expression and messenger RNA differentiation markers BMP-4, CK8 and CK14 were analyzed. The cellular localisation of microRNAs within the oesophageal mucosa was determined using in-situ hybridisation. microRNA involvement in proliferation and apoptosis was assessed following transfection of a human squamous oesophageal mucosal cell line (Het-1A. Results miR-143, miR-145 and miR-205 levels were significantly higher in gastro-oesophageal reflux compared with controls. Elevated miR-143 expression correlated with BMP-4 and CK8 expression, and elevated miR-205 expression correlated negatively with CK14 expression. Endogenous miR-143, miR-145 and miR-205 expression was localised to the basal layer of the oesophageal epithelium. Transfection of miR-143, 145 and 205 mimics into Het-1A cells resulted in increased apoptosis and decreased proliferation. Conclusions Elevated miR-143, miR-145 and miR-205 expression was observed in

  11. [Effect of isorhmnetin on circadian rhythms of DNA synthesis and expression of c-myc gene in Eca-109 cells of human oesophageal cancer].

    Science.gov (United States)

    Yang, Chunlei; Peng, Tao; Qu, Yi; Tao, Dachang; Wang, Zhengrong; Zhu, Bin

    2005-12-01

    This study was focused on the circadian rhythms of DNA synthesis and the expression of c-myc gene in untreated and treated Eca-109 cells in human oesophageal cancer with isorhmnetin. The circadian rhythms of 3H-TdR incorporation and expression of c-myc gene in untreated and treated Eca-109 cells were measured by 3H-thymidine uptake assay and flow cytometry. The data collected were analyzed by ANOVA and Cosinor method. DNA synthesis and expression of c-myc gene in untreated group varied according to circadian time with statistical significance, the distribution curves of both DNA synthesis and the expression level of c-myc were fit for cosinor changes. The circadian rhythms of DNA synthesis and circadian parameters of c-myc expression in treated Eca-109 cells changed. The circadian parameters of DNA synthesis and expression level of c-myc varied after treatment by isorhmnetin. The effects of isorhmnetin on cell proliferation and c-myc expression reached the highest level from 20: 00 to 0: 00. The results provide a guidance for instituting the chemotherapy and chronotherapy of human tumors, when isorhmnetin is for use as anti-cancer agent.

  12. Steady-state visually evoked potential correlates of human body perception.

    Science.gov (United States)

    Giabbiconi, Claire-Marie; Jurilj, Verena; Gruber, Thomas; Vocks, Silja

    2016-11-01

    In cognitive neuroscience, interest in the neuronal basis underlying the processing of human bodies is steadily increasing. Based on functional magnetic resonance imaging studies, it is assumed that the processing of pictures of human bodies is anchored in a network of specialized brain areas comprising the extrastriate and the fusiform body area (EBA, FBA). An alternative to examine the dynamics within these networks is electroencephalography, more specifically so-called steady-state visually evoked potentials (SSVEPs). In SSVEP tasks, a visual stimulus is presented repetitively at a predefined flickering rate and typically elicits a continuous oscillatory brain response at this frequency. This brain response is characterized by an excellent signal-to-noise ratio-a major advantage for source reconstructions. The main goal of present study was to demonstrate the feasibility of this method to study human body perception. To that end, we presented pictures of bodies and contrasted the resulting SSVEPs to two control conditions, i.e., non-objects and pictures of everyday objects (chairs). We found specific SSVEPs amplitude differences between bodies and both control conditions. Source reconstructions localized the SSVEP generators to a network of temporal, occipital and parietal areas. Interestingly, only body perception resulted in activity differences in middle temporal and lateral occipitotemporal areas, most likely reflecting the EBA/FBA.

  13. Cow's milk challenge through human milk evokes immune responses in infants with cow's milk allergy.

    Science.gov (United States)

    Järvinen, K M; Mäkinen-Kiljunen, S; Suomalainen, H

    1999-10-01

    In order to measure the immune response evoked in breast-fed infants with cow's milk allergy (CMA) by cow's milk challenge through human milk, mothers were given increasing doses of cow's milk after they had been on a cow's milk elimination diet. Another objective was to study the secretion of beta-lactoglobulin (BLG) into human milk before and during milk challenge in relation to the appearance of symptoms in infants. Seventeen asymptomatic mothers who had infants with challenge-proven CMA and 10 asymptomatic mothers who had healthy infants were recruited. Infants ranged in age from 1.8 to 9.4 months. A solid-phase enzyme-linked immunoassay (ELISPOT) was used to assess the total number of immunoglobulin-secreting and specific antibody-secreting cells. Flow cytometry was used to enumerate different lymphocyte subpopulations among peripheral blood lymphocytes primed during provocation by cow's milk antigens. BLG levels were assessed in human milk before the challenge and 1, 2, 3, and 4 hours after the commencement of the challenge. All but one of the infants with CMA showed symptoms of CMA during cow's milk challenge through human milk. There was a significant rise in the total number of immunoglobulin-secreting cells in the IgA and IgG classes associated with a positive cow's milk challenge response, but the proportions of peripheral blood B cells bearing CD19, CD23, CD19 and 23, CD5, or CD19 and CD5 were comparable. BLG levels were comparable in both study groups. Most of the infants with CMA reacted to cow's milk challenge through human milk. Hypersensitivity reactions to food antigens through human milk may be more common than previously thought.

  14. Long-term visuo-gustatory appetitive and aversive conditioning potentiate human visual evoked potentials

    DEFF Research Database (Denmark)

    Christoffersen, Gert R.J.; Laugesen, Jakob L.; Møller, Per

    2017-01-01

    and aversive visuo-gustatory conditioning were studied with high density EEG-recordings focusing on late components in the visual evoked potentials (VEPs), specifically the N2-P3 waves. Unfamiliar images were paired with either a pleasant or an unpleasant juice and VEPs evoked by the images were compared...

  15. Long-Term Visuo-Gustatory Appetitive and Aversive Conditioning Potentiate Human Visual Evoked Potentials

    DEFF Research Database (Denmark)

    Christoffersen, Gert Rene Juul; Laugesen, Jakob Lund; Møller, Per

    2017-01-01

    and aversive visuo-gustatory conditioning were studied with high density EEG-recordings focusing on late components in the visual evoked potentials (VEPs), specifically the N2-P3 waves. Unfamiliar images were paired with either a pleasant or an unpleasant juice and VEPs evoked by the images were compared...

  16. Early visual evoked potentials are modulated by eye position in humans induced by whole body rotations

    Directory of Open Access Journals (Sweden)

    Petit Laurent

    2004-09-01

    Full Text Available Abstract Background To reach and grasp an object in space on the basis of its image cast on the retina requires different coordinate transformations that take into account gaze and limb positioning. Eye position in the orbit influences the image's conversion from retinotopic (eye-centered coordinates to an egocentric frame necessary for guiding action. Neuroimaging studies have revealed eye position-dependent activity in extrastriate visual, parietal and frontal areas that is along the visuo-motor pathway. At the earliest vision stage, the role of the primary visual area (V1 in this process remains unclear. We used an experimental design based on pattern-onset visual evoked potentials (VEP recordings to study the effect of eye position on V1 activity in humans. Results We showed that the amplitude of the initial C1 component of VEP, acknowledged to originate in V1, was modulated by the eye position. We also established that putative spontaneous small saccades related to eccentric fixation, as well as retinal disparity cannot explain the effects of changing C1 amplitude of VEP in the present study. Conclusions The present modulation of the early component of VEP suggests an eye position-dependent activity of the human primary visual area. Our findings also evidence that cortical processes combine information about the position of the stimulus on the retinae with information about the location of the eyes in their orbit as early as the stage of primary visual area.

  17. Transcriptional regulation of human mucin MUC4 by bile acids in oesophageal cancer cells is promoter-dependent and involves activation of the phosphatidylinositol 3-kinase signalling pathway.

    Science.gov (United States)

    Mariette, Christophe; Perrais, Michaël; Leteurtre, Emmanuelle; Jonckheere, Nicolas; Hémon, Brigitte; Pigny, Pascal; Batra, Surinder; Aubert, Jean-Pierre; Triboulet, Jean-Pierre; Van Seuningen, Isabelle

    2004-02-01

    Abnormal gastro-oesophageal reflux and bile acids have been linked to the presence of Barrett's oesophageal premalignant lesion associated with an increase in mucin-producing goblet cells and MUC4 mucin gene overexpression. However, the molecular mechanisms underlying the regulation of MUC4 by bile acids are unknown. Since total bile is a complex mixture, we undertook to identify which bile acids are responsible for MUC4 up-regulation by using a wide panel of bile acids and their conjugates. MUC4 apomucin expression was studied by immunohistochemistry both in patient biopsies and OE33 oesophageal cancer cell line. MUC4 mRNA levels and promoter regulation were studied by reverse transcriptase-PCR and transient transfection assays respectively. We show that among the bile acids tested, taurocholic, taurodeoxycholic, taurochenodeoxycholic and glycocholic acids and sodium glycocholate are strong activators of MUC4 expression and that this regulation occurs at the transcriptional level. By using specific pharmacological inhibitors of mitogen-activated protein kinase, phosphatidylinositol 3-kinase, protein kinase A and protein kinase C, we demonstrate that bile acid-mediated up-regulation of MUC4 is promoter-specific and mainly involves activation of phosphatidylinositol 3-kinase. This new mechanism of regulation of MUC4 mucin gene points out an important role for bile acids as key molecules in targeting MUC4 overexpression in early stages of oesophageal carcinogenesis.

  18. The timing of visual evoked potential activity in human area V4.

    Science.gov (United States)

    Buchner, H; Weyen, U; Frackowiak, R S; Romaya, J; Zeki, S

    1994-07-22

    Studies of human occipital visual cortex have demonstrated functional specializations for colour and for motion, with a pivotal area for colour processing (area V4) being located in the fusiform gyrus. To study the timing of arrival of signals in area V4 we have recorded multi-channel visual evoked potentials (VEPS) to colour and grey 'Mondrian' stimuli, spatio-temporal dipole source analysis being computed on two independent group averages of five and six subjects respectively. Three active brain regions were identified, which we interpret to correspond to areas V1, V2 and V4; they showed sequential but overlapping activity in time with no difference in magnitude between colour and grey stimulated VEPs. Source analysis of the difference potentials, colour minus grey, isolated source activity resulting from colour stimulation and located it in the region of area V4. Activity in area V4 started at 100 ms and peaked at 135 ms after the onset of the visual stimulus.

  19. Review of evoked and event-related delta responses in the human brain.

    Science.gov (United States)

    Güntekin, Bahar; Başar, Erol

    2016-05-01

    In the last decade, the brain's oscillatory responses have invaded the literature. The studies on delta (0.5-3.5Hz) oscillatory responses in humans upon application of cognitive paradigms showed that delta oscillations are related to cognitive processes, mainly in decision making and attentional processes. The present manuscript comprehensively reviews the studies on delta oscillatory responses upon cognitive stimulation in healthy subjects and in different pathologies, namely Alzheimer's disease, Mild Cognitive Impairment (MCI), bipolar disorder, schizophrenia and alcoholism. Further delta oscillatory response upon presentation of faces, facial expressions, and affective pictures are reviewed. The relationship between pre-stimulus delta activity and post-stimulus evoked and event-related responses and/or oscillations is discussed. Cross-frequency couplings of delta oscillations with higher frequency windows are also included in the review. The conclusion of this review includes several important remarks, including that delta oscillatory responses are involved in cognitive and emotional processes. A decrease of delta oscillatory responses could be a general electrophysiological marker for cognitive dysfunction (Alzheimer's disease, MCI, bipolar disorder, schizophrenia and alcoholism). The pre-stimulus activity (phase or amplitude changes in delta activity) has an effect on post-stimulus EEG responses. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Cortically evoked responses of human pallidal neurons recorded during stereotactic neurosurgery.

    Science.gov (United States)

    Nishibayashi, Hiroki; Ogura, Mitsuhiro; Kakishita, Koji; Tanaka, Satoshi; Tachibana, Yoshihisa; Nambu, Atsushi; Kita, Hitoshi; Itakura, Toru

    2011-02-15

    Responses of neurons in the globus pallidus (GP) to cortical stimulation were recorded for the first time in humans. We performed microelectrode recordings of GP neurons in 10 Parkinson's disease (PD) patients and 1 cervical dystonia (CD) patient during surgeries to implant bilateral deep brain stimulation electrodes in the GP. To identify the motor territories in the external (GPe) and internal (GPi) segments of the GP, unitary responses evoked by stimulation of the primary motor cortex were observed by constructing peristimulus time histograms. Neurons in the motor territories of the GPe and GPi responded to cortical stimulation. Response patterns observed in the PD patients were combinations of an early excitation, an inhibition, and a late excitation. In addition, in the CD patient, a long-lasting inhibition was prominent, suggesting increased activity along the cortico-striato-GPe/GPi pathways. The firing rates of GPe and GPi neurons in the CD patient were lower than those in the PD patients. Many GPe and GPi neurons of the PD and CD patients showed burst or oscillatory burst activity. Effective cathodal contacts tended to be located close to the responding neurons. Such unitary responses induced by cortical stimulation may be of use to target motor territories of the GP for stereotactic functional neurosurgery. Future findings utilizing this method may give us new insights into understanding the pathophysiology of movement disorders. Copyright © 2011 Movement Disorder Society.

  1. Common cortical responses evoked by appearance, disappearance and change of the human face

    Directory of Open Access Journals (Sweden)

    Kida Tetsuo

    2009-04-01

    Full Text Available Abstract Background To segregate luminance-related, face-related and non-specific components involved in spatio-temporal dynamics of cortical activations to a face stimulus, we recorded cortical responses to face appearance (Onset, disappearance (Offset, and change (Change using magnetoencephalography. Results Activity in and around the primary visual cortex (V1/V2 showed luminance-dependent behavior. Any of the three events evoked activity in the middle occipital gyrus (MOG at 150 ms and temporo-parietal junction (TPJ at 250 ms after the onset of each event. Onset and Change activated the fusiform gyrus (FG, while Offset did not. This FG activation showed a triphasic waveform, consistent with results of intracranial recordings in humans. Conclusion Analysis employed in this study successfully segregated four different elements involved in the spatio-temporal dynamics of cortical activations in response to a face stimulus. The results show the responses of MOG and TPJ to be associated with non-specific processes, such as the detection of abrupt changes or exogenous attention. Activity in FG corresponds to a face-specific response recorded by intracranial studies, and that in V1/V2 is related to a change in luminance.

  2. Speaking modifies voice-evoked activity in the human auditory cortex.

    Science.gov (United States)

    Curio, G; Neuloh, G; Numminen, J; Jousmäki, V; Hari, R

    2000-04-01

    The voice we most often hear is our own, and proper interaction between speaking and hearing is essential for both acquisition and performance of spoken language. Disturbed audiovocal interactions have been implicated in aphasia, stuttering, and schizophrenic voice hallucinations, but paradigms for a noninvasive assessment of auditory self-monitoring of speaking and its possible dysfunctions are rare. Using magnetoencephalograpy we show here that self-uttered syllables transiently activate the speaker's auditory cortex around 100 ms after voice onset. These phasic responses were delayed by 11 ms in the speech-dominant left hemisphere relative to the right, whereas during listening to a replay of the same utterances the response latencies were symmetric. Moreover, the auditory cortices did not react to rare vowel changes interspersed randomly within a series of repetitively spoken vowels, in contrast to regular change-related responses evoked 100-200 ms after replayed rare vowels. Thus, speaking primes the human auditory cortex at a millisecond time scale, dampening and delaying reactions to self-produced "expected" sounds, more prominently in the speech-dominant hemisphere. Such motor-to-sensory priming of early auditory cortex responses during voicing constitutes one element of speech self-monitoring that could be compromised in central speech disorders.

  3. Effects of mastication on human somatosensory processing: A study using somatosensory-evoked potentials.

    Science.gov (United States)

    Nakata, Hiroki; Aoki, Mai; Sakamoto, Kiwako

    2017-04-01

    The aim of the present study was to investigate the effects of mastication on somatosensory processing using somatosensory-evoked potentials (SEPs). Fourteen healthy subjects received a median nerve stimulation at the right wrist under two conditions: Mastication and Control. SEPs were recorded in five sessions for approximately seven minutes: Pre, Post 1, 2, 3, and 4. Subjects were asked to chew gum for five minutes after one session in Mastication. Control included the same five sessions. The amplitudes and latencies of P14, N20, P25, N35, P45, and N60 components at C3', frontal N30 component at Fz, and P100 and N140 components at Pz were analyzed. The amplitude of P45-N60 was significantly smaller at Post 1, 2, 3, and 4 than at Pre in Control, but not in Mastication. The latency of P25 was significantly longer at Post 2, 3, and 4 than at Pre in Control, but not in Mastication. The latency of P100 was significantly longer at Post 2 than at Pre in Control, but not in Mastication. These results suggest the significant effects of mastication on the neural activity of human somatosensory processing. Copyright © 2016 Elsevier Ireland Ltd and Japan Neuroscience Society. All rights reserved.

  4. The suppression of gastro-oesophageal reflux by alginates.

    Science.gov (United States)

    Dettmar, P W; Hampson, F C; Taubel, J; Lorch, U; Johnstone, L M; Sykes, J; Berry, P J

    2007-10-01

    The aim of this study was to compare alginate products with the same amount of active ingredients but different dosage forms, in the suppression of reflux provoked by a standard meal in healthy human volunteers, using ambulatory oesophageal pH monitoring. This was a single centre, randomised, open, three-period crossover, controlled study comparing Gaviscon Advance (10 ml) with a control (10 ml water) and with a new tablet product containing the same active ingredients as Gaviscon Advance. Volunteers who had oesophageal pH Gaviscon Advance and control in the mean angular transformed percentage of time for which oesophageal pH fell below four was statistically significant (p pH fell below four. There were also no significant differences between the two alginate dosage forms in the angular transformed percentage of time for which oesophageal pH fell below five and in the log-transformed number of occasions on which oesophageal pH fell below four and five. The study shows that alginate reflux suppressants containing a low amount of antacid are effective in suppressing acid reflux and that suspension and tablet forms are able to give equivalent acid suppression.

  5. Necrotising Candida oesophagitis after thoracic radiotherapy: significance of oesophageal wall oedema on CT.

    Science.gov (United States)

    Saito, Hirotake; Sueyama, Hiroo; Fukuda, Takanori; Ota, Kyuma

    2015-07-01

    Although oesophageal candidiasis is usually a superficial mucosal infection, necrotising Candida oesophagitis has been reported to cause oesophageal perforation or lung abscess. We report the case of an elderly Japanese man presenting with painless dysphagia after thoracic radiotherapy for oesophageal cancer. Non-contrast CT demonstrated segmental and oedematous thickening of the oesophageal wall. Endoscopy revealed white plaques on the oesophageal mucosa. The patient's oesophagitis responded to systemic antifungal therapy, and did not lead to oesophageal perforation. He died of recurrent oesophageal cancer several months later. The importance of severe radiation-induced oesophagitis without pain, our pathophysiological hypothesis on the local oedema caused by Candida infection and the usefulness of CT in evaluating abnormal thickening of the gastrointestinal tract are discussed separately in the article. 2015 BMJ Publishing Group Ltd.

  6. On shifting the blame to humanity: Historicist narratives regarding transgressors evoke compassion for the transgressor but disdain for humanity.

    Science.gov (United States)

    Gill, Michael J; Getty, Phillip D

    2016-12-01

    People respond compassionately to transgressors whose immorality is rooted in an unfortunate life history. But, are reactions to such historicist narratives uniformly compassionate? We suggest not. We propose that historicist narratives also have a dark side. Specifically, they encourage blame shifting, in which negative evaluations of humanity arise hand in hand with compassion for the focal transgressor of the narrative. Indeed, historicist narratives portray the focal transgressor as victimized by multiple others, who destroy her goodness and remove her chance to flourish in life. This destruction of another's potential is itself a profound moral violation and thus activates far-reaching blame responses that feed a disdainful view of humanity. In three studies, we provide evidence that historicist narratives evoke compassion for one but disdain for the multitude. We show that the resulting disdain can diminish prosocial behaviour in unrelated contexts, that it is elicited by both experimenter-provided and participant-generated historicist narratives, and that it is created via blame shifting. Our findings question the assumption that proliferation of historicist thinking would necessarily contribute to creating a more compassionate, humane society. © 2016 The British Psychological Society.

  7. Locomotor-like leg movements evoked by rhythmic arm movements in humans.

    Directory of Open Access Journals (Sweden)

    Francesca Sylos-Labini

    Full Text Available Motion of the upper limbs is often coupled to that of the lower limbs in human bipedal locomotion. It is unclear, however, whether the functional coupling between upper and lower limbs is bi-directional, i.e. whether arm movements can affect the lumbosacral locomotor circuitry. Here we tested the effects of voluntary rhythmic arm movements on the lower limbs. Participants lay horizontally on their side with each leg suspended in an unloading exoskeleton. They moved their arms on an overhead treadmill as if they walked on their hands. Hand-walking in the antero-posterior direction resulted in significant locomotor-like movements of the legs in 58% of the participants. We further investigated quantitatively the responses in a subset of the responsive subjects. We found that the electromyographic (EMG activity of proximal leg muscles was modulated over each cycle with a timing similar to that of normal locomotion. The frequency of kinematic and EMG oscillations in the legs typically differed from that of arm oscillations. The effect of hand-walking was direction specific since medio-lateral arm movements did not evoke appreciably leg air-stepping. Using externally imposed trunk movements and biomechanical modelling, we ruled out that the leg movements associated with hand-walking were mainly due to the mechanical transmission of trunk oscillations. EMG activity in hamstring muscles associated with hand-walking often continued when the leg movements were transiently blocked by the experimenter or following the termination of arm movements. The present results reinforce the idea that there exists a functional neural coupling between arm and legs.

  8. Prandial states modify the reactivity of the gustatory cortex using gustatory evoked potentials in humans

    Directory of Open Access Journals (Sweden)

    Agnès eJACQUIN-PIQUES

    2016-01-01

    Full Text Available Previous functional Magnetic Resonance Imaging studies evaluated the role of satiety on cortical taste area activity and highlighted decreased activation in the orbito-frontal cortex when food was eaten until satiation. The modulation of orbito-frontal neurons (secondary taste area by ad libitum food intake has been associated with the pleasantness of the food’s flavor. The insula and frontal operculum (primary taste area are also involved in reward processing. The aim was to compare human gustatory evoked potentials (GEP recorded in the primary and secondary gustatory cortices in a fasted state with those after food intake. Fifteen healthy volunteers were enrolled in this observational study. In each of two sessions, two GEP recordings were performed (at 11:00 am and 1:30 pm in response to sucrose gustatory stimulation, and a sucrose-gustatory threshold was determined. During one session, a standard lunch was provided between the two GEP recordings. During the other session, subjects had nothing to eat. Hunger sensation, wanting, liking and the perception of the solution’s intensity were evaluated with visual analogue scales. GEP latencies measured in the Pz (p<0.001, Cz (p<0.01, Fz (p<0.001 recordings (primary taste area were longer after lunch than in the pre-prandial condition. Fp1 and Fp2 latencies (secondary taste area tended to be longer after lunch, but the difference was not significant. No difference was observed for the sucrose-gustatory threshold regardless of the session and time. Modifications in the primary taste area activity during the post-prandial period occurred regardless of the nature of the food eaten and could represent the activity of the frontal operculum and insula, which was recently shown to be modulated by gut signals (GLP-1, CCK, ghrelin, or insulin through vagal afferent neurons or metabolic changes of the internal milieu after nutrient absorption. This trial was registered at clinicalstrials.gov as NCT

  9. Dehydration enhances pain-evoked activation in the human brain compared with rehydration.

    Science.gov (United States)

    Ogino, Yuichi; Kakeda, Takahiro; Nakamura, Koji; Saito, Shigeru

    2014-06-01

    Negative effects of dehydration on the human brain and cognitive function have been reported. In this study, we examined the effects of dehydration on pain thresholds and cortical activations in response to pain, compared with rehydration with an oral rehydration solution (ORS) by functional magnetic resonance imaging. Five healthy adult men were subjected to dehydration and rehydration on 2 different days. The condition on the first day was randomly assigned to each subject. They completed a 40-minute exercise protocol using a walking machine after 12 hours of fasting under both conditions. For rehydration, the subjects consumed up to 3000 mL ORS starting from the night before the test day. After exercise, a painful stimulus (cold pressor test) was applied to the subjects' medial forearm in a magnetic resonance imaging scanning gantry, and pain-evoked brain activation was analyzed. On the rehydration day, each of the subjects consumed an average of 2040 mL (range; 1800-2500 mL) ORS. Physiological data revealed that subjects when dehydrated lost more weight from exercise than subjects when rehydrated had a larger heart rate increase, a higher tympanic temperature, and a higher urine osmolality. Subjective data revealed that the subjects reported significantly stronger thirst while dehydrated than while rehydrated with ORS, although the levels of hunger and anxiety and mood did not significantly differ between conditions. The cold pressor test robustly activated the pain-related neural network, notably the anterior cingulate cortex, insula, and thalamus. Such activations in the dehydrated subjects were greater than those in the rehydrated subjects in terms of peak and cluster, accompanied by a decrease in pain threshold (P = 0.001). Our findings suggest that dehydration brings about increased brain activity related to painful stimuli together with enhanced thirst, whereas rehydration with ORS alleviates thirst and decreases brain activity related to painful stimuli.

  10. Feeding Enterostomy for Oesophageal Obstruction | Okugbo ...

    African Journals Online (AJOL)

    Forty six (46) patients had feeding gastrostomy at the body of the stomach and 3 had feeding jejunostomy. The indications were oesophageal stricture 71.4%, oesophageal atresia 10.2% and oesophageal cancer 10.2%, nasopharyngeal tumors 6.1% and lung cancer made up 2%. Foley's catheter was used as the ...

  11. Endoscopic Dilatation versus Oesophageal Stent in Benign Oesophageal Stricture

    Directory of Open Access Journals (Sweden)

    Hadyanto Caputra

    2016-09-01

    Full Text Available Aim: Oesophageal stricture is one of the causes of dysphagia. It is a condition in which the lumen of oesophagus is narrowed by fibrotic tissue in the oesophageal wall. It is usually caused by inflammation or any other cause that leads to necrotizing of tissue. It is mainly differentiated into benign or malignant. The aim of this article is to answer the clinical question on the effectiveness of oesophageal stenting compared to endoscopic dilatation in patient with benign oesophageal stricture due to ingestion of corrosive substances, who had undergone several endoscopic dilatations. Method: We conducted search of relevant articles using PubMed search engine to answer the clinical question. Keywords being used during the search process were: ("oesophageal stricture"[All Fields] OR "oesophageal stenosis"[All Fields] AND (("dilatation"[All Fields] AND ("stents"[MeSH Terms] OR "stents"[All Fields] OR "stent"[All Fields]. Results were further converged by adding specific filters, which were full text articles and clinical trial. Results: The chosen article was further appraised in order to identify its validity and eligibility to answer the clinical question. We chose to use CONSORT (statement to improve the quality of reporting of RCTs to facilitate the critical appraisal and interpretation of RCTs. Conclusion: Stenting was associated with greater dysphagia, co-medication and adverse events. No randomized controlled trials which compared biodegradable stents with other stents or with balloon dilatation was identified. Lack of adequately robust evidence for effectiveness and cost-effectiveness formed the rationale of this trial.

  12. Brachytherapy in oesophageal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Leung, J.T.; Kuan, R. [Royal Prince Alfred Hospital, Camperdown, NSW (Australia)

    1995-11-01

    Patients with recurrent or locally advanced oesophageal carcinoma have a poor prognosis. Relief of dysphagia is often the goal of any further treatment. Several methods, including laser re-canalization, prosthetic intubation, dilatation, external beam irradiation (EBI) and intraluminal brachytherapy (IBT) can be used to alleviate dysphagia. In this retrospective review of 11 patients, eight with recurrent tumour and three newly diagnosed patients were treated with low dose rate IBT. Relief of dysphagia was achieved in nine patients, all of whom were able to maintain swallowing of at least a semi-solid diet until death or last follow-up. Toxicity was minimal, but survival was poor, with a median survival of only 3 months. IBT presents several advantages over other palliative methods, especially in recurrent tumours where re-treatment with EBI is often difficult because of normal tissue tolerance. Low dose rate IBT takes only 1-2 days to deliver, is highly effective, has little morbidity and the palliation achieved is relatively durable. 19 refs., 2 tabs., 1 fig.

  13. Surgical management of oesophageal atresia.

    Science.gov (United States)

    Teague, Warwick J; Karpelowsky, Jonathan

    2016-06-01

    There have been major advances in the surgery for oesophageal atresia (OA) and tracheo-oesophageal fistula(TOF) with survival now exceeding 90%. The standard open approach to OA and distal TOF has been well described and essentially unchanged for the last 60 years. Improved survival in recent decades is most attributable to advances in neonatal anaesthesia and perioperative care. Recent surgical advances include the use of thoracoscopic surgery for the repair of OA/TOF and in some centres isolated OA, thereby minimising the long term musculo-skeletal morbidity associated with open surgery. The introduction of growth induction by external traction (Foker procedure) for the treatment of long-gap OA has provided an important tool enabling increased preservation of the native oesophagus. Despite this, long-gap OA still poses a number of challenges, and oesophageal replacement still may be required in some cases. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Diffuse noxious inhibitory control evoked by tonic craniofacial pain in humans

    DEFF Research Database (Denmark)

    Sowman, Paul Fredrick; Wang, Kelun; Svensson, P

    2011-01-01

    Tonic pain in one body segment can inhibit the perception of pain in another body segment. This phenomenon is mediated by diffuse noxious inhibitory controls (DNIC), and its efficacy in craniofacial regions is investigated in this study. A compressive device that evoked a tonic, moderate...

  15. Circulatory response evoked by a 3 s bout of dynamic leg exercise in humans

    NARCIS (Netherlands)

    Wieling, W.; Harms, M. P.; ten Harkel, A. D.; van Lieshout, J. J.; Sprangers, R. L.

    1996-01-01

    1. The mechanisms underlying the pronounced transient fall in arterial blood pressure evoked by a 3 s bout of bicycle exercise were investigated in twenty healthy young adults and four patients with hypoadrenergic orthostatic hypotension. 2. In healthy subjects a 3 s bout of upright cycling induced

  16. Oesophageal bleeding from aorto- oesophageal fistula due to aortic ...

    African Journals Online (AJOL)

    1983-01-22

    Jan 22, 1983 ... ing gives warning of fistula formation. S Air Med J 1983: 63: 124-127. Exsanguinating oesophageal haemorrhage due to an established .... tive review has persuaded us that a more alert and vigorous approach in our cases might well have achieved some success. We are indebted to the Department of ...

  17. Reverse gastric tube oesophageal substitution for staged repair of oesophageal atresia and tracheo-oesophageal fistula

    Directory of Open Access Journals (Sweden)

    Christopher Olusanjo Bode

    2014-01-01

    Full Text Available The management of oesophageal atresia and tracheo-oesophageal atresia (OATOF is very challenging. While in developed countries survival of patients with this condition has improved, the outcome in many developing countries has been poor. Primary repair through a thoracotomy (or video-assisted thoracoscopic surgery where available is the gold standard treatment of OATOF. However, in our setting where patients typically present late and with minimum support resources such as Neonatal Intensive Care Unit and total parenteral nutrition; staged repair may be the only hope of survival of these patients and this communication highlights the essential steps of this mode of treatment.

  18. Acquired tracheo-oesophageal fistula.

    Directory of Open Access Journals (Sweden)

    Shah C

    1994-04-01

    Full Text Available Acquired tracheo-oesophageal fistula is rare. The most common causes are tuberculosis and malignancy. Here we report a patient who had come with dysphagia and aspiration pneumonia with paratracheal lymphnodes on X-ray chest and was diagnosed to have a tracheo-bronchial fistula on barium studies. Transtumoral intubation by pull-through method was carried out.

  19. PALLIATIVE TREATMENT OF OESOPHAGEAL CARCINOMA ...

    African Journals Online (AJOL)

    Objectives. A prospective randomised study of patients with irresectable oesophageal carcinoma treated with self- expandable covered metal Wallstent and plastic Procter. Livingstone tubes was performed_ The purpose was to compare the efficacy, cost effectiveness, ease of implantation,. I.ong-term patency and ...

  20. Oesophageal chemoreceptors of blue crabs, Callinectes sapidus, sense chemical deterrents and can block ingestion of food.

    Science.gov (United States)

    Aggio, Juan F; Tieu, Ryan; Wei, Amy; Derby, Charles D

    2012-05-15

    Decapod crustaceans such as blue crabs possess a variety of chemoreceptors that control different stages of the feeding process. All these chemoreceptors are putative targets for feeding deterrents that cause animals to avoid or reject otherwise palatable food. As a first step towards characterizing the chemoreceptors that mediate the effect of deterrents, we used a behavioral approach to investigate their precise location. Data presented here demonstrate that chemoreceptors located on the antennules, pereiopods and mouthparts do not mediate the food-rejection effects of a variety of deterrents, both natural and artificial to crabs. Crabs always searched for deterrent-laced food and took it to their oral region. The deterrent effect was manifested as either rejection or extensive manipulation, but in both cases crabs bit the food. The biting behavior is relevant because the introduction of food into the oral cavity ensured that the deterrents gained access to the oesophageal taste receptors, and so we conclude that they are the ones mediating rejection. Additional support comes from the fact that a variety of deterrent compounds evoked oesophageal dilatation, which is mediated by oesophageal receptors and has been linked to food rejection. Further, there is a positive correlation between a compound's ability to elicit rejection and its ability to evoke oesophageal dilatation. The fact that deterrents do not act at a distance is in accordance with the limited solubility of most known feeding deterrents, and likely influences predator-prey interactions and their outcome: prey organisms will be attacked and bitten before deterrents become relevant.

  1. [Manifestations of the genotypic causality of human evoked potentials during perception of various visual stimuli].

    Science.gov (United States)

    Mariutina, T M; Ivoshina, T G

    1984-01-01

    Intrapair resemblance of the wave form and amplitude-temporal parameters of evoked potentials (EPs) to flashes, chess field, house image, the word "house" and a series of other stimuli was evaluated in 20 pairs of monozygotic and 20 pairs of homosexual dizygotic adult twins. In the occipital area the maximum of genetic dependence was characteristic of EPs to flashes, the minimum--of EPs--to the word "house". In vertex EPs parameters genotypic effects were manifest irrespectively of the stimulus type. Genotypic dependence differed for the amplitudes and latencies of separate EP components.

  2. Brain stem evoked response to forward and reversed speech in humans.

    Science.gov (United States)

    Galbraith, Gary C; Amaya, Elizabeth M; de Rivera, Jacinta M Diaz; Donan, Namee M; Duong, Mylien T; Hsu, Jeffrey N; Tran, Kim; Tsang, Lian P

    2004-09-15

    Speech stimuli played in reverse are perceived as unfamiliar and alien-sounding, even though phoneme duration and fundamental voicing frequency are preserved. Although language perception ultimately resides in the neocortex, the brain stem plays a vital role in processing auditory information, including speech. The present study measured brain stem frequency-following responses (FFR) evoked by forward and reverse speech stimuli recorded from electrodes oriented horizontally and vertically to measure signals with putative origins in auditory nerve and rostral brain stem, respectively. The vertical FFR showed increased amplitude due to forward speech. It is concluded that familiar phonological and prosodic properties of forward speech selectively activate central brain stem neurons.

  3. Whole person-evoked fMRI activity patterns in human fusiform gyrus are accurately modeled by a linear combination of face- and body-evoked activity patterns.

    Science.gov (United States)

    Kaiser, Daniel; Strnad, Lukas; Seidl, Katharina N; Kastner, Sabine; Peelen, Marius V

    2014-01-01

    Visual cues from the face and the body provide information about another's identity, emotional state, and intentions. Previous neuroimaging studies that investigated neural responses to (bodiless) faces and (headless) bodies have reported overlapping face- and body-selective brain regions in right fusiform gyrus (FG). In daily life, however, faces and bodies are typically perceived together and are effortlessly integrated into the percept of a whole person, raising the possibility that neural responses to whole persons are qualitatively different than responses to isolated faces and bodies. The present study used fMRI to examine how FG activity in response to a whole person relates to activity in response to the same face and body but presented in isolation. Using multivoxel pattern analysis, we modeled person-evoked response patterns in right FG through a linear combination of face- and body-evoked response patterns. We found that these synthetic patterns were able to accurately approximate the response patterns to whole persons, with face and body patterns each adding unique information to the response patterns evoked by whole person stimuli. These results suggest that whole person responses in FG primarily arise from the coactivation of independent face- and body-selective neural populations.

  4. Task-specific modulation of human auditory evoked responses in a delayed-match-to-sample task

    Directory of Open Access Journals (Sweden)

    Feng eRong

    2011-05-01

    Full Text Available In this study, we focus our investigation on task-specific cognitive modulation of early cortical auditory processing in human cerebral cortex. During the experiments, we acquired whole-head magnetoencephalography (MEG data while participants were performing an auditory delayed-match-to-sample (DMS task and associated control tasks. Using a spatial filtering beamformer technique to simultaneously estimate multiple source activities inside the human brain, we observed a significant DMS-specific suppression of the auditory evoked response to the second stimulus in a sound pair, with the center of the effect being located in the vicinity of the left auditory cortex. For the right auditory cortex, a non-invariant suppression effect was observed in both DMS and control tasks. Furthermore, analysis of coherence revealed a beta band (12 ~ 20 Hz DMS-specific enhanced functional interaction between the sources in left auditory cortex and those in left inferior frontal gyrus, which has been shown to involve in short-term memory processing during the delay period of DMS task. Our findings support the view that early evoked cortical responses to incoming acoustic stimuli can be modulated by task-specific cognitive functions by means of frontal-temporal functional interactions.

  5. Review article: reflux and its consequences--the laryngeal, pulmonary and oesophageal manifestations. Conference held in conjunction with the 9th International Symposium on Human Pepsin (ISHP) Kingston-upon-Hull, UK, 21-23 April 2010

    NARCIS (Netherlands)

    Pearson, J. P.; Parikh, S.; Orlando, R. C.; Johnston, N.; Allen, J.; Tinling, S. P.; Belafsky, P.; Arevalo, L. F.; Sharma, N.; Castell, D. O.; Fox, M.; Harding, S. M.; Morice, A. H.; Watson, M. G.; Shields, M. D.; Bateman, N.; McCallion, W. A.; van Wijk, M. P.; Wenzl, T. G.; Karkos, P. D.; Belafsky, P. C.

    2011-01-01

    Gastro-oesophageal reflux disease (GERD) is one of the commonest diseases of Western populations, affecting 20 to 30% of adults. GERD is multifaceted and the classical oesophageal symptoms such as heartburn and regurgitation often overlap with atypical symptoms that impact upon the respiratory

  6. Does catastrophic thinking enhance oesophageal pain sensitivity?

    DEFF Research Database (Denmark)

    Martel, M O; Olesen, A E; Jørgensen, D

    2016-01-01

    study visits, mechanical, thermal, and electrical pain sensitivity in the oesophagus was assessed before and after inducing oesophageal sensitization using a 30-min intraluminal oesophageal acid perfusion procedure. RESULTS: Analyses were conducted based on data averaged across the two study visits...... that catastrophic thinking exerts an influence on oesophageal pain sensitivity, but not necessarily on the magnitude of acid-induced oesophageal sensitization. WHAT DOES THIS STUDY ADD?: Catastrophizing is associated with heightened pain sensitivity in the oesophagus. This was substantiated by assessing responses...

  7. Frequency characteristics of human muscle and cortical responses evoked by noisy Achilles tendon vibration.

    Science.gov (United States)

    Mildren, Robyn L; Peters, Ryan M; Hill, Aimee J; Blouin, Jean-Sébastien; Carpenter, Mark G; Inglis, J Timothy

    2017-05-01

    Noisy stimuli, along with linear systems analysis, have proven to be effective for mapping functional neural connections. We explored the use of noisy (10-115 Hz) Achilles tendon vibration to examine somatosensory reflexes in the triceps surae muscles in standing healthy young adults ( n = 8). We also examined the association between noisy vibration and electrical activity recorded over the sensorimotor cortex using electroencephalography. We applied 2 min of vibration and recorded ongoing muscle activity of the soleus and gastrocnemii using surface electromyography (EMG). Vibration amplitude was varied to characterize reflex scaling and to examine how different stimulus levels affected postural sway. Muscle activity from the soleus and gastrocnemii was significantly correlated with the tendon vibration across a broad frequency range (~10-80 Hz), with a peak located at ~40 Hz. Vibration-EMG coherence positively scaled with stimulus amplitude in all three muscles, with soleus displaying the strongest coupling and steepest scaling. EMG responses lagged the vibration by ~38 ms, a delay that paralleled observed response latencies to tendon taps. Vibration-evoked cortical oscillations were observed at frequencies ~40-70 Hz (peak ~54 Hz) in most subjects, a finding in line with previous reports of sensory-evoked γ-band oscillations. Further examination of the method revealed 1 ) accurate reflex estimates could be obtained with vibration; 2 ) responses did not habituate over 2 min of exposure; and importantly, 3 ) noisy vibration had a minimal influence on standing balance. Our findings suggest noisy tendon vibration is an effective novel approach to characterize somatosensory reflexes during standing. NEW & NOTEWORTHY We applied noisy (10-115 Hz) vibration to the Achilles tendon to examine the frequency characteristics of lower limb somatosensory reflexes during standing. Ongoing muscle activity was coherent with the noisy vibration (peak coherence ~40 Hz), and

  8. Dysphagia in children with repaired oesophageal atresia

    NARCIS (Netherlands)

    Coppens, C.H.; Engel-Hoek, L. van den; Scharbatke, H.E.; Groot, S.A. de; Draaisma, J.M.T.

    2016-01-01

    Dysphagia is a common problem in children with repaired oesophageal atresia (OA). Abnormalities in the oropharyngeal and oesophageal phase have hardly been studied. The aims of this study were to assess the prevalence of dysphagia in children with repaired OA and to identify and differentiate oral

  9. Oesophageal cancer and experience with endoscopic stent ...

    African Journals Online (AJOL)

    Background: Oesophageal cancer often presents in advanced stages not amenable to surgical resection. In such patients, palliation of dysphagia remains the mainstay of management. Objectives: To determine the burden of advanced oesophageal cancer and to document the experience with endoscopic metal stent ...

  10. Reflux oesophagitis : an experimental study in rats

    NARCIS (Netherlands)

    S.E. Kranendonk (Steef)

    1980-01-01

    textabstractThe aim of the surgical therapy of reflux oesophagitis is prevention of reflux, and the treatment of the irreversible complications of reflux such as strictures. Recent developments in the treatment of reflux are concentrated on an earlier diagnosis of reflux and oesophagitis and

  11. Oesophageal cancer and experience with endoscopic stent ...

    African Journals Online (AJOL)

    Background: Oesophageal cancer often presents in advanced stages not amenable to surgical resection. In such patients, palliation of dysphagia remains the mainstay of management. oBjectives: To determine the burden of advanced oesophageal cancer and to document the experience with endoscopic metal stent.

  12. Comparison of the physiological properties of human periodontal-masseteric reflex evoked by incisor and canine stimulation

    Directory of Open Access Journals (Sweden)

    Hiroko eOhmori

    2012-06-01

    Full Text Available Introduction: The present study was designed to clarify whether the bilateral cooperation in the human periodontal-masseteric reflex (PMR differs between central incisors and canines. Methods: Surface array electrodes were placed on the bilateral masseter muscles to simultaneously record the firing activities of single motor units from both sides in 7 healthy adults. During light clenching, mechanical stimulation was applied to the right maxillary central incisor and canine to evoke the PMR. Unitary activity was plotted with respect to the background activity and firing frequency. The slope of the regression line (sRL and the correlation coefficient (CC between the central incisor and canine and the lateral differences between these values were compared. Results: There were significant differences in the sRL and CC, as well as lateral differences, between the central incisor- and canine-driven PMR. Discussion: These results suggest that the PMR differs depending on both the tooth position and laterality.

  13. The vestibular implant: frequency-dependency of the electrically evoked vestibulo-ocular reflex in humans.

    Science.gov (United States)

    van de Berg, Raymond; Guinand, Nils; Nguyen, T A Khoa; Ranieri, Maurizio; Cavuscens, Samuel; Guyot, Jean-Philippe; Stokroos, Robert; Kingma, Herman; Perez-Fornos, Angelica

    2014-01-01

    The vestibulo-ocular reflex (VOR) shows frequency-dependent behavior. This study investigated whether the characteristics of the electrically evoked VOR (eVOR) elicited by a vestibular implant, showed the same frequency-dependency. Twelve vestibular electrodes implanted in seven patients with bilateral vestibular hypofunction (BVH) were tested. Stimuli consisted of amplitude-modulated electrical stimulation with a sinusoidal profile at frequencies of 0.5, 1, and 2 Hz. The main characteristics of the eVOR were evaluated and compared to the "natural" VOR characteristics measured in a group of age-matched healthy volunteers who were subjected to horizontal whole body rotations with equivalent sinusoidal velocity profiles at the same frequencies. A strong and significant effect of frequency was observed in the total peak eye velocity of the eVOR. This effect was similar to that observed in the "natural" VOR. Other characteristics of the (e)VOR (angle, habituation-index, and asymmetry) showed no significant frequency-dependent effect. In conclusion, this study demonstrates that, at least at the specific (limited) frequency range tested, responses elicited by a vestibular implant closely mimic the frequency-dependency of the "normal" vestibular system.

  14. The vestibular implant: Frequency-dependency of the electrically evoked Vestibulo-Ocular Reflex in humans

    Directory of Open Access Journals (Sweden)

    Raymond eVan De Berg

    2015-01-01

    Full Text Available The Vestibulo-Ocular Reflex (VOR shows frequency-dependent behavior. This study investigated whether the characteristics of the electrically evoked VOR (eVOR elicited by a vestibular implant, showed the same frequency-dependency.Twelve vestibular electrodes implanted in 7 patients with bilateral vestibular hypofunction were tested. Stimuli consisted of amplitude-modulated electrical stimulation with a sinusoidal profile at frequencies of 0.5Hz, 1Hz, and 2Hz. The main characteristics of the eVOR were evaluated and compared to the natural VOR characteristics measured in a group of age-matched healthy volunteers who were subjected to horizontal whole body rotations with equivalent sinusoidal velocity profiles at the same frequencies.A strong and significant effect of frequency was observed in the total peak eye velocity of the eVOR. This effect was similar to that observed in the natural VOR. Other characteristics of the (eVOR (angle, habituation-index, and asymmetry showed no significant frequency-dependent effect. In conclusion, this study demonstrates that, at least at the specific (limited frequency range tested, responses elicited by a vestibular implant closely mimic the frequency-dependency of the normal vestibular system.

  15. A Pilot Study of Phase-Evoked Acoustic Responses From the Ears of Human Subjects

    DEFF Research Database (Denmark)

    Christensen, Anders Tornvig; Dewey, James; Dhar, Sumitrajit

    2015-01-01

    Temporal properties of otoacoustic emissions (OAEs) are of interest as they help understand the dynamic behavior and spatial distribution of the generating mechanisms. In particular, the ringing behavior of responses to clicks and tone bursts have been investigated, and times of arrival and round......Temporal properties of otoacoustic emissions (OAEs) are of interest as they help understand the dynamic behavior and spatial distribution of the generating mechanisms. In particular, the ringing behavior of responses to clicks and tone bursts have been investigated, and times of arrival...... and roundtrip delays have been related to properties of the dispersive cochlea and internal reflections. Temporal suppression experiments (e.g. Kemp and Chum, 1980; Verhulst et al., 2008), where a suppressor click is presented just before the stimulus click, have shown how a click response depends on preceding...... within one, three and five periods of the stimulus-frequency every 64 ms (54 conditions). Using a combination of level and phase variation, emissions linked to any time-invariant nonlinearity could be extracted. Phase-evoked residual responses (PERRs) look like tone bursts with a phase...

  16. Capnography for detection of accidental oesophageal intubation.

    Science.gov (United States)

    Linko, K; Paloheimo, M; Tammisto, T

    1983-06-01

    The clinical diagnostic signs for detecting inadvertent oesophageal intubation may all be misleading. We therefore tested the practice of recording exhaled carbon dioxide during the intubation procedure as an additional measure for detection of accidental oesophageal intubation. Twenty patients were intubated simultaneously into the trachea and oesophagus and the carbon dioxide concentration was continuously recorded from both sources. Manual ventilation of the lungs always resulted in a typical CO2 curve pattern. Ventilation by mask prior to the intubation obviously resulted in some filling the stomach by exhaled gas in 9 of the 20 patients. In these cases some CO2 could be detected during oesophageal ventilation. As the oesophageal CO2 concentrations were very low initially, compared to the tracheal recordings, and carbon dioxide completely disappeared after a few ventilations into the oesophagus, distinguishing between the tracheal and oesophageal capnography tracings was easy.

  17. Octreotide in the Control of Post-Sclerotherapy Bleeding from Oesophageal Varices, Ulcers and Oesophagitis

    Directory of Open Access Journals (Sweden)

    Spencer A. Jenkins

    1996-01-01

    Full Text Available Bleeding from oesophageal varices, oesophageal ulcers or oesophagitis is occasionally massive and difficult to control. Octreotide, a synthetic analogue of somatostin lowers portal pressure and collateral blood flow including that through varices, increases lower oesophageal sphincter pressure, and inhibits the gastric secretion of acid as well as pepsin. Our current experience suggests it is effective in controlling acute variceal haemorrhage. Therefore we have examined the efficacy of octreotide in the control of postsclerotherapy bleeding from oesophageal varices, oesophageal ulcers and oesophagitis. During the study period 77 patients experienced a significant gastrointestinal bleed (blood pressure 100 beats per min or the need to transfuse 2 or more units of blood to restore the haemoglobin level following injection sclerotherapy of oesophageal varices. The source of bleeding was varices in 42 patients, oesophageal ulcers in 31 and oesophagitis in 4. All patients received a continuous intravenous infusion of octreotide (50 μg/h for between 40–140h. If bleeding was not controlled in the first 12h after commencing octreotide hourly bolus doses (50 μg for 24h were superimposed on the continuous infusion. Haemorrhage was successfully controlled by an infusion of octreotide in 38 of the 42 patients with bleeding from varices, in 30 of 31 patients with oesophageal ulceration, and all patients with oesophagitis. In the 1 patient with persistent bleeding from oesophageal ulceration and in 2 of the 4 with continued haemorrhage from varices, haemostasis was achieved by hourly boluses of 50 μg octreotide for 24h in addition to the continuous infusion. No major complications were associated with octreotide administration. The results of this study clearly indicate that octreotide is a safe and effective treatment for the control of severe haemorrhage after technically successful injection sclerotherapy.

  18. Successful transendoscopic oesophageal mass ablation in two dogs with Spirocerca lupi associated oesophageal sarcoma.

    Science.gov (United States)

    Yas, E; Kelmer, G; Shipov, A; Ben-Oz, J; Segev, G

    2013-09-01

    This report describes two cases of oesophageal tumours managed by transendoscopic neodymium:yttrium-aluminum-garnet laser ablation and polypectomy snare electrocautery. In each dog oesophagoscopy revealed caudal oesophageal masses, suspected to be Spirocerca lupi-induced oesophageal neoplasia. To resect the masses, transendoscopic neodymium:yttrium-aluminum-garnet laser ablation was used in the first case and polypectomy snare electrocautery in the second. Recovery was uneventful. Histopathology was consistent with oesophageal fibrosarcoma and osteosarcoma in each case, respectively. Follow-up oesophagoscopy revealed apparently healthy oesophageal tissue except for focal scar tissue in the first case. Transendoscopic laser ablation and polypectomy snare electrocautery is a potential non-invasive, cost effective alternative for surgical oesophageal mass resection. © 2013 British Small Animal Veterinary Association.

  19. Adjective metaphors evoke negative meanings.

    Science.gov (United States)

    Sakamoto, Maki; Utsumi, Akira

    2014-01-01

    Previous metaphor studies have paid much attention to nominal metaphors and predicative metaphors, but little attention has been given to adjective metaphors. Although some studies have focused on adjective metaphors, they only examined differences in the acceptability of various types of adjective metaphors. This paper explores the cognitive effects evoked by adjective metaphors. Three psychological experiments revealed that (1) adjective metaphors, especially those modified by color adjectives, tend to evoke negative effect; (2) although the meanings of metaphors are basically affected by the meanings of their vehicles, when a vehicle has a neutral meaning, negative meanings are evoked most frequently for adjective metaphors compared to nominal and predicative metaphors; (3) negative meanings evoked by adjective metaphors are related to poeticness, and poetic metaphors evoke negative meanings more easily than less poetic metaphors. Our research sheds new light on studies of the use of metaphor, which is one of the most basic human cognitive abilities.

  20. Adjective metaphors evoke negative meanings.

    Directory of Open Access Journals (Sweden)

    Maki Sakamoto

    Full Text Available Previous metaphor studies have paid much attention to nominal metaphors and predicative metaphors, but little attention has been given to adjective metaphors. Although some studies have focused on adjective metaphors, they only examined differences in the acceptability of various types of adjective metaphors. This paper explores the cognitive effects evoked by adjective metaphors. Three psychological experiments revealed that (1 adjective metaphors, especially those modified by color adjectives, tend to evoke negative effect; (2 although the meanings of metaphors are basically affected by the meanings of their vehicles, when a vehicle has a neutral meaning, negative meanings are evoked most frequently for adjective metaphors compared to nominal and predicative metaphors; (3 negative meanings evoked by adjective metaphors are related to poeticness, and poetic metaphors evoke negative meanings more easily than less poetic metaphors. Our research sheds new light on studies of the use of metaphor, which is one of the most basic human cognitive abilities.

  1. A cholinergic contribution to the circulatory responses evoked at the onset of handgrip exercise in humans

    DEFF Research Database (Denmark)

    Vianna, Lauro C; Fadel, Paul J; Secher, Niels H

    2015-01-01

    A cholinergic (muscarinic) contribution to the initial circulatory response to exercise in humans remains controversial. Herein, we posit that this may be due to exercise mode with a cholinergic contribution being important during isometric handgrip exercise, where the hyperemic response of the m......A cholinergic (muscarinic) contribution to the initial circulatory response to exercise in humans remains controversial. Herein, we posit that this may be due to exercise mode with a cholinergic contribution being important during isometric handgrip exercise, where the hyperemic response...... of the muscle is relatively small compared with the onset of leg cycling, where a marked increase in muscle blood flow rapidly occurs as a consequence of multiple redundant mechanisms. We recorded blood pressure (BP; brachial artery), stroke volume (pulse contour analysis), cardiac output, and systemic vascular...

  2. Intrinsic and Task-Evoked Network Architectures of the Human Brain

    OpenAIRE

    Cole, Michael W.; Bassett, Danielle S.; Power, Jonathan D.; Braver, Todd S.; Petersen, Steven E.

    2014-01-01

    Many functional network properties of the human brain have been identified during rest and task states, yet it remains unclear how the two relate. We identified a whole-brain network architecture present across dozens of task states that was highly similar to the resting-state network architecture. The most frequent functional connectivity strengths across tasks closely matched the strengths observed at rest, suggesting this is an “intrinsic”, standard architecture of functional brain organiz...

  3. Prostaglandin E2 Inhibits Histamine-Evoked Ca2+ Release in Human Aortic Smooth Muscle Cells through Hyperactive cAMP Signaling Junctions and Protein Kinase A.

    Science.gov (United States)

    Taylor, Emily J A; Pantazaka, Evangelia; Shelley, Kathryn L; Taylor, Colin W

    2017-11-01

    In human aortic smooth muscle cells, prostaglandin E2 (PGE2) stimulates adenylyl cyclase (AC) and attenuates the increase in intracellular free Ca2+ concentration evoked by activation of histamine H1 receptors. The mechanisms are not resolved. We show that cAMP mediates inhibition of histamine-evoked Ca2+ signals by PGE2 Exchange proteins activated by cAMP were not required, but the effects were attenuated by inhibition of cAMP-dependent protein kinase (PKA). PGE2 had no effect on the Ca2+ signals evoked by protease-activated receptors, heterologously expressed muscarinic M3 receptors, or by direct activation of inositol 1,4,5-trisphosphate (IP3) receptors by photolysis of caged IP3 The rate of Ca2+ removal from the cytosol was unaffected by PGE2, but PGE2 attenuated histamine-evoked IP3 accumulation. Substantial inhibition of AC had no effect on the concentration-dependent inhibition of Ca2+ signals by PGE2 or butaprost (to activate EP2 receptors selectively), but it modestly attenuated responses to EP4 receptors, activation of which generated less cAMP than EP2 receptors. We conclude that inhibition of histamine-evoked Ca2+ signals by PGE2 occurs through "hyperactive signaling junctions," wherein cAMP is locally delivered to PKA at supersaturating concentrations to cause uncoupling of H1 receptors from phospholipase C. This sequence allows digital signaling from PGE2 receptors, through cAMP and PKA, to histamine-evoked Ca2+ signals. Copyright © 2017 by The Author(s).

  4. Treatment of oesophageal perforation: a multivariate analysis

    NARCIS (Netherlands)

    Tilanus, H. W.; Bossuyt, P.; Eeftinck Schattenkerk, M.; Obertop, H.

    1991-01-01

    Perforation of the oesophagus was retrospectively analysed in 59 patients. Cause and extent of perforation, localization, quality of the oesophageal wall and therapeutic modes were subjected to univariate analysis. The perforations of the intrathoracic oesophagus (39) were also subjected to

  5. oesophageal cancer in Malawi and Scotland

    African Journals Online (AJOL)

    Patients presenting with the symptoms of oesophageal cancer almost always have advanced ... and reviewed for the relevant information. The data available .... Obesity is a major issue in Scotland with 44% of adult men being overweight and ...

  6. Corpus gastritis is protective against reflux oesophagitis

    OpenAIRE

    El-Serag, H; Sonnenberg, A; Jamal, M; Inadomi, J; Crooks, L; Feddersen, R

    1999-01-01

    BACKGROUND—Gastric acid is important in the pathogenesis of reflux oesophagitis. Acid production by the gastric corpus is reduced in corpus gastritis.
AIMS—To determine whether corpus gastritis protects against reflux oesophagitis.
METHODS—Patients presenting for elective oesophagogastroduodenoscopy were studied. Two biopsy specimens were taken from the antrum, corpus, and cardia and stained with haematoxylin/eosin and Diff-Quick II stains. The presence and severity of gastritis were graded a...

  7. Corticospinal activity evoked and modulated by non-invasive stimulation of the intact human motor cortex

    Science.gov (United States)

    Di Lazzaro, Vincenzo; Rothwell, John C

    2014-01-01

    A number of methods have been developed recently that stimulate the human brain non-invasively through the intact scalp. The most common are transcranial magnetic stimulation (TMS), transcranial electric stimulation (TES) and transcranial direct current stimulation (TDCS). They are widely used to probe function and connectivity of brain areas as well as therapeutically in a variety of conditions such as depression or stroke. They are much less focal than conventional invasive methods which use small electrodes placed on or in the brain and are often thought to activate all classes of neurones in the stimulated area. However, this is not true. A large body of evidence from experiments on the motor cortex shows that non-invasive methods of brain stimulation can be surprisingly selective and that adjusting the intensity and direction of stimulation can activate different classes of inhibitory and excitatory inputs to the corticospinal output cells. Here we review data that have elucidated the action of TMS and TES, concentrating mainly on the most direct evidence available from spinal epidural recordings of the descending corticospinal volleys. The results show that it is potentially possible to test and condition specific neural circuits in motor cortex that could be affected differentially by disease, or be used in different forms of natural behaviour. However, there is substantial interindividual variability in the specificity of these protocols. Perhaps in the future it will be possible, with the advances currently being made to model the electrical fields induced in individual brains, to develop forms of stimulation that can reliably target more specific populations of neurones, and open up the internal circuitry of the motor cortex for study in behaving humans. PMID:25172954

  8. Therapeutic consequences of oesophageal function studies in patients with benign oesophageal disease

    DEFF Research Database (Denmark)

    Jakobsen, Erik; Kruse-Andersen, S; Wallin, Lene

    1988-01-01

    Evaluation of oesophageal function was performed in 91 patients referred to a specialized department of cardiothoracic surgery for surgical treatment of benign oesophageal disease. Standard manometry was used in addition to radiology and endoscopy, and in some patients, an acid perfusion test, an...

  9. Assessing the Quality of Steady-state Visual-evoked Potentials for Moving Humans Using a Mobile Electroencephalogram Headset

    Directory of Open Access Journals (Sweden)

    Yuan-Pin eLin

    2014-03-01

    Full Text Available Recent advances in mobile electroencephalogram (EEG systems, featuring non-prep dry electrodes and wireless telemetry, have urged the needs of mobile brain-computer interfaces (BCIs for applications in our daily life. Since the brain may behave differently while people are actively situated in ecologically-valid environments versus highly-controlled laboratory environments, it remains unclear how well the current laboratory-oriented BCI demonstrations can be translated into operational BCIs for users with naturalistic movements. Understanding inherent links between natural human behaviors and brain activities is the key to ensuring the applicability and stability of mobile BCIs. This study aims to assess the quality of steady-state visual-evoked potentials (SSVEPs, which is one of promising channels for functioning BCI systems, recorded using a mobile EEG system under challenging recording conditions, e.g., walking. To systemati-cally explore the effects of walking locomotion on the SSVEPs, this study instructed subjects to stand or walk on a treadmill running at speeds of 1, 2, and 3 mile (s per hour (MPH while con-currently perceiving visual flickers (11 and 12 Hz. Empirical results of this study showed that the SSVEP amplitude tended to deteriorate when subjects switched from standing to walking. Such SSVEP suppression could be attributed to the walking locomotion, leading to distinctly deteriorated SSVEP detectability from standing (84.87±13.55% to walking (1 MPH: 83.03±13.24%, 2 MPH: 79.47±13.53%, and 3 MPH: 75.26±17.89%. These findings not only demonstrated the applicability and limitations of SSVEPs recorded from freely behaving humans in realistic environments, but also provide useful methods and techniques for boosting the translation of the BCI technology from laboratory demonstrations to practical applications.

  10. High-frequency submaximal stimulation over muscle evokes centrally generated forces in human upper limb skeletal muscles.

    Science.gov (United States)

    Blouin, Jean-Sébastien; Walsh, Lee D; Nickolls, Peter; Gandevia, Simon C

    2009-02-01

    Control of posture and movement requires control of the output from motoneurons. Motoneurons of human lower limb muscles exhibit sustained, submaximal activity to high-frequency electrical trains, which has been hypothesized to be partly triggered by monosynaptic Ia afferents. The possibility to trigger such behavior in upper limb motoneurons and the potential unique role of Ia afferents to trigger such behavior remain unclear. Subjects (n = 9) received high-frequency trains of electrical stimuli over biceps brachii and flexor pollicis longus (FPL). We chose to study the FPL muscle because it has weak monosynaptic Ia afferent connectivity and it is involved in fine motor control of the thumb. Two types of stimulus trains (100-Hz bursts and triangular ramps) were tested at five intensities below painful levels. All subjects exhibited enhanced torque in biceps and FPL muscles after both types of high-frequency train. Torques also persisted after stimulation, particularly for the highest stimulus intensity. To separate the evoked torques that resulted from a peripheral mechanism (e.g., muscle potentiation) and that which resulted from a central origin, we studied FPL responses to high-frequency trains after complete combined nerve blocks of the median and radial nerves (n = 2). During the blocks, high-frequency trains over the FPL did not yield torque enhancements or persisting torques. These results suggest that enhanced contractions of central origin can be elicited in motoneurons innervating the upper limb, despite weak monosynaptic Ia connections for FPL. Their presence in a recently evolved human muscle (FPL) indicates that these enhanced contractions may have a broad role in controlling tonic postural outputs of hand muscles and that they may be available even for fine motor activities involving the thumb.

  11. Acute Stress Alters Auditory Selective Attention in Humans Independent of HPA: A Study of Evoked Potentials

    Science.gov (United States)

    Elling, Ludger; Steinberg, Christian; Bröckelmann, Ann-Kathrin; Dobel, Christan; Bölte, Jens; Junghofer, Markus

    2011-01-01

    Background Acute stress is a stereotypical, but multimodal response to a present or imminent challenge overcharging an organism. Among the different branches of this multimodal response, the consequences of glucocorticoid secretion have been extensively investigated, mostly in connection with long-term memory (LTM). However, stress responses comprise other endocrine signaling and altered neuronal activity wholly independent of pituitary regulation. To date, knowledge of the impact of such “paracorticoidal” stress responses on higher cognitive functions is scarce. We investigated the impact of an ecological stressor on the ability to direct selective attention using event-related potentials in humans. Based on research in rodents, we assumed that a stress-induced imbalance of catecholaminergic transmission would impair this ability. Methodology/Principal Findings The stressor consisted of a single cold pressor test. Auditory negative difference (Nd) and mismatch negativity (MMN) were recorded in a tonal dichotic listening task. A time series of such tasks confirmed an increased distractibility occuring 4–7 minutes after onset of the stressor as reflected by an attenuated Nd. Salivary cortisol began to rise 8–11 minutes after onset when no further modulations in the event-related potentials (ERP) occurred, thus precluding a causal relationship. This effect may be attributed to a stress-induced activation of mesofrontal dopaminergic projections. It may also be attributed to an activation of noradrenergic projections. Known characteristics of the modulation of ERP by different stress-related ligands were used for further disambiguation of causality. The conjuncture of an attenuated Nd and an increased MMN might be interpreted as indicating a dopaminergic influence. The selective effect on the late portion of the Nd provides another tentative clue for this. Conclusions/Significance Prior studies have deliberately tracked the adrenocortical influence on cognition

  12. Modulation of nerve-evoked contractions by β3-adrenoceptor agonism in human and rat isolated urinary bladder.

    Science.gov (United States)

    Rouget, Céline; Rekik, Moèz; Camparo, Philippe; Botto, Henry; Rischmann, Pascal; Lluel, Philippe; Palea, Stefano; Westfall, Timothy D

    2014-02-01

    Activation of β3-adrenoceptors has been shown to have a direct relaxant effect on urinary bladder smooth muscle from both rats and humans, however there are very few studies investigating the effects of β3-adrenoceptor agonists on nerve-evoked bladder contractions. Therefore in the current study, the role of β3-adrenoceptors in modulating efferent neurotransmission was evaluated. The effects of β3-adrenoceptor agonism on neurogenic contractions induced by electrical field stimulation (EFS) were compared with effects on contractions induced by exogenous acetylcholine (Ach) and αβ-methylene adenosine triphosphate (αβ-meATP) in order to determine the site of action. Isoproterenol inhibited EFS-induced neurogenic contractions of human bladder (pD2=6.79; Emax=65%). The effect of isoproterenol was selectively inhibited by the β3-adrenoceptor antagonist L-748,337 (pKB=7.34). Contractions induced by exogenous Ach (0.5-1μM) were inhibited 25% by isoproterenol (3μM) while contractions to 10Hz in the same strip were inhibited 67%. The selective β3-adrenoceptor agonist CL-316,243 inhibited EFS-induced neurogenic contractions of rat bladder (pD2=7.83; Emax=65%). The effects of CL-316,243 were inhibited in a concentration dependent manner by L-748,337 (pA2=6.42). Contractions induced by exogenous Ach and αβ-meATP were significantly inhibited by CL-316,243, 29% and 40%, respectively. These results demonstrate that the activation of β3-adrenoceptors inhibits neurogenic contractions of both rat and human urinary bladder. Contractions induced by exogenously applied parasympathetic neurotransmitters are also inhibited by β3-agonism however the effect is clearly less than on neurogenic contractions (particularly in human), suggesting that in addition to a direct effect on smooth muscle, activation of prejunctional β3-adrenoceptors may inhibit neurotransmitter release. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Ten-year survival of patients with oesophageal squamous cell ...

