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Sample records for human esophagus casr

  1. Esophagus

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    2005212 Detection of tumor-associated biomarkers in precancerous lesions of esophagus. Teng Liang- hong (滕梁红), et al. CAMS& PUMC Beijing 100021. World Chin J Digestol, 2005;13(1): 6-9. Objective: AIM: To investigate the expressions of annexin I, Grp94, p53, Ki-67 in esophageal squa-mous cell carcinoma (ESCC) and precancerous lesion, in order to provide valuable clues for early diag-

  2. CaSR function in the intestine: Hormone secretion, electrolyte absorption and secretion, paracrine non-canonical Wnt signaling and colonic crypt cell proliferation.

    Science.gov (United States)

    Macleod, R John

    2013-06-01

    Expression and function of the CaSR have been shown in some mammalian taste buds and basal cells of the esophagus. Signaling cascades responsible for CaSR-mediated stimulation of H(+)-K(+)-ATPase on human parietal cells have been defined. Transgenic mice and reductionistic cell culture models have shown that the CaSR promotes gastrin secretion from G cells, cholecystokinin (CCK) secretion from duodenal I cells and BMP-2 secretion from sub-epithelial myofibroblasts. In addition, the CaSR mediates a novel paracrine relationship between myofibroblasts and overlying epithelial cells in the colon. Thus, CaSR activators stimulate secretion of Wnt5a from myofibroblasts and expression of the Wnt5a receptor Ror2 in epithelial cells. CaSR-mediated Wnt5a/Ror2 engagement stimulates epithelial differentiation and reduces expression of the receptor for tumor necrosis factor (TNFR1). CaSR activators also modulate intestinal motility, inhibit Cl(-) secretion and stimulate Na(+) absorption in both the small intestine and colon. Colonic epithelia from conditional and global CaSR knockout mice exhibit increased proliferation with increased Wnt/β-catenin signaling, demonstrating that the CaSR negatively modulates colonic epithelial growth.

  3. Induction of CaSR expression circumvents the molecular features of malignant CaSR null colon cancer cells.

    Science.gov (United States)

    Singh, Navneet; Chakrabarty, Subhas

    2013-11-15

    We recently reported on the isolation and characterization of calcium sensing receptor (CaSR) null human colon cancer cells (Singh et al., Int J Cancer 2013; 132: 1996-2005). CaSR null cells possess a myriad of molecular features that are linked to a highly malignant and drug resistant phenotype of colon cancer. The CaSR null phenotype can be maintained in defined human embryonic stem cell culture medium. We now show that the CaSR null cells can be induced to differentiate in conventional culture medium, regained the expression of CaSR with a concurrent reversal of the cellular and molecular features associated with the null phenotype. These features include cellular morphology, expression of colon cancer stem cell markers, expression of survivin and thymidylate synthase and sensitivity to fluorouracil. Other features include the expression of epithelial mesenchymal transition linked molecules and transcription factors, oncogenic miRNAs and tumor suppressive molecule and miRNA. With the exception of cancer stem cell markers, the reversal of molecular features, upon the induction of CaSR expression, is directly linked to the expression and function of CaSR because blocking CaSR induction by shRNA circumvented such reversal. We further report that methylation and demethylation of the CaSR gene promoter underlie CaSR expression. Due to the malignant nature of the CaSR null cells, inclusion of the CaSR null phenotype in disease management may improve on the mortality of this disease. Because CaSR is a robust promoter of differentiation and mediates its action through diverse mechanisms and pathways, inactivation of CaSR may serve as a new paradigm in colon carcinogenesis.

  4. Esophagus

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008296 Effect of DNA methyltransferase 5-aza-2′-deoxycytidine on proliferation of human esophageal squamous cancer cell line Eca109 in vitro. YANG Ting(杨婷), et al. Med Res Center, 1st Affili Hosp, Xinjiang Med Univ, Urumqi 830054. Chin J Lab Med 2008;31(4):399-402.Objective To explore the effect of the DNA methyltransferase 5-aza-2’-deoxycytidine(5-asa-CdR)on hu-man esophageal squamous cancer Eca109 cells.Methods Human esophageal squamous cell cancer(ESCC)Eca109 cells were treated by 5-aza-CdR with 10-7,10-6,

  5. Esophagus

    Institute of Scientific and Technical Information of China (English)

    1995-01-01

    950317 Mutation of tumor supressor genes APC andMCC in human esophageal cancer.LI Huachuan(李华川),et al.Cancer Instit,CAMS,Beijing,100021.Chin JOncol 1995;17(1):9-11.The mutation and deletion of APC,MCC genes inhuman esophageal cancer were analyzed by PCR ampli-fication and direct sequencing assay.In PCR amplifica-tion analysis,one of 10 cases of esophageal cancer wasfound to have APC gene deletion in exon 11;one of 10cases of EC was found to have MCC gene deletion inexon 12;one of adjacent non-tumor tissue was also

  6. Malakoplakia of the esophagus caused by human papillomavirus infection

    Institute of Scientific and Technical Information of China (English)

    Ya-Li Yang; Yu-Cheng Xie; Xiao-Ling Li; Jing Guo; Tao Sun; Jing Tang

    2012-01-01

    Malakoplakia is a rare granulomatous disease probably caused by infection and characterized histologically by Michaelis-Gutmann bodies.We report a more rarely seen case esophageal malakoplakia in a 54-year-old woman.She presented with coughing while eating and drinking.Gastroscopy showed yellow nodules in the esophagus,and endoscopic ultrasonography showed a space-occupying lesion in the substratum of the esophageal mucosa.All findings highly resembled esophageal cancer.Histopathological examination finally indentified this space-occupying lesion as malakoplakia and not cancer.Immunohistochemistry showed that she had human papillomavirus (HPV) infection in the esophagus,which indicates that infection was responsible for the malakoplakia.This is believed to be the first case of malakoplakia in the esophagus,and more importantly,we established that HPV infection was the initiator of esophageal malakoplakia.

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

    Institute of Scientific and Technical Information of China (English)

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

    2000-01-01

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

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

    OpenAIRE

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

    1986-01-01

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

  9. Barrett's Esophagus.

    Science.gov (United States)

    Rajendra, Shanmugarajah; Sharma, Prateek

    2014-06-01

    Barrett's esophagus (BE) is the most important and recognizable precursor lesion for esophageal adenocarcinoma (EAC), which is the one of the fastest-growing cancers in the Western world (600 % in the U.S. in the last 40 years), and therefore it is critical to manage the risk of cancer present in BE. New developments in imaging and molecular markers, as well as an armamentarium of novel and effective endoscopic eradication therapy - especially radio-frequency ablation (RFA) and endoscopic mucosal resection (EMR) - are now available to the interventional endoscopist to help curb the significant rise of esophageal adenocarcinoma (EAC). Endoscopic surveillance is currently recommended by most gastroenterology societies worldwide, although there is no data to support this practice in relation to reducing mortality from EAC. Paradoxically, the cancer risk in Barrett's esophagus is being progressively downgraded, which raises fundamental questions about our understanding of the risk factors and molecular biology of the Barrett's metaplasia-dysplasia-adenocarcinoma sequence. The recent discovery of a strong association of transcriptionally active high-risk human papillomavirus (hr-HPV) with Barrett's dysplasia (BD) and EAC may shed some light on this anomaly. It is imperative that we identify the high-risk group of progressors to EAC. While p53 immunohistochemistry is currently probably the best clinical molecular marker for predicting disease progression in BD, we must think outside the box and cast the net wide in search of additional biomarkers (e.g., high-risk human papilloma virus (hr-HPV)].

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

    DEFF Research Database (Denmark)

    Drewes, Asbjørn Mohr; Reddy, Hari Prasad; Ståhl, Camilla

    2005-01-01

    It is believed that mechanical stimuli of the human gut activate afferents responding to either noxious or normal, physiologic stimuli. They might be able to sensitize without relation to the contractile state of the smooth muscle. The current study aimed to verify the above characteristics by us...... of mechanical gut stimuli in human beings. This might increase our understanding of visceral pain in health and disease and guide the statistical analysis of experimental data obtained in the gastrointestinal tract....... by using a statistical model based on correlation analysis. The esophagus was distended with a bag in 32 healthy subjects by using an inflation rate of 25 mL/min. The luminal cross-sectional areas and sensory ratings were determined during the distentions. The stimuli were repeated after relaxation...... esophagus are not correlated and thus probably represent different populations. The response characteristics have no physiologic relationship to the contractile state of the smooth muscle, and sensitization affects all types of afferents. Perspectives The article adds information about sensory processing...

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

    Institute of Scientific and Technical Information of China (English)

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

    2006-01-01

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

  12. Barrett Esophagus

    Science.gov (United States)

    Kinoshita, Yoshikazu

    2008-01-01

    Barrett esophageal cancer has the fastest growing incidence of any cancer in Western countries. In Asian countries, most cases of esophageal cancer consist of squamous cell carcinomas, not adenocarcinomas. Recently, however, the increase in the number of Barrett esophagus cases with subsequent Barrett cancer has become worrisome in Asian countries, as the number of patients with gastro-esophageal reflux disease has been increasing in these countries. In this review, recent reports regarding Barrett esophagus in Asian countries have been collected and this problem is discussed from various perspectives. In Asia, long-segment Barrett esophagus is much less prevalent than in Western countries, whereas short-segment Barrett esophagus is frequently found. In epidemiologic studies, evaluation of the prevalence of Barrett esophagus is limited by poor interob-server diagnostic agreement. Standard criteria for the endoscopic diagnosis of Barrett esophagus in Asian patients, especially of the short-segment type, should be established as soon as possible. A high prevalence of hiatal hernia and a decreasing prevalence of Helico-bacter pylori infection may increase the number of Barrett esophagus cases and subsequent Barrett cancer in Asian countries in the near future. Therefore, a strategy for the clinical management of Barrett esophagus in Asian countries should be devised. PMID:22798736

  13. Detection of methylation status of promoter region of CASR in cell and tissue of human esophageal squamous cell carcinoma%食管鳞状细胞癌细胞及组织中钙敏感受体基因启动子区甲基化状态检测

    Institute of Scientific and Technical Information of China (English)

    景坤玉; 董腾慧; 郭明洲; 薛乐勋

    2013-01-01

    Aim:To investigate the promoter region methylation status of calcium-sensing receptor( CASR ) in esophageal carcinogenesis, and to explore the possibility of CASR promoter methylation as a potential biomarker for human esophageal squamous cell carcinoma ( ESCC ). Methods:The promoter region methylation of CASR in 6 esophageal cancer cell lines, 8 normal esophageal mucosa and 68 primary ESCC tissue samples were investigated using methylation specific PCR. Semi-quantitative RT-PCR was used to evaluate CASR expression levels before and after treatment with 5-aza-2'-deoxycyti-dine ( 5-Aza ) in cell lines. Results:Methylation of the CASR promoter region was detected in 5 cell lines( KYSE30, KYSE70, KYSE140.TE8 and BIC1 ), but not in KYSE510. Loss of CASR expression was found in the methylated cell lines. Re-expression of CASR was induced after 5-Aza treatment for 96 h. In 68 cases of human primary ESCC tissue samples, the methylation rate of CASR promoter region was 71% ( 48/68 ), but no one was methylated in 8 cases of normal e-sophageal mucosa( 0/8 ). No association was found between promoter region hypermethylation and age(X2= 1. 114, P = 0.291 ), gender(X2=0.342, P =0.558 ), tumor location(X2= 1. 209 , P =0. 546 ), tumor stage (X2 =0.181, P= 0.670) or lymph node metastasis(X2= 1. 169, P =0. 280 ). Conclusion:The methylated CASR frequently exists in primary human ESCC, suggesting it may be used as a potential early detection biomarker or target for this disease.%目的:研究钙敏感受体(CASR)基因启动子区甲基化状态与食管鳞状细胞癌(ESCC)发生之间的关系,探讨CASR甲基化作为潜在的ESCC早期诊断标志物的可能性.方法:采用甲基化特异性PCR(MSP)方法分析6株食管癌细胞系、8例正常食管黏膜组织以及68例原发ESCC组织中CASR启动子区的甲基化状态.采用半定量RT-PCR方法分析甲基化酶抑制剂5-氮杂-2-脱氧胞嘧啶核苷(5-Aza)处理前后食管癌细胞系中CASR m

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

    Directory of Open Access Journals (Sweden)

    Sheila Jorge Adad

    2014-12-01

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

  15. Esophagus (image)

    Science.gov (United States)

    ... the nose and mouth with the stomach. The epiglottis folds over the trachea when a swallow occurs, ... either through the mouth or nose, past the epiglottis, into the esophagus and into the stomach. Nutrients ...

  16. Barrett esophagus

    Science.gov (United States)

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Kanaly, Robert A. [Department of Technology and Ecology, Graduate School of Global Environmental Studies, Kyoto University, Kyoto 606-8501 (Japan); Department of Environmental Biosciences, International Graduate School of Arts and Sciences, Yokohama City University, Yokohama 236-0027 (Japan); Matsui, Saburo [Department of Technology and Ecology, Graduate School of Global Environmental Studies, Kyoto University, Kyoto 606-8501 (Japan); Hanaoka, Tomoyuki [Epidemiology and Prevention Division, National Cancer Center Research Institute, Tokyo 104-0045 (Japan); Matsuda, Tomonari [Department of Technology and Ecology, Graduate School of Global Environmental Studies, Kyoto University, Kyoto 606-8501 (Japan)], E-mail: matsuda@z05.mbox.media.kyoto-u.ac.jp

    2007-12-01

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

  18. Short esophagus.

    Science.gov (United States)

    Kunio, Nicholas R; Dolan, James P; Hunter, John G

    2015-06-01

    In the presence of long-standing and severe gastroesophageal reflux disease, patients can develop various complications, including a shortened esophagus. Standard preoperative testing in these patients should include endoscopy, esophagography, and manometry, whereas the objective diagnosis of a short esophagus must be made intraoperatively following adequate mediastinal mobilization. If left untreated, it is a contributing factor to the high recurrence rate following fundoplications or repair of large hiatal hernias. A laparoscopic Collis gastroplasty combined with an antireflux procedure offers safe and effective therapy.

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

    DEFF Research Database (Denmark)

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

    2005-01-01

    BACKGROUND: Worldwide, cancer in the esophagus ranks among the 10 most common cancers. Alterations of retinoic acid receptors (e.g. RARalpha, beta, gamma, and RXRalpha, beta, gamma) expression is considered to play an important role in development of squamous-cell carcinoma (SCC), which is the most...... common esophageal cancer. Alcohol consumption and smoking, which can alter retinoic acid receptor levels, have been identified as key risk factors in the development of carcinoma in the aero-digestive tract. Therefore, the aim of the present study was to evaluate protein levels of retinoic acid receptors...... were found for RARalpha, beta, and RXRbeta protein levels between normal esophageal tissue of patients and that of controls. CONCLUSION: In conclusion, results of the present study suggest that alterations of retinoic acid receptors protein may contribute in the development of SCC in esophagus...

  20. Calcilytic Ameliorates Abnormalities of Mutant Calcium-Sensing Receptor (CaSR) Knock-In Mice Mimicking Autosomal Dominant Hypocalcemia (ADH).

    Science.gov (United States)

    Dong, Bingzi; Endo, Itsuro; Ohnishi, Yukiyo; Kondo, Takeshi; Hasegawa, Tomoka; Amizuka, Norio; Kiyonari, Hiroshi; Shioi, Go; Abe, Masahiro; Fukumoto, Seiji; Matsumoto, Toshio

    2015-11-01

    Activating mutations of calcium-sensing receptor (CaSR) cause autosomal dominant hypocalcemia (ADH). ADH patients develop hypocalcemia, hyperphosphatemia, and hypercalciuria, similar to the clinical features of hypoparathyroidism. The current treatment of ADH is similar to the other forms of hypoparathyroidism, using active vitamin D3 or parathyroid hormone (PTH). However, these treatments aggravate hypercalciuria and renal calcification. Thus, new therapeutic strategies for ADH are needed. Calcilytics are allosteric antagonists of CaSR, and may be effective for the treatment of ADH caused by activating mutations of CaSR. In order to examine the effect of calcilytic JTT-305/MK-5442 on CaSR harboring activating mutations in the extracellular and transmembrane domains in vitro, we first transfected a mutated CaSR gene into HEK cells. JTT-305/MK-5442 suppressed the hypersensitivity to extracellular Ca(2+) of HEK cells transfected with the CaSR gene with activating mutations in the extracellular and transmembrane domains. We then selected two activating mutations locating in the extracellular (C129S) and transmembrane (A843E) domains, and generated two strains of CaSR knock-in mice to build an ADH mouse model. Both mutant mice mimicked almost all the clinical features of human ADH. JTT-305/MK-5442 treatment in vivo increased urinary cAMP excretion, improved serum and urinary calcium and phosphate levels by stimulating endogenous PTH secretion, and prevented renal calcification. In contrast, PTH(1-34) treatment normalized serum calcium and phosphate but could not reduce hypercalciuria or renal calcification. CaSR knock-in mice exhibited low bone turnover due to the deficiency of PTH, and JTT-305/MK-5442 as well as PTH(1-34) increased bone turnover and bone mineral density (BMD) in these mice. These results demonstrate that calcilytics can reverse almost all the phenotypes of ADH including hypercalciuria and renal calcification, and suggest that calcilytics can become a

  1. Metabolism of benzo(a)pyrene, N-nitrosomethylamine, and N-nitrosopyrrolidine and identification of the major carcinogen-DNA adducts formed in cultured human esophagus

    DEFF Research Database (Denmark)

    1979-01-01

    The wide variation in the world-wide incidence of esophageal carcinoma suggests that environmental agents including chemicals cause this cancer. Since the interaction between chemical procarcinogens and human esophagus has not been studied previously, we examined the metabolic fate of benzo......(a)pyrene (BP), N-nitrosodimethylamine (DMN), and A/-nitrosopyrrolidine in cultured nontumorous esophagus from two patients with and six patients without esophageal carcinoma. Esophageal explants were cultured in a chemically defined medium for 7 days prior to adding [3H]BP (1.5 JUM),[14C]DMN (100 /IM), or [14C...

  2. Different responsiveness of excitatory and inhibitory enteric motor neurons in the human esophagus to electrical field stimulation and to nicotine.

    Science.gov (United States)

    González, Asensio A; Farré, Ricard; Clavé, Pere

    2004-07-01

    To compare electrical field stimulation (EFS) with nicotine in the stimulation of excitatory and inhibitory enteric motoneurons (EMN) in the human esophagus, circular lower esophageal sphincter (LES), and circular and longitudinal esophageal body (EB) strips from 20 humans were studied in organ baths. Responses to EFS or nicotine (100 microM) were compared in basal conditions, after N(G)-nitro-l-arginine (l-NNA; 100 microM), and after l-NNA and apamin (1 microM). LES strips developed myogenic tone enhanced by TTX (5 microM) or l-NNA. EFS-LES relaxation was abolished by TTX, unaffected by hexamethonium (100 microM), and enhanced by atropine (3 microM). Nicotine-LES relaxation was higher than EFS relaxation, reduced by TTX or atropine, and blocked by hexamethonium. After l-NNA, EFS elicited a strong cholinergic contraction in circular LES and EB, and nicotine elicited a small relaxation in LES and no contractile effect in EB. After l-NNA and apamin, EFS elicited a strong cholinergic contraction in LES and EB, and nicotine elicited a weak contraction amounting to 6.64 +/- 3.19 and 9.20 +/- 5.51% of that induced by EFS. EFS elicited a contraction in longitudinal strips; after l-NNA and apamin, nicotine did not induce any response. Inhibitory EMN tonically inhibit myogenic LES tone and are efficiently stimulated both by EFS and nicotinic acetylcholine receptors (nAChRs) located in somatodendritic regions and nerve terminals, releasing nitric oxide and an apamin-sensitive neurotransmitter. In contrast, although esophageal excitatory EMN are efficiently stimulated by EFS, their stimulation through nAChRs is difficult and causes weak responses, suggesting the participation of nonnicotinic mechanisms in neurotransmission to excitatory EMN in human esophagus.

  3. Endomicroscopy of Barrett's Esophagus.

    Science.gov (United States)

    Canto, Marcia Irene

    2010-12-01

    Endomicroscopy is a remarkable technical advance in gastrointestinal mucosa imaging. In 2003, Kiesslich and colleagues described the first human use of contrast-aided confocal laser endomicroscopy (CLE) as a novel technique for in vivo microscopic imaging of the gastrointestinal mucosa. Both probe-based and endoscope-based systems have been applied to many gastrointestinal disorders, including Barrett's esophagus (BE) and associated neoplasia. Probe-based confocal laser endomicroscopy can be used in conjunction with highresolution white light endoscopy and other contrast enhancement techniques. It has proven high accuracy for prediction of high-grade neoplasia and cancer. In vivo imaging of both flat BE and mucosal lesions can influence diagnosis and thereby impact upon decision making regarding tissue sampling and endoscopic therapy. This article discusses the scientific literature related to clinical use of CLE for BE, the techniques for performing CLE in the esophagus, and the potential future directions for CLE in BE and esophageal cancer diagnosis and treatment.

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

    Science.gov (United States)

    Liu, N. R.; Chen, G. N.; Wu, S. S.; Chen, R.

    2014-02-01

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

  5. Excessive signal transduction of gain-of-function variants of the calcium-sensing receptor (CaSR are associated with increased ER to cytosol calcium gradient.

    Directory of Open Access Journals (Sweden)

    Marianna Ranieri

    Full Text Available In humans, gain-of-function mutations of the calcium-sensing receptor (CASR gene are the cause of autosomal dominant hypocalcemia or type 5 Bartter syndrome characterized by an abnormality of calcium metabolism with low parathyroid hormone levels and excessive renal calcium excretion. Functional characterization of CaSR activating variants has been so far limited at demonstrating an increased sensitivity to external calcium leading to lower Ca-EC50. Here we combine high resolution fluorescence based techniques and provide evidence that for the efficiency of calcium signaling system, cells expressing gain-of-function variants of CaSR monitor cytosolic and ER calcium levels increasing the expression of the Sarco-Endoplasmic Reticulum Calcium-ATPase (SERCA and reducing expression of Plasma Membrane Calcium-ATPase (PMCA. Wild-type CaSR (hCaSR-wt and its gain-of-function (hCaSR-R990G; hCaSR-N124K variants were transiently transfected in HEK-293 cells. Basal intracellular calcium concentration was significantly lower in cells expressing hCaSR-wt and its gain of function variants compared to mock. In line, FRET studies using the D1ER probe, which detects [Ca2+]ER directly, demonstrated significantly higher calcium accumulation in cells expressing the gain of function CaSR variants compared to hCaSR-wt. Consistently, cells expressing activating CaSR variants showed a significant increase in SERCA activity and expression and a reduced PMCA expression. This combined parallel regulation in protein expression increases the ER to cytosol calcium gradient explaining the higher sensitivity of CaSR gain-of-function variants to external calcium. This control principle provides a general explanation of how cells reliably connect (and exacerbate receptor inputs to cell function.

  6. Excessive signal transduction of gain-of-function variants of the calcium-sensing receptor (CaSR) are associated with increased ER to cytosol calcium gradient.

    Science.gov (United States)

    Ranieri, Marianna; Tamma, Grazia; Di Mise, Annarita; Vezzoli, Giuseppe; Soldati, Laura; Svelto, Maria; Valenti, Giovanna

    2013-01-01

    In humans, gain-of-function mutations of the calcium-sensing receptor (CASR) gene are the cause of autosomal dominant hypocalcemia or type 5 Bartter syndrome characterized by an abnormality of calcium metabolism with low parathyroid hormone levels and excessive renal calcium excretion. Functional characterization of CaSR activating variants has been so far limited at demonstrating an increased sensitivity to external calcium leading to lower Ca-EC50. Here we combine high resolution fluorescence based techniques and provide evidence that for the efficiency of calcium signaling system, cells expressing gain-of-function variants of CaSR monitor cytosolic and ER calcium levels increasing the expression of the Sarco-Endoplasmic Reticulum Calcium-ATPase (SERCA) and reducing expression of Plasma Membrane Calcium-ATPase (PMCA). Wild-type CaSR (hCaSR-wt) and its gain-of-function (hCaSR-R990G; hCaSR-N124K) variants were transiently transfected in HEK-293 cells. Basal intracellular calcium concentration was significantly lower in cells expressing hCaSR-wt and its gain of function variants compared to mock. In line, FRET studies using the D1ER probe, which detects [Ca2+]ER directly, demonstrated significantly higher calcium accumulation in cells expressing the gain of function CaSR variants compared to hCaSR-wt. Consistently, cells expressing activating CaSR variants showed a significant increase in SERCA activity and expression and a reduced PMCA expression. This combined parallel regulation in protein expression increases the ER to cytosol calcium gradient explaining the higher sensitivity of CaSR gain-of-function variants to external calcium. This control principle provides a general explanation of how cells reliably connect (and exacerbate) receptor inputs to cell function.

  7. In vivo analysis of tissue by Raman microprobe: examination of human skin lesions and esophagus Barrett's mucosa on an animal model

    Science.gov (United States)

    Tfayli, Ali; Piot, Olivier; Derancourt, Sylvie; Cadiot, Guillaume; Diebold, Marie D.; Bernard, Philippe; Manfait, Michel

    2006-02-01

    In the last few years, Raman spectroscopy has been increasingly used for the characterization of normal and pathological tissues. A new Raman system, constituted of optic fibers bundle coupled to an axial Raman spectrometer (Horiba Jobin Yvon SAS), was developed for in vivo investigations. Here, we present in vivo analysis on two tissues: human skin and esophagus mucosa on a rat model. The skin is a directly accessible organ, representing a high diversity of lesions and cancers. Including malignant melanoma, basal cell carcinoma and the squamous cell carcinoma, skin cancer is the cancer with the highest incidence worldwide. Several Raman investigations were performed to discriminate and classify different types of skin lesions, on thin sections of biopsies. Here, we try to characterize in vivo the different types of skin cancers in order to be able to detect them in their early stages of development and to define precisely the exeresis limits. Barrett's mucosa was also studied by in vivo examination of rat's esophagus. Barrett's mucosa, induced by gastro-esophageal reflux, is a pretumoral state that has to be carefully monitored due to its high risk of evolution in adenocarcinoma. A better knowledge of the histological transformation of esophagus epithelium in a Barrett's type will lead to a more efficient detection of the pathology for its early diagnosis. To study these changes, an animal model (rats developing Barrett's mucosa after duodenum - esophagus anastomosis) was used. Potential of vibrational spectroscopy for Barrett's mucosa identification is assessed on this model.

  8. Overview of the Esophagus

    Science.gov (United States)

    ... food to the stomach by rhythmic waves of muscular contractions called peristalsis. How the Esophagus Works As a ... food can enter the esophagus, where waves of muscular contractions, called peristalsis, propel the food downward (3). The ...

  9. Adenocarcinoma of the esophagus and Barrett's esophagus

    DEFF Research Database (Denmark)

    Bytzer, P; Christensen, P B; Damkier, P

    1999-01-01

    OBJECTIVE: We described incidence rates of esophageal adenocarcinoma in Denmark in a 20-yr period and determined the proportion of patients diagnosed with esophageal adenocarcinoma who had a previous diagnosis of Barrett's esophagus, making them potential candidates for endoscopic surveillance. M......'s esophagus, but these screening programs are not likely to reduce the death rate from esophageal adenocarcinomas in the general population....

  10. Barrett's Esophagus

    Science.gov (United States)

    ... This content is not available in any other language. Related Research See more about digestive diseases research at NIDDK. ... 30 a.m. to 5 p.m. eastern time, M-F Follow Us NIH… Turning Discovery Into Health ® Research & Funding Current Funding Opportunities Research Programs & Contacts Human ...

  11. Assessment of the incidence of squamous cell papilloma of the esophagus and the presence of high-risk human papilloma virus.

    Science.gov (United States)

    Pantham, Ganesh; Ganesan, Santhi; Einstadter, Douglas; Jin, Ge; Weinberg, Aaron; Fass, Ronnie

    2017-01-01

    There has been a recent increase in the incidence of oropharyngeal cancer (OPC) associated with high-risk human papilloma virus (HPV) infection. We investigated the incidence of esophageal papilloma and the presence of high-risk HPV infection. This is a cross-sectional study conducted at a County teaching hospital. Patients with esophageal papilloma between January 2000 and December 2013 were identified. Patients with sufficient specimens were tested for the HPV virus. Sixty patients with esophageal papilloma lesions were identified from 2000 to 2013. (31 males, age 51 ± 13 years). The incidence was 0.13% in 2000 and increased to 0.57% in 2013 (P papilloma that was more than 5 mm in size, and 20% had multiple lesions. The papilloma was located in the distal esophagus in 35 (58.3%) patients, mid esophagus in 17 (28.3%) patients, and proximal in 8 (13.3%) patients. Three (5%) patients had associated OPC, and 9 (47.4%) of the 19 patients tested were positive for high-risk HPV serotype 16. The incidence of esophageal papilloma has increased by fourfolds over the past 14 years. About half of the tested patients demonstrated high risk HPV. This may suggest a potential growing risk for esophageal squamous cell cancer in the future. © 2016 International Society for Diseases of the Esophagus.

  12. Reduced Expression of the Extracellular Calcium-Sensing Receptor (CaSR Is Associated with Activation of the Renin-Angiotensin System (RAS to Promote Vascular Remodeling in the Pathogenesis of Essential Hypertension.

    Directory of Open Access Journals (Sweden)

    Yuan-Yuan Qu

    Full Text Available The proliferation of vascular smooth muscle cells (VSMCs, remodeling of the vasculature, and the renin-angiotensin system (RAS play important roles in the development of essential hypertension (EH, which is defined as high blood pressure (BP in which secondary causes, such as renovascular disease, are absent. The calcium-sensing receptor (CaSR is involved in the regulation of BP. However, the underlying mechanisms by which the CaSR regulates BP are poorly understood. In the present study, the role of the CaSR in EH was investigated using male spontaneously hypertensive rats (SHRs and rat and human plasma samples. The percentages of medial wall thickness to external diameter (WT%, total vessel wall cross-sectional area to the total area (WA% of thoracic arteries, as well as the percentage of wall area occupied by collagen to total vessel wall area (CA% were determined. Tissue protein expression and plasma concentrations of the CaSR, cyclic adenosine monophosphate (cAMP, renin, and angiotensin II (Ang II were additionally assessed. WT%, WA%, and CA% were found to increase with increasing BP, whereas the plasma concentration of CaSR was found to decrease. With increasing BP, the levels of smooth muscle actin and calponin decreased, whereas those of osteopontin and proliferating cell nuclear antigen increased. The CaSR level negatively correlated with the levels of cAMP and Ang II, but positively correlated with those of renin. Our data suggest that reduced expression of the CaSR is correlated with activation of the RAS, which induces increased vascular remodeling and VSMC proliferation, and thereby associated with EH in the SHR model and in the Han Chinese population. Our findings provide new insights into the pathogenesis of EH.

  13. Clinicopathologic features and treatment outcomes of patients with human epidermal growth factor receptor 2-positive adenocarcinoma of the esophagus and gastroesophageal junction.

    Science.gov (United States)

    Phillips, B E; Tubbs, R R; Rice, T W; Rybicki, L A; Plesec, T; Rodriguez, C P; Videtic, G M; Saxton, J P; Ives, D I; Adelstein, D J

    2013-04-01

    Human epidermal growth factor receptor 2 (HER2) is overexpressed in 21% of gastric and 33% of gastroesophageal junction (GEJ) adenocarcinomas. Trastuzumab has been approved for metastatic HER2-positive gastric/GEJ cancer in combination with chemotherapy. This retrospective analysis was undertaken to better define the clinicopathologic features, treatment outcomes, and prognosis in patients with HER2-positive adenocarcinoma of the esophagus/GEJ. Pathologic specimens from 156 patients with adenocarcinoma of the esophagus/GEJ treated on clinical trials with chemoradiation and surgery were tested for HER2. Seventy-six patients also received 2 years of gefitinib. Baseline characteristics and treatment outcomes of the HER2-positive and negative patients were compared both in aggregate and separately for each of the two trials. Of 156 patients, 135 had sufficient pathologic material available for HER2 assessment. HER2 positivity was found in 23%; 28% with GEJ primaries and 15% with esophageal primaries (P= 0.10). There was no statistical difference in clinicopathologic features between HER2-positive and negative patients except HER2-negative tumors were more likely to be poorly differentiated (P < 0.001). Locoregional recurrence, distant metastatic recurrence, any recurrence, and overall survival were also statistically similar between the HER2-positive and the HER2-negative groups, in both the entire cohort and in the gefitinib-treated subset. Except for tumor differentiation, HER2-positive and negative patients with adenocarcinoma of the esophagus and GEJ do not differ in clinicopathologic characteristics and treatment outcomes. Given the demonstrated benefit of trastuzumab in HER2-positive gastric cancer and the similar incidence of HER2 overexpression in esophageal/GEJ adenocarcinoma, further evaluation of HER2-directed therapy in this disease seems indicated.

  14. General anatomy of the esophagus.

    Science.gov (United States)

    Oezcelik, Arzu; DeMeester, Steven R

    2011-05-01

    This article reviews the embryology and general anatomy of the esophagus, including the topography and relationships of the esophagus to surrounding structures. The esophagus is the only internal organ that traverses 3 body cavities, and a complete understanding of the anatomy and anatomic relationships of the esophagus in each area is essential for surgeons who address esophageal disorders. Details regarding the normal histology and basic function of the esophagus are also provided. Copyright © 2011. Published by Elsevier Inc.

  15. Esophagus Cancer: Palliative Therapy

    Science.gov (United States)

    ... www.nccn.org/professionals/physician_gls/pdf/esophageal.pdf on May 6, 2017. Posner MC, Minsky B, Ilson DH. Ch 45 - Cancer of the esophagus. In: DeVita VT, Hellman S, Rosenberg SA, eds. DeVita, Hellman, and ...

  16. Potential roles for calcium-sensing receptor (CaSR) and transient receptor potential ankyrin-1 (TRPA1) in murine anorectic response to deoxynivalenol (vomitoxin).

    Science.gov (United States)

    Wu, Wenda; Zhou, Hui-Ren; Pestka, James J

    2017-01-01

    Food contamination by the trichothecene mycotoxin deoxynivalenol (DON, vomitoxin) has the potential to adversely affect animal and human health by suppressing food intake and impairing growth. In mice, the DON-induced anorectic response results from aberrant satiety hormone secretion by enteroendocrine cells (EECs) of the gastrointestinal tract. Recent in vitro studies in the murine STC-1 EEC model have linked DON-induced satiety hormone secretion to activation of calcium-sensing receptor (CaSR), a G-coupled protein receptor, and transient receptor potential ankyrin-1 (TRPA1), a TRP channel. However, it is unknown whether similar mechanisms mediate DON's anorectic effects in vivo. Here, we tested the hypothesis that DON-induced food refusal and satiety hormone release in the mouse are linked to activation of CaSR and TRPA1. Oral treatment with selective agonists for CaSR (R-568) or TRPA1 (allyl isothiocyanate (AITC)) suppressed food intake in mice, and the agonist's effects were suppressed by pretreatment with corresponding antagonists NPS-2143 or ruthenium red (RR), respectively. Importantly, NPS-2143 or RR inhibited both DON-induced food refusal and plasma elevations of the satiety hormones cholecystokinin (CCK) and peptide YY3-36 (PYY3-36); cotreatment with both antagonists additively suppressed both anorectic and hormone responses to DON. Taken together, these in vivo data along with prior in vitro findings support the contention that activation of CaSR and TRPA1 contributes to DON-induced food refusal by mediating satiety hormone exocytosis from EEC.