    African Journals Online (AJOL)

    oesophageal junction ... after treatment of cancer. Reports of actual 10-year survivors of oesophageal squamous cell carcinoma (SCC) are rare, and demographic .... nodes, number of resected lymph nodes, adjuvant treatment and length of survival.

  14. Oesophageal lumen pH in yearling horses and effects of management and administration of omeprazole.

    Science.gov (United States)

    Wilson, C S; Brookes, V J; Hughes, K J; Trope, G D; Ip, H; Gunn, A J

    2017-05-01

    In human subjects, arytenoid chondritis can be caused by chemical trauma of mucosa attributable to gastro-oesophageal reflux. Although a similar process may be involved in the aetiopathogenesis of arytenoid chondritis in horses, the oesophageal lumen pH in this species is poorly understood. To determine if gastro-oesophageal reflux occurs in horses by characterising oesophageal lumen pH. Blinded, randomised, placebo-controlled, crossover, experimental study. Luminal oesophageal pH in six yearling horses was recorded over four 24 h periods using an ambulatory pH recorder attached to a catheter with two electrodes (proximal and distal) inserted into the oesophagus. Recordings of pH were made during three management protocols. Initially, horses grazed in a paddock (Protocol A). Horses were then moved to stables to simulate sale preparation of Thoroughbred yearlings, and were given either omeprazole (Protocol B) or placebo paste (Protocol C) orally once per day. Protocol A was repeated for each horse (after a 13 day washout period) between Protocols B and C. Summary statistics described pH range and frequency of pH changes. Associations with predictor variables were investigated using linear mixed-effects models. Data are presented as the mean ± s.d. Oesophageal lumen pH ranged from 4.90 to 9.70 (7.36 ± 0.27 and 7.18 ± 0.24 for the proximal and distal electrodes, respectively) and varied frequently (1.2 ± 0.9 changes/min and 0.8 ± 0.8 changes/min for the proximal and distal electrodes, respectively). Oesophageal lumen pH was associated with time since concentrate feeding, activity and time of day, but not with treatment of omeprazole. A small number of horses were used and measurement periods were limited. Gastro-oesophageal reflux occurs in clinically normal yearling horses. Although omeprazole had no detectable effect, oesophageal lumen pH recorded during this study did not fall within the therapeutic range of omeprazole. © 2016 EVJ Ltd.

  15. Functional MRI brain imaging studies using the Contact Heat Evoked Potential Stimulator (CHEPS) in a human volunteer topical capsaicin pain model

    Science.gov (United States)

    Shenoy, Ravikiran; Roberts, Katherine; Papadaki, Anastasia; McRobbie, Donald; Timmers, Maarten; Meert, Theo; Anand, Praveen

    2011-01-01

    Acute application of topical capsaicin produces spontaneous burning and stinging pain similar to that seen in some neuropathic states, with local hyperalgesia. Use of capsaicin applied topically or injected intradermally has been described as a model for neuropathic pain, with patterns of activation in brain regions assessed using functional magnetic resonance imaging (fMRI) and positron emission tomography. The Contact Heat Evoked Potential Stimulator (CHEPS) is a noninvasive clinically practical method of stimulating cutaneous A-delta nociceptors. In this study, topical capsaicin (1%) was applied to the left volar forearm for 15 minutes of twelve adult healthy human volunteers. fMRI scans and a visual analog pain score were recorded during CHEPS stimulation precapsaicin and postcapsaicin application. Following capsaicin application there was a significant increase in visual analog scale (mean ± standard error of the mean; precapsaicin 26.4 ± 5.3; postcapsaicin 48.9 ± 6.0; P < 0.0001). fMRI demonstrated an overall increase in areas of activation, with a significant increase in the contralateral insular signal (mean ± standard error of the mean; precapsaicin 0.434 ± 0.03; postcapsaicin 0.561 ± 0.07; P = 0.047). The authors of this paper recently published a study in which CHEPS-evoked A-delta cerebral potential amplitudes were found to be decreased postcapsaicin application. In patients with neuropathic pain, evoked pain and fMRI brain responses are typically increased, while A-delta evoked potential amplitudes are decreased. The protocol of recording fMRI following CHEPS stimulation after topical application of capsaicin could be combined with recording of evoked potentials to provide a simple, rapid, and robust volunteer model to develop novel drugs for neuropathic pain. PMID:22090805

  16. ORIGINAL ARTICLES Oesophageal ulceration in HIV-infected patients

    African Journals Online (AJOL)

    Oesophageal candidiasis is the most common oesophageal disorder, and accepted practice is to treat patients with oesophageal symptoms with empiric oral azole therapy for 7 - 14 days. It is mandatory that upper gastrointestinal endoscopy be performed in patients who fail to respond to antifungal therapy. In South Africa.

  17. REFLEX CLOSURE OF THE OESOPHAGEAL GROOVE AND ITS ...

    African Journals Online (AJOL)

    The oesophageal groove reflex and indeed the very function of the oesophageal groove has intrigued physiolo- gists for some considerable period and very rightly so. lt has been generally agreed that the anatomical nature of the oesophageal groove enabled it to function as a con- tinuation of the oesophagus leading from ...

  18. Laparoscopic treatment of type III para-oesophageal hernia | Van ...

    African Journals Online (AJOL)

    Type III congenital para-oesophageal hernia is a rare condition in children and is characterised by the herniation of both a substantial portion of the stomach and the gastro-oesophageal junction into the chest. This report describes the laparoscopic repair of 4 para-oesophageal hernias in children between 2002 and 2010.

  19. [Outcome of children with repaired oesophageal atresia].

    Science.gov (United States)

    Gottrand, F; Sfeir, R; Coopman, S; Deschildre, A; Michaud, L

    2008-12-01

    Although initial prognosis of oesophageal atresia is nowadays excellent with more than 95% of survival, the long-term complications are frequent. A gastro-oesophageal reflux is found in 26 to 75% of the cases, responsible for peptic oesophagitis, anastomotic stenosis and Barrett's oesophagus, risk factor of adenocarcinoma of the oesophagus. A dysphagia is frequently observed on these patients, sometimes several years after the surgery, observed in almost 45% of five-year-old children. Growth retardation is found in nearly a third of these children. Respiratory symptoms are particularly frequent, especially in the first years, associating tracheomalacia facilitating the bronchopulmonary infectious episodes (found in about 30% of 5-year-old children). Esotracheal fistula recurrence is very rare. A deformation of the rib cage is reported in 20%, and a scoliosis in 10% of the patients. However, the quality of life of these patients in the adulthood is good, and influenced by the existence of associated malformations. Even if the current prognosis of oesophageal atresia is good altogether, the frequency of the complications (digestive, respiratory, nutritional, orthopaedic) far from the initial intervention, and the necessity of a surveillance of the secondary oesophageal damages, justifies a systematic and multidisciplinary follow-up until adulthood.

  20. The effects of itopride on oesophageal motility and lower oesophageal sphincter function in man.

    Science.gov (United States)

    Scarpellini, E; Vos, R; Blondeau, K; Boecxstaens, V; Farré, R; Gasbarrini, A; Tack, J

    2011-01-01

    Itopride is a new prokinetic agent that combines antidopaminergic and cholinesterase inhibitory actions. Previous studies suggested that itopride improves heartburn in functional dyspepsia, and decreases oesophageal acid exposure in gastro-oesophageal reflux disease. It remains unclear whether this effect is due to effects of itopride on the lower oesophageal sphincter (LES). To study the effects of itopride on fasting and postprandial LES function in healthy subjects. Twelve healthy volunteers (five men; 32.6 ± 2.0 years) underwent three oesophageal sleeve manometry studies after 3 days premedication with itopride 50 mg, itopride 100 mg or placebo t.d.s. Drug was administered after 30 min and a standardized meal was administered after 90 min, with measurements continuing to 120 min postprandially. Throughout the study, 10 wet swallows were administered at 30-min intervals, and gastrointestinal symptoms were scored on 100 mm visual analogue scales at 15-min intervals. Lower oesophageal sphincter resting pressures, swallow-induced relaxations and the amplitude or duration of peristaltic contractions were not altered by both doses of itopride, at all time points. Itopride pre-treatment inhibited the meal-induced rise of transient LES relaxations (TLESRs). Itopride inhibits TLESRs without significantly affecting oesophageal peristaltic function or LES pressure. These observations support further studies with itopride in gastro-oesophageal reflux disease. © 2010 Blackwell Publishing Ltd.

  1. The ERK MAP kinase-PEA3/ETV4-MMP-1 axis is operative in oesophageal adenocarcinoma

    LENUS (Irish Health Repository)

    Keld, Richard

    2010-12-09

    Abstract Background Many members of the ETS-domain transcription factor family are important drivers of tumourigenesis. In this context, their activation by Ras-ERK pathway signaling is particularly relevant to the tumourigenic properties of many ETS-domain transcription factors. The PEA3 subfamily of ETS-domain transcription factors have been implicated in tumour metastasis in several different cancers. Results Here, we have studied the expression of the PEA3 subfamily members PEA3\\/ETV4 and ER81\\/ETV1 in oesophageal adenocarcinomas and determined their role in oesophageal adenocarcinoma cell function. PEA3 plays an important role in controlling both the proliferation and invasive properties of OE33 oesophageal adenocarcinoma cells. A key target gene is MMP-1. The ERK MAP kinase pathway activates PEA3 subfamily members and also plays a role in these PEA3 controlled events, establishing the ERK-PEA3-MMP-1 axis as important in OE33 cells. PEA3 subfamily members are upregulated in human adenocarcinomas and expression correlates with MMP-1 expression and late stage metastatic disease. Enhanced ERK signaling is also more prevalent in late stage oesophageal adenocarcinomas. Conclusions This study shows that the ERK-PEA3-MMP-1 axis is upregulated in oesophageal adenocarcinoma cells and is a potentially important driver of the metastatic progression of oesophageal adenocarcinomas.

  2. Functional MRI brain imaging studies using the Contact Heat Evoked Potential Stimulator (CHEPS in a human volunteer topical capsaicin pain model

    Directory of Open Access Journals (Sweden)

    Shenoy R

    2011-10-01

    Full Text Available Ravikiran Shenoy1, Katherine Roberts1, Anastasia Papadaki2, Donald McRobbie2, Maarten Timmers3, Theo Meert3, Praveen Anand11Peripheral Neuropathy Unit, Hammersmith Hospital, Imperial College London; 2Imaging Sciences Department, Charing Cross Hospital, London, United Kingdom; 3Johnson and Johnson Pharmaceutical Research and Development, Beerse, BelgiumAbstract: Acute application of topical capsaicin produces spontaneous burning and stinging pain similar to that seen in some neuropathic states, with local hyperalgesia. Use of capsaicin applied topically or injected intradermally has been described as a model for neuropathic pain, with patterns of activation in brain regions assessed using functional magnetic resonance imaging (fMRI and positron emission tomography. The Contact Heat Evoked Potential Stimulator (CHEPS is a noninvasive clinically practical method of stimulating cutaneous A-delta nociceptors. In this study, topical capsaicin (1% was applied to the left volar forearm for 15 minutes of twelve adult healthy human volunteers. fMRI scans and a visual analog pain score were recorded during CHEPS stimulation precapsaicin and postcapsaicin application. Following capsaicin application there was a significant increase in visual analog scale (mean ± standard error of the mean; precapsaicin 26.4 ± 5.3; postcapsaicin 48.9 ± 6.0; P < 0.0001. fMRI demonstrated an overall increase in areas of activation, with a significant increase in the contralateral insular signal (mean ± standard error of the mean; precapsaicin 0.434 ± 0.03; postcapsaicin 0.561 ± 0.07; P = 0.047. The authors of this paper recently published a study in which CHEPS-evoked A-delta cerebral potential amplitudes were found to be decreased postcapsaicin application. In patients with neuropathic pain, evoked pain and fMRI brain responses are typically increased, while A-delta evoked potential amplitudes are decreased. The protocol of recording fMRI following CHEPS stimulation

  3. Traumatic oesophageal perforation due to haematoma

    DEFF Research Database (Denmark)

    Grønhøj Larsen, Christian; Brandt, Bodil

    2014-01-01

    ; or the intramural hematoma gradually lysed and causing late perforation. CONCLUSION: Although extremely rare, an oesophageal haematoma and late complications must be considered in patients on anti-coagulant therapy following blunt thoracic trauma and complaining only of chest pain....... thoracic trauma leading to perforation on the 18th day. DISCUSSION: In treatment of oesophageal haematoma in patients on vitamin-K antagonists, strict control of the International Normalized Ratio (INR) is essential along with total parenteral nutrition therapy and refrainment through nasogastric tubes...

  4. Sex Differences in Orienting to Pictures with and without Humans: Evidence from the Cardiac Evoked Response (ECR) and the Cortical Long Latency Parietal Positivity (LPP)

    Science.gov (United States)

    Althaus, Monika; Groen, Yvonne; van der Schaft, Lutske; Minderaa, Ruud B.; Tucha, Oliver; Mulder, Lambertus J. M.; Wijers, Albertus A.

    2014-01-01

    Objective This study investigated the effect of social relevance in affective pictures on two orienting responses, i.e. the evoked cardiac response (ECR), and a long latency cortical evoked potential (LPP) and whether this effect would differ between males and females. Assuming that orienting to affective social information is fundamental to experiencing affective empathy, associations between self-report measures of empathy and the two orienting responses were investigated. Method ECRs were obtained from 34 female and 30 male students, and LPPs from 25 female and 27 male students viewing 414 pictures from the International Affective Picture System. Pictures portrayed pleasant, unpleasant and neutral scenes with and without humans. Results Both the ECR and LPP showed the largest response to pictures with humans in unpleasant situations. For both measures, the responses to pictures with humans correlated with self-report measures of empathy. While we found a greater male than female responsiveness to the pictures without humans in the ECR, a greater female than male responsiveness was observed in the LPP response to pictures with humans. Conclusion and Significance The sensitivity of these orienting responses to social relevance and their differential contribution to the prediction of individual differences underline the validity of their combined use in clinical studies investigating individuals with social disabilities. PMID:25330003

  5. Factors Affecting the Prevalence of Gastro-oesophageal Reflux in Childhood Corrosive Oesophageal Strictures

    Directory of Open Access Journals (Sweden)

    Serdar H. İskit

    2014-06-01

    Full Text Available Background: Gastro-oesophageal reflux may accompany the corrosive oesophageal damage caused by the ingestion of corrosive substances and affect its treatment. The factors that affect the development of reflux in these cases and their effects on treatment still remain unclear. Aims: Our aim is to investigate the prevalence of gastro-oesophageal reflux in children with corrosive oesophageal strictures, the risk factors affecting this prevalence and the effects of gastro-oesophageal reflux on treatment. Study Design: Case-control study. Methods: We enrolled 52 patients with oesophageal stricture due to corrosive substance ingestion who were referred to our clinic between 2003 and 2010. Groups, which were determined according to the presence of gastro-oesophageal reflux (GER, were compared with each other in terms of clinical findings, results of examination methods, characteristics of the stricture and success of the treatment. Results: The total number of patients in our study was 52; 30 of them were male and 22 of them were female. The mean age of our study population was 4.2±2.88 years. Thirty-three patients had gastro-oesophageal reflux (63.5%. Patients who had strictures caused by the ingestion of alkali substances were 1.6-times more likely to have reflux. There were no differences between patients with or without reflux in terms of number and localisation of strictures. Mean distance of stricture was longer in patients with reflux (3.7±1.8 cm than in patients without (2.2±1.0 cm (p0.05. Conclusion: Corrosive oesophageal stricture was usually accompanied by gastro-oesophageal reflux and the length of stricture is an important risk factor. Negative effects of reflux over dilatation treatment have not yet been demonstrated in the short-term. Nevertheless, this frequent rate of reflux may eventually increase the risk of oesophagitis and Barrett’s oesophagus; therefore, we suggest that these effects should be prospectively evaluated in a

  6. Contribution of M-waves and H-reflexes to contractions evoked by tetanic nerve stimulation in humans.

    Science.gov (United States)

    Klakowicz, Piotr M; Baldwin, Evan R L; Collins, David F

    2006-09-01

    Tetanic neuromuscular stimulation evokes contractions by depolarizing motor axons beneath the stimulating electrodes. However, we have shown that extra torque can develop due to the discharge of spinal neurons recruited by the evoked sensory volley. The present experiments investigated whether extra torque in the ankle plantar- and dorsiflexors was associated with enhanced H-reflexes. The tibial and common peroneal nerves were stimulated using 7-s trains (20 Hz for 2 s, 100 Hz for 2 s, 20 Hz for 3 s). Extra torque was defined as significantly more torque during 20-Hz stimulation after the 100-Hz burst (time2) than before it (time1). In 9 of 11 subjects, extra plantarflexion torque developed during stimulation just above motor threshold. In these nine subjects, torque increased from 8 to 13% MVC (time1 to time2), the soleus H-reflex increased from 13 to 19% Mmax and the M-wave of approximately 2% Mmax did not change significantly. To evoke extra dorsiflexion torque, greater stimulation intensities were required. In 6 of 13 subjects, extra torque developed at intensities that evoked an M-wave of 5-20% Mmax at time1. In these six subjects, torque doubled from 2 to 4% MVC (time1 to time2), whereas tibialis anterior (TA) H-reflexes and M-waves did not change significantly (H-reflex from 0.8 to 2% Mmax; M-wave from 12 to 14% Mmax). In 7 of 13 subjects, extra torque developed at higher stimulation intensities (35-65% Mmax). In these seven subjects, torque increased from 13 to 20% MVC, whereas TA H-reflexes and M-waves were not significantly different (H-reflex from 0.7 to 1% Mmax; M-wave from 49 to 54% Mmax). Thus enhanced H-reflexes contributed to extra plantarflexion, however, other factors generated extra dorsiflexion.

  7. Gastro-oesophageal reflux in mechanically ventilated patients: effects of an oesophageal balloon.

    Science.gov (United States)

    Orozco-Levi, M; Félez, M; Martínez-Miralles, E; Solsona, J F; Blanco, M L; Broquetas, J M; Torres, A

    2003-08-01

    Gastro-oesophageal reflux (GOR) and bronchoaspiration of gastric content are risk factors linked with ventilator-associated pneumonia. This study was aimed at evaluating the effect of a nasogastric tube (NGT) incorporating a low-pressure oesophageal balloon on GOR and bronchoaspiration in patients receiving mechanical ventilation. Fourteen patients were studied in a semi-recumbent position for 2 consecutive days. Inflation or deflation of the oesophageal balloon was randomised. Samples of blood, gastric content, and oropharyngeal and bronchial secretions were taken every 2 h over a period of 8 h. A radioactively labelled nutritional solution was continuously administered through the NGT. The magnitude of both the GOR and bronchoaspiration was measured by radioactivity counting of oropharyngeal and bronchial secretion samples, respectively. Inflation of the oesophageal balloon resulted in a significant decrease of both GOR and bronchoaspiration of gastric content. This protective effect was statistically significant from 4 h following inflation throughout the duration of the study. This study demonstrates that an inflated oesophageal balloon delays and decreases gastro-oesophageal and bronchial aspiration of gastric content in patients carrying a nasogastric tube and receiving enteral nutrition during mechanical ventilation. Although the method was found to be safe when applied for 8 h, longer times should be considered with caution.

  8. Origin of facilitation of motor-evoked potentials after paired magnetic stimulation: direct recording of epidural activity in conscious humans.

    Science.gov (United States)

    Di Lazzaro, V; Pilato, F; Oliviero, A; Dileone, M; Saturno, E; Mazzone, P; Insola, A; Profice, P; Ranieri, F; Capone, F; Tonali, P A; Rothwell, J C

    2006-10-01

    A magnetic transcranial conditioning stimulus given over the motor cortex at intensities below active threshold for obtaining motor-evoked potentials (MEPs) facilitates EMG responses evoked at rest in hand muscles by a suprathreshold magnetic stimulus given 10-25 ms later. This is known as intracortical facilitation (ICF). We recorded descending volleys produced by single and paired magnetic motor cortex stimulation through high cervical epidural electrodes implanted for pain relief in six conscious patients. At interstimulus intervals (ISIs) of 10 and 15 ms, although MEP was facilitated, there was no change in the amplitude or number of descending volleys. An additional I wave sometimes was observed at 25 ms ISI. In one subject, we also evaluated the effects of reversing the direction of the induced current in the brain. At 10 ms ISI, the facilitation of the MEPs disappeared and was replaced by slight suppression; at 2 ms ISI, there was a pronounced facilitation of epidural volleys. Subsequent experiments on healthy subjects showed that a conditioning stimulus capable of producing ICF of MEPs had no effect on the EMG response evoked by transmastoidal electrical stimulation of corticospinal tract. We conclude that ICF occurs because either 1) the conditioning stimulus has a (thus far undetected) effect on spinal cord excitability that increases its response to the same amplitude test volley or 2) that it can alter the composition (but not the amplitude) of the descending volleys set up by the test stimulus such that a larger proportion of the activity is destined for the target muscle.

  9. Anaesthesia for Oesophageal Replacement with Colonconduit– A ...

    African Journals Online (AJOL)

    Elective post-operative ventilationwas necessary in eleven (24%) patients whose pleura were breached during the procedure. Conclusion: Care and protection of the airway and nutritional support are the main pre-operative challenges faced by the anaesthetist in the management of oesophageal burns. During the colon ...

  10. Peptic oesophageal stricture in children: Management problems ...

    African Journals Online (AJOL)

    The clinical picture was dominated by dysphagia. Barium swallow showed hiatal hernia in nine cases (82%). Oesophageal strictures were located most commonly in the lower third of the oesophagus (91%). Three Children (27%) with PES had a neurologic impairment and patients had a mean duration of symptoms of 20 ...

  11. Gastro Oesophageal Reflux Disease

    African Journals Online (AJOL)

    ablative therapy. The latter is not being routinely performed in South Africa. Oesophageal adenocarcinoma is one of the most rapidly increasing forms of malignancy in the western world, and generally has a poor prognosis. Whilst detecting Barrett's oesophagus and dysplasia may have some impact on these numbers, it is ...

  12. Fluoroscopic guided benign oesophageal stricture dilatation in ...

    African Journals Online (AJOL)

    oesophageal fistula repair or gastro-oesopha- geal reflux disease[1] to poorer success rates in. BOSs secondary to caustic ingestion (33%).[5]. One study argued that balloon dilatation decreased hospital stay and postprocedural complications in comparison with bougienage dilatations.[5] In the available literature, bougie-.

  13. Somatostatin analogues for acute bleeding oesophageal varices

    DEFF Research Database (Denmark)

    Gøtzsche, Peter C.; Hrobjartsson, A.

    2008-01-01

    with bleeding oesophageal varices. SEARCH STRATEGY: PubMed and The Cochrane Library were searched (November 2007). Reference lists of publications, contacts with authors. SELECTION CRITERIA: All randomised trials comparing somatostatin or analogues with placebo or no treatment in patients suspected of acute...

  14. Peptic oesophageal stricture in children: Management problems

    Directory of Open Access Journals (Sweden)

    Mohamed Zouari

    2014-01-01

    Full Text Available Background: Peptic oesophageal stricture (PES is a serious complication of gastroesophageal reflux disease (GERD in childhood. The treatment of PES is still controversial, ranging from simple oesophageal dilations to resection/anastomosis of the stenotic portion of the oesophagus. In this study, we want to share our experience with 11 children with GERD and PES. Patients and Methods: A retrospective review of clinical data obtained from children who underwent dilation and antireflux surgery for PES was performed. Results: A total of 11 patients were diagnosed with PES. The clinical picture was dominated by dysphagia. Barium swallow showed hiatal hernia in nine cases (82%. Oesophageal strictures were located most commonly in the lower third of the oesophagus (91%. Three Children (27% with PES had a neurologic impairment and patients had a mean duration of symptoms of 20 months (range, 3 month to 6.2 years before intervention. Children received a median of four dilations (range, 1-21 dilations for PES. Time to first dilation from age of diagnosis was a mean of 4.5 months (range, 2-14 months. Antireflux surgery was performed in all patients. Post-operatively, seven patients required repeat oesophageal dilation. Patients were followed with serial dilation for a median of 6 years (range, 1-9 years and only one patient has a continued requirement of oesophageal dilation for PES. Conclusion: GERD complicated by PES is an important condition affecting a significant number of children. Early and effective treatment of both stricture and GERD is required to improve the prognosis of this serious condition.

  15. Association of visceral adiposity with oesophageal and junctional adenocarcinomas.

    LENUS (Irish Health Repository)

    Beddy, P

    2012-02-01

    BACKGROUND: Obesity is associated with an increased incidence of oesophageal and oesophagogastric junction adenocarcinoma, in particular Siewert types I and II. This study compared abdominal fat composition in patients with oesophageal\\/junctional adenocarcinoma with that in patients with oesophageal squamous cell carcinoma and gastric adenocarcinoma, and in controls. METHOD: In total, 194 patients (110 with oesophageal\\/junctional adenocarcinoma, 38 with gastric adenocarcinoma and 46 with oesophageal squamous cell carcinoma) and 90 matched control subjects were recruited. The abdominal fat area was assessed using computed tomography (CT), and the total fat area (TFA), visceral fat area (VFA) and subcutaneous fat area (SFA) were calculated. RESULTS: Patients with oesophageal\\/junctional adenocarcinoma had significantly higher TFA and VFA values compared with controls (both P < 0.001), patients with gastric adenocarcinoma (P = 0.013 and P = 0.006 respectively) and patients with oesophageal squamous cell carcinoma (both P < 0.001). For junctional tumours, the highest TFA and VFA values were seen in patients with Siewert type I tumours (respectively P = 0.041 and P = 0.033 versus type III; P = 0.332 and P = 0.152 versus type II). CONCLUSION: Patients with oesophageal\\/junctional adenocarcinoma, in particular oesophageal and Siewert type I junctional tumours, have greater CT-defined visceral adiposity than patients with gastric adenocarcinoma or oesophageal squamous cell carcinoma, or controls.

  16. Review article: reflux and its consequences--the laryngeal, pulmonary and oesophageal manifestations. Conference held in conjunction with the 9th International Symposium on Human Pepsin (ISHP) Kingston-upon-Hull, UK, 21-23 April 2010.

    Science.gov (United States)

    Pearson, J P; Parikh, S; Orlando, R C; Johnston, N; Allen, J; Tinling, S P; Johnston, N; Belafsky, P; Arevalo, L F; Sharma, N; Castell, D O; Fox, M; Harding, S M; Morice, A H; Watson, M G; Shields, M D; Bateman, N; McCallion, W A; van Wijk, M P; Wenzl, T G; Karkos, P D; Belafsky, P C

    2011-04-01

    Gastro-oesophageal reflux disease (GERD) is one of the commonest diseases of Western populations, affecting 20 to 30% of adults. GERD is multifaceted and the classical oesophageal symptoms such as heartburn and regurgitation often overlap with atypical symptoms that impact upon the respiratory system and airways. This is referred to as extra-oesophageal reflux disease (EERD), or laryngopharyngeal reflux (LPR), which manifests as chronic cough, laryngitis, hoarseness, voice disorders and asthma. The 'Reflux and its consequences' conference was held in Hull in 2010 and brought together a multidisciplinary group of experts all with a common interest in the many manifestations of reflux disease to present recent research and clinical progress in GERD and EERD. In particular new techniques for diagnosing reflux were showcased at the conference. Both clinical and non-clinical key opinion leaders were invited to write a review on key areas presented at the `Reflux and its consequences' conference for inclusion in this supplement. Eleven chapters contained in this supplement reflected the sessions of the conference and included discussion of the nature of the refluxate (acid, pepsin, bile acids and non-acid reflux); mechanisms of tissue damage and protection in the oesophagus, laryngopharynx and airways. Clinical conditions with a reflux aetiology including asthma, chronic cough, airway disease, LPR, and paediatric EERD were reviewed. In addition methods for diagnosis of reflux disease and treatment strategies, especially with reference to non-acid reflux, were considered. © 2011 Blackwell Publishing Ltd.

  17. Experimental low-level jaw clenching inhibits temporal summation evoked by electrical stimulation in healthy human volunteers.

    Science.gov (United States)

    Tada, Hiroaki; Torisu, Tetsurou; Tanaka, Mihoko; Murata, Hiroshi; De Laat, Antoon; Svensson, Peter

    2015-05-01

    To examine the effect of low-level jaw clenching on temporal summation in healthy volunteers. In 18 healthy volunteers, the pain intensities evoked at the masseter muscle and the hand palm by the first and last stimuli in a train of repeated electrical stimuli (0.3 or 2.0 Hz) were rated using 0-100mm visual analogue scales (VAS), in order to evaluate temporal summation before and after three types of jaw-muscle tasks: low-level jaw clenching, repetitive gum chewing and mandibular rest position. A set of concentric surface electrodes with different diameters (small and large) was used for the electrical stimulation. The temporal summation evoked by the large diameter electrode with 2.0 Hz stimulation decreased significantly both on the masseter and the hand after low-level clenching (P ≤ 0.03), but did not show any significant change after the other tasks (P > 0.23). The VAS score of the first stimulation did not show any significant changes after low-level clenching (P > 0.57). Experimental low-level jaw clenching can inhibit pain sensitivity, especially temporal summation. Low-level jaw clenching can modify pain sensitivity, most likely through the central nervous system. The findings suggest that potential harmful low-level jaw clenching or tooth contacting could continue despite painful symptoms, e.g., temporomandibular disorders. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Oesophageal achalasia: an argument for primary surgical management.

    LENUS (Irish Health Repository)

    Leonard, D S

    2009-04-01

    Achalasia is a primary oesophageal motility disorder resulting from damage to the ganglion cells of the myenteric plexus. Impaired relaxation of the lower oesophageal sphincter and aperistalsis causes its cardinal symptoms of dysphagia, chest pain and reflux-type symptoms. Management is somewhat controversial, with options including systemic and local pharmacotherapy, dilatation and oesophagomyotomy. We review the presentation, investigation and management of oesophageal achalasia and make an argument for primary surgical management.

  19. Functional oesophagoscopy: endoscopic evaluation of the oesophageal phase of deglutition.

    Science.gov (United States)

    Belafsky, P C; Rees, C J

    2009-09-01

    The anatomy and function of the oropharynx and larynx during deglutition can be assessed using the flexible endoscope, but this evaluation does not provide information on the oesophagus. Guided observation of oesophageal swallowing enables extended dysphagia evaluation. To assess the diagnostic utility of guided observation of oesophageal swallowing in the evaluation of dysphagia. Retrospective case series. Procedures for guided observation of oesophageal swallowing were reviewed for oesophageal findings and compared with fluoroscopy and manometry. Twenty-one patients underwent guided observation of oesophageal swallowing and concurrent videofluoroscopy and/or manometry. No complications of the former procedure occurred. The results of guided observation of oesophageal swallowing concurred with those of fluoroscopy in 15/21 cases (71 per cent) and with those of manometry in five of six (83 per cent) cases. Guided observation of oesophageal swallowing revealed anatomic pathology contributing to dysphagia in 15/21 (71 per cent) patients. The procedure identified pathology not detected by fluoroscopy and manometry in 13/21 (62 per cent) patients. Guided observation of oesophageal swallowing appears to be a safe diagnostic tool with which to evaluate the oesophageal phase of deglutition.

  20. Effects of rotation on the sleep state-dependent midlatency auditory evoked P50 potential in the human

    Science.gov (United States)

    Dornhoffer, John L.; Mamiya, N.; Bray, P.; Skinner, Robert D.; Garcia-Rill, Edgar

    2002-01-01

    Sopite syndrome, characterized by loss of initiative, sensitivity to normally innocuous sensory stimuli, and impaired concentration amounting to a sensory gating deficit, is commonly associated with Space Motion Sickness (SMS). The amplitude of the P50 potential is a measure of level of arousal, and a paired-stimulus paradigm can be used to measure sensory gating. We used the rotary chair to elicit the sensory mismatch that occurs with SMS by overstimulating the vestibular apparatus. The effects of rotation on the manifestation of the P50 midlatency auditory evoked response were then assessed as a measure of arousal and distractibility. Results showed that rotation-induced motion sickness produced no change in the level of arousal but did produce a significant deficit in sensory gating, indicating that some of the attentional and cognitive deficits observed with SMS may be due to distractibility induced by decreased habituation to repetitive stimuli.

  1. Oral sucralfate in acute radiation oesophagitis

    Energy Technology Data Exchange (ETDEWEB)

    Sur, R.K. (Dept. of Radiotherapy, Postgraduate Inst. of Medical Education and Research, Chandigarh (India)); Kochhar, R. (Dept. of Gastroenterology, Postgraduate Inst. of Medical Education and Research, Chandigarh (India)); Singh, D.P. (Dept. of Radiotherapy, Postgraduate Inst. of Medical Education and Research, Chandigarh (India))

    1994-01-01

    Eighty patients with carcinoma in the middle third of oesophagus and with acute radiation oesophagitis following external beam and intracavitary radiotherapy were managed by two different schedules. Group 1 (n = 40) received an antacid containing sodium alginate whereas Group 2 (n = 40) were given a 10% sucralfate suspension during 4 weeks. In Group 2, 32 patients had significant relief of symptoms within 7 days of treatment and most ulcers had healed by 12 days of treatment as seen on endoscopy. Patients in Group 1, on the other hand, showed little improvement of symptoms and had persistent ulcers even after 4 weeks of therapy. We conclude that sucralfate is useful in the management of acute radiation oesophagitis. (orig.).

  2. Management of gastro-oesophageal reflux.

    OpenAIRE

    Carré, I. J.

    1985-01-01

    Parental reassurance and thickened feeds are the only requirements in the management of infants with reflux when this is the sole detectable gastro-oesophageal abnormality. In view of the strong propensity for spontaneous clinical resolution and the excellent results achieved by conservative management, infants with reflux due to a partial thoracic stomach (hiatal hernia) uncomplicated by a stricture should be treated in the first instance by postural therapy, with or without thickened feeds ...

  3. Cachexia in patients with oesophageal cancer.

    Science.gov (United States)

    Anandavadivelan, Poorna; Lagergren, Pernilla

    2016-03-01

    Oesophageal cancer is a debilitating disease with a poor prognosis, and weight loss owing to malnutrition prevails in the majority of patients. Cachexia, a multifactorial syndrome characterized by the loss of fat and skeletal muscle mass and systemic inflammation arising from complex host-tumour interactions is a major contributor to malnutrition, which is a determinant of tolerance to treatment and survival. In patients with oesophageal cancer, cachexia is further compounded by eating difficulties owing to the stage and location of the tumour, and the effects of neoadjuvant therapy. Treatment with curative intent involves exceptionally extensive and invasive surgery, and the subsequent anatomical changes often lead to eating difficulties and severe postoperative malnutrition. Thus, screening for cachexia by means of percentage weight loss and BMI during the cancer trajectory and survivorship periods is imperative. Additionally, markers of inflammation (such as C-reactive protein), dysphagia and appetite loss should be assessed at diagnosis. Routine assessments of body composition are also necessary in patients with oesophageal cancer to enable assessment of skeletal muscle loss, which might be masked by sarcopenic obesity in these patients. A need exists for clinical trials examining the effectiveness of therapeutic and physical-activity-based interventions in mitigating muscle loss and counteracting cachexia in these patients.

  4. The history of oesophageal atresia and tracheo-oesophageal fistula--1670-1984.

    Science.gov (United States)

    Myers, N A

    1986-01-01

    The history of oesophageal atresia commenced in the year 1670 with Durston's description of "A narrative of a monstrous birth at Plymouth". However, the most significant contribution in the 17th century was made by Gibson, who clearly described the clinical picture and necropsy findings in a baby with a proximal oesophageal atresia and a distal tracheo-oesophageal fistula. The 18th century was singularly lacking in contributions to the literature, but there were many important presentations during the 19th century. Early in that century Martin in France and Hill in United States of America contributed to the literature; subsequently, many anecdotal references can be found particularly in England, and ultimately a surgical attempt to correct the anomaly was made in 1888 by Steele in London. With this, the pre-surgical era gave way to the surgical era, and at a later stage pre-survival era was to give way to the survival phase. Reference will be made in the text to these various phases in the history and to the many pioneering surgical endeavours which took place in the earlier years of the 20th century. It will be seen that the surgical efforts employed palliative procedures, indirect attacks on the problem and finally direct attacks. The classic successes by indirect methods which were achieved by Ladd and Leven in babies born in 1939 were to be followed by the first successful end-to-end anastomosis which was achieved in Ann Arbor, Michigan, by Cameron Haight. Others had attempted primary anastomosis, and Lanman in particular deserves mention. However, it was Cameron Haight who opened a new era in the history of the treatment of oesophageal atresia; the recent history is largely concerned with increasing experience and refinements in technique. For the future historian many pathways can still be explored, including oesophageal replacement, the unstable trachea, follow-up studies and research projects. This history also included comments on the history of the less

  5. Swainsonine promotes apoptosis in human oesophageal squamous ...

    Indian Academy of Sciences (India)

    2012-10-24

    Oct 24, 2012 ... The ultrastructural morphology changes were observed un- der a transmission electron microscope. After swainsonine treatment, the cells were fixed with 4% glutaraldehyde, and post-fixed with 1% OsO4. Then samples were dehydrated in graded ethanol solutions, followed by embedment and sec- tion.

  6. Human sensory-evoked responses differ coincident with either "fusion-memory" or "flash-memory", as shown by stimulus repetition-rate effects

    Directory of Open Access Journals (Sweden)

    Baird Bill

    2006-02-01

    Full Text Available Abstract Background: A new method has been used to obtain human sensory evoked-responses whose time-domain waveforms have been undetectable by previous methods. These newly discovered evoked-responses have durations that exceed the time between the stimuli in a continuous stream, thus causing an overlap which, up to now, has prevented their detection. We have named them "A-waves", and added a prefix to show the sensory system from which the responses were obtained (visA-waves, audA-waves, somA-waves. Results: When A-waves were studied as a function of stimulus repetition-rate, it was found that there were systematic differences in waveshape at repetition-rates above and below the psychophysical region in which the sensation of individual stimuli fuse into a continuity. The fusion phenomena is sometimes measured by a "Critical Fusion Frequency", but for this research we can only identify a frequency-region [which we call the STZ (Sensation-Transition Zone]. Thus, the A-waves above the STZ differed from those below the STZ, as did the sensations. Study of the psychophysical differences in auditory and visual stimuli, as shown in this paper, suggest that different stimulus features are detected, and remembered, at stimulation rates above and below STZ. Conclusion: The results motivate us to speculate that: 1 Stimulus repetition-rates above the STZ generate waveforms which underlie "fusion-memory" whereas rates below the STZ show neuronal processing in which "flash-memory" occurs. 2 These two memories differ in both duration and mechanism, though they may occur in the same cell groups. 3 The differences in neuronal processing may be related to "figure" and "ground" differentiation. We conclude that A-waves provide a novel measure of neural processes that can be detected on the human scalp, and speculate that they may extend clinical applications of evoked response recordings. If A-waves also occur in animals, it is likely that A-waves will provide

  7. Refractory gastro-oesophageal reflux disease: a major management ...

    African Journals Online (AJOL)

    2009-05-12

    May 12, 2009 ... Refractory oesophagitis (non-healing of erosions) is rare since the advent of potent gastric acid inhibition with proton pump inhibitors (PPIs). However, refractory gastro-oesophageal reflux disease (GORD) symptoms, both typical and atypical (cough, chronic hoarseness, asthma and atypical chest pain), ...

  8. Acoustic Markers of Syllabic Stress in Spanish Excellent Oesophageal Speakers

    Science.gov (United States)

    Cuenca, Maria Heliodora; Barrio, Marina M.; Anaya, Pablo; Establier, Carmelo

    2012-01-01

    The purpose of this investigation is to explore the use by Spanish excellent oesophageal speakers of acoustic cues to mark syllabic stress. The speech material has consisted of five pairs of disyllabic words which only differed in stress position. Total 44 oesophageal and 9 laryngeal speakers were recorded and a computerised designed "ad…

  9. Additional considerations for gastro-oesophageal reflux disease

    African Journals Online (AJOL)

    is the result of the inadequately managed suppression of gastric acid caused by the retrograde flow from the stomach through the lower oesophageal sphincter, which may result in complications, including stricture formation, Barrett's oesophagus, erosive oesophagitis and adenocarcinoma. The incidence per region and ...

  10. Anaesthesia for oesophageal atresia with or without tracheo ...

    African Journals Online (AJOL)

    These patients often present with a multitude of other congenital anomalies that may have a bearing on the oxygen cascade. With improvements in ... oesophageal stenosis, gastro-oesophageal fistula and recurrent fistulae. Epidemiology ... of an association with congenital heart disease, specifically. Tetralogy of Fallot ...

  11. Does acute psychological stress increase perception of oesophageal acid?

    NARCIS (Netherlands)

    Hemmink, G. J. M.; Bredenoord, A. J.; Weusten, B. L. A. M.; Timmer, R.; Smout, A. J. P. M.

    2009-01-01

    Gastro-oesophageal reflux disease (GORD) patients often report an increase in their reflux symptoms during stressful situations. The aim of this study was to assess the influence of acute psychological stress on oesophageal acid perception. In 15 healthy volunteers and 10 GORD patients with a

  12. Does acute psychological stress increase perception of oesophageal acid?

    NARCIS (Netherlands)

    Hemmink, G. J. M.; Bredenoord, A. J.; Weusten, B. L. A. M.; Timmer, R.; Smout, A. J. P. M.

    2009-01-01

    P>Gastro-oesophageal reflux disease (GORD) patients often report an increase in their reflux symptoms during stressful situations. The aim of this study was to assess the influence of acute psychological stress on oesophageal acid perception. In 15 healthy volunteers and 10 GORD patients with a

  13. Tracheo-oesophageal fistula diagnosed with multidetector computed tomography.

    LENUS (Irish Health Repository)

    Hodnett, Pa

    2009-04-01

    This case highlights important issues in investigation of patients with suspected tracheo-oesophageal fistula including the value of multidetector computed tomography, the importance of thorough imaging evaluation when high clinical suspicion of tracheo-oesophageal fistula exists and the value of close interaction between radiologists and intensive care physicians in the investigation of these patients.

  14. Self-induced vomiting – risk for oesophageal cancer? | Matsha ...

    African Journals Online (AJOL)

    Furthermore, self-induced vomiting was found to be significantly and independently associated with oesophageal chronic inflammation (odds ratio 1.83, 95% confidence interval: 1.13 - 2.96, p = 0.013). Conclusion: While the association between the cultural practice of self-induced vomiting and oesophageal cancer has ...

  15. Review article: the pathogenesis and management of eosinophilic oesophagitis.

    Science.gov (United States)

    Furuta, G T; Straumann, A

    2006-07-15

    Eosinophilic oesophagitis is a clinicopathological disease affecting both children and adults that is characterized by symptoms of gastro-oesophageal reflux disease (feeding refusal, vomiting, heartburn, dysphagia and food impaction) and dense oesophageal eosinophilia both of which are unresponsive to proton pump inhibition. To present a review of the recent literature examining the pathogenesis and treatments of eosinophilic oesophagitis. We performed a PubMed search for eosinophilic oesophagitis, pathogenesis and treatments. Translational and basic studies suggest that this disease is sparked by food or by aeroallergens. To date, effective treatments include systemic/topical corticosteroids, specific food elimination or an elemental diet. While several studies identified oesophageal strictures as potential complications of unbridled eosinophilia, the natural history of the disease is still not certain. Recent studies suggest a role for interleukin-5 and eotaxin-3 in the pathogenesis of eosinophilic oesophagitis and suggest an impact of future targeted therapeutic agents. Eosinophilic oesophagitis represents a immune-mediated disease of undetermined pathogenesis. While many patients develop clinicopathological findings following ingestion of foods, others do not. Natural history studies will be critical to defining future treatment paradigms.

  16. Giant lower oesophageal ulcer in a Bushman baby | Heydenrych ...

    African Journals Online (AJOL)

    The case of a giant, penetrating lower oesophageal ulcer in a 14-month-old Bushman baby is reported. This would probably be classified as a Barrett's ulcer. Histological examination showed that the ulcer developed in columnar epithelium and that there was normal stratified squamous oesophageal mucosa both ...

  17. Modern trends in oesophageal surgery | Bremner | South African ...

    African Journals Online (AJOL)

    ... oesophageal disease, advances in instrumentation and the surge of molecular biological interests. The recent explosion of bariatric surgery in the USA has also opened new dimensions for investigation of the effects of bariatric procedures on oesophageal function. South African Journal of Surgery Vol.43(1) 2005: 13-16 ...

  18. Combined oesophageal atresia with upper pouch fistula and ...

    African Journals Online (AJOL)

    Upper pouch tracheoesophageal fistula occurs is less than 1% of all oesophageal atresia variants. Meconium peritonitis is a rare neonatal condition with an incidence of 1:30 000 live births. In this case report, we describe the presentation, clinical findings and management of a patient diagnosed with an oesophageal ...

  19. Endoscopic dilatation for benign oesophageal strictures in infants ...

    African Journals Online (AJOL)

    Purpose: The purpose of this study was to present the safety and effectiveness of an expectant protocol employing Savary-Gilliard dilatation in benign oesophageal stricture in infants and toddlers along a decade of experience. Patients and Methods: Thirty eight infants and toddlers with benign oesophageal stricture with ...

  20. In Oesophageal Squamous Cells Exposed to Acidic Bile Salt Medium, Omeprazole Inhibits IL-8 Expression through Effects on Nuclear Factor-κB and Activator Protein-1

    Science.gov (United States)

    Huo, Xiaofang; Zhang, Xi; Yu, Chunhua; Zhang, Qiuyang; Cheng, Edaire; Wang, David H.; Pham, Thai H.; Spechler, Stuart J.; Souza, Rhonda F.

    2013-01-01

    Objective Oesophagitis might result from the effects of chemokines produced by oesophageal cells in response to gastro-oesophageal reflux, and not solely from the direct, caustic effects of refluxed gastric juice. Proton pump inhibitors (PPIs) can block chemokine production through mechanisms independent of their antisecretory effects. We studied omeprazole effects on chemokine production by oesophageal epithelial cells exposed to acidic bile salts. Design Human primary and telomerase-immortalised oesophageal squamous cells were exposed to acidic bile salt medium with or without omeprazole pretreatment. Interleukin (IL)-8 expression was determined by RT-PCR and ELISA. IL-8 promoter activity was measured by luciferase reporter assay. Binding of NF-κB and AP-1 subunits to the IL-8 promoter was assessed by ChIP assay. Immune cell migration induced by conditioned medium was determined by a double-chamber migration assay system. Results Acidic bile salt medium caused oesophageal epithelial cells to express IL-8 mRNA and protein by activating the IL-8 promoter through NF-κB and AP-1 binding. Omeprazole inhibited that acidic bile salt-stimulated IL-8 expression by blocking the nuclear translocation of p65 (an NF-κB subunit) and by blocking the binding of p65, c-jun and c-fos (AP-1 subunits) to the IL-8 promoter. Omeprazole also blocked the ability of conditioned medium from cells exposed to acidic bile salts to induce immune cell migration. Conclusions In oesophageal squamous epithelial cells, omeprazole inhibits IL-8 expression through effects on NF-κB and AP-1 that are entirely independent of effects on gastric acid secretion. These previously unrecognized PPI effects might contribute to the healing of reflux oesophagitis. PMID:24048734

  1. Stimulus dependency of object-evoked responses in human visual cortex: an inverse problem for category specificity.

    Directory of Open Access Journals (Sweden)

    Britta Graewe

    Full Text Available Many studies have linked the processing of different object categories to specific event-related potentials (ERPs such as the face-specific N170. Despite reports showing that object-related ERPs are influenced by visual stimulus features, there is consensus that these components primarily reflect categorical aspects of the stimuli. Here, we re-investigated this idea by systematically measuring the effects of visual feature manipulations on ERP responses elicited by both structure-from-motion (SFM-defined and luminance-defined object stimuli. SFM objects elicited a novel component at 200-250 ms (N250 over parietal and posterior temporal sites. We found, however, that the N250 amplitude was unaffected by restructuring SFM stimuli into meaningless objects based on identical visual cues. This suggests that this N250 peak was not uniquely linked to categorical aspects of the objects, but is strongly determined by visual stimulus features. We provide strong support for this hypothesis by parametrically manipulating the depth range of both SFM- and luminance-defined object stimuli and showing that the N250 evoked by SFM stimuli as well as the well-known N170 to static faces were sensitive to this manipulation. Importantly, this effect could not be attributed to compromised object categorization in low depth stimuli, confirming a strong impact of visual stimulus features on object-related ERP signals. As ERP components linked with visual categorical object perception are likely determined by multiple stimulus features, this creates an interesting inverse problem when deriving specific perceptual processes from variations in ERP components.

  2. Ultra-low-noise EEG/MEG systems enable bimodal non-invasive detection of spike-like human somatosensory evoked responses at 1 kHz.

    Science.gov (United States)

    Fedele, T; Scheer, H J; Burghoff, M; Curio, G; Körber, R

    2015-02-01

    Non-invasive EEG detection of very high frequency somatosensory evoked potentials featuring frequencies up to and above 1 kHz has been recently reported. Here, we establish the detectability of such components by combined low-noise EEG/MEG. We recorded SEP/SEF simultaneously using median nerve stimulation in five healthy human subjects inside an electromagnetically shielded room, combining a low-noise EEG custom-made amplifier (4.7 nV/√Hz) and a custom-made single-channel low-noise MEG (0.5 fT/√Hz @ 1 kHz). Both, low-noise EEG and MEG revealed three spectrally distinct and temporally overlapping evoked components: N20 (EEG [10 nV] ≅ MEG [1 fT]). Pronounced waveform (peak-by-peak) overlap of EEG and MEG signals is observed in the sigma band, whereas in the kappa band overlap was only partial. A decreasing signal-to-noise ratio (SNR; calculated for n = 12.000 averages) from sigma to kappa components characterizes both, electric and magnetic field recordings: Sigma-band SNR was 12.9  ±  5.5/19.8  ±  12.6 for EEG/MEG, and kappa-band SNR at 3.77  ±  0.8/4.5  ±  2.9. High-frequency performance of a tailor-made MEG matches closely with simultaneously recorded low-noise EEG for the non-invasive detection of somatosensory evoked activity at and above 1 kHz. Thus, future multi-channel dual-mode low-noise technology could offer complementary views for source reconstruction of the neural generators underlying such high-frequency responses, and render neural high-frequency processes related to multi-unit spike discharges accessible in non-invasive recordings.

  3. [Early oesophageal cancer: epidemiology diagnosis and management].

    Science.gov (United States)

    Koessler, T; Bichard, P; Puppa, G; Lepilliez, V; Roth, A; Cacheux, W

    2015-05-20

    In Europe, oesophageal cancers are diagnosed at an early stage in less than 10% of the cases. They are superficial tumours whose invasion is limited to the mucosae and the submucosa. Synchronous node invasion is the most important prognosis factor. Oesophagectomy is the benchmark treatment. Nowadays, endoscopic resection is a validated curative therapeutic alternative. Accurate endoscopic evaluation using chemical or virtual colouring as well as an echoendoscopy, followed by an expert pathological review, must be conducted beforehand. It can be realised for good prognosis tumours after evaluation of the synchronous node invasion or its risk. After completion, regular endoscopic follow-ups are compulsory to detect local relapse.

  4. Paired-pulse behavior of visually evoked potentials recorded in human visual cortex using patterned paired-pulse stimulation.

    Science.gov (United States)

    Höffken, Oliver; Grehl, Torsten; Dinse, Hubert R; Tegenthoff, Martin; Bach, Michael

    2008-07-01

    Paired-pulse stimulation techniques are used as common tools to investigate cortical excitability and cortical plastic changes. Similar to investigations in the somatosensory and motor system here we applied a new paired-pulse paradigm to study the paired-pulse behavior of visually evoked potentials (VEPs) in 25 healthy subjects. VEPs were recorded and the responses to the first and the second P100 peak were analyzed at different SOAs [stimulus onset asynchrony (SOA) = interstimulus interval (ISI) + pulse duration (13 ms)]. Two measures describe the paired pulse interaction: the "amplitude ratio", the ratio of the second to the first amplitude, and the "latency shift", the difference of the inter-peak interval between the P100 peaks and the respective SOA. To separate alterations in the amplitude of the second VEP response due to changes in paired-pulse inhibition from those originating from superposition of the two waveforms, particularly at short SOAs, we created a waveform template from recordings made at SOAs of 1 s, where interaction can be assumed to be negligible. Superposed traces of VEP recordings were then created by adding two templates at delays corresponding to the SOAs used. The original recordings were then digitally subtracted from the traces obtained by superposition. Analysis of the subtracted traces revealed evidence that at short SOAs the second VEP response is substantially suppressed, a finding comparable to the paired-pulse inhibition described for motor and somatosensory cortex following paired-pulse stimulation. However, paired-pulse inhibition seen in V1 varied considerably from subject to subject, both in respect to amplitude, and to time of maximal inhibition. We found paired-pulse inhibition ranging from 12 to 76% (mean 34%) at SOAs between 80 (shortest discriminable SOA) and 320 ms (mean 128 ms). At intermediate SOAs between 80 and 720 ms (mean 215 ms) the amplitude ratios were between 94 and 145% (mean 116%) indicative of slight

  5. Daytime reduction of gastro-oesophageal reflux after healing of oesophagitis and its value as an indicator of favourable response to maintenance treatment.

    OpenAIRE

    Pace, F.; Sangaletti, O.; Bianchi Porro, G

    1990-01-01

    In order to investigate the response of gastro-oesophageal reflux after medically induced healing of oesophagitis and its relation to the occurrence of relapse during prophylactic treatment, 20 patients with erosive/ulcerative oesophagitis underwent 24 hour oesophageal pH monitoring before and after healing achieved with 12 to 24 week treatment with ranitidine 150 or 300 mg twice daily. Compared with pretreatment values, after macroscopic healing, a significant reduction in daytime median per...

  6. Comparative Analysis of Spontaneous and Stimulus-Evoked Calcium Transients in Proliferating and Differentiating Human Midbrain-Derived Stem Cells

    Directory of Open Access Journals (Sweden)

    Torben Johansen

    2017-01-01

    Full Text Available Spontaneous cytosolic calcium transients and oscillations have been reported in various tissues of nonhuman and human origin but not in human midbrain-derived stem cells. Using confocal microfluorimetry, we studied spontaneous calcium transients and calcium-regulating mechanisms in a human ventral mesencephalic stem cell line undergoing proliferation and neuronal differentiation. Spontaneous calcium transients were detected in a large fraction of both proliferating (>50% and differentiating (>55% cells. We provide evidence for the existence of intracellular calcium stores that respond to muscarinic activation of the cells, having sensitivity for ryanodine and thapsigargin possibly reflecting IP3 receptor activity and the presence of ryanodine receptors and calcium ATPase pumps. The observed calcium transient activity potentially supports the existence of a sodium-calcium antiporter and the existence of calcium influx induced by depletion of calcium stores. We conclude that the cells have developed the most important mechanisms governing cytosolic calcium homeostasis. This is the first comparative report of spontaneous calcium transients in proliferating and differentiating human midbrain-derived stem cells that provides evidence for the mechanisms that are likely to be involved. We propose that the observed spontaneous calcium transients may contribute to mechanisms involved in cell proliferation, phenotypic differentiation, and general cell maturation.

  7. Evoked cavernous activity.

    Science.gov (United States)

    Yilmaz, Uğur; Soylu, Ahmet; Ozcan, Cemal; Kutlu, Ramazan; Güneş, Ali

    2002-01-01

    Corpus cavernosum electromyography has been widely done to evaluate autonomic dysfunction in patients with erectile dysfunction. We assessed the value of corpus cavernosum electromyography, evoked cavernous activity and penile sympathetic skin responses for their accuracy in determining autonomic involvement in cases of erectile dysfunction. We evaluated 75 men with erectile dysfunction by corpus cavernosum electromyography, evoked cavernous activity and penile sympathetic skin response tests at our neurourology laboratory. The etiology of dysfunction was vascular, neurogenic, psychogenic or mixed based on a detailed medical and sexual history, physical examination, electrophysiological and laboratory studies, penile color Doppler ultrasonography, and cavernosography and/or cavernosometry. Autonomic involvement was clinically assessed by systemic findings, such as orthostatic hypotension, impaired gastrointestinal motility, sinus dysrhythmia and secretomotor changes. A concentric electromyography needle placed in the right cavernous body was used to record corpus cavernosum electromyography and evoked cavernous activity. The right median nerve was stimulated electrically with 13 to 16 mA. to determine evoked cavernous activity and the penile sympathetic skin response. The latter response was recorded with silver disc electrodes placed on the left cavernous body. All tests were performed using an electromyography/evoked potential machine. We determined the relationships among corpus cavernosum electromyography, evoked cavernous activity and penile sympathetic skin response tests in respect to etiological factors. The 56 patients with normal corpus cavernosum electromyography activity had also evoked cavernous activity and a penile sympathetic skin response except for 1 with no penile sympathetic skin response but evoked cavernous activity. None of these patients had autonomic neuropathy. Of the 19 patients without corpus cavernosum electromyography activity 11 had

  8. Prevalence of eosinophilic oesophagitis in adults presenting with oesophageal food bolus obstruction

    Science.gov (United States)

    Heerasing, Neel; Lee, Shok Yin; Alexander, Sina; Dowling, Damian

    2015-01-01

    AIM: To look at the relationship between eosinophilic oesophagitis (EO) and food bolus impaction in adults. METHODS: We retrospectively analysed medical records of 100 consecutive patients who presented to our hospital with oesophageal food bolus obstruction (FBO) between 2012 and 2014. In this cohort, 96 were adults (64% male), and 4 paediatric patients were excluded from the analysis as our centre did not have paediatric gastroenterologists. Eighty-five adult patients underwent emergency gastroscopy. The food bolus was either advanced into the stomach using the push technique or retrieved using a standard retrieval net. Biopsies were obtained in 51 patients from the proximal and distal parts of the oesophagus at initial gastroscopy. All biopsy specimens were assessed and reviewed by dedicated gastrointestinal pathologists at the Department of Pathology, University Hospital Geelong. The diagnosis of EO was defined and established by the presence of the following histological features: (1) peak eosinophil counts > 20/hpf; (2) eosinophil microabscess; (3) superficial layering of eosinophils; (4) extracellular eosinophil granules; (5) basal cell hyperplasia; (6) dilated intercellular spaces; and (7) subepithelial or lamina propria fibrosis. The histology results of the biopsy specimens were accessed from the pathology database of the hospital and recorded for analysis. RESULTS: Our cohort had a median age of 60. Seventeen/51 (33%) patients had evidence of EO on biopsy findings. The majority of patients with EO were male (71%). Classical endoscopic features of oesophageal rings, furrows or white plaques and exudates were found in 59% of patients with EO. Previous episodes of FBO were present in 12/17 patients and 41% had a history of eczema, hay fever or asthma. Reflux oesophagitis and benign strictures were found in 20/34 patients who did not have biopsies. CONCLUSION: EO is present in approximately one third of patients who are admitted with FBO. Biopsies should be

  9. Dendritic-cell-based immunotherapy evokes potent anti-tumor immune responses in CD105+ human renal cancer stem cells.

    Science.gov (United States)

    Zhang, Xiao-Fei; Weng, De-Sheng; Pan, Ke; Zhou, Zi-Qi; Pan, Qiu-Zhong; Zhao, Jing-Jing; Tang, Yan; Jiang, Shan-Shan; Chen, Chang-Long; Li, Yong-Qiang; Zhang, Hong-Xia; Chang, Alfred E; Wicha, Max S; Zeng, Yi-Xin; Li, Qiao; Xia, Jian-Chuan

    2017-11-01

    Cancer stem cells (CSCs) are responsible for tumor initiation, progression, and resistance to therapeutic agents; they are usually less sensitive to conventional cancer therapies, and could cause tumor relapse. An ideal therapeutic strategy would therefore be to selectively target and destroy CSCs, thereby preventing tumor relapse. The aim of the present study was to evaluate the effectiveness of dendritic cells (DCs) pulsed with antigen derived from CD105+ human renal cell carcinoma (RCC) CSCs against renal cancer cells in vitro and in vivo. We identified "stem-like" characteristics of CD105+ cells in two human RCC cell lines: A498 and SK-RC-39. Loading with cell lysates did not change the characteristics of the DCs. However, DCs loaded with lysates derived from CD105+ CSCs induced more functionally specific active T cells and specific antibodies against CSCs, and clearly depressed the tumor growth in mice. Our results could form the basis for a novel strategy to improve the efficacy of DC-based immunotherapy for human RCC. © 2017 Wiley Periodicals, Inc.

  10. Ductal metaplasia in oesophageal submucosal glands is associated with inflammation and oesophageal adenocarcinoma.

    Science.gov (United States)

    Garman, Katherine S; Kruger, Leandi; Thomas, Samantha; Swiderska-Syn, Marzena; Moser, Barry K; Diehl, Anna Mae; McCall, Shannon J

    2015-12-01

    Recent studies have suggested that oesophageal submucosal gland (ESMG) ducts harbour progenitor cells that may contribute to oesophageal metaplasia. Our objective was to determine whether histological differences exist between the ESMGs of individuals with and without oesophageal adenocarcinoma (EAC). We performed histological assessment of 343 unique ESMGs from 30 control patients, 24 patients with treatment-naïve high-grade columnar dysplasia (HGD) or EAC, and 23 non-EAC oesophagectomy cases. A gastrointestinal pathologist assessed haematoxylin and eosin-stained ESMG images by using a scoring system that assigns individual ESMG acini to five histological types (mucous, serous, oncocytic, dilated, or ductal metaplastic). In our model, ductal metaplastic acini were more common in patients with HGD/EAC (12.7%) than in controls (3.5%) (P = 0.006). We also identified greater proportions of acini with dilation (21.9%, P metaplasia (4.3%, P = 0.001) in non-EAC oesophagectomy cases than in controls. Ductal metaplasia tended to occur in areas of mucosal ulceration or tumour. We found a clear association between ductal metaplastic ESMG acini and HGD/EAC. Non-EAC cases had dilated acini and some ductal dilation. Because ESMGs and ducts harbour putative progenitor cells, these associations could have significance for understanding the pathogenesis of EAC. © 2015 John Wiley & Sons Ltd.

  11. Oesophageal disease: gastroesophageal reflux disease, Barrett's oesophagus, achalasia and eosinophilic oesophagitis.

    Science.gov (United States)

    Calvet, Xavier

    2016-09-01

    The most interesting conclusions and/or advances presented at Digestive Disease Week 2016 were the following: a) gastroesophageal reflux disease: proton pump inhibitor-refractory reflux disease is frequently associated with poor treatment adherence, psychiatric comorbidities and functional gastrointestinal disorders. These possible entities should be investigated in all cases of proton pump inhibitor-refractory reflux disease; b) Barrett's oesophagus: the efficacy of screening remains unclear; however, new minimally-invasive techniques such as the cytosponge allow more effective detection, both of Barrett's oesophagus and Barrett's oesophagus-associated dysplasia or neoplasia; c) achalasia: evidence indicates that peroral endoscopic myotomy is as effective as surgery and is a safer alternative; d) eosinophilic oesophagitis: high-dose proton pump inhibitors are required to rule out proton pump inhibitor-responsive eosinophilic oesophagitis; montelukast is not clearly effective in the treatment of eosinophilic oesophagitis, although moderate efficacy cannot be ruled out. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  12. Recent advances in oesophageal diseases.

    Science.gov (United States)

    Al Dulaimi, David

    2014-01-01

    -esophageal reflux disease alongside more vigilant recording of new cases. Social class was inversely associated with the ASIR of EC regardless of gender which may be attributed to class differences in risk factor distribution particularly smoking, diet and obesity. An appreciation for the limitations of an epidemiological study is important when interpreting results which should be further evaluated in future studies. Islami F et al.Determinants of gastroesophageal reflux disease, including hookah smoking and opium use- A cross-sectional analysis of 50,000 individuals. PLoS One 2014;9(2):e89256 Gastroesophageal reflux disease (GERD) is a highly prevalent cause of gastrointestinal symptoms worldwide incurring great cost to the primary and secondary healthcare sectors. An improved understanding of the factors which influence GERD symptoms in low- to medium- income countries may inform public health initiatives. This study analysed prospective data from the Golestan cohort study, primarily established to investigate determinants of upper gastrointestinal cancers, toexplore the risk factors influencing GERD symptoms (regurgitation and/or heartburn) in 50,045 individuals aged 40-75 years in Golestan Province, Iran enrolled between 01/2004 and 06/2008.Of note, 39.12% of individuals denied ever experiencing GERD symptoms. A further 19.89% reported at least once weekly GERD symptoms with 11.83% experiencing daily symptoms. Severe symptoms, defined as disturbing daily work or sleep, were recorded by 11.33% of individuals. Separately the occurrence of daily GERD symptoms and severe symptoms were inversely associated with male gender (OR 0.36, 95% CI 0.33-0.39 both), level of formal education (p=0.01 and p=0.001 respectively), wealth score (passociated with body mass index (pmarkers to investigate the cellular mechanisms involved in homeostasis of the normal human squamous esophagus in 10 participants undergoing esophagectomy for esophageal cancer. The self-renewal potential of cell

  13. Gastro-oesophageal reflux: an overview of the pharmacotherapeutic ...

    African Journals Online (AJOL)

    oesophageal reflux and secondary gastro-oesopahageal reflux. Management of GORD is aimed at decreasing the amount of stomach acid that enters the distal oesophagus usually by increasing the rate at which the stomach empties into the duodenum ...

  14. Oesophageal sarcomas in dogs: histological and clinical evaluation.

    Science.gov (United States)

    Ranen, Eyal; Dank, Gillian; Lavy, Eran; Perl, Samuel; Lahav, Dan; Orgad, Uri

    2008-10-01

    A histological grading system of oesophageal sarcomas has not been established. Thirty-two cases of oesophageal sarcomas have been reviewed for tumour characteristics and clinical outcome. Nineteen dogs underwent surgical intervention to remove oesophageal tumours; ten of them survived (median 278 days). Primary tumour types included osteosarcoma (47%), osteosarcoma with tumour giant cells (7%), fibroblastic osteosarcoma (13%), chondroblastic osteosarcoma (7%) fibrosarcoma (23%) and undifferentiated sarcoma (3%). Histological grade evaluation revealed 33% grade 1 sarcoma, 50% grade 2 and 17% grade 3. No correlation could be found between survival and signalment, duration of clinical signs, tumour type, tumour grade and chemotherapy. Chemotherapy was found to reduce lung metastases' histological scores in three cases (P=0.0007). Surgery seems to be the treatment of choice but the effect of chemotherapy warrants further investigation. Additional research of cases should be performed in order to further define prognostic factors of oesophageal sarcomas.

  15. GATA6 expression in Barrett's oesophagus and oesophageal adenocarcinoma

    NARCIS (Netherlands)

    Pavlov, Kirill; Honing, Judith; Meijer, Coby; Boersma-van Ek, Wytske; Peters, Frans T.M.; van den Berg, Anke; Karrenbeld, Arend; Plukker, John T.M.; Kruyt, Frank A.E.; Kleibeuker, Jan H.

    2015-01-01

    BACKGROUND: Barrett's oesophagus can progress towards oesophageal adenocarcinoma through a metaplasia-dysplasia-carcinoma sequence, but the underlying mechanisms are poorly understood. The transcription factor GATA6 is known to be involved in columnar differentiation and proliferation, and GATA6

  16. GATA6 expression in Barrett's oesophagus and oesophageal adenocarcinoma

    NARCIS (Netherlands)

    Pavlov, Kirill; Honing, Judith; Meijer, Coby; Boersma-van Ek, Wytske; Peters, Frans T. M.; van den Berg, Anke; Karrenbeld, Arend; Plukker, John T. M.; Kruyt, Frank A. E.; Kleibeuker, Jan H.

    Background: Barrett's oesophagus can progress towards oesophageal adenocarcinoma through a metaplasia-dysplasia-carcinoma sequence, but the underlying mechanisms are poorly understood. The transcription factor GATA6 is known to be involved in columnar differentiation and proliferation, and GATA6

  17. Telomerase activity of the Lugol-stained and -unstained squamous epithelia in the process of oesophageal carcinogenesis.

    Science.gov (United States)

    Inai, M; Kano, M; Shimada, Y; Sakurai, T; Chiba, T; Imamura, M

    2001-09-28

    Up-regulation of telomerase has been reported in many cancers. Our aim was to characterize telomerase activity in various states of the oesophagus to facilitate better understanding of carcinogenesis of oesophageal squamous cell carcinoma. During endoscopic examinations, we obtained 45 Lugol-stained normal epithelia, 31 Lugol-unstained epithelia (14 oesophagitis, 7 mild dysplasia, 5 severe dysplasia and 5 intramucosal cancer) and 9 advanced cancer. Telomerase activity was semi-quantified by a telomeric repeat amplification protocol using enzyme-linked immunosorbent assay, and expression of human telomerase reverse transcriptase mRNA was examined by in situ hybridization. In the Lugol-stained normal epithelia, telomerase activity increased in proportion to the increase of severity of the accompanying lesions, with a rank order of advanced cancer, intramucosal cancer, mild dysplasia and oesophagitis. In the Lugol-unstained lesions and advanced cancer, telomerase activity was highest in advanced cancer. Up-regulation of telomerase in normal squamous epithelium may be a marker of progression of oesophageal squamous cell carcinoma. Copyright 2001 Cancer Research Campaign

  18. The role of obesity in oesophageal cancer development.

    Science.gov (United States)

    Long, Elizabeth; Beales, Ian L P

    2014-11-01

    The incidence of oesophageal adenocarcinoma has increased dramatically in the developed world in the last half century. Over approximately the same period there has been an increase in the prevalence of obesity. Multiple epidemiological studies and meta-analyses have confirmed that obesity, especially abdominal, visceral obesity, is a risk factor for gastro-oesophageal reflux, Barrett's oesophagus and oesophageal adenocarcinoma. Although visceral obesity enhances gastro-oesophageal reflux, the available data also show that visceral obesity increases the risk of Barrett's oesophagus and adenocarcinoma via reflux-independent mechanisms. Several possible mechanisms could link obesity with the risk of oesophageal adenocarcinoma in addition to mechanical effects increasing reflux. These include reduced gastric Helicobacter pylori infection, altered intestinal microbiome, factors related to lifestyle, the metabolic syndrome and associated low-grade inflammation induced by obesity and the secretion of mediators by adipocytes which may directly influence the oesophageal epithelium. Of these adipocyte-derived mediators, increased leptin levels have been independently associated with progression to oesophageal adenocarcinoma and in laboratory studies leptin enhances malignant behaviours in cell lines. Adiponectin is also secreted by adipocytes and levels decline with obesity: decreased serum adiponectin levels are associated with malignant progression in Barrett's oesophagus and experimentally adiponectin exerts anticancer effects in Barrett's cell lines and inhibits growth factor signalling. At present there are no proven chemopreventative interventions that may reduce the incidence of obesity-associated oesophageal cancer: observational studies suggest that the combined use of a statin and aspirin or another cyclo-oxygenase inhibitor is associated with a significantly reduced cancer incidence in patients with Barrett's oesophagus.

  19. Curative surgical management of isolated adrenal recurrence of oesophageal adenocarcinoma.

    LENUS (Irish Health Repository)

    O'Sullivan, K E

    2013-01-01

    Adrenal metastases of oesophageal adenocarcinoma are rarely detected in the clinical setting, more frequently being found as an incidental postmortem finding in the presence of widespread metastases. With improvements in the sensitivity of radiological diagnostic modalities, the incidence of adrenal tumour detection is on the rise. We report herein a particularly rare case of primary operative management by adrenalectomy for an isolated right-sided adrenal metastasis secondary to oesophageal adenocarcinoma, with a long-term survival.

  20. Potenciais miogênicos evocados vestibulares: metodologias de registro em homens e cobaias Vestibular evoked myogenic potential: recording methods in humans and guinea pigs

    Directory of Open Access Journals (Sweden)

    Aline Cabral de Oliveira

    2008-10-01

    Full Text Available O potencial miogênico evocado vestibular (VEMP é um teste clínico que avalia a função vestibular através de um reflexo vestíbulo-cervical inibitório captado nos músculos do corpo em resposta à estimulação acústica de alta intensidade. OBJETIVO: Verificar e analisar os diversos métodos de registro dos potenciais miogênicos evocados vestibulares no homem e em cobaias. MATERIAL E MÉTODO: Realizou-se busca eletrônica nas bases de dados MEDLINE, LILACS, SCIELO e COCHRANE. RESULTADOS: Foram verificadas divergências quanto às formas de registro dos potenciais miogênicos evocados vestibulares, relacionadas com os seguintes fatores: posição do paciente no momento do registro, tipo de estímulo sonoro utilizado (clicks ou tone bursts, parâmetros para a promediação dos estímulos (intensidade, freqüência, tempo de apresentação, filtros, ganho de amplificação das respostas e janelas para captação dos estímulos, tipo de fone utilizado e forma de apresentação dos estímulos (monoaural ou binaural, ipsi ou contralateral. CONCLUSÃO: Não existe consenso na literatura quanto ao melhor método de registro dos potenciais evocados miogênicos vestibulares, havendo necessidade de pesquisas mais específicas para comparação entre estes registros e a definição de um modelo padrão para a utilização na prática clínica.The vestibular evoked myogenic potential (VEMP is a clinical test that assess the vestibular function by means of an inhibitory vestibulo-neck reflex, recorded in body muscles in response to high intensity acoustic stimuli. AIM: To check and analyze the different methods used to record VEMPs in humans and in guinea pigs. MATERIALS AND METHODS: We researched the following databases: MEDLINE, LILACS, SCIELO and COCHRANE. RESULTS: we noticed discrepancies in relation to the ways used to record the vestibular evoked myogenic potentials in relation to the following factors: patient position at the time of recording

  1. Defective Resensitization in Human Airway Smooth Muscle Cells Evokes β-Adrenergic Receptor Dysfunction in Severe Asthma.

    Directory of Open Access Journals (Sweden)

    Manveen K Gupta

    Full Text Available β2-adrenergic receptor (β2AR agonists (β2-agonist are the most commonly used therapy for acute relief in asthma, but chronic use of these bronchodilators paradoxically exacerbates airway hyper-responsiveness. Activation of βARs by β-agonist leads to desensitization (inactivation by phosphorylation through G-protein coupled receptor kinases (GRKs which mediate β-arrestin binding and βAR internalization. Resensitization occurs by dephosphorylation of the endosomal βARs which recycle back to the plasma membrane as agonist-ready receptors. To determine whether the loss in β-agonist response in asthma is due to altered βAR desensitization and/or resensitization, we used primary human airway smooth muscle cells (HASMCs isolated from the lungs of non-asthmatic and fatal-asthmatic subjects. Asthmatic HASMCs have diminished adenylyl cyclase activity and cAMP response to β-agonist as compared to non-asthmatic HASMCs. Confocal microscopy showed significant accumulation of phosphorylated β2ARs in asthmatic HASMCs. Systematic analysis of desensitization components including GRKs and β-arrestin showed no appreciable differences between asthmatic and non-asthmatic HASMCs. However, asthmatic HASMC showed significant increase in PI3Kγ activity and was associated with reduction in PP2A activity. Since reduction in PP2A activity could alter receptor resensitization, endosomal fractions were isolated to assess the agonist ready β2ARs as a measure of resensitization. Despite significant accumulation of β2ARs in the endosomes of asthmatic HASMCs, endosomal β2ARs cannot robustly activate adenylyl cyclase. Furthermore, endosomes from asthmatic HASMCs are associated with significant increase in PI3Kγ and reduced PP2A activity that inhibits β2AR resensitization. Our study shows that resensitization, a process considered to be a homeostasis maintaining passive process is inhibited in asthmatic HASMCs contributing to β2AR dysfunction which may underlie

  2. Proprioceptive evoked gamma oscillations

    DEFF Research Database (Denmark)

    Arnfred, S.M.; Hansen, Lars Kai; Parnas, J.

    2007-01-01

    A proprioceptive stimulus consisting of a weight change of a handheld load has recently been shown to elicit an evoked potential. Previously, somatosensory gamma oscillations have only been evoked by electrical stimuli. We conjectured that a natural proprioceptive stimulus also would be able...... to evoke gamma oscillations. EEG was recorded using 64 channels in 14 healthy subjects. In each of three runs a stimulus of 100 g load increment in each hand was presented in 120 trials. Data were wavelet transformed and runs collapsed. Inter-trial phase coherence (ITPC) was computed as the best measure...... contralateral to stimulus side and additionally an unexpected 20 Hz activity was observed slightly lateralized in the frontal central region. The gamma phase locking may be a manifestation of early somatosensory feature integration. The analyses suggest that the high frequency activity consists of two distinct...

  3. Effects of omeprazole or anti-reflux surgery on lower oesophageal sphincter characteristics and oesophageal acid exposure over 10 years.

    Science.gov (United States)

    Emken, Birgitte-Elise G; Lundell, Lars R; Wallin, Lene; Myrvold, Helge E; Engström, Cecilia; Montgomery, Madeleine; Malm, Anders R; Lind, Tore; Hatlebakk, Jan G

    2017-01-01

    To compare the effect of anti-reflux surgery (ARS) versus proton pump inhibitor therapy on lower oesophageal sphincter (LOS) function and oesophageal acid exposure in patients with chronic gastro-oesophageal reflux disease (GORD) over a decade of follow-up. In this randomised, prospective, multicentre study we compared LOS pressure profiles, as well as oesophageal exposure to acid, at baseline and at 1 and 10 years after randomisation to either open ARS (n = 137) or long-term treatment with omeprazole (OME) 20-60 mg daily (n = 108). Median LOS resting pressure and abdominal length increased significantly and remained elevated in patients operated on with ARS, as opposed to those on OME. The proportion of total time (%) with oesophageal pH <4.0 decreased significantly in both the surgical and medical groups, and was significantly lower after 1 year in patients treated with ARS versus OME. After 10 years, oesophageal acid exposure was normalised in both groups, with no significant differences, and bilirubin exposure was within normal limits. After 10 years, patients with or without Barrett's oesophagus did not differ in acid reflux control between the two treatment options. Open ARS and OME were both effective in normalising acid reflux into the oesophagus even when studied over a period of 10 years. Anatomically and functionally the LOS was repaired durably by surgery, with increased resting pressure and abdominal length.

  4. Brain correlates of music-evoked emotions.

    Science.gov (United States)

    Koelsch, Stefan

    2014-03-01

    Music is a universal feature of human societies, partly owing to its power to evoke strong emotions and influence moods. During the past decade, the investigation of the neural correlates of music-evoked emotions has been invaluable for the understanding of human emotion. Functional neuroimaging studies on music and emotion show that music can modulate activity in brain structures that are known to be crucially involved in emotion, such as the amygdala, nucleus accumbens, hypothalamus, hippocampus, insula, cingulate cortex and orbitofrontal cortex. The potential of music to modulate activity in these structures has important implications for the use of music in the treatment of psychiatric and neurological disorders.

  5. The marine n-3 PUFA DHA evokes cytoprotection against oxidative stress and protein misfolding by inducing autophagy and NFE2L2 in human retinal pigment epithelial cells

    Science.gov (United States)

    Johansson, Ida; Monsen, Vivi Talstad; Pettersen, Kristine; Mildenberger, Jennifer; Misund, Kristine; Kaarniranta, Kai; Schønberg, Svanhild; Bjørkøy, Geir

    2015-01-01

    Accumulation and aggregation of misfolded proteins is a hallmark of several diseases collectively known as proteinopathies. Autophagy has a cytoprotective role in diseases associated with protein aggregates. Age-related macular degeneration (AMD) is the most common neurodegenerative eye disease that evokes blindness in elderly. AMD is characterized by degeneration of retinal pigment epithelial (RPE) cells and leads to loss of photoreceptor cells and central vision. The initial phase associates with accumulation of intracellular lipofuscin and extracellular deposits called drusen. Epidemiological studies have suggested an inverse correlation between dietary intake of marine n-3 polyunsaturated fatty acids (PUFAs) and the risk of developing neurodegenerative diseases, including AMD. However, the disease-preventive mechanism(s) mobilized by n-3 PUFAs is not completely understood. In human retinal pigment epithelial cells we find that physiologically relevant doses of the n-3 PUFA docosahexaenoic acid (DHA) induce a transient increase in cellular reactive oxygen species (ROS) levels that activates the oxidative stress response regulator NFE2L2/NRF2 (nuclear factor, erythroid derived 2, like 2). Simultaneously, there is a transient increase in intracellular protein aggregates containing SQSTM1/p62 (sequestosome 1) and an increase in autophagy. Pretreatment with DHA rescues the cells from cell cycle arrest induced by misfolded proteins or oxidative stress. Cells with a downregulated oxidative stress response, or autophagy, respond with reduced cell growth and survival after DHA supplementation. These results suggest that DHA both induces endogenous antioxidants and mobilizes selective autophagy of misfolded proteins. Both mechanisms could be relevant to reduce the risk of developing aggregate-associate diseases such as AMD. PMID:26237736

  6. Evoked acoustic emission

    DEFF Research Database (Denmark)

    Elberling, C; Parbo, J; Johnsen, N J

    1985-01-01

    Stimulated acoustic emissions were recorded in response to tonal stimuli at 60 dB p.e. SPL in a small group of normal-hearing adults. Power spectral analysis reveals that the evoked activity from each ear contains energy in preferential frequency bands and the change of stimulus frequency has only...

  7. Proprioceptive evoked gamma oscillations

    DEFF Research Database (Denmark)

    Arnfred, Sidse M; Hansen, Lars Kai; Parnas, Josef

    2007-01-01

    to evoke gamma oscillations. EEG was recorded using 64 channels in 14 healthy subjects. In each of three runs a stimulus of 100 g load increment in each hand was presented in 120 trials. Data were wavelet transformed and runs collapsed. Inter-trial phase coherence (ITPC) was computed as the best measure...

  8. Diagnostic yield of oesophageal pH monitoring in patients with chronic unexplained cough

    NARCIS (Netherlands)

    Bogte, Auke; Bredenoord, Arjan J.; Smout, Andre J. P. M.

    2008-01-01

    Objective. One of the main causes of persistent cough is gastro-oesophageal reflux. In these patients, excessive oesophageal acid exposure and/or a temporal association between gastro-oesophageal reflux and cough can be demonstrated during 24-h pH monitoring. Impedance pH monitoring may have a

  9. Diagnostic yield of oesophageal pH monitoring in patients with chronic unexplained cough

    NARCIS (Netherlands)

    Bogte, Auke; Bredenoord, Arjan J.; Smout, André J. P. M.

    2008-01-01

    OBJECTIVE: One of the main causes of persistent cough is gastro-oesophageal reflux. In these patients, excessive oesophageal acid exposure and/or a temporal association between gastro-oesophageal reflux and cough can be demonstrated during 24-h pH monitoring. Impedance pH monitoring may have a

  10. Tylosis with oesophageal cancer: Diagnosis, management and molecular mechanisms.

    Science.gov (United States)

    Ellis, Anthony; Risk, Janet M; Maruthappu, Thiviyani; Kelsell, David P

    2015-09-29

    Tylosis (hyperkeratosis palmaris et plantaris) is characterised by focal thickening of the skin of the hands and feet and is associated with a very high lifetime risk of developing squamous cell carcinoma of the oesophagus. This risk has been calculated to be 95% at the age of 65 in one large family, however the frequency of the disorder in the general population is not known and is likely to be less than one in 1,000,000. Oesophageal lesions appear as small (2-5 mm), white, polyploid lesions dotted throughout the oesophagus and oral leukokeratosis has also been described. Although symptoms of oesophageal cancer can include dysphagia, odynophagia, anorexia and weight loss, there may be an absence of symptoms in early disease, highlighting the importance of endoscopic surveillance in these patients. Oesophageal cancer associated with tylosis usually presents in middle to late life (from mid-fifties onwards) and shows no earlier development than the sporadic form of the disease. Tylosis with oesophageal cancer is inherited as an autosomal dominant trait with complete penetrance of the cutaneous features, usually by 7 to 8 years of age but can present as late as puberty. Mutations in RHBDF2 located on 17q25.1 have recently been found to be causative. A diagnosis of tylosis with oesophageal cancer is made on the basis of a positive family history, characteristic clinical features, including cutaneous and oesophageal lesions, and genetic analysis for mutations in RHBDF2. The key management goal is surveillance for early detection and treatment of oesophageal dysplasia. Surveillance includes annual gastroscopy with biopsy of any suspicious lesion together with quadratic biopsies from the upper, middle and lower oesophagus. This is coupled with dietary and lifestyle modification advice and symptom education. Symptomatic management of the palmoplantar keratoderma includes regular application of emollients, specialist footwear and early treatment of fissures and super

  11. BAER - brainstem auditory evoked response

    Science.gov (United States)

    ... auditory potentials; Brainstem auditory evoked potentials; Evoked response audiometry; Auditory brainstem response; ABR; BAEP ... Normal results vary. Results will depend on the person and the instruments used to perform the test.

  12. [Palliative care for patients with oesophageal cancer].

    Science.gov (United States)

    Junginger, T; Gockel, I; Gönner, U; Schmidberger, H

    2010-12-01

    Palliative therapy for patients with incurable oesophageal cancer necessitates a broad spectrum of different measures to relieve symptoms. Surgical procedures (palliative tumour resections, bypass surgery) are rarely indicated on account of the high morbidity. Preeminent treatment options to eliminate dysphagia and to ensure food passage are endoscopic procedures, in particular, the endoscopically or radiologically guided stent implantation. In case of failure, a percutaneous feeding tube and general palliative measures are required. Furthermore tumour-specific therapies (brachytherapy, radiochemotherapy, chemotherapy) are applied. The choice of the procedure is based on the symptoms, the tumour situation, the patients' general status, and their preferences. If possible, an individual, interdisciplinary treatment concept for each patient should be designed and modified according to the course of the disease. It should be the aim of future studies to elucidate the optimal combination of a merely symptomatic treatment with tumour-specific measures under the aspect of the achievable quality of life. © Georg Thieme Verlag KG Stuttgart ˙ New York.

  13. Distal thoracic oesophageal perforation secondary to blunt trauma: Case report

    Directory of Open Access Journals (Sweden)

    Tandon Ruchi

    2007-03-01

    Full Text Available Abstract Background Traumatic perforation of the distal oesophagus due to blunt trauma is a very rare condition and is still associated with a significant morbidity and mortality. This is further exacerbated by delayed diagnosis and management as symptoms and signs are often masked by or ascribed to more common blunt thoracic injuries. Case report We present a case of a distal oesophageal perforation, secondary to a fall from a third storey window, which was masked by concomitant thoracic injuries and missed on both computed tomography imaging and laparotomy. The delay in his diagnosis significantly worsened the patient's recovery by allowing the development of an overwhelming chest sepsis that contributed to his death. Conclusion Early identification of an intrathoracic oesophageal perforation requires deliberate consideration and is essential to ensure a favorable outcome. Treatment should be individualised taking into account the nature of the oesophageal defect, time elapsed from injury and the patient's general condition.

  14. Gastro-oesophageal reflux and hiatus hernia—endoscopy

    Science.gov (United States)

    Roesch, W.

    1974-01-01

    The endoscopic diagnosis of hiatal hernia (sliding type) relies on direct and indirect criteria during the oesophagoscopic or gastroscopic approach. A wide separation between the anatomic and mucosal oesophago-gastric junction, the presence of a so-called Schatzki-ring, a wandering junction with sliding gastric mucosal folds during inspiration and two ring-like structures are important. Whereas radiology seems to be superior to endoscopy in the diagnosis of asymptomatic hiatus hernia, oesophagoscopy may reveal sequelae of reflux like oesophagitis, erosions, ulcers and strictures. Peptic oesophagitis is found in about 10% to cause upper gastrointestinal haemorrhage. ImagesFig. 1Fig. 2Fig. 3 PMID:4449767

  15. Oesophageal cancer in France and Switzerland: recent time trends.

    Science.gov (United States)

    Tuyns, A J

    1992-04-01

    This paper reports the incidence of oesophageal carcinoma in five cancer registries from France and in a further two from the francophone regions of Switzerland. The cancers are segregated into the two main histological types (squamous cell carcinoma and adenocarcinoma). In Belgium the proportion of adenocarcinomas is much higher than in any of the French registries. A study of time trends shows no clear trend in overall incidence of oesophageal cancer. There is a trend towards an increasing proportion of adenocarcinomas with time, that is most apparent in Doubs, Dijon and Vaud registries.

  16. Idiopathic giant oesophageal ulcer and leucopoenia after renal transplantation.

    Science.gov (United States)

    van Boekel, G A J; Volbeda, M; van den Hoogen, M W F; Hilbrands, L B; Berden, J H M

    2012-10-01

    A 45-year-old male recipient of a renal allograft was admitted because of a giant oesophageal ulcer coinciding with leucopoenia. An extensive workup revealed no explanation for the ulcer and leucopoenia. Our final diagnosis by exclusion was an idiopathic giant oesophageal ulcer and late-onset neutropenia as consequences of rituximab induction therapy given during the transplant procedure. The patient fully recovered after treatment with prednisone. However, after four months, the ulcer and leucopoenia recurred and again successfully responded to treatment with prednisone.

  17. Airborne occupational exposures and risk of oesophageal and cardia adenocarcinoma.

    Science.gov (United States)

    Jansson, C; Plato, N; Johansson, A L V; Nyrén, O; Lagergren, J

    2006-02-01

    The reasons for the increasing incidence of and strong male predominance in patients with oesophageal and cardia adenocarcinoma remain unclear. The authors hypothesised that airborne occupational exposures in male dominated industries might contribute. In a nationwide Swedish population based case control study, 189 and 262 cases of oesophageal and cardia adenocarcinoma respectively, 167 cases of oesophageal squamous cell carcinoma, and 820 frequency matched controls underwent personal interviews. Based on each study participant's lifetime occupational history the authors assessed cumulative airborne occupational exposure for 10 agents, analysed individually and combined, by a deterministic additive model including probability, frequency, and intensity. Furthermore, occupations and industries of longest duration were analysed. Relative risks were estimated by odds ratios (OR), with 95% confidence intervals (CI), using conditional logistic regression, adjusted for potential confounders. Tendencies of positive associations were found between high exposure to pesticides and risk of oesophageal (OR 2.3 (95% CI 0.9 to 5.7)) and cardia adenocarcinoma (OR 2.1 (95% CI 1.0 to 4.6)). Among workers highly exposed to particular agents, a tendency of an increased risk of oesophageal squamous cell carcinoma was found. There was a twofold increased risk of oesophageal squamous cell carcinoma among concrete and construction workers (OR 2.2 (95% CI 1.1 to 4.2)) and a nearly fourfold increased risk of cardia adenocarcinoma among workers within the motor vehicle industry (OR 3.9 (95% CI 1.5 to 10.4)). An increased risk of oesophageal squamous cell carcinoma (OR 3.9 (95% CI 1.2 to 12.5)), and a tendency of an increased risk of cardia adenocarcinoma (OR 2.8 (95% CI 0.9 to 8.5)), were identified among hotel and restaurant workers. Specific airborne occupational exposures do not seem to be of major importance in the aetiology of oesophageal or cardia adenocarcinoma and are unlikely to

  18. A proposition for the diagnosis and treatment of gastro-oesophageal reflux disease in children: A report from a working group on gastro-oesophageal reflux disease

    OpenAIRE

    Vandenplas, Yvan; Ashkenazi, A.; Belli, D.; Boige, N.; Bouquet, Jan; Cadranel, S.; Cezard, J; Cucchiara, S.; Dupont, C.; Geboes, K; F. Gottrand; Heymans, Hugo; Jasinski, C.; Kneepkens, Frank; Koletzko, Sybille

    1993-01-01

    textabstractIn this paper, a Working Group on Gastro-Oesophageal Reflux discusses recommendations for the first line diagnostic and therapeutic approach of gastro-oesophageal reflux disease in infants and children. All members of the Working Group agreed that infants with uncomplicated gastro-oesophageal reflux can be safely treated before performing (expensive and often unnecessary) complementary investigations. However, the latter are mandatory if symptoms persist despite appropriate treatm...

  19. Spinal deformity in patients born with oesophageal atresia and tracheo-oesophageal fistula.

    Science.gov (United States)

    Chetcuti, P; Dickens, D R; Phelan, P D

    1989-01-01

    Spinal deformity was present in 58 (19%) of 302 patients born with oesophageal atresia and fistula when examined at review. This was present in 24 (47%) of 51 patients with vertebral anomalies and 34 (14%) of 251 patients with normal vertebrae. Scoliosis was present in 21 patients with vertebral anomalies, torticollis in two, and lordosis in one. Two thirds of the patients with congenital scoliosis have had or are likely to require operation, compared with five patients with non-congenital scoliosis. Scoliosis associated with mixed vertebral anomalies in the lower thoracic spine had the worst prognosis. The medical records of a further 64 patients who had survived operation but who could not be traced were reviewed, and indicated that four had had congenital vertebral anomalies but none had a spinal deformity. We recommend early detection of vertebral anomalies in this group and careful follow up of patients with these abnormalities. PMID:2817927

  20. [Oesophageal diseases: gastroesophageal reflux disease, Barrett's disease, achalasia and eosinophilic oesophagitis].

    Science.gov (United States)

    Calvet, Xavier

    2015-09-01

    The most important novel findings presented on oesophageal disease in DDW 2015 were the following: 1) GERD: a) hypervigilance seems to be a key pathogenic factor in reflux symptoms refractory to PPI; b) post-reflux swallowing-induced peristaltic waves could be an excellent diagnostic criterion for GERD; c) laryngeal pH-metry is not useful in the diagnosis of extra-oesophageal symptoms; d) the recommendation of weight loss adequately recorded in the clinical reports of patients with GERD and obesity or overweight is an excellent quality indicator and is associated with better outcomes. 2) Barrett's oesophagus: a) persistent low-grade dysplasia in more than one endoscopy and a diagnosis of "indefinite for dysplasia" are associated with a high risk of neoplastic progression; b) narrow-band imaging allows areas of dysplasia on Barrett's oesophagus to be identified with high sensitivity and specificity; c) initial endoscopy fails to identify a high percentage of advanced neoplasms in Barrett's oesophagus. Early re-endoscopy should be considered; d) endoscopists specialized in Barret's oesophagus obtain a much higher yield in the diagnosis of advanced lesions. Patients at high risk-men, older patients, smokers and those with long-segment Barrett's oesophagus-could benefit from follow-up in a referral center. 3) Achalasia: POEM seems safe and effective, independently from patient characteristics (age, comorbidity) and the technical variations used. 4) Eosinophilic esophagitis: topical budesonide and exclusion diets are reasonably effective in PPI non-responders. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  1. Selecting and evoking innovators

    DEFF Research Database (Denmark)

    Kanstrup, Anne Marie; Christiansen, Ellen

    2006-01-01

    prepared for and conducted selection of and collaboration with innovators. The outcome was successful in the sense that the innovators produced excellent foundation for conceptual interaction design by creating mock-ups and explanations incarnating their preferences, attitudes and habits. By referring...... to theories of learning we try to explain how our way of working with selection and evoking of innovators has contributed to this positive result and how our approach to user-driven innovation can be regarded as a way to combine democracy and creativity in design....

  2. Apparent diffusion coefficient correlation with oesophageal tumour stroma and angiogenesis.

    Science.gov (United States)

    Aoyagi, Tomoyoshi; Shuto, Kiyohiko; Okazumi, Shinichi; Hayano, Kohichi; Satoh, Asami; Saitoh, Hiroshige; Shimada, Hideaki; Nabeya, Yoshihiro; Kazama, Toshiki; Matsubara, Hisahiro

    2012-06-01

    Because diffusion-weighted imaging (DWI) can predict the prognosis of patients with oesophageal squamous cell carcinoma (ESCC), we hypothesised that apparent diffusion coefficient (ADC) values might be correlated with the collagen content and tumour angiogenesis. The purpose of this study was to determine the correlation between ADC values of ESCC before treatment and oesophageal tumour stroma and angiogenesis. Seventeen patients with ESCC were enrolled. The ADC values were calculated from the DWI score. Seventeen patients who had undergone oesophagectomy were analysed for tumour stroma, vascular endothelial growth factor (VEGF) and CD34. Tissue collagen was stained with azocarmine and aniline blue to quantitatively analyse the extracellular matrix in cancer stroma. Tissues were stained with VEGF and CD34 to analyse the angiogenesis. The ADC values decreased with stromal collagen growth. We found a negative correlation between the tumour ADC and the amount of stromal collagen (r = -0.729, P = 0.001), i.e. the ADC values decreased with growth of VEGF. We also found a negative correlation between the ADC of the tumours and the amount of VEGF (r = 0.538, P = 0.026). Our results indicated that the ADC value may be a novel prognostic factor and contribute to the treatment of oesophageal cancer. • Magnetic resonance apparent diffusion coefficient values inversely indicate tumour stromal collagen • There is also negative correlation between ADCs and vascular endothelial growth factor • ADC values may contribute to the treatment of oesophageal cancer.

  3. Aetiology, treatment and mortality after oesophageal perforation in Denmark

    DEFF Research Database (Denmark)

    Ryom, Philip; Ravn, Jesper Bohsen; Penninga, Luit

    2011-01-01

    Perforation of the oesophagus into the thoracic cavity is a potentially life-threatening condition. The causes are numerous. Treatment for oesophageal perforation targets mediastinal and pleural contamination. Present knowledge about the causes of perforation and the types of treatment is poor....

  4. Oesophageal pouches and diverticula: A pictorial review | Khan ...

    African Journals Online (AJOL)

    Diverticula of the oesophagus are rare. They can occur at any level, and are often defined by their anatomical location. Three categories are recognised, namely pharyngo-oesophageal, parabronchial and epiphrenic. Although these diverticula are often asymptomatic, patients can develop significant problems with ...

  5. Review article: extra-oesophageal reflux disease in children

    NARCIS (Netherlands)

    Shields, M. D.; Bateman, N.; McCallion, W. A.; van Wijk, M. P.; Wenzl, T. G.

    2011-01-01

    In children, respiratory and ENT disorders are associated with extra-oesophageal reflux. These include asthma, recurrent pneumonia, cough, apnoea, sinusitis, otitis media, laryngomalacia, recurrent croup and recurrent respiratory papillomatosis. The traditional tests of barium swallow, 24 h pH

  6. Oesophageal intubation can be undetected by auscultation of the chest

    DEFF Research Database (Denmark)

    Andersen, K H; Schultz-Lebahn, T

    1994-01-01

    Prompt detection of oesophageal intubation is a primary concern in anaesthetic practice. This blind, randomised study evaluates three widely used tests of intubation. Forty patients had both their trachea and oesophagus intubated, each patient was studied twice. Auscultation of the epigastrium...

  7. Heartburn, gastro-oesophageal reflux disease and non-erosive ...

    African Journals Online (AJOL)

    Reflux is a normal process that occurs in healthy infants, children and adults. Most episodes are short-lived and do not cause bothersome symptoms of complications. Gastro-oesophageal reflux disease (GORD) develops when the reflux of stomach acid causes troublesome reflux-associated symptoms and/or complications.

  8. Heartburn, gastro-oesophageal reflux disease and non-erosive ...

    African Journals Online (AJOL)

    2010-01-31

    Jan 31, 2010 ... not cause bothersome symptoms of complications. Gastro- oesophageal reflux disease (GORD) develops when the reflux of stomach acid causes troublesome reflux-associated symptoms and/or complications.6 ,7 The most common symptom of GORD is heartburn.1 Heartburn is experienced as a burning ...

  9. Oesophageal squamous cell cancer in a South African tertiary hospital

    African Journals Online (AJOL)

    Oesophageal squamous cell cancer in a South African tertiary hospital: a risk factor and presentation analysis. ... Methodology: Information on patients managed at Inkosi Albert Luthuli Central Hospital (IALCH), Durban, South Africa, between 1 October 2013 and 31 December 2014 was retrieved from a prospective ...

  10. Our experience with caustic oesophageal burn in South of Iran ...

    African Journals Online (AJOL)

    Context: The alkaline oesophageal burn (EB) is a very debilitating injury and common in the southern rural area of Iran, where the air conditioning systems are cleaned with an alkaline liquid, which is accidentally ingested by children. Aims: The aim is to share our experiences with caustic injury in children. Settings and ...

  11. Oesophageal Obstruction from a Pharmacobezoar Resulting in Death

    DEFF Research Database (Denmark)

    Mortensen, Katrine Elisabeth; Munkholm, Julie; Dalhoff, Kim Peder

    2017-01-01

    Formation of an intestinal pharmacobezoar is a rare condition. It may form after intake of various oral pharmaceutical preparations of drugs, both as a result of an acute overdose and through chronic use of therapeutic doses of a drug. We report a case with a patient presenting with an oesophageal...

  12. Cardiovascular effects of oesophageal dilation under general anaesthesia

    DEFF Research Database (Denmark)

    Jakobsen, C H; Rasmussen, V; Rosenberg, J

    1999-01-01

    under general anaesthesia. Ten consecutive patients with benign oesophageal strictures were evaluated. Arterial oxygen saturation was measured by continuous pulse oximetry, ECG was recorded continuously with a Holter tape recorder, and blood pressure was measured non-invasively every five minutes during...

  13. Oesophageal candidiasis in an immunocompetent adult, an adverse ...

    African Journals Online (AJOL)

    Dysphagia following cardiac surgery is a frequently encountered problem, being most commonly due to the sternotomy incision and/or prolonged intubation. Oesophageal candidiasis is an increasing problem that is usually associated with immunosuppression or immunodeficiency. We report a 59 years age, ...

  14. Oesophageal variceal band ligation using a Saeed Six-Shooter ...

    African Journals Online (AJOL)

    He had a total of three sessions after which he was maintained on propranolol. Result: The last recheck endoscopy demonstrated obliterated varices after which he was maintained on propranolol. Conclusion: We present a case of successful variceal band ligation of a cirrhotic with extensive oesophageal varices presenting ...

  15. Analysis of 15 cases of oesophageal hiatus hernia in children

    African Journals Online (AJOL)

    In this review the clinical features, operative procedure and outcome of surgery in 15 children with oesophageal hiatus hernia is presented. The commonest type was the sliding hiatus hernia. The main presenting clinical features included repeated vomiting, anaemia and malnutrition. At surgery, either an abdominal or a ...

  16. Apparent diffusion coefficient correlation with oesophageal tumour stroma and angiogenesis

    Energy Technology Data Exchange (ETDEWEB)

    Aoyagi, Tomoyoshi; Shuto, Kiyohiko; Okazumi, Shinichi; Hayano, Kohichi; Satoh, Asami; Saitoh, Hiroshige; Shimada, Hideaki; Nabeya, Yoshihiro; Matsubara, Hisahiro [Chiba University, Department of Frontier Surgery, Graduate School of Medicine, Chiba (Japan); Kazama, Toshiki [Chiba University, Department of Radiology, Graduate School of Medicine, Chiba (Japan)

    2012-06-15

    Because diffusion-weighted imaging (DWI) can predict the prognosis of patients with oesophageal squamous cell carcinoma (ESCC), we hypothesised that apparent diffusion coefficient (ADC) values might be correlated with the collagen content and tumour angiogenesis. The purpose of this study was to determine the correlation between ADC values of ESCC before treatment and oesophageal tumour stroma and angiogenesis. Seventeen patients with ESCC were enrolled. The ADC values were calculated from the DWI score. Seventeen patients who had undergone oesophagectomy were analysed for tumour stroma, vascular endothelial growth factor (VEGF) and CD34. Tissue collagen was stained with azocarmine and aniline blue to quantitatively analyse the extracellular matrix in cancer stroma. Tissues were stained with VEGF and CD34 to analyse the angiogenesis. The ADC values decreased with stromal collagen growth. We found a negative correlation between the tumour ADC and the amount of stromal collagen (r = -0.729, P = 0.001), i.e. the ADC values decreased with growth of VEGF. We also found a negative correlation between the ADC of the tumours and the amount of VEGF (r = 0.538, P = 0.026). Our results indicated that the ADC value may be a novel prognostic factor and contribute to the treatment of oesophageal cancer. circle Magnetic resonance apparent diffusion coefficient values inversely indicate tumour stromal collagen circle There is also negative correlation between ADCs and vascular endothelial growth factor circle ADC values may contribute to the treatment of oesophageal cancer. (orig.)

  17. Gastro-oesophageal reflux in infants and children | Nel | South ...

    African Journals Online (AJOL)

    However, the symptoms in infants and young children are often atypical. Patients with significant symptoms require more extensive diagnostic assessment, such as contrast radiography, oesophagoscopy and oesophageal pH-metry. In most cases, parental reassurance and advice on feeding are sufficient. Thickened feeds ...

  18. REFLEX CLOSURE OF THE OESOPHAGEAL GROOVE AND ITS ...

    African Journals Online (AJOL)

    As to its role in the functioning ruminant animal, there have been several divergent opinions. Up to about 1930, the textbooks of ruminant physiology were dominated by the view of Colin (1886) who contented that the oesophageal groove closed when boli were swallowed during rumination and that tIus was the main route ...

  19. Malignant and pre-malignant oesophageal pathology in a South ...

    African Journals Online (AJOL)

    Introduction: South Africa (SA) has one of the highest global incidences of squamous cell carcinoma of the oesophagus (SCC). A decreasing incidence of oesophageal SCC in SA has been suggested. The study aimed to assess whether the incidence of these malignant histopathological subtypes has changed in this ...

  20. Case Report: Anaesthetic management of a Rare Oesophageal ...

    African Journals Online (AJOL)

    Children less than five years of age are particularly vulnerable. We report the anaesthetic challenges and management of a 2 year old boy with a rare oesophageal foreign body impaction- a peg pin at the level of the C6 vertebra. The impaction affected the trachea resulting in tracheal narrowing just below the vocal cords.

  1. Oesophageal cancer: an overview of a deadly disease | White ...

    African Journals Online (AJOL)

    Oesophageal cancer (OC) is one of the deadliest cancers in the world. Although it affects many people throughout East Africa, relatively little work has been done to fully understand this disease. This review addresses recent changes in the understanding of OC from a global perspective, with special attention given to OC in ...

  2. International Evoked Potentials Symposium

    CERN Document Server

    1980-01-01

    The past decade has seen great progress in the measurement of evoked potentials in man; a steady increase in our understanding of their charac­ teristics, their origins and their usefulness; and a growing application in the field of clinical diagnosis. The topic is a truly multidisciplinary one. Important research contributions have been made by workers of many different backgrounds and clinical applications span the specialities. This book represents a revised and updated version of the work originally presented at the international evoked potential symposium held in Nottingham 4-6 1978. The Nottingham Symposium provided a forum for a state-of-the-art discussion amongst workers from many different disciplines and from many different countries. For each major topic in the field an expert review set the scene for discussion of current research presentations. This format is retained in the book: the chapters in Part A provide the context in which the research presented in Part B is set. The task of selecting m...

  3. Chest pain following oesophageal stenting for malignant dysphagia

    Energy Technology Data Exchange (ETDEWEB)

    Golder, Mark; Tekkis, Paris P.; Kennedy, Colette; Lath, Sadaf; Toye, Rosemary; Steger, Adrian C

    2001-03-01

    AIM: The palliative use of self-expanding metallic stents has been widely reported to relieve dysphagia in cases of oesophageal carcinoma. Little has been documented on the severity of chest pain following oesophageal stenting. The aim of this study was to investigate the association of pain with oesophageal stenting for malignant dysphagia. METHODS: Fifty-two patients with inoperable oesophageal carcinoma underwent stent placement between 1995-1999. Daily opioid analgesic requirements (mg of morphine equivalent doses) were monitored for 3 days before and 7 days after stenting. The degree of palliation was expressed as a dysphagia score (0-3). Hospital stay, readmission days, stent complications and patient survival time were also recorded. RESULTS: Twenty-six patients (50%) required opioid analgesia for chest pain (median dose: 80 mg morphine/day) within 48 h of the procedure compared to 11 (21.2%) patients before stenting (P = 0.0041). A significant increase was evident in the analgesic consumption following stent deployment (P < 0.001). The dysphagia score improved by a median value of 1 (CI 0.25)P < 0.001, with a re-intervention rate of 11.5%. The median survival time was 40 days post stenting (range 1-120). CONCLUSION: A significant proportion of patients developed chest pain after oesophageal stenting, requiring high dose opioid analgesia. As the origin of the pain is still unknown, pre-emptive analgesia may a play role in reducing stent-related morbidity and possibly in-hospital stay. Golder, M. et al. (2001)

  4. Human papillomavirus DNA in aerodigestive squamous carcinomas ...

    African Journals Online (AJOL)

    A series of 10 oesophageal and 10 laryngeal squamous carcinomas was examined by means of immuno cytochemistry and in situ DNA hybridisation to demonstrate human papillomavirus (HPV) infection. Changes in the epithelium adjacent to the carcinoma were found in 5 of 10 oesophageal and 7 of 10 laryngeal ...

  5. A proposition for the diagnosis and treatment of gastro-oesophageal reflux disease in children: A report from a working group on gastro-oesophageal reflux disease

    NARCIS (Netherlands)

    Y. Vandenplas (Yvan); A. Ashkenazi (A.); D. Belli (D.); N. Boige (N.); J. Bouquet (Jan); S. Cadranel (S.); J.P. Cezard (J.); S. Cucchiara (S.); C. Dupont (C.); K. Geboes (K.); F. Gottrand; H.S.A. Heymans (Hugo); C. Jasinski (C.); C.M.F. Kneepkens (Frank); S. Koletzko (Sybille); P. Milla (Peter); J.F. Mougenot (J.); D. Nusslé (D.); J. Navarro (J.); S.J. Newell (S.); E. Olafsdottir (E.); S. Peeters (S.); A. Ravelli (A.); I. Polanco (I.); B. Sandhu; J.J. Tolboom (Jules)

    1993-01-01

    textabstractIn this paper, a Working Group on Gastro-Oesophageal Reflux discusses recommendations for the first line diagnostic and therapeutic approach of gastro-oesophageal reflux disease in infants and children. All members of the Working Group agreed that infants with uncomplicated

  6. Vestibular evoked myogenic potential

    Directory of Open Access Journals (Sweden)

    Felipe, Lilian

    2012-01-01

    Full Text Available Introduction: The Vestibular Evoked Myogenic Potential (VEMP is a promising test for the evaluation of the cholic descending vestibular system. This reflex depends of the integrity from the saccular macula, from the inferior vestibular nerve, the vestibular nuclei, the vestibule-spinal tract and effectors muscles. Objective: Perform a systematic review of the pertinent literature by means of database (COCHRANE, MEDLINE, LILACS, CAPES. Conclusion: The clinical application of the VEMP has expanded in the last years, as goal that this exam is used as complementary in the otoneurological evaluation currently used. But, methodological issues must be clarified. This way, this method when combined with the standard protocol, can provide a more widely evaluation from the vestibular system. The standardization of the methodology is fundamental criterion for the replicability and sensibility of the exam.

  7. Arsenite evokes IL-6 secretion, autocrine regulation of STAT3 signaling, and miR-21 expression, processes involved in the EMT and malignant transformation of human bronchial epithelial cells

    Energy Technology Data Exchange (ETDEWEB)

    Luo, Fei; Xu, Yuan [Institute of Toxicology, Ministry of Education, School of Public Health, Nanjing Medical University (China); The Key Laboratory of Modern Toxicology, Ministry of Education, School of Public Health, Nanjing Medical University (China); Ling, Min [Jiangsu Center for Disease Control and Prevention, Nanjing 211166, Jiangsu (China); Zhao, Yue; Xu, Wenchao [Institute of Toxicology, Ministry of Education, School of Public Health, Nanjing Medical University (China); The Key Laboratory of Modern Toxicology, Ministry of Education, School of Public Health, Nanjing Medical University (China); Liang, Xiao [Mental Health Center of Xuhui-CDC, Shanghai 200232 (China); Jiang, Rongrong; Wang, Bairu [Institute of Toxicology, Ministry of Education, School of Public Health, Nanjing Medical University (China); The Key Laboratory of Modern Toxicology, Ministry of Education, School of Public Health, Nanjing Medical University (China); Bian, Qian [Jiangsu Center for Disease Control and Prevention, Nanjing 211166, Jiangsu (China); Liu, Qizhan, E-mail: drqzliu@hotmail.com [Institute of Toxicology, Ministry of Education, School of Public Health, Nanjing Medical University (China); The Key Laboratory of Modern Toxicology, Ministry of Education, School of Public Health, Nanjing Medical University (China)

    2013-11-15

    Arsenite is an established human carcinogen, and arsenite-induced inflammation contributes to malignant transformation of cells, but the molecular mechanisms by which cancers are produced remain to be established. The present results showed that, evoked by arsenite, secretion of interleukin-6 (IL-6), a pro-inflammatory cytokine, led to the activation of STAT3, a transcription activator, and to increased levels of a microRNA, miR-21. Blocking IL-6 with anti-IL-6 antibody and inhibiting STAT3 activation reduced miR-21 expression. For human bronchial epithelial cells, cultured in the presence of anti-IL-6 antibody for 3 days, the arsenite-induced EMT and malignant transformation were reversed. Thus, IL-6, acting on STAT3 signaling, which up-regulates miR-21in an autocrine manner, contributes to the EMT induced by arsenite. These data define a link from inflammation to EMT in the arsenite-induced malignant transformation of HBE cells. This link, mediated through miRNAs, establishes a mechanism for arsenite-induced lung carcinogenesis. - Highlights: • Arsenite evokes IL-6 secretion. • IL-6 autocrine mediates STAT3 signaling and up-regulates miR-21expression. • Inflammation is involved in arsenite-induced EMT.

  8. Chemotherapy-Induced Oesophageal Stricture in a Child with Osteosarcoma: A Case Report

    Directory of Open Access Journals (Sweden)

    Daichi Ishimaru

    2010-01-01

    Full Text Available Treatment with a combination of chemotherapy and radiotherapy is known to be associated with oesophageal stricture in both children and adults with malignancies. However, oesophageal stricture resulting from chemotherapy alone is a rare complication, with few reports on it. We experienced a rare paediatric case of oesophageal stricture caused by chemotherapy for osteosarcoma of the left distal femur. After completion of the chemotherapy course, the patient showed dysphagia caused by the oesophageal stricture and underwent balloon dilatation for the oesophageal stricture. After balloon dilatation, he was able to ingest solid foods, and the oesophagus was normal without any strictures at the last follow-up (20 months after ballooning. Therefore, oesophageal stricture should be considered as a complication of treatment with chemotherapy alone in children with malignancies.

  9. Music evokes vivid autobiographical memories.

    Science.gov (United States)

    Belfi, Amy M; Karlan, Brett; Tranel, Daniel

    2016-08-01

    Music is strongly intertwined with memories-for example, hearing a song from the past can transport you back in time, triggering the sights, sounds, and feelings of a specific event. This association between music and vivid autobiographical memory is intuitively apparent, but the idea that music is intimately tied with memories, seemingly more so than other potent memory cues (e.g., familiar faces), has not been empirically tested. Here, we compared memories evoked by music to those evoked by famous faces, predicting that music-evoked autobiographical memories (MEAMs) would be more vivid. Participants listened to 30 songs, viewed 30 faces, and reported on memories that were evoked. Memories were transcribed and coded for vividness as in Levine, B., Svoboda, E., Hay, J. F., Winocur, G., & Moscovitch, M. [2002. Aging and autobiographical memory: Dissociating episodic from semantic retrieval. Psychology and Aging, 17, 677-689]. In support of our hypothesis, MEAMs were more vivid than autobiographical memories evoked by faces. MEAMs contained a greater proportion of internal details and a greater number of perceptual details, while face-evoked memories contained a greater number of external details. Additionally, we identified sex differences in memory vividness: for both stimulus categories, women retrieved more vivid memories than men. The results show that music not only effectively evokes autobiographical memories, but that these memories are more vivid than those evoked by famous faces.

  10. Organization of sensory discrimination and response selection in choice and nonchoice conditions: a study using cerebral evoked potentials in normal humans.

    Science.gov (United States)

    Goodin, D S; Aminoff, M J; Shefrin, S L

    1990-10-01

    1. It has been suggested that the long-latency "event-related" cerebral evoked potentials (ERPs) reflect certain aspects of the neural processing underlying sensory discrimination in a two-choice reaction time task. The present paper examines the hypothesis that the coupling of these ERPs to sensory discrimination is variable and that the discrimination process is completed at different points during the course of cerebral processing, depending on the actual requirements of the task. 2. We recorded the cerebral evoked potentials and electromyogram (EMG) of the responding muscle in five different reaction time tasks, each requiring sensory discrimination and response selection of varying complexity. In the Choice condition two stimuli were presented, and two separate responses were required. In the two Go-No Go conditions two stimuli were presented, but a response was required to only one or the other of the stimuli. In the two Simple conditions only one stimulus was presented, and one response was required. 3. Under both Choice and Go-No Go conditions, the frequency histogram of the onset latency of the compound muscle action potential for the response to the frequent tone showed a bimodal distribution without overlap, suggesting that there were two distinct types of responder: fast and slow. The comparable histograms for the onset latency of the response to the rare tone also showed a bimodal distribution, but the mean onset latency was prolonged relative to the response to the frequent tone, and the mean separation was less so that the two distributions overlapped each other. 4. Despite the marked difference in response latencies between the fast and slow responders, there was no appreciable difference in cerebral evoked responses between the two groups. Moreover, in response to the frequent tone, all slow responders and, likewise, all fast responders had similar onset latencies of the averaged EMG activity regardless of condition. Nonetheless, fast or slow

  11. Oesophageal food impaction in achalasia treated with Coca-Cola and nifedipine.

    Science.gov (United States)

    Koumi, Andriani; Panos, Marios Zenon

    2010-01-01

    Achalasia is characterised by the loss of peristaltic movement in the distal oesophagus and failure of the lower oesophageal sphincter relaxation, which results in impaired oesophageal emptying. We report a case of a 92-year-old frail woman with a history of achalasia, who presented with acute oesophageal obstruction due to impaction of a large amount of food material. She was treated successfully with nifedipine, in combination with Coca-Cola (original product, not sugar free), so avoiding the risks associated with repeated endoscopic intubation and piecemeal removal of the oesophageal content.

  12. Not an Aspirin: No Evidence for Acute Anti-Nociception to Laser-Evoked Pain After Motor Cortex rTMS in Healthy Humans.

    Science.gov (United States)

    Bradley, Claire; Perchet, Caroline; Lelekov-Boissard, Taïssia; Magnin, Michel; Garcia-Larrea, Luis

    2016-01-01

    High-frequency repetitive transcranial magnetic stimulation (HF-rTMS) has shown efficacy in relieving neuropathic pain. Whether its analgesic effect also applies to acute physiological nociception remains unclear due to previous contradictory findings. To provide an in-depth investigation of the effects of motor cortex HF-rTMS on acute laser-evoked pain and excitability of nociceptive networks in healthy subjects. Randomized, placebo-controlled, double-blind, cross-over study in 20 healthy participants. Laser heat stimuli at nociceptive threshold were delivered to the right hand, allowing assessment of: (a) subjective pain intensity and unpleasantness; (b) laser-evoked potentials (LEPs, 128 electrodes) and their source model; (c) sympathetic skin responses, and (d) spino-thalamic pathway excitability. Data were collected before and 20 minutes after a session of neuro-navigated 20 Hz rTMS to the contralateral motor cortex. Subjective pain reports to thermal laser pulses, amplitude of late cortical potentials and sympathetic skin responses were decreased after cortical stimulation, to a similar extent whether it was active or placebo. Early cortical potentials and nociceptive network excitability remained identical before and after rTMS, as did anatomical sources of LEPs. Our results do not provide evidence for a genuine anti-nociceptive effect of rTMS on acute physiological pain. We suggest that motor cortex rTMS may act upon high-order networks linked to the emotional and cognitive appraisal of chronic pain, and/or modulate pathologically sensitized networks, rather than change the physiological transmission within an intact nervous system. Such dichotomy is reminiscent of that observed with most drugs used for neuropathic pain. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Procedural sedation associated displacement of sharp oesophageal foreign body.

    Science.gov (United States)

    Sondhi, Vishal; Patnaik, Suprabha Kumari; Khullar, Atul

    2012-03-20

    Oesophageal foreign body is a common clinical problem. The therapeutic intervention varies from endoscopic removal to observation for spontaneous passage of foreign body. The authors illustrate a case of sharp board pin ingestion by a child, which stayed impacted at C(7)-T(1) level for 8 h with indentation of tracheal mucosa. However, upon administration of midazolam and ketamine for procedural sedation, the pin spontaneously advanced to stomach when muscle relaxation had set in. A few oesophageal mucosal erosions were noted on the endoscopy. The foreign body could not be retrieved by the procedure and was spontaneously egested impacted in faeces. This case presents a distinctive hazard associated with procedural sedation for a foreign body in aero-digestive tract, where the associated muscle relaxation can lead to complications due to spontaneous movement of foreign body.

  14. Stromal Interaction Molecule 1 (STIM1) and Orai1 Mediate Histamine-evoked Calcium Entry and Nuclear Factor of Activated T-cells (NFAT) Signaling in Human Umbilical Vein Endothelial Cells*

    Science.gov (United States)

    Zhou, Meng-Hua; Zheng, Hongying; Si, Hongjiang; Jin, Yixin; Peng, Jasmine M.; He, Lian; Zhou, Yubin; Muñoz-Garay, Carlos; Zawieja, David C.; Kuo, Lih; Peng, Xu; Zhang, Shenyuan L.

    2014-01-01

    Histamine is an important immunomodulator involved in allergic reactions and inflammatory responses. In endothelial cells, histamine induces Ca2+ mobilization by releasing Ca2+ from the endoplasmic reticulum and eliciting Ca2+ entry across the plasma membrane. Herein, we show that histamine-evoked Ca2+ entry in human umbilical vein endothelial cells (HUVECs) is sensitive to blockers of Ca2+ release-activated Ca2+ (CRAC) channels. RNA interference against STIM1 or Orai1, the activating subunit and the pore-forming subunit of CRAC channels, respectively, abolishes this histamine-evoked Ca2+ entry. Furthermore, overexpression of dominant-negative CRAC channel subunits inhibits while co-expression of both STIM1 and Orai1 enhances histamine-induced Ca2+ influx. Interestingly, gene silencing of STIM1 or Orai1 also interrupts the activation of calcineurin/nuclear factor of activated T-cells (NFAT) pathway and the production of interleukin 8 triggered by histamine in HUVECs. Collectively, these results suggest a central role of STIM1 and Orai1 in mediating Ca2+ mobilization linked to inflammatory signaling of endothelial cells upon histamine stimulation. PMID:25190815

  15. Oesophageal Foreign Bodies in Port Harcourt, Nigeria | Okoye ...

    African Journals Online (AJOL)

    Fifty-three cases were seen with a M:F ratio of 1.5:1 and an average age of 15.6 years were the commonest accounting for 54.7% of cases and are confined to children. The treatment is endoscopic removal. Difficulty with dentures is highlighted. Key Words: Foreign Bodies, Oesophageal I>Jnl of Medical Investigation and ...

  16. Environmental risk factors for oesophageal cancer in Malawi: A case ...

    African Journals Online (AJOL)

    Environmental risk factors for oesophageal cancer in Malawi: A case-control study. ... Results Firewood cooking, cigarette smoking, and use of white maize flour all had strong associations with squamous cell carcinoma of the oesophagus, with adjusted odds ratios of 12.6 (95% CI: 4.2-37.7), 5.4 (95% CI: 2.0-15.2) and 6.6 ...

  17. Cisapride treatment for gastro-oesophageal reflux in children

    OpenAIRE

    MacLennan, S; Augood, C; Cash-Gibson, L; Logan, S; Gilbert, RE

    2010-01-01

    Background Gastro-oesophageal reflux (GOR) is common and usually self-limiting in infants. Cisapride, a pro-kinetic agent, was commonly prescribed until reports of possible serious adverse events were associated with its use. Objectives To determine the effectiveness of cisapride versus placebo or non-surgical treatments for symptoms of GOR. Search strategy We searched the Cochrane Upper Gastrointestinal and Pancreatic Diseases Group Specialised Register and Central Register of Controlled Tri...

  18. Cisapride treatment for gastro-oesophageal reflux in children.

    OpenAIRE

    Augood, C; MacLennan, S; Gilbert, R.; Logan, S

    2003-01-01

    : Gastro-oesophageal reflux (GOR) is an extremely common and usually self-limiting condition in infants. When treatment is required, Cisapride, a pro-kinetic agent, has been commonly prescribed for the symptomatic management of GOR. There have been recent reports of possibly serious adverse events, e.g. an increased QTc interval, cardiac arrhythmias, and death, associated with the use of Cisapride. : To determine the effectiveness of Cisapride for symptoms of GOR compared with placebo or any ...

  19. Helicobacter pylori and its Association with Gastric and Oesophageal Carcinomas

    OpenAIRE

    Simán, Henrik

    2006-01-01

    Helicobacter pylori is one of the most common infections in man. The infection is often acquired during childhood and usually results in a chronic life-long inflammation in the gastric mucosa. The aim of our studies was to investigate the association between H. pylori seropositivity and the development of gastric and oesophageal carcinomas. Nested case-control studies were performed in the Malmö Preventive Medicine cohort consisting of 32,906 subjects. Tumour cases were identified by the Swed...

  20. The Management of Cyanotic Spells in Children with Oesophageal Atresia

    OpenAIRE

    Mathieu Bergeron; Cohen, Aliza P.; Cotton, Robin T.

    2017-01-01

    Cyanotic spells, also known as blue spells, dying spells, or apparent life-threatening events, refer to a bluish tone visible in the mucosal membranes and skin caused by an oxygen decrease in the peripheral circulation. Although this decrease may be transient and benign, it may also be indicative of a severe underlying problem that requires immediate intervention. Children with oesophageal atresia (OA) are at risk for a number of coexisting conditions that may trigger cyanotic spells. This cu...

  1. Feed thickener for newborn infants with gastro-oesophageal reflux.

    Science.gov (United States)

    Huang, R C; Forbes, D A; Davies, M W

    2002-01-01

    Gastro-oesophageal reflux (GOR) is common in newborn infants. A common first line management is the use of feed thickeners. In newborn infants with GOR, to evaluate the use of feed thickeners in reducing signs and symptoms of GOR, acid episodes on pH monitoring and histological evidence of oesophagitis. We searched MEDLINE from 1966 to December 2001, the Cochrane Controlled Trials Register, The Cochrane Library, Issue 1, 2002. CINAHL from 1982 to December 2001, and conference and symposia proceedings published in Pediatric Research 1990 to 1994. We also searched conference proceedings for the European Society for Paediatric Gastroenterology and Nutrition (ESPGAN) and the North American Society for Pediatric Gastroenterology and Nutrition (NASPGAN) from 1994 to December 2001. We did not restrict the searches to the English language. All randomised controlled trials that examine the effects of thickening formulas on treating gastro-oesophageal reflux in neonates. The eligible studies were to compare thickened feeds to no intervention (unthickened feeds). Two independent reviewers identified potential studies from the literature search. Quality was independently assessed by two independent reviewers. No studies fulfilled the requirements for inclusion in the systematic review. There is no evidence from randomised controlled trials to support or refute the efficacy of feed thickeners in newborn infants with GOR. Given the absence of evidence, we cannot recommend using thickening agents for management of GOR in newborn infants.

  2. Alcohol consumption, cigarette smoking and risk of subtypes of oesophageal and gastric cancer: A prospective cohort study

    NARCIS (Netherlands)

    Steevens, J.; Schouten, L.J.; Goldbohm, R.A.; Brandt, P.A. van den

    2010-01-01

    Objective: Alcohol consumption and cigarette smoking may be differentially associated with oesophageal squamous cell carcinoma (OSCC), oesophageal adenocarcinoma (OAC), gastric cardia adenocarcinoma (GCA) and gastric non-cardia adenocarcinoma (GNCA). However, because this was based on retrospective

  3. Endoscopic assessment of the oesophageal features of eosinophilic oesophagitis: validation of a novel classification and grading system.

    Science.gov (United States)

    Hirano, Ikuo; Moy, Nelson; Heckman, Michael G; Thomas, Colleen S; Gonsalves, Nirmala; Achem, Sami R

    2013-04-01

    Abnormalities are commonly identified during endoscopy in eosinophilic oesophagitis (EoE). There is no standardised classification to describe these features. This study aimed to evaluate the interobserver agreement of a grading system for the oesophageal features of EoE. The proposed system incorporated the grading of four major oesophageal features (rings, furrows, exudates, oedema) and the presence of additional features of narrow calibre oesophagus, feline oesophagus, stricture and crepe paper oesophagus. Endoscopic videos from 25 patients with EoE and controls were reviewed by 21 gastroenterologists. Interobserver agreement was assessed by estimating multi-rater κ and the proportion of pairwise agreement. Using the original grading system, agreement for rings, furrows and exudates was moderate (κ=0.38-0.46, 56-65% agreement) but poor for oedema (κ=0.23, 51% agreement). Identification of narrow calibre oesophagus had fair agreement (κ=0.30, 74% agreement) while feline oesophagus had poor agreement (κ=0.15, 68% agreement). After collapsing the severity grading for oedema and furrows and eliminating poorly performing features of feline oesophagus and narrow calibre oesophagus, a modified grading system demonstrated good agreement for the four major features of EoE (κ=0.40-0.54, 71-81% agreement) and additional features of stricture and crepe paper oesophagus (κ=0.52 and 0.58, 79% and 92% agreement). The proposed system for endoscopically-identified oesophageal features of EoE defines common nomenclature and severity scores for the assessment of EoE disease activity. The system has good interobserver agreement among practising and academic gastroenterologists.