  17. Negative feedback from CaSR signaling to aquaporin-2 sensitizes vasopressin to extracellular Ca2.

    Science.gov (United States)

    Ranieri, Marianna; Tamma, Grazia; Di Mise, Annarita; Russo, Annamaria; Centrone, Mariangela; Svelto, Maria; Calamita, Giuseppe; Valenti, Giovanna

    2015-07-01

    We previously described that high luminal Ca(2+) in the renal collecting duct attenuates short-term vasopressin-induced aquaporin-2 (AQP2) trafficking through activation of the Ca(2+)-sensing receptor (CaSR). Here, we evaluated AQP2 phosphorylation and permeability, in both renal HEK-293 cells and in the dissected inner medullary collecting duct, in response to specific activation of CaSR with NPS-R568. In CaSR-transfected cells, CaSR activation drastically reduced the basal levels of AQP2 phosphorylation at S256 (AQP2-pS256), thus having an opposite effect to vasopressin action. When forskolin stimulation was performed in the presence of NPS-R568, the increase in AQP2-pS256 and in the osmotic water permeability were prevented. In the freshly isolated inner mouse medullar collecting duct, stimulation with forskolin in the presence of NPS-R568 prevented the increase in AQP2-pS256 and osmotic water permeability. Our data demonstrate that the activation of CaSR in the collecting duct prevents the cAMP-dependent increase in AQP2-pS256 and water permeability, counteracting the short-term vasopressin response. By extension, our results suggest the attractive concept that CaSR expressed in distinct nephron segments exerts a negative feedback on hormones acting through cAMP, conferring high sensitivity of hormone to extracellular Ca(2+). © 2015. Published by The Company of Biologists Ltd.

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

    Directory of Open Access Journals (Sweden)

    Alevtina Gall

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

  19. Identification of rare and frequent variants of the CASR gene by high-resolution melting

    DEFF Research Database (Denmark)

    Nissen, Peter H; Christensen, Signe E; Ladefoged, Søren A

    2012-01-01

    of seven new CASR variants and nine recurrent. HRM variant scanning, in combination with small amplicon genotyping, provides a simple workflow with reduced sequencing burden. Bioinformatics analyses using two freely available prediction tools (PolyPhen2 and SIFT) for evaluating amino acid substitutions...

  20. [Foreign Body in Esophagus].

    Science.gov (United States)

    Domeki, Yasushi; Kato, Hiroyuki

    2015-07-01

    An esophageal foreign body is the term for a foreign body in the esophagus. The 2 age groups most prone to this condition are children age 9 and under (and especially toddlers age 4 and under) and elderly individuals age 70 and over. A foreign body often lodges where the esophagus is most constricted. In toddlers, the foreign body is often currency or coins or a toy. In adults, the body is often a piece of fish, dentures, a piece of meat, a pin or needle, or a drug in its blister pack packaging. In children, an esophageal foreign body is treated by fluoroscopically guided removal of the body with a balloon catheter or magnetic catheter or removal of the body via endoscopy or direct esophagoscopy under general anesthesia. In adults, the best choice for treating an esophageal foreign body is removing the body with an endoscope but there are instances where surgery is performed because the body is hard to remove endoscopically, a puncture has occurred, or empyema or mediastinitis has developed. This paper reviews the diagnosis and treatment of an esophageal foreign body.

  1. Use of sting-response techniques for simulate diagnostics in human esophagus; Uso de tecnicas estimulo-respuesta para simular diagnosticos en esofago humano

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez, I.; Gonzalez, Y.; Valdes, L.; Alfonso, J.A.; Estevez, E. [Facultad de Quimica Farmacia, Universidad Central de Las Villas (Cuba)

    2003-07-01

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

  2. Induction of calcium sensing receptor in human colon cancer cells by calcium, vitamin D and aquamin: Promotion of a more differentiated, less malignant and indolent phenotype.

    Science.gov (United States)

    Singh, Navneet; Aslam, Muhammad N; Varani, James; Chakrabarty, Subhas

    2015-07-01

    The calcium sensing receptor (CaSR) is a robust promoter of differentiation in colonic epithelial cells and functions as a tumor suppressor. Cancer cells that do not express CaSR (termed CaSR null) are highly malignant while acquisition of CaSR expression in these cells circumvents the malignant phenotype. We hypothesize that chemopreventive agents mediate their action through the induction of CaSR. Here, we compare the effectiveness of Ca(2+), vitamin D, and Aquamin (a marine algae product containing Ca(2+), magnesium and detectable levels of 72 additional minerals) on the induction of CaSR in the CBS and HCT116 human colon carcinoma cell lines and the corresponding CaSR null cells isolated from these lines. All three agonists induced CaSR mRNA and protein expression and inhibited cellular proliferation in the parental and CaSR null cells. Aquamin was found to be most potent in this regard. Induction of CaSR expression by these agonists resulted in demethylation of the CaSR gene promoter with a concurrent increase in CaSR promoter reporter activity. However, demethylation per se did not induce CaSR transcription. Induction of CaSR expression resulted in a down-regulated expression of tumor inducers and up-regulated expression of tumor suppressors. Again, Aquamin was found to be most potent in these biologic effects. This study provides a rationale for the use of a multi-mineral approach in the chemoprevention of colon cancer and suggests that induction of CaSR may be a measure of the effectiveness of chemopreventive agents.

  3. A novel CaSR mutation presenting as a severe case of neonatal familial hypocalciuric hypercalcemia

    Directory of Open Access Journals (Sweden)

    Tonyushkina Ksenia N

    2012-05-01

    Full Text Available Abstract Background Familial Hypocalciuric Hypercalcemia (FHH is a generally benign disorder caused by heterozygous inactivating mutations in the Calcium-Sensing Receptor (CaSR gene resulting in altered calcium metabolism. Objective We report a case of unusually severe neonatal FHH due to a novel CaSR gene mutation that presented with perinatal fractures and moderate hypercalcemia. Case overview A female infant was admitted at 2 weeks of age for suspected non-accidental trauma (NAT. Laboratory testing revealed hypercalcemia (3.08 mmol/L, elevated iPTH (20.4 pmol/L and low urinary calcium clearance (0.0004. Radiographs demonstrated multiple healing metaphyseal and rib fractures and bilateral femoral bowing. The femoral deformity and stage of healing were consistent with prenatal injuries rather than non-accidental trauma (NAT. Treatment was initiated with cholecalciferol, 400 IU/day, and by 6 weeks of age, iPTH levels had decreased into the high-normal range. Follow up radiographs demonstrated marked improvement of bone lesions by 3 months. A CaSR gene mutation study showed heterozygosity for a T>C nucleotide substitution at c.1664 in exon 6, resulting in amino acid change I555T in the extracellular domain consistent with a missense mutation. Her mother does not carry the mutation and the father is unknown. At 18 months of age, the child continues to have relative hyperparathyroidism and moderate hypercalcemia but is otherwise normal. Conclusion This neonate with intrauterine fractures and demineralization, moderate hypercalcemia and hyperparathyroidism was found to have a novel inactivating missense mutation of the CaSR not detected in her mother. Resolution of bone lesions and reduction of hyperparathyroidism was likely attributable to the natural evolution of the disorder in infancy as well as the mitigating effect of cholecalciferol treatment.

  4. Radiofrequency Ablation in Barrett's Esophagus

    Directory of Open Access Journals (Sweden)

    Vani J.A. Konda

    2014-01-01

    Full Text Available Radiofrequency ablation (RFA is an endoscopic modality used in the treatment of Barrett's esophagus. RFA may be performed using a balloon-based catheter or using one of the probe catheters that attaches to the distal end of the endoscope. Here we demonstrate step-by-step instruction in using radiofrequency ablation in the treatment of Barrett's esophagus and highlight key concepts in the technique.

  5. Esophagus and regenerative medicine

    Institute of Scientific and Technical Information of China (English)

    Ricardo Londono; Blair A Jobe; Toshitaka Hoppo; Stephen F Badylak

    2012-01-01

    In addition to squamous cell carcinoma,the incidence of Barrett's esophagus with high-grade dysplasia and esophageal adenocarcinoma is rapidly increasing worldwide.Unfortunately,the current standard of care for esophageal pathology involves resection of the affected tissue,sometimes involving radical esophagectomy.Without exception,these procedures are associated with a high morbidity,compromised quality of life,and unacceptable mortality rates.Regenerative medicine approaches to functional tissue replacement include the use of biological and synthetic scaffolds to promote tissue remodeling and growth.In the case of esophageal repair,extracellular matrix (ECM) scaffolds have proven to be effective for the reconstruction of small patch defects,anastomosis reinforcement,and the prevention of stricture formation after endomucosal resection (EMR).More so,esophageal cancer patients treated with ECM scaffolds have shown complete restoration of a normal,functional,and disease-free epithelium after EMR.These studies provide evidence that a regenerative medicine approach may enable aggressive resection of neoplastic tissue without the need for radical esophagectomy and its associated complications.

  6. Genetic polymorphisms of CASR and cancer risk: evidence from meta-analysis and HuGE review

    Directory of Open Access Journals (Sweden)

    Jeong S

    2016-02-01

    Full Text Available Sohyun Jeong, Jae Hyun Kim, Myeong Gyu Kim, Nayoung Han, In-Wha Kim, Therasa Kim, Jung Mi Oh College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, South Korea Background: CASR gene appears to be involved in cancer biology and physiology. However, a number of studies investigating CASR polymorphisms and cancer risks have presented inconclusive results. Thus, a systematic review and a meta-analysis of the effect of CASR polymorphisms on several cancer risks were performed to suggest a statistical evidence for the association of CASR polymorphisms with cancer risks.Methods: MEDLINE, EMBASE, Web of Science, Scopus, and the HuGE databases were searched. Nineteen articles of case–control and cohort studies were included for the final analysis.Results: The colorectal cancer risk was reduced in proximal (odds ratio [OR] =0.679, P=0.001 and distal (OR =0.753, P=0.026 colon sites with GG genotype of CASR rs1042636 and increased in distal colon site (OR =1.418, P=0.039 with GG genotype of rs1801726 by additive genetic model. The rs17251221 demonstrated noticeable associations that carrying a homozygote variant increases breast and prostate cancer risk considerably.Conclusion: The significant association of CASR polymorphisms with several cancer risks was observed in this review. In particular, the act of CASR polymorphisms as a tumor suppressor or an oncogene differs by cancer site and can be the research target for tumorigenesis. Keywords: rs1042636, rs1801725, rs1801726, systematic review, colorectal cancer

  7. Defining dysplasia in Barrett esophagus.

    Science.gov (United States)

    Robert, Marie E

    2003-01-01

    Histologic grading of esophageal biopsies remains the cornerstone of management in patients with Barrett esophagus. This remains true despite ongoing research into the genetic abnormalities that occur in the setting of intestinal metaplasia, dysplasia, and adenocarcinoma of the esophagus. As of this writing, there are no objective tests that can replace the pathologist's eyes in predicting prognosis in this setting. However, pathologists and clinicians are well aware that the histologic interpretation of biopsies is an inherently subjective practice. The validity of this exercise depends entirely on the experience of the pathologist. Having said that, two interobserver studies on the grading of dysplasia in Barrett esophagus suggest that, if published criteria are adhered to, the histologic grading of dysplasia is a useful tool in patient management. In this review, the updated pathologic criteria for each category of dysplasia are presented, and the results of two large interobserver variability studies are reviewed.

  8. Comprehensive confocal endomicroscopy of the esophagus in vivo

    Science.gov (United States)

    Kang, Dongkyun; Schlachter, Simon C.; Carruth, Robert W.; Kim, Minkyu; Wu, Tao; Tabatabaei, Nima; Vacas-Jacques, Paulino; Shishkov, Milen; Woods, Kevin; Sauk, Jenny S.; Leung, John; Nishioka, Norman S.; Tearney, Guillermo J.

    2014-01-01

    Background and study aims: Biopsy sampling error can be a problem for the diagnosis of certain gastrointestinal tract diseases. Spectrally-encoded confocal microscopy (SECM) is a high-speed reflectance confocal microscopy technology that has the potential to overcome sampling error by imaging large regions of gastrointestinal tract tissues. The aim of this study was to test a recently developed SECM endoscopic probe for comprehensively imaging large segments of the esophagus at the microscopic level in vivo. Methods: Topical acetic acid was endoscopically applied to the esophagus of a normal living swine. The 7 mm diameter SECM endoscopic probe was transorally introduced into the esophagus over a wire. Optics within the SECM probe were helically scanned over a 5 cm length of the esophagus. Confocal microscopy data was displayed and stored in real time. Results: Very large confocal microscopy images (length = 5 cm; circumference = 2.2 cm) of swine esophagus from three imaging depths, spanning a total area of 33 cm2, were obtained in about 2 minutes. SECM images enabled the visualization of cellular morphology of the swine esophagus, including stratified squamous cell nuclei, basal cells, and collagen within the lamina propria. Conclusions: The results from this study suggest that the SECM technology can rapidly provide large, contiguous confocal microscopy images of the esophagus in vivo. When applied to human subjects, the unique comprehensive, microscopic imaging capabilities of this technology may be utilized for improving the screening and surveillance of various esophageal diseases. PMID:26134959

  9. Barrett’s Esophagus: a Molecular Characterization

    NARCIS (Netherlands)

    D.A. Bax (Dorine)

    2005-01-01

    textabstractBarrett’s esophagus is a premalignant condition that is most likely caused by gastroesophageal reflux. In the western world, about 30% of adults have reflux complaints, such as heartburn, and about 10% of reflux patients will develop Barrett’s esophagus [1]. Barrett’s esophagus is charac

  10. Cough reflex sensitization from esophagus and nose.

    Science.gov (United States)

    Hennel, Michal; Brozmanova, Mariana; Kollarik, Marian

    2015-12-01

    The diseases of the esophagus and nose are among the major factors contributing to chronic cough although their role in different patient populations is debated. Studies in animal models and in humans show that afferent C-fiber activators applied on esophageal or nasal mucosa do not initiate cough, but enhance cough induced by inhaled irritants. These results are consistent with the hypothesis that activation of esophageal and nasal C-fibers contribute to cough reflex hypersensitivity observed in chronic cough patients with gastroesophageal reflux disease (GERD) and chronic rhinitis, respectively. The afferent nerves mediating cough sensitization from the esophagus are probably the neural crest-derived vagal jugular C-fibers. In addition to their responsiveness to high concentration of acid typical for gastroesophageal reflux (pH cough sensitization are less understood. Increased cough reflex sensitivity was also reported in many patients with GERD or rhinitis who do not complain of cough indicating that additional endogenous or exogenous factors may be required to develop chronic coughing in these diseases.

  11. Barrett esophagus: when to endoscope.

    Science.gov (United States)

    Butt, Joshua; Kandel, Gabor

    2014-01-01

    Increasing interest in identifying an effective strategy for decreasing the burden of esophageal adenocarcinoma (EAC) has been fuelled by the rising EAC rates worldwide, the morbidity associated with esophagectomy, and the development of endoscopic methods for curing early-stage EAC. In the face of this enthusiasm, however, we should be cautious about continuing our current evidence-free approach to screening and one with unclear benefits and unclear costs to the community. The literature is increasingly recognizing that the value of traditional endoscopy for screening and surveillance of Barrett esophagus may be more limited than initially believed. A better understanding of the risk factors for Barrett esophagus and progression to dysplasia and a more individualized risk calculation will be useful in defining populations to consider for Barrett screening. The development of novel, nonendoscopic screening techniques and of less expensive endoscopic techniques holds promise for a cost-effective screening and surveillance method to curtail the increasing rates of EAC.

  12. Management strategies of Barrett's esophagus

    Institute of Scientific and Technical Information of China (English)

    Giovanni D De Palma

    2012-01-01

    Barrett's esophagus is a condition resulting from chronic gastro-esophageal reflux disease with a documented risk of esophageal adenocarcinoma.Current strategies for improved survival in patients with Barrett's adenocarcinoma focus on detection of dysplasia.This can be obtained by screening programs in high-risk cohorts of patients and/or endoscopic biopsy surveillance of patients with known Barrett's esophagus (BE).Several therapies have been developed in attempts to reverse BE and reduce cancer risk.Aggressive medical management of acid reflux,lifestyle modifications,antireflux surgery,and endoscopic treatments have been recommended for many patients with BE.Whether these interventions are cost-effective or reduce mortality from esophageal cancer remains controversial.Current treatment requires combinations of endoscopic mucosal resection techniques to eliminate visible lesions followed by ablation of residual metaplastic tissue.Esophagectomy is currently indicated in multifocal high-grade neoplasia or mucosal Barrett's carcinoma which cannot be managed by endoscopic approach.

  13. Comparison of kinome profiles of Barrett's esophagus with normal squamous esophagus and normal gastric cardia

    NARCIS (Netherlands)

    van Baal, Jantine W. P. M.; Diks, Sander H.; Wanders, Ronald J. A.; Rygiel, Agnieskza M.; Milano, Francesca; Joore, Jos; Bergman, Jacques J. G. H. M.; Peppelenbosch, Maikel P.; Krishnadath, Kausilia K.

    2006-01-01

    The precursor metaplastic mucosal lesion that predisposes for esophageal adenocarcinoma is Barrett's esophagus. Because the signal transduction events that occur in Barrett's esophagus are poorly understood, this study aimed at generating a comprehensive description of cellular kinase activity in Ba

  14. Non-neoplastic disorders of the esophagus

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-07-15

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

  15. Biomarkers in Barrett's esophagus.

    Science.gov (United States)

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

    2003-04-01

    future. Biopsy repositories are now readily available for phase 3 studies that can evaluate and compare biomarkers. There are initiatives for multi-institutional Barrett's Centers of Excellence that could provide rapid progress in biomarker evaluation. In addition to new candidate biomarkers, the human genome project has provided high-throughput methodologies and methods for computer analysis of data, which can provide the volume and quality control required for clinically useful biomarkers. Currently, 17p (p53) LOH has progressed the furthest among molecular biomarkers. The authors do not recommend its routine clinical use at the present time, however. Finally, it is likely that clinicians will want to follow the results of clinical treatment-response studies and epidemiologic studies that evaluate relationship between clinical interventions or environmental risk and protective factors and surrogate endpoints, especially if the endpoints are progessing well along the phases of biomarker validation. These studies are likely to be of clinical interest because they may becoming the basis for randomized clinical trials to prevent cancer in BE.

  16. Calcium and calcium sensing receptor modulates the expression of thymidylate synthase, NAD(P)H:quinone oxidoreductase 1 and survivin in human colon carcinoma cells: promotion of cytotoxic response to mitomycin C and fluorouracil

    OpenAIRE

    Liu, Guangming; Hu, Xin; Varani, James; Chakrabarty, Subhas

    2009-01-01

    Ca2+ and the cell-surface calcium sensing receptor (CaSR) constitute a novel and robust ligand/receptor system in regulating the proliferation and differentiation of colonic epithelial cells. Here we show that activation of CaSR by extracellular Ca2+ (or CaSR agonists) enhanced the sensitivity of human colon carcinoma cells to mitomycin C (MMC) and fluorouracil (5-FU). Activation of CaSR up-regulated the expression of MMC activating enzyme, NAD(P)H:quinone oxidoreductase 1 (NQO-1) and down-re...

  17. Well-differentiated liposarcoma of esophagus

    Institute of Scientific and Technical Information of China (English)

    YANG Bin; SHI Pei-zhi; LI Xiao; XU Ru-jun

    2006-01-01

    @@ Gastrointestinal liposarcoma is rare, and the esophagus is the. least common location at which this kind of liposarcoma may occur. We reported a patient with a well-differentiated liposarcoma of esophagus, and discussed the diagnostic utility of these imaging techniques in patient management.

  18. Verrucous Squamous Cell Cancer in the Esophagus

    DEFF Research Database (Denmark)

    Egeland, C; Achiam, M P; Federspiel, B

    2016-01-01

    Verrucous carcinoma is a rare, slow-growing type of squamous cell cancer. Fewer than 50 patients with verrucous carcinoma in the esophagus have been described worldwide. In 2014, two male patients were diagnosed with verrucous carcinoma in the distal part of the esophagus. The endoscopic...

  19. Pedunculated liposarcoma of the esophagus.

    Science.gov (United States)

    Salis, G B; Albertengo, J C; Bruno, M; Palau, G; González Villaveirán, R; Lombardo, D; Villafañe, V; Zorraquín, C; Ghigliani, M

    1998-01-01

    Polypoid tumors of the esophagus present diagnostic and therapeutic problems. Liposarcomas are infrequent among them. We report a recent case. A 73-year-old male patient was seen in May 1995 in the Ear, Nose and Throat (ENT) Department, Clínica Modelo de Morón, with intermittent dysphagia and dyspnoea due to recurrent vomiting. A laryngeal lineal tomography showed a subglottic obstruction due to extrinsic compression. The patient was referred to the Gastroenterology Department, where an upper gastrointestinal (upper GI) series demonstrated mega-esophagus with abundant retained food. Endoscopy showed a large intraluminal mass covered by normal mucosa which arose on the posterior wall. Videofluoroscopy and chest CT diagnosed a probable polypoid lipoma due to its densitometric characteristics. The tumour was resected by left cervicotomy and left esophagotomy. The patient's progress to date is favourable. Pathology studies showed a well-differentiated liposarcoma. According to the literature, the first case was reported in 1983, and ours is only the seventh case in the world to be documented.

  20. Esophagus

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930516 Thrombin in endoscopic embolization ofbleeding esophageal varices.YU Yongzheng(于永征),et al.Dept Gastroenterol,Beijing Friend-ship Hosp,Beijing,100000.Chin J Digest 1992;12(6):328—329.Thrombin,a promising embolic agent,wasused for embolization of bleeding esophagealvariees in 15 cirrhotic patients,with acute bleed-ing in 4 and recent bleeding in 11.By using aflexible fibreoptic endoscope(GIF—IT 10)and aplastic overtube(ST—El),200 to 500 IU ofthrombin for each site was injected in-travariceally and this procedure was immediately

  1. Esophagus

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    2009193 Expression of VEGF-C,VEGFR-3,CD105 and CD68 protein in esophageal squamous cell carcinoma and their significance. CHEN Mingyong(陈明勇),et al.Dept Pathol,1st Affili Hosp Zhengzhou Univ;Henan Key Lab Tumor Pathol,Zhengzhou 450052,world Chin J Digestol,2009;17(6):578-563.

  2. Esophagus

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    2010339 Clinicopathological significance of Bmi-1 and S100A4 expression in esophageal squamous cell carcinoma. FU Zhongbiao(符仲标),et al. Dept Gastroenterol,1st Affil Hosp ,Zhengzhou Univ,Zhengzhou 450052. World Chin J Digestol 2010;18(13):1344-49. Objective To

  3. Esophagus

    Institute of Scientific and Technical Information of China (English)

    1992-01-01

    920681 Endoscopic balloon dilatation forachalasia: an effect observation in 38 cases.CHEN Zhonggui(陈忠贵), et al. Dept Gastro-enterol. 2nd Municip Hosp, Wuhan, 430014.Chin J Intern Med 1992; 31(7): 401-403. From February 1988 to November 1990,thirty eight patients with achalasia were treatedendoscopically with Micro-vasive regiflex balloon

  4. Esophagus

    Institute of Scientific and Technical Information of China (English)

    1997-01-01

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

  5. MicroRNAs, development of Barrett’s esophagus, and progression to esophageal adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    Cameron; M; Smith; David; I; Watson; Michael; Z; Michael; Damian; J; Hussey

    2010-01-01

    Barrett's esophagus is a premalignant condition caused by gastroesophageal reflux. Once developed, it can progress through varying grades of dysplasia to esoph-ageal adenocarcinoma. Whilst it is well accepted that Barrett's esophagus is caused by gastroesophageal reflux, the molecular mechanisms of its pathogenesis and progression to cancer remain unclear. MicroRNAs (miRNAs) are short segments of RNA that have been shown to control the expression of many human genes. They have been implicated in most cellul...

  6. Hypermethylation of the CaSR and VDR genes in the parathyroid glands in chronic kidney disease rats with high-phosphate diet.

    Science.gov (United States)

    Uchiyama, Taketo; Tatsumi, Norifumi; Kamejima, Sahoko; Waku, Tsuyoshi; Ohkido, Ichiro; Yokoyama, Keitaro; Yokoo, Takashi; Okabe, Masataka

    2016-10-01

    Chronic kidney disease (CKD) disrupts mineral homeostasis and its representative pathosis is defined as secondary hyperparathyroidism (SHPT). SHPT occurs during the early course of progressive renal insufficiency, and is associated with mortality and cardiovascular events. SHPT results in reduction of calcium-sensing receptor (CaSR) and vitamin D receptor (VDR) in the parathyroid glands during CKD. However, the precise mechanism of CaSR and VDR reduction is largely unknown. CKD was induced through two-step 5/6 nephrectomy, and then CKD rats and sham-operated rats were maintained for 8 weeks on diets containing 0.7 % phosphorus (normal phosphate) or 1.2 % phosphorus (high phosphate). In gene expression analysis, TaqMan probes were used for quantitative real-time polymerase chain reaction. Finally, CaSR and VDR protein expressions were analyzed using immunohistochemistry. DNA methylation analysis was performed using a restriction digestion and quantitative PCR. CaSR and VDR mRNA were reduced only in CKD rats fed the high-phosphorus diets (CKD HP), then CaSR and VDR immunohistochemical expressions were compatible with gene expression assay. SHPT was then confirmed only in CKD HP rats. Furthermore, sole CKD HP rats showed the hypermethylation in CaSR and VDR genes; however, the percentage methylation of both genes was low. Although CaSR and VDR hypermethylation was demonstrated in PTGs of CKD HP rats, the extent of hypermethylation was insufficient to support the relevance between hypermethylation and down-regulation of gene expression because of the low percentage of methylation. Consequently, our data suggest that mechanisms, other than DNA hypermethylation, were responsible for the reduction in mRNA and protein levels of CaSR and VDR in PTGs of CKD HP rats.

  7. Association of Calcium-Sensing Receptor (CASR rs 1801725 with Colorectal Cancer

    Directory of Open Access Journals (Sweden)

    Fateme Rostami

    2012-07-01

    Full Text Available Background: Calcium induces apoptosis in intestinal epithelial cells and subsequently prevents colorectal cancer through ion calcium receptor. Calcium-sensing receptor mutation reduces the expression of this receptor, and subsequently in reduces calcium transportation. Many studies have shown that Calcium-sensing receptor gene polymorphism may increase the risk of colorectal cancer. The purpose of this study is to assess the prevalence of calcium-sensing receptor polymorphisms (rs 1801725 in Iran society and to examine the role of this polymorphism in the increased risk of colorectal cancer (CRC.Materials and Methods: The research was a case-control study. 105 patients with colorectal cancer and 105 controls were randomly studied using polymerase chain reaction and restriction fragment length polymorphism. χ2 test and software 16- SPSS were used for statistical analysis.Results: In patient samples, the frequency of the genotypes TT, GT, GG in gene CASR rs 1801725 was respectively 64.8, 32.4, and 2.9 and the frequency of this polymorphism in control samples was respectively 51.2, 45.7, and 2.9. Frequency of allele G in patient samples was 0/48 and frequency of allele T was 0.25. In addition, Frequency of allele G in control samples was 0.74 and Frequency of allele T was calculated 0.19.Conclusion: The results show that calcium-sensing receptor variant (1801725 rs is not associated with increased risk of colorectal cancer.

  8. Magnetic and microstructural properties of Al substituted M-type Ca-Sr hexaferrites

    Science.gov (United States)

    Yang, Yujie; Wang, Fanhou; Liu, Xiansong; Shao, Juxiang; Huang, Duohui

    2017-01-01

    In the current study, Al substituted M-type Ca-Sr hexaferrites, with composition Ca0.6Sr0.1La0.3Fe12-xAlxO19 (0≤x≤1.4), have been prepared using the conventional ceramic techniques. The phase composition of the magnetic powders was characterized by X-ray diffraction (XRD). The XRD data show that the magnetic powders with Al content (x) from 0 to 0.8 show α-Fe2O3 as a second phase, while the magnetic powders with x from 1.0 to 1.4 consist of pure magnetoplumbite without any other impurity phases. A field emission scanning electron microscopy (FE-SEM) was used to observe the morphologies of the magnetic powders. FE-SEM images of the magnetic powders show the hexagonal platelet-like shape. The magnetic properties of the magnetic powders were measured by a physical property measurement system-vibrating sample magnetometer (PPMS-VSM). The saturation magnetization (Ms) linearly decreases with Al content (x) from 0 to 1.4. While the remanent magnetization (Mr) first increases with Al content (x) from 0 to 0.2 and then decreases when Al content (x)≥0.2. However, the coercivity (Hc) increases with Al content (x) from 0 to 1.4.

  9. Capsule endoscopy of the esophagus.

    Science.gov (United States)

    Waterman, Matti; Gralnek, Ian M

    2009-08-01

    Video capsule endoscopy has acquired wide clinical acceptance since its the US Food and Drug Administration approval in 2001. Recently, the technology of video capsule endoscopy has been adapted to other organs in the gastrointestinal tract, including the esophagus and colon. In this review, we discuss esophageal capsule endoscopy (ECE)-the procedure, its indications, contraindications, safety, and future applications. ECE is a minimally invasive procedure that uses special video capsules with ability to acquire images from 2 cameras with high image storing speed of 14 to 18 frames per second. A special ingestion procedure allows for prolonged esophageal transit time and an optimized view of the gastroesophageal junction. ECE has been shown to have moderately high sensitivity and accuracy in the diagnosis and surveillance of Barrett esophagus in patients with gastroesophageal reflux disease but has not demonstrated superiority to esogastroduodenoscopy in cost-effectiveness models. In patients with portal hypertension, ECE has a sensitivity of 63% to 100% for screening of esophageal varices, but does not seem to be superior to esogastroduodenoscopy in its cost-effectiveness. No serious complications have been reported after ECE although a low rate of esophageal capsule retention (0.7% to 2.2%) has been reported, usually because of unsuspected esophageal strictures. Contraindications to capsule endoscopy include known or suspected gastrointestinal and esophageal obstruction, strictures, or fistulas, intestinal pseudoobstruction, and children under 10 years of age. It is expected that improvements in imaging technology will improve the accuracy of ECE with the development of immunological-based and chemical-based diagnostic capabilities.

  10. Endoscopic diagnosis of Barrett's esophagus

    Institute of Scientific and Technical Information of China (English)

    Tomoyuki Akiyama; Yusuke Sekino; Hiroshi Iida; Shigeru Koyama; Eiji Gotoh; Shin Maeda; Atsushi Nakajima; Masahiko Inamori

    2012-01-01

    The Prague C and M Criteria have been developed for the objective endoscopic diagnosis of Barrett's esophagus (BE).BE arises between the squamocolumnar junction and the gastroesophageal junction at the proximal margin of the gastric folds.In this study,we reported that 43.0% of the subjects examined were diagnosed with BE based on the Prague C and M Criteria.Previous criticism by John Dent proposed that our data should be considered invalid because the prevalence of BE reported in our study was extraordinarily high and discordant with previous studies.Dent predicted that the position of the gastroesophageal junction in our study was judged to be lower than the actual position due to the effacement of the proximal ends of the gastric folds because of the routine use of a high degree of air distension during typical Japanese endoscopic examinations.The endoscopic evaluation of the superior gastric folds is certainly influenced by the degree of air distension of the esophagus.However,in our study,the proximal limit of the gastric mucosal folds was prospectively imaged while the oesophagus was minimally insufflated.Then,under a high level of air distension,the distal ends of the palisade-shaped longitudinal vessels were imaged because they are more easily observed when distended.In the majority of patients,the distal ends of the palisade-shaped longitudinal vessels correspond to the proximal limit of the gastric mucosal folds.Our endoscopic evaluation was appropriately performed according to the Prague C and M Criteria.We suspect that the high prevalence of BE in our study may be due to the inclusion of ultrashort-segment BE,which defines BE with an affected mucosal length under 5 mm,in our positive results.

  11. Carcinoid of the Esophagus Concomitant with Adenocarcinoma of the Esophagus: One Case Report and Literature Review

    Institute of Scientific and Technical Information of China (English)

    Chun-hui LI; Li-hui PAN; Bei-bei XU; De-li ZHANG; Xiao-ping JIN

    2010-01-01

    @@ Introduction Neuroendocrine tumor covers a wide range of neoplasms that originate in the neuroendocrine cells which spread throughout the body.Carcinoid tumor, and neuroendocrine tumor are low-grade malignant tumors, their growth is slow, and mainly in the gastrointestinal epithelium. Esophageal adenocarcinoma tumor is a big problem in esophageal cancer. Combined esophageal adenocarcinoma and carcinoid tumor both as primary tumors is very rare[1]. Neuroendocrine tumors of the esophagus are derived from the diffuse neuroendocrine system in the gastrointestinal tract. Neuroendocrine tumors in the esophagus can be distinguished from other mesenchymal tumors by immunostaining for synaptophysin and chromogranin-A. Both carcinoid of the esophagus and adenocarcinoma of the esophagus are malignant tumors and considered to have a specifi c molecular pathogenesis. This paper presents a rare case diagnosed as carcinoid of the esophagus concomitant with an adenocarcinoma of the esophagus, a review of the literature is also presented here.

  12. What Is Cancer of the Esophagus?

    Science.gov (United States)

    ... are 2 main types of esophageal cancer: Squamous cell carcinoma The esophagus is normally lined with squamous ... Our Volunteers More ACS Sites Bookstore Shop Cancer Atlas Press Room Cancer Statistics Center Volunteer Learning Center ...

  13. Atopic dermatitis with possible polysensitization and monkey esophagus reactivity

    Directory of Open Access Journals (Sweden)

    Ana Maria Abreu Velez

    2010-01-01

    Full Text Available Context: Atopic dermatitis is a chronic inflammatory skin disease resulting from interactions between environmental and genetic factors. Recent studies link atopic dermatitis with asthma and with eosinophilic esophagitis. Case Report: Based on this association, we investigated by indirect immunofluorescence the immunoreactivity patterns on monkey esophagus substrate utilizing the serum of a patient with severe atopic dermatitis. We also examined the patient′s skin biopsy by H&E histology and immunohistochemistry. We detected strong deposits of albumin, IgE, IgG, IgD, IgA, Complement/C1q and mast cell tryptase in multiples structures of the skin, as well as a broad pattern of intraepithelial staining on monkey esophagus. Strong staining positivity was also detected within the inflammatory infiltrate around the upper dermal vessels, as well as additional positive staining for the human leukocyte antigen system antigens DR DP and DQ. Conclusion: Our findings demonstrate that there could be an indication for testing patients with severe atopic dermatitis for autoreactivity to filaggrin (anti-keratin antibodies utilizing monkey esophagus. Larger studies are needed to clarify any immunologic interaction between the reactivity to albumin and food allergens that may sensitize patients via the esophageal mucosa.