  4. Clinical evaluation of cochlear hearing status in dogs using evoked otoacoustic emissions.

    Science.gov (United States)

    Gonçalves, R; McBrearty, A; Pratola, L; Calvo, G; Anderson, T J; Penderis, J

    2012-06-01

    Evoked otoacoustic emission testing is the preferred test in human patients for sensorineural deafness screening in neonates and cochlear outer hair cell function monitoring in adults. This study evaluated evoked otoacoustic emission testing for cochlear function assessment in dogs within a clinical setting. Two populations of anaesthetised dogs were included. In group 1 the evoked otoacoustic emission response was compared to the brainstem auditory evoked response in 10 dogs having hearing assessment. Group 2 comprised 43 presumed normal dogs, in which the suitability of two types of evoked otoacoustic emissions, transient-evoked and distortion product otoacoustic emissions, were evaluated (brainstem auditory evoked response was not performed in this group). Valid transient-evoked otoacoustic emission and distortion-product otoacoustic emission responses were successfully recorded within the clinical setting and correctly identified deaf and hearing ears. Within presumed healthy dogs, normal otoacoustic emission response was demonstrated in more than 80% of dogs using a single, short distortion-product otoacoustic emission run and in 78% of dogs with valid transient-evoked otoacoustic emission responses using a series of three repeated transient-evoked otoacoustic emission short runs. Transient-evoked otoacoustic emission and distortion-product otoacoustic emission testing provided a rapid, non-invasive frequency-specific assessment of cochlear function. Transient-evoked otoacoustic emission and distortion product otoacoustic emission testing is suitable as a screening procedure to detect loss of cochlear function in dogs, although further investigation is needed. © 2012 British Small Animal Veterinary Association.

  5. The importance of the time of digitalization for the incidence of spasms evoked by ouabain in strips of human saphenous vein.

    Science.gov (United States)

    Zerkowski, H R; Wagner, J

    1982-10-01

    The extent of contracture induced by ouabain on preparations of the greater saphenous vein obtained from patients undergoing elective coronary bypass surgery was investigated. The medical pretreatment of the various donor patients was similar but differed with regard to the duration of preoperative digitalization ranging from several days to months. Whereas the maximal contraction induced by noradrenaline was not influenced by prior digitalization, the contracture evoked by ouabain showed a strong dependency on the duration of preoperative digitalization. In patients without or with only short-term preoperative digitalization the spasm exerted by ouabain amounted to 48.8% and 49.2%, respectively, of the maximal contraction induced by noradrenaline, and decreased to zero in patients with long-term digitalization. From this result it is concluded that, in patients after coronary artery bypass grafting who did not receive cardiac glycosides for long-term treatment, the acute administration of glycosides may be a mechanism responsible for the early occlusion of saphenous vein bypass grafts.

  6. Oesophageal pseudodiverticulum after foregut duplication cyst excision: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Iuliana D Bobanga

    2016-01-01

    Full Text Available Oesophageal pseudodiverticula rarely occur after excision of benign oesophageal neoplasms. While management and outcomes have been reported in the adult leiomyoma literature, sparse data exist on the occurrence and management of pseudodiverticula after foregut duplication cyst excision. We discuss our experience with a paediatric patient and review relevant literature regarding operative techniques and surgical outcomes.

  7. A novel method to detect accidental oesophageal intubation based on ventilation pressure waveforms

    NARCIS (Netherlands)

    Kalmar, Alain F.; Absalom, Anthony; Monsieurs, Koenraad G.

    Background: Emergency endotracheal intubation results in accidental oesophageal intubation in up to 17% of patients. This is frequently undetected thereby adding to the morbidity and mortality. No current method to detect accidental oesophageal intubation in an emergency setting is both highly

  8. Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the Los Angeles classification

    NARCIS (Netherlands)

    Lundell, L. R.; Dent, J.; Bennett, J. R.; Blum, A. L.; Armstrong, D.; Galmiche, J. P.; Johnson, F.; Hongo, M.; Richter, J. E.; Spechler, S. J.; Tytgat, G. N.; Wallin, L.

    1999-01-01

    Endoscopic oesophageal changes are diagnostically helpful and identify patients exposed to the risk of disease chronicity. However, there is a serious lack of agreement about how to describe and classify the appearance of reflux oesophagitis To examine the reliability of criteria that describe the

  9. Spontaneous oesophageal perforation due to mediastinal tuberculous lymphadenitis - atypical presentation of tuberculosis.

    Directory of Open Access Journals (Sweden)

    Desai C

    1999-01-01

    Full Text Available Spontaneous non-traumatic oesophageal perforation secondary to bursting of a mediastinal tuberculous abscess into the oesophagus is rare. The diagnosis is delayed, as perforation remains localised due to mediastinal lymph nodes. Patient can be effectively managed by paraoesophageal drainage of the mediastinal abscess and oesophageal diversion.

  10. Prospective study of serum B vitamins levels and oesophageal and gastric cancers in China

    Science.gov (United States)

    B vitamins play an essential role in DNA synthesis and methylation, and may protect against oesophageal and gastric cancers. In this case-cohort study, subjects were enrolled from the General Population Nutrition Intervention Trial in Linxian, China. Subjects included 498 oesophageal squamous cell c...

  11. A tale of two cities – oesophageal cancer in Malawi and Scotland ...

    African Journals Online (AJOL)

    The high incidence of oesophageal cancer in both Scotland and Malawi can be attributed to a combination of environmental and lifestyle factors. The aim of this study is to give a perspective on the comparative epidemiology of oesophageal cancer in these two very different populations (Blantyre, Malawi and Aberdeen, ...

  12. Oesophageal stricture caused by lichen planus and intramural pseudo-diverticulosis

    DEFF Research Database (Denmark)

    Jensen, Jonas Sanberg; Lindebjerg, Jan; Jørgensen, Lars Stig

    2017-01-01

    We present the rare case of a proximal oesophageal stricture caused by a combination of oesophageal lichen planus without any other manifestations and intramural pseudo-diverticulosis, resulting in significant dysphagia. The diagnosis was not reached until a second set of biopsies were performed...

  13. Analysis of 24-h oesophageal pH and pressure recordings

    NARCIS (Netherlands)

    Weusten, B. L.; Smout, A. J.

    1995-01-01

    In patients with non-cardiac chest pain, ambulatory oesophageal pressure and pH monitoring provide valuable information. In this paper, the global analysis describing severity and pattern of reflux or the mean amplitude or duration of oesophageal contractions, and the symptom analysis of 24-h

  14. Documenting the prevalence of hiatal hernia and oesophageal abnormalities in brachycephalic dogs using fluoroscopy.

    Science.gov (United States)

    Reeve, E J; Sutton, D; Friend, E J; Warren-Smith, C M R

    2017-09-30

    To report the prevalence of abnormal fluoroscopic findings in brachycephalic dogs that were presented to a referral hospital for obstructive airway syndrome. Hospital records between May 2013 and November 2015 identified 36 brachycephalic dogs investigated for obstructive airway disease: 21 French bulldogs, 6 bulldogs, 4 Boston terriers, 2 pugs, 2 boxers and 1 shih-tzu. The presence or absence of hiatal hernia, delayed oesophageal transit, gastro-oesophageal reflux and redundant oesophagus were recorded. Of the 36 dogs, 16 had hiatal hernia, all of which were French bulldogs; 31 dogs had delayed oesophageal transit time, 27 had gastro-oesophageal reflux, and 4 had redundant oesophagus. Clinical Significance: The prevalence of hiatal hernia is higher than expected in the French bulldog, and there was a high prevalence of oesophageal disease in this group in general. These results suggest a need to investigate similar cases for evidence of gastrointestinal disease that may also require attention. © 2017 British Small Animal Veterinary Association.

  15. [Dysphagia after introduction of solid food: typical presentation of congenital oesophageal stenosis].

    Science.gov (United States)

    Kockelkoren, Esther; Sleeboom, Christien; van der Voorn, J Patrick; Wilde, Jim C H; Koot, Bart G P; Kneepkens, C M Frank

    2012-01-01

    Congenital oesophageal stenosis is a rare cause of food passage symptoms in infants. It has a typical presentation with symptoms of dysphagia of solid food, starting at the time of introducing supplementary feeding. We present a 6-month-old girl, who started spitting and coughing and had a slower growth rate after the introduction of solid food. Using upper gastrointestinal tract radiography, oesophagogastroscopy and histopathological examination, a congenital oesophageal stenosis due to tracheobronchial remnants was demonstrated. The stenosis was surgically removed. This case description is typical for congenital oesophageal stenosis. Early recognition of the typical presentation of congenital oesophageal stenosis can prevent unnecessary investigation and delay in treatment. Surgical resection of the stenotic oesophageal segment usually results in full recovery.

  16. Detecting a dexmedetomidine-evoked reduction of noradrenaline release in the human brain with the alpha2C-adrenoceptor PET ligand [11C]ORM-13070.

    Science.gov (United States)

    Lehto, Jussi; Scheinin, Annalotta; Johansson, Jarkko; Marjamäki, Päivi; Arponen, Eveliina; Scheinin, Harry; Scheinin, Mika

    2016-02-01

    PET imaging can for some neurotransmitters be used to measure synaptic neurotransmitter concentrations. The objective of this study was to test whether the receptor binding of the α2C -AR antagonist PET tracer [(11)C]ORM-13070 would increase in response to reductions in synaptic noradrenaline, evoked by dexmedetomidine as a sympatholytic drug challenge. Six subjects underwent a control PET scan and two dexmedetomidine PET scans. Dexmedetomidine was infused with target plasma concentrations of 0.6 and 0.2 ng/ml. Tracer binding was measured by voxel-based analysis of bound per free (B/F) images. ROI-based analysis was performed in the dorsal striatum and in the thalamus. Vital signs and drug concentrations in plasma were measured and the sedative effect was estimated with the visual analog scale. In the voxel-based analysis, dexmedetomidine administration was associated with a tendency to increased B/F tracer in the right thalamus (mean, +17%, P = 0.14, and +19%, P = 0.05, with the low and high dose, respectively). Tracer binding in the dorsal striatum was unaffected by dexmedetomidine. A cluster with significantly increased B/F tracer (+42%, P = 0.01) was seen in the right superior temporal gyrus with low-dose dexmedetomidine, but not after the high dose. Brain uptake of [(11)C]ORM-13070 has previously been shown to be reduced in conditions of increased synaptic noradrenaline concentrations. In this study, tracer binding in the thalamus tended to increase in accordance with reduced activity of noradrenergic projections from the locus coeruleus, but statistical significance was not reached. © 2015 Wiley Periodicals, Inc.

  17. Evoked emotions predict food choice.

    Directory of Open Access Journals (Sweden)

    Jelle R Dalenberg

    Full Text Available In the current study we show that non-verbal food-evoked emotion scores significantly improve food choice prediction over merely liking scores. Previous research has shown that liking measures correlate with choice. However, liking is no strong predictor for food choice in real life environments. Therefore, the focus within recent studies shifted towards using emotion-profiling methods that successfully can discriminate between products that are equally liked. However, it is unclear how well scores from emotion-profiling methods predict actual food choice and/or consumption. To test this, we proposed to decompose emotion scores into valence and arousal scores using Principal Component Analysis (PCA and apply Multinomial Logit Models (MLM to estimate food choice using liking, valence, and arousal as possible predictors. For this analysis, we used an existing data set comprised of liking and food-evoked emotions scores from 123 participants, who rated 7 unlabeled breakfast drinks. Liking scores were measured using a 100-mm visual analogue scale, while food-evoked emotions were measured using 2 existing emotion-profiling methods: a verbal and a non-verbal method (EsSense Profile and PrEmo, respectively. After 7 days, participants were asked to choose 1 breakfast drink from the experiment to consume during breakfast in a simulated restaurant environment. Cross validation showed that we were able to correctly predict individualized food choice (1 out of 7 products for over 50% of the participants. This number increased to nearly 80% when looking at the top 2 candidates. Model comparisons showed that evoked emotions better predict food choice than perceived liking alone. However, the strongest predictive strength was achieved by the combination of evoked emotions and liking. Furthermore we showed that non-verbal food-evoked emotion scores more accurately predict food choice than verbal food-evoked emotions scores.

  18. Evoked emotions predict food choice.

    Science.gov (United States)

    Dalenberg, Jelle R; Gutjar, Swetlana; Ter Horst, Gert J; de Graaf, Kees; Renken, Remco J; Jager, Gerry

    2014-01-01

    In the current study we show that non-verbal food-evoked emotion scores significantly improve food choice prediction over merely liking scores. Previous research has shown that liking measures correlate with choice. However, liking is no strong predictor for food choice in real life environments. Therefore, the focus within recent studies shifted towards using emotion-profiling methods that successfully can discriminate between products that are equally liked. However, it is unclear how well scores from emotion-profiling methods predict actual food choice and/or consumption. To test this, we proposed to decompose emotion scores into valence and arousal scores using Principal Component Analysis (PCA) and apply Multinomial Logit Models (MLM) to estimate food choice using liking, valence, and arousal as possible predictors. For this analysis, we used an existing data set comprised of liking and food-evoked emotions scores from 123 participants, who rated 7 unlabeled breakfast drinks. Liking scores were measured using a 100-mm visual analogue scale, while food-evoked emotions were measured using 2 existing emotion-profiling methods: a verbal and a non-verbal method (EsSense Profile and PrEmo, respectively). After 7 days, participants were asked to choose 1 breakfast drink from the experiment to consume during breakfast in a simulated restaurant environment. Cross validation showed that we were able to correctly predict individualized food choice (1 out of 7 products) for over 50% of the participants. This number increased to nearly 80% when looking at the top 2 candidates. Model comparisons showed that evoked emotions better predict food choice than perceived liking alone. However, the strongest predictive strength was achieved by the combination of evoked emotions and liking. Furthermore we showed that non-verbal food-evoked emotion scores more accurately predict food choice than verbal food-evoked emotions scores.

  19. Oesophageal elongation with traction sutures (FOKER procedure in a newborn baby with long-gap oesophageal atresia (LGEA: Maybe too early, maybe too dangerous?

    Directory of Open Access Journals (Sweden)

    Holger Till

    2013-01-01

    Full Text Available In children with long gap oesophageal atresia (LGEA, the FOKER technique (oesophageal elongation with traction sutures has been criticized for its high complication rate. We advocate analysing such problems to increase the safety in the future. The present case report will focus on timing. A female newborn (3000 g with LGEA (gap of 5 cm was delivered in an outward hospital. On day two of life, she received traction sutures on both pouches. By day five, all sutures had torn out, and a primary anastomosis was attempted. However, it leaked severely. Thus, on day ten, the oesophagus was approached from the neck converting the proximal end into a spit fistula and closing the distal end blindly. Furthermore, the gastro-oesophageal (GE- junction was wrapped with a Teflon sling. When the baby arrived in our institution, she suffered from cavernous oesophageal masses extending from the thoracic inlet down to the diaphragm and fistulas draining them into the neck as well as into the right lung. Moreover, the Teflon sling had dislodged allowing for GE-reflux. In several stages, the oesophageal remnants were resected without any complications. Finally, Prof. Alaa Hamza performed a colonic interposition, which is working well today. In conclusion, the present case aims to caution paediatric surgeons to apply traction sutures for oesophageal elongation in newborns with LGEA.

  20. Curcumin induces apoptosis-independent death in oesophageal cancer cells.

    LENUS (Irish Health Repository)

    O'Sullivan-Coyne, G

    2009-10-06

    Background:Oesophageal cancer incidence is increasing and survival rates remain extremely poor. Natural agents with potential for chemoprevention include the phytochemical curcumin (diferuloylmethane). We have examined the effects of curcumin on a panel of oesophageal cancer cell lines.Methods:MTT (3-(4,5-dimethyldiazol-2-yl)-2,5 diphenyl tetrazolium bromide) assays and propidium iodide staining were used to assess viability and DNA content, respectively. Mitotic catastrophe (MC), apoptosis and autophagy were defined by both morphological criteria and markers such as MPM-2, caspase 3 cleavage and monodansylcadaverine (MDC) staining. Cyclin B and poly-ubiquitinated proteins were assessed by western blotting.Results:Curcumin treatment reduces viability of all cell lines within 24 h of treatment in a 5-50 muM range. Cytotoxicity is associated with accumulation in G2\\/M cell-cycle phases and distinct chromatin morphology, consistent with MC. Caspase-3 activation was detected in two out of four cell lines, but was a minor event. The addition of a caspase inhibitor zVAD had a marginal or no effect on cell viability, indicating predominance of a non-apoptotic form of cell death. In two cell lines, features of both MC and autophagy were apparent. Curcumin-responsive cells were found to accumulate poly-ubiquitinated proteins and cyclin B, consistent with a disturbance of the ubiquitin-proteasome system. This effect on a key cell-cycle checkpoint regulator may be responsible for the mitotic disturbances and consequent cytotoxicity of this drug.Conclusion:Curcumin can induce cell death by a mechanism that is not reliant on apoptosis induction, and thus represents a promising anticancer agent for prevention and treatment of oesophageal cancer.British Journal of Cancer advance online publication, 6 October 2009; doi:10.1038\\/sj.bjc.6605308 www.bjcancer.com.

  1. Individual patient oesophageal cancer 3D models for tailored treatment.

    Science.gov (United States)

    Saunders, John H; Onion, David; Collier, Pamela; Dorrington, Matthew S; Argent, Richard H; Clarke, Philip A; Reece-Smith, Alex M; Parsons, Simon L; Grabowska, Anna M

    2017-04-11

    A model to predict chemotherapy response would provide a marked clinical benefit, enabling tailored treatment of oesophageal cancer, where less than half of patients respond to the routinely administered chemotherapy. Cancer cells were established from tumour biopsies taken from individual patients about to undergo neoadjuvant chemotherapy. A 3D-tumour growth assay (3D-TGA) was developed, in which cancer cells were grown with or without supporting mesenchymal cells, then subjected to chemo-sensitivity testing using the standard chemotherapy administered in clinic, and a novel emerging HDAC inhibitor, Panobinostat. Individual patient's cancer cells could be expanded and screened within a clinically applicable timescale of 3 weeks. Incorporating mesenchymal support within the 3D-TGA significantly enhanced both the growth and drug resistance profiles of the patient's cancer cells. The ex vivo drug response in the presence, but not absence, of mesenchymal cells accurately reflected clinical chemo-sensitivity, as measured by tumour regression grade. Combination with Panobinostat enhanced response and proved efficacious in otherwise chemo-resistant tumours. This novel method of establishing individual patient oesophageal cancers in the laboratory, from small endoscopic biopsies, enables clinically-relevant chemo-sensitivity testing, and reduces use of animals by providing more refined in vitro models for pre-screening of drugs. The 3D-TGA accurately predicted chemo-sensitivity in patients, and could be developed to guide tailored patient treatment. The incorporation of mesenchymal cells as the stromal cell component of the tumour micro-environment had a significant effect upon enhancing chemotherapy drug resistance in oesophageal cancer, and could prove a useful target for future drug development.

  2. Curcumin induces apoptosis-independent death in oesophageal cancer cells.

    LENUS (Irish Health Repository)

    O'Sullivan-Coyne, G

    2012-01-31

    BACKGROUND: Oesophageal cancer incidence is increasing and survival rates remain extremely poor. Natural agents with potential for chemoprevention include the phytochemical curcumin (diferuloylmethane). We have examined the effects of curcumin on a panel of oesophageal cancer cell lines. METHODS: MTT (3-(4,5-dimethyldiazol-2-yl)-2,5 diphenyl tetrazolium bromide) assays and propidium iodide staining were used to assess viability and DNA content, respectively. Mitotic catastrophe (MC), apoptosis and autophagy were defined by both morphological criteria and markers such as MPM-2, caspase 3 cleavage and monodansylcadaverine (MDC) staining. Cyclin B and poly-ubiquitinated proteins were assessed by western blotting. RESULTS: Curcumin treatment reduces viability of all cell lines within 24 h of treatment in a 5-50 muM range. Cytotoxicity is associated with accumulation in G2\\/M cell-cycle phases and distinct chromatin morphology, consistent with MC. Caspase-3 activation was detected in two out of four cell lines, but was a minor event. The addition of a caspase inhibitor zVAD had a marginal or no effect on cell viability, indicating predominance of a non-apoptotic form of cell death. In two cell lines, features of both MC and autophagy were apparent. Curcumin-responsive cells were found to accumulate poly-ubiquitinated proteins and cyclin B, consistent with a disturbance of the ubiquitin-proteasome system. This effect on a key cell-cycle checkpoint regulator may be responsible for the mitotic disturbances and consequent cytotoxicity of this drug. CONCLUSION: Curcumin can induce cell death by a mechanism that is not reliant on apoptosis induction, and thus represents a promising anticancer agent for prevention and treatment of oesophageal cancer.

  3. The Management of Cyanotic Spells in Children with Oesophageal Atresia.

    Science.gov (United States)

    Bergeron, Mathieu; Cohen, Aliza P; Cotton, Robin T

    2017-01-01

    Cyanotic spells, also known as blue spells, dying spells, or apparent life-threatening events, refer to a bluish tone visible in the mucosal membranes and skin caused by an oxygen decrease in the peripheral circulation. Although this decrease may be transient and benign, it may also be indicative of a severe underlying problem that requires immediate intervention. Children with oesophageal atresia (OA) are at risk for a number of coexisting conditions that may trigger cyanotic spells. This current article will focus on the management of cyanotic spells both in children with innominate artery compression and those with tracheomalacia.

  4. Oesophageal lesions as first manifestation of necrotising sarcoid granulomatosis.

    Science.gov (United States)

    Attou, Rachid; Duttmann, Ruth; Devriendt, Arnaud; De Bels, David

    2015-07-06

    Necrotising sarcoid granulomatosis is a rare disease associating sarcoid-like granulomas, vasculitis and necrosis in the lungs and seldom in extrapulmonary locations. We report the case of a 23-year-old woman with an initial symptom consisting of epigastric pain. Oesophagoscopy demonstrated oesophagitis. Evolution was marked by fever, dyspnoea and pulmonary lesions. The first presumptive diagnosis was Wegener disease but biopsies (of the lungs and the oesophagus) demonstrated the diagnosis of necrotising sarcoid granulomatosis. Evolution was favourable under corticoid therapy. Necrotising sarcoid granulomatosis may present as an extrapulmonary disease and is an important differential diagnosis of other disease such as Wegener disease. 2015 BMJ Publishing Group Ltd.

  5. The Management of Cyanotic Spells in Children with Oesophageal Atresia

    Directory of Open Access Journals (Sweden)

    Mathieu Bergeron

    2017-05-01

    Full Text Available Cyanotic spells, also known as blue spells, dying spells, or apparent life-threatening events, refer to a bluish tone visible in the mucosal membranes and skin caused by an oxygen decrease in the peripheral circulation. Although this decrease may be transient and benign, it may also be indicative of a severe underlying problem that requires immediate intervention. Children with oesophageal atresia (OA are at risk for a number of coexisting conditions that may trigger cyanotic spells. This current article will focus on the management of cyanotic spells both in children with innominate artery compression and those with tracheomalacia.

  6. Time trends in the incidence of oesophageal cancer in Asia: Variations across populations and histological types.

    Science.gov (United States)

    Xie, Shao-Hua; Lagergren, Jesper

    2016-10-01

    We aimed to assess temporal trends in incidence rates of oesophageal cancer in Asian countries. Using data from the Cancer Incidence in Five Continents series, we examined the temporal trends in incidence rates of oesophageal cancer by population and histological type in seven Asian countries in 1988-2007. Age-period-cohort analyses estimated the overall annual percentage changes (net drifts) and their 95% confidence intervals (CIs) in incidence rates. The age-standardised incidence rate of oesophageal cancer declined in most Asian populations, but remained relatively unchanged in Japan and Israel. The rate of oesophageal squamous cell carcinoma decreased in Hong Kong, Singapore and Israel, but was stable in Japan. The net drifts were statistically significant in men in Hong Kong (-3.4%, 95% CI: -6.1%, -0.7%) and in women in Singapore (-10.1%, 95% CI: -14.4%, -5.5%). The age-standardised incidence rates of oesophageal adenocarcinoma were below 2 and 0.5 per 100 000 in men and women, respectively, across all periods in the all registers containing valid data on histological type. The age-standardised incidence rate of oesophageal adenocarcinoma slightly increased in Japan, Singapore, and Israel, although the net drift was statistically significant only in Israeli men (4.9%, 95% CI: 0.8%, 9.1%). The overall incidence rates of oesophageal cancer declined in most Asian countries, which is due to a decrease in oesophageal squamous cell carcinoma incidence. However, attention needs to be paid to a probable beginning of an increasing incidence of oesophageal adenocarcinoma in Asia. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Electromyographic study of the cat's diaphragm during oesophageal distension.

    Science.gov (United States)

    Aziz, H A; Rex, M A

    1984-08-01

    In 10 cats, under acute experimental conditions, the effects of distension of the oesophagus on diaphragmatic activity were studied. Bipolar recording electrodes were implanted in the diaphragmatic dome muscular fibres and crura muscular fibres. Electrodes similar to those in the diaphragm were inserted in the oesophageal muscular wall above the hiatus and in the rectus abdominis muscle. Changes in the intrathoracic pressure and blood pressure were recorded by catheters placed in the pleural cavity and carotid artery respectively. Distension of the lower part of the thoracic oesophagus (at the level between the heart and the hiatus, 5 to 7 cm from the hiatus) by inflating a balloon with 10 to 15 ml of air produced a partial or total inhibition of the inspiratory electrical activity of the inner hiatal muscular fibres, while the inspiratory electrical activity of the dome muscular fibres was generally unchanged. This inhibition was increasingly pronounced as the distension volume increased and as the balloon was positioned nearer to the hiatus. During the distension period, only electrocardiographic potentials were recorded on the oesophageal muscular wall and rectus abdominis muscle traces and no significant changes were observed from intrathoracic pressure or blood pressure channels. Distension by means of a balloon either inflated with up to 5 ml of air when placed 5 to 7 cm cranial to the hiatus or inflated with 15 ml of air when localised in the cervical oesophagus and intrahiatally produced no effect. All areas of the diaphragm were silent during expiration.

  8. Curative treatment of oesophageal carcinoma: current options and future developments

    Directory of Open Access Journals (Sweden)

    Bruns Christiane

    2011-05-01

    Full Text Available Abstract Since the 1980s major advances in surgery, radiotherapy and chemotherapy have established multimodal approaches as curative treatment options for oesophageal cancer. In addition the introduction of functional imaging modalities such as PET-CT created new opportunities for a more adequate patient selection and therapy response assessment. The majority of oesophageal carcinomas are represented by two histologies: squamous cell carcinoma and adenocarcinoma. In recent years an epidemiological shift towards the latter was observed. From a surgical point of view, adenocarcinomas, which are usually located in the distal third of the oesophagus, may be treated with a transhiatal resection, whereas squamous cell carcinomas, which are typically found in the middle and the upper third, require a transthoracic approach. Since overall survival after surgery alone is poor, multimodality approaches have been developed. At least for patients with locally advanced tumors, surgery alone can no longer be advocated as routine treatment. Nowadays, scientific interest is focused on tumor response to induction radiochemotherapy. A neoadjuvant approach includes the early and accurate assessment of clinical response, optimally performed by repeated PET-CT imaging and endoscopic ultrasound, which may permit early adaption of the therapeutic concept. Patients with SCC that show clinical response by PET CT are considered to have a better prognosis, regardless of whether surgery will be performed or not. In non-responding patients salvage surgery improves survival, especially if complete resection is achieved.

  9. Balloon dilatation in children for oesophageal strictures other than those due to primary repair of oesophageal atresia, interposition or restrictive fundoplication

    Energy Technology Data Exchange (ETDEWEB)

    Fasulakis, Stephen [Royal Children' s Hospital, Melbourne (Australia); Andronikou, Savvas [Royal Children' s Hospital, Melbourne (Australia); Department of Paediatric Radiology, Red Cross Children' s Hospital, Klipfontein Road, Rondebosch, 7700, Cape Town (South Africa)

    2003-10-01

    Balloon dilatation of the oesophagus in children has been performed predominantly for treating strictures, which are the result of primary repair of oesophageal atresia, interposition surgery or restrictive Nissen's fundoplication. Reports of the use of this technique for alternative causes of stricture are few. To report our experience and success with balloon dilatation of strictures due to caustic ingestion, achalasia, oesophagitis, congenital stenosis, and epidermolysis bullosa (EB) and to make comparisons with our treatment of patients with primary repair of oesophageal atresia (OA), as well as with reports in the English language literature. Retrospective review of fluoroscopically guided balloon oesophageal dilatation procedures in 19 patients over a 5-year period, and comparison of those performed for OA repair complications with those due to other diseases. The average radiation dose, per procedure, was calculated by a medical physicist. Ten patients had strictures as a result of primary repair of OA. Three patients had stricture as a result of EB, two from achalasia, two from caustic injury, one due to an oesophageal web and one from reflux oesophagitis. Our results show that the technique can also be curative for the last group and that it may be used intermittently to alleviate symptoms in ongoing diseases. We have not experienced any complications and have also calculated that, even with prolonged use of multiple procedures, the radiation exposure is comparable to other radiological techniques. Patients with alternative causes for oesophageal stricture may be treated to resolution within 2 years using balloon dilatation. Ongoing diseases such as EB require ongoing dilatation, but balloon dilatation of strictures has been successful in alleviating swallowing difficulty. Patients with stricture from OA repair sometimes need ongoing dilatation. Radiation exposure for multiple procedures, over an extended period, is comparable to that from a single

  10. Evoked Emotions Predict Food Choice

    NARCIS (Netherlands)

    Dalenberg, Jelle R.; Gutjar, Swetlana; ter Horst, Gert J.; de Graaf, Kees; Renken, Remco J.; Jager, Gerry

    2014-01-01

    In the current study we show that non-verbal food-evoked emotion scores significantly improve food choice prediction over merely liking scores. Previous research has shown that liking measures correlate with choice. However, liking is no strong predictor for food choice in real life environments.

  11. Thoracoscopic repair of congenital tracheo-oesophageal fistula manifesting in an adult

    Directory of Open Access Journals (Sweden)

    Hrishikesh P Salgaonkar

    2014-01-01

    Full Text Available Congenital trcheo-oesophageal fistula (TOF without oesophageal atresia is usually diagnosed and managed in the neonatal period. Its presentation in adulthood is a rarity. Traditional treatment of a TOF in adults involves its repair via a thoracotomy. We report the case of a 23-year-old man diagnosed with an H-type TOF during workup undertaken for his symptoms of gastro-oesophageal reflux. This fistula located at the level of third thoracic vertebra was repaired successfully using a thoracoscopic approach.

  12. Scintigraphy in the detection of gastro-oesophageal reflux in children with caustic oesophageal burns: a comparative study with radiography and 24-h pH monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Oezcan, Z.; Erinc, R.; Dirlik, A. [Dept. of Nuclear Medicine, Ege University Medical Faculty, Izmir (Turkey); Oezcan, C.; Mutaf, O. [Dept. of Paediatric Surgery, Ege University Medical Faculty, Izmir (Turkey)

    2001-10-01

    Background: Caustic injury of the oesophagus not only causes luminal narrowing but is also responsible for longitudinal contraction, resulting in gastro-oesophageal reflux (GOR), which leads to failure of conventional therapy. Therefore, the development of GOR should be investigated periodically to direct appropriate management of these patients. Purpose: To determine the ability of scintigraphy to detect GOR in children with caustic oesophageal strictures in comparison with barium study and 24-h pH monitoring. Materials and methods: Seventeen children with caustic oesophageal injury underwent scintigraphy, an upper GI barium study and 24-h pH monitoring within the same week. Five patients were also investigated post-operatively for the assessment of surgical outcome after antireflux surgery. Results: On the whole, there was good correlation (r = 0.78, P < 0.00 l) between scintigraphy and 24-h oesophageal pH monitoring. Scintigraphy detected all but one (9/10) refluxing patients and also correctly identified all (7/7) non-refluxing patients. Barium studies demonstrated 6 out of 10 refluxing patients. There were no false-positive barium studies in non-refluxing patients. Post-operative studies demonstrated no evidence of GOR in surgically treated patients. Conclusions: Our results indicate that, by comparison with barium studies, scintigraphy is useful in the detection of GOR in cases with caustic oesophageal strictures and may be used as a screening modality for those under clinical follow-up. (orig.)

  13. Do ambient urban odors evoke basic emotions?

    Directory of Open Access Journals (Sweden)

    Sandra Theresia Weber-Glass

    2014-04-01

    Full Text Available Fragrances, such as plant odors, have been shown to evoke autonomic response patterns associated with Ekman’s (Ekman et al., 1983 basic emotions happiness, surprise, anger, fear, sadness and disgust. Inducing positive emotions by odors in highly frequented public spaces could serve to improve the quality of life in urban environments. Thus, the present study evaluated the potency of ambient odors connoted with an urban environment to evoke basic emotions on an autonomic and cognitive response level. Synthetic mixtures representing the odors of disinfectant, candles / bees wax, summer air, burnt smell, vomit and musty smell as well as odorless water as a control were presented five times in random order to 30 healthy, non-smoking human subjects with intact sense of smell. Skin temperature, skin conductance, breathing rate, forearm muscle activity, blink rate and heart rate were recorded simultaneously. Subjects rated the odors in terms of pleasantness, intensity and familiarity and gave verbal labels to each odor as well as cognitive associations with the basic emotions. The results showed that the amplitude of the skin conductance response varied as a function of odor presentation. Burnt smell and vomit elicited significantly higher electrodermal responses than summer air. Also, a negative correlation was revealed between the amplitude of the skin conductance response and hedonic odor valence indicating that the magnitude of the electrodermal response increased with odor unpleasantness. The analysis of the cognitive associations between odors and basic emotions showed that candles / bees wax and summer air were specifically associated with happiness whereas burnt smell and vomit were uniquely associated with disgust. Our findings suggest that city odors may evoke specific cognitive associations of basic emotions and that autonomic activity elicited by such odors is related to odor hedonics.

  14. Low morbidity after palliation of obstructing gastro-oesophageal adenocarcinoma to restore swallowing function

    DEFF Research Database (Denmark)

    Kofoed, Steen Christian; Lundsgaard, Martin; Ellemann, Ann-Camilla

    2012-01-01

    This study describes the procedure-related complications and survival after deployment of self-expanding metal stents (SEMS) or use of argon plasma coagulation (APC) in patients with obstructing gastro-oesophageal junction (GEJ) adenocarcinoma....

  15. Met expression is an independent prognostic risk factor in patients with oesophageal adenocarcinoma

    NARCIS (Netherlands)

    J.B. Tuynman; S.M. Lagarde (Sjoerd); F.J.W. ten Kate (Fiebo); D.J. Richel (Dirk); J.J.B. van Lanschot (Jan)

    2008-01-01

    textabstractOesophageal adenocarcinoma is an aggressive malignancy with propensity for early lymphatic and haematogenous dissemination. Since conventional TNM staging does not provide accurate prognostic information, novel molecular prognostic markers and potential therapeutic targets are subject of

  16. Met expression is an independent prognostic risk factor in patients with oesophageal adenocarcinoma

    NARCIS (Netherlands)

    Tuynman, J. B.; Lagarde, S. M.; ten Kate, F. J. W.; Richel, D. J.; van Lanschot, J. J. B.

    2008-01-01

    Oesophageal adenocarcinoma is an aggressive malignancy with propensity for early lymphatic and haematogenous dissemination. Since conventional TNM staging does not provide accurate prognostic information, novel molecular prognostic markers and potential therapeutic targets are subject of intense

  17. Long-term treatment of gastro-oesophageal reflux disease in primary care

    NARCIS (Netherlands)

    van der Velden, A.W.

    2008-01-01

    Gastro-oesophageal reflux disease (GORD), characterized by heartburn and acid regurgitation, is one of the most common gastrointestinal diseases general practitioners encounter. GORD is effectively treated with acid suppressive medication (ASM), of which proton pump inhibitors (PPIs) are most

  18. Radiation-induced oesophagitis in lung cancer patients. Is susceptibility for neutropenia a risk factor?

    Energy Technology Data Exchange (ETDEWEB)

    Ruysscher, D. de [MAASTRO Clinic, Maastricht (Netherlands). Dept. of Radiation Oncology; Meerbeeck, J. van [Ghent Univ. Hospital (Belgium). Dept. of Respiratory Medicine; Vandecasteele, K. [Ghent Univ. Hospital (BE). Dept. of Radiation Oncology] (and others)

    2012-07-15

    Background: Radiation-induced oesophagitis is a major side effect of concurrent chemotherapy and radiotherapy. A strong association between neutropenia and oesophagitis was previously shown, but external validation and further elucidation of the possible mechanisms are lacking. Methods and patients: A total of 119 patients were included at two institutions. The concurrent group comprised 34 SCLC patients treated with concurrent carboplatin and etoposide, and concurrent chest irradiation, and 36 NSCLC patients with concurrent cisplatin and etoposide, and concurrent radiotherapy, while the sequential group comprised 49 NSCLC patients received sequential cisplatin and gemcitabine, and radiotherapy. Results: Severe neutropenia was very frequent during concurrent chemoradiation (grade: 4 41.4%) and during induction chemotherapy in sequentially treated patients (grade 4: 30.6%), but not during radiotherapy (only 4% grade 1). In the concurrent group, the odds ratios of grade 3 oesophagitis vs. neutropenia were the following: grade 2 vs. grade 0/1: 5.60 (95% CI 1.55-20.26), p = 0.009; grade 3 vs. grade 0/1: 10.40 (95% CI 3.19-33.95); p = 0.0001; grade 4 vs. grade 0/1: 12.60 (95% CI 4.36-36.43); p < 0.00001. There was no correlation between the occurrence of neutropenia during induction chemotherapy and acute oesophagitis during or after radiotherapy alone. In the univariate analysis, total radiation dose (p < 0.001), overall treatment time of radiotherapy (p < 0.001), mean oesophageal dose (p = 0.038) and neutropenia (p < 0.001) were significantly associated with the development of oesophagitis. In a multivariate analysis, only neutropenia remained significant (p = 0.023). Conclusion: We confirm that neutropenia is independently correlated with oesophagitis in concurrent chemoradiation, but that the susceptibility for chemotherapy-induced neutropenia is not associated with radiation-induced oesophagitis. Further studies focusing on the underlying mechanisms are thus

  19. Banding ligation versus beta-blockers for primary prevention in oesophageal varices in adults

    DEFF Research Database (Denmark)

    Gluud, Lise Lotte; Krag, Aleksander

    2012-01-01

    Non-selective beta-blockers are used as a first-line treatment for primary prevention in patients with medium- to high-risk oesophageal varices. The effect of non-selective beta-blockers on mortality is debated and many patients experience adverse events. Trials on banding ligation versus non......-selective beta-blockers for patients with oesophageal varices and no history of bleeding have reached equivocal results....

  20. Soya and isoflavone intakes associated with reduced risk of oesophageal cancer in north-west China.

    Science.gov (United States)

    Tang, Li; Lee, Andy H; Xu, Fenglian; Zhang, Taotao; Lei, Jun; Binns, Colin W

    2015-01-01

    To ascertain the association between soya consumption, isoflavone intakes and oesophageal cancer risk in remote north-west China, where the incidence of oesophageal cancer is known to be high. Case-control study. Information on habitual consumption of soya foods and soya milk was obtained by personal interview. The intakes of isoflavones were then estimated using the US Department of Agriculture nutrient database. Logistic regression analyses were performed to assess the association between soya consumption, isoflavone intakes and oesophageal cancer risk. Urumqi and Shihezi, Xinjiang Uyghur Autonomous Region, China. Participants were 359 incident oesophageal cancer patients and 380 hospital-based controls. The oesophageal cancer patients consumed significantly less (P soya foods (mean 57·2 (sd 119·0) g/d) and soya milk (mean 18·8 (sd 51·7) ml/d) than the controls (mean 93·3 (sd 121·5) g/d and mean 35·7 (sd 73·0) ml/d). Logistic regression analyses showed an inverse association between intake of soya products and the risk of oesophageal cancer. The adjusted odds were OR = 0·33 (95 % CI 0·22, 0·49) and OR = 0·48 (95 % CI 0·31, 0·74) for consuming at least 97 g of soya foods and 60 ml of soya milk daily (the highest tertiles of consumption), respectively, relative to the lowest tertiles of consumption. Similarly, inverse associations with apparent dose-response relationships were found between isoflavone intakes and oesophageal cancer risk. Habitual consumption of soya products appears to be associated with reduced risk of oesophageal cancer in north-west China.

  1. Low morbidity after palliation of obstructing gastro-oesophageal adenocarcinoma to restore swallowing function

    DEFF Research Database (Denmark)

    Kofoed, Steen Christian; Lundsgaard, Martin; Ellemann, Ann-Camilla

    2012-01-01

    This study describes the procedure-related complications and survival after deployment of self-expanding metal stents (SEMS) or use of argon plasma coagulation (APC) in patients with obstructing gastro-oesophageal junction (GEJ) adenocarcinoma.......This study describes the procedure-related complications and survival after deployment of self-expanding metal stents (SEMS) or use of argon plasma coagulation (APC) in patients with obstructing gastro-oesophageal junction (GEJ) adenocarcinoma....

  2. A quantitative investigation into some ultrastructural characteristics of guinea-pig oesophageal striated muscle.

    OpenAIRE

    Whitmore, I; Notman, J A

    1987-01-01

    Electron micrographs of guinea-pig oesophageal striated muscle have been subjected to quantitative assessment. The results show that whereas the motor end-plates are considerably simpler than those of control hindlimb muscles, the Z-line width and M-line bridges are those of fast-twitch, oxidative and glycolytic fibres. Guinea-pig oesophageal striated muscle continues to defy classification into the normally accepted subtypes for skeletal muscle and should thus be considered as an example of ...

  3. Frequencies of HER-2/neu expression and gene amplification in patients with oesophageal squamous cell carcinoma

    OpenAIRE

    Mimura, K; Kono, K; Hanawa, M.; Mitsui, F; Sugai, H.; Miyagawa, N; Ooi, A.; Fujii, H

    2005-01-01

    The utilisation of antitumour T cells induced by cancer vaccination with HER-2 peptides or antibodies (Herceptin) against HER-2, as immunotherapy for oesophageal cancer, is a novel and attractive approach. It is important to clarify the frequencies of HER-2 expression and gene amplification in patients with oesophageal squamous cell carcinoma (SCC) and to evaluate the relationship between HER-2 status and HLA haplotype, since the candidates for HER-2 peptide-based vaccination are restricted t...

  4. Evoked Emotions Predict Food Choice

    OpenAIRE

    Dalenberg, Jelle R.; Swetlana Gutjar; Gert J Ter Horst; Kees de Graaf; Renken, Remco J.; Gerry Jager

    2014-01-01

    In the current study we show that non-verbal food-evoked emotion scores significantly improve food choice prediction over merely liking scores. Previous research has shown that liking measures correlate with choice. However, liking is no strong predictor for food choice in real life environments. Therefore, the focus within recent studies shifted towards using emotion-profiling methods that successfully can discriminate between products that are equally liked. However, it is unclear how well ...

  5. EVOKED CAVERNOUS ACTIVITY: NEUROANATOMIC IMPLICATIONS

    OpenAIRE

    Yilmaz, Ugur; Vicars, Brenda; Yang, Claire C.

    2009-01-01

    We investigated the autonomic innervation of the penis by using evoked cavernous activity (ECA). We recruited 7 males with thoracic spinal cord injury (SCI) and sexual dysfunction and 6 males who were scheduled to have pelvic surgery (PS), specifically non-nerve-sparing radical cystoprostatectomy. In the PS subjects, ECA was performed both pre- and postoperatively. The left median nerve was electrically stimulated and ECA was recorded with two concentric electromyography needles placed into t...

  6. Non-linear associations between laryngo-pharyngeal symptoms of gastro-oesophageal reflux disease: clues from artificial intelligence analysis.

    Science.gov (United States)

    Grossi, E

    2006-10-01

    The relationship between the different symptoms of gastro-oesophageal reflux disease remain markedly obscure due to the high underlying non-linearity and the lack of studies focusing on the problem. Aim of this study was to evaluate the hidden relationships between the triad of symptoms related to gastro-oesophageal reflux disease using advanced mathematical techniques, borrowed from the artificial intelligence field, in a cohort of patients with oesophagitis. A total of 388 patients (from 60 centres) with endoscopic evidence of oesophagitis were recruited. The severity of oesophagitis was scored by means of the Savary-Miller classification. PST algorithm was employed. This study shows that laryngo-pharyngeal symptoms related to gastro-oesophageal reflux disease are correlated even if in a non-linear way.

  7. Model of evoked rabbit phonation.

    Science.gov (United States)

    Ge, Ping Jiang; French, Lesley C; Ohno, Tsunehisa; Zealear, David L; Rousseau, Bernard

    2009-01-01

    We describe a method for eliciting phonation in an in vivo rabbit preparation using low-frequency, bipolar pulsed stimulation of the cricothyroid muscles with airflow delivered to the glottis. Ten New Zealand White breeder rabbits weighing 3 to 5 kg were used in this study. The cricothyroid muscles were isolated bilaterally, and separate pairs of anode-cathode hooked-wire electrodes were inserted into each muscle. A Grass S-88 stimulator and 2 constant-current PSIU6 isolation units were used to deliver bipolar square wave pulses to each cricothyroid muscle, with airflow delivered to the glottis through a cuffed endotracheal tube. Phonation was evoked with a 50-Hz, 4-mA stimulus train of 1-ms pulses delivered to each cricothyroid muscle. The pulse trains were on for 2 seconds and were repeated every 5 seconds over a period of 180 minutes. Airflow was delivered at 143 cm3/s, producing phonation measuring 71 to 85 dB sound pressure level. Evoked phonation is feasible in rabbits by use of bipolar stimulation of the cricothyroid muscles with airflow delivered to the glottis. The in vivo rabbit preparation described may provide a useful small animal option for studies of evoked phonation. From the level and consistency of the adduction observed, we hypothesize that current spreading to the underlying adductor muscles and nerves resulted in neural pathway involvement beyond discrete activation of the cricothyroid muscle, providing sufficient approximation of the vocal folds for phonation.

  8. [Palliative management of malignant oesophageal strictures with endoprosthesis implantation -- 25 years experience].

    Science.gov (United States)

    Balázs, Akos; Kokas, Péter; Lukovich, Péter; Kupcsulik, Péter

    2011-12-01

    The aim of this study was to analyse the feasibility of the use of oesophageal endoprosthesis based on a large series of cases. 2952 malignant oesophageal strictures managed between 1984 and 2009 were analysed. While surgical intubation was carried out in 42 patients, endoscopic implantation was feasible in 1143 cases. Patients not eligible for oesophageal stenting were treated with gastrostomy in 125, percutaneous endoscopic gastrostomy in 19, catheter jejunostomy in 9 and supportive therapy in 965 cases, respectively. Endoprosthesis could have been inserted in 61.2% of the patients. Dysphagia was terminated temporarily in 6.2% and permanently in 93.5%. Complications were detected in 23.7% of the cases, which included stent migration, perforation, bleeding, airway obstruction, early unexpected death, aspiration, stent obstruction, tumor overgrowth, oesophago-respiratory fistula formation and neoformation, and reflux. Complications were treated endoscopically primarily (69.2%). Lethal complication rate was 2.1% (27 cases). Furthermore, complication rate of patients who underwent surgical stent insertion was 21.9%. Mean survival of patients with oesophageal intubation was 5.4 months, with nutritional support via gastrostomy, percutaneous endoscopic gastrostomy or jejunostomy 3.6 months and with supportive therapy alone 3.2 months. Oesophageal endoprosthesis insertion is an effective method for the palliative management of malignant oesophageal strictures. Stent implantation improves survival as well as quality of life. Methods used for nutritional support decreases hungriness but do not influence survival.

  9. Gastro-oesophageal reflux disease in 20 dogs (2012 to 2014).

    Science.gov (United States)

    Muenster, M; Hoerauf, A; Vieth, M

    2017-05-01

    To describe the clinical features of canine gastro-oesophageal reflux disease. A search of our medical records produced 20 dogs with clinical signs attributable to oesophageal disease, hyper-regeneratory oesophagopathy and no other oesophageal disorders. The clinical, endoscopic and histological findings of the dogs were analysed. The 3-year incidence of gastro-oesophageal reflux disease was 0·9% of our referral dog population. Main clinical signs were regurgitation, discomfort or pain (each, 20/20 dogs) and ptyalism (18/20 dogs). Oesophagoscopy showed no (5/20 dogs) or minimal (13/20 dogs) mucosal lesions. In oesophageal mucosal biopsy specimens, there were hyperplastic changes of the basal cell layer (13/20 dogs), stromal papillae (14/20 dogs) and entire epithelium (9/20 dogs). Eleven dogs received omeprazole or pantoprazole and regurgitation and ptyalism improved in eight and pain diminished in six of these dogs within three to six weeks. Our findings suggest that canine gastro-oesophageal reflux disease is a more common clinical problem than hitherto suspected. © 2017 British Small Animal Veterinary Association.

  10. Immediate primary anastomosis for isolated oesophageal atresia: A single-centre experience

    Directory of Open Access Journals (Sweden)

    Ibrahim Uygun

    2015-01-01

    Full Text Available Background: Isolated oesophageal atresia without tracheo-oesophageal fistula represents a major challenge for most paediatric surgeons. Here, we present our experience with six neonates with isolated oesophageal atresia who successfully underwent immediate primary anastomosis using multiple Livaditis circular myotomy. Materials and Methods: All six neonates were gross type A isolated oesophageal atresia (6%, from among 102 neonates with oesophageal atresia, treated between January 2009 and December 2013. Five neonates were female; one was male. The mean birth weight was 2300 (range 1700-3100 g. Results: All six neonates successfully underwent immediate primary anastomosis using multiple myotomies (mean 3; range 2-4 within 10 (median 3 days after birth. The gap under traction ranged from 6 to 7 cm. One neonate died of a major cardiac anomaly. Another neonate was lost to follow-up after being well for 3 months. Three anastomotic strictures were treated with balloon dilatation, and four anastomotic leaks were treated conservatively. The mean duration of follow-up was 33 months. Conclusions: To treat isolated oesophageal atresia, an immediate primary anastomosis can be achieved using multiple myotomies. Although, this approach is associated with high complication rates, as are other similar approaches, these complications can be overcome.

  11. KIF11 Is Required for Spheroid Formation by Oesophageal and Colorectal Cancer Cells.

    Science.gov (United States)

    Imai, Takeharu; Oue, Naohide; Sentani, Kazuhiro; Sakamoto, Naoya; Uraoka, Naohiro; Egi, Hiroyuki; Hinoi, Takao; Ohdan, Hideki; Yoshida, Kazuhiro; Yasui, Wataru

    2017-01-01

    Oesophageal squamous cell carcinoma (ESCC) and colorectal cancer (CRC) are common types of human cancer. Spheroid colony formation is used to characterize cancer stem cell (CSCs). In the present study, we analyzed the significance of kinesin family 11 (KIF11 in human ESCC and CRC. Expression of KIF11 in 105 ESCC and 100 CRC cases was determined using immunohistochemistry. RNA interference was used to inhibit KIF11 expression in ESCC and CRC cell lines. In total, 61 out of 105 (58%) ESCC and 62 out of 100 (62%) CRC cases were positive for KIF11. Expression of KIF11 was not associated with any clinicopathological characteristics. Both the number and size of spheres produced by from TE-5 ESCC cells and DLD-1 CRC cells were significantly reduced upon KIF11 siRNA transfection compared to negative control siRNA transfection. These results indicate that KIF11 plays an important role in CSCs of ESCC and CRC. Copyright© 2017 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  12. Oesophageal-cancer-derived death in the population of Belgrade in a period 1989-2006

    Directory of Open Access Journals (Sweden)

    Janković Janko

    2009-01-01

    Full Text Available Background/Aim. Oesophageal cancer is the sixth most common cause of death from all malignant tumors in the world (fifth in men, eighth in women. This cancer was estimated to account for about 529 000 new cases and about 442 000 deaths in the year 2007. In the year 2002 the highest standardized mortality rates (per 100 000 habitants of oesophageal carcinoma were noticed in the East Asia (men/women: 18.8/7.7 and East Africa (18.6/7.8, while the lowest were noticed in the Middle Africa (1.4/0.2 and West Africa (1.3/0.5. The aim of this descriptive epidemiologic study was to analyze epidemiologic situation of oesophageal cancer in Belgrade population during the period 1989-2006, using mortality data. Methods. Mortality data were collected from the City Organization for Statistics. In data analysis we used mortality rates which were standardized directly using those of the world population as the standard, and proportions. A denominator for mortality rates was calculated using the Belgrade population which was an average of the two latest register years (1991 and 2002. In order to analyze trend mortality from oesophageal cancer we used linear trend. Results. In Belgrade deaths from oesophageal cancer accounted for about 5.2% of all malignant tumors of intestinal system in male population, and 2.4% in female population. This cancer is, according to standardized mortality rates (per 100 000 habitants, on the fifth place in Belgrade population behind colorectal, stomach, pancreatic, liver and cholecystic cancer. During the period 1989-2006 in Belgrade 44 persons died from oesophageal carcinoma on the average each year, mainly men (75%, and the rest were women (25%. In male population during the same period we noticed a significant increase in trend mortality (y = 1.61 + 0.06x, p = 0.001, while in female population the increase of mortality was not significant. The male/female oesophageal cancer mortality ratio was 3:1. Mortality rates for oesophageal

  13. [Oesophageal-cancer-derived death in the population of Belgrade in a period 1989-2006].

    Science.gov (United States)

    Janković, Janko; Ratkov, Isidora; Sipetić, Sandra; Marinković, Jelena; Maksimović, Jadranka

    2009-07-01

    Oesophageal cancer is the sixth most common cause of death from all malignant tumors in the world (fifth in men, eighth in women). This cancer was estimated to account for about 529 000 new cases and about 442 000 deaths in the year 2007. In the year 2002 the highest standardized mortality rates (per 100 000 habitants) of oesophageal carcinoma were noticed in the East Asia (men/women: 18.8/7.7) and East Africa (18.6/7.8), while the lowest were noticed in the Middle Africa (1.4/0.2) and West Africa (1.3/0.5). The aim of this descriptive epidemiologic study was to analyze epidemiologic situation of oesophageal cancer in Belgrade population during the period 1989-2006, using mortality data. Mortality data were collected from the City Organization for Statistics. In data analysis we used mortality rates which were standardized directly using those of the world population as the standard, and proportions. A denominator for mortality rates was calculated using the Belgrade population which was an average of the two latest register years (1991 and 2002). In order to analyze trend mortality from oesophageal cancer we used linear trend. In Belgrade deaths from oesophageal cancer accounted for about 5.2% of all malignant tumors of intestinal system in male population, and 2.4% in female population. This cancer is, according to standardized mortality rates (per 100 000 habitants), on the fifth place in Belgrade population behind colorectal, stomach, pancreatic, liver and cholecystic cancer. During the period 1989-2006 in Belgrade 44 persons died from oesophageal carcinoma on the average each year, mainly men (75%), and the rest were women (25%). In male population during the same period we noticed a significant increase in trend mortality (y = 1.61 + 0.06x, p = 0.001), while in female population the increase of mortality was not significant. The male/female oesophageal cancer mortality ratio was 3:1. Mortality rates for oesophageal cancer rise with age in both sexes and they

  14. Bayesian analysis of MEG visual evoked responses

    Energy Technology Data Exchange (ETDEWEB)

    Schmidt, D.M.; George, J.S.; Wood, C.C.

    1999-04-01

    The authors developed a method for analyzing neural electromagnetic data that allows probabilistic inferences to be drawn about regions of activation. The method involves the generation of a large number of possible solutions which both fir the data and prior expectations about the nature of probable solutions made explicit by a Bayesian formalism. In addition, they have introduced a model for the current distributions that produce MEG and (EEG) data that allows extended regions of activity, and can easily incorporate prior information such as anatomical constraints from MRI. To evaluate the feasibility and utility of the Bayesian approach with actual data, they analyzed MEG data from a visual evoked response experiment. They compared Bayesian analyses of MEG responses to visual stimuli in the left and right visual fields, in order to examine the sensitivity of the method to detect known features of human visual cortex organization. They also examined the changing pattern of cortical activation as a function of time.

  15. Initial results of the oesophageal and gastric cancer registry from the Comunidad Valenciana.

    Science.gov (United States)

    Escrig, Javier; Mingol, Fernando; Martí, Roberto; Puche, José; Trullenque, Ramón; Barreras, José Antonio; Asencio, Francisco; Aguiló, Javier; Navarro, José Manuel; Alberich, Carmen; Salas, Dolores; Lacueva, Francisco Javier

    2017-10-01

    To evaluate the initial results of the oesophagogastric cancer registry developed for the Sociedad Valenciana de Cirugía and the Health Department of the Comunidad Valenciana (Spain). Fourteen of the 24 public hospitals belonging to the Comunidad Valenciana participated. All patients with diagnosis of oesophageal or gastric carcinomas operated from January 2013 to December 2014 were evaluated. Demographic, clinical and pathological data were analysed. Four hundred and thirty-four patients (120 oesophageal carcinomas and 314 gastric carcinomas) were included. Only two hospitals operated more than 10 patients with oesophageal cancer per year. Transthoracic oesophaguectomy was the most frequent approach (84.2%) in tumours localized within the oesophagus. A total gastrectomy was performed in 50.9% patients with gastroesophageal junction (GOJ) carcinomas. Postoperative 30-day and 90-day mortality were 8% and 11.6% in oesophageal carcinoma and 5.9 and 8.6% in gastric carcinoma. Before surgery, middle oesophagus carcinomas were treated mostly (76,5%) with chemoradiotherapy. On the contrary, lower oesophagus and GOJ carcinomas were treated preferably with chemotherapy alone (45.5 and 53.4%). Any neoadjuvant treatment was administered to 73.6% of gastric cancer patients. Half patients with oesophageal carcinoma or gastric carcinoma received no adjuvant treatment. This registry revealed that half patients with oesophageal cancer were operated in hospitals with less than 10 cases per year at the Comunidad Valenciana. Also, it detected capacity improvement for some clinical outcomes of oesophageal and gastric carcinomas. Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Genetic heterogeneity of oesophageal cancer in high-incidence areas of southern and northern China.

    Directory of Open Access Journals (Sweden)

    Zhang Guohong

    Full Text Available BACKGROUND AND OBJECTIVE: Oesophageal cancer is one of the most common and deadliest cancers worldwide. Our previous population-based study reported a high prevalence of oesophageal cancer in Chaoshan, Guangdong Province, China. Ancestors of the Chaoshan population migrated from the Taihang Mountain region of north-central China, which is another high-incidence area for oesophageal cancer. The purpose of the present study was to obtain evidence of inherited susceptibility to oesophageal cancer in the Chaoshan population, with reference to the Taihang Mountain population, with the eventual goal of molecular identification of the disease genes. METHODS: We conducted familial correlation, commingling, and complex segregation analyses of 224 families from the Chaoshan population and 403 families from the Taihang population using the FPMM program of S.A.G.E. version 5.3.0. A second analysis focused on specific families having large numbers of affected individuals or early onset of the disease. RESULTS: For the general population, moderate sib-sib correlation was noticed for esophageal cancer. Additionally, brother-brother correlation was even higher. Commingling analyses indicated that a three-component distribution model best accounts for the variation in age of onset of oesophageal cancer, and that a multifactorial model provides the best fit to the general population data. An autosomal dominant mode and a dominant or recessive major gene with polygenic inheritance were found to be the best models of inherited susceptibility to oesophageal cancer in some large families. CONCLUSIONS: The current results provide evidence for inherited susceptibility to oesophageal cancer in certain high-risk groups in China, and support efforts to identify the susceptibility genes.

  17. Cisapride treatment for gastro-oesophageal reflux in children.

    Science.gov (United States)

    Augood, C; MacLennan, S; Gilbert, R; Logan, S

    2000-01-01

    Gastro-oesophageal reflux (GOR) is an extremely common and usually self limiting condition in infants. When treatment is required, Cisapride, a pro-kinetic agent, has been commonly prescribed for the symptomatic management of GOR. There have been recent reports of possibly serious adverse events e.g. an increased QTc interval, cardiac arrhythmias, and death, associated with the use of Cisapride. To determine the effectiveness of Cisapride for symptoms of GOR in children compared with placebo or any other non-surgical treatments. Searches were conducted of the Cochrane Central Trials Register and the specialised Trials register of the Cochrane Upper Gastrointestinal and Pancreatic Diseases Group, MEDLINE and Embase. Reference lists of relevant review articles and identified trials were scrutinised and forward citation searches were performed in the Science Citation Index on all trials identified. Randomised controlled trials that compared oral Cisapride therapy with placebo or with other non-surgical treatments for children with a diagnosis of GOR were included. Only studies in which Cisapride was administered orally for a minimum of one week and which documented at least one of the primary outcomes were included. The primary outcomes were defined as a change in symptoms at the end of treatment, presence of adverse events, occurrence of clinical complications, and weight gain. The secondary outcomes included physiological measures of GOR or histological evidence of oesophagitis. We dichotomised symptoms into 'same or worse' vs 'improved' and calculated summary odds ratios. Continuous measures of GOR (e.g. reflux index) were summarised as a weighted mean difference. All outcomes were analysed using a random effects method. Sensitivity analyses were also performed. Searches identified eight trials which met the inclusion criteria. Seven trials (a total of 236 participants) compared Cisapride with placebo. The odds ratio for 'same or worse' vs 'improved symptoms' at

  18. Achieving Presence through Evoked Reality

    Science.gov (United States)

    Pillai, Jayesh S.; Schmidt, Colin; Richir, Simon

    2013-01-01

    The sense of “Presence” (evolving from “telepresence”) has always been associated with virtual reality research and is still an exceptionally mystifying constituent. Now the study of presence clearly spans over various disciplines associated with cognition. This paper attempts to put forth a concept that argues that it’s an experience of an “Evoked Reality (ER)” (illusion of reality) that triggers an “Evoked Presence (EP)” (sense of presence) in our minds. A Three Pole Reality Model is proposed to explain this phenomenon. The poles range from Dream Reality to Simulated Reality with Primary (Physical) Reality at the center. To demonstrate the relationship between ER and EP, a Reality-Presence Map is developed. We believe that this concept of ER and the proposed model may have significant applications in the study of presence, and in exploring the possibilities of not just virtual reality but also what we call “reality.” PMID:23550234

  19. Evoked Electromyographically Controlled Electrical Stimulation

    Directory of Open Access Journals (Sweden)

    Mitsuhiro Hayashibe

    2016-07-01

    Full Text Available Time-variant muscle responses under electrical stimulation (ES are often problematic for all the applications of neuroprosthetic muscle control. This situation limits the range of ES usage in relevant areas, mainly due to muscle fatigue and also to changes in stimulation electrode contact conditions, especially in transcutaneous ES. Surface electrodes are still the most widely used in noninvasive applications.Electrical field variations caused by changes in the stimulation contact condition markedly affect the resulting total muscle activation levels. Fatigue phenomena under functional electrical stimulation (FES are also well known source of time-varying characteristics coming from muscle response under ES. Therefore it is essential to monitor the actual muscle state and assess the expected muscle response by ES so as to improve the current ES system in favour of adaptive muscle-response-aware FES control. To deal with this issue, we have been studying a novel control technique using evoked electromyography (eEMG signals to compensate for these muscle time-variances under ES for stable neuroprosthetic muscle control. In this perspective article, I overview the background of this topic and highlight important points to be aware of when using ES to induce the desired muscle activation regardless of the time-variance. I also demonstrate how to deal with the common critical problem of ES to move toward robust neuroprosthetic muscle control with the Evoked Electromyographically Controlled Electrical Stimulation paradigm.

  20. Hiatal hernia predisposes to nocturnal gastro-oesophageal reflux.

    Science.gov (United States)

    Karamanolis, Georgios; Polymeros, Dimitrios; Triantafyllou, Konstantinos; Adamopoulos, Adam; Barbatzas, Charalampos; Vafiadis, Irini; Ladas, Spiros D

    2013-06-01

    Nocturnal reflux has been associated with severe complications of gastro-oesophageal reflux disease and a poorer quality of life. Hiatal hernia predisposes to increased oesophageal acid exposure, but the effect on night reflux symptoms has never been investigated. The aim of the study was to investigate if hiatal hernia is associated with more frequent and severe night reflux symptoms. A total of 215 consecutive patients (110 male, mean age 52.6 ± 14.7 years) answered a detailed questionnaire on frequency and severity of specific day and night reflux symptoms. Subsequently, all patients underwent upper endoscopy and were categorized in two groups based on the endoscopic presence of hiatal hernia. Patients with hiatal hernia were more likely to have nocturnal symptoms compared to those without hiatal hernia (78.6 vs. 51.8%, p = 0.0001); 59.2% of patients with hiatal hernia reported heartburn and 60.2% regurgitation compared to 43.8 and 39.3% of those without hiatal hernia, respectively (p = 0.033 and p = 0.003). The proportions of patients with day heartburn or regurgitation were not significantly different between the two groups. Night heartburn and regurgitation were graded as significantly more severe by patients with hiatal hernia (4.9 ± 4.2 vs. 3.2 ± 3.7, p = 0.002, and 3.8 ± 4.2 vs. 2.2 ± 3.5, p = 0.001, respectively). Patients with hiatal hernia had more frequent weekly night heartburn and regurgitation compared to those without hiatal hernia (p = 0.004 and p = 0.008, respectively). More patients with hiatal hernia reported nocturnal reflux symptoms compared to those without hiatal hernia. Furthermore, nocturnal reflux symptoms were significantly more frequent and graded as significantly more severe in patients with presence of hiatal hernia rather than in those without hiatal hernia.

  1. Prognosis in adenocarcinomas of lower oesophagus, gastro-oesophageal junction and cardia evaluated by uPAR-immunohistochemistry

    DEFF Research Database (Denmark)

    Laerum, Ole Didrik; Ovrebo, Kjell; Skarstein, Arne

    2012-01-01

    Adenocarcinomas of lower oesophagus, gastro-oesophageal junction and cardia in humans are highly invasive tumours with poor prognosis. The localisation of urokinase-type plasminogen activator receptor (uPAR) was determined in 66 patients; 60 with adenocarcinomas and six cases with Barrett......'s oesophagus. uPAR was expressed in nearly all cases of invasive adenocarcinomas by populations of cancer cells, macrophages and myofibroblasts at both the invasion front and the tumour core. In areas with high-grade dysplasia or with Barrett's metaplasia adjacent to the tumour tissue, no u......PAR-positivity on immmunohistochemically stained specimens, a significant association was found between poor overall survival and high uPAR-score for cancer cells in the tumour core and for macrophages peripherally at the tumour invasion zone. In multivariate analysis, these two uPAR-scores were confirmed as highly significant prognostic...

  2. Esculetin, a natural coumarin compound, evokes Ca(2+) movement and activation of Ca(2+)-associated mitochondrial apoptotic pathways that involved cell cycle arrest in ZR-75-1 human breast cancer cells.

    Science.gov (United States)

    Chang, Hong-Tai; Chou, Chiang-Ting; Lin, You-Sheng; Shieh, Pochuen; Kuo, Daih-Huang; Jan, Chung-Ren; Liang, Wei-Zhe

    2016-04-01

    Esculetin (6,7-dihydroxycoumarin), a derivative of coumarin compound, is found in traditional medicinal herbs. It has been shown that esculetin triggers diverse cellular signal transduction pathways leading to regulation of physiology in different models. However, whether esculetin affects Ca(2+) homeostasis in breast cancer cells has not been explored. This study examined the underlying mechanism of cytotoxicity induced by esculetin and established the relationship between Ca(2+) signaling and cytotoxicity in human breast cancer cells. The results showed that esculetin induced concentration-dependent rises in the intracellular Ca(2+) concentration ([Ca(2+)]i) in ZR-75-1 (but not in MCF-7 and MDA-MB-231) human breast cancer cells. In ZR-75-1 cells, this Ca(2+) signal response was reduced by removing extracellular Ca(2+) and was inhibited by the store-operated Ca(2+) channel blocker 2-aminoethoxydiphenyl borate (2-APB). In Ca(2+)-free medium, pre-treatment with the endoplasmic reticulum Ca(2+) pump inhibitor thapsigargin (TG) abolished esculetin-induced [Ca(2+)]i rises. Conversely, incubation with esculetin abolished TG-induced [Ca(2+)]i rises. Esculetin induced cytotoxicity that involved apoptosis, as supported by the reduction of mitochondrial membrane potential and the release of cytochrome c and the proteolytic activation of caspase-9/caspase-3, which were partially reversed by pre-chelating cytosolic Ca(2+) with 1,2-bis(2-aminophenoxy)ethane-N,N,N',N'-tetraacetic acid-acetoxymethyl ester (BAPTA-AM). Moreover, esculetin increased the percentage of cells in G2/M phase and regulated the expressions of p53, p21, CDK1, and cyclin B1. Together, in ZR-75-1 cells, esculetin induced [Ca(2+)]i rises by releasing Ca(2+) from the ER and causing Ca(2+) influx through 2-APB-sensitive store-operated Ca(2+) entry. Furthermore, esculetin activated Ca(2+)-associated mitochondrial apoptotic pathways that involved G2/M cell cycle arrest. Graphical abstract The summary of esculetin-evoked

  3. Oesophageal lichen planus: the efficacy of topical steroid-based therapies.

    Science.gov (United States)

    Podboy, A; Sunjaya, D; Smyrk, T C; Murray, J A; Binder, M; Katzka, D A; Alexander, J A; Halland, M

    2017-01-01

    Oesophageal lichen planus is an idiopathic inflammatory disorder characterized by significant oesophageal stricturing. Oesophageal lichen planus is a rare, difficult to diagnose, and likely an under recognized disease. As a result, there is no standardized approach to therapy and treatment strategies vary. To examine the utility of topical steroid therapy (fluticasone or budesonide) in the management of oesophageal lichen planus. A retrospective chart review was conducted of patients diagnosed with oesophageal lichen planus who underwent baseline and follow up endoscopy pre and post topical steroid therapy between 1995 and 2016 at Mayo Clinic, Rochester MN. Average time between upper GI endoscopy was 3.2 months (0.7-11.7). Swallowed steroid preparations included fluticasone 880 μg twice daily or budesonide 3 mg twice daily. Patients were reviewed for symptomatic response to therapy using the Dakkak-Bennett dysphagia score (0-4, no dysphagia to total aphagia). Pre- and post-endoscopic findings were assessed. Additional baseline demographic, endoscopic, and histologic data were also obtained. We identified 40 patients who met the inclusion criteria. A significant reduction in median dysphagia score from 1 (0-4) to 0 (0-3) after steroid therapy (P lichen planus. © 2016 John Wiley & Sons Ltd.

  4. Objective determination of pH thresholds in the analysis of 24 h ambulatory oesophageal pH monitoring

    NARCIS (Netherlands)

    Weusten, B. L.; Roelofs, J. M.; Akkermans, L. M.; vanBerge-Henegouwen, G. P.; Smout, A. J.

    1996-01-01

    In 24 h oesophageal pH monitoring, pH 4 is widely but arbitrarily used as the threshold between reflux and non-reflux pH values. The aim of the study was to define pH thresholds objectively, based on Gaussian curve fitting of pH frequency distributions. Single-channel 24 h oesophageal pH monitoring

  5. Development of a method for estimating oesophageal temperature by multi-locational temperature measurement inside the external auditory canal

    Science.gov (United States)

    Nakada, Hirofumi; Horie, Seichi; Kawanami, Shoko; Inoue, Jinro; Iijima, Yoshinori; Sato, Kiyoharu; Abe, Takeshi

    2017-09-01

    We aimed to develop a practical method to estimate oesophageal temperature by measuring multi-locational auditory canal temperatures. This method can be applied to prevent heatstroke by simultaneously and continuously monitoring the core temperatures of people working under hot environments. We asked 11 healthy male volunteers to exercise, generating 80 W for 45 min in a climatic chamber set at 24, 32 and 40 °C, at 50% relative humidity. We also exposed the participants to radiation at 32 °C. We continuously measured temperatures at the oesophagus, rectum and three different locations along the external auditory canal. We developed equations for estimating oesophageal temperatures from auditory canal temperatures and compared their fitness and errors. The rectal temperature increased or decreased faster than oesophageal temperature at the start or end of exercise in all conditions. Estimated temperature showed good similarity with oesophageal temperature, and the square of the correlation coefficient of the best fitting model reached 0.904. We observed intermediate values between rectal and oesophageal temperatures during the rest phase. Even under the condition with radiation, estimated oesophageal temperature demonstrated concordant movement with oesophageal temperature at around 0.1 °C overestimation. Our method measured temperatures at three different locations along the external auditory canal. We confirmed that the approach can credibly estimate the oesophageal temperature from 24 to 40 °C for people performing exercise in the same place in a windless environment.

  6. New insights regarding the incidence, presentation and treatment options of aorto-oesophageal fistulation after thoracic endovascular aortic repair

    DEFF Research Database (Denmark)

    Czerny, Martin; Eggebrecht, Holger; Sodeck, Gottfried

    2014-01-01

    To review the incidence, clinical presentation, definite management and 1-year outcome in patients with aorto-oesophageal fistulation (AOF) following thoracic endovascular aortic repair (TEVAR).......To review the incidence, clinical presentation, definite management and 1-year outcome in patients with aorto-oesophageal fistulation (AOF) following thoracic endovascular aortic repair (TEVAR)....

  7. Alterations confined to the gastro-oesophageal junction: the relationship between low LOSP, TLOSRs, hiatus hernia and acid pocket

    NARCIS (Netherlands)

    Boeckxstaens, Guy E.

    2010-01-01

    The gastro-oesophageal junction is a specialised segment of the gut designed to prevent reflux of gastric contents into the oesophagus. This task is fulfilled by two structures, i.e. the lower oesophageal sphincter and the crural diaphragm, which generate a high pressure zone. Especially during low

  8. Gastro-oesophageal reflux in obese subjects: Influence of overweight, weight loss and chronic gastric balloon distension

    NARCIS (Netherlands)

    Mathus-Vliegen, E. M. H.; Tygat, G. N. J.

    2002-01-01

    Background: Gastro-oesophageal reflux is an obesity-related health risk assumed to improve after weight loss. Prolonged intragastric balloon distension might oppose this. The purpose of the study was to investigate the prevalence of gastro-oesophageal reflux in untreated obese subjects and to study

  9. Artefacts in 24-h pharyngeal and oesophageal pH monitoring: Is simplification of pH data analysis feasible?

    NARCIS (Netherlands)

    Mathus-Vliegen, E. M. H.; Smit, C. F.; Devriese, P. P.

    2004-01-01

    Background: Ambulatory 24-h dual-channel pharyngeal and oesophageal pH monitoring is the standard test for measuring gastro-oesophageal and gastropharyngeal reflux. Artefacts caused by the intake of food may result in falsely positive gastropharyngeal reflux, which necessitates a manual review of

  10. RECORDING OF VESTIBULAR EVOKED MYOGENIC POTENTIALS

    Directory of Open Access Journals (Sweden)

    A. A. Sazgar

    2006-05-01

    Full Text Available It has been shown recently that loud clicks evoke myogenic potentials in the tonically contracting sternocleidomastoid muscles. Studies have suggested that these potentials are of vestibular origin, especially of the saccule and inferior vestibular nerve. A pilot study was undertaken in our hospital to record vestibular evoked myogenic potentials (VEMP for the first time in Iran. Eighteen healthy volunteers (32 ears without history of otologic or vestibular disorders were subjected to the VEMP test. Twenty-one patients (26 ears with unilateral (6 patients and bilateral (5 patients high frequency sensorineural hearing loss with unknown etiology, acoustic neuroma (1 patient, Meniere’s disease (4 patients and unilateral low frequency sensorineural hearing loss without vestibular complaint (5 patients were also enrolled in this study. VEMP response to clicks was obtained from 84.4% of ears of healthy subjects. These subjects demonstrated short latency waves to click stimuli during tonic neck flexor activation. Mean latencies of first positive (p13 and first negative (n23 potentials in healthy subjects were 12.45 ± 1.9 ms and 20.8 ± 3.5 ms, respectively. Median latencies of these two potentials were 12.1 and 19.3 ms, respectively. We could record VEMP in 5 patients with unilateral and all patients with high and low frequency sensorineural hearing loss without vestibular complaint. In the patient with acoustic neuroma VEMP was absent on the affected side. This technique may offer a new method to evaluate otolith and sacculocollic pathways in human.

  11. Contact heat evoked potentials using simultaneous EEG and fMRI and their correlation with evoked pain

    Directory of Open Access Journals (Sweden)

    Atherton Duncan

    2008-12-01

    Full Text Available Abstract Background The Contact Heat Evoked Potential Stimulator (CHEPS utilises rapidly delivered heat pulses with adjustable peak temperatures to stimulate the differential warm/heat thresholds of receptors expressed by Aδ and C fibres. The resulting evoked potentials can be recorded and measured, providing a useful clinical tool for the study of thermal and nociceptive pathways. Concurrent recording of contact heat evoked potentials using electroencephalogram (EEG and functional magnetic resonance imaging (fMRI has not previously been reported with CHEPS. Developing simultaneous EEG and fMRI with CHEPS is highly desirable, as it provides an opportunity to exploit the high temporal resolution of EEG and the high spatial resolution of fMRI to study the reaction of the human brain to thermal and nociceptive stimuli. Methods In this study we have recorded evoked potentials stimulated by 51°C contact heat pulses from CHEPS using EEG, under normal conditions (baseline, and during continuous and simultaneous acquisition of fMRI images in ten healthy volunteers, during two sessions. The pain evoked by CHEPS was recorded on a Visual Analogue Scale (VAS. Results Analysis of EEG data revealed that the latencies and amplitudes of evoked potentials recorded during continuous fMRI did not differ significantly from baseline recordings. fMRI results were consistent with previous thermal pain studies, and showed Blood Oxygen Level Dependent (BOLD changes in the insula, post-central gyrus, supplementary motor area (SMA, middle cingulate cortex and pre-central gyrus. There was a significant positive correlation between the evoked potential amplitude (EEG and the psychophysical perception of pain on the VAS. Conclusion The results of this study demonstrate the feasibility of recording contact heat evoked potentials with EEG during continuous and simultaneous fMRI. The combined use of the two methods can lead to identification of distinct patterns of brain

  12. Effect of dietary sodium chloride on gastro-oesophageal reflux: a randomized controlled trial.

    Science.gov (United States)

    Aanen, Marissa C; Bredenoord, Albert J; Smout, André J P M

    2006-10-01

    It has been suggested that a high consumption of sodium chloride (NaCl) is associated with reflux symptoms. The objective of this study was to investigate the effect of increased dietary NaCl intake on gastro-oesophageal reflux and reflux mechanisms. In this double-blind, placebo-controlled, crossover study 10 healthy male subjects received 5 g NaCl or placebo in capsules per day for one week, after which concurrent manometric, pH and impedance monitoring was carried out for 4.5 h. Oesophageal acid exposure time (pH salt intake lowered LOS pressure overall and in the first postprandial hour (p<0.01). High dietary sodium intake does not increase gastro-oesophageal reflux in healthy volunteers, despite a decrease in LOS pressure.

  13. Outcomes at one-year post anastomosis from a national cohort of infants with oesophageal atresia.

    Directory of Open Access Journals (Sweden)

    Benjamin Allin

    Full Text Available We aimed to provide a contemporaneous assessment of outcomes at one-year post oesophageal atresia/tracheoesophageal fistula (OA-TOF repair, focussing particularly on post-operative complications. It is generally accepted that oesophageal stricture is the most common complication and causes significant morbidity. We also aimed to assess the efficacy of prophylactic anti-reflux medication (PARM in reducing stricture formation.A prospective, multi-centre cohort study of all infants live-born with oesophageal atresia in the United Kingdom and Ireland in 2008/9 was performed, recording clinical management and outcomes at one year. The effect of PARM on stricture formation in infants with the type-c anomaly was assessed using logistic regression analysis.151 infants were live-born with oesophageal atresia in the defined reporting period, 126 of whom had the type-c anomaly. One-year follow-up information was returned for 105 infants (70%; the mortality rate was 8.6% (95% CI 4.7-14.3%. Post-operative complications included anastomotic leak (5.4%, recurrent fistula (3.3% and oesophageal stricture (39%. Seventy-six (60% of those with type-c anomaly were alive at one-year with returned follow-up, 57(75% of whom had received PARM. Of these, 24 (42% developed a stricture, compared to 4 (21% of those who had not received PARM (adjusted odds ratio 2.60, 95% CI 0.71-9.46, p = 0.147.This study provides a benchmark for current outcomes and complication rates following OA-TOF repair, with oesophageal stricture causing significant morbidity. The use of PARM appeared ineffective in preventing strictures. This study creates enough doubt about the efficacy of PARM in preventing stricture formation to warrant further investigation of its use with a randomised controlled trial.

  14. Gastro-oesophageal reflux in infants. Evaluation of treatment by pH monitoring.

    Science.gov (United States)

    Vandenplas, Y; Sacré-Smits, L

    1987-09-01

    Forty bottle-fed babies, 4-12 weeks old, with clinical gastro-oesophageal reflux were studied. Continuous 24 h oesophageal pH monitoring in a prone position demonstrated a gastro-oesophageal reflux with all of the following parameters: reflux index, duration of the longest reflux episode, number of reflux episodes in 24 h, number of reflux episodes greater than 5 min in 24 h. Positional therapy (prone-antitrendelenburg position), applied to all infants, resulted in a normalization of these parameters in ten of them. The remaining 30 infants were treated with milk-thickening agents, as recommended by Carre. Nearly all (N = 25) showed an important clinical improvement. A third pH monitoring was performed after 10-14 days of treatment. In six infants the results were completely within normal ranges. In 24 infants a decrease in the number of reflux episodes was demonstrated, with a comparable reflux index and number of long lasting reflux episodes. The duration of the longest reflux episode however increased significantly (P less than 0.001). Drugs (domperidone, Gaviscon) added to the milk-thickening agents in these 24 children, led to normalization of pH tracings. Clinical symptoms were less severe or disappeared in all infants but one. We conclude that if positional therapy (prone-antitrendelenburg) does not correct gastro-oesophageal reflux in infants, pharmacological treatment should be applied. Milk-thickening agents alone can be effective in individual cases but should be prescribed with care as they can lead to more occult gastro-oesophageal reflux with episodes of longer duration, increasing the risk of oesophagitis or respiratory distress.

  15. Childhood body mass index in relation to future risk of oesophageal adenocarcinoma

    DEFF Research Database (Denmark)

    Cook, M B; Freedman, N D; Gamborg, M

    2015-01-01

    BACKGROUND: Middle-aged obese adults are at substantially elevated risk of oesophageal adenocarcinoma. It is unclear whether this risk originates earlier in life. METHODS: We assessed associations between childhood body mass index (BMI) and height-measured annually between ages 7 and 13-with adult...... the mechanisms require further investigation, our findings provide additional evidence for the long-term health risks of childhood obesity....... oesophageal adenocarcinoma in a cohort from the Copenhagen School Health Records Register. Analyses included 255 053 children born during 1930-1971. Danish Cancer Registry linkage provided outcomes. We calculated hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox proportional hazards regression...

  16. The management of acute oesophageal obstruction from a food bolus. Can we be more conservative?

    Science.gov (United States)

    Tsikoudas, A; Kochillas, X; Kelleher, R J; Mills, R

    2005-07-01

    The objective was to assess the number of patients with acute oesophageal bolus obstruction that resolves spontaneously and to aid the identification of the best practice. This prospective and retrospective case series study at a teaching hospital and a district general hospital in Scotland, UK, involved 37 patients with acute oesophageal obstruction from a food bolus who were observed for 24 h from the beginning of symptoms. The bolus passed spontaneously in 54% of the patients during the observational period. A short observational period following the admission of patients with acute food bolus obstruction is reasonable as it may reduce exposure to surgical morbidity and decrease inpatient stay.

  17. Reliability of histologic assessment in patients with eosinophilic oesophagitis.

    Science.gov (United States)

    Warners, M J; Ambarus, C A; Bredenoord, A J; Verheij, J; Lauwers, G Y; Walsh, J C; Katzka, D A; Nelson, S; van Viegen, T; Furuta, G T; Gupta, S K; Stitt, L; Zou, G; Parker, C E; Shackelton, L M; D Haens, G R; Sandborn, W J; Dellon, E S; Feagan, B G; Collins, M H; Jairath, V; Pai, R K

    2018-02-20

    The validity of the eosinophilic oesophagitis (EoE) histologic scoring system (EoEHSS) has been demonstrated, but only preliminary reliability data exist. Formally assess the reliability of the EoEHSS and additional histologic features. Four expert gastrointestinal pathologists independently reviewed slides from adult patients with EoE (N = 45) twice, in random order, using standardised training materials and scoring conventions for the EoEHSS and additional histologic features agreed upon during a modified Delphi process. Intra- and inter-rater reliability for scoring the EoEHSS, a visual analogue scale (VAS) of overall histopathologic disease severity, and additional histologic features were assessed using intra-class correlation coefficients (ICCs). Almost perfect intra-rater reliability was observed for the composite EoEHSS scores and the VAS. Inter-rater reliability was also almost perfect for the composite EoEHSS scores and substantial for the VAS. Of the EoEHSS items, eosinophilic inflammation was associated with the highest ICC estimates and consistent with almost perfect intra- and inter-rater reliability. With the exception of dyskeratotic epithelial cells and surface epithelial alteration, ICC estimates for the remaining EoEHSS items were above the benchmarks for substantial intra-rater, and moderate inter-rater reliability. Estimation of peak eosinophil count and number of lamina propria eosinophils were associated with the highest ICC estimates among the exploratory items. The composite EoEHSS and most component items are associated with substantial reliability when assessed by central pathologists. Future studies should assess responsiveness of the score to change after a therapeutic intervention to facilitate its use in clinical trials. © 2018 John Wiley & Sons Ltd.

  18. Ocular Vestibular Evoked Myogenic Potentials

    Directory of Open Access Journals (Sweden)

    Felipe, Lilian

    2014-01-01

    Full Text Available Introduction Diagnostic testing of the vestibular system is an essential component of treating patients with balance dysfunction. Until recently, testing methods primarily evaluated the integrity of the horizontal semicircular canal, which is only a portion of the vestibular system. Recent advances in technology have afforded clinicians the ability to assess otolith function through vestibular evoked myogenic potential (VEMP testing. VEMP testing from the inferior extraocular muscles of the eye has been the subject of interest of recent research. Objective To summarize recent developments in ocular VEMP testing. Results Recent studies suggest that the ocular VEMP is produced by otolith afferents in the superior division of the vestibular nerve. The ocular VEMP is a short latency potential, composed of extraocular myogenic responses activated by sound stimulation and registered by surface electromyography via ipsilateral otolithic and contralateral extraocular muscle activation. The inferior oblique muscle is the most superficial of the six extraocular muscles responsible for eye movement. Therefore, measurement of ocular VEMPs can be performed easily by using surface electrodes on the skin below the eyes contralateral to the stimulated side. Conclusion This new variation of the VEMP procedure may supplement conventional testing in difficult to test populations. It may also be possible to use this technique to evaluate previously inaccessible information on the vestibular system.

  19. Evoked cavernous activity: neuroanatomic implications.

    Science.gov (United States)

    Yilmaz, U; Vicars, B; Yang, C C

    2009-01-01

    We investigated the autonomic innervation of the penis by using evoked cavernous activity (ECA). We recruited seven men with thoracic spinal cord injury (SCI) and sexual dysfunction, and six men who were scheduled to have pelvic surgery (PS), specifically non-nerve-sparing radical cystoprostatectomy. In the PS patients, ECA was performed both pre- and postoperatively. The left median nerve was electrically stimulated and ECA was recorded with two concentric electromyography needles placed into the right and left cavernous bodies. We simultaneously recorded hand and foot sympathetic skin responses (SSRs) as controls. In the SCI group, all but one patient had reproducible hand SSRs. None of these patients had ECA or foot SSRs. All the PS patients had reproducible ECA and SSRs, both preoperatively and postoperatively. There was no difference in the latency and amplitude measurements of ECA and SSRs in the postoperative compared with that of the pre-operative period (P>0.05). In conclusion, ECA is absent in men with SCI above the sympathetic outflow to the genitalia. In men, after radical pelvic surgery, ECA is preserved, indicating the preservation of sympathetic fibers.

  20. Hypopharyngeal cancer associated with synchronous oesophageal cancer: risk factors and benefits of image-enhanced endoscopic screening.

    Science.gov (United States)

    Ni, X-G; Zhang, Q-Q; Zhu, J-Q; Wang, G-Q

    2017-12-14

    To explore the risk factors associated with the occurrence of synchronous oesophageal cancer in patients with hypopharyngeal cancer, and to investigate the roles of image-enhanced endoscopic screening in the prediction and diagnosis of early oesophageal cancer. The clinical characteristics of patients with hypopharyngeal cancer (n = 160) were analysed. All patients underwent laryngoscopic and gastroscopic examination using image-enhanced endoscopic techniques before treatment. Of 160 hypopharyngeal cancer patients, 43 (27 per cent) had synchronous oesophageal cancer. Heavy drinking (odds ratio = 4.787, p = 0.029) and local invasion of three or more anatomical sites (odds ratio = 14.391, p = 0.000) were independent risk factors for synchronous oesophageal cancer. Narrow-band imaging laryngoscopy could detect more invaded anatomical sites than ordinary white light endoscopy (t = 8.532, p = 0.000). More early oesophageal cancer cases were detected with Lugol chromoendoscopy than with non-Lugol iodine staining examination (χ2 = 4.925, p = 0.026). Synchronous oesophageal cancer is common in patients with hypopharyngeal cancer. The heavy drinking patients with hypopharyngeal cancer should undergo intensive monitoring. Image-enhanced endoscopic screening is helpful in the prediction and early detection of second primary oesophageal cancer.

  1. Transient evoked otoacoustic emissions testing for screening of sensorineural deafness in puppies

    OpenAIRE

    McBrearty, A; Penderis, J

    2011-01-01

    Background: Transient evoked otoacoustic emissions (TEOAE) are widely used for human neonatal deafness screening, but have not been reported for clinical use in dogs. \\ud \\ud Hypothesis/Objectives: To investigate the feasibility of TEOAE testing in conscious puppies and the ability of TEOAE testing to correctly identify deaf and hearing ears, as defined by brainstem auditory evoked response (BAER). \\ud \\ud Animals: Forty puppies from 10 litters. \\ud \\ud Methods: Prospective study on puppies p...

  2. Diet-related inflammation and oesophageal cancer by histological type: a nationwide case-control study in Sweden.

    Science.gov (United States)

    Lu, Yunxia; Shivappa, Nitin; Lin, Yulan; Lagergren, Jesper; Hébert, James R

    2016-06-01

    This project sought to test the role of diet-related inflammation in modulating the risk of oesophageal cancer. A nationwide population-based case-control study was conducted from 1 December 1994 through 31 December 1997 in Sweden. All newly diagnosed patients with adenocarcinoma of the oesophagus or gastroesophageal junction and a randomly selected half of patients with oesophageal squamous cell carcinoma were eligible as cases. Using the Swedish Registry of the Total Population, the control group was randomly selected from the entire Swedish population and frequency-matched on age (within 10 years) and sex. The literature-derived dietary inflammatory index (DII) was developed to describe the inflammatory potential of diet. DII scores were computed based on a food frequency questionnaire. Higher DII scores indicate more pro-inflammatory diets. Odds ratios and 95 % confidence intervals (CI) were computed to assess risk associated between DII scores and oesophageal cancer using logistic regression adjusted by potential confounders. In total, 189 oesophageal adenocarcinomas, 262 gastroesophageal junctional adenocarcinomas, 167 oesophageal squamous cell carcinomas, and 820 control subjects were recruited into the study. Significant associations with DII were observed for oesophageal squamous cell carcinoma (ORQuartile4vs1 4.35, 95 % CI 2.24, 8.43), oesophageal adenocarcinoma (ORQuartile4vs1 3.59, 95 % CI 1.87, 6.89), and gastroesophageal junctional adenocarcinoma (ORQuartile4vs1 2.04, 95 % CI 1.24, 3.36). Significant trends across quartiles of DII were observed for all subtypes of oesophageal cancer. Diet-related inflammation appears to be associated with an increased risk of oesophageal cancer, regardless of histological type.

  3. The efficacy of sodium alginate (Gaviscon) for the treatment of gastro-oesophageal reflux in preterm infants.

    Science.gov (United States)

    Corvaglia, L; Aceti, A; Mariani, E; De Giorgi, M; Capretti, M G; Faldella, G

    2011-02-01

    Gastro-oesophageal reflux is common in preterm newborns; at present, no studies have evaluated the efficacy of sodium alginate in this population. To evaluate the effect of sodium alginate on gastro-oesophageal reflux features in preterm newborns by combined pH and impedance monitoring (pH-MII). Thirty-two symptomatic preterm newborns underwent a 24 h pH-MII, during which each baby was fed eight times. Sodium alginate was given four times at alternate meals [drug-given (DG) vs. drug-free (DF) meals]. Gastro-oesophageal reflux features (i.e. number, acidity, duration and height of gastro-oesophageal reflux) after DG and DF meals were compared by Wilcoxon signed ranks test. Sodium alginate significantly decreased the number of acid gastro-oesophageal reflux detected either by pH monitoring (DG vs. DF: median 17.00 vs. 29.00, P = 0.002) and MII (DG vs. DF: 4.0 vs. 6.00, P = 0.050), and also acid oesophageal exposure (DG vs. DF: 4.0% vs. 7.6%, P = 0.030), without any influence on non-acid gastro-oesophageal reflux. Furthermore, it decreased the number of gastro-oesophageal reflux reaching proximal oesophagus (DG vs. DF: 5.50 vs. 7.50, P = 0.030). The use of sodium alginate in preterm infants seems to be promising, because this drug decreases gastro-oesophageal reflux acidity and height with the advantage of a nonsystemic way of action and a more favourable safety profile over H2 blockers and PPIs. © 2010 Blackwell Publishing Ltd.

  4. Adenocarcinomas of the gastro-oesophageal junction : from gene to clinic

    NARCIS (Netherlands)

    B.P.L. Wijnhoven (Bas)

    2001-01-01

    textabstractAdenocarcinomas of the gastro-oesophageal junction are thought to arise from premalignant Barretr's epithelium. Barrett's epithelium is columnar epithelium that has replaced the normal squamous cell lining of the oesopha",ous. This metaplastic change is driven by

  5. The contribution of fetal MR imaging to the assessment of oesophageal atresia

    Energy Technology Data Exchange (ETDEWEB)

    Hochart, V.; Verpillat, P.; Bigot, J.; Avni, F.E. [CHRU Lille, Jeanne de Flandre Hospital, Department of Pediatric Radiology, Lille (France); Langlois, C. [EA2694 USDL CHRU Lille, Department of Biostatistics, Lille (France); Garabedian, C.; Debarge, V.H. [CHRU Lille, Jeanne de Flandre Hospital, Department of Obstetrics and Gynecology, Lille (France); Sfeir, R. [CHRU Lille, Jeanne de Flandre Hospital, Department of Pediatric Surgery, Reference Center for Congenital Anomalies of the Esophagus, Lille (France)

    2014-10-11

    Present challenges are to improve the diagnosis rate of oesophageal atresia (OA) and evaluate as completely as possible a fetus affected by OA, specifically the type of OA and the length of the gap. Our aim was to evaluate the accuracy of fetal MR imaging (fMRI) for diagnosis of OA. We reviewed fMRI performed because of sonographic suspicion of an OA. The signs reviewed included stomach size, ''pouch sign'', bowing of the trachea and visualization of the lower oesophageal lumen. The fetuses were assigned by consensus as having or not having EA, as well as having a tracheaoesophageal fistula (TOF). All findings were correlated with postnatal data. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated. Se, Sp, PPV and NPV of the technique were respectively 91 %, 100 %, 100 % and 88 %. The presence of the pouch sign yielded corresponding values of 82 %, 100 %, 100 % and 78 %. Mid-tracheal bowing was correlated positively with EA. The type of atresia was correctly evaluated in 90 % of patients. fMRI is useful for the diagnosis of EA through the visualization of the oesophageal pouch or through associated signs such as tracheal bowing. Visualization of the lower oesophageal lumen seems to be a good sign of TEF. (orig.)

  6. Living with incurable oesophageal cancer. A phenomenological hermeneutical interpretation of patient stories

    DEFF Research Database (Denmark)

    Missel, Malene; Birkelund, Regner

    2010-01-01

    , Løgstrup, Merleau-Ponty, Ricoeur, Benner & Wrubel, and on empirical research. CONCLUSIONS: Based on the phenomena in the ill person's life world brought about by analysis, it seems that incurably ill oesophageal cancer patients find themselves in a complex life situation, in which they need more than...

  7. Effect of coffee on gastro-oesophageal reflux in patients with reflux disease and healthy controls

    NARCIS (Netherlands)

    Boekema, PJ; Samsom, M; Smout, AJP

    1999-01-01

    Background Many patients with gastro-oesophageal reflux disease (GORD) report that coffee aggravates their symptoms and doctors tend to discourage its use in GORD. Objective To assess the effect of coffee ingestion on gastro-oesophageaI acid reflux. Design A randomized, controlled, crossover study.

  8. Gastro-oesophageal reflux: An overview of the cost-effectiveness of ...

    African Journals Online (AJOL)

    Patients who suffer from gastro-oesophageal reflux disease. (GORD) suffer from acid heartburn (dyspepsia) due to the reflux of stomach acid into the distal part of the oesophagus. Drug management is aimed at decreasing the amount of stomach acid that enters the distal oesophagus, usually by increasing the rate at which ...

  9. Carbon-11 choline or FDG-PET for staging of oesophageal cancer?

    NARCIS (Netherlands)

    Jager, PL; Que, TH; Vaalburg, W; Pruim, J; Elsinga, P; Plukker, JT

    2001-01-01

    We investigated the feasibility of using carbon-11 choline (CHOL) positron emission tomography (PET) for the staging of oesophageal cancer, in comparison with fluorine-18 fluorodeoxyglucose (FDG) PET, using histopathological findings as the gold standard. Eighteen patients were studied: 16 patients

  10. Corpus gastritis in patients with endoscopic diagnosis of reflux oesophagitis and Barrett's oesophagus.

    NARCIS (Netherlands)

    Laheij, R.J.F.; Rossum, L.G.M. van; Boer, W.A. de; Jansen, J.B.M.J.

    2002-01-01

    BACKGROUND: A high level of gastric acid secretion is considered to be a risk factor for reflux oesophagitis or Barrett's oesophagus. Corpus gastritis may have a protective effect on the oesophagus, because of decreased gastric acid output. AIM: To determine if corpus gastritis is associated with

  11. Beneficial effect of omeprazole in a patient with severe bronchial asthma and gastro-oesophageal reflux

    NARCIS (Netherlands)

    Depla, A. C.; Bartelsman, J. F.; Roos, C. M.; Tytgat, G. N.; Jansen, H. M.

    1988-01-01

    A 25-yr-old man suffered from severe nocturnal asthma, which was shown to be provoked by pathological gastro-oesophageal reflux. A dramatic, immediate improvement of his pulmonary condition was achieved by treatment with omeprazole after failure of other therapeutic measures, including high doses of

  12. Relationships between air swallowing, intragastric air, belching and gastro-oesophageal reflux

    NARCIS (Netherlands)

    Bredenoord, A. J.; Weusten, B. L. A. M.; Timmer, R.; Akkermans, L. M. A.; Smout, A. J. P. M.

    2005-01-01

    BACKGROUND: With each swallow a certain amount of air is transported to the stomach. The stomach protects itself against excessive distention by swallowed air through belching (gas reflux). The mechanism of belching (transient lower oesophageal sphincter relaxation) is also one of the mechanisms

  13. Relationships between air swallowing, intragastric air, belching and gastro-oesophageal reflux

    NARCIS (Netherlands)

    Bredenoord, AJ; Weusten, BLAM; Timmer, R; Akkermans, LMA; Smout, AJPM

    Background: With each swallow a certain amount of air is transported to the stomach. The stomach protects itself against excessive distention by swallowed air through belching (gas reflux). The mechanism of belching (transient lower oesophageal sphincter relaxation) is also one of the mechanisms

  14. Current Evaluation of Upper Oesophageal Sphincter Opening in Dysphagia Practice: An International SLT Survey

    Science.gov (United States)

    Regan, Julie; Walshe, Margaret; McMahon, Barry P.

    2012-01-01

    Background: The assessment of adequate upper oesophageal sphincter (UOS) opening during swallowing is an integral component of dysphagia evaluation. Aims: To ascertain speech and language therapists' (SLTs) satisfaction with current methods for assessing UOS function in people with dysphagia and to identify challenges encountered by SLTs with UOS…

  15. Prolonged measurement of lower oesophageal sphincter function in patients with intestinal metaplasia at the oesophagogastric junction

    NARCIS (Netherlands)

    Wolf, C; Timmer, R; Breumelhof, R; Seldenrijk, CA; Smout, AJPM

    Background and aims-It has been shown that gastro-oesophageal reflux plays a role in the pathogenesis of intestinal metaplasia (IM) limited to the oesophagogastric junction (OGJ), similar to the pathogenesis of IM in long segments of columnar lined oesophagus. The aim of this study was to examine

  16. Prognostic value of nodal micrometastases in patients with cancer of the gastro-oesophageal junction

    NARCIS (Netherlands)

    Heeren, PAM; Kelder, W; Blondeel, [No Value; van Westreenen, HL; Hollema, H; Plukker, JT

    Aims. Aim of this study was to examine the presence and the prognostic impact of immunohistochemically identified nodal micrometastases in patients with astro-oesophageal junction (GEJ) carcinomas. Methods. Between January 1988 and December 2000, 148 patients underwent a radical (R0) resection with

  17. Psychometric evaluation of a daily gastro-oesophageal reflux disease symptom measure

    DEFF Research Database (Denmark)

    Bytzer, Peter; Reimer, Christine; Smith, Gary

    2017-01-01

    OBJECTIVE: The objective of this study was to evaluate the validity of the Heartburn Reflux Dyspepsia Questionnaire (HRDQ), a newly developed measure of gastro-oesophageal reflux disease (GORD) symptoms. Specifically, the HRDQ was developed for patients, who still experience symptoms with proton ...

  18. The influence of Helicobacter pylori on oesophageal acid exposure in GERD during acid suppressive therapy

    NARCIS (Netherlands)

    Peters, FTM; Kuipers, EJ; Ganesh, S; Sluiter, WJ; Klinkenberg-Knol, EC; Lamers, CBHW; Kleibeuker, JH

    Background: Helicobacter pylori exaggerates the effect of acid suppressive drugs on intragastric pH. It is unknown whether this is relevant for the treatment of GERD. Aim: To compare oesophageal acid exposure and symptoms in H. pylori-negative and H. pylori-positive GERD patients during low and

  19. Dog Bite – A Rare Cause Of Oesophageal Injury | Arif | South African ...

    African Journals Online (AJOL)

    Though rabies has been successfully controlled in some provinces, dog bite is a common problem encountered in the Accident and Emergency (A & E) departments of South Africa. In our experience, dog bites are usually from police dog units or a neighbour's dog. Oesophageal injury is very lethal if not treated early.

  20. Ifosfamide in advanced adenocarcinoma of the oesophagus or oesophageal-gastric junction area

    NARCIS (Netherlands)

    T.C. Kok (Tjebbe); A. van der Gaast (Ate); T.A.W. Splinter (Ted); H.W. Tilanus (Hugo)

    1991-01-01

    markdownabstractAbstract 25 previously untreated patients with inoperable or metastatic adenocarcinoma of the oesophagus or oesophageal-gastric junction area were treated with ifosfamide 6 g/m2 over 48 hours, combined with mesna 6 g/m2. 1 complete response and 1 partial response were seen among

  1. Combined endobronchial and oesophageal endosonography for the diagnosis and staging of lung cancer

    DEFF Research Database (Denmark)

    Vilmann, Peter; Clementsen, Paul Frost; Colella, Sara

    2015-01-01

    New guidelines for combined endobronchial and oesophageal mediastinal nodal staging of lung cancer. This is an official guideline of the European Society of Gastrointestinal Endoscopy (ESGE), produced in cooperation with the European Respiratory Society (ERS) and the European Society of Thoracic...

  2. Role of the insulin-like growth factor 1 axis and visceral adiposity in oesophageal adenocarcinoma.

    LENUS (Irish Health Repository)

    Donohoe, C L

    2012-03-01

    Epidemiological studies have linked obesity with many cancers. The insulin-like growth factor (IGF) 1 axis may be an important mediator in obesity-associated cancer. This study examined the relationship between IGF-1 and its receptor (IGF-1R) in oesophageal adenocarcinoma, a cancer strongly linked to obesity.

  3. Is oesophageal stenting for cancer the answer? A report from a ...

    African Journals Online (AJOL)

    Patients and methods. We retrospectively reviewed the data on 30 patients seen between February 2005 and January 2008. All presented with inoperable oesophageal cancer and were palliated with either stenting (N=18) or radiotherapy (N=12). We compared number of admissions, length of hospital stay and time from ...

  4. Diaphragmatic hernia following oesophagectomy for oesophageal cancer – Are we too radical?

    Directory of Open Access Journals (Sweden)

    F. Argenti

    2016-03-01

    Conclusion: This case series investigated the recommended extent of hiatal dissection in oesophageal surgery. Currently there is no clear guidance available on this subject and further studies are needed to ascertain the optimum resection margin that results in the best balance of oncological parameters vs. post operative morbidity.

  5. Expression of hexokinases and glucose transporters in treated and untreated oesophageal adenocarcinoma

    NARCIS (Netherlands)

    Fonteyne, Philippe; Casneuf, Veerle; Pauwels, Patrick; Van Damme, Nancy; Peeters, Marc; Dierckx, Rudi; Van de Wiele, Christophe

    The aim of this study was to assess the expression pattern of the high glucose affinity glucose transporters GLUT 1, 2, 3, 4, 8 and 9 and of hexokinases I, II and III in newly diagnosed oesophageal adenocarcinoma by means of immunohistochemistry. Twenty patients eligible to undergo primary surgery

  6. Hospital of diagnosis and probability to receive a curative treatment for oesophageal cancer

    NARCIS (Netherlands)

    Koeter, M.; van Steenbergen, L. N.; Lemmens, V. E. P. P.; Rutten, H.J.; Roukema, J. A.; Wijnhoven, B. P. L.; Nieuwenhuijzen, G. A. P.

    2014-01-01

    Background Surgical treatment of oesophageal cancer in the Netherland is performed in high volume centres. However, the decision to refer patients for curative surgery is made in the referring hospital of diagnosis. The objective of this study was to determine the influence of hospital of diagnosis

  7. Endoscopic Sclerotherapy for Bleeding Oesophageal Varices: Experience in Gezira State, Sudan

    Directory of Open Access Journals (Sweden)

    Moawia Elbalal Mohammed

    2011-01-01

    Full Text Available Introduction Bleeding due to oesophageal varices is the most common cause of upper gastrointestinal tract haemorrhage in Gezira State, Central Sudan. Endoscopic injection sclerotherapy (EST is a valuable therapeutic modality for the management of variceal bleeding. Other options for treatment such as variceal band ligation are either expensive or unavailable. Objectives A retrospective study to evaluate the outcome of (EST in the management of bleeding oesophageal varices due to portal hypertension in Gezira State, the centre of a developing country, Sudan. Methods A total of 1073 patients, during 2001-2010, were carefully selected particularly those with bleeding oesophageal varices consequent to portal hypertension. EST was performed using a standard technique and ethanolamine oleate (5% was utilized as sclerosing agent. Results There were 777 males (72.4% and 296 females (27.6% in a ratio of 2.6. The causes of portal hypertension were found to be schistosomal periportal fibrosis (PPF in 1001 (93.3% patients, liver cirrhosis in 60 (5.5% mixed PPF and cirrhosis in seven (0.7% and portal vein thrombosis in five (0.5% patients. Full obliteration of varices required a mean of four sessions with a range of 2-6. In the present study 350 (32.6% patients have been followed up until complete sclerosis of varices. Conclusion This study provides evidence that endoscopic injection sclerotherapy is an important component in the management of bleeding oesophageal varices caused by hypertension. It is a safe and effective procedure.

  8. Comparison of the incidence of oesophageal cancer in two 6-year ...

    African Journals Online (AJOL)

    Conclusion: Reasons for the decline shown here are unknown as patient risk factors were not available. Furthermore, major healthcare centres were not included. These are points for future investigation. The incidence of oesophageal cancer has decreased since 2001, owing to the decrease in SCC in African males and ...

  9. Is oesophageal stenting for cancer the answer? A report from a ...

    African Journals Online (AJOL)

    socio-economic reasons. Patients who were stented immediately had a dramatic decrease in hospital stay and obtained immediate relief from dysphagia. Our study focuses on the short median survival of patients with end-stage oesophageal cancer, where it has been shown that patients who receive brachytherapy or ...

  10. Induced viscosity fibre system for the treatment or prevention of gastro-oesophageal reflux (gor)

    NARCIS (Netherlands)

    Belle, F.N.; Harthoorn, L.F.; Venema, P.; Choi, W.M.C.

    2014-01-01

    The invention pertains to the use of pectin and alginate in the manufacture of a liquid nutritional composition in the treatment or prevention of gastro-oesophageal reflux in a patient, said composition comprising pectin and alginate, said composition exhibiting a maximum gel strength at a pH in the

  11. Evoked potentials in neuroinfections in children

    Directory of Open Access Journals (Sweden)

    V. N. Komantsev

    2013-01-01

    Full Text Available We present the results of the neurophysiological study in which 95 children with viral encephalitis and 30 children with meningitis (age from 2 up to 17 years undergo evoked potentials investigation. Some specific features of evoked potentials in neuroinfections have been shown to correlate with the course of disease and the age of the patients. We give a description of a logistic model of predicting outcomes in such patients by complex diagnostic method. We have found that evoked potentials may be successfully implemented in correcting the therapeutic strategies. Study of evoked potentials in neuroinfections in children can define the severity and extent of lesions and help to identify subclinical dysfunction and monitor the recovery processes under the therapy.

  12. Visual Evoked Potentials in Rett Syndrome

    Directory of Open Access Journals (Sweden)

    J. Gordon Millichap

    2015-11-01

    Full Text Available Investigators from the Boston Children's Hospital recorded pattern-reversal visual evoked potentials (VEPs in Mecp2 heterozygous female mice and in 34 girls with Rett syndrome (RTT.

  13. Changes in treatment and outcome of oesophageal cancer in Denmark between 2004 and 2013.

    Science.gov (United States)

    Kjaer, D W; Larsson, H; Svendsen, L B; Jensen, L S

    2017-09-01

    Since 2003, care for patients with oesophageal cancer has been centralized in a few dedicated centres in Denmark. The aim of this study was to assess changes in the treatment and outcome of patients registered in a nationwide database. All patients diagnosed with oesophageal cancer or cancer of the gastro-oesophageal junction who underwent oesophagectomy in Denmark between 2004 and 2013, and who were registered in the Danish clinical database of carcinomas in the oesophagus, gastro-oesophageal junction and stomach (DECV database) were included. Quality-of-care indicators, including number of lymph nodes removed, anastomotic leak rate, 30- and 90-day mortality, and 2- and 5-year overall survival, were assessed. To compare quality-of-care indicators over time, the relative risk (RR) was calculated using a multivariable log binomial regression model. Some 6178 patients were included, of whom 1728 underwent oesophagectomy. The overall number of patients with 15 or more lymph nodes in the resection specimen increased from 38·1 per cent in 2004 to 88·7 per cent in 2013. The anastomotic leak rate decreased from 14·8 to 7·6 per cent (RR 0·66, 95 per cent c.i. 0·43 to 1·01). The 30-day mortality rate decreased from 4·5 to 1·7 per cent (RR 0·51, 0·22 to 1·15) and the 90-day mortality rate from 11·0 to 2·9 per cent (RR 0·46, 0·26 to 0·82). There were no statistically significant changes in 2- or 5-year survival rates over time. Indicators of quality of care have improved since the centralization of oesophageal cancer treatment in Denmark. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

  14. Oesophageal strictures caused by the ingestion of corrosive agents: effectiveness of balloon dilatation in children

    Energy Technology Data Exchange (ETDEWEB)

    Doo, E.-Y. [Department of Radiology, Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center (Korea, Republic of); Shin, J.H. [Department of Radiology, Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center (Korea, Republic of)], E-mail: jhshin@amc.seoul.kr; Kim, J.H.; Song, H.-Y. [Department of Radiology, Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center (Korea, Republic of)

    2009-03-15

    Aim: To evaluate the safety and clinical effectiveness of balloon dilatation in children for oesophageal strictures caused by the ingestion of corrosive agents. Materials and methods: The study comprised 11 children (median age 6 years; range 1-14 years) with oesophageal strictures caused by corrosive agents, who underwent a total of 36 balloon dilatation sessions. The technical and clinical success, recurrence of dysphagia, complications, and primary and secondary patency rates were retrospectively evaluated. Results: Technical success was achieved in 91% of patients and in 97% of balloon dilatation sessions. Clinical success (defined as improved food intake and reduced dysphagia within 1 month of the first balloon dilatation session) was achieved in 64% of patients (7/11). During the mean 35-month follow-up period (range 1-89 months), 10 (91%) patients experienced recurrence. Oesophageal rupture (types 1 or 2) occurred in 45% of patients and in 31% of balloon dilatation sessions. Primary patency rates at 6 months and 1, 2, 3, 4, and 5 years were 36, 27, 14, 14, 14, and 14%, respectively. Secondary patency rates at 6 months and 1, 2, 3, 4, and 5 years were 82, 82, 82, 56, 42, and 42%, respectively. The secondary patency rate was higher than the primary patency rate (p < 0.05). Conclusion: The present study examined oesophageal balloon dilatation for paediatric oesophageal strictures caused by the ingestion of corrosive agents. Although the technical success rate was high and there were no deaths, the clinical success rate was low owing to a high recurrence rate. However, repeated balloon dilatations resulted in an acceptable secondary patency rate.

  15. The Role of Odor-Evoked Memory in Psychological and Physiological Health

    Directory of Open Access Journals (Sweden)

    Rachel S. Herz

    2016-07-01

    Full Text Available This article discusses the special features of odor-evoked memory and the current state-of-the-art in odor-evoked memory research to show how these unique experiences may be able to influence and benefit psychological and physiological health. A review of the literature leads to the conclusion that odors that evoke positive autobiographical memories have the potential to increase positive emotions, decrease negative mood states, disrupt cravings, and reduce physiological indices of stress, including systemic markers of inflammation. Olfactory perception factors and individual difference characteristics that would need to be considered in therapeutic applications of odor-evoked-memory are also discussed. This article illustrates how through the experimentally validated mechanisms of odor-associative learning and the privileged neuroanatomical relationship that exists between olfaction and the neural substrates of emotion, odors can be harnessed to induce emotional and physiological responses that can improve human health and wellbeing.

  16. High oesophageal web formation in association with heterotopic gastric mucosa (the gastric inlet patch): a small case series

    Science.gov (United States)

    Ainley, Eric J

    2011-01-01

    Background Upper oesophageal webs or rings have rarely been reported in association with heterotopic gastric mucosa (HGM). Objective To describe the finding of oesophageal webs in association with HGM. Design Small case series. Setting Patients presenting with dysphagia to an open access hospital dysphagia clinic. Patients Six cases were found. Interventions Symptomatic improvement is demonstrated with oesophageal dilatation in symptomatic patients. Main outcome measurements Symptomatic improvement. Results The six cases which are described here demonstrate that a web or ring exactly matches the distribution of the heterotopic mucosa, can occur at both proximal and distal squamo-columnar junctions and the inlet patches may be multiple with multiple rings. A radiological double web sign is described. Limitations A rare condition with a small number of patients. Conclusions Effective treatment can be by oesophageal dilatation and acid suppression. The cause of web formation is thought to be due to heterotopic acid production and is analogous to the Schatzki ring. PMID:28839593

  17. Auditory evoked potentials in children and adolescents with Down syndrome.

    Science.gov (United States)

    Gregory, Letícia; Rosa, Rafael F M; Zen, Paulo R G; Sleifer, Pricila

    2018-01-01

    Down syndrome, or trisomy 21, is the most common genetic alteration in humans. The syndrome presents with several features, including hearing loss and changes in the central nervous system, which may affect language development in children and lead to school difficulties. The present study aimed to investigate group differences in the central auditory system by long-latency auditory evoked potentials and cognitive potential. An assessment of 23 children and adolescents with Down syndrome was performed, and a control group composed of 43 children and adolescents without genetic and/or neurological changes was used for comparison. All children underwent evaluation with pure tone and vocal audiometry, acoustic immitance measures, long-latency auditory evoked potentials, and cognitive potential. Longer latencies of the waves were found in the Down syndrome group than the control group, without significant differences in amplitude, suggesting that individuals with Down syndrome have difficulty in discrimination and auditory memory. It is, therefore, important to stimulate and monitor these children in order to enable adequate development and improve their life quality. We also emphasize the importance of the application of auditory evoked potentials in clinical practice, in order to contribute to the early diagnosis of hearing alterations and the development of more research in this area. © 2017 Wiley Periodicals, Inc.

  18. H-type tracheo-oesophageal fistula: a diagnostic challenge in a resource-poor country. A case report.

    Science.gov (United States)

    Elebute, O A; Ademuyiwa, A O; Seyi-Olajide, J O; Bode, C O

    2013-09-01

    H-type fistula is a rare form of congenital tracheo-oesophageal fistula accounting for 4% of all cases of Tracheo-oesophageal fistula. The typical picture is that of recurrent chest infection due to both missed and delayed diagnosis as well as cyanosis and choking during feeds. In resource poor countries this problem is further exaggerated by ignorance, poverty and lack of access to basic investigative modalities. This is the case of [abstract incomplete].

  19. The potential of molecular markers to improve interventions through the natural history of oesophageal squamous cell carcinoma

    OpenAIRE

    da Costa, Nathalia?Meireles; Soares Lima, Sheila Coelho; de Almeida Sim?o, Tatiana; Ribeiro Pinto, Luis Felipe

    2013-01-01

    EC (oesophageal cancer) is one of the ten most frequent and fatal tumours worldwide and ESCC (oesophageal squamous cell carcinoma) accounts for about 80% of the cases. The first symptoms of ESCC arise late during the progression of the disease and, therefore, the diagnosis is usually done in advanced stages. This leads to an inefficient treatment and consequently to a poor prognosis. Thus, a comprehensive knowledge of ESCC biology is of major importance to identify risk factors, especially in...

  20. Africa's Oesophageal Cancer Corridor: Geographic Variations in Incidence Correlate with Certain Micronutrient Deficiencies.

    Directory of Open Access Journals (Sweden)

    Torin Schaafsma

    Full Text Available The aetiology of Africa's easterly-lying corridor of squamous cell oesophageal cancer is poorly understood. Micronutrient deficiencies have been implicated in this cancer in other areas of the world, but their role in Africa is unclear. Without prospective cohorts, timely insights can instead be gained through ecological studies.Across Africa we assessed associations between a country's oesophageal cancer incidence rate and food balance sheet-derived estimates of mean national dietary supplies of 7 nutrients: calcium (Ca, copper (Cu, iron (Fe, iodine (I, magnesium (Mg, selenium (Se and zinc (Zn. We included 32 countries which had estimates of dietary nutrient supplies and of better-quality GLOBCAN 2012 cancer incidence rates. Bayesian hierarchical Poisson lognormal models were used to estimate incidence rate ratios for oesophageal cancer associated with each nutrient, adjusted for age, gender, energy intake, phytate, smoking and alcohol consumption, as well as their 95% posterior credible intervals (CI. Adult dietary deficiencies were quantified using an estimated average requirements (EAR cut-point approach.Adjusted incidence rate ratios for oesophageal cancer associated with a doubling of mean nutrient supply were: for Fe 0.49 (95% CI: 0.29-0.82; Mg 0.58 (0.31-1.08; Se 0.40 (0.18-0.90; and Zn 0.29 (0.11-0.74. There were no associations with Ca, Cu and I. Mean national nutrient supplies exceeded adult EARs for Mg and Fe in most countries. For Se, mean supplies were less than EARs (both sexes in 7 of the 10 highest oesophageal cancer ranking countries, compared to 23% of remaining countries. For Zn, mean supplies were less than the male EARs in 8 of these 10 highest ranking countries compared to in 36% of other countries.Ecological associations are consistent with the potential role of Se and/or Zn deficiencies in squamous cell oesophageal cancer in Africa. Individual-level analytical studies are needed to elucidate their causal role in this

  1. Pharmacological treatment of children with gastro-oesophageal reflux.

    Science.gov (United States)

    Tighe, Mark; Afzal, Nadeem A; Bevan, Amanda; Hayen, Andrew; Munro, Alasdair; Beattie, R Mark

    2014-11-24

    Gastro-oesophageal reflux (GOR) is a common disorder, characterised by regurgitation of gastric contents into the oesophagus. GOR is a very common presentation in infancy in both primary and secondary care settings. GOR can affect approximately 50% of infants younger than three months old (Nelson 1997). The natural history of GOR in infancy is generally that of a functional, self-limiting condition that improves with age; pH probe, but improvement in symptoms and reflux index was noted in a subgroup treated with domperidone and co-magaldrox(Maalox(®) ). In another RCT of 17 children, after eight weeks of therapy. 33% of participants treated with domperidone noted an improvement in symptoms (P value was not significant). In neonates, the evidence is even weaker; one RCT of 26 neonates treated with domperidone over 24 hours showed that although reflux frequency was significantly increased, reflux duration was significantly improved.Diversity of RCT evidence was found regarding efficacy of compound alginate preparations(Gaviscon Infant(®) ) in infants, although as a result of these studies, Gaviscon Infant(®) was changed to become aluminium-free and has been assessed in its current form in only two studies since 1999. Given the diversity of study designs and the heterogeneity of outcomes, as well as the evolution in formulation, it was not possible to perform a meta-analysis on the efficacy of Gaviscon Infant(®) . Moderate evidence indicates that Gaviscon Infant(®) improves symptoms in infants, including those with functional reflux; the largest study of the current formulation showed improvement in symptom control but was limited by length of follow-up.No serious side effects were reported.No RCTs on pharmacological treatments for children with neurodisability were identified. Moderate evidence was found to support the use of PPIs, along with some evidence to support the use of H₂ antagonists in older children with GORD, based on improvement in symptom scores

  2. Characterization of music-evoked autobiographical memories.

    Science.gov (United States)

    Janata, Petr; Tomic, Stefan T; Rakowski, Sonja K

    2007-11-01

    Despite music's prominence in Western society and its importance to individuals in their daily lives, very little is known about the memories and emotions that are often evoked when hearing a piece of music from one's past. We examined the content of music-evoked autobiographical memories (MEAMs) using a novel approach for selecting stimuli from a large corpus of popular music, in both laboratory and online settings. A set of questionnaires probed the cognitive and affective properties of the evoked memories. On average, 30% of the song presentations evoked autobiographical memories, and the majority of songs also evoked various emotions, primarily positive, that were felt strongly. The third most common emotion was nostalgia. Analyses of written memory reports found both general and specific levels of autobiographical knowledge to be represented, and several social and situational contexts for memory formation were common across many memories. The findings indicate that excerpts of popular music serve as potent stimuli for studying the structure of autobiographical memories.

  3. Predictability of painful stimulation modulates the somatosensory-evoked potential in the rat

    NARCIS (Netherlands)

    Schaap, M.W.H.|info:eu-repo/dai/nl/314411488; van Oostrom, H.|info:eu-repo/dai/nl/340414634; Doornenbal, A.; Baars, A.M.; Arndt, S.S.|info:eu-repo/dai/nl/30483615X; Hellebrekers, L.J.|info:eu-repo/dai/nl/073499234

    2013-01-01

    Abstract Somatosensory-evoked potentials (SEPs) are used in humans and animals to increase knowledge about nociception and pain. Since the SEP in humans increases when noxious stimuli are administered unpredictably, predictability potentially influences the SEP in animals as well. To assess the

  4. Excessive crying and gastro-oesophageal reflux disease in infants: misalignment of biology and culture.

    Science.gov (United States)

    Douglas, Pamela S

    2005-01-01

    Excessive crying is the most common problem presenting to the doctor in the first months of life in western industrialised societies, affecting up to 30% of infants. There has been an exponential increase in the diagnosis of gastro-oesophageal reflux disease (GORD) in babies who cry excessively over the past few decades, and many parents believe their crying infant "has reflux". This paper proposes that culturocentric assumptions have confused interpretation of research into GORD, and re-examines the findings of GORD research from the perspective of evolutionary biology. Evolutionary biologists argue that the human infant is an exterogestate foetus for at least the first six months of life, dependent on maternal co-regulation for optimal physiological function. However, infant-care practices in western industrialised societies shifted towards an emphasis on infant autonomy at the time of the Industrial Revolution. From the perspective of evolutionary biology, a misalignment between western culture and the biological expectations of the infant developed over two million years of evolution may result in excessive crying in less adapted babies. The key biocultural factors that impact on infant distress are feeding management, parental responsiveness, sensory nourishment and sleep management. When the concept of the human infant as an exterogestate foetus is integrated with the findings of GORD research, a hypothesis and its corollary emerge. This hypothesis proposes that infant GORD is a physiological manifestation of misalignment between biology and culture, and proposes, as a corollary, that if the impact of biocultural factors upon the physiology of otherwise well crying babies is not addressed in the first months of life, populations of infants who cry excessively may be predisposed to GORD after three to four months of age. If this hypothesis is correct, an integrated clinical approach to crying babies less than three to four months of age that considers feeding

  5. Predictability of painful stimulation modulates the somatosensory-evoked potential in the rat.

    Directory of Open Access Journals (Sweden)

    Manon W H Schaap

    Full Text Available Somatosensory-evoked potentials (SEPs are used in humans and animals to increase knowledge about nociception and pain. Since the SEP in humans increases when noxious stimuli are administered unpredictably, predictability potentially influences the SEP in animals as well. To assess the effect of predictability on the SEP in animals, classical fear conditioning was applied to compare SEPs between rats receiving SEP-evoking electrical stimuli either predictably or unpredictably. As in humans, the rat's SEP increased when SEP-evoking stimuli were administered unpredictably. These data support the hypothesis that the predictability of noxious stimuli plays a distinctive role in the processing of these stimuli in animals. The influence of predictability should be considered when studying nociception and pain in animals. Additionally, this finding suggests that animals confronted with (unpredictable noxious stimuli can be used to investigate the mechanisms underlying the influence of predictability on central processing of noxious stimuli.

  6. Evaluation of gastro-oesophageal reflux disease in wheezy infants using 24-h oesophageal combined impedance and pH monitoring.

    Science.gov (United States)

    Abdallah, Ahmed; El-Desoky, Tarek; Fathi, Khalid; Fawzi Elkashef, Wagdi; Zaki, Ahmed

    2017-06-01

    Gastro-oesophageal reflux disease (GERD) is incriminated as a cause of non-asthmatic infantile wheeze. To date, no diagnostic test is considered standard for GERD-related airway reflux diagnosis. Oesophageal combined multiple channel intraluminal impedance and pH (MII-pH) monitoring is proposed to be a sensitive tool for evaluation of all GERD including infantile wheeze. We aimed to determine the GERD prevalence amongst wheezy infants in the first year of life using combined MII-pH versus pH monitoring alone and evaluate the sensitivity and specificity of objective MII-pH monitoring parameters in GERD-associated infantile wheeze diagnosis compared to those of lipid-laden macrophage index (LLMI). Thirty-eight wheezy infants below 1year of age were evaluated for GERD using oesophageal combined MII-pH monitoring and LLMI. Totally, 60.5% of cases had abnormal MII-pH; only 7.9% of them had abnormal pH monitoring. LLMI was significantly higher in wheezy infants with abnormal MII-pH than infants with normal MII-pH monitoring (112±88 versus 70±48; P=0.036). The current definitions of abnormal MII-pH study, reflux index≥10% and distal reflux episodes≥100, had low sensitivity (23%) but high specificity (100% and 96%, respectively) in GERD-related aspiration diagnosis defined by LLMI≥100. Using ROC curves, bolus contact time≥2.4% and proximal reflux episodes≥46 had 61% and 54% sensitivity and 64% and 76% specificity, respectively, in GERD-related aspiration diagnosis. Combined MII-pH is superior to pH monitoring in reflux-associated infantile wheeze diagnosis. Objective data including proximal reflux episodes and bolus contact time should be combined with the current parameters used in reflux-associated infantile wheeze diagnosis. Copyright © 2017 Pan-Arab Association of Gastroenterology. Published by Elsevier B.V. All rights reserved.

  7. Characterization of Motor and Somatosensory Evoked Potentials in the Yucatan Micropig Using Transcranial and Epidural Stimulation.

    Science.gov (United States)

    Benavides, Francisco D; Santamaria, Andrea J; Bodoukhin, Nikita; Guada, Luis G; Solano, Juan P; Guest, James D

    2017-09-15

    Yucatan micropigs have brain and spinal cord dimensions similar to humans and are useful for certain spinal cord injury (SCI) translational studies. Micropigs are readily trained in behavioral tasks, allowing consistent testing of locomotor loss and recovery. However, there has been little description of their motor and sensory pathway neurophysiology. We established methods to assess motor and sensory cortical evoked potentials in the anesthetized, uninjured state. We also evaluated epidurally evoked motor and sensory stimuli from the T6 and T9 levels, spanning the intended contusion injury epicenter. Response detection frequency, mean latency and amplitude values, and variability of evoked potentials were determined. Somatosensory evoked potentials were reliable and best detected during stimulation of peripheral nerve and epidural stimulation by referencing the lateral cortex to midline Fz. The most reliable hindlimb motor evoked potential (MEP) occurred in tibialis anterior. We found MEPs in forelimb muscles in response to thoracic epidural stimulation likely generated from propriospinal pathways. Cranially stimulated MEPs were easier to evoke in the upper limbs than in the hindlimbs. Autopsy studies revealed substantial variations in cortical morphology between animals. This electrophysiological study establishes that neurophysiological measures can be reliably obtained in micropigs in a time frame compatible with other experimental procedures, such as SCI and transplantation. It underscores the need to better understand the motor control pathways, including the corticospinal tract, to determine which therapeutics are suitable for testing in the pig model.

  8. Proposed follow up programme after curative resection for lower third oesophageal cancer

    Directory of Open Access Journals (Sweden)

    Moyes LH

    2010-09-01

    Full Text Available Abstract The incidence of oesophageal adenocarcinoma has risen throughout the Western world over the last three decades. The prognosis remains poor as many patients are elderly and present with advanced disease. Those patients who are suitable for resection remain at high risk of disease recurrence. It is important that cancer patients take part in a follow up protocol to detect disease recurrence, offer psychological support, manage nutritional disorders and facilitate audit of surgical outcomes. Despite the recognition that regular postoperative follow up plays a key role in ongoing care of cancer patients, there is little consensus on the nature of the process. This paper reviews the published literature to determine the optimal timing and type of patient follow up for those after curative oesophageal resection.