  14. Juxtaglomerular cell CaSR stimulation decreases renin release via activation of the PLC/IP(3) pathway and the ryanodine receptor.

    Science.gov (United States)

    Ortiz-Capisano, M Cecilia; Reddy, Mahendranath; Mendez, Mariela; Garvin, Jeffrey L; Beierwaltes, William H

    2013-02-01

    The calcium-sensing receptor (CaSR) is a G-coupled protein expressed in renal juxtaglomerular (JG) cells. Its activation stimulates calcium-mediated decreases in cAMP content and inhibits renin release. The postreceptor pathway for the CaSR in JG cells is unknown. In parathyroids, CaSR acts through G(q) and/or G(i). Activation of G(q) stimulates phospholipase C (PLC), and inositol 1,4,5-trisphosphate (IP(3)), releasing calcium from intracellular stores. G(i) stimulation inhibits cAMP formation. In afferent arterioles, the ryanodine receptor (RyR) enhances release of stored calcium. We hypothesized JG cell CaSR activation inhibits renin via the PLC/IP(3) and also RyR activation, increasing intracellular calcium, suppressing cAMP formation, and inhibiting renin release. Renin release from primary cultures of isolated mouse JG cells (n = 10) was measured. The CaSR agonist cinacalcet decreased renin release 56 ± 7% of control (P PLC inhibitor U73122 reversed cinacalcet inhibition of renin (104 ± 11% of control). The IP(3) inhibitor 2-APB also reversed inhibition of renin from 56 ± 6 to 104 ± 11% of control (P PLC/IP(3) pathway, activating RyR, increasing intracellular calcium, and resulting in calcium-mediated renin inhibition.

  15. Genome-wide meta-analysis for serum calcium identifies significantly associated SNPs near the calcium-sensing receptor (CASR gene.

    Directory of Open Access Journals (Sweden)

    Karen Kapur

    2010-07-01

    Full Text Available Calcium has a pivotal role in biological functions, and serum calcium levels have been associated with numerous disorders of bone and mineral metabolism, as well as with cardiovascular mortality. Here we report results from a genome-wide association study of serum calcium, integrating data from four independent cohorts including a total of 12,865 individuals of European and Indian Asian descent. Our meta-analysis shows that serum calcium is associated with SNPs in or near the calcium-sensing receptor (CASR gene on 3q13. The top hit with a p-value of 6.3 x 10(-37 is rs1801725, a missense variant, explaining 1.26% of the variance in serum calcium. This SNP had the strongest association in individuals of European descent, while for individuals of Indian Asian descent the top hit was rs17251221 (p = 1.1 x 10(-21, a SNP in strong linkage disequilibrium with rs1801725. The strongest locus in CASR was shown to replicate in an independent Icelandic cohort of 4,126 individuals (p = 1.02 x 10(-4. This genome-wide meta-analysis shows that common CASR variants modulate serum calcium levels in the adult general population, which confirms previous results in some candidate gene studies of the CASR locus. This study highlights the key role of CASR in calcium regulation.

  16. Natural history of Barrett's esophagus

    Institute of Scientific and Technical Information of China (English)

    Rao Milind; Stephen E Attwood

    2012-01-01

    The natural history of Barrett's esophagus (BE) is difficult to quantify because,by definition,it should describe the course of the condition if left untreated.Pragmatically,we assume that patients with BE will receive symptomatic treatment with acid suppression,usually a proton pump inhibitor,to treat their heartburn.This paper describes the development of complications of stricture,ulcer,dysplasia and adenocarcinoma from this standpoint.Controversies over the definition of BE and its implications in clinical practice are presented.The presence of intestinal metaplasia and its relevance to cancer risk is discussed,and the need to measure the extent of the Barrett's epithelium (long and short segments) using the Prague guidelines is emphasized.Guidelines and international consensus over the diagnosis and management of BE are being regularly updated.The need for expert consensus is important due to the lack of randomized trials in this area.After searching the literature,we have tried to collate the important studies regarding progression of Barrett's to dysplasia and adenocarcinoma.No therapeutic studies yet reported show a clear reduction in the development of cancer in BE.The effect of pharmacological and surgical intervention on the natural history of Barrett's is a subject of ongoing research,including the Barrett's Oesophagus Surveillance Study and the aspirin and esomeprazole cancer chemoprevention trial with interesting results.The geographical variation and the wide range of outcomes highlight the difficulty of providing an individualized risk profile to patients with BE.Future studies on the interaction of genome wide abnormalities in Barrett's and their interaction with environmental factors may allow individualization of the risk of cancer developing in BE.

  17. Cx43和Pax3在人胚胎食管肌层组织中的表达及意义%Expression and Significance of Cx43 and Pax3 in the Esophagus of a Human Embryo

    Institute of Scientific and Technical Information of China (English)

    张剑; 刘学红

    2009-01-01

    应用免疫组织化学SABC法检测第2,3,4三个月胎龄段,Cx43和Pax3蛋白在人胚胎食管组织中的表达.结果表明:第2个月胚龄时,Cx43和Pax3在食管肌层肌细胞中呈阳性表达,在肌间神经丛处神经细胞呈阴性表达;第3个月胎龄段,Cx43和Pax3在食管肌层肌细胞阳性表达与第2个月胚龄相似,在肌间神经丛处大部分神经细胞呈阳性表达;第4个月胎龄段,Cx43和Pax3在食管肌层神经细胞和肌细胞均呈弱阳性表达.因此,Cx43和Pax3蛋白与人胚胎早期食管肌层组织细胞的生长发育关系密切.%The objective of the paper is to explore the patterns of Connexin43 (Cx43) and Pairedbox3 (Pax3) protein expressions in the esophageal muscular layers of a human embryo.The SABC method in Immunohistochemistry has been employed to examine the expressions of Cx43 and Pax3 proteins in the muscular layers of the esophagus in human embryos from the second to fourth months of gestation.The following are the results:In the second month of gestation,their muscle cells of the esophageal muscular layers are positive while the nerve cells in the myenteric plexus are negative;In the third month,the Cx43 and Pax3 expressions in the muscle cells in the esophageal muscular layers are similar to those of the second month,with most nerve cells positive in the myenteric plexus;In the fourth month,the Cx43 and Pax3 protein expressions are weakly positive both in the muscle cells and nerve cells of the esophageal muscular layers.A conclusion is reached:Their Cx43 and Pax3 proteins are closely related to the growth and development of the cells and tissues in the esophageal muscular layers in human embryos.

  18. Direct observation of charged domain walls in hybrid improper ferroelectric (Ca,Sr)3Ti2O7

    Science.gov (United States)

    Kurushima, Kousuke; Yoshimoto, Wataru; Ishii, Yui; Cheong, Sang-Wook; Mori, Shigeo

    2017-10-01

    We investigated ferroelectric (FE) domain wall structures including “charged domain walls” of hybrid improper FE (Ca,Sr)3Ti2O7 at the subatomic resolution by dark-field transmission electron microscopy (TEM) and high-resolution state-of-the-art aberration-corrected high-angle annular-dark-field (HAADF) scanning transmission electron microscopy (STEM). Dark-field TEM and high-resolution HAADF-STEM images obtained in the FE phase of single crystals of Ca2.46Sr0.54Ti2O7 revealed the formation of abundant charged domain walls with the head-to-head and tail-to-tail configurations in the FE domain structure, in addition to the FE 180° domain structure. The charged domain walls with the head-to-head and tail-to-tail FE polarizations exist stably and can be characterized as the unique double arc-type displacement of Ca/Sr ions in a unit cell without charge accumulation.

  19. Fibrovascular polyp of the hypopharynx and esophagus

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

  20. Color-matched esophagus phantom for fluorescent imaging

    Science.gov (United States)

    Yang, Chenying; Hou, Vivian; Nelson, Leonard Y.; Seibel, Eric J.

    2013-02-01

    We developed a stable, reproducible three-dimensional optical phantom for the evaluation of a wide-field endoscopic molecular imaging system. This phantom mimicked a human esophagus structure with flexibility to demonstrate body movements. At the same time, realistic visual appearance and diffuse spectral reflectance properties of the tissue were simulated by a color matching methodology. A photostable dye-in-polymer technology was applied to represent biomarker probed "hot-spot" locations. Furthermore, fluorescent target quantification of the phantom was demonstrated using a 1.2mm ultrathin scanning fiber endoscope with concurrent fluorescence-reflectance imaging.

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

    LENUS (Irish Health Repository)

    Quigley, Eamonn M M

    2011-09-01

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

  2. Black esophagus with concomitant candidiasis developed after diabetic ketoacidosis

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Black esophagus is a very rare disease and its pathogenesis has been unclear. Black esophagus developed concomitantly with candidiasis after diabetic ketoacidosis has not been reported yet. We report a case who developed esophageal stricture after the treatment of black esophagus and thus balloon dilatation was performed several times but failed, hence, surgical treatment was performed.

  3. Advances in the therapy of Barrett's Esophagus

    Institute of Scientific and Technical Information of China (English)

    Han Min; Jinchang Wu

    2009-01-01

    The rising incidence of esophageal adenocarcinoma(EAC) in the world has led to continued interest in its precursor lesion,Barrett's esophagus(BE).This review endeavors to summarize the recent advances in the therapy of BE with an emphasis on novel endoscopic therapies.

  4. Effect of Slip Time in Forming Neo-Esophageal Stenosis After Replacement of a Thoracic Esophagus With Nitinol Artificial Esophagus.

    Science.gov (United States)

    Liang, Xian-Liang; Liang, Jian-Hui

    2015-07-01

    Attempts have been made to investigate the effect of slip time of nitinol artificial esophagus for forming neo-esophageal stenosis after replacement of a thoracic esophagus with nitinol artificial esophagus in 20 experimental pigs. The pigs whose slip time was less than 90 days postoperatively had severe dysphagia (Bown's III) immediately after they were fed, and the dysphagia aggravated gradually later on (Bown's III-IV). The pigs whose slip time was more than 90 days postoperatively had mild/moderate dysphagia (Bown's I-II) immediately after they were fed, and the dysphagia relieved gradually later on (Bown's II-I-0). The ratios between the diameter of neo-esophagus in different slip time and normal esophagus were 25% (at 2 months postoperatively), 58% (at 4 months postoperatively), and 93% (at 6 months postoperatively), respectively. The relationship between nitinol artificial esophagus slip time and neo-esophageal stenosis showed a positive correlation. After replacement of a thoracic esophagus with nitinol artificial esophagus, the artificial esophageal slip time not only affected the original diameter of the neo-esophagus immediately, but also affected the neo-esophageal scar stricture forming process later on. The narrowing of neo-esophagus is caused by overgrowth of scar tissue. But there is the positive correlation between artificial esophagus slip time and neo-esophageal stenosis, so this can be a way of overcoming neo-esophageal stenosis by delaying slip time of artificial esophagus.

  5. Measurement of PTHrP, PTHR1, and CaSR expression levels in tissues of sea bream (Sparus aurata) using quantitative PCR

    NARCIS (Netherlands)

    Hang, X.M.; Power, D.; Flik, G.; Balment, R.J.

    2005-01-01

    A quantitative PCR (Q-PCR) method has been established to measure the mRNA expression levels of parathyroid hormone-related protein (PTHrP), parathyroid hormone receptor type 1 (PTHR1), and calcium-sensing receptor (CaSR) in sea bream (Sparus aurata), using the housekeeping gene, beta-actin, as

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

    Science.gov (United States)

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

    2009-02-01

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

  7. Anatomy and physiology of the esophagus.

    Science.gov (United States)

    Gavaghan, M

    1999-02-01

    Modern diagnosis and treatment of esophageal disease is a result of progress in assessing the anatomy and physiology of the esophagus, as well as refinements in anesthetic and surgical techniques. Esophageal carcinoma spreads rapidly and metastasizes easily. The tendency for early spread and the absence of symptoms result in late diagnosis that reduces treatment options and cure rates. Lifestyle (i.e., use of alcohol and tobacco), nutritional deficiencies, ingestion of nitrosamines, and mutagen-inducing fungi are blamed for cancer of the esophagus. Other pathologic conditions (e.g., achalasia, Barrett's epithelium, gastric reflux, hiatal hernia) are potential contributors to the development of carcinoma. Nurses are in key positions to identify the existence of factors contributing to premalignant or malignant lesions and to educate patients and make the appropriate referrals.

  8. An unusual foreign body of esophagus

    Directory of Open Access Journals (Sweden)

    Surinder K Singhal

    2010-07-01

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

  9. Black esophagus: Acute esophageal necrosis syndrome

    Institute of Scientific and Technical Information of China (English)

    Grigoriy; E; Gurvits

    2010-01-01

    Acute esophageal necrosis (AEN), commonly referred to as "black esophagus", is a rare clinical entity arising from a combination of ischemic insult seen in hemodynamic compromise and low-flow states, corrosive injury from gastric contents in the setting of esophago-gastroparesis and gastric outlet obstruction, and decreased function of mucosal barrier systems and reparative mechanisms present in malnourished and debilitated physical states. AEN may arise in the setting of multiorgan dysfunction, hypoperfusi...

  10. Pathogenesis of columnar-lined esophagus

    Institute of Scientific and Technical Information of China (English)

    Kamal E Bani-Hani; Bayan K Bani-Hani

    2006-01-01

    Since its initial description, the pathogenesis of the columnar-lined esophagus (CLE) has been surrounded by many controversies. The first controversy is related to the existence of the condition itself. The second controversy centers on whether the CLE is a congenital or an acquired condition. In this article, we review the congenital and acquired theories of development of CLE and discuss the various factors in acquisition of CLE. The bulk of evidence in the literature suggests that CLE is an acquired condition.

  11. Adenomatous polyp with intestinal metaplasia of the esophagus (Barrett esophagus) in a dog.

    Science.gov (United States)

    Gibson, C J; Parry, N M A; Jakowski, R M; Cooper, J

    2010-01-01

    Multiple endoscopic biopsy specimens of esophageal mucosa were received from a 13-year-old castrated male standard Poodle. The dog was presented for painful swallowing. Endoscopically, the distal aspect of the esophagus was inflamed with a polypoid mass that protruded into the esophageal lumen. Histologically, the stratified squamous epithelium overlying the mass and lining the adjacent esophageal mucosa was replaced by papillary projections covered by columnar epithelium with goblet cells supported by a fibrous stroma. This article reports a case of spontaneous esophageal adenomatous polyp with intestinal metaplasia (Barrett esophagus) and reviews the pathogenesis of esophageal metaplasia and adenocarcinoma.

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

    Science.gov (United States)

    ... VideoGIE Calendar Training Center For Trainees Clinical Topics Anatomy Colorectal Esophagus Hepatopancreatobiliary Small Intestine Stomach Procedures A - E Ablation Advanced Imaging Bariatrics Biliary ...

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

    NARCIS (Netherlands)

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

    2004-01-01

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

  14. Red flag imaging techniques in Barrett's esophagus.

    Science.gov (United States)

    Saxena, Payal; Canto, Marcia Irene

    2013-07-01

    The key to detection and treatment of early neoplasia in Barrett's esophagus (BE) is thorough and careful inspection of the Barrett's segment. The greatest role for red flag techniques is to help identify neoplastic lesions for targeted biopsy and therapy. High-definition white light endoscopy (HD-WLE) can potentially improve endoscopic imaging of BE compared with standard endoscopy, but little scientific evidence supports this. The addition of autofluorescence imaging to HD-WLE and narrow band imaging increases sensitivity and the false-positive rate without significantly improving overall detection of BE-related neoplasia.

  15. Comparative expression of the extracellular calcium-sensing receptor in the mouse, rat, and human kidney.

    Science.gov (United States)

    Graca, J A Z; Schepelmann, M; Brennan, S C; Reens, J; Chang, W; Yan, P; Toka, H; Riccardi, D; Price, S A

    2016-03-15

    The calcium-sensing receptor (CaSR) was cloned over 20 years ago and functionally demonstrated to regulate circulating levels of parathyroid hormone by maintaining physiological serum ionized calcium concentration ([Ca(2+)]). The receptor is highly expressed in the kidney; however, intrarenal and intraspecies distribution remains controversial. Recently, additional functions of the CaSR receptor in the kidney have emerged, including parathyroid hormone-independent effects. It is therefore critical to establish unequivocally the localization of the CaSR in the kidney to relate this to its proposed physiological roles. In this study, we determined CaSR expression in mouse, rat, and human kidneys using in situ hybridization, immunohistochemistry (using 8 different commercially available and custom-made antibodies), and proximity ligation assays. Negative results in mice with kidney-specific CaSR ablation confirmed the specificity of the immunohistochemistry signal. Both in situ hybridization and immunohistochemistry showed CaSR expression in the thick ascending limb, distal tubule, and collecting duct of all species, with the thick ascending limb showing the highest levels. Within the collecting ducts, there was significant heterogeneity of expression between cell types. In the proximal tubule, lower levels of immunoreactivity were detected by immunohistochemistry and proximity ligation assays. Proximity ligation assays were the only technique to demonstrate expression within glomeruli. This study demonstrated CaSR expression throughout the kidney with minimal discrepancy between species but with significant variation in the levels of expression between cell and tubule types. These findings clarify the intrarenal distribution of the CaSR and enable elucidation of the full physiological roles of the receptor within this organ.

  16. Barrett's esophagus: Origin, development and options for therapeutic intervention

    NARCIS (Netherlands)

    V. Menke (Vivianda)

    2012-01-01

    textabstractBarrett’s esophagus (BE) consists of a metaplasia in which the normal squamous cells lining the esophagus are replaced by a mixture of gastric and intestinal lining cells. The intestinal-type lining cells are often referred to as specialized columnar cells and include e.g. goblet cells.

  17. Benign Strictures of the Esophagus and Gastric Outlet: Interventional Management

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Hyoung; Shin, Ji Hoon; Song, Ho Young [University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2010-10-15

    Benign strictures of the esophagus and gastric outlet are difficult to manage conservatively and they usually require intervention to relieve dysphagia or to treat the stricture-related complications. In this article, authors review the non-surgical options that are used to treat benign strictures of the esophagus and gastric outlet, including balloon dilation, temporary stent placement, intralesional steroid injection and incisional therapy

  18. IS CHEMOTHERAPY ASSOCIATED WITH DEVELOPMENT OF BARRETT-ESOPHAGUS

    NARCIS (Netherlands)

    PETERS, FTM; SLEIJFER, DT; VANIMHOFF, GW; KLEIBEUKER, JH

    1993-01-01

    Columnar-lined or Barrett's esophagus is a premalignant condition. It is almost unvariably due to chronic gastroesophageal reflux. Since there are some reports that Barrett's esophagus can be induced by chemotherapy, we investigated 20 male patients, treated with chemotherapy for testicular cancer,

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

    Institute of Scientific and Technical Information of China (English)

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

    2005-01-01

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

  20. Recurrent giant fibrovascular polyp of the esophagus

    Institute of Scientific and Technical Information of China (English)

    Ser Yee Lee; Weng Hoong Chan; Ranjiv Sivanandan; Dennis Teck Hock Lim; Wai Keong Wong

    2009-01-01

    Giant fibrovascular polyps of the esophagus and hypopharynx are rare benign esophageal tumors. They arise most commonly in the upper esophagus and may, rarely, originate in the hypopharynx. They can vary significantly in size. Even though they are benign, they may be lethal due to either bleeding or, rarely, asphyxiation if a large polyp is regurgitated. Patients commonly present with dysphagia or hematemesis. The polyps may not be well visualized on endoscopy and imaging plays a vital role in aiding diagnosis as well as providing important information for preoperative planning, such as the location of the pedicle, the vascularity of the polyp and the tissue elements of the mass. They can also be recurrent in rare cases, especially if the resection margins of the base are involved. We review the recent literature and report a case of a 61-year-old man with a recurrent giant esophageal fibrovascular polyp with illustrative contrast barium swallow, CT and intra-operative images, who required several surgeries via a combination of endoscopic, trans-oral, trans-cervical, trans-thoracic and trans-abdominal approaches.

  1. Morphological Study on the Development of Human Fetal Trachea and Esophagus%人胚气管食管组织发生发育的形态结构研究

    Institute of Scientific and Technical Information of China (English)

    贾书花; 王东; 王改琴; 张旭东; 牛香兰

    2016-01-01

    Objectives:To discussed the development process of tracheoesophageal organization structure,for rich the tracheoesophageal content in Embryology to provide the morphological data.Methods:Collect different weekly embryos by drug abortion and induced labor from affiliated hospital,take tracheoesophageal to do paraffin section,observe the tracheoesophageal structure at different stages by microscope. Results:At 4-week embryo,tracheoesophageal wall consists of simple cuboidal epithelium and mesenchymal.At 6-week embryo, tracheoesophageal wall is made up of stratified columnar epithelium and mesenchymal.Embryo 10 ~ 12 weeks,tracheal tube wall can distinguish the mucosa and submucosa and outer membrane three layer structure;esophageal wall can distinguish the mucosa and submucosa and muscular layer and adventitia four layer structure;the epithelium of trachea and esophagus all were stratified ciliated columnar.Embryo 16~28 weeks,the structure of tracheoesophageal gradually mature,similar to adults at 28 week.Conclusion:Due to the homology in early de-velopment,the trachea and esophagus shows the same structure.With the embryonic development,the structure of trachea and esophagus has differentiated induced by different factors effect,but their stratified ciliated columnar epithelium lasts for along time,then gradually evolved into their respective characteristic of the epithelium.The results illustrate that early ciliated columnar epithelium has its special significance in the evolution of the epithelium and the development of the whole organ differentiation.%目的::探讨气管食管组织结构的发生发育过程,为丰富气管食管的胚胎学内容提供形态学资料。方法:收集附属医院药流及引产的不同周次人胚,取气管食管进行石蜡切片,显微镜观察不同阶段气管食管组织结构。结果:胚胎4周,气管食管壁由单层立方上皮和外周间充质构成。胚胎6周,气管食管壁由复层柱状上皮和外

  2. Establishment of rules for interpreting ultraviolet autofluorescence microscopy images for noninvasive detection of Barrett's esophagus and dysplasia

    Science.gov (United States)

    Lin, Bevin; Urayama, Shiro; Saroufeem, Ramez M. G.; Matthews, Dennis L.; Demos, Stavros G.

    2012-01-01

    The diagnostic potential of autofluorescence (AF) microscopy under ultraviolet (UV) excitation is explored using ex vivo human specimens. The aim is to establish optical patterns (the rules for interpretation) that correspond to normal and abnormal histologies of the esophagus, spanning from early benign modifications (Barrett's esophagus) to subsequent dysplastic change and progression toward carcinoma. This was achieved by developing an image library categorized by disease progression. We considered morphological changes of disease as they are compared with histological diagnosis of the pathological specimen, as well as control samples of normal esophagus, proximal stomach, and small intestine tissue. Our experimental results indicate that UV AF microscopy could provide real-time histological information for visualizing changes in tissue microstructure that are currently undetectable using conventional endoscopic methods.

  3. Biomarkers of Barrett’s esophagus

    Institute of Scientific and Technical Information of China (English)

    Yasser; Mahrous; Fouad; Ibrahim; Mostafa; Reem; Yehia; Hisham; El-Khayat

    2014-01-01

    Barrett’s esophagus is the strongest risk for esophageal adenocarcinoma(EAC). Metaplasia in patients with BE may progress to dysplasia and then invasive carcinoma. Well-defined diagnostic, progressive, predictive, and prognostic biomarkers are needed to identify the presence of the disease, estimate the risk of malignant transformation, and predict the therapeutic outcome and survival of EAC patients. There are many predictive and prognostic markers that lack substantial validation, and do not allow stratification of patients with gastroesophageal reflux disease in clinical practice for outcome and effectiveness of therapy. In this short review we summarize the current knowledge regarding possible biomarkers, focusing on the pathophysiologic mechanisms to improve prognostic and therapeutic approaches.

  4. Endoscopic imaging of Barrett’s esophagus

    Institute of Scientific and Technical Information of China (English)

    Mariam Naveed; Kerry B Dunbar

    2016-01-01

    The incidence of esophageal adenocarcinoma(EAC) has dramatically increased in the United States as well as Western European countries. The majority of esophageal adenocarcinomas arise from a backdrop of Barrett’s esophagus(BE),a premalignant lesion that can lead to dysplasia and cancer. Because of the increased risk of EAC,GI society guidelines recommend endoscopic surveillance of patients with BE. The emphasis on early detection of dysplasia in BE through surveillance endoscopy has led to the development of advanced endoscopic imaging technologies. These techniques have the potential to both improve mucosal visualization and characterization and to detect small mucosal abnormalities which are difficult to identify with standard endoscopy. This review summarizes the advanced imaging technologies used in evaluation of BE.

  5. Mussel Shell Impaction in the Esophagus

    Directory of Open Access Journals (Sweden)

    Sunmin Kim

    2013-03-01

    Full Text Available Mussels are commonly used in cooking around the world. The mussel shell breaks more easily than other shells, and the edge of the broken mussel shell is sharp. Impaction can ultimately cause erosion, perforation and fistula. Aside from these complications, the pain can be very intense. Therefore, it is essential to verify and remove the shell as soon as possible. In this report we describe the process of diagnosing and treating mussel shell impaction in the esophagus. Physicians can overlook this unusual foreign body impaction due to lack of experience. When physicians encounter a patient with severe chest pain after a meal with mussels, mussel shell impaction should be considered when diagnosing and treating the patient.

  6. Management of primary small cell carcinoma of the esophagus

    Institute of Scientific and Technical Information of China (English)

    SUN Ke-lin; HE Jie; CHENG Gui-yu; CHAI Li-xun

    2007-01-01

    Background Primary small cell carcinoma of the esophagus is rare. Although surgery is successful in eradicating local tumor, the five-year survival rate of patients with primary small cell carcinoma of the esophagus after resection is lower than that of patients with primary squamous cell carcinoma of the esophagus. The purpose of this study was to analyze the clinical manifestations, pathological features and treatment of primary small cell carcinoma of the esophagus.Methods A total of 73 patients with primary small cell carcinoma of the esophagus who had been treated by surgery from 1984 to 2003 were analyzed retrospectively.Results In this series, the overall resection rate was 94.5% (69/73), the radical resection rate 89.0% (65/73) and the operative mortality 1.4% (1/73). The 1-, 3- and 5-year survival rates of patients were 50.7%, 13.7% and 8.2%,respectively.Conclusions Primary small cell carcinoma of the esophagus is rare with a poor prognosis. Surgical resection is the leading method for patients with stage Ⅰ or Ⅱ primary small cell carcinoma of the esophagus. Postoperative chemotherapy is beneficial to these patients. The patients of stage Ⅲ or Ⅳ should be given chemotherapy and radiation therapy.

  7. Development of a brief measure of intimate partner violence experiences: the Composite Abuse Scale (Revised)—Short Form (CASR-SF)

    Science.gov (United States)

    Ford-Gilboe, Marilyn; Wathen, C Nadine; Varcoe, Colleen; MacMillan, Harriet L; Scott-Storey, Kelly; Mantler, Tara; Hegarty, Kelsey; Perrin, Nancy

    2016-01-01

    Objectives Approaches to measuring intimate partner violence (IPV) in populations often privilege physical violence, with poor assessment of other experiences. This has led to underestimating the scope and impact of IPV. The aim of this study was to develop a brief, reliable and valid self-report measure of IPV that adequately captures its complexity. Design Mixed-methods instrument development and psychometric testing to evolve a brief version of the Composite Abuse Scale (CAS) using secondary data analysis and expert feedback. Setting Data from 5 Canadian IPV studies; feedback from international IPV experts. Participants 31 international IPV experts including academic researchers, service providers and policy actors rated CAS items via an online survey. Pooled data from 6278 adult Canadian women were used for scale development. Primary/secondary outcome measures Scale reliability and validity; robustness of subscales assessing different IPV experiences. Results A 15-item version of the CAS has been developed (Composite Abuse Scale (Revised)—Short Form, CASR-SF), including 12 items developed from the original CAS and 3 items suggested through expert consultation and the evolving literature. Items cover 3 abuse domains: physical, sexual and psychological, with questions asked to assess lifetime, recent and current exposure, and abuse frequency. Factor loadings for the final 3-factor solution ranged from 0.81 to 0.91 for the 6 psychological abuse items, 0.63 to 0.92 for the 4 physical abuse items, and 0.85 and 0.93 for the 2 sexual abuse items. Moderate correlations were observed between the CASR-SF and measures of depression, post-traumatic stress disorder and coercive control. Internal consistency of the CASR-SF was 0.942. These reliability and validity estimates were comparable to those obtained for the original 30-item CAS. Conclusions The CASR-SF is brief self-report measure of IPV experiences among women that has demonstrated initial reliability and validity

  8. The regulation of K- and L-cell activity by GLUT2 and the calcium-sensing receptor CasR in rat small intestine.

    Science.gov (United States)

    Mace, Oliver J; Schindler, Marcus; Patel, Sonal

    2012-06-15

    Intestinal enteroendocrine cells (IECs) secrete gut peptides in response to both nutrients and non-nutrients. Glucose and amino acids both stimulate gut peptide secretion. Our hypothesis was that the facilitative glucose transporter, GLUT2, could act as a glucose sensor and the calcium-sensing receptor, CasR, could detect amino acids in the intestine to modify gut peptide secretion. We used isolated loops of rat small intestine to study the secretion of gluco-insulinotropic peptide (GIP), glucagon-like peptide-1 (GLP-1) and peptide tyrosine tyrosine (PYY) secretion stimulated by luminal perfusion of nutrients or bile acid. Inhibition of the sodium-dependent glucose cotransporter 1 (SGLT1) with phloridzin partially inhibited GIP, GLP-1 and PYY secretion by 45%, suggesting another glucose sensor might be involved in modulating peptide secretion. The response was completely abolished in the presence of the GLUT2 inhibitors phloretin or cytochalasin B. Given that GLUT2 modified gut peptide secretion stimulated by glucose, we investigated whether it was involved in the secretion of gut peptide by other gut peptide secretagogues. Phloretin completely abolished gut peptide secretion stimulated by artificial sweetener (sucralose), dipeptide (glycylsarcosine), lipid (oleoylethanolamine), short chain fatty acid (propionate) and major rat bile acid (taurocholate) indicating a fundamental position for GLUT2 in the gut peptide secretory mechanism. We investigated how GLUT2 was able to influence gut peptide secretion mediated by a diverse range of stimulators and discovered that GLUT2 affected membrane depolarisation through the closure of K+(ATP)-sensitive channels. In the absence of SGLT1 activity (or presence of phloridzin), the secretion of GIP, GLP-1 and PYY was sensitive to K+(ATP)-sensitive channel modulators tolbutamide and diazoxide. L-amino acids phenylalanine (Phe), tryptophan (Trp), asparagine (Asn), arginine (Arg) and glutamine (Gln) also stimulated GIP, GLP-1 and

  9. Conditionally immortalized human proximal tubular epithelial cells isolated from the urine of a healthy subject express functional calcium-sensing receptor.

    Science.gov (United States)

    Di Mise, Annarita; Tamma, Grazia; Ranieri, Marianna; Svelto, Maria; Heuvel, Bert van den; Levtchenko, Elena N; Valenti, Giovanna

    2015-06-01

    The calcium-sensing receptor (CaSR) is a G protein-coupled receptor, which plays an essential role in regulating Ca(2+) homeostasis. Here we show that conditionally immortalized proximal tubular epithelial cell line (ciPTEC) obtained by immortalizing and subcloning cells exfoliated in the urine of a healthy subject expresses functional endogenous CaSR. Immunolocalization studies of polarized ciPTEC revealed the apical localization of the receptor. By Western blotting of ciPTEC lysates, both monomeric and dimeric forms of CaSR at 130 and ∼250 kDa, respectively, were detected. Functional studies indicated that both external calcium and the positive CaSR allosteric modulator, NPS-R568, induced a significant increase in cytosolic calcium, proving a high sensitivity of the endogenous receptor to its agonists. Calcium depletion from the endoplasmic reticulum using cyclopiazonic acid abolished the increase in cytosolic calcium elicited by NPS-R568, confirming calcium exit from intracellular stores. Activation of CaSR by NPS-R significantly reduced the increase in cAMP elicited by forskolin (FK), a direct activator of adenylate cyclase, further confirming the functional expression of the receptor in this cell line. CaSR expressed in ciPTEC was found to interact with Gq as a downstream effector, which in turn can cause release of calcium from intracellular stores via phospholipase C activation. We conclude that human proximal tubular ciPTEC express functional CaSR and respond to its activation with a release of calcium from intracellular stores. These cell lines represent a valuable tool for research into the disorder associated with gain or loss of function of the CaSR by producing cell lines from patients. Copyright © 2015 the American Physiological Society.

  10. Longitudinal Muscle Dysfunction in Achalasia Esophagus and Its Relevance

    OpenAIRE

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

    2013-01-01

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

  11. Multiphoton microscopic imaging of esophagus during the early phase of tumor progression.

    Science.gov (United States)

    Xu, Jian; Kang, Deyong; Xu, Meifang; Zhuo, Shuangmu; Zhu, Xiaoqin; Chen, Jianxin

    2013-01-01

    Esophageal cancer is one of the most common cancer and leading cause of cancer death worldwide. Multiphoton microscopy (MPM) has become a novel optical tool of choice for imaging tissue architecture and cellular morphology based on two-photon excited fluorescence and second harmonic generation. In this study, we used MPM to image microstructure of human normal esophagus, carcinoma in situ, and early invasive carcinoma in order to investigate the morphological change of tissue structure during the early phase of tumor progression. The diagnostic features such as the appearance of cancerous cells, the absence of the basement membrane were extracted to distinguish between normal and cancerous esophagus tissue. The infiltration depth during tumor progression was determined by the appearance of cancerous cells. The significant change of layer structure between cancerous tissue and normal esophagus was described. We also quantitatively described the differences of morphology between normal and cancerous cells. These results correlated well with the corresponding histological findings. With the advancement of clinically miniaturized MPM and the multi-photon probe, combining MPM with standard endoscopy will therefore allow us to make a real-time in vivo diagnosis of early esophageal cancer at the cellular level. © Wiley Periodicals, Inc.