  9. Growth and development after oesophageal atresia surgery: Need for long-term multidisciplinary follow-up.

    Science.gov (United States)

    IJsselstijn, Hanneke; Gischler, Saskia J; Toussaint, Leontien; Spoel, Marjolein; Zijp, Monique H M van der Cammen-van; Tibboel, Dick

    2016-06-01

    Survival rates in oesophageal atresia patients have reached over 90%. In long-term follow-up studies the focus has shifted from purely surgical or gastrointestinal evaluation to a multidisciplinary approach. We reviewed the literature on the long-term morbidity of these patients and discuss mainly issues of physical growth and neurodevelopment. We conclude that growth problems - both stunting and wasting - are frequently seen, but that sufficient longitudinal data are lacking. Therefore, it is unclear whether catch-up growth into adolescence and adulthood occurs. Data on determinants of growth retardation are also lacking in current literature. Studies on neurodevelopment beyond preschool age are scarce but oesophageal atresia patients seem at risk for academic problems and motor function delay. Many factors contribute to the susceptibility to growth and development problems and we propose a multidisciplinary follow-up schedule into adulthood future care which may help improve quality of life. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Woven polydioxanone biodegradable stents: a new treatment option for benign and malignant oesophageal strictures

    Energy Technology Data Exchange (ETDEWEB)

    Stivaros, S.M.; Williams, L.R.; Senger, C.; Laasch, Hans-Ulrich [Christie NHS Foundation Trust, Department of Radiology, Manchester (United Kingdom); Wilbraham, L. [Christie NHS Foundation Trust, Department of Nutrition and Dietetics, Manchester (United Kingdom)

    2010-05-15

    We present our initial experience with a new biodegradable (BD) esophageal stent in two patients, one for a therapy-resistant benign esophageal stricture, and the other as a temporary measure during curative radiotherapy for oesophageal carcinoma. The BD stents need to be loaded into a conventional pull-back delivery system but are then placed in a standard fashion. Pre-dilatation should be avoided to reduce the risk of migration, however if migration occurs the stents can be left to dissolve in the stomach. The stents are radiolucent but easily identified on CT with minimal artefact and thus might even aid with radiotherapy planning. BD stents offer an exciting new strategy for therapy-resistant benign strictures as well as a supportive measure for oesophageal cancer undergoing non-surgical treatment. (orig.)

  11. A study of Raman spectroscopy for the early detection and classification of malignancy in oesophageal tissue

    CERN Document Server

    Kendall, C A

    2002-01-01

    Raman Spectroscopy for the identification and classification of malignancy in the oesophagus has been demonstrated in this thesis. The potential of Raman spectroscopy in this field is twofold; as an adjunct for the pathologist and as a biopsy targeting tool at endoscopy. This study has demonstrated the feasibility of these potential applications in vitro. Spectral diagnostic models have been developed by correlating spectral information with histopathology. This is the current 'gold standard' diagnostic method for the identification of dysplasia, the established risk factor for the development of oesophageal cancer. Histopathology is a subjective assessment and widely acknowledged to have limitations. A more rigorous gold standard was therefore developed, as part of this study, using the consensus opinion of three independent expert pathologists to train the diagnostic models. Raman spectra have been measured from oesophageal tissue covering the full spectrum of malignant disease in the oesophagus, using a ne...

  12. Role of CD1A and HSP60 in the antitumoral response of oesophageal cancer

    Directory of Open Access Journals (Sweden)

    Giovanni Zummo

    2011-12-01

    Full Text Available Oesophageal cancer (OC is one of the most common and severe forms of tumor. A wider knowledge of molecular mechanisms which lead to a normal epithelium becoming a neoplasm may reveal new strategies to improve treatment and outcome of this disease. In this review, we report recent findings concerning molecular events which take place during carcinogenesis of the oesophagus. In particular, we focus on the role of two molecules, CD1a and Hsp60, which are overexpressed in oesophageal and many other types of tumor. Both molecules may present tumor antigens and promote in situ the stimulation of an antitumoral immune activity. We suggest there is a synergistic action between these molecules. Further knowledge about their intracellular pathways and extracellular roles may help develop new antitumoral tools for OC.

  13. Septic pericarditis and pneumopericardium in a dog with an oesophageal foreign body

    Directory of Open Access Journals (Sweden)

    Willem J. Botha

    2017-01-01

    Full Text Available A 5-year-old, intact, male Yorkshire Terrier presented with a 6-day history of lethargy and anorexia. Clinical examination revealed dental plaque accumulation, abdominal effort during respiration and muffled heart sounds. Thoracic radiographs revealed an enlarged globoid cardiac silhouette and mild pneumopericardium, transthoracic ultrasonography revealed a pericardial effusion after which pericardiocentesis, cytology and culture diagnosed septic pericarditis. Three multidrug-resistant bacteria were isolated, two of which have been implicated in gas-producing infections before. Medical management failed to resolve the pericarditis and euthanasia was opted for. A chronic osseocartilaginous oesophageal foreign body cranial to the heart base was found on necropsy. Septic pericarditis and pneumopericardium are rare conditions in dogs. This is the first case to describe a multidrug-resistant polybacterial aetiology causing mild pneumopericardium and only the second case to describe septic pericarditis associated with an oesophageal foreign body.

  14. Sentinel Bleeding as a Sign of Gastroaortic Fistula Formation after Oesophageal Surgery

    Directory of Open Access Journals (Sweden)

    M. Uittenbogaart

    2014-01-01

    Full Text Available Gastroaortic fistula formation is a very rare complication following oesophageal resection and, in most cases, leads to sudden death. We report the case of a 65-year-old male with an adenocarcinoma of the oesophagus who underwent neoadjuvant chemoradiation followed by a minimally invasive transthoracic oesophagectomy with gastric tube reconstruction and intrathoracic anastomosis. After an uneventful postoperative course and hospital discharge, the patient reported blood regurgitation on postoperative day 23. Endoscopy revealed an adherent blood clot on the oesophageal wall, which after dislocation caused exsanguination. Autopsy determined the cause of death being massive haemorrhage due to a gastroaortic fistula. The sudden onset of haemorrhage makes this condition particularly difficult to treat. Recognition of warning signs such as thoracic or epigastric pain, regurgitation of blood, or the passing of bloody stools or melena is crucial in the early detection of fistula and may improve patient outcome.

  15. Septic pericarditis and pneumopericardium in a dog with an oesophageal foreign body.

    Science.gov (United States)

    Botha, Willem J; Mukorera, Varaidzo; Kirberger, Robert M

    2017-05-29

    A 5-year-old, intact, male Yorkshire Terrier presented with a 6-day history of lethargy and anorexia. Clinical examination revealed dental plaque accumulation, abdominal effort during respiration and muffled heart sounds. Thoracic radiographs revealed an enlarged globoid cardiac silhouette and mild pneumopericardium, transthoracic ultrasonography revealed a pericardial effusion after which pericardiocentesis, cytology and culture diagnosed septic pericarditis. Three multidrug-resistant bacteria were isolated, two of which have been implicated in gas-producing infections before. Medical management failed to resolve the pericarditis and euthanasia was opted for. A chronic osseocartilaginous oesophageal foreign body cranial to the heart base was found on necropsy. Septic pericarditis and pneumopericardium are rare conditions in dogs. This is the first case to describe a multidrug-resistant polybacterial aetiology causing mild pneumopericardium and only the second case to describe septic pericarditis associated with an oesophageal foreign body.

  16. Evoking prescribed spike times in stochastic neurons

    Science.gov (United States)

    Doose, Jens; Lindner, Benjamin

    2017-09-01

    Single cell stimulation in vivo is a powerful tool to investigate the properties of single neurons and their functionality in neural networks. We present a method to determine a cell-specific stimulus that reliably evokes a prescribed spike train with high temporal precision of action potentials. We test the performance of this stimulus in simulations for two different stochastic neuron models. For a broad range of parameters and a neuron firing with intermediate firing rates (20-40 Hz) the reliability in evoking the prescribed spike train is close to its theoretical maximum that is mainly determined by the level of intrinsic noise.

  17. Conservative management of gunshot oesophageal injuries: A report of two consecutive exceptional cases

    Directory of Open Access Journals (Sweden)

    Francesco Virdis

    2016-09-01

    Discussion: Non-operative management of intrathoracic oesophageal perforation is controversial. Small perforations or contained leaks diagnosed within 24–48 h in a stable patient with no mediastinitis or empyema can be managed non-operatively with antibiotics and nasogastric feeds. These two case reports support the notion of selective non-operative management of asymptomatic patients with penetrating injury to the oesophagus.

  18. The Effects of Ankaferd Blood Stopper on the Recovery Process in an Experimental Oesophageal Perforation Model

    Directory of Open Access Journals (Sweden)

    Necla Gürbüz Sarıkaş

    2015-03-01

    Full Text Available Background: Oesophageal perforation is a life-threatening pathology that is generally treated conservatively; however, surgical procedures are frequently performed. A topical haemostatic agent, Ankaferd Blood Stopper (ABS, also has beneficial wound-healing effects. Aims: This study aimed to determine the effects of ABS following experimental oesophageal perforations. Study Design: Animal experiment. Methods: The experimental rats were classified into 6 groups (with 7 rats in each group. Pairs of groups (primary repair alone and primary repair + ABS were terminated in the 1st, 2nd, and 3rd weeks following injury. The oesophageal perforations, which were 8-10 mm in length, were created using a nasogastric tube. The perforation sites were repaired with a 6-0 polyglactine thread in the primary repair groups. Additionally, ABS was sprayed over the perforation site in the treatment groups. Each oesophagus was evaluated histopathologically. Results: There were fewer microabscesses and areas of necrosis in the ABS groups compared with the primary repair groups. The histopathological evaluation revealed that the ABS groups had less inflammation and more re-epithelisation compared to the primary repair groups (p=0.002 and p=0.003, respectively. Fibrosis in the ABS groups was moderate in the 2nd week and mild in the 3rd week. Comparing the groups with respect to the time intervals, only the 1st week groups showed a significant difference in terms of re-epithelialisation (p=0.044. Conclusion: Topical ABS application on the repaired experimental oesophageal perforation regions led to positive wound-healing effects compared with the rats that were administered the primary repair alone.

  19. Thioredoxin interacting protein and its association with clinical outcome in gastro-oesophageal adenocarcinoma.

    Science.gov (United States)

    Woolston, Caroline M; Madhusudan, Srinivasan; Soomro, Irshad N; Lobo, Dileep N; Reece-Smith, Alexander M; Parsons, Simon L; Martin, Stewart G

    2013-01-01

    The overall prognosis for operable gastro-oesophageal adenocarcinoma remains poor and therefore neoadjuvant chemotherapy has become the standard of care, in addition to radical surgery. Certain anticancer agents (e.g. anthracyclines and cisplatin) generate damaging reactive oxygen species as by-products of their mechanism of action. Drug effectiveness can therefore depend upon the presence of cellular redox buffering systems that are often deregulated in cancer. The expression of the redox protein, thioredoxin interacting protein, was assessed in gastro-oesophageal adenocarcinomas. Thioredoxin interacting protein expression was assessed using conventional immunohistochemistry on a tissue microarray of 140 adenocarcinoma patients treated by primary surgery alone and 88 operable cases treated with neoadjuvant chemotherapy. In the primary surgery cases, high thioredoxin interacting protein expression associated with a lack of lymph node involvement (p=0.005), no perineural invasion (p=0.030) and well/moderate tumour differentiation (p=0.033). In the neoadjuvant tumours, high thioredoxin interacting protein expression was an independent marker for improved disease specific survival (p=0.002) especially in cases with anthracycline-based regimes (p=0.008). This study highlights the potential of thioredoxin interacting protein as a biomarker for response in neoadjuvant treated gastro-oesophageal adenocarcinoma and may represent a useful therapeutic target due to its association with tumour progression.

  20. Thioredoxin interacting protein and its association with clinical outcome in gastro-oesophageal adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Caroline M. Woolston

    2013-01-01

    Full Text Available The overall prognosis for operable gastro-oesophageal adenocarcinoma remains poor and therefore neoadjuvant chemotherapy has become the standard of care, in addition to radical surgery. Certain anticancer agents (e.g. anthracyclines and cisplatin generate damaging reactive oxygen species as by-products of their mechanism of action. Drug effectiveness can therefore depend upon the presence of cellular redox buffering systems that are often deregulated in cancer. The expression of the redox protein, thioredoxin interacting protein, was assessed in gastro-oesophageal adenocarcinomas. Thioredoxin interacting protein expression was assessed using conventional immunohistochemistry on a tissue microarray of 140 adenocarcinoma patients treated by primary surgery alone and 88 operable cases treated with neoadjuvant chemotherapy. In the primary surgery cases, high thioredoxin interacting protein expression associated with a lack of lymph node involvement (p=0.005, no perineural invasion (p=0.030 and well/moderate tumour differentiation (p=0.033. In the neoadjuvant tumours, high thioredoxin interacting protein expression was an independent marker for improved disease specific survival (p=0.002 especially in cases with anthracycline-based regimes (p=0.008. This study highlights the potential of thioredoxin interacting protein as a biomarker for response in neoadjuvant treated gastro-oesophageal adenocarcinoma and may represent a useful therapeutic target due to its association with tumour progression.

  1. Thioredoxin interacting protein and its association with clinical outcome in gastro-oesophageal adenocarcinoma☆

    Science.gov (United States)

    Woolston, Caroline M.; Madhusudan, Srinivasan; Soomro, Irshad N.; Lobo, Dileep N.; Reece-Smith, Alexander M.; Parsons, Simon L.; Martin, Stewart G.

    2013-01-01

    The overall prognosis for operable gastro-oesophageal adenocarcinoma remains poor and therefore neoadjuvant chemotherapy has become the standard of care, in addition to radical surgery. Certain anticancer agents (e.g. anthracyclines and cisplatin) generate damaging reactive oxygen species as by-products of their mechanism of action. Drug effectiveness can therefore depend upon the presence of cellular redox buffering systems that are often deregulated in cancer. The expression of the redox protein, thioredoxin interacting protein, was assessed in gastro-oesophageal adenocarcinomas. Thioredoxin interacting protein expression was assessed using conventional immunohistochemistry on a tissue microarray of 140 adenocarcinoma patients treated by primary surgery alone and 88 operable cases treated with neoadjuvant chemotherapy. In the primary surgery cases, high thioredoxin interacting protein expression associated with a lack of lymph node involvement (p=0.005), no perineural invasion (p=0.030) and well/moderate tumour differentiation (p=0.033). In the neoadjuvant tumours, high thioredoxin interacting protein expression was an independent marker for improved disease specific survival (p=0.002) especially in cases with anthracycline-based regimes (p=0.008). This study highlights the potential of thioredoxin interacting protein as a biomarker for response in neoadjuvant treated gastro-oesophageal adenocarcinoma and may represent a useful therapeutic target due to its association with tumour progression. PMID:24024162

  2. The diagnosis and management of gastro-oesophageal reflux in infants.

    Science.gov (United States)

    Vandenplas, Yvan; Salvatore, Silvia; Hauser, Bruno

    2005-12-01

    Gastro-oesophageal reflux (GOR) and gastro-oesophageal reflux disease (GORD) occur frequently during the first months of life. Gastro-oesophageal reflux may be a primary gastro-intestinal motility disorder, but it may also be secondary to other conditions such as cow's milk protein allergy. Objective diagnosis can be difficult because there may be absence of correlation between history, results of pH monitoring and histology. Severe GORD may cause minor symptoms, and minor GOR may cause severe symptoms. Several different therapeutic interventions exist. Simply stated, thickened formula reduces regurgitation and alginates and proton pump inhibitors can be used to decrease acid GOR, depending on the severity of the GORD. Efficacy data of prokinetic drugs are either lacking or disappointing. Regarding side-effects, interest has been focused on cisapride, although other molecules have similar effects. Long-term side-effects such as the nutritional consequence of therapeutic management have been insufficiently studied, especially for the acid-reducing molecules.

  3. A relation between cell cycle and intestinal metaplasia in oesophageal biopsies using optical and digital microscopy.

    Science.gov (United States)

    Máté, Miklós; Molnár, Béla

    2015-07-01

    Protein expression changes in relation to cell cycles provide important information, and it may represent a new method for an early diagnosis of metaplasia - dysplasia - adenocarcinoma sequence. We investigated potential changes in cell cycle genes such as protooncogenes (PCNA, EGFR), tumour suppressor gene (p53), apoptotic TUNNEL (Tdt mediated dUTP nick and labelling) gene, as well as small intestinal mucus antigen (SIMA) and large intestinal mucus antigen (LIMA), which accumulates in metaplastic epithelium due to the inflammatory process in routine oesophageal biopsies using immunohistochemistry. Oesophageal biopsies were taken from patients with Barrett's oesophagus (n = 30), reflux oesophagitis (n = 30), healthy oesophagus (n = 30) and healthy cardia (n = 10). Immunohistochemical signalling was carried out by Streptavidin-Biotin-AEC (aminoetil-carbazol). Expression of PCNA was statistically significantly lower in healthy oesophagus (p metaplasia. Further, EGFR, p53 and TUNNEL levels were significantly different in healthy versus Barrett's oesophagus. Manual counting using virtual microscopy was comparable with the result using conventional light microscopy, but the former is significantly quicker. There was no difference between manual and automated cell counting (p > 0.05).

  4. Preoperative imaging and prediction of oesophageal conduit necrosis after oesophagectomy for cancer.

    Science.gov (United States)

    Lainas, P; Fuks, D; Gaujoux, S; Machroub, Z; Fregeville, A; Perniceni, T; Mal, F; Dousset, B; Gayet, B

    2017-09-01

    Oesophageal conduit necrosis following oesophagectomy is a rare but life-threatening complication. The present study aimed to assess the impact of coeliac axis stenosis on outcomes after oesophagectomy for cancer. The study included consecutive patients who had an Ivor Lewis procedure with curative intent for middle- and lower-third oesophageal cancer at two tertiary referral centres. All patients underwent preoperative multidetector CT with arterial phase to detect coeliac axis stenosis. The coeliac artery was classified as normal, with extrinsic stenosis due to a median arcuate ligament or with intrinsic stenosis caused by atherosclerosis. Some 481 patients underwent an Ivor Lewis procedure. Of these, ten (2·1 per cent) developed oesophageal conduit necrosis after surgery. Coeliac artery evaluation revealed a completely normal artery in 431 patients (91·5 per cent) in the group without conduit necrosis and in one (10 per cent) with necrosis (P necrosis and five (50 per cent) with necrosis (P necrosis had a single and thin left gastric artery (P necrosis after oesophagectomy for cancer may be due to pre-existing coeliac axis stenosis. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

  5. The use of Coca-Cola in the management of bolus obstruction in benign oesophageal stricture.

    Science.gov (United States)

    Karanjia, N. D.; Rees, M.

    1993-01-01

    Oesophageal stricture is a complication of oesophageal reflux and may itself be complicated by bolus obstruction. We reviewed the records of patients presenting with dysphagia and who were found to have benign oesophageal strictures. We studied the outcome of bolus obstruction in 13 episodes affecting eight patients. In six episodes Coca-Cola was administered on the day before endoscopy, and in all these patients the bolus had cleared. In seven episodes nothing was administered before endoscopy, and in all seven a bolus was evident at endoscopy. In five of these seven the bolus was removed piecemeal and in each of these instances the endoscope had to be passed between two and five times. In the remaining two instances the procedure was abandoned and the patients returned to the ward for the administration of Coca-Cola. At subsequent endoscopy these patients were found to be clear of any bolus. These results suggest that the administration of Coca-Cola (or other aerated drinks) may clear a bolus in the acutely obstructed oesophagus. PMID:8476194

  6. Nivolumab treatment for oesophageal squamous-cell carcinoma: an open-label, multicentre, phase 2 trial.

    Science.gov (United States)

    Kudo, Toshihiro; Hamamoto, Yasuo; Kato, Ken; Ura, Takashi; Kojima, Takashi; Tsushima, Takahiro; Hironaka, Shuichi; Hara, Hiroki; Satoh, Taroh; Iwasa, Satoru; Muro, Kei; Yasui, Hirofumi; Minashi, Keiko; Yamaguchi, Kensei; Ohtsu, Atsushi; Doki, Yuichiro; Kitagawa, Yuko

    2017-05-01

    Nivolumab is a human monoclonal IgG4 antibody that inhibits programmed cell death protein 1 (PD-1) expressed on activated T cells. We investigated the safety and activity of nivolumab in patients with treatment-refractory oesophageal cancer. We did an open-label, single-arm, multicentre phase 2 study. Eligible patients had advanced squamous-cell carcinoma, adenosquamous-cell carcinoma, or adenocarcinoma of the oesophagus refractory or intolerant to fluoropyrimidine-based, platinum-based, and taxane-based chemotherapy. Patients were treated with 3 mg/kg nivolumab given intravenously once every 2 weeks in 6-week cycles. The primary endpoint was centrally assessed objective response (the proportion of patients whose best response was complete or partial response), according to the Response Evaluation Criteria In Solid Tumors, version 1.1. Adverse events and treatment-related adverse events (defined as events for which a causal relation to nivolumab could not be ruled out) were monitored throughout the study. The safety analysis was done in patients who received at least one dose of nivolumab, and drug activity was assessed in patients who received at least one dose of nivolumab and had at least one central assessment of tumour response. This study is registered with clinicaltrials.jp, number ONO-4538-07/JapicCTI-No.142422. Follow-up of patients is ongoing. Between Feb 25 and Nov 14, 2014, 65 patients were enrolled, all with squamous-cell carcinoma. 64 patients were assessable for the primary endpoint as one patient was excluded due to having multiple primary cancers; all patients were assessable for safety. Median follow-up was 10·8 months (IQR 4·9-14·3). 11 (17%, 95% CI 10-28) of 64 patients had a centrally assessed objective response. Of the 65 patients assessed for adverse events, the most common grade 3 or 4 events were grade 4 dyspnoea and hyponatraemia (one [2%) patient each), grade 3 lung infection (five [8%] patients), grade 3 decreased appetite (two [3

  7. Oral disease and risk of oesophageal and gastric cancer in a nationwide nested case-control study in Sweden.

    Science.gov (United States)

    Ljung, Rickard; Martin, Lena; Lagergren, Jesper

    2011-09-01

    The association between the exposure to oral disease and the outcomes of oesophageal and gastric cancer was examined in a Swedish nationwide inpatient register-based nested case-control study in 1964-2008. The study included 6,156 oesophageal squamous-cell carcinoma cases that were compared with 29,993 controls, 2684 oesophageal adenocarcinoma cases that were compared with 15,036 controls and 38,308 gastric cancer cases that were compared with 99,991 controls. For oesophageal squamous cell carcinoma, the age and sex adjusted odds ratio (OR) among patients with a history of oral disease was 1.3 (95% confidence interval (95% CI): 0.9,-1.9), and 1.1 (95% CI 0.8,-1.7) after adjustment for diseases related to alcohol consumption or tobacco smoking. For oesophageal adenocarcinoma, the age and sex adjusted OR was increased (OR 1.7, 95% CI 1.1-2.6), and remained increased (OR 1.6, 95% CI 1.0-2.4) after adjustment for diseases related to smoking or alcohol consumption, gastroesophageal reflux, obesity and ulcer disease. For gastric cancer, no statistically significantly increased risk was observed (age and sex adjusted OR 0.9, 95% CI 0.7-1.1, and fully adjusted OR 0.9, 95% CI 0.7-1.1). In conclusion, this study supports the hypothesis that oral disease increases the risk of oesophageal adenocarcinoma, but not for oesophageal squamous cell carcinoma or gastric cancer. Further investigations are warranted. Copyright © 2011 Elsevier Ltd. All rights reserved.

  8. Voice prosthesis insertion after endoscopic balloon-catheter dilatation in case of a stenotic hypopharyngo-oesophageal junction.

    Science.gov (United States)

    Móricz, Péter; Gerlinger, Imre; Solt, Jeno; Somogyvári, Krisztina; Pytel, József

    2007-12-01

    Stenosis of the hypopharyngo-oesophageal junction can be a rare complication of laryngectomy and/or partial pharyngectomy and makes the insertion of voice prosthesis extremely difficult. This study describes the authors' experiences gained by endoscopic balloon-catheter dilatation of hypopharyngo-oesophageal stenoses prior to implantation of voice prostheses in four cases. In two patients a single balloon-catheter dilatation resulted in wide enough pharyngo-oesophageal lumen on the long run. The average prosthesis wearing-times were 6.8 months in case 1 and 4.6 months in case 2, corresponding to the published literature data. In case 3, repeated dilatation of the pharyngo-oesophageal transition had proved to be unsuccessful despite taking every effort with the endoscopic balloon-catheter method. Having excised the stenotic segment, reconstruction with pectoralis major myocutaneous flap (PMMF) was indicated. Eighteen months later, a repeated restenosis was observed and a free jejunal flap needed to be performed as a final solution. In case 4, the insertion was carried out into a previously dilated jejunal free flap, which became gradually ischemic and stenotic since the major head-and neck procedure was carried out that resulted in prosthesis rejection after just 1 week. The authors emphasize that correct indication of pedicled and free flaps in head and neck reconstruction is a prerequisite from the aspect of prevention of pharyngo-oesophageal strictures. Endoscopic balloon-catheter dilatation is a safe and established method for dilatating hypopharyngo-oesophageal stenoses of different origin. The procedure provides maximum patient benefit with minimal trauma and morbidity; moreover, facilitates insertion of voice prostheses. However, a single balloon-catheter dilatation cannot always result in wide enough oesophageal lumen on the long run (case 3). Insertion of a voice prosthesis into a previously dilated ischemic jejunal segment is challenging and avoidable due

  9. Alcohol consumption pattern and risk of Barrett's oesophagus and erosive oesophagitis: an Italian case-control study.

    Science.gov (United States)

    Filiberti, Rosa A; Fontana, Vincenzo; De Ceglie, Antonella; Blanchi, Sabrina; Grossi, Enzo; Della Casa, Domenico; Lacchin, Teresa; De Matthaeis, Marina; Ignomirelli, Orazio; Cappiello, Roberta; Rosa, Alessandra; Foti, Monica; Laterza, Francesco; D'Onofrio, Vittorio; Iaquinto, Gaetano; Conio, Massimo

    2017-04-01

    Knowledge about the association between alcohol and Barrett's oesophagus and reflux oesophagitis is conflicting. In this case-control study we evaluated the role of specific alcoholic beverages (red and white wine, beer and liquors) in 339 Barrett's oesophagus and 462 oesophagitis patients compared with 619 endoscopic controls with other disorders, recruited in twelve Italian endoscopic units. Data on alcohol and other individual characteristics were obtained from structured questionnaires. No clear, monotonic significant dose-response relationship was pointed out for red wine. However, a generalised U-shaped trend of Barrett's oesophagus/oesophagitis risk due to red wine consumption particularly among current drinkers was found. Similar results were also found for white wine. Liquor/spirit consumption seemed to bring about a 1·14-2·30 risk excess, although statistically non-significant, for current Barrett's oesophagus/oesophagitis drinkers. Statistically significant decreasing dose-response relationships were found in Barrett's oesophagus for frequency and duration of beer consumption. Similar, but less clear downward tendencies were also found for oesophagitis patients. In conclusion, although often not statistically significant, our data suggested a reduced risk of Barrett's oesophagus and oesophagitis with a low/moderate intake of wine and beer consumption. A non-significant increased risk of Barrett's oesophagus/oesophagitis was observed with a higher intake of any type of heavy alcohol consumption, but no conclusion can be drawn owing to the high number of non-spirit drinkers and to the small number of drinkers at higher alcohol intake levels.

  10. Markers of sarcopenia quantified by computed tomography predict adverse long-term outcome in patients with resected oesophageal or gastro-oesophageal junction cancer

    Energy Technology Data Exchange (ETDEWEB)

    Tamandl, Dietmar; Baltzer, Pascal A.; Ba-Ssalamah, Ahmed [Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Comprehensive Cancer Center GET-Unit, Vienna (Austria); Paireder, Matthias; Asari, Reza; Schoppmann, Sebastian F. [Medical University of Vienna, Department of Surgery, Upper-GI-Service, Comprehensive Cancer Center GET-Unit, Vienna (Austria)

    2016-05-15

    To assess the impact of sarcopenia and alterations in body composition parameters (BCPs) on survival after surgery for oesophageal and gastro-oesophageal junction cancer (OC). 200 consecutive patients who underwent resection for OC between 2006 and 2013 were selected. Preoperative CTs were used to assess markers of sarcopenia and body composition (total muscle area [TMA], fat-free mass index [FFMi], fat mass index [FMi], subcutaneous, visceral and retrorenal fat [RRF], muscle attenuation). Cox regression was used to assess the primary outcome parameter of overall survival (OS) after surgery. 130 patients (65 %) had sarcopenia based on preoperative CT examinations. Sarcopenic patients showed impaired survival compared to non-sarcopenic individuals (hazard ratio [HR] 1.87, 95 % confidence interval [CI] 1.15-3.03, p = 0.011). Furthermore, low skeletal muscle attenuation (HR 1.91, 95 % CI 1.12-3.28, p = 0.019) and increased FMi (HR 3.47, 95 % CI 1.27-9.50, p = 0.016) were associated with impaired outcome. In the multivariate analysis, including a composite score (CSS) of those three parameters and clinical variables, only CSS, T-stage and surgical resection margin remained significant predictors of OS. Patients who show signs of sarcopenia and alterations in BCPs on preoperative CT images have impaired long-term outcome after surgery for OC. (orig.)

  11. Transient Evoked aotacoustic emissions otologically normal adults

    African Journals Online (AJOL)

    ABUTH

    Objective: To examine the effects of aging on the existence of transient evoked otoacoustic emissions in normal adult. Material and methods 40 ... wax or any middle ear pathology which might affect the recording at TEOAEs. After that, ... related to decreased hearing sensitivity and are independent of aging, Previous studies.

  12. Neural correlates of evoked phantom limb sensations.

    Science.gov (United States)

    Andoh, J; Diers, M; Milde, C; Frobel, C; Kleinböhl, D; Flor, H

    2017-05-01

    Previous work showed the existence of changes in the topographic organization within the somatosensory cortex (SI) in amputees with phantom limb pain, however, the link between nonpainful phantom sensations such as cramping or tingling or the percept of the limb and cortical changes is less clear. We used functional magnetic resonance imaging (fMRI) in a highly selective group of limb amputees who experienced inducible and reproducible nonpainful phantom sensations. A standardized procedure was used to locate body sites eliciting phantom sensations in each amputee. Selected body sites that could systematically evoke phantom sensations were stimulated using electrical pulses in order to induce phasic phantom sensations. Homologous body parts were also stimulated in a group of matched controls. Activations related to evoked phantom sensations were found bilaterally in SI and the intraparietal sulci (IPS), which significantly correlated with the intensity of evoked phantom sensations. In addition, we found differences in intra- and interhemispheric interaction between amputees and controls during evoked phantom sensations. We assume that phantom sensations might be associated with a functional decoupling between bilateral SI and IPS, possibly resulting from transcallosal reorganization mechanisms following amputation. Copyright © 2017. Published by Elsevier B.V.

  13. PET-CT offers accurate assessment of tumour length in oesophageal malignancy

    Energy Technology Data Exchange (ETDEWEB)

    Rollins, K.E., E-mail: james.catton@nuh.nhs.uk [Department of Oesophago-Gastric Surgery, Nottingham University Hospitals, Hucknall Road, Nottingham (United Kingdom); Lucas, E. [University of Nottingham, Derby Road, Nottingham (United Kingdom); Tewari, N. [Department of Oesophago-Gastric Surgery, Nottingham University Hospitals, Hucknall Road, Nottingham (United Kingdom); James, E. [Department of Oncology, Nottingham University Hospitals, Hucknall Road, Nottingham (United Kingdom); Hughes, S. [Department of Radiology, Nottingham University Hospitals, Hucknall Road, Nottingham (United Kingdom); Catton, J.A. [Department of Oesophago-Gastric Surgery, Nottingham University Hospitals, Hucknall Road, Nottingham (United Kingdom)

    2015-02-15

    Highlights: • We examine the accuracy of staging modalities in estimating tumour length of oesophageal malignancy. • PET CT correlates most strongly with histopathological length of resected specimen. • Better measure than EUS with OGD correlating poorly. • Potential impact in radiotherapy and surgical resection planning. - Abstract: Introduction: Radiotherapy is increasingly used for both curative and palliative treatment of oesophageal malignancy. Accurate treatment depends on determining tumour location and length. This study assessed the value of PET-CT versus other staging modalities in determining tumour length. Materials and methods: Oesophageal cancer patients who underwent staging with PET/CT and endoscopic ultrasound (EUS) in addition to their diagnostic upper GI endoscopy and subsequent surgical resection were assessed. PET/CT length was obtained retrospectively by using Hermes Hybrid Viewer™ with a 1–5 Standardised Uptake Value grey scale. An SUV of 5 was used as the cut off for determining length. Direct measurement by EUS and OGD were determined. Results: 53 patients underwent PET-CT, EUS, OGD and surgical resection for oesophageal cancer. Overall the correlation between PET-CT and histopathological length was strongest (Pearson r = 0.5977, 95% CI 0.390–0.747) versus EUS (Pearson R = 0.5365, 95% CI 0.311–0.705) and OGD (Pearson r = 0.1574, 95% CI −0.118 to 0.410). After excluding tumours with a significant chemotherapy response, PET-CT length correlated significantly with histopathological length (R = 0.5651, p = 0.0005). In comparison, the correlation between histological length and EUS (R = 0.4637, p = 0.0057) measurement was less significant and this did not correlate with OGD (R = −0.1084, p = 0.5417). Conclusion: Tumour length estimated by PET-CT correlated most strongly with histopathological length of oesophageal malignancy and is the most accurate determinant of tumour length of all the staging modalities. This suggests a

  14. Visually Evoked Spiking Evolves While Spontaneous Ongoing Dynamics Persist

    DEFF Research Database (Denmark)

    Huys, Raoul; Jirsa, Viktor K; Darokhan, Ziauddin

    2016-01-01

    attractor. Its existence guarantees that evoked spiking return to the spontaneous state. However, the spontaneous ongoing spiking state and the visual evoked spiking states are qualitatively different and are separated by a threshold (separatrix). The functional advantage of this organization...

  15. Phase II study of biweekly cetuximab in combination with irinotecan as second-line treatment in patients with platinum-resistant gastro-oesophageal cancer

    DEFF Research Database (Denmark)

    Schønnemann, K R; Yilmaz, Mette Karen; Bjerregaard, J K

    2012-01-01

    The purpose of this phase II trial was to evaluate the efficacy and safety of cetuximab and irinotecan as second-line treatment in patients with gastro-oesophageal adenocarcinoma.......The purpose of this phase II trial was to evaluate the efficacy and safety of cetuximab and irinotecan as second-line treatment in patients with gastro-oesophageal adenocarcinoma....

  16. Partial symptom-response to proton pump inhibitors in patients with non-erosive reflux disease or reflux oesophagitis - a post hoc analysis of 5796 patients

    DEFF Research Database (Denmark)

    Bytzer, P; van Zanten, S Veldhuyzen; Mattsson, H

    2012-01-01

    Although most patients with gastro-oesophageal reflux disease (GERD) benefit from proton pump inhibitor (PPI) therapy, some experience only partial symptom relief.......Although most patients with gastro-oesophageal reflux disease (GERD) benefit from proton pump inhibitor (PPI) therapy, some experience only partial symptom relief....

  17. The neonatal development of the light flash visual evoked potential.

    Science.gov (United States)

    Kraemer, M; Abrahamsson, M; Sjöström, A

    1999-01-01

    To follow visual development longitudinally in the normal neonate using the flash visual evoked potential (VEP) and to find indications for a relationship between potential development and visual development. Twenty healthy infants, born at term, were included in the study. Flash and patterned flash VEPs were used. The first VEP was recorded the day of birth or just postnatally, and succeeding recordings were performed the following weeks and months. The data revealed different types of VEP in the neonatal period suggesting great variability in visual function on the day of birth. In the early development a potential of long latency and duration preceded the development of a more compound potential of shorter latency. The two types of responses seemed to coalesce during early development; the first late response was attenuated and was eventually integrated in the more mature VEP. At approximately five weeks of age changes in the VEP were simultaneous with the development of responsive smiling and another visual behaviour of the infants. The results showed many similarities between the VEP development in infants and in immature animals. In developing animals geniculo-cortical and extra-geniculate visual afferent pathways evoke two types of VEPs similar to those recorded in the present study. The early responses were also similar to previous recordings from children with lesions in the geniculo-striatal pathway or primary cortex. Our interpretation of the results was that the human VEP also consists of responses evoked by afferents running both in geniculo-cortical and extra-geniculate pathways and that the two types of responses could be separated in the VEP in the neonatal period. These findings are important for our understanding of conditions with a delay in visual maturation, for example intracranial haemorrhages, hydrocephalus, pre/dys-maturity and 'idiopathic' delayed visual maturation.

  18. Wiener kernel analysis of a noise-evoked otoacoustic emission

    NARCIS (Netherlands)

    van Dijk, P; Maat, A; Wit, H P

    1997-01-01

    In one specimen of the frog species, Rana esculenta, the following were measured: (1) a spontaneous otoacoustic emission; (2) a click-evoked otoacoustic emissions; and (3) a noise evoked otoacoustic emission. From the noise evoked emission response, a first-and a second-order Wiener kernel and the

  19. Isoflurane reduces the carbachol-evoked Ca2+ influx in neuronal cells.

    Science.gov (United States)

    Corrales, Alexandra; Xu, Fang; Garavito-Aguilar, Zayra V; Blanck, Thomas J J; Recio-Pinto, Esperanza

    2004-10-01

    The authors previously reported that the isoflurane-caused reduction of the carbachol-evoked cytoplasmic Ca transient increase ([Ca]cyt) was eliminated by K or caffeine-pretreatment. In this study the authors investigated whether the isoflurane-sensitive component of the carbachol-evoked [Ca]cyt transient involved Ca influx through the plasma membrane. Perfused attached human neuroblastoma SH-SY5Y cells were exposed to carbachol (1 mm, 2 min) in the absence and presence of isoflurane (1 mm) and in the absence and presence of extracellular Ca (1.5 mm). The authors studied the effect of the nonspecific cationic channel blocker La (100 microm), of the L-type Ca channel blocker nitrendipine (10 microm), and of the N-type Ca channel blocker omega-conotoxin GVIA (0.1 microm) on isoflurane modulation of the carbachol-evoked [Ca]cyt transient. [Ca]cyt was detected with fura-2 and experiments were carried out at 37 degrees C. Isoflurane reduced the peak and area of the carbachol-evoked [Ca]cyt transient in the presence but not in the absence of extracellular Ca. La had a similar effect as the removal of extracellular Ca. Omega-conotoxin GVIA and nitrendipine did not affect the isoflurane sensitivity of the carbachol response although nitrendipine reduced the magnitude of the carbachol response. The current data are consistent with previous observations in that the carbachol-evoked [Ca]cyt transient involves both Ca release from intracellular Ca stores and Ca entry through the plasma membrane. It was found that isoflurane attenuates the carbachol-evoked Ca entry. The isoflurane sensitive Ca entry involves a cationic channel different from the L- or N- type voltage-dependent Ca channels. These results indicate that isoflurane attenuates the carbachol-evoked [Ca]cyt transient at a site at the plasma membrane that is distal to the muscarinic receptor.

  20. Motor behaviors in the sheep evoked by electrical stimulation of the subthalamic nucleus.

    Science.gov (United States)

    Lentz, Linnea; Zhao, Yan; Kelly, Matthew T; Schindeldecker, William; Goetz, Steven; Nelson, Dwight E; Raike, Robert S

    2015-11-01

    Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is used to treat movement disorders, including advanced Parkinson's disease (PD). The pathogenesis of PD and the therapeutic mechanisms of DBS are not well understood. Large animal models are essential for investigating the mechanisms of PD and DBS. The purpose of this study was to develop a novel sheep model of STN DBS and quantify the stimulation-evoked motor behaviors. To do so, a large sample of animals was chronically-implanted with commercial DBS systems. Neuroimaging and histology revealed that the DBS leads were implanted accurately relative to the neurosurgical plan and also precisely relative to the STN. It was also possible to repeatedly conduct controlled evaluations of stimulation-evoked motor behavior in the awake-state. The evoked motor responses depended on the neuroanatomical location of the electrode contact selected for stimulation, as contacts proximal to the STN evoked movements at significantly lower voltages. Tissue stimulation modeling demonstrated that selecting any of the contacts stimulated the STN, whereas selecting the relatively distal contacts often also stimulated thalamus but only the distal-most contact stimulated internal capsule. The types of evoked motor behaviors were specific to the stimulation frequency, as low but not high frequencies consistently evoked movements resembling human tremor or dyskinesia. Electromyography confirmed that the muscle activity underlying the tremor-like movements in the sheep was consistent with human tremor. Overall, this work establishes that the sheep is a viable a large-animal platform for controlled testing of STN DBS with objective motor outcomes. Moreover, the results support the hypothesis that exaggerated low-frequency activity within individual nodes of the motor network can drive symptoms of human movement disorders, including tremor and dyskinesia. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Surgical treatment of benign tracheo-oesophageal fistulas with tracheal resection and oesophageal primary closure: is the muscle flap really necessary?

    Science.gov (United States)

    Camargo, José Jesus; Machuca, Tiago Noguchi; Camargo, Spencer Marcantônio; Lobato, Vivalde F; Medina, Carlos Remolina

    2010-03-01

    Nowadays, despite the advances of the low-pressure high-volume cuffs, post-intubation tracheo-oesophageal fistula (TEF) still poses a major challenge to thoracic surgeons. The original technique includes interposition of muscle flaps between suture lines to avoid recurrence. It is not clear if this manoeuvre is indispensable and, in fact, we and others have faced problems with it. Our aim is to present our experience with TEF management in a consecutive group with no muscle interposition. From June 1992 to November 2007, we evaluated 14 patients presenting with TEF, with a mean age of 44 years (from 18 to 79 years). Thirteen patients had a prolonged intubation history. The remaining case was a 40-year-old male with congenital TEF. Three patients had been previously submitted to failed repairs in other institutions. Ten patients had associated tracheal stenosis, which was subglottic in three of them. Regarding surgical technique, in all cases, we performed a single-staged procedure, which consisted of tracheal resection and anastomosis with double-layer oesophageal closure. In none of our cases was a muscle flap interposed between suture lines. All operations were performed through a cervical incision; however, in one case, an extension with partial sternotomy was required. There was no operative mortality. Thirteen patients were extubated in the first 24h after the procedure, while one patient required 48 h of mechanical ventilation. Four complications were recorded: one each of pneumonia and left vocal cord paralysis and two small tracheal dehiscences managed with a T-tube and a tracheostomy tube. After discharge, three patients returned to their native cities and were lost to follow-up. The remaining 11 patients have been followed up by a mean of 32 months (from three to 108 months), with 10 presenting excellent and one good anatomic and functional results. The single-staged repair with tracheal resection and anastomosis with oesophageal closure provides good

  2. Sensory gating of auditory evoked potentials in rats: Effects of repetitive stimulation and the interstimulus interval

    NARCIS (Netherlands)

    Bruin, N.M.W.J. de; Ellenbroek, B.A.; Schaijk, W.J. van; Cools, A.R.; Coenen, A.M.L.; Luijtelaar, E.L.J.M. van

    2001-01-01

    In the P50 gating or conditioning-testing (C-T) paradigm, the P50 response, a small positive midlatency (~50 ms after stimulus onset) component of the human auditory evoked potential (AEP), is reduced towards the second click (S2) as compared to the response to the first click (S1). This phenomenon

  3. Sensory gating of auditory evoked potentials in rats: effects of repetitive stimulation and the interstimulus interval.

    NARCIS (Netherlands)

    Bruin, N.M.W.J. de; Ellenbroek, B.A.; Schaijk, W.J. van; Cools, A.R.; Coenen, A.M.L.; Luijtelaar, E.L.J.M. van

    2001-01-01

    In the P50 gating or conditioning-testing (C-T) paradigm, the P50 response, a small positive midlatency ( approximately 50 ms after stimulus onset) component of the human auditory evoked potential (AEP), is reduced towards the second click (S2) as compared to the response to the first click (S1).

  4. The behavior of evoked otoacoustic emissions during and after postural changes

    NARCIS (Netherlands)

    de Kleine, E; Wit, HP; Avan, P; van Dijk, P

    Click-evoked and stimulus frequency otoacoustic emissions (CEOAEs and SFOAEs, respectively) were studied in humans during and after postural changes. The subjects were tilted from upright to a recumbent position (head down 30 deg) and upright again. Due to the downward posture change, CEOAEs showed

  5. Altered Evoked Gamma-Band Responses Reveal Impaired Early Visual Processing in ADHD Children

    Science.gov (United States)

    Lenz, Daniel; Krauel, Kerstin; Flechtner, Hans-Henning; Schadow, Jeanette; Hinrichs, Hermann; Herrmann, Christoph S.

    2010-01-01

    Neurophysiological studies yield contrary results whether attentional problems of patients with attention-deficit/hyperactivity disorder (ADHD) are related to early visual processing deficits or not. Evoked gamma-band responses (GBRs), being among the first cortical responses occurring as early as 90 ms after visual stimulation in human EEG, have…

  6. Thought-evoking approaches in engineering problems

    CERN Document Server

    2014-01-01

    In creating the value-added product in not distant future, it is necessary and inevitable to establish a holistic and though-evoking approach to the engineering problem, which should be at least associated with the inter-disciplinary knowledge and thought processes across the whole engineering spheres. It is furthermore desirable to integrate it with trans-disciplinary aspects ranging from manufacturing culture, through liberal-arts engineering, and industrial sociology.   The thought-evoking approach can be exemplified and typified by representative engineering problems: unveiling essential features in ‘Tangential Force Ratio and Interface Pressure’, prototype development for ‘Bio-mimetic Needle’ and application of ‘Water-jet Machining to Artificial Hip Joint’, product innovation in ‘Heat Sink for Computer’, application of ‘Graph Theory’ to similarity evaluation of production systems, leverage among reciprocity attributes in ‘Industrial and Engineering Designs for Machine Enclosure’,...

  7. Endosonography can detect residual tumour infiltration after medical treatment of oesophageal cancer in the absence of endoscopic lesions.

    Science.gov (United States)

    Nousbaum, J B; Robaszkiewicz, M; Cauvin, J M; Calament, G; Gouerou, H

    1992-01-01

    Endoscopic ultrasound (endosonography) is useful in the preoperative staging of oesophageal tumours. It may also have a role in evaluation and surveillance of patients with inoperable carcinomas. Thirty four patients with inoperable oesophageal cancer were investigated by endosonography and computed tomography before medical treatment. In 10 patients receiving combined chemotherapy and radiotherapy, the endoscopic lesions resolved and biopsy specimens were negative. When endosonography suggested the persistence of tumour infiltration in these patients, a local recurrence or distant metastases appeared within a few months. In contrast, when no infiltration was detected, no tumoral recurrence or progression was observed within eight months. These results suggest that endosonography is better than endoscopic biopsy specimens and computed tomography in assessing the response of oesophageal carcinoma to non-surgical treatment. Images Figure 1 Figure 2 PMID:1452067

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

    Science.gov (United States)

    Winzer, Brooke M; Paratz, Jennifer D; Reeves, Marina M; Whiteman, David C

    2010-06-16

    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 preventing the progression of

  9. Music-Evoked Emotions-Current Studies.

    Science.gov (United States)

    Schaefer, Hans-Eckhardt

    2017-01-01

    The present study is focused on a review of the current state of investigating music-evoked emotions experimentally, theoretically and with respect to their therapeutic potentials. After a concise historical overview and a schematic of the hearing mechanisms, experimental studies on music listeners and on music performers are discussed, starting with the presentation of characteristic musical stimuli and the basic features of tomographic imaging of emotional activation in the brain, such as functional magnetic resonance imaging (fMRI) and positron emission tomography (PET), which offer high spatial resolution in the millimeter range. The progress in correlating activation imaging in the brain to the psychological understanding of music-evoked emotion is demonstrated and some prospects for future research are outlined. Research in psychoneuroendocrinology and molecular markers is reviewed in the context of music-evoked emotions and the results indicate that the research in this area should be intensified. An assessment of studies involving measuring techniques with high temporal resolution down to the 10 ms range, as, e.g., electroencephalography (EEG), event-related brain potentials (ERP), magnetoencephalography (MEG), skin conductance response (SCR), finger temperature, and goose bump development (piloerection) can yield information on the dynamics and kinetics of emotion. Genetic investigations reviewed suggest the heredity transmission of a predilection for music. Theoretical approaches to musical emotion are directed to a unified model for experimental neurological evidence and aesthetic judgment. Finally, the reports on musical therapy are briefly outlined. The study concludes with an outlook on emerging technologies and future research fields.

  10. Visual acuity of the midland banded water snake estimated from evoked telencephalic potentials.

    Science.gov (United States)

    Baker, Robert A; Gawne, Timothy J; Loop, Michael S; Pullman, Sheena

    2007-08-01

    The visual acuity of seven midland banded water snakes was measured by recording evoked responses from telencephalon to temporally modulated square wave grating patterns. Using conventional electrophysiological techniques and signal averaging, high contrast square wave gratings of different spatial frequencies were presented. Acuity was estimated by extrapolating relative response amplitude/log(10) spatial frequency functions which yielded an average acuity of 4.25 cycles/degree. Refractive state was also estimated by recording evoked potentials to intermediate spatial frequencies with different lenses in front of the eye. Polynomial fits indicated that under the experimental conditions the snakes were around 6.4 diopters hyperopic suggesting a corrected acuity of 4.89 cycles/degree. Reduction of grating luminance resulted in a reduction in evoked potential acuity measurements. These results indicate that the spatial resolution of midland banded water snakes is the equal of cat; about 20/120 in human clinical terms.

  11. Eosinophilic Oesophagitis in Infants and Children in the Region of Southern Denmark: A Prospective Study of Prevalence and Clinical Presentation

    DEFF Research Database (Denmark)

    Dalby, Kasper; Nielsen, Rasmus G; Kruse-Andersen, Soren

    2010-01-01

    OBJECTIVE:: Eosinophilic oesophagitis (EE) is a clinical entity characterised by a set of symptoms and eosinophilic infiltration of the oesophageal epithelium. Recent reports indicate that EE is increasingly diagnosed in paediatric patients. We aimed to evaluate the epidemiology of paediatric EE...... and 16 years of age, a yearly incidence of EE of 0.16/10,000 was estimated. CONCLUSION:: We report a European prospective study of EE. It was documented in 6 of 78 patients with symptoms of GERD corresponding to an annual incidence of 0.16/10,000 infants and children....

  12. Expression of the calpain system is associated with poor clinical outcome in gastro-oesophageal adenocarcinomas.

    Science.gov (United States)

    Storr, Sarah J; Pu, Xuan; Davis, Jillian; Lobo, Dileep; Reece-Smith, Alex M; Parsons, Simon L; Madhusudan, Srinivasan; Martin, Stewart G

    2013-11-01

    Surgery is critical in the management of gastro-oesophageal cancer, and the addition of neo-adjuvant chemotherapy has proved to be of benefit. The calpain system has been implicated in tumour progression and response to various anti-cancer therapies, and therefore expression of the system was determined in this tumour type. Two cohorts of gastro-oesophageal adenocarcinomas were investigated for calpain-1, calpain-2, calpain-9 and calpastatin expression using conventional immunohistochemistry. 88 patients who received neo-adjuvant chemotherapy and 140 patients who received surgery alone were investigated using a tissue microarray approach. Calpain-1, calpain-2 and calpastatin expression was associated with adverse cancer-specific survival in the neo-adjuvant cohort (P = 0.004, P = 0.001 and P = 0.012 respectively); which remained significant in multivariate analysis (Hazard ratio (HR) = 0.337; 95% confidence interval (CI) = 0.140-0.81; P = 0.015, HR = 0.375; 95% CI = 0.165-0.858; P = 0.020 and HR = 0.481; 95% CI = 0.257-0.900; P = 0.022 respectively). Calpain-1 and calpastatin expression was also associated with adverse cancer specific survival in the primary surgery cohort (P = 0.001 and P = 0.013 respectively); which remained significant in multivariate analysis (HR = 0.309; 95% CI = 0.159-0.601; P = 0.001 and HR = 0.418; 95% CI = 0.205-0.850; P = 0.016 respectively). Calpain-9 expression was not associated with cancer-specific survival in the neo-adjuvant and primary surgery cohorts. Determining the expression levels of calpain-1, calpain-2 and calpastatin may provide clinically relevant prognostic information for gastro-oesophageal adenocarcinomas; these findings warrant further studies in larger cohorts of patients.

  13. Research priority setting in Barrett's oesophagus and gastro-oesophageal reflux disease.

    Science.gov (United States)

    Britton, James; Gadeke, Lisa; Lovat, Laurence; Hamdy, Shaheen; Hawkey, Chris; McLaughlin, John; Ang, Yeng

    2017-11-01

    The incidence of gastro-oesophageal reflux disease and Barrett's oesophagus is increasing. Barrett's oesophagus is the main precursor to oesophageal adenocarcinoma, which has a poor prognosis. In view of the vast potential burden of these diseases on patients and health-care resources, there is a real need to define and focus research efforts. This priority setting exercise aimed to produce a list of the top ten uncertainties in the field that reflect the priorities of patients and health-care providers. We adopted the robust and transparent methodologies previously outlined by the James Lind Alliance. This qualitative approach firstly involves an ideas gathering survey that, once distilled, generates a longlist of research uncertainties. These uncertainties are then prioritised via an interim ranking survey and a final workshop to achieve consensus agreement. The initial 629 uncertainties, generated from a survey of 170 individual respondents (47% professional, 53% non-professional) and one workshop, were narrowed down to the final top ten uncertainties of priority for future research. These priorities covered a range of issues, including a need for improved patient risk stratification, alternative diagnostic and surveillance tests, efficacy of a dedicated service for Barrett's oesophagus, cost-effectiveness and appropriateness of current surveillance, advances in development of non-drug treatments for gastro-oesophageal reflux disease, safety of long-term drug treatment, and questions regarding the durability and role of different endoscopic therapies for dysplastic Barrett's oesophagus. This is the first patient-centred assessment of priorities for researchers in this chronic disease setting. We hope that recognition and dissemination of these results will shape the future direction of research and translate into meaningful gains for patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Pre and post PET-CT impact on oesophageal cancer management: a retrospective analysis.

    Science.gov (United States)

    Azmi, NA; Razak, HRA; Vinjamuri, S.

    2017-05-01

    Assessment of the retrospective cancer incidence, prevalence and crude survival rates of oesophageal cancer to allow comparison between pre and post PET-CT introduction are part of 4 phase cost effectiveness research. It will provide baseline data for to assess PET or PET-CT cost effective potential for staging. A total of 849 patient’s data received from NWCIS databases with various stages of oesophageal cancer between 2001 and 2008. The fundamental activities are retrospective analysis of patient data. In most cases where appropriate, results are presented with 95 percent confidence intervals (CI). Variances between patient groups and variables are assessed using chi-square test. In cases where it deems vital, multiple logistic regression are used to modify for potential confounder such as age and sex. All p-values are two-sided and any value lower than 0.05 were considered to suggest a statistically significant result. Retrospective analysis were categorised into two categories, patients from 2001-2003 considered as pre PET and post PET for 2004-2008. This categorisation allows better comparison of patients’ survival trend to be made between both groups. Rates are presented in percentages and being grouped by tumour characteristics and other variables associated with demographic profile, diagnosis, staging and treatment. Results allowed comparison of oesophageal cancer trends between the pre and post PET-CT introduction such as changes in incidence rate or changes in survival. These data were used to normalise the decision tree model so that cost-effectiveness analysis can be performed across the whole population.

  15. FDG-PET in the initial staging of squamous cell oesophageal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Buchmann, I.; Schreckenberger, M.; Bartenstein, P. [Dept. of Nuclear Medicine, Univ. Hospital Mainz (Germany); Hansen, T. [Inst. of Pathology, Univ. Hospital, Jena (Germany); Inst. of Pathology, Univ. Hospital, Mainz (Germany); Brochhausen, C. [Inst. of Pathology, Univ. Hospital, Mainz (Germany); Kneist, W.; Junginger, T. [Dept. of Surgery, Univ. Hospital Mainz (Germany); Oberholzer, K. [Dept. of Radiology, Univ. Hospital Mainz (Germany)

    2006-07-01

    Squamous cell oesophageal carcinoma is the most common carcinoma of the oesophagus worldwide. The tumour stage as most important prognostic factor determines the clinical management. Aim of this study was to evaluate the value of FDG-PET 1. in imaging the primary tumour and 2. in N- and M-staging of squamous cell oesophogeal carcinoma. Patients, methods: in 20 patients with histological proven squamous cell carcinoma of the upper and middle oesophagus, FDG-PET was performed in standard technique prior to therapy. FDG uptake in the primary was determined by calculation of the SUVmax. NM-staging due to PET findings was performed as designated by the AJCC/UICC group classification and was compared with pathological and clinically based staging. Sensitivities, specificities and accuracies were calculated. Results: in 19 of 20 patients, primary squamous cell oesopohageal carcinoma was detected by FDG-PET findings with a maximum SUV of 12.5 (mean) {+-} 5.1 (median 11.5; range 4.8-23.8). One carcinoma in situ was missed. The sensitivity of FDG-PET in imaging the primary tumour was 96%. The sensitivities, specificities and accuracies were 20%, 100%, 58% for N-staging, and 60%, 86% and 93% for M-staging. PET findings caused changes of therapy in 5% (1 patient). Conclusions: FDG-PET was excellent in imaging the primary of squamous cell oesophageal carcinoma in stage T1-T4 and was efficient in M-staging. The low sensitivity in N-staging is of inferior clinical importance. The efficacy of FDG-PET seems to be not significantly be influenced by the histological subtype of oesophageal carcinoma. (orig.)

  16. Carcinogenic nitrosamines in traditional beer as the cause of oesophageal squamous cell carcinoma in black South Africans.

    Science.gov (United States)

    Pillay, Viness; Isaacson, Charles; Mothobi, Pride; Hale, Martin; Tomar, Lomas Kumar; Tyagi, Charu; Altini, Mario; Choonara, Yahya Essop; Kumar, Pradeep

    2015-09-21

    Before the 1930s, squamous cell carcinoma (SCC) of the oesophagus was almost unknown among black South Africans. From the 1930s the annual frequency rose. A dietary cause was sought, the staple diet of black people having changed from sorghum to maize (corn), with traditional beer being brewed from maize. Carcinogenic N-nitrosamines in traditional beer were suggested as a cause of SCC of the oesophagus, with Fusarium moniliforme, a corn saprophyte, thought to play a role. To confirm the presence of N-nitrosamines in traditional beer and demonstrate a mechanism for the oncogenesis of oesophageal carcinoma. Analysis by high-performance liquid chromatography was conducted for the identification of nitrosamines in traditional beer samples, and molecular docking studies were employed to predict the affinity between N-nitrosamines and the S100A2 protein. Carcinogenic N-nitrosamines were identified in all six samples of traditional beer examined (N=18 analyses), and docking studies confirmed a high affinity of the nitrosamine N-nitrosopyrrolidone with the S100A2 protein. This may result in the altered expression of the S100A2 protein, leading to tumour progression and prognosis. It is suggested that carcinogenic N-nitrosamines in traditional beer are a major factor in the causation of SCC of the oesophagus in black South Africans. N-nitrosamines have been shown to produce cancer experimentally, but there has not been conclusive epidemiological evidence that N-nitrosamines are carcinogenic to humans. This study is the first to demonstrate the potential link between N-nitrosamines and a human tumour.

  17. [Loss of brain stem auditory evoked potential waves I and II during controlled hypotension].

    Science.gov (United States)

    Papadopoulos, G; Lang, M; Link, J; Schäfer, M; Schaffartzik, W; Eyrich, K; Bornfeld, N; Foerster, M H

    1995-11-01

    For surgical removal of a malignant choroid melanoma, it is necessary to reduce systolic blood pressure to around 50-60 mmHg in order to prevent choroidal haemorrhages. However, blood pressure reduction is associated with the risk of cerebral ischaemia. We report a patient with a malignant choroid melanoma in whom waves I and II of the brainstem auditory evoked potentials (BAEP) disappeared during surgery under controlled arterial hypotension and hypothermia (31.1 degrees C). The waves could be recorded again immediately after the mean arterial pressure was increased from 48 to 77 mmHg. The oesophageal temperature had dropped by 0.3 degrees C at this time. The 2-channel electroencephalogram (EEG) showed no irregularities during this time period. A bilateral, reversible, apparently blood-pressure-dependent loss of waves I and II during arterial hypotension despite a normal EEG has to our knowledge not been previously described in the literature. The isolated loss of waves I and II with maintenance of waves III, IV, and V is unusual. The literature contains reports of acoustic neurinoma patients in whom only wave V could be recorded. This is regarded as an indication of continued impulse conduction despite the loss of waves I to IV. Others have observed a patient with temporary and reversible loss of BAEP wave I due to vasospasm of the internal auditory artery that apparently occurred during or shortly after manipulation of the internal auditory meatus. Assuming anatomic peculiarities in the blood supply to the generators of the BAEP waves, a stenosis of the basilar artery could be considered as the cause of the bilateral reversible loss of waves I and II. Another potential source could be induced hypothermia, but this does not seem very likely because the patient's temperature was 0.3 degrees C lower at the return of the waves than at their loss.

  18. Secondary oesophageal or gastric cancer in patients treated for head and neck squamous cell carcinoma

    DEFF Research Database (Denmark)

    Rosenlund Andersen, Anja; Bjerring, Ole Steen; Godballe, Christian

    2016-01-01

    INTRODUCTION: Patients with head and neck squamous cell carcinoma (HNSCC) are at an elevated risk of developing second primary malignancies (SPM). Our objectives were to estimate the excess risk of oesophageal and gastric SPMs in patients with malignancies of the pharynx or larynx and, additionally......, to examine possible risk factors of developing SPMs. METHODS: Data on all patients treated for HNSCC with curative intent in the Region of Southern Denmark in the period between 1 January 2000 and 31 December 2010 were reviewed. A total of 1,172 patients were identified. The combined data from the DAHANCA...

  19. Gaviscon and Carobel compared with cisapride in gastro-oesophageal reflux.

    OpenAIRE

    Greally, P; Hampton, F J; MacFadyen, U M; Simpson, H

    1992-01-01

    We compared the efficacy of the prokinetic agent cisapride with that of Gaviscon (an alginate/alkaline compound) plus Carobel (carob seed flour) in the treatment of gastrooesophageal reflux (GOR). Fifty infants with confirmed GOR received either oral cisapride (0.8 mg/kg/day) or Gaviscon plus Carobel for one month in a randomised, parallel group study. Parental evaluations, diary scores, and 24 hour lower oesophageal pH recordings before and at the end of each treatment were compared. In the ...

  20. Enhancement of Spanish Oesophageal Speech vowels using coherent subband modulator Kalman filtering.

    Science.gov (United States)

    Ishaq, Rizwan; Zapirain, Begoña García

    2016-01-01

    This paper proposes an Oesophageal Speech (OES) enhancement method, based on Kalman filtering. The Kalman filter is applied to modulators of OES frequency subbands instead of the fullband signal. The OES frequency subbands are decomposed into modulators and carriers components using coherent demodulation. In comparison with fullband Kalman filtering and pole stabilization, the proposed technique shows better results. The system performance is evaluated objectively and subjectively using the Harmonic to Noise Ratio (HNR) and Mean Opinion Score (MOS) respectively. Results have shown that Kalman filter in subband modulators processing is robust and efficient, improving the HNR by 4 to 5 dB for all Spanish vowels.

  1. The great debate: open or thoracoscopic repair for oesophageal atresia or diaphragmatic hernia.

    Science.gov (United States)

    Davenport, Mark; Rothenberg, Steven S; Crabbe, David C G; Wulkan, Mark L

    2015-02-01

    Controversy exists over the best method and technique of repair of oesophageal atresia and diaphragmatic hernia. Open surgical repairs have a long established history of over 60 years of experience. Set against this has been a series of successful thoracoscopic repairs of both congenital anomalies reported over the past decade. This review was based upon a four-handed debate on the merits and weaknesses of the two contrasting surgical philosophies and reviews existing literature, techniques, complications, and importantly outcome and results. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Risk factors for oesophageal, lung, oral and laryngeal cancers in black South Africans.

    Science.gov (United States)

    Pacella-Norman, R; Urban, M I; Sitas, F; Carrara, H; Sur, R; Hale, M; Ruff, P; Patel, M; Newton, R; Bull, D; Beral, V

    2002-06-05

    The authors used data collected from 1995 to 1999, from an on-going cancer case-control study in greater Johannesburg, to estimate the importance of tobacco and alcohol consumption and other suspected risk factors with respect to cancer of the oesophagus (267 men and 138 women), lung (105 men and 41 women), oral cavity (87 men and 37 women), and larynx (51 men). Cancers not associated with tobacco or alcohol consumption were used as controls (804 men and 1370 women). Tobacco smoking was found to be the major risk factor for all of these cancers with odds ratios ranging from 2.6 (95% CI 1.5-4.5) for oesophageal cancer in female ex-smokers to 50.9 (95% CI 12.6-204.6) for lung cancer in women, and 23.9 (95% CI 9.5-60.3) for lung cancer and 23.6 (95% CI 4.6-121.2) for laryngeal cancer in men who smoked 15 or more grams of tobacco a day. This is the first time an association between smoking and oral and laryngeal cancers has been shown in sub-Saharan Africa. Long-term residence in the Transkei region in the southeast of the country continues to be a risk factor for oesophageal cancer, especially in women (odds ratio=14.7, 95% CI 4.7-46.0), possibly due to nutritional factors. There was a slight increase in lung cancer (odds ratio=2.9, 95% CI 1.1-7.5) in men working in 'potentially noxious' industries. 'Frequent' alcohol consumption, on its own, caused a marginally elevated risk for oesophageal cancer (odds ratio=1.7, 95% CI 1.0-2.9, for women and odds ratio=1.8, 95% CI 1.2-2.8, for men). The risks for oesophageal cancer in relation to alcohol consumption increased significantly in male and female smokers (odds ratio=4.7, 95% CI=2.8-7.9 in males and odds ratio=4.8, 95% CI 3.2-6.1 in females). The above results are broadly in line with international findings. Copyright 2002 Cancer Research UK

  3. Perioperative epidural analgesia reduces cancer recurrence after gastro-oesophageal surgery.

    Science.gov (United States)

    Hiller, J G; Hacking, M B; Link, E K; Wessels, K L; Riedel, B J

    2014-03-01

    Recent interest has focused on the role of perioperative epidural analgesia in improving cancer outcomes. The heterogeneity of studies (tumour type, stage and outcome endpoints) has produced inconsistent results. Clinical practice also highlights the variability in epidural effectiveness. We considered the novel hypothesis that effective epidural analgesia improves cancer outcomes following gastro-oesophageal cancer surgery in patients with grouped pathological staging. Following institutional approval, a database analysis identified 140 patients, with 2-year minimum follow-up after gastro-oesophageal cancer surgery. All patients were operated on by a single surgeon (2005-2010). Information pertaining to cancer and survival outcomes was extracted. Univariate analysis demonstrated a 1-year 14% vs. 33% (P = 0.01) and 2-year 27% vs. 40% [hazard ratio (HR)=0.59; 95% CI, 0.32-1.09, P = 0.087] incidence of cancer recurrence in patients with (vs. without) effective (> 36 h duration) epidural analgesia, respectively. Multivariate analysis demonstrated increased time to cancer recurrence (HR = 0.33; 95% CI: 0.17-0.63, P < 0.0001) and overall survival benefit (HR = 0.42; 95% CI: 0.21-0.83, P < 0.0001) at 2-year follow-up following effective epidural analgesia. Subgroup analysis identified epidural-related cancer recurrence benefit in patients with oesophageal cancer (HR = 0.34; 95% CI: 0.16-0.75, P = 0.005) and in patients with tumour lymphovascular space infiltration (LVSI), (HR = 0.49; 95% CI: 0.26-0.94, P = 0.03). Effective epidural analgesia improved estimated median time to death (2.9 vs. 1.8 years, P = 0.029) in patients with tumour LVSI. This study found an association between effective post-operative epidural analgesia and medium-term benefit on cancer recurrence and survival following oesophageal surgery. A prospective study that controls for disease type, stage and epidural effectiveness is warranted. © 2014 The Acta

  4. Auditory evoked field measurement using magneto-impedance sensors

    Energy Technology Data Exchange (ETDEWEB)

    Wang, K., E-mail: o-kabou@echo.nuee.nagoya-u.ac.jp; Tajima, S.; Song, D.; Uchiyama, T. [Graduate School of Engineering, Nagoya University, Nagoya (Japan); Hamada, N.; Cai, C. [Aichi Steel Corporation, Tokai (Japan)

    2015-05-07

    The magnetic field of the human brain is extremely weak, and it is mostly measured and monitored in the magnetoencephalography method using superconducting quantum interference devices. In this study, in order to measure the weak magnetic field of the brain, we constructed a Magneto-Impedance sensor (MI sensor) system that can cancel out the background noise without any magnetic shield. Based on our previous studies of brain wave measurements, we used two MI sensors in this system for monitoring both cerebral hemispheres. In this study, we recorded and compared the auditory evoked field signals of the subject, including the N100 (or N1) and the P300 (or P3) brain waves. The results suggest that the MI sensor can be applied to brain activity measurement.

  5. Music-Evoked Emotions—Current Studies

    Directory of Open Access Journals (Sweden)

    Hans-Eckhardt Schaefer

    2017-11-01

    Full Text Available The present study is focused on a review of the current state of investigating music-evoked emotions experimentally, theoretically and with respect to their therapeutic potentials. After a concise historical overview and a schematic of the hearing mechanisms, experimental studies on music listeners and on music performers are discussed, starting with the presentation of characteristic musical stimuli and the basic features of tomographic imaging of emotional activation in the brain, such as functional magnetic resonance imaging (fMRI and positron emission tomography (PET, which offer high spatial resolution in the millimeter range. The progress in correlating activation imaging in the brain to the psychological understanding of music-evoked emotion is demonstrated and some prospects for future research are outlined. Research in psychoneuroendocrinology and molecular markers is reviewed in the context of music-evoked emotions and the results indicate that the research in this area should be intensified. An assessment of studies involving measuring techniques with high temporal resolution down to the 10 ms range, as, e.g., electroencephalography (EEG, event-related brain potentials (ERP, magnetoencephalography (MEG, skin conductance response (SCR, finger temperature, and goose bump development (piloerection can yield information on the dynamics and kinetics of emotion. Genetic investigations reviewed suggest the heredity transmission of a predilection for music. Theoretical approaches to musical emotion are directed to a unified model for experimental neurological evidence and aesthetic judgment. Finally, the reports on musical therapy are briefly outlined. The study concludes with an outlook on emerging technologies and future research fields.

  6. Music-Evoked Emotions—Current Studies

    Science.gov (United States)

    Schaefer, Hans-Eckhardt

    2017-01-01

    The present study is focused on a review of the current state of investigating music-evoked emotions experimentally, theoretically and with respect to their therapeutic potentials. After a concise historical overview and a schematic of the hearing mechanisms, experimental studies on music listeners and on music performers are discussed, starting with the presentation of characteristic musical stimuli and the basic features of tomographic imaging of emotional activation in the brain, such as functional magnetic resonance imaging (fMRI) and positron emission tomography (PET), which offer high spatial resolution in the millimeter range. The progress in correlating activation imaging in the brain to the psychological understanding of music-evoked emotion is demonstrated and some prospects for future research are outlined. Research in psychoneuroendocrinology and molecular markers is reviewed in the context of music-evoked emotions and the results indicate that the research in this area should be intensified. An assessment of studies involving measuring techniques with high temporal resolution down to the 10 ms range, as, e.g., electroencephalography (EEG), event-related brain potentials (ERP), magnetoencephalography (MEG), skin conductance response (SCR), finger temperature, and goose bump development (piloerection) can yield information on the dynamics and kinetics of emotion. Genetic investigations reviewed suggest the heredity transmission of a predilection for music. Theoretical approaches to musical emotion are directed to a unified model for experimental neurological evidence and aesthetic judgment. Finally, the reports on musical therapy are briefly outlined. The study concludes with an outlook on emerging technologies and future research fields. PMID:29225563

  7. Somatosensory evoked response: application in neurology

    Directory of Open Access Journals (Sweden)

    Carlos A. M. Guerreiro

    1982-03-01

    Full Text Available One technique used for short-latency somatosensory evoked response (SER is described. SER following nerve stimulation is a unique non-invasive, clinical test used to evaluate the somatosensory pathways. It tests the physiological function of the median nerve, the brachial plexus, the C6-7 cervical roots, cervical spinal cord, the cuneate nuclei, the medial lemniscus, the thalamus, and the contralateral sensory cortex. It has been shown to be a reliable and useful clinical test partiicularly in multiple sclerosis and comatose patients. The promising technique of SER following peroneal nerve stimulation is mentioned.

  8. Influence of respiratory physiotherapy on gastro-oesophageal reflux in infants: A systematic review.

    Science.gov (United States)

    Van Ginderdeuren, Filip; Kerckhofs, Eric; Deneyer, Michel; Vanlaethem, Sylvie; Vandenplas, Yvan

    2015-09-01

    To provide a survey on the literature concerning the influence of respiratory physiotherapy on gastro-oesophageal reflux (GOR) in infants and young children. Electronic databases (Pubmed, Web of Science, PEDro) and reference lists of articles and narrative reviews were searched. Articles were included when infants and small children underwent oesophageal pH monitoring or pH-multichannel intraluminal impedance monitoring while respiratory physiotherapy was administered. Descriptive analysis was performed and two researchers scored the methodological quality of these studies. Out of 985 articles, seven (six English, one French) have been included, In total 277 patients were involved, 71 with cystic fibrosis. Depending on the technique used, four studies showed GOR to be aggravated during therapy, three studies reported no effect. The evidence is not conclusive on whether respiratory physiotherapy induces or aggravates GOR in infants and small children. Age, disease, and treatment options play an important role. More specific research, also focussing on the influence of respiratory physiotherapy on non-acid reflux and the impact of recently developed airway clearance techniques (ACT's) on GOR is necessary. © 2015 Wiley Periodicals, Inc.

  9. Body size and composition and the risk of gastric and oesophageal adenocarcinoma.

    Science.gov (United States)

    MacInnis, Robert J; English, Dallas R; Hopper, John L; Giles, Graham G

    2006-05-15

    Although evidence has been mounting that obesity may be related to the increased incidence of oesophageal and gastric cardia malignancies, these reports (mainly case-control studies) have relied on imperfect measures of obesity such as body mass index (BMI), and generally have not clearly distinguished between anatomical subsites within the oesophagus and stomach. In a prospective study of people aged 27-75 years, we directly measured fat mass and fat-free mass (using bioelectrical impedance analysis), height, weight and waist and hip circumferences. Among 41,295 people followed on average for 11.3 years, 30 cases with cancers in the gastric cardia or lower third of the oesophagus and 68 cases with noncardia gastric adenocarcinomas were ascertained via the population cancer registry. The risk of adenocarcinoma of the lower oesophagus and gastric cardia was positively associated with BMI with a hazards ratio (HR) and (95% confidence interval) for people with BMI>or=30 kg/m2 compared with thosegastric adenocarcinoma showed little relationship with body size. We observed an increased risk of adenocarcinoma of the lower oesophagus and gastric cardia associated with increased BMI, central adiposity and the nonfat component of weight, but found no association with noncardia gastric adenocarcinoma. An increasing prevalence of obesity may be associated with the increasing incidence of gastro-oesophageal cancer observed in many populations. Copyright (c) 2005 Wiley-Liss, Inc.

  10. Oesophageal bezoar as a complication of enteral nutrition in critically ill patients. Two case studies.

    Science.gov (United States)

    Gil-Almagro, Fernanda; Carmona-Monge, Francisco Javier

    2016-02-01

    Enteral nutrition has a relatively low incidence of major complications. The most common complications are mechanical problems, bronchoaspiration and diarrhoea. A rare complication associated with the use of enteral nutrition is oesophageal bezoar. A bezoar is a body of undigested and partially digested matter in the gastrointestinal tract. The main risks factors are gastric motility dysfunction and the use of opiates or sucralfate. The aim of this paper was to present two cases of oesophageal obstruction resulting from the formation of bezoars due to enteral nutrition. Both patients experienced prolonged stays in the intensive care unit and were receiving enteral nutrition, and both cases involved an obstruction of the nasogastric tube and the regurgitation of solid chunks of enteral nutrition through the mouth and the nose. Impactions of solidified enteral nutrition in the distal parts of the oesophagus were confirmed with gastroscopies. Enzymatic complexes containing papain, cellulose, pancreatin, pepsin and diastase were used to successfully dissolve the bezoars in both cases. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Metabolic response at repeat PET/CT predicts pathological response to neoadjuvant chemotherapy in oesophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Gillies, R.S. [Oxford Cancer and Haematology Centre, Department of Oncology, Oxford (United Kingdom); Oxford Cancer and Haematology Centre, Department of Oesophagogastric Surgery, Oxford (United Kingdom); NIHR Biomedical Research Centre, Oxford (United Kingdom); Middleton, M.R. [Oxford Cancer and Haematology Centre, Department of Oncology, Oxford (United Kingdom); NIHR Biomedical Research Centre, Oxford (United Kingdom); Blesing, C.; Patel, K.; Warner, N. [Oxford Cancer and Haematology Centre, Department of Oncology, Oxford (United Kingdom); Marshall, R.E.K.; Maynard, N.D. [Oxford Cancer and Haematology Centre, Department of Oesophagogastric Surgery, Oxford (United Kingdom); Bradley, K.M. [Oxford Cancer and Haematology Centre, Department of Radiology, Oxford (United Kingdom); Gleeson, F.V. [Oxford Cancer and Haematology Centre, Department of Radiology, Oxford (United Kingdom); NIHR Biomedical Research Centre, Oxford (United Kingdom)

    2012-09-15

    Reports have suggested that a reduction in tumour 18F-fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET) examination during or after neoadjuvant chemotherapy may predict pathological response in oesophageal cancer. Our aim was to determine whether metabolic response predicts pathological response to a standardised neoadjuvant chemotherapy regimen within a prospective clinical trial. Consecutive patients staged with potentially curable oesophageal cancer who underwent treatment within a non-randomised clinical trial were included. A standardised chemotherapy regimen (two cycles of oxaliplatin and 5-fluorouracil) was used. PET/CT was performed before chemotherapy and repeated 24-28 days after the start of cycle 2. Forty-eight subjects were included: mean age 65 years; 37 male. Using the median percentage reduction in SUV{sub max} (42%) to define metabolic response, pathological response was seen in 71% of metabolic responders (17/24) compared with 33% of non-responders (8/24; P = 0.009, sensitivity 68%, specificity 70%). Pathological response was seen in 81% of subjects with a complete metabolic response (13/16) compared with 38% of those with a less than complete response (12/32; P = 0.0042, sensitivity 52%, specificity 87%). There was no significant histology-based effect. There was a significant association between metabolic response and pathological response; however, accuracy in predicting pathological response was relatively low. (orig.)

  12. HER2 testing in advanced gastric and gastro-oesophageal cancer: analysis of an Australia-wide testing program.

    Science.gov (United States)

    Kumarasinghe, M Priyanthi; Morey, Adrienne; Bilous, Michael; Farshid, Gelareh; Francis, Glenn; Lampe, Guy; McCue, Glenda; Von Neumann-Cosel, Vita; Fox, Stephen B

    2017-10-01

    This Australian human epidermal growth factor receptor 2 (HER2) testing program aimed to analyse >800 cases tested in a coordinated setting to further evaluate the criteria to establish HER2 status in advanced gastric and gastro-oesophageal junction (GOJ) cancer. Heterogeneity, and minimum number of biopsy fragments for reliable HER2 assessment were also examined in a subset of samples. Five laboratories tested 891 samples referred to determine HER2 status for potential anti-HER2 treatment. Cancer site, specimen type (endoscopic biopsy/resection/metastases), immunohistochemistry (IHC) score, HER2 gene and CEP17 copy number (CN) and HER2:CEP17 ratios were recorded. Samples were derived from stomach (53.1%), GOJ (28.2%) or metastases (18.5%). IHC for HER2 and dual probe HER2:CEP17 in situ hybridisation (ISH) were performed in parallel. A stringent definition (SD) of HER2 positivity was used (IHC2+/3+ plus CN>6 and ratio>2) and compared with other published criteria. HER2 positive rate was 13.9% (114/820) by SD, and 12.9-16.0% using other definitions. There was higher concordance between IHC and HER2 CN by ISH than with ratio. The HER2 positive rate was significantly higher in GOJ samples than others (p = 0.03) and in endoscopic biopsies than resections (p = 0.047). In a subset of 98 positive cases, 39 (39.8%) showed heterogeneity, and in 282 endoscopic biopsies positivity rate plateaued at five tumour fragments, suggesting this is the minimum number of biopsies that should be examined. Copyright © 2017 Royal College of Pathologists of Australasia. All rights reserved.

  13. Endoluminal brachytherapy in the treatment of oesophageal cancer: technique description, case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Luisa Castilla

    2015-07-01

    Full Text Available Endoesophageal brachytherapy is a useful technique for the palliative treatment of dysphagia in advanced oesophageal cancer. This technique offers good results on dysphagia control and quality of life. We report the case of a patient treated with this technique presenting complete response to the dysphagia. We describe endoesophageal brachyterapy technique and we comment on the literature.

  14. Review article: acidity and volume of the refluxate in the genesis of gastro-oesophageal reflux disease symptoms

    NARCIS (Netherlands)

    Sifrim, D.; Mittal, R.; Fass, R.; Smout, A.; Castell, D.; Tack, J.; Gregersen, H.

    2007-01-01

    BACKGROUND: A number of mechanisms, other than acid reflux, may be responsible for the symptoms of gastro-oesophageal reflux disease. AIM: To assess the importance of non-acid reflux mechanisms. METHODS: This review is based on presentations and discussion at a workshop, where specialists in the

  15. Association of ECRG2 TCA short tandem repeat polymorphism with the risk of oesophageal cancer in a North Indian population.

    Science.gov (United States)

    Jain, Meenu; Kumar, Shaleen; Ghoshal, Uday C; Mittal, Balraj

    2008-06-01

    Oesophageal cancer-related gene (ECRG2) is a tumour suppressor gene and it has been suggested that a triplet TCA short tandem repeat (STR) in the noncoding region of exon 4 plays a role in genetic susceptibility to oesophageal cancer. In the present study, ECRG2 STR polymorphism was studied in 134 patients with oesophageal cancer and 194 controls, using PCR and polyacrylamide gel electrophoresis. The results showed a higher frequency of the ECRG2 TCA (3)/TCA (4) genotype in cancer patients than in controls (odds ratio 2.6, 95% CI 1.0-6.4, p = 0.03). The association of the ECRG2 TCA (3)/TCA (4) genotype with clinical characteristics showed an increased risk for squamous cell histology (2.8, 95% CI 1.1-7.1, p = 0.03), while no association with tumor location or lymph node involvement was observed. Interaction of tobacco, alcohol and occupational exposure with the ECRG2 genotypes did not show modulation of risk. In conclusion, the ECRG2 TCA (3)/TCA (4) genotype is associated with the risk of oesophageal carcinoma in a North Indian population.

  16. Ambulatory oesophageal pH monitoring: a comparison between antimony, ISFET, and glass pH electrodes

    NARCIS (Netherlands)

    Hemmink, Gerrit J. M.; Weusten, Bas L. A. M.; Oors, Jac; Bredenoord, Albert J.; Timmer, Robin; Smout, André J. P. M.

    2010-01-01

    BACKGROUND AND AIM: Ambulatory oesophageal pH-impedance monitoring is a widely used test to evaluate patients with reflux symptoms. Several types of pH electrodes are available: antimony, ion sensitive field effect transistor (ISFET), and glass electrodes. These pH electrodes have not been compared

  17. Neoadjuvant chemoradiotherapy plus surgery versus active surveillance for oesophageal cancer: a stepped-wedge cluster randomised trial

    NARCIS (Netherlands)

    Noordman, Bo Jan; Wijnhoven, Bas P. L.; Lagarde, Sjoerd M.; Boonstra, Jurjen J.; Coene, Peter Paul L. O.; Dekker, Jan Willem T.; Doukas, Michael; van der Gaast, Ate; Heisterkamp, Joos; Kouwenhoven, Ewout A.; Nieuwenhuijzen, Grard A. P.; Pierie, Jean-Pierre E. N.; Rosman, Camiel; van Sandick, Johanna W.; van der Sangen, Maurice J. C.; Sosef, Meindert N.; Spaander, Manon C. W.; Valkema, Roelf; van der Zaag, Edwin S.; Steyerberg, Ewout W.; van Lanschot, J. Jan B.; Noordman, B. J.; van Lanschot, J. J. B.; Wijnhoven, B. P. L.; Biermann, K.; van der Gaast, A.; Ista, E.; Krak, N. C.; Nuyttens, J. J. M. E.; Polinder, S.; Spaander, M. C. W.; Steyerberg, E. W.; Valkema, R.; Agool, A.; van Baarlen, J.; Hendriksen, E. M.; Hoekstra, Ronald; Kouwenhoven, E. A.; van der Linde, A.; Bartels-Rutten, A.; van Dieren, J.; van Sandick, J.; Snaebjornsson, P.; Vegt, E.; Voncken, F. E. M.; Doornewaard, H.; Erkelens, G. W.; Madretsma, G. S.; van der Zaag, E. S.; ten Broek, M. R. J.; Dallinga, R. J.; Dekker, J. W. T.; Dezentjé, V. O.; de Krijger, R. R.; Neelis, K. J.; Quispel, R.; Creemers, G. J.; Nieuwenhuijzen, G. A. P.; van der Sangen, M. C.; Schoon, E. J.; Wyndaele, D. N. J.; Buijsen, J.; Riedl, R. G.; Schreurs, W. M. J.; Sosef, M. N.; Oostenbrug, L. E.; Warmerdam, F. A. R. M.; Boonstra, J. J.; Slingerland, M.; de Steur, W. O.; Lips, I. M.; Fiets, W. E.; van der Linde, K.; Nieken, J.; Oppedijk, V.; Pierie, J. P. E. N.; Wolf, R.; Coene, P. P. L. O.; Al Butaihi, I.; Kliffen, M.; Kuiper, E. M. M.; Courrech Staal, E. F.; Janssen, M. J. R.; Liedenbaum, M. H.; van der Post, C.; Radema, S. A.; Rosman, C.; Rütten, H.; Siersema, P. D.; Beerepoot, L. V.; Hazen, W. L.; Heisterkamp, J.; van Oord, J. C.; Rozema, T.; Vermeltfoort, I. A. C.; van der Wurff, A. A. M.

    2018-01-01

    Neoadjuvant chemoradiotherapy (nCRT) plus surgery is a standard treatment for locally advanced oesophageal cancer. With this treatment, 29% of patients have a pathologically complete response in the resection specimen. This provides the rationale for investigating an active surveillance approach.

  18. Neoadjuvant chemoradiotherapy plus surgery versus active surveillance for oesophageal cancer: A stepped-wedge cluster randomised trial

    NARCIS (Netherlands)

    B.J. Noordman (Bo Jan); B.P.L. Wijnhoven (Bas); S.M. Lagarde (Sjoerd); J.J. Boonstra (Jurjen); P-P. Coene (Peter Paul); J.W.T. Dekker (Jan Willem); M. Doukas (Michael); A. van der Gaast (Ate); J. Heisterkamp (Joos); E.A. Kouwenhoven (Ewout); G.A.P. Nieuwenhuijzen (Gerard); Pierie, J.-P.E.N. (Jean-Pierre E.N.); C. Rosman (Camiel); J.W. van Sandick (J.); M.J.C. van der Sangen (Maurice); M.N. Sosef (Meindert); M.C.W. Spaander (Manon); R. Valkema (Roelf); E.S. van der Zaag (Edwin); E.W. Steyerberg (Ewout W.); J.J.B. van Lanschot (Jan); K. Biermann (Katharina); E. Ista (Erwin); N.C. Krak (Nanda); J.J.M.E. Nuyttens (Joost); S. Polinder (Suzanne); Agool, A. (A.); Hoekstra, R. (R.); van der Linde, A. (A.); J. Van Baarlen; Hendriksen, E.M. (E. M.); Bartels-Rutten, A. (A.); van Dieren, J. (J.); van Sandick, J. (J.); P. Snaebjornsson; E. Vegt (Erik); Voncken, F.E.M. (F. E.M.); Doornewaard, H. (H.); G.W. Erkelens (G.Willemien); Madretsma, G.S. (G. S.); M.R.J. ten Broek (M. R J); Dallinga, R.J. (R. J.); V.O. Dezentjé; R.R. de Krijger (Ronald); K.J. Neelis (Karen); R. Quispel (Rutger); G.J.M. Creemers (Geert-Jan); E.J. Schoon (Erik); Wyndaele, D.N.J. (D. N.J.); J. Buijsen (Jeroen); R.G. Riedl; Schreurs, W.M.J. (W. M.J.); L.E. Oostenbrug (Liekele); Warmerdam, F.A.R.M. (F. A.R.M.); M. Slingerland (Marije); W.O. de Steur (Wobbe O.); I.M. Lips (Irene M.); H. Balink; Fiets, W.E. (W. E.); van der, K. (K.); R. Wolf (Rinze); V. Oppedijk (Vera); Al Butaihi, I. (I.); M. Kliffen (Mike); Kuiper, E.M.M. (E. M.M.); Courrech, E.F. (E. F.); Janssen, M.J.R. (M. J.R.); Liedenbaum, M.H. (M. H.); van der Post, C. (C.); S.A. Radema (Sandra A.); H.J.T. Rutten (Harm); P.D. Siersema (Peter); L.V. Beerepoot (Laurens); Hazen, W.L. (W. L.); van Oord, J.C. (J. C.); T. Rozema (Tom); Vermeltfoort, I.A.C. (I. A.C.); A.A.M. Van Der Wurff (A. A M)

    2018-01-01

    textabstractBackground: Neoadjuvant chemoradiotherapy (nCRT) plus surgery is a standard treatment for locally advanced oesophageal cancer. With this treatment, 29% of patients have a pathologically complete response in the resection specimen. This provides the rationale for investigating an active

  19. Surgical management without resection of the oesophagus for aorto-oesophageal fistula secondary to aortic arch aneurysm rupture.

    Science.gov (United States)

    Omura, Atsushi; Yoshida, Masato; Koda, Yojiro; Mukohara, Nobuhiko

    2016-12-01

    A 79-year-old moderately frail man with a history of graft replacement for descending thoracic aortic aneurysm and chronic kidney disease presented with the onset of haemoptysis. Computed tomography demonstrated aorto-oesophageal fistula secondary to aortic arch aneurysm rupture. Emergency surgery was performed through a median sternotomy. Cardiopulmonary bypass was established via femoral artery inflow and bicaval venous drainage. After establishing circulatory arrest, the aortic arch was excised. Resection of the aortic aneurysm and debridement were performed during antegrade cerebral perfusion and lower body perfusion from femoral artery inflow using balloon occlusion of the previous graft. Aortic arch graft replacement with concomitant debridement of mediastinal tissue and direct repair of oesophageal perforation comprised a first-stage operation. Forty hours later, abundant irrigation of warm normal saline around the mediastinal cavity and the omental flap covering the graft and the repair site of the oesophagus comprised the second-stage operation. Although the postoperative course was complicated, the patient resumed oral intake within 2 months after the initial operation. Serial computed tomography and oesophageal endoscopy showed good healing of the aorto-oesophageal fistula. There were no clinical manifestations or imaging findings of deep mediastinal infection throughout the postoperative course. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  20. Systematic review: role of acid, weakly acidic and weakly alkaline reflux in gastro-oesophageal reflux disease

    NARCIS (Netherlands)

    Boeckxstaens, G. E.; Smout, A.

    2010-01-01

    The importance of weakly acidic and weakly alkaline reflux in gastro-oesophageal reflux disease (GERD) is gaining recognition. To quantify the proportions of reflux episodes that are acidic (pH <4), weakly acidic (pH 4-7) and weakly alkaline (pH >7) in adult patients with GERD, and to evaluate their

  1. Evoked potentials in pediatric cerebral malaria

    Directory of Open Access Journals (Sweden)

    Minal Bhanushali

    2011-08-01

    Full Text Available Cortical evoked potentials (EP provide localized data regarding brain function and may offer prognostic information and insights into the pathologic mechanisms of malariamediated cerebral injury. As part of a prospective cohort study, we obtained somatosensory evoked potentials (SSEPs and brainstem auditory EPs (AEPs within 24 hours of admission on 27 consecutive children admitted with cerebral malaria (CM. Children underwent follow-up for 12 months to determine if they had any long term neurologic sequelae. EPs were obtained in 27 pediatric CM admissions. Two children died. Among survivors followed an average of 514 days, 7/25 (28.0% had at least one adverse neurologic outcome. Only a single subject had absent cortical EPs on admission and this child had a good neurologic outcome. Among pediatric CM survivors, cortical EPs are generally intact and do not predict adverse neurologic outcomes. Further study is needed to determine if alterations in cortical EPs can be used to predict a fatal outcome in CM.

  2. [Personality dimensions and cerebral evoked potential].

    Science.gov (United States)

    Camposano, S; Alvarez, C; Lolas, F

    1994-12-01

    Eysenck's personality theory postulates 3 orthogonal dimensions of personality: extraversion (E), neuroticism (N) and psychoticism (P), predicting conductual and physiological predispositions to suffer mental illness. Biological bases of Eysenck's personality traits have been documented electrophysiologically. Psychoticism, the latest described dimension, is controverted, since there is some evidence of common factors with the other two. In order to assess the relation between Eysenck's dimensions and sensorial reactivity and information encoding processes we studied 20 healthy young subjects (mean age 28.5 years) with flash visual cortical evoked potentials (VEP, 3 intensities, peak to peak amplitude of III, IV-V-VI, VII components), and auditory cognitive evoked potentials (odd ball paradigm, P300 latency). There was a positive correlation between N and P dimensions (Spearman, r = 0.52), between N and VEP amplitude at high intensity (r = 0.58) and a negative correlation between E and P300 latency (r = 0.58). In short we found that P is not an independent dimension, but is related to sensorial reactivity. E dimension was related to encoding processes supporting Eysenck's observations about memory and learning differences.

  3. Long Latency Auditory Evoked Potentials during Meditation.

    Science.gov (United States)

    Telles, Shirley; Deepeshwar, Singh; Naveen, Kalkuni Visweswaraiah; Pailoor, Subramanya

    2015-10-01

    The auditory sensory pathway has been studied in meditators, using midlatency and short latency auditory evoked potentials. The present study evaluated long latency auditory evoked potentials (LLAEPs) during meditation. Sixty male participants, aged between 18 and 31 years (group mean±SD, 20.5±3.8 years), were assessed in 4 mental states based on descriptions in the traditional texts. They were (a) random thinking, (b) nonmeditative focusing, (c) meditative focusing, and (d) meditation. The order of the sessions was randomly assigned. The LLAEP components studied were P1 (40-60 ms), N1 (75-115 ms), P2 (120-180 ms), and N2 (180-280 ms). For each component, the peak amplitude and peak latency were measured from the prestimulus baseline. There was significant decrease in the peak latency of the P2 component during and after meditation (Pmeditation facilitates the processing of information in the auditory association cortex, whereas the number of neurons recruited was smaller in random thinking and non-meditative focused thinking, at the level of the secondary auditory cortex, auditory association cortex and anterior cingulate cortex. © EEG and Clinical Neuroscience Society (ECNS) 2014.

  4. New perspectives on vestibular evoked myogenic potentials.

    Science.gov (United States)

    Rosengren, Sally M; Kingma, Herman

    2013-02-01

    Although the vestibular evoked myogenic potential (VEMP) measured from the cervical muscles (cVEMP, cervical VEMP) is well described and has documented clinical utility, its analogue recorded from the extraocular muscles (oVEMP, ocular VEMP) has been described only recently and is currently emerging as an additional test of otolith function. This review will, therefore, summarize recent developments in VEMP research with a focus on the oVEMP. Recent studies suggest that the oVEMP is produced by otolith afferents in the superior vestibular nerve division, whereas the cVEMP evoked by sound is thought to be an inferior vestibular nerve reflex. Correspondingly, the oVEMP correlates better with caloric and subjective visual vertical tests than sound-cVEMPs. cVEMPs are more complicated than often thought, as shown by the presence of crossed responses and conflicting results of recent vibration studies. Altered inner ear mechanics produced by the vestibular diseases superior semicircular canal dehiscence and Ménière's disease lead to changes in the preferred frequency of the oVEMP and cVEMP. The oVEMP provides complementary diagnostic information to the cVEMP and is likely to be a useful addition to the diagnostic test battery in neuro-otology.

  5. Speech Evoked Auditory Brainstem Response in Stuttering

    Directory of Open Access Journals (Sweden)

    Ali Akbar Tahaei

    2014-01-01

    Full Text Available Auditory processing deficits have been hypothesized as an underlying mechanism for stuttering. Previous studies have demonstrated abnormal responses in subjects with persistent developmental stuttering (PDS at the higher level of the central auditory system using speech stimuli. Recently, the potential usefulness of speech evoked auditory brainstem responses in central auditory processing disorders has been emphasized. The current study used the speech evoked ABR to investigate the hypothesis that subjects with PDS have specific auditory perceptual dysfunction. Objectives. To determine whether brainstem responses to speech stimuli differ between PDS subjects and normal fluent speakers. Methods. Twenty-five subjects with PDS participated in this study. The speech-ABRs were elicited by the 5-formant synthesized syllable/da/, with duration of 40 ms. Results. There were significant group differences for the onset and offset transient peaks. Subjects with PDS had longer latencies for the onset and offset peaks relative to the control group. Conclusions. Subjects with PDS showed a deficient neural timing in the early stages of the auditory pathway consistent with temporal processing deficits and their abnormal timing may underlie to their disfluency.

  6. A nested case-control study of oesophageal and stomach cancers in the Linxian nutrition intervention trial.

    Science.gov (United States)

    Guo, W; Blot, W J; Li, J Y; Taylor, P R; Liu, B Q; Wang, W; Wu, Y P; Zheng, W; Dawsey, S M; Li, B

    1994-06-01

    Rates of oesophageal/gastric cardia cancer in Linxian, a rural county in north central China, are among the world's highest, but the risk factors are not well understood. A nested case-control study of oesophageal and stomach cancers was conducted within a cohort of 29,584 adults who participated in a randomized nutrition intervention trial. Information on participant characteristics collected during interviews before the trial began was compared between individuals who subsequently developed cancers of the oesophagus (N = 640) or stomach (N = 539), mainly cardia, and individually matched controls (control/case ratio = 5). Analyses were performed separately for oesophageal and stomach cancers using conditional logistic regression. For oesophageal cancer, tobacco smoking was associated with a significantly elevated risk, with a twofold increase among long-term smokers. Alcohol consumption was uncommon and not related to risk. High consumption of eggs or fresh vegetables was associated with 20% reductions in risk, and risk significantly declined as pre-trial body mass index (BMI), an indicator of long-term nutritional status, increased. No increases in risk were associated with intake of pickled vegetables or mouldy foods, although consumption levels at the start of the trial were low. Excess risks of 40-80% were found among individuals who had reported a history of cancer, notably of the oesophagus and stomach, in parents or sibs. For stomach cancer, only low BMI was significantly associated with elevated risk. This study indicates that several risk factors for oesophageal and stomach cancers in Linxian, including smoking, nutritional deficiency, and familial cancer occurrence, resemble those in other areas of the world and contribute partly to the remarkably elevated rates in this area of China.

  7. Concurrent Large Para-oesophageal Hiatal Hernia Repair and Laparoscopic Adjustable Gastric Banding: Results from 5-year Follow Up.

    Science.gov (United States)

    Long, Andrew J; Burton, Paul R; Laurie, Cheryl P; Anderson, Margaret L; Hebbard, Geoff S; O'Brien, Paul E; Brown, Wendy A

    2016-05-01

    The objective of the study is to identify the efficacy and safety of combining laparoscopic adjustable gastric banding with repair of large para-oesophageal hernias. Para-oesophageal hernias are more common in the obese with higher recurrence rates following repair. The effect and safety of combining para-oesophageal hernia repair with laparoscopic adjustable gastric banding is unknown. One-hundred fourteen consecutive patients undergoing primary laparoscopic adjustable gastric banding with concurrent repair of a large para-oesophageal hernia were prospectively identified and matched to a control group undergoing primary laparoscopic adjustable gastric banding only. Weight loss and complication data were retrieved from a prospectively maintained database, and a standardised bariatric outcome questionnaire was used to assess post-operative symptoms, satisfaction with surgery and satiety scores. At a mean follow up of 4.9 ± 2.1 years, total weight loss was 16.4 ± 9.9% in the hernia repair group and 17.6 ± 12.6% in the control group (p = 0.949), with 17 vs. 11% loss to follow up rates (p = 0.246). No statistically significant difference in revisional surgery rate and symptomatic recurrence of hiatal hernia was documented in four patients in the hernia repair group (3.5%). No statistically significant difference in mean reflux (9.9 vs. 10.3, p = 0.821), dysphagia (20.7 vs. 20.1, p = 0.630) or satiety scores was identified. Concurrent repair of large para-oesophageal hiatal hernia and laparoscopic adjustable gastric banding placement is safe and effective both in terms of symptom control and weight loss over the intermediate term. In obese patients with large hiatal hernias, consideration should be given to combining repair of the hernia with a bariatric procedure.

  8. Intraurethral stimulation evokes bladder responses via 2 distinct reflex pathways.

    Science.gov (United States)

    Woock, John P; Yoo, Paul B; Grill, Warren M

    2009-07-01

    Recent animal studies have shown that selective activation of pudendal nerve branches can evoke bladder responses through 2 distinct reflex pathways. We examined intraurethral electrical stimulation as a minimally invasive means of selectively activating these pathways in the cat. Bladder responses evoked by intraurethral electrical stimulation were measured in alpha-chloralose anesthetized male cats at different stimulation frequencies, stimulation intensities and intraurethral locations. Intraurethral electrical stimulation evoked inhibitory and excitatory bladder reflexes depending on stimulation frequency and location. Stimulation in the penile urethra 0 to 3 cm from the urethral meatus at 33 Hz evoked bladder contraction and at 10 Hz it evoked bladder relaxation. These responses were abolished after bilateral transection of the dorsal penile nerves. Stimulation in the membranous urethra 5 to 7 cm from the urethral meatus at 2, 10 and 33 Hz evoked bladder contractions. These responses were abolished after bilateral transection of the cranial sensory nerves. Following acute spinal cord transection bladder contractions were still evoked by 33 Hz stimulation in the penile urethra but not by stimulation at any frequency in the membranous urethra. Intraurethral electrical stimulation selectively evoked bladder responses by activating 2 distinct pudendal afferent pathways. Responses depended on stimulation frequency and location. Intraurethral electrical stimulation is a valid means of determining the pathways involved in bladder responses evoked by pudendal nerve stimulation.

  9. Overexpression of microRNA-1288 in oesophageal squamous cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Gopalan, Vinod; Islam, Farhadul; Pillai, Suja [Cancer Molecular Pathology, School of Medicine and Menzies Health Institute Queensland, Griffith University, Gold Coast (Australia); Tang, Johnny Cheuk-On [State Key Laboratory of Chirosciences, Lo Ka Chung Centre for Natural Anti-cancer Drug Development, Department of Applied Biology and Chemical Technology, the Hong Kong Polytechnic University (Hong Kong); Tong, Daniel King-Hung; Law, Simon [Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital (Hong Kong); Chan, Kwok-Wah [Department of Pathology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital (Hong Kong); Lam, Alfred King-Yin, E-mail: a.lam@griffith.edu.au [Cancer Molecular Pathology, School of Medicine and Menzies Health Institute Queensland, Griffith University, Gold Coast (Australia)

    2016-11-01

    Purpose: This study aims to examine the expression profiles miR-1288 in oesophageal squamous cell carcinoma (ESCC). The cellular implications and target interactions of ESCC cells following miR-1288 overexpression was also examined. Methods: In total, 120 oesophageal tissues (90 primary ESCCs and 30 non-neoplastic tissues) were recruited for miR-1288 expression analysis using qRT-PCR. An exogenous miR-1288 mimic and its inhibitor were used to explore the in-vitro effects of miR-1288 on ESCC cells by performing cell proliferation, colony formation, cell invasion and migration assays. Localisation and modulatory changes of various miR-1288 regulated proteins such as FOXO1, p53, TAB3, BCL2 and kRAS was examined using immunofluorescence and western blot. Results: Overexpression of miR-1288 was more often noted in ESCC tissues when compared to non-neoplastic oesophageal tissues. High expression was often noted in high grade carcinomas and with metastases. Patients with high levels of miR-1288 expression showed a slightly better survival compared to patients with low miR-1288 levels. Furthermore, overexpression of miR-1288 showed increased cell proliferation and colony formation, improved cell migration and enhanced cell invasion properties in ESCC cells. In addition, miR-1288 overexpression in ESCC cells showed repression of cytoplasmic tumour suppressor FOXO1 protein expression. Inversely, inhibition of miR-1288 expression exhibited remarkable upregulation of FOXO1 protein, while expressions of other tested proteins remain unchanged. Conclusions: Up regulation of miR-1288 expression in ESCC tissues and miR-1288 induced oncogenic features of ESCC cells in-vitro indicates the oncogenic roles of miR-1288 in ESCCs. Overexpression of miR-1288 play a key role in the pathogenesis of ESCCs and its modulation may have potential therapeutic value in patients with ESCC. - Highlights: • miR-1288 was more often noted in neoplastic than non-neoplastic tissue. • miR-1288

  10. Systematic review and meta-analysis of laparoscopic Nissen (posterior total) versus Toupet (posterior partial) fundoplication for gastro-oesophageal reflux disease.

    NARCIS (Netherlands)

    Broeders, J.A.; Mauritz, F.A.; Ahmed Ali, U.; Draaisma, W.A.; Ruurda, J.P.; Gooszen, H.G.; Smout, A.J.P.M.; Broeders, I.A.M.J.; Hazebroek, E.J.

    2010-01-01

    BACKGROUND: Laparoscopic Nissen fundoplication (LNF) is currently considered the surgical approach of choice for gastro-oesophageal reflux disease (GORD). Laparoscopic Toupet fundoplication (LTF) has been said to reduce troublesome dysphagia and gas-related symptoms. A systematic review and

  11. Split-course chemoradiotherapy with S-1, a novel oral fluorouracil, and cisplatin for distant metastases of oesophageal cancer stage IVb

    National Research Council Canada - National Science Library

    H, Iwase; M, Shimada; N, Hirashima; N, Ryuge; N, Urata; M, Goto; T, Kondo; D, Tanaka; S, Unita; E, Kato

    2017-01-01

    Objectives: To evaluate the efficacy and safety of split-course chemoradiotherapy with S-1, a novel oral fluorouracil, together with cisplatin in patients with distant oesophageal cancer stage IVb metastasis. Methods...

  12. Resting Heart Rate and Auditory Evoked Potential

    Directory of Open Access Journals (Sweden)

    Simone Fiuza Regaçone

    2015-01-01

    Full Text Available The objective of this study was to evaluate the association between rest heart rate (HR and the components of the auditory evoked-related potentials (ERPs at rest in women. We investigated 21 healthy female university students between 18 and 24 years old. We performed complete audiological evaluation and measurement of heart rate for 10 minutes at rest (heart rate monitor Polar RS800CX and performed ERPs analysis (discrepancy in frequency and duration. There was a moderate negative correlation of the N1 and P3a with rest HR and a strong positive correlation of the P2 and N2 components with rest HR. Larger components of the ERP are associated with higher rest HR.

  13. Visual evoked potentials in rubber factory workers.

    Science.gov (United States)

    Tandon, O P; Kumar, V

    1997-01-01

    Pattern reversal visual evoked potentials (pVEP) were studied in 39 male rubber factory workers in the age range of 18-55 years and 20 control subjects (aged 18-46 years) not exposed to the rubber factory environment. Results revealed that 20 (51%) rubber factory workers had abnormal latencies of wave P1 (dominant component of pVEP) as per accepted criteria of 99% tolerance limit set for the control group (i.e. any value above mean +3 SD of control was considered abnormal). The section-wise per cent distribution of abnormalities was vulcanization (83%), tubing (75%), calendering (60%), loading (38%) and mixing (14%). This study provides electrophysiological evidence that rubber factory environments affect the conduction processes in optical pathways from their origin in the retina to striate cortex. However, this study has its limitations in not identifying the specific chemical(s) causing these changes in VEP.

  14. Music evokes vicarious emotions in listeners

    Science.gov (United States)

    Kawakami, Ai; Furukawa, Kiyoshi; Okanoya, Kazuo

    2014-01-01

    Why do we listen to sad music? We seek to answer this question using a psychological approach. It is possible to distinguish perceived emotions from those that are experienced. Therefore, we hypothesized that, although sad music is perceived as sad, listeners actually feel (experience) pleasant emotions concurrent with sadness. This hypothesis was supported, which led us to question whether sadness in the context of art is truly an unpleasant emotion. While experiencing sadness may be unpleasant, it may also be somewhat pleasant when experienced in the context of art, for example, when listening to sad music. We consider musically evoked emotion vicarious, as we are not threatened when we experience it, in the way that we can be during the course of experiencing emotion in daily life. When we listen to sad music, we experience vicarious sadness. In this review, we propose two sides to sadness by suggesting vicarious emotion. PMID:24910621

  15. A translational study on looming-evoked defensive response and the underlying subcortical pathway in autism.

    Science.gov (United States)

    Hu, Yu; Chen, Zhuoming; Huang, Lu; Xi, Yue; Li, Bingxiao; Wang, Hong; Yan, Jiajian; Lee, Tatia M C; Tao, Qian; So, Kwok-Fai; Ren, Chaoran

    2017-11-07

    Rapidly approaching objects indicating threats can induce defensive response through activating a subcortical pathway comprising superior colliculus (SC), lateral posterior nucleus (LP), and basolateral amygdala (BLA). Abnormal defensive response has been reported in autism, and impaired synaptic connections could be the underlying mechanism. Whether the SC-LP-BLA pathway processes looming stimuli abnormally in autism is not clear. Here, we found that looming-evoked defensive response is impaired in a subgroup of the valproic acid (VPA) mouse model of autism. By combining the conventional neurotracer and transneuronal rabies virus tracing techniques, we demonstrated that synaptic connections in the SC-LP-BLA pathway were abnormal in VPA mice whose looming-evoked defensive responses were absent. Importantly, we further translated the finding to children with autism and observed that they did not present looming-evoked defensive response. Furthermore, the findings of the DTI with the probabilistic tractography showed that the structural connections of SC-pulvinar-amygdala in autism children were weak. The pulvinar is parallel to the LP in a mouse. Because looming-evoked defensive response is innate in humans and emerges much earlier than do social and language functions, the absence of defensive response could be an earlier sign of autism in children.

  16. [Invagination of the oesophageal mucosa in the presence of a Schatzki ring (author's transl)].

    Science.gov (United States)

    Greuel, D

    1978-08-01

    A patient is described who suffered from prolapse of the lower oesophageal mucosa in the presence of a Schatzki ring. There was variable dysphagia culminating in total aphagia. The clinical symptoms disappeared without any treatment once the patient had overcome several years of psychological stress. The radiological appearances gave rise to a discussion of the radiological anatomy of the terminal oesophagus with a Schatzki ring since numerous similar appearances illustrated in the literature have been interpreted as axial hiatus hernias. A comparison of manometric and radiological fingings has shown that a hernia did not exist. The advantages and errors inherent in diagnosing hernias with the help of the "three rings", as described by Hafter, are discussed. The mucosal prolapse during the stage of aphagia is demonstrated and compared with cases from the literature showing prolapse at the upper and lower vestibular margins. The mechanism leading to these appearances is discussed.

  17. Stroke volume averaging for individualized goal-directed fluid therapy with oesophageal Doppler

    DEFF Research Database (Denmark)

    Jorgensen, C.C.; Bundgaard-Nielsen, M.; Skovgaard, Lene Theil

    2009-01-01

    BACKGROUND: An individualized fluid optimization strategy, based on maximization of cardiac stroke volume (SV) with colloid boluses (goal-directed therapy), improves outcome after surgery. Oesophageal Doppler (OD) is used for SV maximization in most randomized studies, but evidence-based guidelines...... for the SV maximization procedure are lacking and variation in SV may influence the indication for fluid administration. We measured beat-to-beat OD SV before and after fluid optimization in order to estimate the number of heartbeats for which SV needs to be averaged to provide an acceptable accuracy...... for goal-directed therapy with this technology. METHODS: Twenty patients scheduled for surgery were anaesthetized, followed by OD SV assessment. Thirty seconds of beat-to-beat data were recorded before and after volume optimization performed by successive boluses of 200 ml colloid until SV did not increase...

  18. A study of Raman spectroscopy for the early detection and classification of malignancy in oesophageal tissue

    Energy Technology Data Exchange (ETDEWEB)

    Kendall, C.A

    2002-07-01

    Raman Spectroscopy for the identification and classification of malignancy in the oesophagus has been demonstrated in this thesis. The potential of Raman spectroscopy in this field is twofold; as an adjunct for the pathologist and as a biopsy targeting tool at endoscopy. This study has demonstrated the feasibility of these potential applications in vitro. Spectral diagnostic models have been developed by correlating spectral information with histopathology. This is the current 'gold standard' diagnostic method for the identification of dysplasia, the established risk factor for the development of oesophageal cancer. Histopathology is a subjective assessment and widely acknowledged to have limitations. A more rigorous gold standard was therefore developed, as part of this study, using the consensus opinion of three independent expert pathologists to train the diagnostic models. Raman spectra have been measured from oesophageal tissue covering the full spectrum of malignant disease in the oesophagus, using a near infrared Raman spectrometer customised for tissue spectral measurements. Two spectral datasets were measured with different volumes of tissue probed using twenty and eighty times magnification ultra long working distance objectives. Multivariate statistical analysis has been used to extract the required spectral information with the greatest discriminative power. Principal component fed linear discriminant spectral models have been tested with leave one out cross validation procedures. Three pathology group models have correctly classified up to 91% of spectra, and eight group models have correctly classified up to 82% of spectra. Optimisation of the spectral models by selection of significant principal components, filtering the data and using staggered models was investigated. Effort has been made to understand the findings in their clinical context, with review of patient history and clinical progress, long term follow up is required. Preliminary

  19. Right circumflex retro-oesophageal aortic arch with coarctation of a high-positioned right arch

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Kyung-Sik; Yong, Hwan Seok; Woo, Ok Hee; Kang, Eun-Young [Korea University Guro Hospital, Department of Radiology, Seoul (Korea); Lee, Joo-Won [Korea University Guro Hospital, Department of Paediatrics, Seoul (Korea)

    2007-06-15

    We present a rare case of right circumflex retro-oesophageal aortic arch with coarctation of a high-positioned right arch. A 7-month-old boy presented with a cardiac murmur. Cardiac situs was normal and there was no evidence of an intracardiac shunt or patent ductus arteriosus. MR aortography revealed a right aortic arch that was high-positioned, tortuous and narrowed. This right aortic arch crossed the midline behind the oesophagus and continued as a left-sided descending aorta. The left common carotid and subclavian arteries arose from a large branching vascular structure that derived from the top of the left-sided descending aorta. The right common carotid artery arose from the ascending aorta. The proximal portion of the right common carotid artery showed very severe stenosis and poststenotic dilatation. The right subclavian artery originated distal to the narrowed and tortuous segment of the aortic arch. (orig.)

  20. Some functional characteristics of the oesophageal vestibule in infants and children

    Science.gov (United States)

    Chrispin, A. R.; Friedland, G. W.; Wright, D. E.

    1967-01-01

    The oesophageal vestibule lies immediately above the stomach and during quiet respiration is located partly in the thorax, partly in the hiatus in the diaphragm, and partly in the abdomen. An analysis of some aspects of function of the vestibule in infants and children who have a non-contractile gullet above the vestibule is presented. Opening of the vestibule is related to deglutition and is independent of the oesophagus above. In its opening and closing the vestibule is shown to have the characteristics of a `muscle throttle'. The rapidity of the event of either opening or closing is accounted for. The important relationship of calibre of lumen of the vestibule to flow through it is analysed. The effect of the indentations of mucosa into the lumen when the vestibule is partially open is analysed from a theoretical standpoint, and it is inferred that the vestibule when only partially open has the characteristics of a highly efficient choke. PMID:6040654

  1. Feed thickener for infants up to six months of age with gastro-oesophageal reflux.

    Science.gov (United States)

    Kwok, T'ng Chang; Ojha, Shalini; Dorling, Jon

    2017-12-05

    Gastro-oesophageal reflux (GOR) is common in infants, and feed thickeners are often used to manage it in infants as they are simple to use and perceived to be harmless. However, conflicting evidence exists to support the use of feed thickeners. To evaluate the use of feed thickeners in infants up to six months of age with GOR in terms of reduction in a) signs and symptoms of GOR, b) reflux episodes on pH probe monitoring or intraluminal impedance or a combination of both, or c) histological evidence of oesophagitis. We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (CENTRAL 2016, Issue 2), MEDLINE via PubMed (1966 to 22 November 2016), Embase (1980 to 22 November 2016), and CINAHL (1982 to 22 November 2016). We also searched clinical trials databases, conference proceedings, and the reference lists of retrieved articles for randomised controlled trials. We included randomised controlled trials if they examined the effects of feed thickeners as compared to unthickened feeds (no treatment or placebo) in treating GOR in term infants up to six months of age or six months of corrected gestational age for those born preterm. Two review authors independently identified eligible studies from the literature search. Two review authors independently performed data extraction and quality assessments of the eligible studies. Differences in opinion were resolved by discussion with a third review author, and consensus was reached among all three review authors. We used the GRADE approach to assess the quality of the evidence. Eight trials recruiting a total of 637 infants met the inclusion criteria for the systematic review. The infants included in the review were mainly formula-fed term infants. The trials were of variable methodological quality. Formula-fed term infants with GOR on feed thickeners had nearly two fewer episodes of regurgitation per day (mean difference -1.97 episodes per day

  2. Chemical gastro-oesophagitis, upper gastrointestinal haemorrhage and gastroscopic findings following Dettol poisoning.

    Science.gov (United States)

    Chan, T Y; Sung, J J; Critchley, J A

    1995-01-01

    1. Dettol liquid (chloroxylenol 4.8%, pine oil, isopropyl alcohol), a household disinfectant, has a corrosive action on the gastrointestinal mucosa when swallowed. The incidence of upper gastrointestinal haemorrhage and gastroscopic findings following Dettol poisoning was studied in 89 patients. 2. Five patients (5.6%) developed minor haematemesis, in the form of coffee-coloured or blood-stained vomitus. One patient had a gastroscopy performed on the day after admission, showing signs of chemical burns in the oesophagus and stomach. Gastroscopy was performed in one other patient on day 11 to rule out oesophageal stricture; the patient was normal. All patients completely recovered. 3. The data from this study suggest that upper gastrointestinal haemorrhage following Dettol poisoning tends to be mild and self-limiting. Gastroscopy, which may increase the risk of aspiration in patients with impaired consciousness, is not required unless other causes of gastrointestinal bleeding are suspected.

  3. Living with incurable oesophageal cancer. A phenomenological hermeneutical interpretation of patient stories.

    Science.gov (United States)

    Missel, Malene; Birkelund, Regner

    2011-09-01

    The study explores how patients diagnosed with incurable oesophageal cancer experience living with the illness, and provides insight into and an understanding of the patients' situation, reality and phenomena in their life world. The method takes a phenomenological-hermeneutic approach, inspired by the French philosopher Paul Ricoeur's narrative theory on mimesis as the structure and process of the method, and Ricoeur's theory of interpretation for the analysis of patient stories. The stories materialise from narrative interviews, and the phenomena of the patients' life world results in an analysis of these stories. Through the analysis of the narrative interviews, phenomena of the patients' life world appear which are described in themes such as debut of the illness, denial, the person's own suspicion, existential turning point, despair, hope, the body, affirmation of irrevocable illness, acknowledgement of dying, life phenomena, relations and feeling of independence. The understanding of the patients' experiences is augmented and improved through a discussion of the themes in a philosophical perspective, drawing upon theoretical and philosophical viewpoints of Kierkegaard, Løgstrup, Merleau-Ponty, Ricoeur, Benner & Wrubel, and on empirical research. Based on the phenomena in the ill person's life world brought about by analysis, it seems that incurably ill oesophageal cancer patients find themselves in a complex life situation, in which they need more than an objective estimate and fulfilment of need from hospital service. Our study illustrates some perspectives on the life situation of the incurably ill, which will contribute to the improved development of supportive care in nursing. Copyright © 2010 Elsevier Ltd. All rights reserved.

  4. Relationship between motor function of the proximal stomach and transient lower oesophageal sphincter relaxation after morphine

    Science.gov (United States)

    Penagini, R; Allocca, M; Cantù, P; Mangano, M; Savojardo, D; Carmagnola, S; Bianchi, P A

    2004-01-01

    Background: Morphine reduces the rate of transient lower oesophageal sphincter (LOS) relaxations but its site of action is presently unknown. There are no data available concerning its motor effects on the proximal stomach, an important site for triggering transient LOS relaxations. Aim: To evaluate the effect of morphine on the rate of transient LOS relaxations and motor function of the proximal stomach. Subjects and methods: In 19 healthy subjects, concurrent transient LOS relaxations with a sleeve sensor and motor function of the proximal stomach with a bag connected to an electronic barostat were recorded during pressure controlled (n = 9) and volume controlled (n = 10) gastric distensions after intravenous administration of placebo and morphine 100 μg/kg. Results: During pressure controlled distensions, intrabag volume was markedly decreased by morphine (median 189 ml (interquartile range 101–448) v 404 (265–868) after placebo; p<0.01) as was the rate of transient LOS relaxations (0.5/30 minutes (0.4–2) v 2.5 (2–4); p<0.01). When intrabag volume was kept constant (525 ml (490–600)) (that is, in volume controlled distensions), the rate of transient LOS relaxations was not affected by morphine (2/30 minutes (2–3) v 2.5 (2–3)). Gastric contractions decreased after morphine similarly during pressure controlled and volume controlled distensions (8.5/30 minutes (4–10) v 15.5 (9.5–20.5), p<0.02; and 6.5 (0–24) v 19.5 (12–22), p<0.05). Conclusions: The effect of morphine on transient LOS relaxations is dependent on the decrease in volume of the proximal stomach. Our data suggest that pharmacological interventions which decrease fundal volume should result in control of transient LOS relaxation mediated gastro-oesophageal reflux. PMID:15306575

  5. Multicentre survey on the current surgical management of oesophageal atresia in Belgium and Luxembourg.

    Science.gov (United States)

    Reusens, Helena; Matthyssens, Lucas; Vercauteren, Charlotte; van Renterghem, Katrien

    2017-02-01

    The surgical management of oesophageal atresia (OA) differs between pediatric surgical teams without consensus. We aimed to describe the current practice of OA treatment in Belgium and Luxembourg and compare this to the literature. A questionnaire was created and sent to all 18 hospitals (14 pediatric surgical units) performing OA surgery in Belgium and Luxembourg. The results were compared to the literature. Most units treat an average of 2-5 OA+TOF (71%) and ≤1 pure OA (pOA) per year (86%). The preferred surgical approach for OA+TOF is thoracotomy (86%), mostly extra-pleural (75%). Thoracoscopic OA repair is performed in 21%. All centers perform an end-to-end anastomosis (interrupted sutures), and all leave a transanastomotic tube. A chest drain is routinely used in 8units (57%). In pOA the preferred surgical approach is gastrostomy formation with delayed primary anastomosis (77%). The timing for delayed anastomosis is 2 to 24months. Intra-operative lengthening is mostly attempted with Foker technique (46%). If oesophageal replacement is needed, gastric interposition is mostly used (75%). A postoperative contrast study is routinely performed in 86% for OA+TOF and in 100% for pOA. Anti-reflux medication is routinely prescribed by all units but one. There are still many differences and controversies in the perioperative management of OA. Part of this is based on habits and is difficult to change without scientific evidence. There is a need for prospective (inter)national registries to further identify the existing differences, leading to a more widely accepted consensus. Level III. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Oesophageal achalasia in elderly people: results of the laparoscopic Heller-Dor myotomy.

    Science.gov (United States)

    Ferulano, G P; Dilillo, S; D'Ambra, M; Lionetti, R; Saviano, C; Fico, D

    2005-01-01

    To assess the outcome of laparoscopic Heller-Dor myotomy for oesophageal achalasia in two groups of patients identified by age (under and over 70 years) using functional and clinical instruments. Current therapies for achalasia can't restore normal motility but can palliate dysphagia. Many other symptoms may persist difficult to quantify and to compare. In order to understand if age is a factor that influences the therapeutic outcome we tested the reliability of a specific QoL instrument for comparing outcomes of surgery for achalasia. Functional examinations and the Gastrointestinal Quality of Life Index (GIQLI) were used before and after laparoscopic Heller-Dor myotomy. Starting in January 1996, 28 consecutive patients of 32 diagnosed (instrumental evidences) achalasia were operated on laparoscopically for various clinical stages of achalasia. In 78% of patients dysphagia disappeared, the incidence of gastro-oesophageal reflux was of 11%. The patients completed a GIQLI questionnaire preoperatively and after a minimum postoperative follow-up of 1 year. Median preoperative GIQLI score was 78(range 38-109) out of a theoretical maximum score of 144. At a median follow-up of 35 months (range 18-72), the score had significantly improved to 115 (range 71-140). All the items assessing gastrointestinal symptoms and physical, social, and emotional function were significantly improved. There is no difference between the two groups identified. The laparoscopic Heller-Dor myotomy is an effective palliation for acalasia, the medium-term outcome is not affected by the age of the patients. The GIQLI is a reliable instrument to compare the impact of achalasia symptoms on health-related QoL.

  7. Hormone replacement therapy is associated with gastro-oesophageal reflux disease: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Close Helen

    2012-05-01

    Full Text Available Abstract Background Oestrogen and progestogen have the potential to influence gastro-intestinal motility; both are key components of hormone replacement therapy (HRT. Results of observational studies in women taking HRT rely on self-reporting of gastro-oesophageal symptoms and the aetiology of gastro-oesophageal reflux disease (GORD remains unclear. This study investigated the association between HRT and GORD in menopausal women using validated general practice records. Methods 51,182 menopausal women were identified using the UK General Practice Research Database between 1995–2004. Of these, 8,831 were matched with and without hormone use. Odds ratios (ORs were calculated for GORD and proton-pump inhibitor (PPI use in hormone and non-hormone users, adjusting for age, co-morbidities, and co-pharmacy. Results In unadjusted analysis, all forms of hormone use (oestrogen-only, tibolone, combined HRT and progestogen were statistically significantly associated with GORD. In adjusted models, this association remained statistically significant for oestrogen-only treatment (OR 1.49; 1.18–1.89. Unadjusted analysis showed a statistically significant association between PPI use and oestrogen-only and combined HRT treatment. When adjusted for covariates, oestrogen-only treatment was significant (OR 1.34; 95% CI 1.03–1.74. Findings from the adjusted model demonstrated the greater use of PPI by progestogen users (OR 1.50; 1.01–2.22. Conclusions This first large cohort study of the association between GORD and HRT found a statistically significant association between oestrogen-only hormone and GORD and PPI use. This should be further investigated using prospective follow-up to validate the strength of association and describe its clinical significance.

  8. Sensory-Evoked Intrinsic Imaging Signals in the Olfactory Bulb Are Independent of Neurovascular Coupling

    OpenAIRE

    Vincis; Lagier; van de Ville; Rodriguez; Carleton

    2015-01-01

    Summary Functional brain-imaging techniques used in humans and animals, such as functional MRI and intrinsic optical signal (IOS) imaging, are thought to largely rely on neurovascular coupling and hemodynamic responses. Here, taking advantage of the well-described micro-architecture of the mouse olfactory bulb, we dissected the nature of odor-evoked IOSs. Using in vivo pharmacology in transgenic mouse lines reporting activity in different cell types, we show that parenchymal IOSs are largely ...

  9. Whiplash evokes descending muscle recruitment and sympathetic responses characteristic of startle

    OpenAIRE

    Mang, Daniel WH; Siegmund, Gunter P.; Blouin, Jean-Sébastien

    2014-01-01

    Whiplash injuries are the most common injuries following rear-end collisions. During a rear-end collision, the human muscle response consists of both a postural and a startle response that may exacerbate injury. However, most previous studies only assessed the presence of startle using data collected from the neck muscles and head/neck kinematics. The startle response also evokes a descending pattern of muscle recruitment and changes in autonomic activity. Here we examined the recruitment of ...

  10. The bed nucleus of the stria terminalis is critical for anxiety-related behavior evoked by CO2 and acidosis.

    Science.gov (United States)

    Taugher, Rebecca J; Lu, Yuan; Wang, Yimo; Kreple, Collin J; Ghobbeh, Ali; Fan, Rong; Sowers, Levi P; Wemmie, John A

    2014-07-30

    Carbon dioxide (CO2) inhalation lowers brain pH and induces anxiety, fear, and panic responses in humans. In mice, CO2 produces freezing and avoidance behavior that has been suggested to depend on the amygdala. However, a recent study in humans with bilateral amygdala lesions revealed that CO2 can trigger fear and panic even in the absence of amygdalae, suggesting the importance of extra-amygdalar brain structures. Because the bed nucleus of the stria terminalis (BNST) contributes to fear- and anxiety-related behaviors and expresses acid-sensing ion channel-1A (ASIC1A), we hypothesized that the BNST plays an important role in CO2-evoked fear-related behaviors in mice. We found that BNST lesions decreased both CO2-evoked freezing and CO2-conditioned place avoidance. In addition, we found that CO2 inhalation caused BNST acidosis and that acidosis was sufficient to depolarize BNST neurons and induce freezing behavior; both responses depended on ASIC1A. Finally, disrupting Asic1a specifically in the BNST reduced CO2-evoked freezing, whereas virus-vector-mediated expression of ASIC1A in the BNST of Asic1a(-/-) and Asic1a(+/+) mice increased CO2-evoked freezing. Together, these findings identify the BNST as an extra-amygdalar fear circuit structure important in CO2-evoked fear-related behavior. Copyright © 2014 the authors 0270-6474/14/3410247-09$15.00/0.

  11. Sex differences in pudendal somatosensory evoked potentials.

    Science.gov (United States)

    Pelliccioni, G; Piloni, V; Sabbatini, D; Fioravanti, P; Scarpino, O

    2014-06-01

    Somatosensory evoked potentials (SEPs) of the pudendal nerve are a well-established diagnostic tool for the evaluation of pelvic floor disorders. However, the possible influence of sex differences on response latencies has not been established yet. The aim of this study was to standardize the procedures and to evaluate possible effects of gender differences on anal and penile/clitoral SEPs. The anal and dorsal penile/clitoral SEPs were recorded in 84 healthy subjects (40 males and 44 females; mean age 47.9 ± 16.6 years, range 16-81 years; mean height 168.3 ± 20.3 cm, range 155-187 cm). Pudendal SEPs were evoked with a bipolar surface electrode stimulating the clitoris or the base of the penis and the anal orifice and recorded using scalp electrodes. The latency of the first positive component (P1) was measured. The effect and possible interaction of (a) stimulation site and (b) gender on the two variables was explored by multivariate analysis of variance (MANOVA). The examination was well tolerated and a reproducible waveform of sufficient quality was obtained in all the subjects examined. In the female subjects, a mean cortical P1 latency of 37.0 ± 2.6 and 36.4 ± 3.2 ms for anal and clitoral stimulation, respectively, was found. In the male subjects, the cortical latencies were 38.0 ± 3.5 ms for the anal stimulation and 40.2 ± 3.7 ms for the penile stimulation. At MANOVA, a statistically significant main effect of stimulation site and gender as well as a significant interaction between the two variables was found. Anal and dorsal penile/clitoral SEPs represent a well-tolerated and reproducible method to assess the functional integrity of the sensory pathways in male and female subjects. Obtaining sex-specific reference data, by individual electrophysiological testing, is highly recommended because of significant latency differences between males and females, at least as far as penile/clitoral responses are concerned.