  12. Response of the canine esophagus to irradiation.

    Science.gov (United States)

    Gillette, S M; Poulson, J M; Deschesne, K M; Chaney, E L; Gillette, E L

    1998-09-01

    One hundred twenty-eight beagle dogs were randomized to receive thoracic irradiation with doses between 0 and 72 Gy in 1.5-Gy fractions over 6 weeks. Dogs were randomized to have either 33, 67 or 100% of their lung volume irradiated. The entire thoracic portion of the esophagus and variable portions of the fundus of the stomach were included in the treatment field at all volumes. Sixteen of the 128 dogs entered in the study developed clinical signs of esophagitis. These 16 dogs received doses between 45 and 72 Gy. Clinical signs of esophagitis/gastritis included dysphagia, anorexia, emesis, excessive salivation and weight loss that required force-feeding of a liquid diet. An ED50 of 67.2 Gy (95% CI 61.45-79.7 Gy) was calculated for the occurrence of clinical signs that required some supportive treatment. Three of the 16 dogs receiving 63 or 72 Gy failed to respond to treatment and were euthanized. Twenty-five other dogs were euthanized prior to 2 years due to other treatment-related complications. Two dogs died of causes not related to treatment. No late esophageal complications were observed in the remaining 98 dogs out to 2 years after irradiation. Esophageal specimens from 79 dogs were available for quantitative histological analysis 2 years after irradiation. Histological analysis showed a decrease in the percentage of glandular tissue with a corresponding increase in lamina propria and muscle.

  13. Cancer of the esophagus and asbestos exposure.

    Science.gov (United States)

    Clin, Bénédicte; Thaon, Isabelle; Boulanger, Mathilde; Brochard, Patrick; Chamming's, Soizick; Gislard, Antoine; Lacourt, Aude; Luc, Amandine; Ogier, Guy; Paris, Christophe; Pairon, Jean-Claude

    2017-09-07

    Our study aimed at analyzing incidence and mortality from esophageal cancer within a cohort of workers with previous occupational asbestos exposure (ARDCo Program). A 10-year follow-up study was conducted in the 14 515 male subjects included in this program between October 2003 and December 2005. Follow-up began when exposure stopped. Asbestos exposure was analyzed by industrial hygienists using data from a standardized questionnaire. The Cox model was used, with age as the time axis variable adjusted for smoking, time since first exposure (TSFE) and cumulative exposure index (CEI) of exposure to asbestos. We reported a significant dose-response relationship between CEI of exposure to asbestos and esophageal cancer, in both incidence (hazard ratio [HR] 1.26, 95% confidence interval [CI] 1.00-1.58), and mortality (HR 1.40, [95%CI 1.12-1.75]). This large-scale study suggests the existence of a relationship between asbestos exposure and cancer of the esophagus. © 2017 Wiley Periodicals, Inc.

  14. Bacterial biota in reflux esophagitis and Barrett's esophagus

    Institute of Scientific and Technical Information of China (English)

    Zhiheng Pei; Liying Yang; Richard M Peek; Jr Steven M Levine; David T Pride; Martin J Blaser

    2005-01-01

    AIM: To identify the bacterial flora in conditions such as Barrett's esophagus and reflux esophagitis to determine if they are similar to normal esophageal flora.METHODS: Using broad-range 16S rDNA PCR,esophageal biopsies were examined from 24 patients [9with normal esophageal mucosa, 12 with gastroesophageal reflux disease (GERD), and 3 with Barrett's esophagus].Two separate broad-range PCR reactions were performed for each patient, and the resulting products were cloned.In one patient with Barrett's esophagus, g9 PCR clones were analyzed.RESULTS: Two separate clones were recovered from each patient (total = 48), representing 24 different species, with 14 species homologous to known bacteria,5 homologous to unidentified bacteria, and 5 were not homologous (<97% identity) to any known bacterial 16S rDNA sequences. Seventeen species were found in the reflux esophagitis patients, 5 in the Barrett's esophagus patients, and 10 in normal esophagus patients.Further analysis concentrating on a single biopsy from an individual with Barrett's esophagus revealed the presence of 21. distinct bacterial species. Members of four phyla were represented, including Bacteroidetes,Firmicutes, Proteobacteria, and Actinobacteria.Microscopic examination of each biopsy demonstrated bacteria in intimate association with the distal esophageal epithelium, suggesting that the presence of these bacteria is not transitory.CONCLUSION: These findings provide evidence for a complex, residential bacterial population in esophageal reflux-related disorders. While much of this biota is present in the normal esophagus, more detailed comparisons may help identify potential disease associations.

  15. Involvement of the calcium-sensing receptor in human taste perception.

    Science.gov (United States)

    Ohsu, Takeaki; Amino, Yusuke; Nagasaki, Hiroaki; Yamanaka, Tomohiko; Takeshita, Sen; Hatanaka, Toshihiro; Maruyama, Yutaka; Miyamura, Naohiro; Eto, Yuzuru

    2010-01-08

    By human sensory analyses, we found that various extracellular calcium-sensing receptor (CaSR) agonists enhance sweet, salty, and umami tastes, although they have no taste themselves. These characteristics are known as "kokumi taste" and often appear in traditional Japanese cuisine. Although GSH is a typical kokumi taste substance (taste enhancer), its mode of action is poorly understood. Here, we demonstrate how the kokumi taste is enhanced by the CaSR, a close relative of the class C G-protein-coupled receptors T1R1, T1R2, and T1R3 (sweet and umami receptors). We identified a large number of CaSR agonist gamma-glutamyl peptides, including GSH (gamma-Glu-Cys-Gly) and gamma-Glu-Val-Gly, and showed that these peptides elicit the kokumi taste. Further analyses revealed that some known CaSR agonists such as Ca(2+), protamine, polylysine, L-histidine, and cinacalcet (a calcium-mimetic drug) also elicit the kokumi taste and that the CaSR-specific antagonist, NPS-2143, significantly suppresses the kokumi taste. This is the first report indicating a distinct function of the CaSR in human taste perception.

  16. Spontaneous rupture of the esophagus: report of two cases

    Directory of Open Access Journals (Sweden)

    Ali Said Esgaib

    Full Text Available OBJECTIVE - To study the diagnosis, prognosis and management of spontaneous rupture of the esophagus. DESIGN: This is a retrospective study through the analysis of two cases with delayed diagnosis and subsequent treatment at the Track Surgery Service. LOCALE: The study was performed at the Thoracic Surgery Unit of the Hospital do Servidor Público Estadual Francisco Morato de Oliveira in the city of São Paulo. This is a specialized service. PARTICIPANTS: The two patients reported on had suffered spontaneous rupture of the esophagus. They were transferred to the Thoracic Surgery Unit because of the worsening of their condition in the previous institution which they had been admitted into. MEASUREMENT: The two patients with esophagus pleural fistula received similar treatment, initially advocated by Kanashin in Russia and Hauer-Santos in the United States, which consists of washing the fistula and using continuous pleural aspiration. RESULTS: Although both patients had to spend a long period of time in hospital, their evolution was satisfactory with the treatment adopted, and the fistula closed. CONCLUSION: The authors conclude that the method of lavage of the mediastinum and continuous pleural aspiration, in patients who after spontaneous rupture of the esophagus developed a pleural esophagus fistula due to belated diagnosis, is an alternative and satisfactory therapy. Furthermore, in order to have the best outcome, an early diagnosis is recommended and thoracostomy as the surgical procedure, with primary suture.

  17. Barrett's esophagus and its correlation with gastroesophageal reflux in Chinese

    Institute of Scientific and Technical Information of China (English)

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

    2004-01-01

    AIM: To study the prevalence of Barrett's esophagus in Chinese and its correlation with gastroesophageal reflux.METHODS: This study was carried out in a large prospective series of 391 patients who had undergone upper endoscopy.The patients were divided into 3 groups according to the position of squamocolumnar junction (SCJ). Reflux esophagitis (RE) and its degree were recorded. Intestinal metaplasia (IlMl) in biopsy specimen was typed according to histochemistry and HE and alcian blue (pH2.5) staining separately. Results correlating with clinical, endoscopic, and pathological data were analysed.RESULTS: The prevalence of IM endoscopically appearing Long-segment Barrett's Esophagus (LSBE) was 26.53%,Short-segment Barrett's Esophagus (SSBE) was 33.85% and gastroesophageal junction (GFJ) was 34.00% . IM increased with age of above 40 years old and no difference was found between male and female. Twelve were diagnosed as dysplasia (7 low -grade, 5 high-grade), 16 were diagnosed as cardiac adenocarcinoma and 1 as esophageal adenocarcinoma. The more far away the SCJ moved upward above GFJ, the higher the prevalence and the more severe the RE were.CONCLUSION: There was no difference of the prevalence of IM in different places of SCJ, and IM increased with age of above 40 years old. It is important to pay attention to dysplasia in the distal esophagus and gastro-esophageal junction, and adenocarcinoma is more common in cardia than in esophagus. BE is a consequence of gastroesophageal reflux disease.

  18. Tracing thermal aquifers of El Chichón volcano-hydrothermal system (México) with 87Sr/ 86Sr, Ca/Sr and REE

    Science.gov (United States)

    Peiffer, L.; Taran, Y. A.; Lounejeva, E.; Solís-Pichardo, G.; Rouwet, D.; Bernard-Romero, R. A.

    2011-08-01

    The volcano-hydrothermal system of El Chichón volcano, Chiapas, Mexico, is characterized by numerous thermal manifestations including an acid lake, steam vents and boiling springs in the crater and acid and neutral hot springs and steaming ground on the flanks. Previous research on major element chemistry reveals that thermal waters of El Chichón can be divided in two groups: (1) neutral waters discharging in the crater and southern slopes of the volcano with chloride content ranging from 1500 to 2200 mg/l and (2) acid-to-neutral waters with Cl up to 12,000 mg/l discharging at the western slopes. Our work supports the concept that each group of waters is derived from a separate aquifer (Aq. 1 and Aq. 2). In this study we apply Sr isotopes, Ca/Sr ratios and REE abundances along with the major and trace element water chemistry in order to discriminate and characterize these two aquifers. Waters derived from Aq. 1 are characterized by 87Sr/ 86Sr ratios ranging from 0.70407 to 0.70419, while Sr concentrations range from 0.1 to 4 mg/l and Ca/Sr weight ratios from 90 to 180, close to average values for the erupted rocks. Waters derived from Aq. 2 have 87Sr/ 86Sr between 0.70531 and 0.70542, high Sr concentrations up to 80 mg/l, and Ca/Sr ratio of 17-28. Aquifer 1 is most probably shallow, composed of volcanic rocks and situated beneath the crater, within the volcano edifice. Aquifer 2 may be situated at greater depth in sedimentary rocks and by some way connected to the regional oil-gas field brines. The relative water output (l/s) from both aquifers can be estimated as Aq. 1/Aq. 2-30. Both aquifers are not distinguishable by their REE patterns. The total concentration of REE, however, strongly depends on the acidity. All neutral waters including high-salinity waters from Aq. 2 have very low total REE concentrations (hydrothermal vapors, REE distribution in thermal waters reflects the dissolution of volcanic rocks close to the surface or lake sediments as is the case

  19. Primary malignant melanoma of esophagus at esophagogastric junction: case report

    Institute of Scientific and Technical Information of China (English)

    高玉平; 朱建善; 林维; 郑文钧

    2003-01-01

    @@ Primary malignant melanoma of the esophagus is a rare tumor that accounts for only 0.1% of primary esophageal neoplasms.1 Although it was once thought that primary melanoma could not arise in the esophagus because of the lack of precursor cells, it has since been shown in autopsy series that 4%-8% of individuals have melanoblasts in the esophageal mucosa.2 To date, approximately 200 cases of primary esophageal malignant melanoma have been reported in global literatures while less than 20 cases of primary esophageal malignant melanoma have been reported in China.2-4 In this report we present a case of primary malignant melanoma of the esophagus in a Chinese man.

  20. Outcome of Surgical Treatment of Primary Adenocarcinoma of Esophagus

    Institute of Scientific and Technical Information of China (English)

    ZHAO Jinming; YUAN Heping; LIU Fucai; ZHANG Ming; CHEN Xiaodong

    2004-01-01

    Objective The incidence of primaryad enocarcinoma of esophagus is much lower than the of squamous carcinoma in China. The aim of this study was to evaluate the clinical characteristics of primary ad enocarcinoma of esophagus.Methods All patients in this group un derwent esophagectomy.The clinicopathologic characteristics of twenty eight cases of primary adenocarcinoma of esophagus were retrospectively studied and compar ed with 1224 cases of squamous carcinoma who underwent operation in the same per iod.Included in this group were 1224 cases of squamous carcinoma,16 cases of ade nocarcinoma,10 cases of adenoacanthomas and adenosquamous carcinoma and 2 adenoid cystic carcinoma.Results The resectability was 100%,the opera tive mortality was 3.6%,the incidence of complication was 25.9%.The 1-,3-,5-year survival rates were 77.8%,48.1% and 29.6% respectively.Six of them survived over 10 years.According to international TNM staging system (1987),the 5-year survi vals of stage Ⅱ and stage Ⅲ~Ⅳ were 46.7% and 8.3% respectively while in 1224 cases of squamous carcinoma of esophagus underwent operation in the same period it was 44.4% and 10.35.There is no significant difference between them. Conclusion Primary adenocarcinoma of esophagus could get the same resul ts as that of squamous carcinoma of esophagus.The main factors that influence the curative effect were the depth of infiltration,the presence of lymph node metastasis,the TNM stage and the histological classification and degree of differenc tiation of tumor.

  1. Insights into esophagus tissue architecture using two-photon confocal microscopy

    Science.gov (United States)

    Liu, Nenrong; Wang, Yue; Feng, Shangyuan; Chen, Rong

    2013-08-01

    In this paper, microstructures of human esophageal mucosa were evaluated using the two-photon laser scanning confocal microscopy (TPLSCM), based on two-photon excited fluorescence (TPEF) and second harmonic generation (SHG). The distribution of epithelial cells, muscle fibers of muscularis mucosae has been distinctly obtained. Furthermore, esophageal submucosa characteristics with cancer cells invading into were detected. The variation of collagen, elastin and cancer cells is very relevant to the pathology in esophagus, especially early esophageal cancer. Our experimental results indicate that the MPM technique has the much more advantages for label-free imaging, and has the potential application in vivo in the clinical diagnosis and monitoring of early esophageal cancer.

  2. Oxygen desorption from YBa2Cu3O(7-x) and Bi2CaSr2Cu2O(8 + delta) superconductors

    Science.gov (United States)

    Mesarwi, A.; Levenson, L. L.; Ignatiev, A.

    1991-01-01

    Oxygen desorption experiments from YBa2Cu3O(7-x) (YBCO) and Bi2CaSr2Cu2O(8 + delta) (BSCCO) superconductors were carried out using a quadrupole mass spectrometer for monitoring the desorbing species and X-ray photoemission spectroscopy for surface characterization. Molecular oxygen was found to desorb from both superconductors following photoirradiation with ultraviolet/optical radiation and subsequent heating at over 150 C. Both YBCO and BSCCO were found to have similar oxygen desorption rates and similar activation energies. The desorption data as well as the X-ray photoemission data indicate that the oxygen desorption is not intrinsic to the superconductors but rather due to molecular oxygen entrapped in the material.

  3. The van der Waals potentials of MgCa, MgSr, MgBa, CaSr, CaBa, and SrBa

    Science.gov (United States)

    Wei, L. M.; Li, P.; Tang, K. T.

    2015-08-01

    Based on the facts that the potential energy curves of the homo-nuclear group 2 dimers (group IIA metal), except Be2, are conformal, and they can be described by the Tang-Toennies potential model, a set of simple combining rules are proposed for the parameters of the reduced potentials of the hetero-nuclear dimers. Together with the well-established combining rules of the range parameters of the exponential repulsion and the known dispersion coefficients, these rules enable us to determine the ground state potential energy curves of MgCa, MgSr, MgBa, CaSr, CaBa, and SrBa from those of Mg2, Ca2, Sr2, and Ba2. The determined potentials are comparable to some ab initio calculations and in excellent agreement with the experiment.

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

    Directory of Open Access Journals (Sweden)

    LUCKY OBUKOWHO ONOTAI

    2015-07-01

    Full Text Available Foreign body (FB ingestion is common in clinical practice especially in children. Its impaction in the esophagus constitutes an important cause of morbidity and mortality in our environment. Due to technological advancement and increase use of disk batteries to power children toys and remote control gadgets, ingestion of disk batteries is now commonplace. In our environment there is paucity of information on disk batteries hence we decided to present case series of disk batteries in the esophagus of children highlighting the peculiarities of disk batteries, the dangers posed by them, the mode of retrieval, complications encountered, and possible recommendations to curtail the increasing occurrence.

  5. Jackhammer esophagus treated by a peroral endoscopic myotomy.

    Science.gov (United States)

    Ko, Weon Jin; Lee, Byoung Moo; Park, Won Young; Kim, Jin Nyoung; Cho, Jun Hyung; Lee, Tae Hee; Hong, Su Jin; Cho, Joo Young

    2014-12-01

    A 49-year-old woman visited our hospital with dysphagia and chest pain. In another hospital, she was diagnosed as reflux esophagitis. Although she had taken proton pump inhibitor and prokinetics drugs for a long time, she was not relieved of any symptoms. On the basis of high resolution manometry and endoscopic ultrasonography findings, Jackhammer esophagus was diagnosed. In this patient, peroral endoscopic myotomy (POEM) was performed for long myotomy of thickened circular muscle. During the procedure, there were no significant complications and she was discharged uneventfully. Symptoms were completely improved during three months after POEM. Here, we report on a case of Jackhammer esophagus treated by POEM.

  6. Barrett's Esophagus Translational Research Network (BETRNet) | Division of Cancer Prevention

    Science.gov (United States)

    The goal of BETRNet is to reduce the incidence, morbidity, and mortality of esophageal adenocarcinoma by answering key questions related to the progression of the disease, especially in the premalignant stage. In partnership with NCI’s Division of Cancer Biology, multidisciplinary translational research centers collaborate to better understand the biology of Barrett's esophagus and esophageal adenocarcinoma to improve risk stratification and develop prevention strategies.  | Multi-disciplinary, multi-institutional collaboration to enhance understanding of Barrett's esophagus and to prevent esophageal adenocarcinoma.

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

    DEFF Research Database (Denmark)

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

    2012-01-01

    Barrett's Esophagus (BE) is a premalignant condition in the esophagus. Esophageal adenocarcinomas have the fastest increase of incidence of all solid tumors in the western world. BE is defined as areas with macroscopic visible columnar epithelium and intestinal metaplasia oral of the anatomical...... and it is not recommended outside controlled studies. Treatment of high grade dysplasia and carcinoma in situ is handled in departments treating esophageal cancer. Follow-up with endoscopy and biopsy can be offered. Follow-up endoscopy with biopsy can only be recommended after thorough information to the patients...

  8. Endoscopic diagnosis and therapies for Barrett esophagus: a review

    Directory of Open Access Journals (Sweden)

    Irving Waxman

    2014-02-01

    Full Text Available Barrett's esophagus is an area of great interest in Gastroenterology, with an increasing number of research studies being published in recent years and decades. Due to the fast growing evidence regarding this disease, it has become extremely difficult to keep updated on this subject. The present review article aims to summarize and update what is known regarding diagnosis and therapy in Barrett's esophagus. A critical and detailed review is made and the role of surveillance for this condition, techniques available for diagnosis (standard white light endoscopy, virtual chromoendoscopy, magnification... and treatment (mucosectomy, ablation... are presented. New and emerging technologies are described in detail and existing evidence is presented.

  9. Aggressive Adenocarcinoma of the Cervical Esophagus: Importance of a Multidisciplinary Approach

    Science.gov (United States)

    Fashoyin, Adedayo; Hartig, Gregory; Schelman, William R.; Ritter, Mark; Agni, Rashmi; Gopal, Deepak V.; Pfau, Patrick R.; Weiss, Jennifer M.

    2012-01-01

    Adenocarcinoma of the cervical esophagus is a rare tumor, in comparison to adenocarcinoma of the distal esophagus which is on the rise and is often associated with Barrett's esophagus. We present a case of aggressive cervical esophageal adenocarcinoma in a 46-year-old female with no endoscopic or histopathologic evidence of Barrett's esophagus. We discuss the possible etiology of this tumor and review the treatment options, highlighting the importance of a multidisciplinary approach to the management of this rare disease. PMID:23304576

  10. Clinical and histopathological features and relationship of Barrett esophagus and its related adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    陈慧

    2014-01-01

    Objective To explore the clinical and histopathological features of Barrett esophagus and its related adenocarcinoma as well as the relationship between them.Methods From ajanuary 2002 to January 2012,the clinical data of 35 patients with Barrett esophagus,850 patients with esophagus cancer and 218 patients with esophageal-gastric junction cancer were collected,and the histopathological features of all the patients and the followup in patients with Barrett esophagus were retrospectively

  11. Comparisons of endoscopic and pathological characteristics between long and short segment Barrett’s esophagus

    Institute of Scientific and Technical Information of China (English)

    周晶

    2006-01-01

    Objective To investigate the similarities and differences of endoscopic and pathological charaeteristics between long and short segment Barrett’ s esophagus. Methods One hundred and twenty-eight cases of Barrett’s esophagus identified both by endoscopy and pathology were enrolled in this retrospective study. Among them, 40 cases were long segment Barrett’s esophagus

  12. File list: NoD.Dig.20.AllAg.Esophagus [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available NoD.Dig.20.AllAg.Esophagus hg19 No description Digestive tract Esophagus SRX190764,...0 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/NoD.Dig.20.AllAg.Esophagus.bed ...

  13. File list: NoD.Dig.10.AllAg.Esophagus [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  14. File list: NoD.Dig.05.AllAg.Esophagus [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available NoD.Dig.05.AllAg.Esophagus hg19 No description Digestive tract Esophagus SRX134731,...5 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/NoD.Dig.05.AllAg.Esophagus.bed ...

  15. File list: NoD.Dig.50.AllAg.Esophagus [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available NoD.Dig.50.AllAg.Esophagus hg19 No description Digestive tract Esophagus SRX190764,...0 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/NoD.Dig.50.AllAg.Esophagus.bed ...

  16. Black esophagus (acute esophageal necrosis) after spinal anesthesia.

    Science.gov (United States)

    Román Fernández, A; López Álvarez, A; Fossati Puertas, S; Areán González, I; Varela García, O; Viaño López, P M

    2014-01-01

    Acute esophagic necrosis or black esophagus is an uncommon clinical entity that owes its name to the endoscopic view of the necrotic esophageal mucosa. It is always related with a critical medical condition and usually has an ischemic etiology. We report the first case of acute esophageal necrosis after a spinal anesthetic for partial hip joint arthroplasty. We discuss the underlying pathophysiological mechanisms.

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

    Directory of Open Access Journals (Sweden)

    Engy Yousry El Sayed

    2014-12-01

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

  18. Intramural hematoma of the esophagus : Appearance on magnetic resonance imaging

    NARCIS (Netherlands)

    Kamphuis, AGA; Baur, CHJCM; Freling, NJM

    1995-01-01

    A 73-yr-old woman on anticoagulant therapy experienced progressive dyspnea and dysphagia due to a large compressing mass in the posterior mediastinum. Because her clinical condition deteriorated rapidly surgery was performed. A large intramural hematoma along the full length of the esophagus with di

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1986-08-01

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

  20. [FUNCTIONING PROTEASES IN THE ESOPHAGUS MUCOSA AFTER CHEMICAL BURNS].

    Science.gov (United States)

    Ishchuk, T V; Savchuk, O M; Raetska, Ya B; Vereschaka, V V; Ostapchenko, L I

    2015-01-01

    The main result of esophagus burn is the formation of scars, that caused by excessive synthesis of collagen and changes the balance of metalloproteinases and their tissue inhibitors. It was studied the activity of proteolytic enzymes, participation of MMP (metalloproteinase) and their tissue inhibitors (TIMP) in alkali burns of the esophagus 1st and 2nd degrees. We have shown a significant increase of TIMP level in homogenate after alkali burns of the esophagus (an average of 31-56% depend on of burn degree). We observed a reduced activity of serine proteinase after 1st degree burns on 15th, 21st day 35 and 18% respectively, after burns 2nd degree on 15th, 21st day 54 and 50%. The decrease of activity MMP after 1st degree burns on 15th and 21st day 30, 19%, respectively, in conditions of chemical burns 2nd degree on 15th and 21st day 30, 37%. These data may indicate the development of scarring after burn simulation of 2nd degree. Further investigation of the MMP and TIMP in the process of wound healing can be useful in creating effective approaches to prevent formation of post scarring of the esophagus.

  1. What Happens After Treatment for Cancer of the Esophagus?

    Science.gov (United States)

    ... www.nccn.org/professionals/physician_gls/pdf/esophageal.pdf on May 6, 2017. Posner MC, Minsky B, Ilson DH. Ch 45 - Cancer of the esophagus. In: DeVita VT, Hellman S, Rosenberg SA, eds. DeVita, Hellman, and ...

  2. Current status of surgery for benign disorders of the esophagus

    NARCIS (Netherlands)

    Draaisma, Werner Adriaan

    2006-01-01

    This thesis aimed at exploring new techniques for the surgical treatment of benign disorders of the esophagus. Specifically, studies were performed on surgery for gastroesophageal reflux disease and large (type II-IV) hiatal hernia. The chapters presented in this thesis involve studies that have bee

  3. Prognostic factors in adenocarcinoma of the esophagus or gastroesophageal junction

    NARCIS (Netherlands)

    S.M. Lagarde; F.W. ten Kate; J.B. Reitsma; O.R.C. Busch; J.J.B. van Lanschot

    2006-01-01

    The incidence of adenocarcinoma of the esophagus is rising rapidly in Western Europe and North America. It is an aggressive disease with early lymphatic and hematogenous dissemination. TNM cancer staging systems predict survival on the basis of the anatomic extent of the tumor. However, the adequacy

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

    Directory of Open Access Journals (Sweden)

    Efiaty A. Soepardi

    2005-03-01

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

  5. Calcium sensing receptor suppresses human pancreatic tumorigenesis through a novel NCX1/Ca(2+)/β-catenin signaling pathway.

    Science.gov (United States)

    Tang, Bo; Chow, Jimmy Y C; Dong, Tobias Xiao; Yang, Shi-Ming; Lu, De-Sheng; Carethers, John M; Dong, Hui

    2016-07-10

    The calcium sensing receptor (CaSR) is functionally expressed in normal human pancreases, but its pathological role in pancreatic tumorigenesis is currently unknown. We sought to investigate the role of CaSR in pancreatic cancer (PC) and the underlying molecular mechanisms. We revealed that the expression of CaSR was consistently downregulated in the primary cancer tissues from PC patients, which was correlated with tumor size, differentiation and poor survival of the patients. CaSR activation markedly suppressed pancreatic tumorigenesis in vitro and in vivo likely through the Ca(2+) entry mode of Na(+)/Ca(2+) exchanger 1 (NCX1) to induce Ca(2+) entry into PC cells. Moreover, NCX1-mediated Ca(2+) entry resulted in Ca(2+)-dependent inhibition of β-catenin signaling in PC cells, eventually leading to the inhibition of pancreatic tumorigenesis. Collectively, we demonstrate for the first time that CaSR exerts a suppressive function in pancreatic tumorigenesis through a novel NCX1/Ca(2+)/β-catenin signaling pathway. Targeting this specific signaling pathway could be a potential therapeutic strategy for PC.

  6. Barrett's esophagus in a child with de Lange syndrome: report of one case.

    Science.gov (United States)

    Pei, R S; Lin, C C; Mak, S C; Chi, C S; Chou, G

    2000-01-01

    Barrett's esophagus, a premalignant condition, is recognized as stratified squamous epithelium of the esophagus substituted by columnar epithelium. The risk factors for development of Barrett's esophagus include frequent gastroesophageal reflux, esophageal stricture, male sex and mental retardation, but there is no report of Barrett's esophagus in children with de Lange syndrome. We report a 7-year-old boy who was diagnosed as de Lange syndrome shortly after birth and had gastroesophageal reflux since early infancy. Upper gastrointestinal endoscopic examination revealed a cauliflower-like mass and a pink-red velvety mass over the lower third of the esophagus. Biopsy showed goblet cells metaplasia, confirming Barrett's esophagus. We suggest surveillance of Barrett's esophagus could be done ahead of schedule in children with long-standing gastroesophageal reflux or with de Lange syndrome.

  7. Efficacité du traitement par calcimimétiques dans l'hyperparathyroïdie néonatale sévère, associée à des mutations du calcium sensing receptor (CaSR)

    OpenAIRE

    Wilhelm-Bals, Alexandra Marina

    2013-01-01

    L'Hyperparathyroïdie néonatale sévère (NPHT) est associée à des mutations homozygotes inactivatrices du récepteur du calcium (CaSR). Le CaSR est exprimé majoritairement dans les glandes parathyroïdes et les reins où il régule l'homéostasie du calcium en modulant la sécrétion de PTH et la réabsorption rénale du calcium. L'NPHT se présente avec une hypercalcémie sévère mettant en jeu le pronostic vital. La chirurgie est le traitement de choix. Les bisphosphonates offrent une bonne alternative d...

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

    Energy Technology Data Exchange (ETDEWEB)

    Lamart, Stephanie, E-mail: stephanie.lamart@nih.gov [Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland (United States); Stovall, Marilyn [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Simon, Steven L. [Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland (United States); Smith, Susan A.; Weathers, Rita E.; Howell, Rebecca M. [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Curtis, Rochelle E. [Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland (United States); Aleman, Berthe M.P. [Department of Radiotherapy, The Netherlands Cancer Institute, Amsterdam (Netherlands); Travis, Lois [Rubin Center for Cancer Survivorship and Department of Radiation Oncology, University of Rochester Medical Center, Rochester, New York (United States); Kwon, Deukwoo [Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida (United States); Morton, Lindsay M. [Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland (United States)

    2013-07-15

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

  9. Experimental reconstruction of cervical esophageal defect with artificial esophagus made of polyurethane in a dog model.

    Science.gov (United States)

    Jiang, H; Cui, Y; Ma, K; Gong, M; Chang, D; Wang, T

    2016-01-01

    The defect of esophagus after surgical excision in patients is usually replaced by autologous stomach, jejunum, or colon. The operation brings severe trauma and complications. Using artificial esophagus to replace the defect in situ can reduce the operative trauma, simplify the operative procedures, and decrease the influence to digestive function. A variety of experiments have been designed for developing a practical artificial esophagus. Nevertheless, a safe and reliable artificial esophagus is not yet available. The objective is to evaluate the possibility of the artificial esophagus made of non-degradable polyurethane materials being used in reconstruction of the segmental defect of cervical esophagus in beagles, observe the regeneration of esophageal tissue, and gather experience for future study. The cervical esophageal defects in 13 beagles were designed to 2-cm long and were constructed by the artificial esophagus made of non-degradable polyurethane materials. Nutrition supports were given after the operation. The operative mortality, anastomotic leakage, migration of artificial esophagus, and dysphagia were followed up. The regeneration of the esophageal tissues was evaluated by histopathology and immunohistochemical labeled streptavidin-biotin method. The surgical procedures were successfully completed in all beagles, and 12-month follow-ups were done. Only one beagle died of severe infection, and all others survived until being killed. The anastomotic leakage occurred in nine beagles, most of them (8/9) were cured after supportive therapy. The migration of artificial esophagus occurred in all 12 surviving beagles, and one artificial esophagus stayed in situ after migration. All 12 surviving beagles showed dysphagia with taking only fluid or soft food. No beagle died of malnutrition. The neo-esophagus was composed of granulation tissue, and the inner surface was covered by epithelium in 2-3 months completely. But the inner surface of neo-esophagus with

  10. Prolonged Impacted Denture in the Esophagus: A Case Report and

    Directory of Open Access Journals (Sweden)

    Gulzar Ahmad Dar

    2015-01-01

    Full Text Available Foreign body ingestion and aspiration is among the most common causes of emergency department visit associated with high morbidity and mortality. Ingested and aspirated denture is rare conditions being scarcely reported in the literature. We herein report a 57-year-old man who presented with 2-day history of liquid and solid dysphagia who was diagnosed to have impacted denture in esophagus since 3 years prior to presentation. He was diagnosed to have esophagus adenocarcinoma and had undergone esophageal radiotherapy. The denture was removed successfully using esophagoscopy and the patient was discharged after 48-hour care with good condition. To prevent accidental ingestion, dentures should be made to fit properly. Damaged or malfitting dentures should be discarded and replaced. Patients should be strongly advised against wearing them during sleep-time.

  11. Verrucous Squamous Cell Cancer in the Esophagus: An Obscure Diagnosis.

    Science.gov (United States)

    Egeland, Charlotte; Achiam, Michael P; Federspiel, Birgitte; Svendsen, Lars Bo

    2016-01-01

    Verrucous carcinoma is a rare, slow-growing type of squamous cell cancer. Fewer than 50 patients with verrucous carcinoma in the esophagus have been described worldwide. In 2014, two male patients were diagnosed with verrucous carcinoma in the distal part of the esophagus. The endoscopic examinations showed a similar wart-like, white, irregular mucosa in both cases. The diagnosis was difficult to make since all biopsies taken from the affected area showed no malignancy. This cancer type has a relatively good prognosis when the diagnosis is finally obtained. Both our patients presented with dysphagia, weight loss, and an endoscopically malignant tumor, but surgery was not performed until after 9 and 10 months, respectively, and then in order to get a diagnosis. At the last follow-up, both patients were without any recurrence of the disease.

  12. Extraosseous Osteosarcoma of the Esophagus: A Case Report

    Directory of Open Access Journals (Sweden)

    Rodney E. Wegner

    2010-01-01

    Full Text Available Extraosseous osteosarcoma (EOO is a malignant mesenchymal neoplasm that is located in the soft tissues without direct attachment to the skeletal system and that produces osteoid, bone, or chondroid material. EOO is an extremely rare disease, accounting for only 1% of soft tissue sarcomas, and typically presents in either an extremity or the retroperitoneum. This paper presents the case of a 45-year-old Caucasian male with extraosseous osteosarcoma of the esophagus.

  13. Update on management of Barrett’s esophagus

    Institute of Scientific and Technical Information of China (English)

    Fernando Macías-García; J Enrique Domínguez-Mu?oz

    2016-01-01

    Barrett’s esophagus(BE)is a common condition thatdevelops as a consequence of gastroesophageal reflux disease.The significance of Barrett’s metaplasia is that predisposes to cancer development.This article provides a current evidence-based review for the management of BE and related early neoplasia.Controversial issues that impact the management of patients with BE,including definition,screening,clinical aspects,diagnosis,surveillance,and management of dysplasia and early cancer have been assessed.

  14. Clinicopathologic Observations on Small Cell Carcinoma of the Esophagus

    Institute of Scientific and Technical Information of China (English)

    XiaolingWang; ShuongLiu; GuoxiangWu; XionliMeng; MingGuo; HuichaiYang

    2004-01-01

    OBJECTIVE To investigate the histogenesis and biological characteristics and factors influencing prognosis of small cell carcinoma of the esophagus(ESCC).METHODS The expression of CK, NSE, Syn, CHr-A and CD56 proteins were detected immunohistochemically in 63 cases of small cell carcinoma of the esophagus.RESULTS The ESCC cases were divided into two groups as follows: a puresmall cell group (28/63) and compound small cell group (35/63). Theimmunohistochemistry results were positive for: CK in 41.3%, NSE in 36.5%,Syn in 90.5%, CHr-A in 60.3% and CD56 in 50.8%. The difference betweenstaining of the pure small cell carcinoma and compound small cellcarcinoma was not statistically significant. The size and depth of tumorinvasion, the positive residual incision edge and lymph node metastasiswere the major factors influencing long-term survival.CONCLUSION Small cell carcinoma of the esophagus is a highly malignanttumor, which expresses neuroendocrine antigens. The histophathologicorigin is still unknown but the non-neuroepithelial origin was accepted in thisstudy.

  15. Palliative treatment of patients with malignant structures of esophagus

    Science.gov (United States)

    Zavodnov, Victor Y.; Kuzin, M. I.; Kharnas, Sergey S.; Linkov, Kirill G.; Loschenov, Victor B.; Stratonnikov, Alexander A.; Posypanova, Anna M.

    1996-01-01

    Photodynamic therapy with the use of laser endoscopic spectrum analyzer (LESA-5), spectral- analyzing video-imaging system, Kr laser and various types of catheters for different localizations and different geometry of tumor, and phthalocyanine aluminum photosensitizers in patients with malignant strictures of esophagus is discussed. Photodynamic therapy was carried out to four patients: with esophageal cancer (3 patients) and gastric cancer with infiltration of lower esophagus (1 patient). All patients suffered from severe dysphagia. Photosensitizer was used in a dose 1-1.5 mg/kg of weight. Usually we used 3-4 seances of laser treatment 10-30 minutes long. The accumulation of photosensitizer was controlled by LESA-5. Laser induced fluorescent image was monitored by the video-imaging system in order to control laser treatment. There were no side-effects. The results show high efficiency of photodynamic therapy. There was marked reduction of dysphagia symptoms in all cases. It seems that photodynamic therapy is a good alternative to palliative surgical treatment of patients with malignant strictures of esophagus.

  16. Role of receptor activity modifying protein 1 in function of the calcium sensing receptor in the human TT thyroid carcinoma cell line.

    Directory of Open Access Journals (Sweden)

    Aditya J Desai

    Full Text Available The Calcium Sensing Receptor (CaSR plays a role in calcium homeostasis by sensing minute changes in serum Ca(2+ and modulating secretion of calciotropic hormones. It has been shown in transfected cells that accessory proteins known as Receptor Activity Modifying Proteins (RAMPs, specifically RAMPs 1 and 3, are required for cell-surface trafficking of the CaSR. These effects have only been demonstrated in transfected cells, so their physiological relevance is unclear. Here we explored CaSR/RAMP interactions in detail, and showed that in thyroid human carcinoma cells, RAMP1 is required for trafficking of the CaSR. Furthermore, we show that normal RAMP1 function is required for intracellular responses to ligands. Specifically, to confirm earlier studies with tagged constructs, and to provide the additional benefit of quantitative stoichiometric analysis, we used fluorescence resonance energy transfer to show equal abilities of RAMP1 and 3 to chaperone CaSR to the cell surface, though RAMP3 interacted more efficiently with the receptor. Furthermore, a higher fraction of RAMP3 than RAMP1 was observed in CaSR-complexes on the cell-surface, suggesting different ratios of RAMPs to CaSR. In order to determine relevance of these findings in an endogenous expression system we assessed the effect of RAMP1 siRNA knock-down in medullary thyroid carcinoma TT cells, (which express RAMP1, but not RAMP3 constitutively and measured a significant 50% attenuation of signalling in response to CaSR ligands Cinacalcet and neomycin. Blockade of RAMP1 using specific antibodies induced a concentration-dependent reduction in CaSR-mediated signalling in response to Cinacalcet in TT cells, suggesting a novel functional role for RAMP1 in regulation of CaSR signalling in addition to its known role in receptor trafficking. These data provide evidence that RAMPs traffic the CaSR as higher-level oligomers and play a role in CaSR signalling even after cell surface localisation has

  17. Removal of press-through-packs impacted in the upper esophagus using an overtube

    Institute of Scientific and Technical Information of China (English)

    Yeon Seok Seo; Jong-Jae Park; Ji Hoon Kim; Jin Yong Kim; Jong Eun Yeon; Jae Seon Kim; Kwan Soo Byun; Young-Tae Bak

    2006-01-01

    Foreign bodies in the upper esophagus should be removed as soon as possible to avoid serious complications. However, removals of foreign bodies in the upper esophagus are very difficult, especially if they have sharp edges, such as press-through-packs (PTPs). We experienced four cases of the impacted PTPs in the upper esophagus which was successfully extracted endoscopically with the overtube. Because two edges of PTPs were so firmly impacted in the esophageal wall in all cases,the PTPs were not movable in the upper esophagus.However, after insertion of the overtube, PTPs became movable and were successfully extracted and no serious complications occurred after extraction of PTPs. In one case, insertion of the overtube rapidly expanded the upper esophagus and PTP progressed to the gastric cavity and it could be extracted with the endoscopic protector hood. The endoscopic removal with the overtube was a simple, safe and effective technique for the removal of the impacted PTPs in upper esophagus.

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

    Institute of Scientific and Technical Information of China (English)

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

    2009-01-01

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

  19. [Incidence and physiopathology of high-grade dysplasia in Barrett's esophagus].

    Science.gov (United States)

    Coriat, Romain; Perkins, Géraldine; Brezault, Catherine

    2011-05-01

    Barrett's esophagus is a well-known precursor of esophageal adenocarcinoma. Monitoring patients with Barrett's esophagus is recommended for detecting high-grade dysplasia or cancer. Gastroesophageal reflux disease affects approximately 20% of the population in developed countries. About 10-15% of patients with gastroesophageal reflux disease develop Barrett's esophagus, which can progress to adenocarcinoma. The esophagus is normally lined by squamous mucosa. Therefore, it is clear that for an adenocarcinoma, there is a prior sequence of events that lead to normal squamous mucosa transformation.

  20. Aggressive Adenocarcinoma of the Cervical Esophagus: Importance of a Multidisciplinary Approach

    Directory of Open Access Journals (Sweden)

    Adedayo Fashoyin

    2012-01-01

    Full Text Available Adenocarcinoma of the cervical esophagus is a rare tumor, in comparison to adenocarcinoma of the distal esophagus which is on the rise and is often associated with Barrett's esophagus. We present a case of aggressive cervical esophageal adenocarcinoma in a 46-year-old female with no endoscopic or histopathologic evidence of Barrett’s esophagus. We discuss the possible etiology of this tumor and review the treatment options, highlighting the importance of a multidisciplinary approach to the management of this rare disease.

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

    DEFF Research Database (Denmark)

    Piaggi, Simona; Marchi, Santino; Ciancia, Eugenio

    2009-01-01

    Barrett's esophagus (BE) represents a major risk factor for esophageal adenocarcinoma (AC). For this reason, patients with BE are subjected to a systematic endoscopic surveillance to detect initial evolution towards non-invasive neoplasia (NiN) and cancer, that eventually occurs only in a small f...... fraction of BE patients. This study was aimed to investigate the possible role of glutathione-S-transferase-omega 1 (GSTO1), a recently discovered member of the glutathione-S-transferase family, as a progression marker in the Barrett's disease in order to improve the diagnosis of Ni...... equally divided between nuclear, cytoplasmic and diffuse staining (2 each, respectively). Experiments in vitro showed that in human HeLa cancer cells, GSTO1 translocates into the nucleus as a consequence of heath shock. These findings suggested that the nuclear translocation of glutathione-S-transferase-omega...

  2. Application of a computer-assisted flexible endoscope system for transoral surgery of the hypopharynx and upper esophagus.

    Science.gov (United States)

    Friedrich, Daniel T; Scheithauer, M O; Greve, J; Rotter, N; Doescher, J; Hoffmann, T K; Schuler, P J

    2017-05-01

    Zenker's diverticulum is a common pathology in the transition zone of the posterior hypopharynx and esophagus. Surgical treatment is routinely performed by ENT and general surgeons. Besides the traditional open transcervical diverticulectomy, the introduction of transoral rigid treatment led to a paradigm change and is now the preferred treatment option for patients who are fit for general anesthesia. The implementation of interventional flexible endoscopy has opened another new micro-invasive approach for patients with high morbidity. Here, we present the potential utilization of a flexible, single port, robot-assisted, and physician-controlled endoscope system to facilitate transoral surgical access to the hypopharynx and upper esophagus. Transoral surgery of the hypopharynx and upper esophagus was performed in human cadavers (n = 5) using the Flex System (Medrobotics, Raynham, USA). Anatomical landmarks were identified, and posterior cricothyroid myotomy was performed with compatible flexible instruments in all cases. The approach to the hypopharynx and upper esophagus using the Flex system is feasible in a cadaveric model. Myotomy with a flexible tool and needle knife (from the perspective of treatment of Zenker´s diverticulum) was successful in all cases. Visualization of the surgical site with the system's HD camera is suitable and the flexible instruments meet the special needs of a micro-invasive transoral approach. Zenker´s diverticulum can be potentially treated with a transoral minimally invasive approach using a computer-assisted flexible endoscope system. This setup could be of advantage in patients with reduced mobility of the cervical spine to prevent open transcervical surgery. In our study, the Flex system enabled advanced visualization of the surgical site and extended intervention options, compared to standard flexible endoscopic treatment. However, general anesthesia is mandatory for the presented approach. Application in live patients

  3. Automatic grade classification of Barretts Esophagus through feature enhancement

    Science.gov (United States)

    Ghatwary, Noha; Ahmed, Amr; Ye, Xujiong; Jalab, Hamid

    2017-03-01

    Barretts Esophagus (BE) is a precancerous condition that affects the esophagus tube and has the risk of developing esophageal adenocarcinoma. BE is the process of developing metaplastic intestinal epithelium and replacing the normal cells in the esophageal area. The detection of BE is considered difficult due to its appearance and properties. The diagnosis is usually done through both endoscopy and biopsy. Recently, Computer Aided Diagnosis systems have been developed to support physicians opinion when facing difficulty in detection/classification in different types of diseases. In this paper, an automatic classification of Barretts Esophagus condition is introduced. The presented method enhances the internal features of a Confocal Laser Endomicroscopy (CLE) image by utilizing a proposed enhancement filter. This filter depends on fractional differentiation and integration that improve the features in the discrete wavelet transform of an image. Later on, various features are extracted from each enhanced image on different levels for the multi-classification process. Our approach is validated on a dataset that consists of a group of 32 patients with 262 images with different histology grades. The experimental results demonstrated the efficiency of the proposed technique. Our method helps clinicians for more accurate classification. This potentially helps to reduce the need for biopsies needed for diagnosis, facilitate the regular monitoring of treatment/development of the patients case and can help train doctors with the new endoscopy technology. The accurate automatic classification is particularly important for the Intestinal Metaplasia (IM) type, which could turn into deadly cancerous. Hence, this work contributes to automatic classification that facilitates early intervention/treatment and decreasing biopsy samples needed.

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

    Science.gov (United States)

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

    2016-05-01

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

  5. Editorial: Best Practices in Surveillance of Barrett's Esophagus.

    Science.gov (United States)

    Wani, Sachin; Gaddam, Srinivas

    2017-07-01

    Endoscopic surveillance in Barrett's esophagus (BE) has numerous limitations and thus provides several opportunities for improving the effectiveness of our current surveillance strategies. Several risk stratification and prediction tools have been investigated to identify patients at highest risk for progression to esophageal adenocarcinoma (EAC). Persistence of non-dysplastic BE (NDBE) has been proposed as an indicator of lower risk of progression to EAC. This editorial highlights the variable results and methodologies in studies evaluating persistence of NDBE as a risk stratification tool in the surveillance of BE patients and provides guidance for optimizing outcomes in BE patients enrolled in surveillance programs.

  6. Mid-Esophagus Columnar Metaplasia: What Is the Biopathogenic Pathway?

    Science.gov (United States)

    Rolim, Inês; Rodrigues, Rita Vale; Bettencourt, António; Barros, Rita; Camilo, Vânia; Dias Pereira, António; Almeida, Raquel; Chaves, Paula

    2016-10-05

    We report a case of metaplastic columnar epithelium in the mid-esophagus in a patient with history of caustic ingestion. A cardiac-type gastric phenotype, with early signs of intestinalization, was confirmed by immunohistochemistry studies (MUC5AC, MUC6, SOX2, and CDX2). Nonmetaplastic mucosa had histologic evidence of gastroesophageal reflux. In this case, esophageal reepithelization seems to have been modulated by acidic gastroesophageal reflux, which might activate transcription factors leading to phenotypic reprogramming of the regenerative epithelium. Most interestingly, it is a clinical example showcasing the origin of columnar metaplasia from stem cells located within the esophageal epithelium.

  7. Barrett esophagus: perspectives on its diagnosis and management in asian populations.

    Science.gov (United States)

    Amano, Yuji; Kinoshita, Yoshikazu

    2008-01-01

    Barrett esophageal cancer has the fastest growing incidence of any cancer in Western countries. In Asian countries, most cases of esophageal cancer consist of squamous cell carcinomas, not adenocarcinomas. Recently, however, the increase in the number of Barrett esophagus cases with subsequent Barrett cancer has become worrisome in Asian countries, as the number of patients with gastro-esophageal reflux disease has been increasing in these countries. In this review, recent reports regarding Barrett esophagus in Asian countries have been collected and this problem is discussed from various perspectives. In Asia, long-segment Barrett esophagus is much less prevalent than in Western countries, whereas short-segment Barrett esophagus is frequently found. In epidemiologic studies, evaluation of the prevalence of Barrett esophagus is limited by poor interob-server diagnostic agreement. Standard criteria for the endoscopic diagnosis of Barrett esophagus in Asian patients, especially of the short-segment type, should be established as soon as possible. A high prevalence of hiatal hernia and a decreasing prevalence of Helico-bacter pylori infection may increase the number of Barrett esophagus cases and subsequent Barrett cancer in Asian countries in the near future. Therefore, a strategy for the clinical management of Barrett esophagus in Asian countries should be devised.

  8. Barrett's esophagus : high cancer-risk groups, cardiovascular co-morbidity and interaction with Helicobacter pylori

    NARCIS (Netherlands)

    S. Gudlaugsdottir (Sunna)

    2002-01-01

    textabstractBarrett's esophagus (BE) has come to be regarded as an impOliant premalignant condition. In recent years the incidence of adenocarcinoma of the esophagus and of the gastric cardia has risen dramatically. Analyses of cancer incidence data fi'om nine areas of the United States revealed

  9. Gene expression profile comparison of Barrett's esophagus epithelial cell cultures and biopsies

    NARCIS (Netherlands)

    van Baal, J. W. P. M.; Rygiel, A. M.; Milano, F.; Anderson, M.; Bergman, J. J. G. H. M.; Spek, C. A.; Wang, K. K.; Peppelenbosch, M. P.; Krishnadath, K. K.

    2008-01-01

    Barrett's esophagus (BE) is a metaplastic process in which the normal squamous epithelium of the distal esophagus is replaced by columnar lined epithelium. The aim was to gain more insight in the process of metaplasia and to identify which genes are specifically expressed by the epithelial cells and

  10. Barrett's esophagus : high cancer-risk groups, cardiovascular co-morbidity and interaction with Helicobacter pylori

    NARCIS (Netherlands)

    S. Gudlaugsdottir (Sunna)

    2002-01-01

    textabstractBarrett's esophagus (BE) has come to be regarded as an impOliant premalignant condition. In recent years the incidence of adenocarcinoma of the esophagus and of the gastric cardia has risen dramatically. Analyses of cancer incidence data fi'om nine areas of the United States revealed ste

  11. Barrett's Esophagus: A Comprehensive and Contemporary Review for Pathologists.

    Science.gov (United States)

    Naini, Bita V; Souza, Rhonda F; Odze, Robert D

    2016-05-01

    This review provides a summary of our current understanding of, and the controversies surrounding, the diagnosis, pathogenesis, histopathology, and molecular biology of Barrett's esophagus (BE) and associated neoplasia. BE is defined as columnar metaplasia of the esophagus. There is worldwide controversy regarding the diagnostic criteria of BE, mainly with regard to the requirement to histologically identify goblet cells in biopsies. Patients with BE are at increased risk for adenocarcinoma, which develops in a metaplasia-dysplasia-carcinoma sequence. Surveillance of patients with BE relies heavily on the presence and grade of dysplasia. However, there are significant pathologic limitations and diagnostic variability in evaluating dysplasia, particularly with regard to the more recently recognized unconventional variants. Identification of non-morphology-based biomarkers may help risk stratification of BE patients, and this is a subject of ongoing research. Because of recent achievements in endoscopic therapy, there has been a major shift in the treatment of BE patients with dysplasia or intramucosal cancer away from esophagectomy and toward endoscopic mucosal resection and ablation. The pathologic issues related to treatment and its complications are also discussed in this review article.

  12. Definition, Derivation, and Diagnosis of Barrett's Esophagus: Pathological Perspectives.

    Science.gov (United States)

    Lowes, H; Somarathna, T; Shepherd, Neil A

    More than 60 years have elapsed since Barrett described the condition that continues to bear his name. Despite much research, clinical and basic, the defining features and the diagnosis of columnar-lined esophagus (CLO) are still embroiled with controversy and uncertainty. For pathologists, these controversies are notorious. The disease has been defined by the pathological demonstration of "specialized intestinal metaplasia" and yet there is compelling evidence that this approach is flawed due to sampling issues, poor levels of agreement between expert pathologists as to what constitutes "goblet cells," and the fact that most glandular epithelium in the esophagus is "intestinalized," even if goblet cells are not demonstrable. We believe that reliance on such pathological features can result in erroneous diagnoses of CLO and that the endoscopic diagnosis of CLO is more reliable with pathology corroborative in uncertain cases, when there is stricturing and/or ulceration and in shorter segment disease. Intriguingly, there are recent research findings that elucidate our understanding of the pathogenesis and the derivation of CLO and the way that initial gastric metaplasia converts to the unstable and neoplasia-associated intestinal phenotype. Even so, more research is required to enable a better understanding of the pathogenesis of CLO and to further improve the current management of the disease and its neoplastic complications.

  13. Trimodal therapy in squamous cell carcinoma of the esophagus

    Directory of Open Access Journals (Sweden)

    Matuschek C

    2011-10-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Yong Seok; Kim, Jun Young; Ko, Myoung Kwan; Kim, Dong Hyun; Byun, Ju Nam; Kim, Young Suk; Kim, Young Cheol; Oh, Jae Hee [Chosun University College of Medicine, Kwangju (Korea, Republic of)

    2000-03-15

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

  15. The changes of CaSR activity on the formation of calcium oxalate stones%钙敏感受体活性改变对大鼠泌尿系草酸钙结石形成的影响

    Institute of Scientific and Technical Information of China (English)

    李笑然; 岳中瑾; 马俊海; 裴薇; 辛文虎; 明星; 杨雄

    2013-01-01

    Objective To study the changes of CaSR activity on the formation of calcium oxalate stones. Methods A-dult male Sprague Dawley rats were given ethylene glycol and ammonium chloride to induce urolithiasis. Meanwhile, different doses of CaSR inhibitors (NPS-2390) were administered. The values of serum urea, creatinine,P,Ca2+ and Mg2+ ,PTH,24 h urine volume,urine pH,Ca2+ , Mg2+and oxalate were evaluated at the end of the experiment. Kidney sections were examined under a light microscope to study the calcium oxalate crystal deposition, pathological changes and the expression of CaSR. Results The urolithiasis induced by ethylene glycol and ammonium chloride caused not only significant increase of serum ure-a,creatinine, urine oxalate and Ca2+ ,but also great amount of calcium oxalate crystal deposition in kidney. PTH secretion of CaSR inhibitor group increased and blood Ca2+ urine Ca2+ raised. Renal histopathologic examination showed significant increase of calcium oxalate crystals in the kidney tissue of the CaSR inhibitor group,and kidney tissue damage was obvious.Conclusions In the kidney and parathyroid gland the low expression of CaSR can increase the formation of calcium oxalate crystal.%目的 探讨钙敏感受体(CaSR)活性改变对草酸钙结石形成的影响.方法 在实验期间给予乙二醇和氯化铵诱导雄性SD大鼠产生泌尿系草酸钙结石.在造模期间给予不同剂量的CaSR抑制剂(NPS-2390).实验结束时检测各组大鼠血尿素氮(BUN)、肌酐(Cr)、血磷、血钙、血镁、PTH的含量、24 h尿量、尿pH值、尿钙、镁、尿草酸的分泌量,显微镜下观察肾组织切片中草酸钙结晶沉积及病理变化情况及肾脏中CaSR表达情况.从而评价CaSR活性的改变对泌尿系结石形成的影响.结果 成石对照组大鼠血BUN、Cr、尿草酸、尿钙较空白组明显升高并且有大量结晶形成,表明建模成功.CaSR抑制剂组较成石对照组甲状旁腺激素(PTH

  16. Long segments of columnar-lined lower esophagus are not always metaplastic

    Directory of Open Access Journals (Sweden)

    Antonio Dias-Pereira

    2015-07-01

    Full Text Available The presence of columnar epithelium in the esophagus is associated with two conditions: Barrett's esophagus and heterotopic gastric mucosa. The former results from the metaplastic replacement of the normal distal squamous esophageal lining, is associated with gastroesophageal reflux and is a pre-neoplastic condition. The second is thought as a congenital condition, resulting from the incomplete squamous epithelialization of the esophagus during embryologic development. It is found mainly in the cervical esophagus. Histologically, Barrett's esophagus is composed of an admixture of cardiac mucosa, oxintocardiac mucosa and intestinal metaplasia. Most of heterotopic gastric mucosa consists of oxyntic mucosa where the mucosal glands are straight and composed of parietal and chief cells. There are few reports of heterotopic gastric mucosa in the lower esophagus, generally presenting as small islands. In the present report, a series of four cases of large lower esophageal heterotopic gastric mucosa is described. All patients were initially misdiagnosed with Barrett's esophagus and referred for surveillance. The correct diagnosis was based in endoscopic and histological features. In all, a circular tiny strip of squamous mucosa was observed at endoscopy between the lower end of the columnar-lined esophagus and the esophagogastric junction, defined as the proximal end of the gastric folds. Biopsy samples taken from the columnar-lined segments of the four patients showed pure oxyntic mucosa. When columnar-lined esophagus is observed in the distal esophagus not in continuity with gastric mucosa, the diagnosis of heterotopic gastric mucosa must be thought and confirmed histologically by the presence of pure oxyntic mucosa.

  17. Management of small cell carcinoma of esophagus in China.

    Science.gov (United States)

    Lu, Xu-jing; Luo, Ju-dong; Ling, Yang; Kong, Ying-Ze; Feng, Li-Li; Zhou, Jian; Wang, Feng

    2013-07-01

    Small cell carcinoma of esophagus (SCEC) is characterized by high malignancy and early metastasis. Although the morbidity of SCEC is very low, few studies of patients with SCEC have been conducted in China, there are no sufficient studies of SCEC conducted and reported in the existing published works, and the choices of treatment remain controversial. In this work, we aim to study the clinical characteristics of SCEC, and explore the corresponding treatment and prognosis through retrospective analysis. The original articles were identified through the leading digital libraries in China in which the terms "esophagus or esophageal" and "small cell esophageal carcinoma" appeared from 2005 to 2009, 1,176 eligible cases were reviewed for clinical data. Analysis of survival was conducted using the Kaplan-Meier method, and differences were compared using the log-rank test. One thousand one hundred seventy-six eligible cases were analyzed; the median age of patients was 57 years, with a male-to-female ratio of 2.4:1. The number of SCEC accounted for 1.26 % of esophageal cancer treated in the same period. Of the tumors, 89.7 % were located in mid- and lower thoracic esophagus. The average tumor length was 5.4 cm (0.5-17 cm). The median overall survival was 11.1 months for all patients. The 1-, 2-, 3-, and 5-year average overall survival rates of 469 patients was 51.1, 25.5, 13.2, 7.9 %, respectively. The median survival time for LD patients who received systemic treatment was 16.8 m, whereas for those who received local treatment (surgery), the median survival time was 10.1 m; the median survival time for ED patients who received systemic treatment was 7.4 m, compared with 5.8 m for those who received sole treatment (chemotherapy or radiotherapy). SCEC is a tumor characterized by high malignancy and early metastasis. Although our retrospective analysis cannot provide definitive conclusions on the optimal treatment modality for SCEC, however, our results suggest

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

    Science.gov (United States)

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

  19. Turning Skyscrapers into Town Houses: Insights into Barrett's Esophagus.

    Science.gov (United States)

    Ahrens, Theresa D; Lutz, Lisa; Lassmann, Silke; Werner, Martin

    2017-01-01

    Barrett's esophagus (BE) is defined as metaplasia of the esophageal squamous epithelium with multiple cell layers into a single layer of intestinal columnar epithelial cells - or, in other words, skyscrapers are turned into town houses. The underlying pathomechanism(s) and the cell of origin of BE lesions have not been defined yet. However, four potential hypotheses for BE development have been suggested. The morphological changes during BE development are associated with rather well-described aberrant gene/protein expression patterns. However, the potential key regulators of this conversion process are still unclear. The process of metaplastic conversion is difficult to monitor in a spatiotemporal manner in vitro, and robust models are lacking. There is therefore a need for novel experimental systems. This review focuses on potential key regulators, microenvironmental influences, epigenetic alterations and experimental research systems related to BE.

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

    Institute of Scientific and Technical Information of China (English)

    Elizabeth F Wiseman; Yeng S Ang

    2011-01-01

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

  1. Barrett′s esophagus: Where do we stand?

    Directory of Open Access Journals (Sweden)

    Al Madi Majid

    2009-01-01

    Full Text Available Barrett′s esophagus (BE is a precursor for esophageal adenocarcinoma, which has an increased incidence rate over the last few decades. Its importance stems from the poor five-year survival of esophageal adenocarcinoma and current data that suggest a survival benefit when surveillance programs are implemented. In this review, we will cover the pathophysiology and natural history of BE and the different endoscopic findings. The prevalence of BE in different geographic areas and the incidence of high-grade dysplasia and adenocarcinoma in this patient population is reviewed. Recent recommendation for screening and surveillance of BE has been covered in this review as well as the efficacy of nonconventional imaging modalities and endoscopic ablation therapies.

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

    Directory of Open Access Journals (Sweden)

    Basu S

    2005-01-01

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

  3. Outcomes of Radiofrequency Ablation for Dysplastic Barrett’s Esophagus: A Comprehensive Review

    Directory of Open Access Journals (Sweden)

    Carmelo Luigiano

    2016-01-01

    Full Text Available Barrett’s esophagus is a condition in which the normal squamous lining of the esophagus has been replaced by columnar epithelium containing intestinal metaplasia induced by recurrent mucosal injury related to gastroesophageal reflux disease. Barrett’s esophagus is a premalignant condition that can progress through a dysplasia-carcinoma sequence to esophageal adenocarcinoma. Multiple endoscopic ablative techniques have been developed with the goal of eradicating Barrett’s esophagus and preventing neoplastic progression to esophageal adenocarcinoma. For patients with high-grade dysplasia or intramucosal neoplasia, radiofrequency ablation with or without endoscopic resection for visible lesions is currently the most effective and safe treatment available. Recent data demonstrate that, in patients with Barrett’s esophagus and low-grade dysplasia confirmed by a second pathologist, ablative therapy results in a statistically significant reduction in progression to high-grade dysplasia and esophageal adenocarcinoma. Treatment of dysplastic Barrett’s esophagus with radiofrequency ablation results in complete eradication of both dysplasia and of intestinal metaplasia in a high proportion of patients with a low incidence of adverse events. A high proportion of treated patients maintain the neosquamous epithelium after successful treatment without recurrence of intestinal metaplasia. Following successful endoscopic treatment, endoscopic surveillance should be continued to detect any recurrent intestinal metaplasia and/or dysplasia. This paper reviews all relevant publications on the endoscopic management of Barrett’s esophagus using radiofrequency ablation.

  4. Outcomes of Radiofrequency Ablation for Dysplastic Barrett's Esophagus: A Comprehensive Review

    Science.gov (United States)

    Iabichino, Giuseppe; Arena, Monica; Consolo, Pierluigi; Morace, Carmela; Opocher, Enrico; Mangiavillano, Benedetto

    2016-01-01

    Barrett's esophagus is a condition in which the normal squamous lining of the esophagus has been replaced by columnar epithelium containing intestinal metaplasia induced by recurrent mucosal injury related to gastroesophageal reflux disease. Barrett's esophagus is a premalignant condition that can progress through a dysplasia-carcinoma sequence to esophageal adenocarcinoma. Multiple endoscopic ablative techniques have been developed with the goal of eradicating Barrett's esophagus and preventing neoplastic progression to esophageal adenocarcinoma. For patients with high-grade dysplasia or intramucosal neoplasia, radiofrequency ablation with or without endoscopic resection for visible lesions is currently the most effective and safe treatment available. Recent data demonstrate that, in patients with Barrett's esophagus and low-grade dysplasia confirmed by a second pathologist, ablative therapy results in a statistically significant reduction in progression to high-grade dysplasia and esophageal adenocarcinoma. Treatment of dysplastic Barrett's esophagus with radiofrequency ablation results in complete eradication of both dysplasia and of intestinal metaplasia in a high proportion of patients with a low incidence of adverse events. A high proportion of treated patients maintain the neosquamous epithelium after successful treatment without recurrence of intestinal metaplasia. Following successful endoscopic treatment, endoscopic surveillance should be continued to detect any recurrent intestinal metaplasia and/or dysplasia. This paper reviews all relevant publications on the endoscopic management of Barrett's esophagus using radiofrequency ablation. PMID:28070182

  5. [Plasma taurine levels in patients with esophagus cancer].

    Science.gov (United States)

    Lamônica-Garcia, Vânia Cristina; Marin, Flávia Andréa; Lerco, Mauro Masson; Moreto, Fernando; Henry, Maria Aparecida Coelho Arruda; Burini, Roberto Carlos

    2008-01-01

    The esophagus cancer-host has a two way close relationship as seen in its sulphur-amino acid metabolism. Taurine one of these compounds has ubiquous role in host defense and other physiological mechanisms related to survival. To study the plasma levels of taurine and its precursors in patients with esophagus cancer. In a sectional design both groups, patients (n = 16, 43-73 yrs old) and healthy controls (n = 20, 27-65 yrs old) were assessed for anthropometry, body-weight lost, hematology (Hb, Ht, total leukocytes and lymphocyte counts), general biochemistry (albumin, glucose, lipids and aminotransferases) and chromatographic analysis for taurine, cysteine, and homocysteine. The survival time was registered there since from the clinical-histopathological diagnosis. All participants had a written ethical consent for the research. The cancer patients were predominantly, white males of low social economic class, with spinocellular carcinoma stage IV located at upper 3rd half of them presented hypoalbuminemia and 16% referred significant body-weight loss. The patients showed statistically lower values of Hb, Ht, total and HDL cholesterol and cysteine and significantly higher values of taurine, homocysteine and aminotransferases than healthy controls. A positive relationship was found between taurine and either TLC (r = 0.50) and survival (r = 0.81). Lower plasma cysteine along with higher levels of taurine and homocysteine and the positive direct association of taurine with indications of survival suggest an effective role of this compound and therefore a prospective special nutritional care in its precursors (cysteine, methionine and B vitamins) of these patients.

  6. Interobserver reproducibility in pathologist interpretation of columnar-lined esophagus.

    Science.gov (United States)

    Mastracci, Luca; Piol, Nataniele; Molinaro, Luca; Pitto, Francesca; Tinelli, Carmine; De Silvestri, Annalisa; Fiocca, Roberto; Grillo, Federica

    2016-02-01

    Confirmation of endoscopically suspected esophageal metaplasia (ESEM) requires histology, but confusion in the histological definition of columnar-lined esophagus (CLE) is a longstanding problem. The aim of this study is to evaluate interpathologist variability in the interpretation of CLE. Thirty pathologists were invited to review three ten-case sets of CLE biopsies. In the first set, the cases were provided with descriptive endoscopy only; in the second and the third sets, ESEM extent using Prague criteria was provided. Moreover, participants were required to refer to a diagnostic chart for evaluation of the third set. Agreement was statistically assessed using Randolph's free-marginal multirater kappa. While substantial agreement in recognizing columnar epithelium (K = 0.76) was recorded, the overall concordance in clinico-pathological diagnosis was low (K = 0.38). The overall concordance rate improved from the first (K = 0.27) to the second (K = 0.40) and third step (K = 0.46). Agreement was substantial when diagnosing Barrett's esophagus (BE) with intestinal metaplasia or inlet patch (K = 0.65 and K = 0.89), respectively, in the third step, while major problems in interpretation of CLE were observed when only cardia/cardia-oxyntic atrophic-type epithelium was present (K = 0.05-0.29). In conclusion, precise endoscopic description and the use of a diagnostic chart increased consistency in CLE interpretation of esophageal biopsies. Agreement was substantial for some diagnostic categories (BE with intestinal metaplasia and inlet patch) with a well-defined clinical profile. Interpretation of cases with cardia/cardia-oxyntic atrophic-type epithelium, with or without ESEM, was least consistent, which reflects lack of clarity of definition and results in variable management of this entity.

  7. Concurrent chemoradiation in patients with cancer of the esophagus

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kang Kyoo; Park, Kyung Ran; Lee, Jong Young; Shin, Hyun Soo; Lee, Chong In; Chang, Woo Ick; Shim, Young Hak [Yonsei Univ. Wonju College of Medicine, Wonju (Korea, Republic of)

    1998-03-01

    To evaluate survival rate and prognostic factors affecting survival of patients with esophageal cancer treated with concurrent chemoradiation. Eligibility included biopsy proven invasive carcinoma of the cerivical or thoracic esophagus, confined to esophagus and mediastinum with or without regional lymph node and supraclavicular lymph node, and ECOG performance status H{sub 0}-H{sub 2}. Patients received radiation therapy with 5940cGy over 7 weeks and chemotherapy, consisted of 5-FU(1000mg/m{sup 2}/day in continuous infusion for 5 days, days 1 to 5 and days 29 to 33) and mitomycin C(8mg/m{sup 2} intravenous bolus at day 1). After concurrent chemoradiation, maintenance chemotherapy was followed with 5-FU(1000mg/m{sup 2}/day in continuous infusion for 5 days at 9th, 13th, and 17th weeks)and cisplatin(80mg/m{sup 2} intravenous bolus at the first day of each cycle). From November 1989 to November 1995, 44 patients were entered in this study. After treatment, complete response rate and partial response rate were 59% and 41%. Overall 1, 2, and 5-year survivals were 59%, 38%, and 9.6%(median 17 months). Prognostic factors affecting survival were response to treatment and T-stage. Among 26 complete responders, there were 6 local recurrences, 3 distant recurrences, 1 local and distant recurrence, and 2 unknown site recurrences. Acute and chronic complication rates with grade 3 or more were 20% and 13.6% and there was no treatment-related mortality. Concurrent chemoradiation, compared with historical control groups that treated with radiation alone, improved median survival and did not significantly increase treatment-related complications. Complete responders had longer survival duration than partial responders. Predominant failure pattern was local failure. So, efforts to improve local control should be proposed.