  12. Nivolumab in patients with advanced gastric or gastro-oesophageal junction cancer refractory to, or intolerant of, at least two previous chemotherapy regimens (ONO-4538-12, ATTRACTION-2): a randomised, double-blind, placebo-controlled, phase 3 trial.

    Science.gov (United States)

    Kang, Yoon-Koo; Boku, Narikazu; Satoh, Taroh; Ryu, Min-Hee; Chao, Yee; Kato, Ken; Chung, Hyun Cheol; Chen, Jen-Shi; Muro, Kei; Kang, Won Ki; Yeh, Kun-Huei; Yoshikawa, Takaki; Oh, Sang Cheul; Bai, Li-Yuan; Tamura, Takao; Lee, Keun-Wook; Hamamoto, Yasuo; Kim, Jong Gwang; Chin, Keisho; Oh, Do-Youn; Minashi, Keiko; Cho, Jae Yong; Tsuda, Masahiro; Chen, Li-Tzong

    2017-10-05

    Patients with advanced gastric or gastro-oesophageal junction cancer refractory to, or intolerant of, two or more previous regimens of chemotherapy have a poor prognosis, and current guidelines do not recommend any specific treatments for these patients. We assessed the efficacy and safety of nivolumab, a fully human IgG4 monoclonal antibody inhibitor of programmed death-1 (PD-1), in patients with advanced gastric or gastro-oesophageal junction cancer who had been previously been treated with two or more chemotherapy regimens. In this randomised, double-blind, placebo-controlled, phase 3 trial done at 49 clinical sites in Japan, South Korea, and Taiwan, eligible patients (aged ≥20 years with unresectable advanced or recurrent gastric or gastro-oesophageal junction cancer refractory to, or intolerant of, standard therapy [including two or more previous chemotherapy regimens], with an Eastern Cooperative Oncology Group [ECOG] performance status of 0-1, and naive to anti-PD-1 therapy or other therapeutic antibodies and pharmacotherapies for the regulation of T cells) were recruited. Patients were randomly assigned (2:1) using an interactive web response system to receive 3 mg/kg nivolumab or placebo intravenously every 2 weeks, stratified by country, ECOG performance status, and number of organs with metastases. Study treatment was continued until progressive disease per investigator assessment or onset of toxicities requiring permanent discontinuation. Patients and investigators were masked to group assignment. The primary endpoint was overall survival in the intention-to-treat population. Safety was analysed in all patients who received at least one dose of study treatment. This study is ongoing but not recruiting new patients, and is registered with ClinicalTrials.gov, number NCT02267343. Between Nov 4, 2014, and Feb 26, 2016, we randomly assigned 493 patients to receive nivolumab (n=330) or placebo (n=163). At the data cutoff (Aug 13, 2016), median follow-up in

  13. 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

  14. Visually evoked spiking evolves while spontaneous ongoing dynamics persist

    Directory of Open Access Journals (Sweden)

    Raoul eHuys

    2016-01-01

    Full Text Available Neurons in the primary visual cortex spontaneously spike even when there are no visual stimuli. It is unknown whether the spiking evoked by visual stimuli is just a modification of the spontaneous ongoing cortical spiking dynamics or whether the spontaneous spiking state disappears and is replaced by evoked spiking. This study of laminar recordings of spontaneous spiking and visually evoked spiking of neurons in the ferret primary visual cortex shows that the spiking dynamics does not change: the spontaneous spiking as well as evoked spiking is controlled by a stable and persisting fixed point attractor. Its existence guarantees that evoked spiking return to the spontaneous state. However, the spontaneous ongoing spiking state and the visual evoked spiking states are qualitatively different and are separated by a threshold (separatrix. The functional advantage of this organization is that it avoids the need for a system reorganization following visual stimulation, and impedes the transition of spontaneous spiking to evoked spiking and the propagation of spontaneous spiking from layer 4 to layers 2-3.

  15. Evoked otoacoustic emissions behaviour in retinitis pigmentosa.

    Science.gov (United States)

    Fiore, C; Cagini, C; Menduno, P; Toniassoni, I; Desantis, A; Pennacchi, A; Ricci, G; Molini, E

    1994-01-01

    The hearing function was studied in 26 patients affected by retinitis pigmentosa (RP) and in their relatives. Sixteen patients showed bilateral normal hearing when examined with traditional audiometric methods. In these normoacusic patients evoked otoacoustic emissions (EOE) have been studied. The EOE offer a unique opportunity to measure objectively the function of outer hair cells: they record the amplitude of the energy produced by the outer hair cells of the coclea following an acoustic stimulation. The data have been statistically compared, using the Student's t-test, with those obtained in a homogeneous control-group of normal subjects. In normoacusic subjects with RP the average values of EOE intensity are statistically lower than those of normal subjects in 64 of the 127 frequency bands examined. Moreover, the distribution of the EOE in patients with retinitis pigmentosa proved to be more discontinous than that observed in the normal subjects. The EOE recorded in 14 normoacusic relatives show in some cases small anomalies but the data, on account of the limited sample group, cannot be statistically evaluated. Therefore a subclinical alteration of the Organ of Corti is found in 100% of the patients affected by RP, although they appear to be normoacusic to usual audiometric tests.

  16. Transient evoked otoacoustic emissions in rock musicians.

    Science.gov (United States)

    Høydal, Erik Harry; Lein Størmer, Carl Christian; Laukli, Einar; Stenklev, Niels Christian

    2017-09-01

    Our focus in this study was the assessment of transient evoked otoacoustic emissions (TEOAEs) in a large group of rock musicians. A further objective was to analyse tinnitus among rock musicians as related to TEOAEs. The study was a cross-sectional survey of rock musicians selected at random. A control group was included at random for comparison. We recruited 111 musicians and a control group of 40 non-musicians. Testing was conducted by using clinical examination, pure tone audiometry, TEOAEs and a questionnaire. TEOAE SNR in the half-octave frequency band centred on 4 kHz was significantly lower bilaterally in musicians than controls. This effect was strongly predicted by age and pure-tone hearing threshold levels in the 3-6 kHz range. Bilateral hearing thresholds were significantly higher at 6 kHz in musicians. Twenty percent of the musicians had permanent tinnitus. There was no association between the TEOAE parameters and permanent tinnitus. Our results suggest an incipient hearing loss at 6 kHz in rock musicians. Loss of TEOAE SNR in the 4 kHz half-octave frequency band was observed, but it was related to higher mean 3-6 kHz hearing thresholds and age. A large proportion of rock musicians have permanent tinnitus.

  17. Visual evoked potential study in slow learners.

    Science.gov (United States)

    Khaliq, Farah; Anjana, Yumnam; Vaney, Neelam

    2009-01-01

    Slow learners are individuals with low achievement and comparably low IQ scores. It may be a symptom reflecting a larger underlying problem in them. Sensory neural processing of visual information can be one of the contributory factors for their underachievement. The present study was undertaken to examine the integrity and function of visual pathway by means of Visual Evoked Potential (VEP). Pattern reversal VEP was performed on seventeen slow learners. Fifteen age and sex matched children with good school performance and normal IQ were taken as controls. There was significant prolongation of N75 component of VEP in slow learners. The latencies of P100 and N145 were also increased but could not reach the level of significance. Our findings are suggestive of the presence of a weaker VEP response in slow learners indicative of a deficit early in the visual processing. There is some abnormality in the geniculate afferents to V1 which is consistent with a defect in the magnocellular pathway at the level of Visual Area 1 or earlier.

  18. The feasibility of an exercise intervention in males at risk of oesophageal adenocarcinoma: a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Brooke M Winzer

    Full Text Available To investigate the feasibility and safety of a 24-week exercise intervention, compared to control, in males with Barrett's oesophagus, and to estimate the effect of the intervention, compared to control, on risk factors associated with oesophageal adenocarcinoma development.A randomized controlled trial of an exercise intervention (60 minutes moderate-intensity aerobic and resistance exercise five days/week over 24 weeks; one supervised and four unsupervised sessions versus attention control (45 minutes stretching five days/week over 24 weeks; one supervised and four unsupervised sessions in inactive, overweight/obese (25.0-34.9 kg/m2 males with Barrett's oesophagus, aged 18-70 years. Primary outcomes were obesity-associated hormones relevant to oesophageal adenocarcinoma risk (circulating concentrations of leptin, adiponectin, interleukin-6, tumour necrosis factor-alpha, C-reactive protein, and insulin resistance [HOMA]. Secondary outcomes included waist circumference, body composition, fitness, strength and gastro-oesophageal reflux symptoms. Outcomes were measured at baseline and 24-weeks. Intervention effects were analysed using generalised linear models, adjusting for baseline value.Recruitment was difficult in this population with a total of 33 participants recruited (target sample size: n = 80; 97% retention at 24-weeks. Adherence to the exercise protocol was moderate. No serious adverse events were reported. A statistically significant intervention effect (exercise minus control was observed for waist circumference (-4.5 [95% CI -7.5, -1.4] cm; p < 0.01. Effects on primary outcomes were not statistically significant.This small, exploratory trial provides important information to inform future trial development including recruitment rates and estimates of effect sizes on outcomes related to oesophageal adenocarcinoma risk. Future trials should investigate a combined dietary and exercise intervention to achieve greater weight loss in this

  19. The 100 most cited articles investigating the radiological staging of oesophageal and junctional cancer: a bibliometric analysis.

    Science.gov (United States)

    Foley, Kieran G; Powell, Arfon; Lewis, Wyn G; Roberts, Stuart Ashley

    2016-08-01

    Accurate staging of oesophageal cancer (OC) is vital. Bibliometric analysis highlights key topics and publications that have shaped understanding of a subject. The 100 most cited articles investigating radiological staging of OC are identified. The Thomas Reuters Web of Science database with search terms including "CT, PET, EUS, oesophageal and gastro-oesophageal junction cancer" was used to identify all English language, full-script articles. The 100 most cited articles were further analysed by topic, journal, author, year and institution. A total of 5,500 eligible papers were returned. The most cited paper was Flamen et al. (n = 306), investigating the utility of positron emission tomography (PET) for the staging of patients with potentially operable OC. The most common research topic was accuracy of staging investigations (n = 63). The article with the highest citation rate (38.00), defined as the number of citations divided by the number of complete years published, was Tixier et al. investigating PET texture analysis to predict treatment response to neo-adjuvant chemo-radiotherapy, cited 114 times since publication in 2011. This bibliometric analysis has identified key publications regarded as important in radiological OC staging. Articles with the highest citation rates all investigated PET imaging, suggesting this modality could be the focus of future research. • This study identifies key articles that investigate radiological staging of oesophageal cancer. • The most common topic was accuracy of staging investigations. • The article with the highest citation rate investigated the use of texture analysis in PET images.

  20. Airway cellularity, lipid laden macrophages and microbiology of gastric juice and airways in children with reflux oesophagitis

    Directory of Open Access Journals (Sweden)

    Lewindon PJ

    2005-07-01

    Full Text Available Abstract Background Gastroesophageal reflux disease (GORD can cause respiratory disease in children from recurrent aspiration of gastric contents. GORD can be defined in several ways and one of the most common method is presence of reflux oesophagitis. In children with GORD and respiratory disease, airway neutrophilia has been described. However, there are no prospective studies that have examined airway cellularity in children with GORD but without respiratory disease. The aims of the study were to compare (1 BAL cellularity and lipid laden macrophage index (LLMI and, (2 microbiology of BAL and gastric juices of children with GORD (G+ to those without (G-. Methods In 150 children aged Results BAL neutrophil% in G- group (n = 63 was marginally but significantly higher than that in the G+ group (n = 77, (median of 7.5 and 5 respectively, p = 0.002. Lipid laden macrophage index (LLMI, BAL percentages of lymphocyte, eosinophil and macrophage were similar between groups. Viral studies were negative in all, bacterial cultures positive in 20.7% of BALs and in 5.3% of gastric aspirates. BAL cultures did not reflect gastric aspirate cultures in all but one child. Conclusion In children without respiratory disease, GORD defined by presence of reflux oesophagitis, is not associated with BAL cellular profile or LLMI abnormality. Abnormal microbiology of the airways, when present, is not related to reflux oesophagitis and does not reflect that of gastric juices.

  1. Role of nutritional status and intervention in oesophageal cancer treated with definitive chemoradiotherapy: outcomes from SCOPE1.

    Science.gov (United States)

    Cox, S; Powell, C; Carter, B; Hurt, C; Mukherjee, Somnath; Crosby, Thomas David Lewis

    2016-07-12

    Malnutrition is common in oesophageal cancer. We aimed to identify nutritional prognostic factors and survival outcomes associated with nutritional intervention in the SCOPE1 (Study of Chemoradiotherapy in OesoPhageal Cancer with or without Erbitux) trial. Two hundred and fifty eight patients were randomly allocated to definitive chemoradiotherapy (dCRT) +/- cetuximab. Nutritional Risk Index (NRI) scores were calculated; NRINutritional intervention included dietary advice, oral supplementation or major intervention (enteral feeding/tube placement). Univariable and multivariable analyses using Cox proportional hazard modelling were conducted. At baseline NRINutritional intervention improved survival if provided at baseline (dietary advice (HR 0.12, P=0.004), oral supplementation (HR 0.13, Pintervention (HR 0.13, P=0.003)), but not if provided later in the treatment course. Cetuximab patients receiving major nutritional intervention had worse outcomes compared with controls (13 vs 28 months, P=0.003). Pre-treatment assessment and correction of malnutrition may improve survival outcomes in oesophageal cancer patients treated with dCRT. Nutritional Risk Index is a simple and objective screening tool to identify patients at risk of malnutrition.

  2. Effect of Gaviscon Infant on gastro-oesophageal reflux in infants assessed by combined intraluminal impedance/pH.

    Science.gov (United States)

    Del Buono, R; Wenzl, T G; Ball, G; Keady, S; Thomson, M

    2005-05-01

    Gaviscon Infant (GI) has been recommended for gastro-oesophageal reflux (GOR) in infants. Its efficacy has not been examined with a physiologically appropriate denominator to define the degree of GOR. To investigate the influence of Gaviscon Infant on GOR in infants using combined pH and intraluminal impedance measurement. Twenty infants (mean age 163.5 days, range 34-319 days) exclusively bottle fed, with symptoms clinically suggestive of GOR, underwent 24 hour studies of intra-oesophageal 6 channel impedance and dual channel pH monitoring, during which six random administrations (3+3) of Gaviscon Infant (625 mg in 225 ml milk) or placebo (mannitol and Solvito N, 625 mg in 225 ml milk) were given in a double blind fashion. Impedance/pH reflux data were recorded and analysed blind by one observer. The median number of reflux events/hour (1.58 v 1.68), acid reflux events/hour (0.26 v 0.43), minimum distal or proximal pH, total acid clearance time per hour (time with pH below pH 4), and total reflux duration per hour were not significantly different after GI than after placebo. Reflux height was marginally lower after GI (median 66.6% v 77.3% oesophageal length) compared with placebo. Results showed a marginal but significant difference between Gaviscon Infant and placebo in average reflux height, and raises questions regarding any perceived clinical benefit of its use.

  3. Two years' experience of using the Bravo wireless oesophageal pH monitoring system at a single UK tertiary centre.

    Science.gov (United States)

    Rao, Nagendra M; Campbell, David I; Rao, Prithviraj

    2017-02-01

    The Bravo wireless pH monitoring system enables oesophageal pH to be monitored in children intolerant to nasal catheters and records measurements over 48 hours. This study aimed to document the minimum child weight that enabled successful capsule placement and any associated complications. We also compared the diagnostic sensitivity of 48 hours versus 24 hours. We included 203 consecutive patients (122 male children) with clinically documented or suspected reflux symptoms. The age range was two years to 19 years, and the minimum weight was 9.29 kg. The pH capsule was deployed endoscopically under general anaesthetic. Recordings taken over 24 and 48 hours were compared to determine the frequency of differences and correlations in the reflux index and DeMeester scores. Testing using the detached probe was successful in 190 children (93.6%) with weight as low as 9.29 kg, with no side effects, with failed deployment being the most frequent problem. Clinically different results in the reflux index were found in 16% of the children's day 1 or day 2 readings (p < 0.0001), suggesting the benefit of 48-hour measurements. Measuring oesophageal pH with the Bravo wireless pH monitoring system was successful in 93.6% of cases. A 48-hour test improved the detection rate of gastro-oesophageal reflux disease by 16%. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  4. Initial experience with magnetic resonance fluoroscopy in the evaluation of oesophageal motility disorders. Comparison with manometry and barium fluoroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Panebianco, Valeria; Anzidei, Michele; Catalano, Carlo; Passariello, Roberto [University of Rome ' ' La Sapienza' ' , Department of Radiological Sciences, Rome (Italy); Habib, Fortunee I.; Tomei, Ernesto [University of Rome ' ' La Sapienza' ' , Division of Gastroenterology, Rome (Italy); Paolantonio, Pasquale; Laghi, Andrea [University of Rome ' ' La Sapienza' ' , Department of Radiological Sciences - Polo Didattico Pontino I.C.O.T, Rome (Italy)

    2006-09-15

    The aim of this paper was to assess the diagnostic value of magnetic resonance (MR) fluoroscopy in the study of oesophageal motility disorders and to compare MR fluoroscopy results with those of manometry and barium contrast radiography. Twenty-five subjects referred for dysphagia and three patients in follow-up after pneumatic dilatation of the lower oesophageal sphincter to treat severe achalasia underwent esophageal manometry, barium contrast radiography and MR fluoroscopy. Examinations were performed on a 1.5 T scanner. Dynamic turbo- fast low angle shot (turbo-FLASH) sequences acquired during oral contrast agent administration were used to perform MR fluoroscopy. MR fluoroscopy correctly diagnosed achalasia in nine patients, uncoordination of esophageal body motility in ten and scleroderma oesophagus in one. Diagnostic performance was satisfactory, with a sensitivity of 87.5% and a specificity of 100% in the general depiction of motility alterations. Our work demonstrates that MR fluoroscopic examination in subject affected by oesophageal motility disorders is feasible and can properly depict motility and morphology alterations, achieving correct diagnosis in the majority of cases. Studies on larger populations are necessary to obtain statistically significant results. (orig.)

  5. Cortically evoked potentials in the human subthalamic nucleus

    NARCIS (Netherlands)

    Zwartjes - de Klerk, D.G.M; Janssen, M.L.F; Heida, Tjitske; van Kranen-Mastenbroek, V.; Bour, L.; Temel, Y.; Visser-Vandewalle, V.; Martens, H.C.F.; Veltink, Petrus H.

    2013-01-01

    Deep brain stimulation (DBS) of the subthalamic nucleus (STN) alleviates motor symptoms in Parkinson’s disease (PD) patients. However, in a substantial number of patients the beneficial effects of STN DBS are overshadowed by psychiatric side effects. We hypothesize that stimulation of the STN motor

  6. Transoesophageal spinal cord stimulation for motor-evoked potentials monitoring: feasibility, safety and stability.

    Science.gov (United States)

    Tsuda, Kazumasa; Shiiya, Norihiko; Takahashi, Daisuke; Ohkura, Kazuhiro; Yamashita, Katsushi; Kando, Yumi

    2015-08-01

    Specificity of transcranial motor-evoked potentials (MEPs) is low because amplitude fluctuation is common, which seems due to several technical and fundamental reasons including difficulty in electrodes positioning and fixation for transcranial stimulation and susceptibility to anaesthesia. This study aimed to investigate the feasibility, safety and stability of our novel technique of transoesophageal spinal cord stimulation to improve the stability of MEPs. Ten anaesthetized adult beagle dogs were used. Transoesophageal stimulation was performed between the oesophageal luminal surface electrode (cathode) and a subcutaneous needle electrode (anode) at the fourth to fifth thoracic vertebra level. Stimulation was achieved with a train of five pulses delivered at 2.0-ms intervals. Compound muscle action potentials were recorded from four limbs and external anal sphincter muscles. Stability to anaesthetic agents was tested at varying speeds of propofol and remifentanil, and effects of varying concentration of sevoflurane inhalation were also evaluated. Transoesophageal MEPs could be recorded without difficulty in all dogs. Fluoroscopic evaluation showed that electrodes misalignment up to 5 cm cranially or caudally could be tolerated. Stimulus intensity to achieve maximum amplitude of hindlimb muscle potentials on both sides was significantly lower by transoesophageal stimulation than by transcranial stimulation (383 ± 41 vs 533 ± 121 V, P = 0.02) and had less interindividual variability. Latency of transoesophageal MEPs was shorter than that of transcranial MEPs at every recording point. No arrhythmia was provoked during stimulation. Animals that were allowed to recover showed no neurological abnormality. In the two sacrificed animals, the explanted oesophagus showed no mucosal injury. Stability to varying dose of anaesthetic agents was similar between transoesophageal and transcranial stimulation, except for the potentials of forelimbs by transoesophageal

  7. Objective measures of binaural masking level differences and comodulation masking release based on late auditory evoked potentials

    DEFF Research Database (Denmark)

    Epp, Bastian; Yasin, Ifat; Verhey, Jesko L.

    2013-01-01

    The audibility of important sounds is often hampered due to the presence of other masking sounds. The present study investigates if a correlate of the audibility of a tone masked by noise is found in late auditory evoked potentials measured from human listeners. The audibility of the target sound...... in a masking release (i: binaural masking level difference; ii: comodulation masking release) compared to a condition where those cues are not present. Late auditory evoked potentials (N1, P2) were recorded for the stimuli at a constant masker level, but different signal levels within the same set of listeners...

  8. Evoked potentials and head injury. 1. Rating of evoked potential abnormality.

    Science.gov (United States)

    Rappaport, M; Hall, K; Hopkins, H K; Belleza, T

    1981-10-01

    This paper describes a method for rating the degree of abnormality of auditory, visual and somatosensory evoked potential patterns in head injury (HI) patients. Criteria for judging degree of EP abnormality are presented that allow assessment of the extent and severity of subcortical and cortical dysfunction associated with traumatic brain damage. Interrater reliability data based upon blind ratings of normal and HI patients are presented and shown to be highly significant. Tables of normative values of peak latencies and amplitudes are given and illustrations of EP patterns of different degrees of abnormality are presented.

  9. Auditory Perceptual and Visual-Spatial Characteristics of Gaze-Evoked Tinnitus

    Directory of Open Access Journals (Sweden)

    Jamileh Fattahi

    1996-09-01

    Full Text Available Auditory perceptual and visual-spatial characteristics of subjective tinnitus evoked by eye gaze were studied in two adult human subjects. This uncommon form of tinnitus occurred approximately 4-6 weeks following neurosurgery for gross total excision of space Occupying lesions of the cerebellopontine angle and hearing was lost in the operated ear. In both cases, the gaze evoked tinnitus was characterized as being tonal in nature, with pitch and loudness percepts remaining constant as long as the same horizontal or vertical eye directions were maintained. Tinnitus was absent when the eyes were in a neutral head referenced position with subjects looking straight ahead. The results and implications of ophthalmological, standard and modified visual field assessment, pure tone audio metric assessment, spontaneous otoacoustic emission testing and detailed psychophysical assessment of pitch and loudness are discussed

  10. Sensory-Evoked Intrinsic Imaging Signals in the Olfactory Bulb Are Independent of Neurovascular Coupling

    Directory of Open Access Journals (Sweden)

    Roberto Vincis

    2015-07-01

    Full Text Available Functional brain-imaging techniques used in humans and animals, such as functional MRI and intrinsic optical signal (IOS imaging, are thought to largely rely on neurovascular coupling and hemodynamic responses. Here, taking advantage of the well-described micro-architecture of the mouse olfactory bulb, we dissected the nature of odor-evoked IOSs. Using in vivo pharmacology in transgenic mouse lines reporting activity in different cell types, we show that parenchymal IOSs are largely independent of neurotransmitter release and neurovascular coupling. Furthermore, our results suggest that odor-evoked parenchymal IOSs originate from changes in light scattering of olfactory sensory neuron axons, mostly due to water movement following action potential propagation. Our study sheds light on a direct correlate of neuronal activity, which may be used for large-scale functional brain imaging.

  11. Objective information-theoretic algorithm for detecting brainstem-evoked responses to complex stimuli.

    Science.gov (United States)

    Bidelman, Gavin M

    2014-09-01

    The scalp-recorded frequency-following response (FFR), an auditory-evoked potential with putative neural generators in the rostral brainstem, provides a robust representation of the neurophysiologic encoding of complex stimuli. The FFR is rapidly becoming a valuable tool for understanding the neural transcription of speech and music, language-related processing disorders, and brain plasticity at initial stages of the auditory pathway. Despite its potential clinical and empirical utility, determining the presence of a response is still dependent on the subjective interpretation by an experimenter/clinician. The purpose of the present work was to develop and validate a fully objective procedure for the automatic detection of FFRs elicited by complex auditory stimuli, including speech. Mutual information (MI) was computed between the spectrographic representation of neural FFRs and their evoking acoustic stimuli to quantify the amount of shared time-frequency information between electrophysiologic responses and stimulus acoustics. To remove human subjectivity associated with typical response evaluation, FFRs were first simulated at known signal-to-noise ratios using a computational model of the auditory periphery. The MI at which model FFRs contained +3 dB Signal-to-noise ratio was taken as the criterion threshold (θMI) for the presence of a response. θMI was then applied as a binary classifier on actual neurophysiologic responses recorded previously in human participants (n = 35). Sham recordings, in which no stimulus was presented to participants, allowed us to determine the receiver operating characteristics of the MI metric and the capabilities of the algorithm to segregate true evoked responses from sham recordings. RESULTS showed high overall accuracy (93%) in the metric's ability to identify true responses from sham recordings. The metric's overall performance was considerably better than trained human observers who, on average, accurately identified only

  12. Review article: management of oesophageal adenocarcinoma -- control of acid, bile and inflammation in intervention strategies for Barrett's oesophagus.

    Science.gov (United States)

    Jankowski, J A; Anderson, M

    2004-10-01

    Oesophagitis is associated with Barrett's metaplasia in about 10% of individuals. The UK has one of the highest world-wide prevalences of Barrett's metaplasia, with 1% of adults having the condition, resulting in an incidence of oesophageal adenocarcinoma two to three times that seen in either Europe or North America. In addition, the conversion rate to cancer in individuals with Barrett's metaplasia in UK surveillance programmes is twice that observed in the USA (0.96% per year vs. 0.4% per year), lending further support to the notion that the UK is a high-risk region. The evidence base on what can be achieved with medical therapy to reduce the risk of dysplasia or the development of adenocarcinoma needs to be strengthened with data from randomized controlled trials, as existing data have many limitations. Patients with Barrett's metaplasia respond variably to proton pump inhibitor therapy (even high-dose therapy 'normalizes' acid reflux in only 85% of cases), and symptom control is a poor determinant of the adequacy of suppression of acid reflux. Gastro-oesophageal reflux is implicated in the pathogenesis of Barrett's metaplasia, and ex vivo and in vitro evidence suggests that its attenuation reverses proliferation and biological variables over days, and perhaps the metaplastic histology to a degree over years. The effect of proton pump inhibitor therapy on cancer risk in the long term is essentially unknown. Acid suppressant therapy or anti-reflux surgery on its own does not result in the complete regression of the metaplastic epithelium. Bile acids, present especially frequently in the refluxate of Barrett's oesophagus patients, are also likely to influence the development and persistence of metaplasia. Barrett's metaplasia is replaced by a squamous epithelium when acid reflux is well controlled and the epithelium is physically destroyed by ablation with argon plasma coagulation or photodynamic therapy. These modalities are invasive and are not likely to be

  13. Towards a neural basis of music-evoked emotions.

    Science.gov (United States)

    Koelsch, Stefan

    2010-03-01

    Music is capable of evoking exceptionally strong emotions and of reliably affecting the mood of individuals. Functional neuroimaging and lesion studies show that music-evoked emotions can modulate activity in virtually all limbic and paralimbic brain structures. These structures are crucially involved in the initiation, generation, detection, maintenance, regulation and termination of emotions that have survival value for the individual and the species. Therefore, at least some music-evoked emotions involve the very core of evolutionarily adaptive neuroaffective mechanisms. Because dysfunctions in these structures are related to emotional disorders, a better understanding of music-evoked emotions and their neural correlates can lead to a more systematic and effective use of music in therapy. Copyright 2010 Elsevier Ltd. All rights reserved.

  14. Distraction Reduces Both Early and Late Electrocutaneous Stimulus Evoked Potentials

    NARCIS (Netherlands)

    Blom, J.H.G.; Wiering, Caro H.; van der Lubbe, Robert Henricus Johannes

    2012-01-01

    Previous electroencephalography studies revealed mixed effects of sustained distraction on early negative and later positive event-related potential components evoked by electrocutaneous stimuli. In our study we further examined the influence of sustained distraction to clarify these discrepancies.

  15. Click-evoked responses in vestibular afferents in rats

    National Research Council Canada - National Science Library

    Zhu, Hong; Tang, Xuehui; Wei, Wei; Mustain, William; Xu, Youguo; Zhou, Wu

    2011-01-01

    Sound activates not only the cochlea but also the vestibular end organs. Research on this phenomenon led to the discovery of the sound-evoked vestibular myogenic potentials recorded from the sternocleidomastoid muscles...

  16. Should oesophageal stents be used before neo-adjuvant therapy to treat dysphagia in patients awaiting oesophagectomy? Best evidence topic (BET).

    Science.gov (United States)

    Jones, Christopher M; Griffiths, Ewen A

    2014-11-01

    Patients who develop significant dysphagia secondary to a potentially curable oesophageal cancer pose a significant clinical problem. Their nutritional needs can be met either by dietary supplementation, insertion of an oesophageal stent or through nasogastric or surgical feeding tube placement. We sought to determine whether, in patients about to start neo-adjuvant therapy prior to oesophagectomy, the use of oesophageal stent improves clinical outcomes. A best evidence topic in upper gastrointestinal surgery was written according to a structured protocol in order to answer this question. Two hundred and forty eight papers were found, of which eleven level III and one level IV study were considered to best address the clinical question. These indicate that whilst oesophageal stents do successfully relieve dysphagia throughout neoadjuvant therapy, they are not consistently associated with maintenance of, or improvement in, serum albumin or body weight. They are, however, commonly associated with stent migration and chest discomfort, both of which may frequently result in the need for stent removal or replacement. There is additional evidence within the manuscripts reviewed to demonstrate that the use of oesophageal stents in the neoadjuvant setting can lead to significant complications in a small proportion of patients which can compromise opportunity for curative surgery. The use of stents in this situation cannot be recommended. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  17. Flash visual evoked potentials in preterm infants.

    Science.gov (United States)

    Feng, Jing-Jing; Wang, Wei-Ping; Guo, Shu-Juan; Liu, Zhi-Wei; Xu, Xiu

    2013-03-01

    To describe the development of flash visual evoked potentials (FVEPs) in preterm infants from 1 to 18 months and to determine if the maturation of FVEPs is similar to that of term infants. Longitudinal follow-up study. Twenty very low birth weight (VLBW) preterm infants, 42 low birth weight (LBW) preterm infants, and 41 term infants underwent FVEP recordings and neurodevelopmental examinations at 1, 3, 6, 9, 12, and 18 months of corrected and chronological ages. The FVEP recordings were carried out with the VikingQuest-IV neuroelectrophysiological device (VikingQuest, Nicolet, WI), and neurodevelopmental assessments were made by the Development Screen Test and Bayley Scales of Infant Development, Second Edition. At 1, 3, 6, and 9 months of age, neurodevelopment was measured with the Mental Index and Developmental Quotient. At 12 and 18 months, neurodevelopment was assessed using the Mental Developmental Index and Psychomotor Developmental Index. Two FVEP values were analyzed: the P2 amplitude (peak to peak from the preceding N2 wave) and the latency of the P2 wave. There was no significant difference for age-dependent decreased pattern of FVEP P2 latency between preterm infants and the control group. This pattern consisted of a rapid decrease in the first 6 months of life, a gradual decline from 6 to 12 months of age, and a steady reduction from 12 to 18 months of age. The P2 latencies were prolonged significantly at all 6 recorded times in the VLBW group compared with the controls and showed a delay in the LBW group at 1 and 3 months of corrected age. The maturation of P2 latency in LBW infants is similar to that of the controls at 3 months of corrected age, but the maturation of P2 latency in VLBW children remained delayed when compared with the controls until 18 months of corrected age. Although the FVEP development pattern of preterm infants was similar to that of healthy full-term infants, the former had deficits in visual electrophysiologic maturation

  18. Design, testing and modelling of a novel robotic system for trans-oesophageal ultrasound.

    Science.gov (United States)

    Wang, Shuangyi; Housden, James; Singh, Davinder; Althoefer, Kaspar; Rhode, Kawal

    2016-09-01

    Trans-oesophageal echocardiography (TOE) has been widely utilized for cardiac disease diagnosis and interventional procedure guidance. However, the TOE operator is required to manually manipulate the probe, often for long periods of time and sometimes in an X-ray environment where there is exposure to ionizing radiation. A novel robotic manipulation system for remote control of commercial TOE probes has been developed and tested. The system has four degrees of freedom (DOFs) and is characterized by a kinematic model. The accuracy of the model and the error propagation were analysed. The prototype system was shown to exhibit the required function in terms of the mechanical reliability and range of motion. The forward kinematic model can accurately predict the trajectory of the probe tip movement. The average point-to-point errors were 2.60 mm and 3.55°. Robotic assistance provided by the proposed system may improve the TOE operating environment. The proposed forward kinematic model can be further employed for automatic control. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  19. Infant gastro-oesophageal reflux disease (GORD): Australian GP attitudes and practices.

    Science.gov (United States)

    Kirby, Catherine N; Segal, Ahuva Y; Hinds, Rupert; Jones, Kay M; Piterman, Leon

    2016-01-01

    The aim of this study was to evaluate the attitudes and practices of Australian general practitioners (GPs) regarding infant gastro-oesophageal reflux disease (GORD) diagnosis and management. A national cross-sectional survey, involving a random sample of currently practising Australian GPs (n = 2319) was undertaken between July and September 2011. GPs attitudes and management of infant GORD were surveyed via an online and paper-based 41-item questionnaire. In total, 400 responses were analysed (17.24% response rate). The majority of GPs employed empirical trials of acid-suppression medication and/or lifestyle modifications to diagnose infant GORD. GPs frequently recommended dietary modification despite the belief that they were only moderately effective at best. In addition, GPs frequently prescribed acid-suppression medication, despite concerns regarding their safety in the infant population. Other GP concerns included the lack of clinical guidelines and education for GPs about infant GORD, as well as the level of evidence available for the safety and efficacy of diagnostic tests and treatments. Despite the important role Australian GPs play in the diagnosis and management of infant GORD, high-level evidence-based guidelines for GPs are lacking. Consequently, GPs engage in diagnostic and management practices despite their concerns regarding the safety and effectiveness. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  20. Downhill oesophageal varices resulting from superior vena cava graft occlusion after resection of a thymoma†

    Science.gov (United States)

    Inoue, Yoshimasa; Sakai, Shoji; Aoki, Teruhiro

    2013-01-01

    Downhill oesophageal varices (DEV) may occur as a rare complication of superior vena cava (SVC) obstruction. DEV are usually associated with SVC obstruction caused by systemic vasculitis or mediastinal tumours. In this report, we describe a very rare case of DEV resulting from SVC graft occlusion after resection of a thymoma. A 66-year old man with an invasive thymoma was treated by radical resection and bypass grafting from the right brachiocephalic vein to the right atrium. Occlusion of the SVC graft was diagnosed postoperatively; however, the patient could be managed conservatively. Although there had been no significant findings in the oesophagus in previous endoscopic examinations, grade F2 varices were found in the proximal oesophagus in the 19th postoperative month, and DEV caused by SVC graft occlusion was diagnosed. Until now, 2 years since the diagnosis, no apparent symptoms or deterioration of the DEV have been observed. The possible development of DEV should be borne in mind during the follow-up of patients with postoperative SVC graft occlusion. PMID:23686892

  1. Gaviscon and Carobel compared with cisapride in gastro-oesophageal reflux.

    Science.gov (United States)

    Greally, P; Hampton, F J; MacFadyen, U M; Simpson, H

    1992-05-01

    We compared the efficacy of the prokinetic agent cisapride with that of Gaviscon (an alginate/alkaline compound) plus Carobel (carob seed flour) in the treatment of gastrooesophageal reflux (GOR). Fifty infants with confirmed GOR received either oral cisapride (0.8 mg/kg/day) or Gaviscon plus Carobel for one month in a randomised, parallel group study. Parental evaluations, diary scores, and 24 hour lower oesophageal pH recordings before and at the end of each treatment were compared. In the cisapride group 14/26 (53%) were considered better by their parents compared with 19/24 (79%) of those who received Gaviscon plus Carobel. Diary scores, range (0.00-1.00), improved in both groups with the median change being greater in the Gaviscon plus Carobel group (-0.21) than the cisapride group (-0.15). Five of 17 pH variables had significantly improved from baseline in infants who had received cisapride compared with 11/17 in those receiving Gaviscon plus Carobel. However, unpaired analysis of diary and pH data showed no significant differences between the two groups. We conclude that first line treatment of GOR with cisapride is no more effective than conventional treatment with Gaviscon plus Carobel.

  2. Oesophageal foreign body in children: 15 years experience in a tertiary care paediatric centre

    Directory of Open Access Journals (Sweden)

    Amit Singh

    2014-01-01

    Full Text Available Background: The objective of this study was to report our experience and outcome in the management of oesophageal foreign body (EFB in suspected cases of foreign body (FB ingestion. Materials and Methods: Records of children with documented EFB ingestion treated in the Department of Pediatric surgery from January 1997 to December 2012 were analysed. Diagnosis was made on the basis of history, clinical examination and radiological evaluation. Stronger index of suspicion was kept in cases of sudden onset of symptoms with an inappropriate history of FB ingestion. Results: A total of 317 children underwent emergency rigid oesophagoscopy for EFB. Out of these, 206 were males and 111 were females. The most common EFB found was coins in 209 (65.9% cases, followed by food bolus obstruction in 54 (17%, metallic FB in 29 (9.1%, plastic FB in 21 (6.6%, and button batteries in 14 (4.4% cases. The most common site of FB impaction was found to be cricopharynx in 291 (92% cases. Conclusions: High index of suspicion should be kept for EFB in children who present with unavailable history of FB ingestion. The wait-and-watch policy in cases of FB oesophagus is not always the correct approach, especially when it presents as respiratory distress of sudden onset.

  3. Modern oncologic and operative outcomes for oesophageal cancer treated with curative intent.

    LENUS (Irish Health Repository)

    Reynolds, J V

    2011-09-01

    The curative approach to oesophageal cancer carries significant risks and a cure is achieved in approximately 20 per cent. There has been a recent trend internationally to observe improved operative and oncological outcomes. This report audits modern outcomes from a high volume centre with a prospective database for the period 2004-08. 603 patients were referred and 310 (52%) were treated with curative intent. Adenocarcinoma represented 68% of the cohort, squamous cell cancer 30%. Of the 310 cases, 227 (73%) underwent surgery, 105 (46%) underwent surgery alone, and 122 (54%) had chemotherapy or combination chemotherapy and radiation therapy. The postoperative mortality rate was 1.7%. The median and 5-year survival of the 310 patients based on intention to treat was 36 months and 36%, respectively, and of the 181 patients undergoing R0 resection, 52 months and 42%, respectively. An in-hospital postoperative mortality rate of less than 2 per cent, and 5-year survival of between 35 and 42% is consistent with benchmarks from international series.

  4. Recurrent Complete Pharyngo-Oesophageal Stricture Treated by Multidisciplinary Anterograde-Retrograde Endoscopic Dilation

    Directory of Open Access Journals (Sweden)

    Paulo Castro Soares

    2016-10-01

    Full Text Available Complete pharyngo-oesophageal stricture (PES after radiotherapy for head and neck cancer is a relatively rare and difficult complication to manage. Historically this condition has been treated surgically, but endoscopic approaches are now available. We present a 61-year-old man with an epidermoid carcinoma of the supraglottic stage and a micro-invasive epidermoid carcinoma of the oropharynx treated surgically and subsequently by adjuvant radiotherapy. Eight months after the end of the radiotherapy, a complete PES was diagnosed and treated with a combined anterograde-retrograde endoscopic dilation (CARD. The procedure was performed using a transoral anterograde progression with a rigid pharyngoscope and a retrograde progression with an extra-slim nasal endoscope using the percutaneous gastrostomy already in place. Using both transillumination and direct visualisation from both sides of the complete stenosis patency was restored between the neopharynx and the oesophagus. Despite the use of an endoprosthesis, the complete PES recurred and the technique had to be performed a second time. Illustrating the complexity of the case different types of endoprosthesis and several dilations had to be performed for our patient to achieve and maintain a normal oral intake. This case report illustrates that even in complicated recurrent radiation-induced complete PES a CARD can be performed safely and successfully using different types of endoprosthesis.

  5. Automatic Adjustments of a Trans-oesophageal Ultrasound Robot for Monitoring Intra-operative Catheters

    Science.gov (United States)

    Wang, Shuangyi; Housden, James; Singh, Davinder; Rhode, Kawal

    2017-12-01

    3D trans-oesophageal echocardiography (TOE) has become a powerful tool for monitoring intra-operative catheters used during cardiac procedures in recent years. However, the control of the TOE probe remains as a manual task and therefore the operator has to hold the probe for a long period of time and sometimes in a radiation environment. To solve this problem, an add-on robotic system has been developed for holding and manipulating a commercial TOE probe. This paper focuses on the application of making automatic adjustments to the probe pose in order to accurately monitor the moving catheters. The positioning strategy is divided into an initialization step based on a pre-planning method and a localized adjustments step based on the robotic differential kinematics and related image servoing techniques. Both steps are described in the paper along with simulation experiments performed to validate the concept. The results indicate an error less than 0.5 mm for the initialization step and an error less than 2 mm for the localized adjustments step. Compared to the much bigger live 3D image volume, it is concluded that the methods are promising. Future work will focus on evaluating the method in the real TOE scanning scenario.

  6. Factors associated with the high prevalence of oesophageal cancer in Western Kenya: a review

    Directory of Open Access Journals (Sweden)

    Gabriel Kigen

    2017-11-01

    Full Text Available Abstract Oesophageal carcinoma (OC is highly prevalent in Western Kenya especially among the members of the Kalenjin community who reside in the Northern and Southern areas of the Rift Valley. Previous authors have suggested potential association of environmental and genetic risk factors with this high prevalence. The environmental factors that have been suggested include contamination of food by mycotoxins and/or pesticides, consumption of traditional alcohol (locally referred to “Busaa” and “Chan’gaa”, use of fermented milk (“Mursik”, poor diet, tobacco use and genetic predisposition. The aim of this paper is to critically examine the potential contribution of each of the factors that have been postulated to be associated with the high prevalence of the disease in order to establish the most likely cause. We have done this by analyzing the trends, characteristics and behaviours that are specifically unique in the region, and corroborated this with the available literature. From our findings, the most plausible cause of the high incidence of OC among the Kalenjin community is mycotoxins, particularly fumonisins from the food chain resulting from poor handling of cereals; particularly maize combined with traditional alcohol laced with the toxins interacting synergistically with other high-risk factors such as dietary deficiencies associated alcoholism and viral infections, especially HPV. Urgent mitigating strategies should be developed in order to minimize the levels of mycotoxins in the food chain.

  7. Feature selection for outcome prediction in oesophageal cancer using genetic algorithm and random forest classifier.

    Science.gov (United States)

    Paul, Desbordes; Su, Ruan; Romain, Modzelewski; Sébastien, Vauclin; Pierre, Vera; Isabelle, Gardin

    2017-09-01

    The outcome prediction of patients can greatly help to personalize cancer treatment. A large amount of quantitative features (clinical exams, imaging, …) are potentially useful to assess the patient outcome. The challenge is to choose the most predictive subset of features. In this paper, we propose a new feature selection strategy called GARF (genetic algorithm based on random forest) extracted from positron emission tomography (PET) images and clinical data. The most relevant features, predictive of the therapeutic response or which are prognoses of the patient survival 3 years after the end of treatment, were selected using GARF on a cohort of 65 patients with a local advanced oesophageal cancer eligible for chemo-radiation therapy. The most relevant predictive results were obtained with a subset of 9 features leading to a random forest misclassification rate of 18±4% and an areas under the of receiver operating characteristic (ROC) curves (AUC) of 0.823±0.032. The most relevant prognostic results were obtained with 8 features leading to an error rate of 20±7% and an AUC of 0.750±0.108. Both predictive and prognostic results show better performances using GARF than using 4 other studied methods. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Assessment of prognostic significance of cytoplasmic survivin expression in advanced oesophageal cancer.

    Directory of Open Access Journals (Sweden)

    G Wallner

    2004-10-01

    Full Text Available Survivin is a member of the family of proteins, which inhibit apoptosis (inhibitor of apoptosis proteins - IAP. Expression of survivin was found in colorectal cancer, neuroblastoma, bladder cancer, non-small cell lung cancer, and breast cancer. There is some recent data indicating the correlation of poor prognosis and worse response to chemotherapy in patients with oesophageal squamous cell carcinoma (OSCC expressing survivin. The aim of the present study was to assess survivin expression in cancerous tissue of patients with advanced OSCC and to test the potential correlation between survivin expression and clinicopathological data. Forty two patients (mean age 58.36+/-8.97 yrs, who were oesophagectomised due to squamous cell carcinoma of the thoracic oesophagus between 1998 and 2000, were retrospectively analysed. Cytoplasmic survivin expression, examined immunohistochemically, was found in 35 (83.33% cases. No statistically significant correlation between survivin expression in the tumour and patients' gender, TNM stage, or vascular involvement was noted. The mean survival of patients with cytoplasmic survivin expression (17.81+/-5.51 months was not statistically different to those with negative survivin staining (16+/-6.28 months as assessed by Mantel-Cox test (p=0.49. Univariate regression analysis revealed UICC staging as the only predictor of survival in the analysed group (p<0.05. These results indicate that the cytoplasmic survivin expression does not seem to be the prognostic factor in advanced cases of OSCC.

  9. Intermediate Latency-Evoked Potentials of Multimodal Cortical Vestibular Areas: Galvanic Stimulation.

    Science.gov (United States)

    Kammermeier, Stefan; Singh, Arun; Bötzel, Kai

    2017-01-01

    Human multimodal vestibular cortical regions are bilaterally anterior insulae and posterior opercula, where characteristic vestibular-related cortical potentials were previously reported under acoustic otolith stimulation. Galvanic vestibular stimulation likely influences semicircular canals preferentially. Galvanic stimulation was compared to previously established data under acoustic stimulation. 14 healthy right-handed subjects, who were also included in the previous acoustic potential study, showed normal acoustic and galvanic vestibular-evoked myogenic potentials. They received 2,000 galvanic binaural bipolar stimuli for each side during EEG recording. Vestibular cortical potentials were found in all 14 subjects and in the pooled data of all subjects ("grand average") bilaterally. Anterior insula and posterior operculum were activated exclusively under galvanic stimulation at 25, 35, 50, and 80 ms; frontal regions at 30 and 45 ms. Potentials at 70 ms in frontal regions and at 110 ms at all of the involved regions could also be recorded; these events were also found using acoustic stimulation in our previous study. Galvanic semicircular canal stimulation evokes specific potentials in addition to those also found with acoustic otolith stimulation in identically located regions of the vestibular cortex. Vestibular cortical regions activate differently by galvanic and acoustic input at the peripheral sensory level. Differential effects in vestibular cortical-evoked potentials may see clinical use in specific vertigo disorders.

  10. Intermediate Latency-Evoked Potentials of Multimodal Cortical Vestibular Areas: Galvanic Stimulation

    Directory of Open Access Journals (Sweden)

    Stefan Kammermeier

    2017-11-01

    Full Text Available IntroductionHuman multimodal vestibular cortical regions are bilaterally anterior insulae and posterior opercula, where characteristic vestibular-related cortical potentials were previously reported under acoustic otolith stimulation. Galvanic vestibular stimulation likely influences semicircular canals preferentially. Galvanic stimulation was compared to previously established data under acoustic stimulation.Methods14 healthy right-handed subjects, who were also included in the previous acoustic potential study, showed normal acoustic and galvanic vestibular-evoked myogenic potentials. They received 2,000 galvanic binaural bipolar stimuli for each side during EEG recording.ResultsVestibular cortical potentials were found in all 14 subjects and in the pooled data of all subjects (“grand average” bilaterally. Anterior insula and posterior operculum were activated exclusively under galvanic stimulation at 25, 35, 50, and 80 ms; frontal regions at 30 and 45 ms. Potentials at 70 ms in frontal regions and at 110 ms at all of the involved regions could also be recorded; these events were also found using acoustic stimulation in our previous study.ConclusionGalvanic semicircular canal stimulation evokes specific potentials in addition to those also found with acoustic otolith stimulation in identically located regions of the vestibular cortex. Vestibular cortical regions activate differently by galvanic and acoustic input at the peripheral sensory level.SignificanceDifferential effects in vestibular cortical-evoked potentials may see clinical use in specific vertigo disorders.

  11. Rab35 protein regulates evoked exocytosis of endothelial Weibel–Palade bodies

    Science.gov (United States)

    Biesemann, Anja; Gorontzi, Alexandra; Barr, Francis; Gerke, Volker

    2017-01-01

    Weibel–Palade bodies (WPB) are secretory organelles of endothelial cells that undergo evoked exocytosis following intracellular Ca2+ or cAMP elevation, thereby supplying the vasculature with factors controlling hemostasis. Several cytosolic and membrane-associated proteins, including the Rab family members Rab3, Rab15, and Rab27a, have been implicated in regulating the acute exocytosis of WPB. Here, we carried out a genome-wide screen to identify Rab pathways affecting WPB exocytosis. Overexpression of a specific subset of Rab GTPase–activating proteins (RabGAPs) inhibited histamine-evoked, Ca2+-dependent WPB exocytosis, presumably by inactivating the target Rab GTPases. Among these RabGAPs, we concentrated on TBC1D10A and showed that the inhibitory effect depends on its GAP activity. We confirmed that Rab35 was a target Rab of TBC1D10A in human endothelial cells; Rab35 interacted with TBC1D10A, and expression of the GAP-insensitive Rab35(Q67A) mutant rescued the inhibitory effect of TBC1D10A overexpression on WPB exocytosis. Furthermore, knockdown of Rab35 and expression of a dominant-negative Rab35 mutant both inhibited histamine-evoked secretion of the WPB cargos von Willebrand factor and P-selectin. Pulldown and co-immunoprecipitation experiments identified the ArfGAP with coiled-coil, Ank repeat, and pleckstrin homology domain–containing protein ACAP2 as an Rab35 effector in endothelial cells, and depletion as well as overexpression approaches revealed that ACAP2 acts as a negative regulator of WPB exocytosis. Interestingly, a known ACAP2 target, the small GTPase Arf6, supported histamine-evoked WPB exocytosis, as shown by knockdown and overexpression of a dominant-negative Arf6 mutant. Our data identify Rab35 as a novel regulator of WPB exocytosis, most likely acting through the downstream effectors ACAP2 and Arf6. PMID:28566286

  12. Is the auditory evoked P2 response a biomarker of learning?

    Directory of Open Access Journals (Sweden)

    Kelly eTremblay

    2014-02-01

    Full Text Available Even though auditory training exercises for humans have been shown to improve certain perceptual skills of individuals with and without hearing loss, there is a lack of knowledge pertaining to which aspects of training are responsible for the perceptual gains, and which aspects of perception are changed. To better define how auditory training impacts brain and behavior, electroencephalography and magnetoencephalography have been used to determine the time course and coincidence of cortical modulations associated with different types of training. Here we focus on P1-N1-P2 auditory evoked responses (AEP, as there are consistent reports of gains in P2 amplitude following various types of auditory training experiences; including music and speech-sound training. The purpose of this experiment was to determine if the auditory evoked P2 response is a biomarker of learning. To do this, we taught native English speakers to identify a new pre-voiced temporal cue that is not used phonemically in the English language so that coinciding changes in evoked neural activity could be characterized. To differentiate possible effects of repeated stimulus exposure and a button-pushing task from learning itself, we examined modulations in brain activity in a group of participants who learned to identify the pre-voicing contrast and compared it to participants, matched in time, and stimulus exposure, that did not. The main finding was that the amplitude of the P2 auditory evoked response increased across repeated EEG sessions for all groups, regardless of any change in perceptual performance. What’s more, these effects were retained for months. Changes in P2 amplitude were attributed to changes in neural activity associated with the acquisition process and not the learned outcome itself. A further finding was the expression of a late negativity (LN wave 600-900 ms post-stimulus onset, post-training, exclusively for the group that learned to identify the pre

  13. Is the auditory evoked P2 response a biomarker of learning?

    Science.gov (United States)

    Tremblay, Kelly L.; Ross, Bernhard; Inoue, Kayo; McClannahan, Katrina; Collet, Gregory

    2014-01-01

    Even though auditory training exercises for humans have been shown to improve certain perceptual skills of individuals with and without hearing loss, there is a lack of knowledge pertaining to which aspects of training are responsible for the perceptual gains, and which aspects of perception are changed. To better define how auditory training impacts brain and behavior, electroencephalography (EEG) and magnetoencephalography (MEG) have been used to determine the time course and coincidence of cortical modulations associated with different types of training. Here we focus on P1-N1-P2 auditory evoked responses (AEP), as there are consistent reports of gains in P2 amplitude following various types of auditory training experiences; including music and speech-sound training. The purpose of this experiment was to determine if the auditory evoked P2 response is a biomarker of learning. To do this, we taught native English speakers to identify a new pre-voiced temporal cue that is not used phonemically in the English language so that coinciding changes in evoked neural activity could be characterized. To differentiate possible effects of repeated stimulus exposure and a button-pushing task from learning itself, we examined modulations in brain activity in a group of participants who learned to identify the pre-voicing contrast and compared it to participants, matched in time, and stimulus exposure, that did not. The main finding was that the amplitude of the P2 auditory evoked response increased across repeated EEG sessions for all groups, regardless of any change in perceptual performance. What’s more, these effects are retained for months. Changes in P2 amplitude were attributed to changes in neural activity associated with the acquisition process and not the learned outcome itself. A further finding was the expression of a late negativity (LN) wave 600–900 ms post-stimulus onset, post-training exclusively for the group that learned to identify the pre

  14. The paradox of music-evoked sadness: an online survey.

    Science.gov (United States)

    Taruffi, Liila; Koelsch, Stefan

    2014-01-01

    This study explores listeners' experience of music-evoked sadness. Sadness is typically assumed to be undesirable and is therefore usually avoided in everyday life. Yet the question remains: Why do people seek and appreciate sadness in music? We present findings from an online survey with both Western and Eastern participants (N = 772). The survey investigates the rewarding aspects of music-evoked sadness, as well as the relative contribution of listener characteristics and situational factors to the appreciation of sad music. The survey also examines the different principles through which sadness is evoked by music, and their interaction with personality traits. Results show 4 different rewards of music-evoked sadness: reward of imagination, emotion regulation, empathy, and no "real-life" implications. Moreover, appreciation of sad music follows a mood-congruent fashion and is greater among individuals with high empathy and low emotional stability. Surprisingly, nostalgia rather than sadness is the most frequent emotion evoked by sad music. Correspondingly, memory was rated as the most important principle through which sadness is evoked. Finally, the trait empathy contributes to the evocation of sadness via contagion, appraisal, and by engaging social functions. The present findings indicate that emotional responses to sad music are multifaceted, are modulated by empathy, and are linked with a multidimensional experience of pleasure. These results were corroborated by a follow-up survey on happy music, which indicated differences between the emotional experiences resulting from listening to sad versus happy music. This is the first comprehensive survey of music-evoked sadness, revealing that listening to sad music can lead to beneficial emotional effects such as regulation of negative emotion and mood as well as consolation. Such beneficial emotional effects constitute the prime motivations for engaging with sad music in everyday life.

  15. The paradox of music-evoked sadness: an online survey.

    Directory of Open Access Journals (Sweden)

    Liila Taruffi

    Full Text Available This study explores listeners' experience of music-evoked sadness. Sadness is typically assumed to be undesirable and is therefore usually avoided in everyday life. Yet the question remains: Why do people seek and appreciate sadness in music? We present findings from an online survey with both Western and Eastern participants (N = 772. The survey investigates the rewarding aspects of music-evoked sadness, as well as the relative contribution of listener characteristics and situational factors to the appreciation of sad music. The survey also examines the different principles through which sadness is evoked by music, and their interaction with personality traits. Results show 4 different rewards of music-evoked sadness: reward of imagination, emotion regulation, empathy, and no "real-life" implications. Moreover, appreciation of sad music follows a mood-congruent fashion and is greater among individuals with high empathy and low emotional stability. Surprisingly, nostalgia rather than sadness is the most frequent emotion evoked by sad music. Correspondingly, memory was rated as the most important principle through which sadness is evoked. Finally, the trait empathy contributes to the evocation of sadness via contagion, appraisal, and by engaging social functions. The present findings indicate that emotional responses to sad music are multifaceted, are modulated by empathy, and are linked with a multidimensional experience of pleasure. These results were corroborated by a follow-up survey on happy music, which indicated differences between the emotional experiences resulting from listening to sad versus happy music. This is the first comprehensive survey of music-evoked sadness, revealing that listening to sad music can lead to beneficial emotional effects such as regulation of negative emotion and mood as well as consolation. Such beneficial emotional effects constitute the prime motivations for engaging with sad music in everyday life.

  16. The Paradox of Music-Evoked Sadness: An Online Survey

    Science.gov (United States)

    Taruffi, Liila; Koelsch, Stefan

    2014-01-01

    This study explores listeners’ experience of music-evoked sadness. Sadness is typically assumed to be undesirable and is therefore usually avoided in everyday life. Yet the question remains: Why do people seek and appreciate sadness in music? We present findings from an online survey with both Western and Eastern participants (N = 772). The survey investigates the rewarding aspects of music-evoked sadness, as well as the relative contribution of listener characteristics and situational factors to the appreciation of sad music. The survey also examines the different principles through which sadness is evoked by music, and their interaction with personality traits. Results show 4 different rewards of music-evoked sadness: reward of imagination, emotion regulation, empathy, and no “real-life” implications. Moreover, appreciation of sad music follows a mood-congruent fashion and is greater among individuals with high empathy and low emotional stability. Surprisingly, nostalgia rather than sadness is the most frequent emotion evoked by sad music. Correspondingly, memory was rated as the most important principle through which sadness is evoked. Finally, the trait empathy contributes to the evocation of sadness via contagion, appraisal, and by engaging social functions. The present findings indicate that emotional responses to sad music are multifaceted, are modulated by empathy, and are linked with a multidimensional experience of pleasure. These results were corroborated by a follow-up survey on happy music, which indicated differences between the emotional experiences resulting from listening to sad versus happy music. This is the first comprehensive survey of music-evoked sadness, revealing that listening to sad music can lead to beneficial emotional effects such as regulation of negative emotion and mood as well as consolation. Such beneficial emotional effects constitute the prime motivations for engaging with sad music in everyday life. PMID:25330315

  17. Head movements evoked in alert rhesus monkey by vestibular prosthesis stimulation: implications for postural and gaze stabilization.

    Directory of Open Access Journals (Sweden)

    Diana E Mitchell

    Full Text Available The vestibular system detects motion of the head in space and in turn generates reflexes that are vital for our daily activities. The eye movements produced by the vestibulo-ocular reflex (VOR play an essential role in stabilizing the visual axis (gaze, while vestibulo-spinal reflexes ensure the maintenance of head and body posture. The neuronal pathways from the vestibular periphery to the cervical spinal cord potentially serve a dual role, since they function to stabilize the head relative to inertial space and could thus contribute to gaze (eye-in-head + head-in-space and posture stabilization. To date, however, the functional significance of vestibular-neck pathways in alert primates remains a matter of debate. Here we used a vestibular prosthesis to 1 quantify vestibularly-driven head movements in primates, and 2 assess whether these evoked head movements make a significant contribution to gaze as well as postural stabilization. We stimulated electrodes implanted in the horizontal semicircular canal of alert rhesus monkeys, and measured the head and eye movements evoked during a 100 ms time period for which the contribution of longer latency voluntary inputs to the neck would be minimal. Our results show that prosthetic stimulation evoked significant head movements with latencies consistent with known vestibulo-spinal pathways. Furthermore, while the evoked head movements were substantially smaller than the coincidently evoked eye movements, they made a significant contribution to gaze stabilization, complementing the VOR to ensure that the appropriate gaze response is achieved. We speculate that analogous compensatory head movements will be evoked when implanted prosthetic devices are transitioned to human patients.

  18. Trends in oral cavity, pharyngeal, oesophageal and gastric cancer mortality rates in Spain, 1952-2006: an age-period-cohort analysis.

    Science.gov (United States)

    Seoane-Mato, Daniel; Aragonés, Nuria; Ferreras, Eva; García-Pérez, Javier; Cervantes-Amat, Marta; Fernández-Navarro, Pablo; Pastor-Barriuso, Roberto; López-Abente, Gonzalo

    2014-04-11

    Although oral cavity, pharyngeal, oesophageal and gastric cancers share some risk factors, no comparative analysis of mortality rate trends in these illnesses has been undertaken in Spain. This study aimed to evaluate the independent effects of age, death period and birth cohort on the mortality rates of these tumours. Specific and age-adjusted mortality rates by tumour and sex were analysed. Age-period-cohort log-linear models were fitted separately for each tumour and sex, and segmented regression models were used to detect changes in period- and cohort-effect curvatures. Among men, the period-effect curvatures for oral cavity/pharyngeal and oesophageal cancers displayed a mortality trend that rose until 1995 and then declined. Among women, oral cavity/pharyngeal cancer mortality increased throughout the study period whereas oesophageal cancer mortality decreased after 1970. Stomach cancer mortality decreased in both sexes from 1965 onwards. Lastly, the cohort-effect curvature showed a certain degree of similarity for all three tumours in both sexes, which was greater among oral cavity, pharyngeal and oesophageal cancers, with a change point in evidence, after which risk of death increased in cohorts born from the 1910-1920s onwards and decreased among the 1950-1960 cohorts and successive generations. This latter feature was likewise observed for stomach cancer. While the similarities of the cohort effects in oral cavity/pharyngeal, oesophageal and gastric tumours support the implication of shared risk factors, the more marked changes in cohort-effect curvature for oral cavity/pharyngeal and oesophageal cancer could be due to the greater influence of some risk factors in their aetiology, such as smoking and alcohol consumption. The increase in oral cavity/pharyngeal cancer mortality in women deserves further study.

  19. Amiodarone reduces depolarization-evoked glutamate release from hippocampual synaptosomes

    Directory of Open Access Journals (Sweden)

    Chia Yu Chang

    2017-03-01

    Full Text Available Decreased brain glutamate level has emerged as a new therapeutic approach for epilepsy. This study investigated the effect and mechanism of amiodarone, an anti-arrhythmic drug with antiepileptic activity, on glutamate release in the rat hippocampus. In a synaptosomal preparation, amiodarone reduced 4-aminopyridine-evoked Ca2+-dependent glutamate release and cytosolic Ca2+ concentration elevation. Amiodarone did not affect the 4-aminopyridine-evoked depolarization of the synaptosomal membrane potential or the Na+ channel activator veratridine-evoked glutamate release, indicating that the amiodarone-mediated inhibition of glutamate release is not caused by a decrease in synaptosomal excitability. The inhibitory effect of amiodarone on 4-aminopyridine-evoked glutamate release was markedly decreased in synaptosomes pretreated with the Cav2.2 (N-type and Cav2.1 (P/Q-type channel blocker ω-conotoxin MVIIC, the calmodulin antagonists W7 and calmidazolium, or the protein kinase A inhibitors H89 and KT5720. However, the intracellular Ca2+-release inhibitors dantrolene and CGP37157 had no effect on the amiodarone-mediated inhibition of glutamate release. Furthermore, amiodarone reduced the frequency of miniature excitatory postsynaptic currents without affecting their amplitude in hippocampal slices. Our data suggest that amiodarone reduces Ca2+ influx through N- and P/Q-type Ca2+ channels, subsequently reducing the Ca2+-calmodulin/protein kinase A cascade to inhibit the evoked glutamate release from rat hippocampal nerve terminals.

  20. Impact of nutritional factors on survival in patients with inoperable oesophageal cancer undergoing self-expanding metal stent insertion.

    Science.gov (United States)

    Gray, Ronan T; O'donnell, Mark E; Scott, Ryan D; McGuigan, James A; Mainie, Inder

    2011-06-01

    Undernutrition has been shown to be predictive of 30-day mortality in patients undergoing self-expanding metal stent (SEMS) insertion for inoperable oesophageal cancer. The aim of this study was to assess the relationship between nutritional factors and 30-day mortality in patients undergoing SEMS insertion for palliation of oesophageal cancer. A retrospective cohort study was conducted from April 2007 to June 2009. BMI, swallowing ability, calorific intake and nature of nutritional support were recorded. ICD-10 causes of death were obtained from the Department of Health and Social Services. Fifty-six stents were inserted into 53 patients (mean age 70 years, male n=35). Median (interquartile range) BMI was 21.0 kg/m (18.7-24.0). Median pre-SEMS swallowing grade was 3. Median calorific intake as a percentage of estimated daily requirements was 94.0% (75.6-100.0%). Thirty (56.6%) patients tolerated an oral diet enhanced with supplement drinks whereas 23 (43.4%) patients required more invasive forms of enteral and parenteral support. The 30-day mortality rate was 11.3% (n=6) and cumulative median survival was 84 (interquartile range 38-156) days. BMI, calorific intake and swallowing capacity were not predictors of survival. Although there was a nonsignificant trend for reduced survival in those patients who did (n=23) receive invasive nutritional support compared with those who did not (n=30) (83.9 vs. 151.3 days, P=0.053), invasive nutritional support itself was not predictive of 30-day mortality (P=0.74). The requirement for invasive nutritional support before SEMS insertion is associated with a poor prognosis and possibly represents more aggressive tumour pathology. Further prospective assessment of prognostic factors, including nutritional parameters, to facilitate reliable selection of appropriate palliative modalities in oesophageal cancer is required.