  8. Cytoskeletal changes induced by allosteric modulators of calcium-sensing receptor in esophageal epithelial cells.

    Science.gov (United States)

    Abdulnour-Nakhoul, Solange; Brown, Karen L; Rabon, Edd C; Al-Tawil, Youhanna; Islam, Mohammed T; Schmieg, John J; Nakhoul, Nazih L

    2015-11-01

    The calcium-sensing receptor (CaSR), a G-protein-coupled receptor, plays a role in glandular and fluid secretion in the gastrointestinal tract, and regulates differentiation and proliferation of epithelial cells. We examined the expression of CaSR in normal and pathological conditions of human esophagus and investigated the effect of a CaSR agonist, cinacalcet (CCT), and antagonist, calhex (CHX), on cell growth and cell-cell junctional proteins in primary cultures of porcine stratified squamous esophageal epithelium. We used immunohistochemistry and Western analysis to monitor expression of CaSR and cell-cell adhesion molecules, and MTT assay to monitor cell proliferation in cultured esophageal cells. CCT treatment significantly reduced proliferation, changed the cell shape from polygonal to spindle-like, and caused redistribution of E-cadherin and β-catenin from the cell membrane to the cytoplasm. Furthermore, it reduced expression of β-catenin by 35% (P < 0.02) and increased expression of a proteolysis cleavage fragment of E-cadherin, Ecad/CFT2, by 2.3 folds (P < 0.01). On the other hand, CHX treatment enhanced cell proliferation by 27% (P < 0.01), increased the expression of p120-catenin by 24% (P < 0.04), and of Rho, a GTPase involved in cytoskeleton remodeling, by 18% (P < 0.03). In conclusion, CaSR is expressed in normal esophagus as well as in Barrett's, esophageal adenocarcinoma, squamous cell carcinoma, and eosinophilic esophagitis. Long-term activation of CaSR with CCT disrupted the cadherin-catenin complex, induced cytoskeletal remodeling, actin fiber formation, and redistribution of CaSR to the nuclear area. These changes indicate a significant and complex role of CaSR in epithelial remodeling and barrier function of esophageal cells.

  9. Ablation of Barrett’s esophagus using the second-generation argon plasma coagulation

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    Objective To investigate the efficacy and safety of the second-generation argon plasma coagulation (VIO APC) in ablation of Barrett’s esophagus. Methods Eighteen patients with Barrett’s esophagus (12 males, median age of 55 years, median length of 2.1 cm,1 low-grade dysplasia, 13 cases of short segment Barrett’s esophagus) received VIO APC, which was performed at a power setting of 40W and argon gas flow at 1.5-2.0 L/min, "forced" mode, in 1-3 sessions (mean 1.3). All the patients received treatment with hi...

  10. 8-gene Panel for Barrett's Esophagus — EDRN Public Portal

    Science.gov (United States)

    Eight methylation biomarkers - p16, RUNX3, HPP1 (HGNC name TMEFF2), NELL1, TAC1, SST, AKAP12 and CDH13 - were tested in a restrospective multicenter double-blinded validation study for their accuracy in predicting neoplastic progression in Barrett's Esophagus. Hypermethylation of p16, RUNX3 and HPP1 has been show to occur in early Barrett's Esophagus-related neoplastic progression and predicts progression risk. Several of the panel (NELL1, TAC1, SST, AKAP12 and CDH13) were also shown to be methylated early and often in Barrett's Esophagus-related neoplastic progression.

  11. Squamous Cell Carcinoma of the Oropharynx and Esophagus with Pulmonary Metastasis in a Backyard Laying Hen.

    Science.gov (United States)

    Laura, Nordio; Marta, Vascellari; Giacomo, Berto; Luca, Bano

    2016-09-01

    A backyard laying hen exhibiting muscular atrophy, dyspnea, and absence of egg production was analyzed for diagnostic insights. Gross findings revealed the presence of a large ulcerated mass with irregular edges involving the caudal part of the oropharynx and the cranial part of the esophagus, occluding the lumen of the esophagus and compressing the trachea. Small nodular lesions were detected also in the lungs. Histologically, both esophageal and pulmonary masses were characterized by nests of pleomorphic epithelial cells with squamous differentiation. The diagnosis was of squamous cell carcinoma of the esophagus with the uncommon feature of pulmonary metastasis.

  12. Esophagus Segmentation from 3D CT Data Using Skeleton Prior-Based Graph Cut

    Directory of Open Access Journals (Sweden)

    Damien Grosgeorge

    2013-01-01

    Full Text Available The segmentation of organs at risk in CT volumes is a prerequisite for radiotherapy treatment planning. In this paper, we focus on esophagus segmentation, a challenging application since the wall of the esophagus, made of muscle tissue, has very low contrast in CT images. We propose in this paper an original method to segment in thoracic CT scans the 3D esophagus using a skeleton-shape model to guide the segmentation. Our method is composed of two steps: a 3D segmentation by graph cut with skeleton prior, followed by a 2D propagation. Our method yields encouraging results over 6 patients.

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

    Science.gov (United States)

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

    2016-08-01

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

  14. Cisplatin and 5-fluorouracil Enhance Expression of NKG2D Ligands and CIK Cells Killing Effect of Human Esophagus Carcinoma Cell EC9706%顺铂和氟尿嘧啶增强食管癌细胞NKG2D配体的表达及CIK细胞的杀伤活性

    Institute of Scientific and Technical Information of China (English)

    李瑞君; 梅家转; 禹萌; 刘桂举; 冯睿婷; 张晓娟

    2012-01-01

    目的 研究顺铂(Cisplatin,DDP)和氟尿嘧啶(5-fluorouracil,5-Fu)对人食管癌EC9706细胞NKG2D配体表达及CIK细胞杀伤活性的影响.方法 MTT法测定DDP、5-Fu的50%抑制浓度(IC50);以1/2 IC50浓度DDP、5-Fu作用EC9706细胞72h,RT-PCR检测DNA损伤修复系统相关信号分子的表达.流式细胞仪检测DDP、5-Fu作用前、后EC9706细胞NKG2D配体的表达.乳酸脱氢酶释放法检测效靶比20∶1时,CIK细胞对DDP、5-Fu作用前、后EC9706细胞的杀伤活性.结果 DDP、5-Fu的IC50分别为5μg/ml、10μg/ml.DDP、5-Fu可上调DNA损伤修复系统相关信号分子mRNA的表达.DDP与EC9706细胞共孵育72h后,EC9706细胞MICA、MICB、ULBP2、ULBP3表达较DDP作用前明显增强(P<0.05),ULBP1无明显变化(P>0.05).5-Fu与EC9706细胞共孵育72h后,EC9706细胞MICA、ULBP2、ULBP3表达明显增强(P<0.05),MICB、ULBP1无明显变化(P>0.05).效靶比20:1时,CIK细胞对EC9706细胞的杀伤活性为(37.08±0.62)%,CIK细胞对1/2 IG50DDP、1/2 IC50 5-Fu作用后的EC9706细胞杀伤活性分别为(59.33±2.10)%、(52.44±0.97)%,与作用前相比差异均有统计学意义(P<0.05).结论 DDP、5-Fu通过激活DNA损伤修复系统相关信号分子,提高EC9706细胞NKG2D配体的表达,从而增强EC9706细胞对CIK细胞杀伤的敏感度.%Objective To explore the effects of Cisplatin(DDP) and 5-fluorouracil(5-Fu) on the expression of NKG2D ligands of human esophagus carcinoma cell EC9706 and cytokine-induced killer (CIK) cells cy-totoxicity. Methods The IC50 of DDP,5-Fu against EC9706 cells were measured by MTT assay. Expressions of signal pathway molecules involved in DNA damage and repair system were detected by RT-PCR. The expression of NKG2D ligands (MICA.MICB, ULBP1 ,ULBP2, ULBP3) were analyzed by flow cy-tometery. Cytotoxicities of CIK cells against EC9706 cells before and after cultured by 1/2 IC50, DDP or 5-Fu were analyzed by LDH releasing assay at effector-to-target cell ratio(E:T) of

  15. PRIMARY MALIGNANT MELANOMA OF ESOPHAGUS: REPORT OF FOUR CASES AND REVIEW OF THE LITERATURES

    Institute of Scientific and Technical Information of China (English)

    张辉; 汪良骏; 赵峻

    2002-01-01

    Objective: To investigate the clinical features and prognosis of the primary malignant melanoma of esophagus, to try to find out a rational therapy and to evaluate the value of surgical resection. Methods: Retrospective study was conducted for four cases with Primary malignant melanoma of esophagus hospitalized from May 1975 to April 1999. The relevant literatures of primary malignant melanoma of esophagus in recent years were also reviewed. Results: Four patients received multimodality therapy including surgical resection. The survival time is 16 years, 53 months, 5 months and 6 months, respectively. Conclusion: Primary malignant melanoma of the esophagus has a poor prognosis. Surgical resection plays an important role and is indispensable. The patterns of combination treatment modality need further investigation. Preoperative therapy combined with surgical resection and post-operative therapy may be a better management.

  16. A study of serum zinc, selenium and copper levels in carcinoma of esophagus patients.

    Science.gov (United States)

    Goyal, M M; Kalwar, A K; Vyas, R K; Bhati, A

    2006-03-01

    The association of serum trace elements like selenium, zinc and copper has been found in different types of cancer. This study was conducted to see the serum level of these three trace elements in cancer esophagus patients. Biopsy confirmed cancer esophagus, 24 patients (12 males, 12 females, mean age 54.5±11.65 year with 23 healthy subjects (16 males, 7 females, mean age 44 ±13.82 years) were included in this study. Both control and study group patients were of same socio-economic status and dietary habits. Serum zinc and copper level were estimated using standard absorption spectrometer technique and serum selenium by Hydride generation method.We observed significant low serum levels of zinc and selenium while high level of serum copper in carcinoma esophagus patients, as compared with normal healthy controls. This shows an association of serum selenium zinc and copper with cancer esophagus.

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

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    Bhat Ramachandra

    2008-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2009-01-01

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

  19. Endoscopic radiofrequency ablation therapy for the prevention of esophageal cancer in Barrett’s esophagus

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    Ha NH

    2015-07-01

    Full Text Available Ngoc Hoang Ha, Richard Hummel, David I WatsonDepartment of Surgery, Flinders University, Flinders Medical Centre, Bedford Park, Adelaide, South Australia, AustraliaAbstract: Barrett’s esophagus is the only known precursor lesion for esophageal adenocarcinoma. Previous studies have shown that a variety of methods can be applied to destroy Barrett’s esophagus epithelium, and healing with a new esophageal squamous epithelium usually occurs following ablation. Radiofrequency ablation (RFA is a relatively new endoscopic technique. It has been claimed that ablation using RFA reduces the risk of cancer progression. RFA is usually easy to apply and is associated with a low risk of morbidity. It achieves complete eradication of (non dysplastic Barrett’s esophagus in most individuals, and the risk of progression to higher grades of dysplasia or cancer is reduced after RFA, although not completely eliminated. Limitations include recurrence of Barrett’s esophagus in up to one-third of individuals, a risk of “buried islands” of Barrett’s esophagus remaining below the regenerated mucosa, and uncertainty about the biological behavior of the new squamous epithelium after RFA. Current evidence supports the use of RFA in individuals with high-grade dysplasia in Barrett’s esophagus, and early stage (T1a intramucosal cancer, and select individuals with low-grade dysplasia. As accurate diagnosis of low-grade dysplasia remains difficult outside expert centers, it is probably premature to recommend routine RFA for all patients diagnosed with low-grade dysplasia in the community, despite the favorable outcomes from one randomized trial. Furthermore, long-term outcomes following ablation remain uncertain, and ongoing endoscopy surveillance is still required after RFA as progression to cancer remains a possibility. Outcomes from large studies with long-term follow-up are needed to definitively confirm that RFA ablation can reliably prevent cancer

  20. Large-Cell Neuroendocrine Carcinoma of the Esophagus: A Case from Saudi Arabia

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    Hadi Kuriry

    2015-10-01

    Full Text Available Neuroendocrine carcinomas of the esophagus are very rare, and the majority are high grade (poorly differentiated. They occur most frequently in males in their sixth and seventh decades of life. There have been no concrete data published on clinical features or on prognosis. We report a case of large-cell neuroendocrine carcinoma of the esophagus in a 66-year-old Saudi female with progressive dysphagia and weight loss. Upper endoscopy revealed an esophageal ulcerated mass.

  1. Scintigraphic assessment of Barrett's esophagus

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    Kotler, J.A.; Sampliner, R.E.; Kogan, F.J.; Henry, R.E.; Mason, B.F.

    1984-01-01

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

  2. Gene expression in Barrett's esophagus and reflux esophagitis induced by gastroduodenoesophageal reflux in rats

    Institute of Scientific and Technical Information of China (English)

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

    2005-01-01

    AIM: To investigate the difference of gene expression profiles between Barrett's esophagus and reflux esophagitis induced by gastroduodenoesophageal reflux in rats.METHODS: Eight-week-old Sprague-Dawley rats were treated esophagoduodenostomy to produce gastroduodenoesophageal reflux, and another group received sham operation as control. Esophageal epithelial tissues were dissected and frozen in liquid nitrogen immediately for pathology 40 wk after surgery. The expression profiles of 4 096 genes in reflux esophagitis and Barrett's esophagus tissues were compared with normal esophageal epithelium by cDNA microarray.RESULTS: Four hundred and forty-eight genes in Barrett'sesophagus were more than three times different from those in normal esophageal epithelium, including 312 up regulated and 136 down-regulated genes. Two hundred and thirty-twogenes in RE were more than three times different from those in normal esophageal epithelium, 90up-regulated and 142 down-regulated genes. Compared to reflux esophagitis, there were 214 up-regulated and 142 down-regulated genes in Barrett's esophagus. CONCLUSION: Esophageal epithelium exposed excessively to harmful ingredients of duodenal and gastric reflux can develop esophagitis and Barrett's esophagus gradually.The gene expression level is different between reflux esophagitis and Barrett's esophagus and the differentially expressed genes might be related to the occurrence and development of Barrett's esophagus and the promotion or progression in adenocarcinoma.

  3. Experimental replacement of thoracic esophageal segment with a biomaterial artificial esophagus in dogs

    Institute of Scientific and Technical Information of China (English)

    Zhang Lanjun; Rong Tiehua; Su Xiaodong; Wu Qiuliang; Xu Guoliang; Lin Peng; Long Hao; FU Jianhua

    2008-01-01

    Objective: To implant 80 mm-long artificial esophagi constructed of biomaterial in dogs, observe the perioperative survival rates and the incidence of postoperative complications, and study the mechanisms of postoperative healing. Methods: Specimens of the implanted esophagus, the "neo-esophagi", were taken for histopathologic study 1, 3, 6, 12, 24 months after operation. Results: The incidence of anastomotic leakage after the artificial esophagus implantation was 3.33%. The perioperative survival rate was 96.67%. The incidence of postoperative stenosis in the "neo-esophagi" was 81.48%; the stenoses were treated by expanding with esophagoscopy and implanting a stent. Epithelization of the mucosa in the "neo-esophagi" was completed in 3 to 6 months after surgery.Structures such as submucosal muscle layers, mucous glands, nerve fibers, capillaries, etc. were regenerated after 12 months, and then reconstruction of the fibrous connective tissue layer was completed. Conclusion: Implanting a biomaterial artificial esophagus accomplishes safe reconstruction of defects in the esophagus. Advanced cellular structure of "rico-esophagus" can be regenerated after 1 year. Postoperative stenosis, which is related to hyperplasia and retraction of scar tissue, is still the most common complications which limiting the clinical application of the artificial esophagus.

  4. The Prevalence of Barrett Esophagus Diagnosed in the Second Endoscopy

    Science.gov (United States)

    Suna, Nuretdin; Parlak, Erkan; Kuzu, Ufuk Baris; Yildiz, Hakan; Koksal, Aydin Seref; Oztas, Erkin; Sirtas, Zeliha; Yuksel, Mahmut; Aydinli, Onur; Bilge, Zulfikar; Taskiran, Ismail; Sasmaz, Nurgul

    2016-01-01

    Abstract At present, we do not know the exact prevalence of Barrett esophagus (BE) developing later in patients without BE in their first endoscopic screening. The purpose of this study was to determine the prevalence of BE on the second endoscopic examination of patients who had no BE in their first endoscopic examination. The data of the patients older than 18 years who had undergone upper gastrointestinal system endoscopy more than once at the endoscopy unit of our clinic during the last 6 years were retrospectively analyzed. During the last 6 years, 44,936 patients had undergone at least one endoscopic examination. Among these patients, 2701 patients who had more than one endoscopic screening were included in the study. Of the patients, 1276 (47.3%) were females and 1425 (52.7%) were males, with an average age of 54.9 (18–94) years. BE was diagnosed in 18 (0.66%) of the patients who had no BE in the initial endoscopic examination. The patients with BE had reflux symptoms in their medical history and in both endoscopies, they revealed a higher prevalence of lower esophageal sphincter laxity, hiatal hernia, and reflux esophagitis when compared to patients without BE (P < 0.001). Our study showed that in patients receiving no diagnosis of BE on their first endoscopic examination performed for any reason, the prevalence of BE on their second endoscopy within 6 years was very low (0.66%). PMID:27057907

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

    Science.gov (United States)

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

    2003-06-01

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

  6. Improved biopsy accuracy in Barrett's esophagus with a transparent cap.

    Science.gov (United States)

    Chen, Bai-Li; Xing, Xiang-Bin; Wang, Jin-Hui; Feng, Ting; Xiong, Li-Shou; Wang, Jin-Ping; Cui, Yi

    2014-04-28

    To evaluate the efficacy of endoscopy with a transparent cap on biopsy positioning in Barrett's esophagus (BE). One hundred and sixty-eight patients with suspected BE at endoscopy were enrolled in our study from November 2007 to December 2009 and divided into two groups: transparent cap group (n = 60) and control group (n = 108). Endoscopy with or without a transparent cap and subsequent biopsy of suspected lesions were performed by five experienced endoscopists in our hospital. In both groups, two biopsy specimens were taken from each patient, and the columnar epithelium or goblet cells in histological assessment were used as the diagnostic standard for BE. In the transparent cap group, 41 cases were tongue type, while 17 and two cases were identified as island type and circumferential type, respectively. In the control group, 65 tongue-type cases were confirmed, with 38 island-type and five circumferential-type cases. Moreover, there was no significant difference with regard to the composition of endoscopic BE types in the two groups (P > 0.05). In the biopsy specimens, BE was detected in 50 cases in the transparent cap group (83.3%, 50/60), whereas the detection rate in the control group (69.4%, 75/108) was lower compared to that in the transparent cap group (P cap group, with 11 cases in the control group. Transparent cap-fitted endoscopy can guide biopsy positioning in BE without other accompanying complications, thus increasing the detection rate of BE.

  7. Three-dimensional photoacoustic endoscopic imaging of the rabbit esophagus.

    Science.gov (United States)

    Yang, Joon Mo; Favazza, Christopher; Yao, Junjie; Chen, Ruimin; Zhou, Qifa; Shung, K Kirk; Wang, Lihong V

    2015-01-01

    We report photoacoustic and ultrasonic endoscopic images of two intact rabbit esophagi. To investigate the esophageal lumen structure and microvasculature, we performed in vivo and ex vivo imaging studies using a 3.8-mm diameter photoacoustic endoscope and correlated the images with histology. Several interesting anatomic structures were newly found in both the in vivo and ex vivo images, which demonstrates the potential clinical utility of this endoscopic imaging modality. In the ex vivo imaging experiment, we acquired high-resolution motion-artifact-free three-dimensional photoacoustic images of the vasculatures distributed in the walls of the esophagi and extending to the neighboring mediastinal regions. Blood vessels with apparent diameters as small as 190 μm were resolved. Moreover, by taking advantage of the dual-mode high-resolution photoacoustic and ultrasound endoscopy, we could better identify and characterize the anatomic structures of the esophageal lumen, such as the mucosal and submucosal layers in the esophageal wall, and an esophageal branch of the thoracic aorta. In this paper, we present the first photoacoustic images showing the vasculature of a vertebrate esophagus and discuss the potential clinical applications and future development of photoacoustic endoscopy.

  8. Carcinogenesis of Barrett's esophagus: a review of the clinical literature.

    Science.gov (United States)

    Watari, Jiro; Oshima, Tadayuki; Fukui, Hirokazu; Tomita, Toshihiko; Miwa, Hiroto

    2013-12-01

    Barrett's esophagus (BE) is a premalignant condition of esophageal adenocarcinoma (EAC). Although the incidence of BE has risen rapidly in the West, it is rare in Asia despite a recent increase in the prevalence of gastroesophageal reflux disease. Controversies over the definition of BE are presented because most cases show short-segment BE, especially ultra-short BE, in Asia. Here we review possible risk factors for the development of EAC, particularly possible roles of ethnicity, specialized intestinal metaplasia (SIM), BE length, and environmental factors, such as Helicobacter pylori infection and obesity. Additionally, we summarize recent studies on the effect of chemoprevention including proton pump inhibitors, nonsteroidal anti-inflammatory drugs or aspirin in order to reduce the risk of neoplastic progression in BE patients. Although substantial knowledge of risk factors of dysplasia/EAC in BE is shown, the risk for neoplastic development may be influenced by geographic variation, study population, the presence or absence of SIM or dysplasia at baseline, and the small number of BE patients investigated. Recently, the efficiency of surveillance for BE patients has been discussed from the standpoint of cost-effectiveness. It may be too difficult to draw conclusions because no randomized clinical trials of BE surveillance have been performed.

  9. A Multiscale Model Evaluates Screening for Neoplasia in Barrett's Esophagus.

    Directory of Open Access Journals (Sweden)

    Kit Curtius

    2015-05-01

    Full Text Available Barrett's esophagus (BE patients are routinely screened for high grade dysplasia (HGD and esophageal adenocarcinoma (EAC through endoscopic screening, during which multiple esophageal tissue samples are removed for histological analysis. We propose a computational method called the multistage clonal expansion for EAC (MSCE-EAC screening model that is used for screening BE patients in silico to evaluate the effects of biopsy sampling, diagnostic sensitivity, and treatment on disease burden. Our framework seamlessly integrates relevant cell-level processes during EAC development with a spatial screening process to provide a clinically relevant model for detecting dysplastic and malignant clones within the crypt-structured BE tissue. With this computational approach, we retain spatio-temporal information about small, unobserved tissue lesions in BE that may remain undetected during biopsy-based screening but could be detected with high-resolution imaging. This allows evaluation of the efficacy and sensitivity of current screening protocols to detect neoplasia (dysplasia and early preclinical EAC in the esophageal lining. We demonstrate the clinical utility of this model by predicting three important clinical outcomes: (1 the probability that small cancers are missed during biopsy-based screening, (2 the potential gains in neoplasia detection probabilities if screening occurred via high-resolution tomographic imaging, and (3 the efficacy of ablative treatments that result in the curative depletion of metaplastic and neoplastic cell populations in BE in terms of the long-term impact on reducing EAC incidence.

  10. Three-dimensional photoacoustic endoscopic imaging of the rabbit esophagus.

    Directory of Open Access Journals (Sweden)

    Joon Mo Yang

    Full Text Available We report photoacoustic and ultrasonic endoscopic images of two intact rabbit esophagi. To investigate the esophageal lumen structure and microvasculature, we performed in vivo and ex vivo imaging studies using a 3.8-mm diameter photoacoustic endoscope and correlated the images with histology. Several interesting anatomic structures were newly found in both the in vivo and ex vivo images, which demonstrates the potential clinical utility of this endoscopic imaging modality. In the ex vivo imaging experiment, we acquired high-resolution motion-artifact-free three-dimensional photoacoustic images of the vasculatures distributed in the walls of the esophagi and extending to the neighboring mediastinal regions. Blood vessels with apparent diameters as small as 190 μm were resolved. Moreover, by taking advantage of the dual-mode high-resolution photoacoustic and ultrasound endoscopy, we could better identify and characterize the anatomic structures of the esophageal lumen, such as the mucosal and submucosal layers in the esophageal wall, and an esophageal branch of the thoracic aorta. In this paper, we present the first photoacoustic images showing the vasculature of a vertebrate esophagus and discuss the potential clinical applications and future development of photoacoustic endoscopy.

  11. Endoscopic treatment of Barrett's esophagus: From metaplasia to intramucosal carcinoma.

    Science.gov (United States)

    Chennat, Jennifer; Waxman, Irving

    2010-08-14

    The annual incidence of adenocarcinoma arising from Barrett's esophagus (BE) is approximately 0.5%. Through a process of gradual transformation from low-grade dysplasia to high-grade dysplasia (HGD), adenocarcinoma can develop in the setting of BE. The clinical importance of appropriate identification and treatment of BE in its various stages, from intestinal metaplasia to intramucosal carcinoma (IMC) hinges on the dramatically different prognostic status between early neoplasia and more advanced stages. Once a patient has symptoms of adenocarcinoma, there is usually locally advanced disease with an approximate 5-year survival rate of about 20%. Esophagectomy has been the gold standard treatment for BE with HGD, due to the suspected risk of harboring occult invasive carcinoma, which was traditionally estimated to be as high as 40%. In recent years, the paradigm of BE early neoplasia management has recently evolved, and endoscopic therapies (endoscopic mucosal resection, radiofrequency ablation, and cryotherapy) have entered the clinical forefront as acceptable non-surgical alternatives for HGD and IMC. The goal of endoscopic therapy for HGD or IMC is to ablate all BE epithelium (both dysplastic and non-dysplastic) due to risk of synchronous/metachronous lesion development in the remaining BE segment.

  12. [Study on FTIR spectra of finger nails of normal people and patients of esophagus cancer].

    Science.gov (United States)

    Wang, Hong-Yan; Lü, Yin; Wang, Fan; Ma, Xiao-Dong; Jiang, Shi-Ping; Wang, Wei; Li, Cheng-Xiang

    2008-02-01

    To investigate the application of human finger nails in the diagnosis of cancer, Fourier transform infrared (FTIR) spectroscopy was employed to study the finger nails from some normal people and some with esophagus cancer and others with an operation for curing esophagus cancer five months ago. The results showed that there are obvious differences between FTIR spectra in them in spectral parameters such as frequency, intensity and band shape etc. The changes in the phosphate symmetric stretching vibration v(s) (PO2-) and asymmetric stretching vibration v(a)s(PO2-) modes are uniform, the v(s) (PO2-) and v(a)s(PO2-) absorption peaks of cancerous ones shift to high wave number compared with those of normal people, while those with operation shift to low wave number compared with those of cancerous ones. The C-O stretching vibration mode of protein located at 1 164 cm(-1) is composed of three absorption peaks located at 1 173.3, 1 158.0 and 1 151.1 cm(-1) respectively, meanwhile, the intensities and the wave numbers of the three peaks of cancerous ones all increase compared with normal people. The wave numbers of amide I and amide II of cancerous ones are both lower than those of normal people, while those with operation are between the cancerous ones and normal people, which suggest that the contents of protein and alpha-helix in finger nails of normal people, cancerous ones and the ones with operation are discriminative. The peak of bending vibration delta(CH2) mode of CH2 groups of protein lipid of cancerous ones shifts to high wave number slightly and the intensity of the peak weakens compared with that of normal people, which indicate that the methylene chain in the finger nails membrane lipids of cancerous ones is more ordered than that of normal people. Nevertheless, the peak of stretching vibration v(s) (CH2) of cancerous ones is lower than that of normal people, while that of the ones with operation is between cancerous ones and normal ones. As a result, the

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

    Institute of Scientific and Technical Information of China (English)

    CHANG Ying; LIU Bin

    2006-01-01

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

  14. Aspirin in Preventing Disease Recurrence in Patients With Barrett Esophagus After Successful Elimination by Radiofrequency Ablation | Division of Cancer Prevention

    Science.gov (United States)

    This randomized phase II trial studies the safety of and how well aspirin works in preventing Barrett's esophagus from returning after it has been successfully eliminated by radiofrequency ablation. Studying samples of tissue from patients with Barrett's esophagus for the levels of a specific protein that is linked to developing Barrett's esophagus may help doctors learn whether aspirin can prevent it from returning after it has been successfully treated. |

  15. Xenogeneic acellular dermal matrix in combination with pectoralis major myocutaneous flap reconstructs hypopharynx and cervical esophagus.

    Science.gov (United States)

    Yin, Danhui; Tang, Qinglai; Wang, Shuang; Li, Shisheng; He, Xiangbo; Liu, Jiajia; Liu, Bingbing; Yang, Mi; Yang, Xinming

    2015-11-01

    The aim of this study was to explore xenogeneic acellular dermal matrix (ADM) in combination with pectoralis major myocutaneous flap in hypopharynx and cervical esophagus reconstruction. A total of five patients were treated with this surgical method to reconstruct hypopharynx and cervical esophagus in Second Xiangya Hospital between January 2012 and April 2013. Four of them had hypopharyngeal carcinoma with laryngeal and cervical esophageal invasion, while the fifth patient with hypopharyngeal cancer had developed scars and atresia after postoperative radiotherapy. The defect length after hypopharyngeal and cervical esophageal resection was 6-8 cm, and was repaired by a combination of ADM and pectoralis major myocutaneous flap by our team. Interestingly, the four patients had primary healing and regained their eating function about 2-3 weeks after surgery, the fifth individual suffered from pharyngeal fistula, but recovered after dressing change about 2 months. Postoperative esophageal barium meals revealed that the pharynx and esophagus were unobstructed in all five patients. Xenogeneic ADM in combination with pectoralis major myocutaneous flap for hypopharynx and cervical esophagus reconstruction is a simple, safe and effective method with fewer complications. Nevertheless, according to the defect length of the cervical esophagus, the patients need to strictly follow the medical advice.

  16. Lactobacillus species shift in distal esophagus of high-fatdiet-fed rats

    Institute of Scientific and Technical Information of China (English)

    Xin Zhao; Xiao-Wei Liu; Ning Xie; Xue-Hong Wang; Yi Cui; Jun-Wen Yang; Lin-Lin Chen; Fang-Gen Lu

    2011-01-01

    AIM: To analyze the microbiota shift in the distal esophagus of Sprague-Dawley rats fed a high-fat diet. METHODS: Twenty Sprague-Dawley rats were divided into high-fat diet and normal control groups of 10 rats each. The composition of microbiota in the mucosa from the distal esophagus was analyzed based on selective culture. A variety of Lactobacillus species were identified by molecular biological techniques. Bacterial DNA from Lactobacillus colonies was extracted, and 16S rDNA was amplified by PCR using bacterial universal primers. The amplified 16S rDNA products were separated by denaturing gradient gel electrophoresis (DGGE). Every single band was purified from the gel and sent to be sequenced. RESULTS: Based on mucosal bacterial culturing in the distal esophagus, Staphylococcus aureus was absent, and total anaerobes and Lactobacillus species were decreased significantly in the high-fat diet group compared with the normal control group (P < 0.01). Detailed DGGE analysis on the composition of Lactobacillus species in the distal esophagus revealed that Lactobacillus crispatus , Lactobacillus gasseri (L. gasseri ) and Lactobacillus reuteri (L. reuteri ) comprised the Lactobacillus species in the high-fat diet group, while the composition of Lactobacillus species in the normal control group consisted of L. gasseri , Lactobacillus jensenii and L. reuteri . CONCLUSION: High-fat diet led to a mucosal microflora shift in the distal esophagus in rats, especially the composition of Lactobacillus species.

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

    Science.gov (United States)

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

    2010-12-01

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

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

    Science.gov (United States)

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

    2016-07-01

    Transient lower esophageal sphincter relaxation (TLESR) is the major mechanism of gastroesophageal reflux, but the regulation of TLESR by stimuli in the esophagus is incompletely understood. We have recently reported that acid infusion in the esophagus substantially (by 75%) increased the number of meal-induced TLESR in healthy subjects. We concluded that the TLESR reflex triggered by gastric distention with meal was enhanced by the stimulation of esophageal nerves by acid. However, the possibilities that the acid infused into the esophagus acts after passing though lower esophageal sphincter in stomach to enhance TLESR, or that the acid directly initiates TLESR from the esophagus were not addressed. Here, we evaluated the effect of acid infusion into the proximal stomach on meal-induced TLESR (study 1) and the ability of acid infusion into the esophagus to initiate TLESR without prior meal (study 2). We analyzed TLESRs by using high-resolution manometry in healthy subjects in paired randomized studies. In study 1, we found that acid infusion into the proximal stomach did not affect TLESRs induced by standard meal. The number of meal-induced TLESRs following the acid infusion into the proximal stomach was similar to the number of meal-induced TLESRs following the control infusion. In study 2, we found that acid infusion into the esophagus without prior meal did not initiate TLESRs. We conclude that the increase in the meal-induced TLESRs by acid in the esophagus demonstrated in our previous study is not attributable to the action of acid in the stomach or to direct initiation of TLESR from the esophagus by acid. Our studies are consistent with the concept that the stimuli in the esophagus can influence TLESRs. The enhancement of TLESR by acid in the esophagus may contribute to pathogenesis of gastroesophageal reflux in some patients. © 2015 International Society for Diseases of the Esophagus.

  19. Thermostable direct hemolysin downregulates human colon carcinoma cell proliferation with the involvement of E-cadherin, and β-catenin/Tcf-4 signaling.

    Directory of Open Access Journals (Sweden)

    Pinki Chowdhury

    Full Text Available BACKGROUND: Colon cancers are the frequent causes of cancer mortality worldwide. Recently bacterial toxins have received marked attention as promising approaches in the treatment of colon cancer. Thermostable direct hemolysin (TDH secreted by Vibrio parahaemolyticus causes influx of extracellular calcium with the subsequent rise in intracellular calcium level in intestinal epithelial cells and it is known that calcium has antiproliferative activity against colon cancer. KEY RESULTS: In the present study it has been shown that TDH, a well-known traditional virulent factor inhibits proliferation of human colon carcinoma cells through the involvement of CaSR in its mechanism. TDH treatment does not induce DNA fragmentation, nor causes the release of lactate dehydrogenase. Therefore, apoptosis and cytotoxicity are not contributing to the TDH-mediated reduction of proliferation rate, and hence the reduction appears to be caused by decrease in cell proliferation. The elevation of E-cadherin, a cell adhesion molecule and suppression of β-catenin, a proto-oncogene have been observed in presence of CaSR agonists whereas reverse effect has been seen in presence of CaSR antagonist as well as si-RNA in TDH treated cells. TDH also triggers a significant reduction of Cyclin-D and cdk2, two important cell cycle regulatory proteins along with an up regulation of cell cycle inhibitory protein p27(Kip1 in presence of CaSR agonists. CONCLUSION: Therefore TDH can downregulate colonic carcinoma cell proliferation and involves CaSR in its mechanism of action. The downregulation occurs mainly through the involvement of E-cadherin-β-catenin mediated pathway and the inhibition of cell cycle regulators as well as upregulation of cell cycle inhibitors.

  20. Cellular heterogeneity in the mouse esophagus implicates the presence of a nonquiescent epithelial stem cell population.

    Science.gov (United States)

    DeWard, Aaron D; Cramer, Julie; Lagasse, Eric

    2014-10-23

    Because the esophageal epithelium lacks a defined stem cell niche, it is unclear whether all basal epithelial cells in the adult esophagus are functionally equivalent. In this study, we showed that basal cells in the mouse esophagus contained a heterogeneous population of epithelial cells, similar to other rapidly cycling tissues such as the intestine or skin. Using a combination of cell-surface markers, we separated primary esophageal tissue into distinct cell populations that harbored differences in stem cell potential. We also used an in vitro 3D organoid assay to demonstrate that Sox2, Wnt, and bone morphogenetic protein signaling regulate esophageal self-renewal. Finally, we labeled proliferating basal epithelial cells in vivo to show differing cell-cycle profiles and proliferation kinetics. Based on our results, we propose that a nonquiescent stem cell population resides in the basal epithelium of the mouse esophagus.

  1. Cellular Heterogeneity in the Mouse Esophagus Implicates the Presence of a Nonquiescent Epithelial Stem Cell Population

    Directory of Open Access Journals (Sweden)

    Aaron D. DeWard

    2014-10-01

    Full Text Available Because the esophageal epithelium lacks a defined stem cell niche, it is unclear whether all basal epithelial cells in the adult esophagus are functionally equivalent. In this study, we showed that basal cells in the mouse esophagus contained a heterogeneous population of epithelial cells, similar to other rapidly cycling tissues such as the intestine or skin. Using a combination of cell-surface markers, we separated primary esophageal tissue into distinct cell populations that harbored differences in stem cell potential. We also used an in vitro 3D organoid assay to demonstrate that Sox2, Wnt, and bone morphogenetic protein signaling regulate esophageal self-renewal. Finally, we labeled proliferating basal epithelial cells in vivo to show differing cell-cycle profiles and proliferation kinetics. Based on our results, we propose that a nonquiescent stem cell population resides in the basal epithelium of the mouse esophagus.

  2. Poly-ε-caprolactone mesh as a scaffold for in vivo tissue engineering in rabbit esophagus

    DEFF Research Database (Denmark)

    Diemer, Pernille; Markoew, S.; Le, Dang Quang Svend

    2015-01-01

    Repair of long-gap esophageal atresia is associated with a high degree of complications. Tissue engineering on a scaffold of a bioresorbable material could be a solution. The aim of the present study was to investigate the in vivo tissue engineering of smooth muscle cells and epithelium on a poly......-ε-caprolactone mesh in rabbit esophagus. Twenty female rabbits had a window of 0.6 × 1 cm cut in the abdominal part of the esophagus. The defect was covered with a poly-ε-caprolactone mesh. The rabbits were killed on postoperative day 28–30, and mesh with surrounding esophagus was removed for histological examination....... Fifteen rabbits survived the trial period. Six had no complications and had the mesh in situ. They all had ingrowth of epithelial and smooth muscle cells and an almost completely degraded mesh. Nine rabbits developed pseudo-diverticula. It proved possible to engineer both epithelial and smooth muscle...

  3. Lung tissue flap repairs esophagus defection with an inner chitosan tube stent

    Institute of Scientific and Technical Information of China (English)

    Gang Chen; Wen-Jun Shi

    2009-01-01

    AIM:To repair the partial esophagus defect with a chitosan stent, a new esophageal prosthesis made of pulmonary tissue with vascular pedicle. METHODS:Fifteen Japanese big ear white rabbits were divided into experimental group ( n = 10) and control group ( n = 5). Esophagus defect in rabbits of experimental group was repaired using lung tissue flap with a chitosan tube stent, gross and histological appearance was observed at week 2, 4 and 8 after operation, and barium sulphate X-ray screen was performed at week 10 after operation. Esophagus defect of rabbits in control group was repaired using lung tissue flap with no chitosan tube stent, gross and histological appearance was observed at week 2, 4 and 8 after operation, and barium sulphate X-ray screen was performed at week 10 after operation. RESULTS:In the experimental group, 6 rabbits survived for over two weeks, the lung tissue flap healed esophageal defec t ion, and squamous metaplasia occurred on the surface of lung tissue flap. At week 10 after operation, barium sulphate examination found that barium was fluent through the esophagus with no stricture or back stream, the creeping was good. In the control group, 4 rabbits survived for two weeks, the lung tissue flap healed esophageal defection with fibrous tissue hyperplasia, barium sulphate examination found that barium was fluent through the esophagus with a slight stricture or back stream, and the creeping was not good at week 10 after operation.CONCLUSION:Esophagus defect can be repaired using lung tissue flap with an inner chitosan tube stent.

  4. Transitioning from preclinical to clinical chemopreventive assessments of lyophilized black raspberries: interim results show berries modulate markers of oxidative stress in Barrett's esophagus patients.

    OpenAIRE

    Kresty, Laura A.; Frankel, Wendy L.; Hammond, Cynthia D.; Baird, Maureen E.; Mele, Jennifer M.; Stoner, Gary D.; Fromkes, John J.

    2006-01-01

    Dietary modulation of cancer & cancer biomarkers; Dietary modulation of carcinogenesis-related pathwaysDietary item or component studied: black raspberries. Outcome studied: 8-epi-prostaglandin F2alpha (8-Iso-PGF2); 8-hydroxy-2'-deoxyguanosine (8-OHdG)Study type: humansStudy design: cohort study. Study size: 10 Barrett's esophagus (BE) cases. Tissue/biological material/sample size: urine. Mode of exposure: dietary. Impact on outcome (including dose-response): Mean concentrations of 8-Iso-PGF...

  5. The challenge of esophagoscopy in infants with open safety pin in the esophagus: report of two cases.

    Science.gov (United States)

    Bizakis, J G; Prokopakis, E P; Papadakis, C E; Skoulakis, C E; Velegrakis, G A; Helidonis, E S

    2000-01-01

    Among all foreign bodies impacted at the esophagus, the safety pin still seems to be a challenge for the specialist. This is a report of 2 cases presenting infants with open safety pin impacted in the esophagus. The strategy and intraoperative management of this rare finding is discussed in detail.

  6. Jackhammer esophagus: high-resolution manometry and therapeutic approach using peroral endoscopic myotomy (POEM).

    Science.gov (United States)

    Kandulski, A; Fuchs, K-H; Weigt, J; Malfertheiner, P

    2016-08-01

    We present the first report on peroral endoscopic myotomy (POEM) in the treatment of jackhammer esophagus. A 34-year-old female patient was newly diagnosed with a jackhammer esophagus. After failure of medical treatment, the patient underwent POEM procedure for myotomy of the spastic segment. Postoperatively, a mild emphysema and pneumothorax occurred that required drainage and antibiotic therapy until full recovery. Discharge was possible after 5 days. Six months later, she presented with recurrent but mild pain due to a remnant spastic segment proximal to the myotomy. Endoscopic balloon dilation was performed twice within 6 weeks with full symptomatic relief of pain and mild symptoms of dysphagia.

  7. The sensory system of the esophagus--what do we know?

    DEFF Research Database (Denmark)

    Brock, Christina; Gregersen, Hans; Gyawali, C Prakash;

    2016-01-01

    innervation and possibilities for quantitative sensory testing, the mechanosensory properties, the potential of high-resolution manometry and imaging, and the sensory system in special conditions, such as Barrett's esophagus. It is mandatory to understand the complex pathophysiology of the esophagus...... to enhance our understanding of esophageal disorders, but it also increases the complexity of future experimental and clinical studies. The new methods, as outlined in the current review, provide the possibility for researchers to enhance the quality of interdisciplinary research and to gain more knowledge...

  8. Determination of homeostatic elastic moduli in two layers of the esophagus

    DEFF Research Database (Denmark)

    Gregersen, Hans; Liao, Donghua; Fung, Yuan Cheng

    2008-01-01

    for determination of incremental moduli in circumferential, axial, and cross directions in the two layers. The experiments are inflation, axial stretching, circumferential bending, and axial bending. The analysis takes advantage of knowing the esophageal zero-stress state (an open sector with an opening angle of 59......The function of the esophagus is mechanical. To understand the function, it is necessary to know how the stress and strain in the esophagus can be computed, and how to determine the stress-strain relationship of the wall materials. The present article is devoted to the issue of determining...

  9. On the origin of rhythmic contractile activity of the esophagus in early achalasia, a clinical case study

    Directory of Open Access Journals (Sweden)

    Ji-Hong eChen

    2013-05-01

    Full Text Available A patient with early achalasia presented spontaneous strong rhythmic non-propulsive contractions at ~ 7/min, independent of swallows. Our aim was to evaluate characteristics of the rhythmic contractions, provide data on the structure of pacemaker cells in the esophagus and discuss a potential role for interstitial cells of Cajal (ICC in the origin of rhythmicity. We hypothesize that intramuscular ICC (ICC-IM are the primary pacemaker cells. The frequency but not the amplitude of the rhythmic contractions was inhibited by the phosphodiesterase inhibitor drotaverine consistent with cAMP inhibiting pacemaker currents in ICC-IM. The frequency increased by wet swallows but not dry swallows, consistent with stretch causing increase in slow wave frequency in ICC-IM. New studies on archival material showed that ICC-IM were present throughout the human esophageal musculature and were not diminished in early achalasia. Although ICC-IM exhibited a low density, they were connected to PDGFRα-positive fibroblast-like cells with whom they formed a dense gap junction coupled network. Nitrergic innervation of ICC was strongly diminished in early achalasia because of the loss of nitrergic nerves. It therefore appears possibly that ICC-IM function as pacemaker cells in the esophagus and that the network of ICC and PDGFRα-positive cells allows for coupling and propagation of the pacemaker activity. Loss of nitrergic innervation to ICC in achalasia may render them more excitable such that its pacemaker activity is more easily expressed. Loss of propagation in achalasia may be due to loss of contraction-induced aboral nitrergic inhibition.

  10. On the origin of rhythmic contractile activity of the esophagus in early achalasia, a clinical case study.

    Science.gov (United States)

    Chen, Ji-Hong; Wang, Xuan-Yu; Liu, Louis W C; Yu, Wenzhen; Yu, Yuanjie; Zhao, Liang; Huizinga, Jan D

    2013-01-01

    A patient with early achalasia presented spontaneous strong rhythmic non-propulsive contractions at ~7/min, independent of swallows. Our aim was to evaluate characteristics of the rhythmic contractions, provide data on the structure of pacemaker cells in the esophagus and discuss a potential role for interstitial cells of Cajal (ICC) in the origin of rhythmicity. We hypothesize that intramuscular ICC (ICC-IM) are the primary pacemaker cells. The frequency but not the amplitude of the rhythmic contractions was inhibited by the phosphodiesterase inhibitor drotaverine consistent with cAMP inhibiting pacemaker currents in ICC-IM. The frequency increased by wet swallows but not dry swallows, consistent with stretch causing increase in slow wave frequency in ICC-IM. New studies on archival material showed that ICC-IM were present throughout the human esophageal musculature and were not diminished in early achalasia. Although ICC-IM exhibited a low density, they were connected to PDGFRα-positive fibroblast-like cells with whom they formed a dense gap junction coupled network. Nitrergic innervation of ICC was strongly diminished in early achalasia because of the loss of nitrergic nerves. It therefore appears possibly that ICC-IM function as pacemaker cells in the esophagus and that the network of ICC and PDGFRα-positive cells allows for coupling and propagation of the pacemaker activity. Loss of nitrergic innervation to ICC in achalasia may render them more excitable such that its pacemaker activity is more easily expressed. Loss of propagation in achalasia may be due to loss of contraction-induced aboral nitrergic inhibition.

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

    Directory of Open Access Journals (Sweden)

    Fumiaki Sato

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

  12. The risk of Barrett's esophagus associated with abdominal obesity in males and females

    NARCIS (Netherlands)

    Kendall, B.J.; Macdonald, G.A.; Hayward, N.K.; Prins, J.B.; O'Brien, S.; Whiteman, D.C.

    2013-01-01

    Esophageal adenocarcinoma arises from Barrett's esophagus (BE). Both occur predominantly in males. The role of abdominal obesity in this sex distribution is uncertain. Our study aimed to determine whether there is an association between abdominal obesity and risk of BE and if present was it modified

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

    Institute of Scientific and Technical Information of China (English)

    李国庆; 单根法; 张辅贤; 钟竑

    2003-01-01

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

  14. Foreign body esophagus in a neonate: Unusual age and unusual presentation

    Directory of Open Access Journals (Sweden)

    Ranju Singh

    2012-01-01

    Full Text Available Foreign body ingestion in neonatal period is an uncommon occurrence, despite foreign ingestion being common among pediatric age group. We report a rare case of foreign body esophagus in a 12-day-old female neonate causing obstructive symptoms after a homicidal attempt. The unusual age and circumstances involving the ingestion of the foreign body prompted us to report this case.

  15. Non-invasive optical detection of esophagus cancer based on urine surface-enhanced Raman spectroscopy

    Science.gov (United States)

    Huang, Shaohua; Wang, Lan; Chen, Weiwei; Lin, Duo; Huang, Lingling; Wu, Shanshan; Feng, Shangyuan; Chen, Rong

    2014-09-01

    A surface-enhanced Raman spectroscopy (SERS) approach was utilized for urine biochemical analysis with the aim to develop a label-free and non-invasive optical diagnostic method for esophagus cancer detection. SERS spectrums were acquired from 31 normal urine samples and 47 malignant esophagus cancer (EC) urine samples. Tentative assignments of urine SERS bands demonstrated esophagus cancer specific changes, including an increase in the relative amounts of urea and a decrease in the percentage of uric acid in the urine of normal compared with EC. The empirical algorithm integrated with linear discriminant analysis (LDA) were employed to identify some important urine SERS bands for differentiation between healthy subjects and EC urine. The empirical diagnostic approach based on the ratio of the SERS peak intensity at 527 to 1002 cm-1 and 725 to 1002 cm-1 coupled with LDA yielded a diagnostic sensitivity of 72.3% and specificity of 96.8%, respectively. The area under the receive operating characteristic (ROC) curve was 0.954, which further evaluate the performance of the diagnostic algorithm based on the ratio of the SERS peak intensity combined with LDA analysis. This work demonstrated that the urine SERS spectra associated with empirical algorithm has potential for noninvasive diagnosis of esophagus cancer.

  16. Oligomicroarray-based primary study of gene expression profile changes in Barrett's esophagus

    Institute of Scientific and Technical Information of China (English)

    Wang Xingwei; Sun Yonggang; Xu Mei; Fang Dianchun; Gao Hengjun; Xu Jiangtao

    2008-01-01

    Objective: To analyze the differential expression genes (DEGs) between Barrett's esophagus (BE) and normal esophagus mucosa and explore the target genes related to the development and progression of BE. Methods: The total RNAs of matched BE and normal esophagus mucosa of BE patients were isolated using one step Trizol method.Matched RNAs were qualified using 10 g/L agarose gel electrophoresis, cRNAs were synthesized, fluorescence labeled and purified after total RNAs were purified. The RNAs of BE and normal esophagus mucosa were hybridized with Agilent oligomicroarray (30 968 probes). The fluorescence intensity features were detected by Agilent scanner and quantified by feature extraction software. Results: (1) The total RNA, reverse transcription product and fluorescence labeled cRNA were all of high quality; (2) There were 142 up-regulated genes and 284 down-regulated genes among 2-fold DEGs. Conclusion: Microarray-based studies are feasible in endoscopically obtained tissues. Many BE-associated genes are screened by the high-throughput gene chip. The development and progression of BE is a complicated process involving multiple genes and multiple procedures, and functional study of these genes may help to identify the key genes or pathways involved in the pathogenesis and development of BE.

  17. The risk of Barrett's esophagus associated with abdominal obesity in males and females

    NARCIS (Netherlands)

    Kendall, B.J.; Macdonald, G.A.; Hayward, N.K.; Prins, J.B.; O'Brien, S.; Whiteman, D.C.

    2013-01-01

    Esophageal adenocarcinoma arises from Barrett's esophagus (BE). Both occur predominantly in males. The role of abdominal obesity in this sex distribution is uncertain. Our study aimed to determine whether there is an association between abdominal obesity and risk of BE and if present was it modified

  18. Historia morbi atrocis--2 new cases of spontaneous rupture of the esophagus (Boerhaave syndrome).

    Science.gov (United States)

    Tagan, D; Boesch, C; Baur, A; Berger, J P

    1990-11-24

    We report the case of two patients hospitalized within a few weeks of each other and both presenting with spontaneous rupture of the esophagus whose evolution proved fatal. We take the opportunity of drawing attention to this rare and challenging disease, which is often diagnosed too late.

  19. Non-parametric classification of esophagus motility by means of neural networks

    DEFF Research Database (Denmark)

    Thøgersen, C; Rasmussen, C; Rutz, K

    1997-01-01

    . The aim of the present work has been to test the ability of neural networks to identify abnormal contraction patterns in patients with non-obstructive dysphagia (NOBD). Nineteen volunteers and 22 patients with NOBD underwent simultaneous recordings of four pressures in the esophagus for at least 23 hours...

  20. Fulminant phlegmonitis of the esophagus, stomach, and duodenum due to Bacillus thuringiensis

    Science.gov (United States)

    Matsumoto, Hisatake; Ogura, Hiroshi; Seki, Masafumi; Ohnishi, Mitsuo; Shimazu, Takeshi

    2015-01-01

    We report a case of phlegmonitis of the esophagus, stomach, and duodenum in patient in an immunocompromised state. Culture of gastric juice and blood yielded Bacillus thuringiensis. This case showed that even low-virulence bacilli can cause lethal gastrointestinal phlegmonous gastritis in conditions of immunodeficiency. PMID:25834344

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

    NARCIS (Netherlands)

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

    2015-01-01

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

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

    NARCIS (Netherlands)

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

    2015-01-01

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

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

    DEFF Research Database (Denmark)

    Rumessen, J J; de Kerchove d'Exaerde, A; Mignon, S;

    2001-01-01

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

  4. Esophageal Adenocarcinoma and Its Rare Association with Barrett's Esophagus in Henan, China.

    Directory of Open Access Journals (Sweden)

    Shuzheng Liu

    Full Text Available Incidence of esophageal adenocarcinoma (EAC has increased sharply in Western Europe and United States over the past three decades. Nearly all cases of EAC in the west are thought to be associated with Barrett's esophagus (BE at the time of diagnosis. Regions in the Henan province of China have one of world's highest incidences of esophageal cancer, yet recent temporal trends in the relative rates of EAC with respect to esophageal squamous-cell carcinoma (ESCC, as well as its association with Barrett's esophagus (BE, have not been reported. In this report, we present large-scale longitudinal clinical and histological data on 5401 esophageal cancers (EC patients diagnosed during the recent 10-year period (2002-2011 at Henan Cancer Hospital, China. All 217 esophageal adenocarcinoma (EAC patients from these 5401 EC patients were examined to better understand the relationship between Barrett's esophagus (BE and EAC. We found that EAC was relatively rare and accounted for approximately 5% of all esophageal cancers each year during 2002-2011. There is no evidence of significant temporal trends in the rate of EAC relative to ESCC. Only 10 out of 217 (4.6% EAC cases were detected to have any evidence of Barrett's esophagus. This result raises the possibility of a different etiological basis for EAC in China motivating more detailed epidemiological, clinical and molecular characterization of EAC in China in order to better understand the neoplastic development of EAC.

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

    Institute of Scientific and Technical Information of China (English)

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

    2014-01-01

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

  6. Advances in imaging and endoscopic therapy in Barrett’s esophagus

    NARCIS (Netherlands)

    Alvarez Herrero, L.

    2014-01-01

    This thesis evaluated the role of advanced imaging around endoscopic therapy as well as explored the further possibilities of endoscopic therapy of early neoplasia (i.e. high-grade dysplasia and early cancer) in Barrett's esophagus. Advanced imaging techniques such as autofluorescence and narrow-ban

  7. Epithelial cell proliferative activity of Barrett's esophagus : methodology and correlation with traditional cancer risk markers

    NARCIS (Netherlands)

    Peters, F T; Ganesh, S; Kuipers, E J; de Jager-Krikken, A; Karrenbeld, A; Harms, G; Sluiter, W J; Koudstaal, J; Klinkenberg-Knol, E C; Lamers, C B; Kleibeuker, J H

    1998-01-01

    Barrett's esophagus (BE) is a premalignant condition, due to chronic gastroesophageal reflux. Effective antireflux therapy may diminish cancer risk. To evaluate this option an intermediate marker is needed. We developed a methodology for measurement of epithelial cell proliferative activity of Barre

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

    NARCIS (Netherlands)

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

    2015-01-01

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

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  10. Fulminant phlegmonitis of the esophagus, stomach, and duodenum due to Bacillus thuringiensis.

    Science.gov (United States)

    Matsumoto, Hisatake; Ogura, Hiroshi; Seki, Masafumi; Ohnishi, Mitsuo; Shimazu, Takeshi

    2015-03-28

    We report a case of phlegmonitis of the esophagus, stomach, and duodenum in patient in an immunocompromised state. Culture of gastric juice and blood yielded Bacillus thuringiensis. This case showed that even low-virulence bacilli can cause lethal gastrointestinal phlegmonous gastritis in conditions of immunodeficiency.

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

    Directory of Open Access Journals (Sweden)

    Hiroyuki Ando

    2012-05-01

    Full Text Available Esophageal perforation is a relatively uncommon disease with a high rate of mortality and morbidity. Delay in the diagnosis and treatment occurs in more than 50% of cases, leading to a mortality rate of 40–60%. Primary repair is generally considered the gold standard for patients who present within the first 24 h following perforation of the esophagus. In this paper, we present a case of successful surgical treatment of spontaneous rupture of the esophagus that was diagnosed 2 days after onset. The patient was a 42-year-old man admitted to internal medicine with a diagnosis of pleuritis and complaining of chest and back pain. The next day, computed tomography revealed left-sided pleural effusion and mediastinal emphysema. An esophagogram revealed extravasation of the contrast medium from the lower left esophagus to the mediastinal cavity. These results confirmed a rupture of the esophagus, and an emergency left thoracotomy was performed. The perforation was repaired with a single-layered closure and was covered with elevated great omentum obtained by laparotomy. The patient was discharged 23 days after the first surgery. In conclusion, primary repair surgery must be selected as the best treatment beyond 24 h if the patient’s general state was stable and there was no evidence of clinical sepsis.

  12. Role of concurrent chemoradiation in inoperable carcinoma esophagus: A prospective study

    Directory of Open Access Journals (Sweden)

    Virendra Bhandari

    2014-01-01

    Full Text Available Introduction: The treatment of choice in cancer esophagus is controversial. Radiation therapy oncology group, Eastern cooperative oncology group and Cochrane studies have shown superiority of concurrent chemoradiation in inoperable carcinoma esophagus. In these studies full dose cisplatin was given every 3 weeks along with radiotherapy and hence had some toxicity. So, we started treating inoperable carcinoma esophagus patients with low dose weekly cisplatin given concurrently with radiotherapy aiming at low toxicity and similar results. Materials and Methods: A total of 31 cases of inoperable cases of carcinoma esophagus were treated with once weekly cisplatin 30 mg/m 2 along with radiotherapy 60 Gy in 30 fractions in 6 weeks on Telecobalt/Linear accelerator. Results : w0 e could achieve lower toxicity with 80%, 35% and 19% with 1, 2, and 3 year′s survival with a median survival of 18 months. So, we conclude that this regimen is better than 3 weekly chemotherapy regimen as is better tolerated with less toxicity and similar outcome.

  13. Proximal and distal esophageal sensitivity is decreased in patients with Barrett's esophagus

    Institute of Scientific and Technical Information of China (English)

    Anne L Krarup; S(o)en S Olesen; Peter Funch-Jensen; Hans Gregersen; Asbj(o)n M Drewes

    2011-01-01

    AIM: To investigate sensations to multimodal pain stimulation in the metaplastic and normal parts of the esophagus in patients with Barrett's esophagus (BE). METHODS: Fifteen patients with BE and 15 age-matched healthy volunteers were subjected to mechanical, thermal and electrical pain stimuli of the esophagus. Both the metaplastic part and the normal part (4 and 14 cm, respectively, above the esophago-gastric junction) were examined. At sensory thresholds the stimulation intensity, referred pain areas, and evoked brain potentials were recorded. RESULTS: Patients were hyposensitive to heat stimulation both in the metaplastic part [median stimulation time to reach the pain detection threshold: 15 (12-34) s vs 14 (6-23) s in controls; F = 4.5, P = 0.04] and the normal part of the esophagus [median 17 (6-32) s vs 13 (8-20) s in controls; F = 6.2, P = 0.02]. Furthermore, patients were hyposensitive in the metaplastic part of the esophagus to mechanical distension [median volume at moderate pain: 50 (20-50) mL vs 33 (13-50) mL in controls; F = 5.7, P = 0.02]. No indication of central nervous system abnormalities was present, as responses were comparable between groups to electrical pain stimuli in the metaplastic part [median current evoking moderate pain: 13 (6-26) mA vs 12 (9-24) mA in controls; F = 0.1, P = 0.7], and in the normal part of the esophagus [median current evoking moderate pain: 9 (6-16) mA, vs 11 (5-11) mA in controls; F = 3.4, P = 0.07]. Furthermore, no differences were seen for the referred pain areas (P -values all > 0.3) or latencies and amplitudes for the evoked brain potentials (P -values all > 0.1). CONCLUSION: Patients with BE are hyposensitive both in the metaplastic and normal part of esophagus likely as a result of abnormalities affecting peripheral nerve pathways.

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

    Institute of Scientific and Technical Information of China (English)

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

    2005-01-01

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

  15. Presence of Hypoderma lineatum stage I larvae in the esophagus of cattle slaughtered in Chihuahua, Chih., Mexico.

    Science.gov (United States)

    Quintero-Martínez, M T; Otero Negrete, J; Benítez, R; Méndez, M A; Juárez Vega, G; Cruz-Vázquez, C

    2007-05-15

    In order to detect the presence of Hypoderma lineatum stage I larvae within the esophagus of cattle slaughtered in Chihuahua, Chihuahua, Mexico, a total of five samplings were carried out between July and November 2000. In each instance, a random sample was taken from 10% of the animals slaughtered in a single work shift in each of the two slaughterhouses included in this study. The esophagus were cut longitudinally in order to carry out visual inspection and detect the presence of H. lineatum stage I larvae in the submucosa. The larvae were separated and counted. We identified the presence of H. lineatum stage I larvae in the esophagus for all sampling dates, nevertheless, within the last sampling only one esophagus had them. For all sampling dates the prevalence ranged between 11 and 33%; the latter corresponded to the sampling in October. A total of 287 esophagus was inspected of which 54 were positive with one or more larvae (19%); 233 larvae were obtained from these cases. The number of larvae recovered per sampling ranged from 46 to 74 between July and October, the highest number was found in September's sampling. The largest amount of stage I larvae per esophagus was 22 in the months of July and August. Larvae were always located in the submucosa of the esophagus and all were oriented longitudinally.

  16. IgG BULLOUS PEMPHIGOID WITH ANTIBODIES TO IgD, DERMAL BLOOD VESSELS, ECCRINE GLANDS AND THE ENDOMYSIUM OF MONKEY ESOPHAGUS

    Directory of Open Access Journals (Sweden)

    Abreu Velez Ana Maria

    2011-04-01

    Full Text Available Context: Bullous pemphigoid is mediated by autoantibodies primarily targeting two structural proteins of basement membrane hemidesmosomes, BP180 (BPAG2; collagen XVII and BP230 (BPAG1. Case Report: A 70-year-old Caucasian male patient was evaluated for a seven day history of multiple itching, erythematous blisters on his extremities. Biopsies for hematoxylin and eosin examination, direct immunofluorescence and indirect immunofluorescence (including salt split skin analysis were performed. Results: Hematoxylin and eosin examination demonstrated a subepidermal blister. Within the blister lumen, numerous eosinophils and lymphocytes were noted. Direct and indirect immunofluorescence revealed linear deposits of IgG, Complement/C3 and fibrinogen at the basement membrane zone of the skin and surrounding selected dermal blood vessels and sweat glands. Positive intracytoplasmic staining for anti-human IgD was noted in most of the epidermis, as well as surrounding some dermal blood vessels. Indirect immunofluorescence utilizing monkey esophagus substrate demonstrated strong positivity within the endomysium for IgG antibodies. Conclusion: We report a unique case of bullous pemphigoid with reactivity to eccrine sweat glands, and selected dermal blood vessels. In addition, the observed reactivity of anti-human IgD, and of IgG to monkey esophagus endomysium warrant further investigation.

  17. In vivo imaging of human breast cancer mouse model with high level expression of calcium sensing receptor at 3T.

    Science.gov (United States)

    Baio, Gabriella; Fabbi, Marina; Emionite, Laura; Cilli, Michele; Salvi, Sandra; Ghedin, Piero; Prato, Sabina; Carbotti, Grazia; Tagliafico, Alberto; Truini, Mauro; Neumaier, Carlo Emanuele

    2012-03-01

    To demonstrate that manganese can visualise calcium sensing receptor (CaSR)-expressing cells in a human breast cancer murine model, as assessed by clinical 3T magnetic resonance (MR). Human MDA-MB-231-Luc or MCF7-Luc breast cancer cells were orthotopically grown in NOD/SCID mice to a minimum mass of 5 mm. Mice were evaluated on T1-weighted sequences before and after intravenous injection of MnCl(2). To block the CaSR-activated Ca(2+) channels, verapamil was injected at the tumour site 5 min before Mn(2+) administration. CaSR expression in vivo was studied by immunohistochemistry. Contrast enhancement was observed at the tumour periphery 10 min after Mn(2+) administration, and further increased up to 40 min. In verapamil-treated mice, no contrast enhancement was observed. CaSR was strongly expressed at the tumour periphery. Manganese enhanced magnetic resonance imaging can visualise CaSR-expressing breast cancer cells in vivo, opening up possibilities for a new MR contrast agent. • Manganese contrast agents helped demonstrate breast cancer cells in an animal model. • Enhancement was most marked in cells with high calcium sensing receptor expression. • Manganese uptake was related to the distribution of CaSR within the tumour. • Manganese MRI may become useful to investigate human breast cancer.

  18. Structural mechanism of ligand activation in human calcium-sensing receptor

    Energy Technology Data Exchange (ETDEWEB)

    Geng, Yong; Mosyak, Lidia; Kurinov, Igor; Zuo, Hao; Sturchler, Emmanuel; Cheng, Tat Cheung; Subramanyam, Prakash; Brown, Alice P.; Brennan, Sarah C.; Mun, Hee-chang; Bush, Martin; Chen, Yan; Nguyen, Trang X.; Cao, Baohua; Chang, Donald D.; Quick, Matthias; Conigrave, Arthur D.; Colecraft, Henry M.; McDonald, Patricia; Fan, Qing R.

    2016-07-19

    Human calcium-sensing receptor (CaSR) is a G-protein-coupled receptor (GPCR) that maintains extracellular Ca2+homeostasis through the regulation of parathyroid hormone secretion. It functions as a disulfide-tethered homodimer composed of three main domains, the Venus Flytrap module, cysteine-rich domain, and seven-helix transmembrane region. Here, we present the crystal structures of the entire extracellular domain of CaSR in the resting and active conformations. We provide direct evidence that L-amino acids are agonists of the receptor. In the active structure, L-Trp occupies the orthosteric agonist-binding site at the interdomain cleft and is primarily responsible for inducing extracellular domain closure to initiate receptor activation. Our structures reveal multiple binding sites for Ca2+and PO43-ions. Both ions are crucial for structural integrity of the receptor. While Ca2+ions stabilize the active state, PO43-ions reinforce the inactive conformation. The activation mechanism of CaSR involves the formation of a novel dimer interface between subunits.

  19. Esophageal Acid Clearance Is Faster in Patients with Barrett's Esophagus Than in Healthy Controls During Random Swallowing

    DEFF Research Database (Denmark)

    Lottrup, Christian; Krarup, Anne Petas Swane; Gregersen, Hans;

    2016-01-01

    Background/Aims: Impaired esophageal acid clearance may be a contributing factor in the pathogenesis of Barrett's esophagus. However, few studies have measured acid clearance as such in these patients. In this explorative, cross-sectional study, we aimed to compare esophageal acid clearance...... and swallowing rate in patients with Barrett's esophagus to that in healthy controls. Methods: A total of 26 patients with histology-confirmed Barrett's esophagus and 12 healthy controls underwent (1) upper endoscopy, (2) an acid clearance test using a pH-impedance probe under controlled conditions including...... clearance test were not correlated (all P > 0.3). Conclusions: More frequent swallowing and thus faster acid clearance in Barrett's esophagus may constitute a protective reflex due to impaired mucosal integrity and possibly acid hypersensitivity. Despite these reinforced mechanisms, acid clearance ability...

  20. Lupus Gastrointestinal Tract Vasculopathy: Lupus “Enteritis” Involving the Entire Gastrointestinal Tract from Esophagus to Rectum

    OpenAIRE

    Bert, Joseph; Gertner, Elie

    2017-01-01

    Gastrointestinal symptoms are very common in systemic lupus erythematosus (SLE). Lupus “enteritis” is very responsive to treatment but can have devastating consequences if not detected. Most descriptions of enteritis involve the small and large bowel. This is the first report of lupus “enteritis” involving the entire gastrointestinal tract from the esophagus and stomach to the rectum. Lupus “enteritis” is another cause of upper gastrointestinal involvement in SLE (involving even the esophagus...

  1. Randomized Phase II Trial of Lyophilized Strawberries in Patients with Dysplastic Precancerous Lesions of the Esophagus

    Science.gov (United States)

    Chen, Tong; Yan, Fei; Qian, Jiaming; Guo, Mingzhou; Zhang, Hongbing; Tang, Xiaofei; Chen, Fang; Stoner, Gary D.; Wang, Xiaomin

    2016-01-01

    Dysplasia is a histologic precursor of esophageal squamous cell carcinoma (SCC). We previously showed that dietary freeze-dried, or lyophilized, strawberry powder inhibits N-nitrosomethylbenzylamine-induced SCC in the rat esophagus. On the basis of this observation, we conducted a randomized (noncomparative) phase II trial in China to investigate the effects of two doses of freeze-dried strawberries in patients with esophageal dysplastic lesions in a high-risk area for esophageal cancer. We randomly assigned 75 patients identified by endoscopy to have dysplastic esophageal premalignant lesions to receive freeze-dried strawberry powder at either 30 g/d (37 patients) or 60 g/d (38 patients) for six months; the powder was mixed with water and drunk. After six months, we assessed the changes in histologic grade of these lesions (primary endpoint) in a blinded fashion. The dose of 30 g/d, did not significantly affect histology or any other measured parameter. The dose of 60 g/d, however, reduced the histologic grade of dysplastic premalignant lesions in 29 (80.6%) of the 36 patients at this dose who were evaluated for histology (P < 0.0001). The strawberry powder was well tolerated, with no toxic effects or serious adverse events. Strawberries (60 g/d) also reduced protein expression levels of inducible nitric oxide synthase (iNOS) by 79.5% (P < 0.001), cyclooxygenase-2 (COX-2) by 62.9% (P < 0.001), phospho-nuclear factor kappa B (NFκB)-p65 (pNFκB-p65) by 62.6% (P < 0.001), and phospho-S6 (pS6) by 73.2% (P < 0.001). Freeze-dried strawberries (60 g/d) also significantly inhibited the Ki-67 labeling index by 37.9% (P = 0.023). Our present results indicate the potential of freeze-dried strawberry powder for preventing human esophageal cancer, supporting further clinical testing of this natural agent in this setting. PMID:22135048

  2. Endoscopic diagnosis of early carcinoma of the esophagus using Lugol's solution.

    Science.gov (United States)

    Sugimachi, K; Kitamura, K; Baba, K; Ikebe, M; Kuwano, H

    1992-01-01

    Small esophageal lesions, particularly intraepithelial cancers, are extremely difficult to detect. We used Lugol's iodine solution with panendoscopic examination to detect the presence and spread of small squamous cell carcinomas of the esophagus. Serial histologic specimens of the surgically removed esophagus from 32 patients with Lugol's combined endoscopic diagnosis of early esophageal carcinoma were examined to determine the correlation between endoscopic and histologic findings. All of the early staged carcinomas clearly remained unstained by Lugol's solution. We believe that the application of Lugol's solution will greatly aid in instances when a suspicious mucosal lesion is noted, when the margin of the lesion is unclear, or when there is suspicion that a mucosal lesion may have been overlooked.

  3. Confocal laser endomicroscopy for diagnosis of Barrett´s esophagus

    Directory of Open Access Journals (Sweden)

    Helmut eNeumann

    2012-05-01

    Full Text Available Barrett´s esophagus (BE is established as a premalignant condition in the distal esophagus. Current surveillance guidelines recommend random biopsies every 1-2 cm at intervals of 3-5 years. Advanced endoscopic imaging of BE underwent several technical revolutions within the last decade including broad-field (red-flag techniques (e.g. chromoendoscopy and small-field techniques with confocal laser endomicroscopy (CLE at the forefront. In this review we will focus on advanced endoscopic imaging using CLE for the diagnosis and characterization of BE and associated neoplasia. In addition, we will critically discuss the technique of CLE and provide some tricks and hints for the daily routine practice of CLE for diagnosis of BE.

  4. Imaging rat esophagus using combination of reflectance confocal and multiphoton microscopy

    Science.gov (United States)

    Zhuo, S. M.; Chen, J. X.; Jiang, X. S.; Lu, K. C.; Xie, S. S.

    2008-08-01

    We combine reflectance confocal microscopy (RCM) with multiphoton microscopy (MPM) to image rat esophagus. The two imaging modalities allow detection of layered-resolved complementary information from esophagus. In the keratinizing layer, the keratinocytes boundaries can be characterized by RCM, while the keratinocytes cytoplasm (keratin) can be further imaged by multiphoton autofluorescence signal. In the epithelium, the epithelial cellular boundaries and nucleus can be detected by RCM, and MPM can be used for imaging epithelial cell cytoplasm and monitoring metabolic state of epithelium. In the stroma, multiphoton autofluorescence signal is used to image elastin and second harmonic generation signal is utilized to detect collagen, while RCM is used to determine the optical property of stroma. Overall, these results suggest that the combination of RCM and MPM has potential to provide more important and comprehensive information for early diagnosis of esophageal cancer.

  5. [Early complications of pneumatic dilatation in the treatment of primary motility disorders of the esophagus].

    Science.gov (United States)

    Sala, T; Ponce, J; Pertejo, V; Linares, M; Garrigues, V; Berenguer, J

    1990-04-01

    We analyze the incidence and evolution of the early complications of 96 consecutive patients with primary esophagus motor disorders, treated with pneumatic dilatation under endoscopic control (1.4 sessions per patient). In 4 (0.042/patient, 0.029/dilatation) patients the esophagus was perforated; the diagnosis was made in the first 24 hours; pneumomediastinum was a constant finding in the radiological exploration. In three cases the complication was suspected because of the apparition of sustained thoracic pain after the dilatation maneuver and in one case the presentation symptom was bleeding of cardial mucosa, larger than usual, at the end of the dilatation. The four patients evolved favorably with conservative treatment (avoidance of oral food intake, gastroesophageal aspiration, antibiotic therapy and parenteral nutrition).

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

    Directory of Open Access Journals (Sweden)

    H. Zhang

    2015-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Nelson Adami Andreollo

    2003-09-01

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

  8. Ablation of Barrett's esophagus using the second-generation argon plasma coagulation

    Institute of Scientific and Technical Information of China (English)

    Li Zhang; Lei Dong; Jia Liu; Xiao-lan Lu

    2009-01-01

    Objective To investigate the efficacy and safety of the second-generation argon plasma coagulation (VIO APC) in ablation of Barrett's esophagus. Methods Eighteen patients with Barrett's esophagus (12 males, median age of 55 years, median length of 2.1 cm,1 low-grade dysplasia, 13 cases of short segment Barrett's esophagus) received VIO APC, which was performed at a power setting of 40W and argon gas flow at 1. 5-2. 0 L/min, "forced" mode, in 1-3 sessions (mean 1.3). All the patients received treatment with high-dose proton pump inhibitors. The main complaints before ablation were upper abdominal pain in 12 patients (66%), sour regurgitation in 14 patients (77%), and dysphagia or odynophagia in 7 patients (38%). Two patients (11%) had esophageal hiatal hernia. Results The percentage of patients in whom ablation was endoscopically achieved proximal to the gastroesophageal junction was 77. 8%(14/18), and histologically achieved in 66. 7% (12/18). Berried glands were observed in 2 patients who had achieved endoscopic ablation, the areas of Barrett's mucosa were reduced by more than 60% in the other 4 patients. After treatment, 4 patients had transient retrosternal pain and 3 patients had mild epigastric discomfort. One patient had small amounts of hemorrhage during the process, and it ceased after norepinephrine and thrombosin were administered through endoscope biopsy channel. No esophageal stricture or other severe adverse events was observed. During 11.8 (4-15) months' follow-up, the patients who had achieved the complete ablation had no evidence of relapse of Barrett's esophagus. Conclusion VIO APC with a relatively low power setting can effectively ablate the Barrett's mucosa with special intestinal metaplasia when standard APC has been done. No severe adverse events were observed. Long-term follow-up is needed to assess cancer prevention and the durability of the neo-squamous epithelium.

  9. The Trend in Histological Changes and the Incidence of Esophagus Cancer in Iran (2003-2008).

    Science.gov (United States)

    Rafiemanesh, Hosein; Maleki, Farzad; Mohammadian-Hafshejani, Abdollah; Salemi, Morteza; Salehiniya, Hamid

    2016-01-01

    Esophageal cancer is the sixth cause of death in the world, there was a lack of population-based information on the trend and incidence rate of esophagus cancer, so this study aimed to determine the incidence and pathological changes of esophagus cancer in Iran. In this study, data were extracted from annual cancer registry reports of Iranian ministry of health between 2003 and 2008. Standardized incidence rates were calculated using the world standard population, and incidence rate was calculated by age groups, sex, and histological type. Data on epidemiologic trend and histology were analyzed using Joinpoint software package. In this study, there were 18,177 recorded cases of esophagus cancer. Of all cases, 45.72% were females and 54.28% were males. Sex ratio was 1.19. The most common histological types related to squamous cell carcinoma NOS and adenocarcinoma NOS were 64.53% and 10.37%, respectively. The trend of annual changes of incidence rate significantly increased in both sexes. The annual percentage changes, the incidence rate was 7.9 (95% confidence interval [CI]: 3.3-12.6) for women and 9.6 (95% CI: 6.0-13.2) for men. The histology type of SCC, large cell, nonkeratinizing and SCC, keratinizing and SCC, NOS had a significant decreasing trend in total population (P trend of age-standardized incidence rate of esophagus cancer in Iran is rising. Hence, to prevent and control this cancer, it is necessary to investigate related risk factors and implement prevention programs in Iran.

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

    Institute of Scientific and Technical Information of China (English)

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

    2001-01-01

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

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

    DEFF Research Database (Denmark)

    Jørgensen, Anni; Maraldo, M.; Brodin, Nils Patrik

    2013-01-01

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

  12. High definition versus standard definition white light endoscopy for detecting dysplasia in patients with Barrett's esophagus.

    Science.gov (United States)

    Sami, S S; Subramanian, V; Butt, W M; Bejkar, G; Coleman, J; Mannath, J; Ragunath, K

    2015-01-01

    High-definition endoscopy systems provide superior image resolution. The aim of this study was to assess the utility of high definition compared with standard definition endoscopy system for detecting dysplastic lesions in patients with Barrett's esophagus. A retrospective cohort study of patients with non-dysplastic Barrett's esophagus undergoing routine surveillance was performed. Data were retrieved from the central hospital electronic database. Procedures performed for non-surveillance indications, Barrett's esophagus Prague C0M1 classification with no specialized intestinal metaplasia on histology, patients diagnosed with any dysplasia or cancer on index endoscopy, and procedures using advanced imaging techniques were excluded. Logistic regression models were constructed to estimate adjusted odds ratios and 95% confidence intervals comparing outcomes with standard definition and high-definition systems. The high definition was superior to standard definition system in targeted detection of all dysplastic lesions (odds ratio 3.27, 95% confidence interval 1.27-8.40) as well as overall dysplasia detected on both random and target biopsies (odds ratio 2.36, 95% confidence interval 1.50-3.72). More non-dysplastic lesions were detected with the high-definition system (odds ratio 1.16, 95% confidence interval 1.01-1.33). There was no difference between high definition and standard definition endoscopy in the overall (random and target) high-grade dysplasia or cancers detected (odds ratio 0.93, 95% confidence interval 0.83-1.04). Trainee endoscopists, number of biopsies taken, and male sex were all significantly associated with a higher yield for dysplastic lesions. The use of the high-definition endoscopy system is associated with better targeted detection of any dysplasia during routine Barrett's esophagus surveillance. However, high-definition endoscopy cannot replace random biopsies at present time.

  13. Curative effect of photodynamic therapy for 42 cases of moderate or late stage in esophagus cancer

    Science.gov (United States)

    Bai, Xiao-Min; Shen, Guang-Rong; Chen, Weng-Ge; Guo, Tao

    1998-11-01

    34 patients with advanced esophagus cancer and 8 cases of cancer of gastric cardia were treated by photodynamic therapy. The therapeutic effectiveness of the treatment was evaluated according the criteria used in China. CR 63.2 percent SR 11.3 percent, MR 2 percent. The total effective rate was 76.5 percent. There was no significant side effect in this group except mild skin photosensitization and pigmentation and exacerbation of pain in a few cases.

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

    Science.gov (United States)

    Neves, Lucio P.; Santos, William S.; Gorski, Ronan; Perini, Ana P.; Maia, Ana F.; Caldas, Linda V. E.; Orengo, Gilberto

    2014-11-01

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

  15. The Efficacy of Mesenchymal Stem Cell Transplantation in Caustic Esophagus Injury: An Experimental Study

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    Murat Kantarcioglu

    2014-01-01

    Full Text Available Introduction. Ingestion of corrosive substances may lead to stricture formation in esophagus as a late complication. Full thickness injury seems to exterminate tissue stem cells of esophagus. Mesenchymal stem cells (MSCs can differentiate into specific cell lineages and have the capacity of homing in sites of injury. Aim and Methods. We aimed to investigate the efficacy of MSC transplantation, on prevention of esophageal damage and stricture formation after caustic esophagus injury in rats. 54 rats were allocated into four groups; 4 rats were sacrificed for MSC production. Group 1, untreated controls (n: 10. Group 2, membrane labeled MSCs-treated rats (n: 20. Group 3, biodistribution of fluorodeoxyglucose labeled MSCs via positron emission tomography (PET imaging (n: 10. Group 4, sham operated (n: 10. Standard caustic esophageal burns were created and MSCs were transplanted 24 hours after. All rats were sacrificed at the 21st days. Results. PET scan images revealed the homing behavior of MSCs to the injury site. The histopathology damage score was not significantly different from controls. However, we demonstrated Dil labeled epithelial and muscle cells which were originating from transplanted MSCs. Conclusion. MSC transplantation after caustic esophageal injury may be a helpful treatment modality; however, probably repeated infusions are needed.

  16. A mathematical model for the movement of food bolus of varying viscosities through the esophagus

    Science.gov (United States)

    Tripathi, Dharmendra

    2011-09-01

    This mathematical model is designed to study the influence of viscosity on swallowing of food bolus through the esophagus. Food bolus is considered as viscous fluid with variable viscosity. Geometry of esophagus is assumed as finite length channel and flow is induced by peristaltic wave along the length of channel walls. The expressions for axial velocity, transverse velocity, pressure gradient, volume flow rate and stream function are obtained under the assumptions of long wavelength and low Reynolds number. The impacts of viscosity parameter on pressure distribution, local wall shear stress, mechanical efficiency and trapping are numerically discussed with the help of computational results. On the basis of presented study, it is revealed that swallowing of low viscous fluids through esophagus requires less effort in comparison to fluids of higher viscosity. This result is similar to the experimental result obtained by Raut et al. [1], Dodds [2] and Ren et al. [3]. It is further concluded that the pumping efficiency increases while size of trapped bolus reduces when viscosity of fluid is high.

  17. The evolution of viscous flow structures in the esophagus during tracheoesophageal speech

    Science.gov (United States)

    Erath, Byron; Hemsing, Frank

    2015-11-01

    A laryngectomy is an invasive surgical procedure whereby the entire larynx is removed, usually as a result of cancer. Removal of the larynx renders conventional voiced speech impossible, with the most common remediation following surgery being tracheoeosphageal (TE) speech. TE speech is produced by inserting a one-way valve to connect the posterior wall of the trachea with the anterior wall of the esophagus. As air is forced up from the lungs it passes through the prosthesis and into the esophagus. The resulting esophageal pressure field incites self-sustained oscillations of the pharyngoesophageal segment (PES), which ultimately produces sound. Unfortunately, the physics of TE speech are not well understood, with up to 50% of individuals unable to produce intelligible sound. This failure can be related to a lack of understanding regarding the esophageal flow field, where all previous scientific investigations have assumed the flow is one-dimensional and steady. An experimental TE speech flow facility was constructed and particle image velocimetry measurements were acquired at the exit of the model prosthesis (entrance of the esophagus). The flow is observed to be highly unsteady, and the formation and propagation of vortical flow structures through the esophageal tract are identified. Observations regarding the influence of the flow dynamics on the esophageal pressure field and its relation to the successful production of TE speech are discussed.

  18. Anesthetic management for surgery of esophagus atresia in a newborn with Goldenhar's syndrome

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    Rosana Guerrero-Domínguez

    2015-08-01

    Full Text Available BACKGROUND AND OBJECTIVES: Goldenhar's syndrome is a polymalformative condition consisting of a craniofacial dysostosis that determines difficult airway in up to 40% of cases. We described a case of a newborn with Goldenhar's syndrome with esophageal atresia and tracheoesophageal fistula who underwent repair surgery.CASE REPORT: We report the case of a 24-h-old newborn with Goldenhar's syndrome. He had esophageal atresia with distal tracheoesophageal fistula. It was decided that an emergency surgery would be performed for repairing it. It was carried out under sedation, intubation with fibrobronchoscope distal to the fistula, to limit the air flow into the esophagus, and possible abdominal distension. Following complete repair of the esophageal atresia and fistula ligation, the patient was transferred to the intensive care unit and intubated under sedation and analgesia.CONCLUSIONS: The finding of a patient with Goldenhar's syndrome and esophageal atresia assumes an exceptional situation and a challenge for anesthesiologists, since the anesthetic management depends on the patient comorbidity, the type of tracheoesophageal fistula, the usual hospital practice and the skills of the anesthesiologist in charge, with the main peculiarity being maintenance of adequate pulmonary ventilation in the presence of a communication between the airway and the esophagus. Intubation with fibrobronchoscope distal to the fistula deals with the management of a probably difficult airway and limits the passage of air to the esophagus through the fistula.

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

    Institute of Scientific and Technical Information of China (English)

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

    2005-01-01

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

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

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    Caner Isbir

    2016-04-01

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

  1. A battery in the stenotic esophagus of a child with a congenital tracheoesophageal fistula.

    Science.gov (United States)

    Colović, Zavisa; Racić, Goran; Poljak, Nikola Kolja; Sunara, Davor; Klancnik, Marisa; Despot, Ranka

    2012-03-01

    A case of a three-year-old male child who was admitted to our hospital with the suspicion that he had swallowed a battery approximately one hour before admittance. The parents believed that it was a button-shaped lithium battery approximately 12 mm in diameter. A chest X-ray was taken immediately, and a battery was identified in the esophagus at the fifth thoracic vertebra. By reviewing the child's medical history, we found that the child had had surgery the day after birth due to congenital atresia of the esophagus and a tracheoesophageal fistula type III b. An esophagoscopy was performed one hour after admittance, and the battery was found to be partially past the scar from the first surgery. Because of that, the battery was pushed further toward the stomach, out of fear that retrieving the battery through the scarred section of the child's esophagus could damage the stenotic wall. Upon the next X-ray of the abdomen, the battery was observed in the stomach. The child was monitored, and X-rays were taken over the next several days. The battery was evacuated in stool eight days after it had been ingested.

  2. Kaempferol inhibits cell proliferation and glycolysis in esophagus squamous cell carcinoma via targeting EGFR signaling pathway.

    Science.gov (United States)

    Yao, Shihua; Wang, Xiaowei; Li, Chunguang; Zhao, Tiejun; Jin, Hai; Fang, Wentao

    2016-08-01

    Antitumor activity of kaempferol has been studied in various tumor types, but its potency in esophagus squamous cell carcinoma is rarely known. Here, we reported the activity of kaempferol against esophagus squamous cell carcinoma as well as its antitumor mechanisms. Results of cell proliferation and colony formation assay showed that kaempferol substantially inhibited tumor cell proliferation and clone formation in vitro. Flow cytometric analysis demonstrated that tumor cells were induced G0/G1 phase arrest after kaempferol treatment, and the expression of protein involved in cell cycle regulation was dramatically changed. Except the potency on cell proliferation, we also discovered that kaempferol had a significant inhibitory effect against tumor glycolysis. With the downregulation of hexokinase-2, glucose uptake and lactate production in tumor cells were dramatically declined. Mechanism studies revealed kaempferol had a direct effect on epidermal growth factor receptor (EGFR) activity, and along with the inhibition of EGFR, its downstream signaling pathways were also markedly suppressed. Further investigations found that exogenous overexpression of EGFR in tumor cells substantially attenuated glycolysis suppression induced by kaempferol, which implied that EGFR also played an important role in kaempferol-mediated glycolysis inhibition. Finally, the antitumor activity of kaempferol was validated in xenograft model and kaempferol prominently restrained tumor growth in vivo. Meanwhile, dramatic decrease of EGFR activity and hexokinase-2 expression were observed in kaempferol-treated tumor tissue, which confirmed these findings in vitro. Briefly, these studies suggested that kaempferol, or its analogues, may serve as effective candidates for esophagus squamous cell carcinoma management.

  3. Efficacy and safety of endoscopic submucosal dissection for superficial cancer of the cervical esophagus.

    Science.gov (United States)

    Iizuka, Toshiro; Kikuchi, Daisuke; Hoteya, Shu; Kajiyama, Yoshiaki; Kaise, Mitsuru

    2017-08-01

    Cervical esophageal cancer (CEC) is a less common form of cancer and often locally advanced at the time of diagnosis; thus, survival rates for patients with CEC remain poor. However, no reports exist on results of endoscopic submucosal dissection (ESD) for superficial cancer at the cervical esophagus. The aim of this retrospective study was to elucidate the clinicopathological features and clinical outcomes of ESD for superficial CEC.  ESD was performed on 891 lesions (in 662 patients) for superficial esophageal cancer from January 2008 to December 2015. Of these, 45 lesions (45 patients) were enrolled in the case group (CEC), and 405 lesions (375 patients) were enrolled in the control group (superficial cancer in the middle thoracic esophagus). The safety of ESD, including R0 resection rate and adverse events, and the efficacy, such as the local recurrence rate and overall survival rate, were evaluated.  The R0 resection rate was 91.1 % in the case group and 96 % in the control group. The rate of esophageal stricture was significantly higher in the case group (20 %) than in the control group (6.6 %). There was no local recurrence, and the 3-year survival rate was 88.4 % in the case group and 96.7 % in the control group. ESD for superficial cancer in the cervical esophagus was achieved safely, and successful local control was also confirmed. However, the esophageal stricture after ESD was more frequent.

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

    CERN Document Server

    Misra, J C

    2011-01-01

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

  5. NON-THORACOTOMY ESOPHAGECTOMY FOR CARCINOMA OF THE ESOPHAGUS AND CARDIA

    Institute of Scientific and Technical Information of China (English)

    Li Xiangsheng; Ding Yunling; Wu Xuliang

    1998-01-01

    Objective: To try to use Non-Thoracotomy Esophagectomy (NTE) for patient with carcinoma of esophagus and cardia avoiding thoracotomy, and by utilizing a cervical esophagogastric anastomosis in order to reduce perioperative morbidity and mortality. Methods: 18 patients were treated with NTE between 1989 to 1998. Of them, 5adenocarcinoma of the cardia and 13 squamous cell carcinoma of the esophagus (2 upper thoracic, and 11distal third). Everting stripping were performed in all patients. Esophagus were extracted either upwards (n=2)or downwards (n=16). The esophageal substitute was a resulting gastric tube (n=5) or the stomach (n=13) and was positioned in the posterior mediastinum. Results:The mean age of the patients was 64 years (ranged 40 to 72). The male:female ratio was 10:8. The mean intraoperative blood loss was 400 ml. There was no hospital deaths. Only one patient had a cervical esophagogastric anastomotic leakage. Conclusion: NTE is to be recommended becauseof its operative ease, safety and rare operative complications. CT scanning of the thorax and bronchoscopy is necessary before using the technique of NTE.

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

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

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

  7. Embracing change: striated-for-smooth muscle replacement in esophagus development.

    Science.gov (United States)

    Krauss, Robert S; Chihara, Daisuke; Romer, Anthony I

    2016-01-01

    The esophagus functions to transport food from the oropharyngeal region to the stomach via waves of peristalsis and transient relaxation of the lower esophageal sphincter. The gastrointestinal tract, including the esophagus, is ensheathed by the muscularis externa (ME). However, while the ME of the gastrointestinal tract distal to the esophagus is exclusively smooth muscle, the esophageal ME of many vertebrate species comprises a variable amount of striated muscle. The esophageal ME is initially composed only of smooth muscle, but its developmental maturation involves proximal-to-distal replacement of smooth muscle with striated muscle. This fascinating phenomenon raises two important questions: what is the developmental origin of the striated muscle precursor cells, and what are the cellular and morphogenetic mechanisms underlying the process? Studies addressing these questions have provided controversial answers. In this review, we discuss the development of ideas in this area and recent work that has shed light on these issues. A working model has emerged that should permit deeper understanding of the role of ME development and maturation in esophageal disorders and in the functional and evolutionary underpinnings of the variable degree of esophageal striated myogenesis in vertebrate species.

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

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    Suo-lin FU

    2012-09-01

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

  9. Intramural hematoma of the esophagus in a woman with chronic renal failure and prophylactic heparin therapy

    Directory of Open Access Journals (Sweden)

    Francesco Serafini

    2013-04-01

    Full Text Available CASE REPORT An 86 year-old woman experienced chest pain, dyspnea, and dysphagia two days following orthopaedic surgery for a bimalleolus fracture of the right ankle. The patient was on prophylactic low weight molecular heparin and was affected by chronic renal failure. The chest computed tomography (CT ruled out a pulmonary embolism but showed an intramural esophageal mass involving the entire esophagus. The lesion exhibited a blood like CT attenuation content that did not enhance after contrast administration. The esophagogram with gastrografin did not reveal filling defects nor communications between lumen and mucosa. Magnetic resonance confirmed CT results and excluded an aortic dissection. All radiological findings were suggestive of intramural hematoma of the esophagus. DISCUSSION AND CONCLUSIONS Intramural hematoma of the esophagus (IHE is part of the spectrum of esophageal injuries that includes Mallory-Weiss tear and Boerhaave’s syndrome. IHE is the result of a hemorrhage within the submucosal layer. Predisposing conditions are abnormal hemostasis, traumatic events, aortic diseases. It can also occur spontaneously (idiopathic. Treatment should be conservative and includes risk factors withdrawal. The hematoma usually resolves in 1 to 3 weeks.

  10. Signal transduction of bombesin-induced circular smooth muscle cell contraction in cat esophagus

    Institute of Scientific and Technical Information of China (English)

    Sung-Uk Park; Chang-Yell Shin; Jung-Su Ryu; Hyen-O La; Sun-Young Park; Hyun-Ju Song; Young-Sil Min; Dong-Seok Kim; Uy-Dong Sohn

    2006-01-01

    AIM: To investigate the mechanism of bombesin-induced circular smooth muscle cell contraction in cat esophagus.METHODS: Specific G protein or phospholipase C involved in cat esophagus contraction was identified,muscle cells were permeabilized with saponin. After permeabilization of muscle cells, the Gi3 antibody inhibited bombesin-induced smooth muscle cell contraction.RESULTS: Incubation of permeabilized circular muscle cells with PLC-β3 antibody could inhibit bombesin-induced contraction. H-7, chelerythrine (PKC inhibitor)and genistein (protein tyrosine kinase inhibitor) inhibited bombesin-induced contraction, but DAG kinase inhibitor,R59949, could not inhibit it. To examine which mitogenactivated protein kinase (MAPK) was involved in bombesin-induced contraction, the specific MAPK inhibitors (MEK inhibitor, PD98059 and p38 MAPK inhibitor, SB202190)were used. Preincubation of PD98059 blocked the contraction induced by bombesin in a concentration-dependent manner. However, SB202190 had no effects on contraction.CONCLUSION: Bombesin-induced circular muscle cell contraction in cat esophagus is madiated via a PKC or a PTK-dependent pathway or p44/p42 MAPK pathway.

  11. Verrucous carcinoma of the esophagus: A case report and literature review.

    Science.gov (United States)

    Ramani, Chintan; Shah, Neil; Nathan, Ramasamy Swami

    2014-07-16

    Verrucous carcinoma of the esophagus is a variant of a squamous cell cancer. Our case is a 78-year-old male patient comes in with the dysphagia and weight loss, and on endoscopy (EGD) he is found to have an irregular intraluminal mass at the distal esophagus. With the deep EGD assisted biopsy, diagnosis of the verrucous carcinoma is made. Due to multiple co morbidities and possible infiltration to the pericardium, patient is taken for the esophageal stent placement and is being referred for the chemo-radiation treatment. The diagnosis can be very difficult to make with the superficial biopsies due to very non specific histological changes and requires very high clinical suspicion and deep mucosal biopsies are required for accurate diagnosis of the tumor. Chronic and local disease process is the main risk factor for the development of the verrucous carcinoma of the esophagus. Surgery is the treatment of the choice for the early stage tumor and advanced cases are treated with the palliation and possibly chemo- radiation. The prognosis is usually guarded and needs long term follow up.

  12. Circumferential optical coherence tomography angiography imaging of the swine esophagus using a micromotor balloon catheter.

    Science.gov (United States)

    Lee, Hsiang-Chieh; Ahsen, Osman Oguz; Liang, Kaicheng; Wang, Zhao; Cleveland, Cody; Booth, Lucas; Potsaid, Benjamin; Jayaraman, Vijaysekhar; Cable, Alex E; Mashimo, Hiroshi; Langer, Robert; Traverso, Giovanni; Fujimoto, James G

    2016-08-01

    We demonstrate a micromotor balloon imaging catheter for ultrahigh speed endoscopic optical coherence tomography (OCT) which provides wide area, circumferential structural and angiographic imaging of the esophagus without contrast agents. Using a 1310 nm MEMS tunable wavelength swept VCSEL light source, the system has a 1.2 MHz A-scan rate and ~8.5 µm axial resolution in tissue. The micromotor balloon catheter enables circumferential imaging of the esophagus at 240 frames per second (fps) with a ~30 µm (FWHM) spot size. Volumetric imaging is achieved by proximal pullback of the micromotor assembly within the balloon at 1.5 mm/sec. Volumetric data consisting of 4200 circumferential images of 5,000 A-scans each over a 2.6 cm length, covering a ~13 cm(2) area is acquired in <18 seconds. A non-rigid image registration algorithm is used to suppress motion artifacts from non-uniform rotational distortion (NURD), cardiac motion or respiration. En face OCT images at various depths can be generated. OCT angiography (OCTA) is computed using intensity decorrelation between sequential pairs of circumferential scans and enables three-dimensional visualization of vasculature. Wide area volumetric OCT and OCTA imaging of the swine esophagus in vivo is demonstrated.

  13. Feasibility of laser marking in Barrett's esophagus with volumetric laser endomicroscopy: first-in-man pilot study.

    Science.gov (United States)

    Swager, Anne-Fré; de Groof, Albert J; Meijer, Sybren L; Weusten, Bas L; Curvers, Wouter L; Bergman, Jacques J

    2017-09-01

    Volumetric laser endomicroscopy (VLE) provides a circumferential scan of the esophageal wall layers and has potential to improve detection of neoplasia in Barrett's esophagus (BE). The novel VLE laser marking system enables direct in vivo marking of suspicious areas as identified on VLE. These laser marked areas can subsequently be targeted for biopsies. The aim was to evaluate the visibility and positional accuracy of laser marks (LMs) in different esophageal tissue types on white light endoscopy (WLE) and VLE. Patients with BE with or without neoplasia underwent imaging with VLE. Protocol refinements were practiced in a learning phase. In the second phase, visibility of LMs was assessed by random marking in squamous, BE, and gastric tissue. In phase 3, positional accuracy of the LMs was tested by identifying and laser marking surrogate targets (endoscopically placed cautery marks). In the final phase, the most suspicious areas for neoplasia were identified in each patient using VLE, targeted by LMs, and biopsy samples subsequently obtained. Sixteen patients with BE were included (14 men; median age, 68 years), 1 of whom was included twice in different study phases. Worst histologic diagnoses were 9 non-dysplastic Barrett's esophagus (NDBE), 3 low-grade dysplasia (LGD), 4 high-grade dysplasia (HGD), and 1 early adenocarcinoma (EAC). In total, 222 LMs were placed, of which 97% was visible on WLE. All LMs were visible on VLE directly after marking, and 86% could be confirmed during post hoc analysis. LM targeting was successful with positional accuracy in 85% of cautery marks. Inaccurate targeting was caused by system errors or difficult cautery mark visualization on VLE. In the final phase (5 patients), 18 areas suspicious on VLE were identified, which were all successfully targeted by LMs (3 EAC, 3 HGD, 1 LGD, and 11 NDBE). Mean VLE procedure time was 22 minutes (±6 minutes standard deviation); mean endoscopy time was 56 minutes (±17 minutes). No adverse events

  14. Statistical Analysis 82 Cases Esophagus Cancer%82例食管癌统计分析

    Institute of Scientific and Technical Information of China (English)

    张桂清; 孔平; 秦永胜

    2011-01-01

    目的 分析食管癌住院病人临床资料,为食管癌的预防和控制提供依据.方法 回顾分析食管癌病人出院病案及相关资料,对食管癌患者的性别、年龄、及其转归等情况进行综合分析.结果 在82例食管癌病人中60岁-69岁组病人构成比最大(32例,39.0%),50岁以下最少(3例,3.7%).治愈1例(1.2%),好转51例(62.2%),死亡3例(3.7%).结论 应提高人们的自我防患意识,改变不良生活习惯,同时加强对高危人群的筛查和重点防治,提高早期诊断率,做到早发现、早治疗.%O bjective T his article analyzes the clinical m aterials of hospitalization patients of esophagus cancer providing basis for the prevention andcontrol of esophagus cancer.M ethods It had retrospective analysis on discharge m edical records and related m aterials of esophagus cancer,com prehensivelyanalyzing the gender,ages and prognosis of esophagus cancer.R esults In these 82 esophagus cancer patients,the constituent ratio of people from60 to 69 ages is the biggest (32 cases,39.0 % ),people under 50 ages are the least (3 cases,3.7 % ).O ne case is cured (1.2 % ) ;51 cases are im -proved ;3 cases are dead (3.7 % ).C onclusions W e need self-prevention consciousness im provem ent and bad life habit change,screening of high riskpeople and key prevention strengthening as w ell,im proving early diagnosis rate for early discover and treatm ent.

  15. Fully automatic segmentation of complex organ systems: example of trachea, esophagus and heart segmentation in CT images

    Science.gov (United States)

    Meyer, Carsten; Peters, Jochen; Weese, Jürgen

    2011-03-01

    Automatic segmentation is a prerequisite to efficiently analyze the large amount of image data produced by modern imaging modalities. Many algorithms exist to segment individual organs or organ systems. However, new clinical applications and the progress in imaging technology will require the segmentation of more and more complex organ systems composed of a number of substructures, e.g., the heart, the trachea, and the esophagus. The goal of this work is to demonstrate that such complex organ systems can be successfully segmented by integrating the individual organs into a general model-based segmentation framework, without tailoring the core adaptation engine to the individual organs. As an example, we address the fully automatic segmentation of the trachea (around its main bifurcation, including the proximal part of the two main bronchi) and the esophagus in addition to the heart with all chambers and attached major vessels. To this end, we integrate the trachea and the esophagus into a model-based cardiac segmentation framework. Specifically, in a first parametric adaptation step of the segmentation workflow, the trachea and the esophagus share global model transformations with adjacent heart structures. This allows to obtain a robust, approximate segmentation for the trachea even if it is only partly inside the field-of-view, and for the esophagus in spite of limited contrast. The segmentation is then refined in a subsequent deformable adaptation step. We obtained a mean segmentation error of about 0.6mm for the trachea and 2.3mm for the esophagus on a database of 23 volumetric cardiovascular CT images. Furthermore, we show by quantitative evaluation that our integrated framework outperforms individual esophagus segmentation, and individual trachea segmentation if the trachea is only partly inside the field-of-view.

  16. Lymph node metastases of adenocarcinoma of the esophagus and esophagogastric junction

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xun; David I Watson; Glyn G Jamieson

    2007-01-01

    Background Esophageal adenocarcinoma is becoming an increasingly important problem.It has been the most rapidly increasing malignancy in western countries in the last decades,and its prognosis is poor.The aim of this study was to evaluate the relationship between tumor invasion depth and lymph node metastasis for adenocarcinoma of the esophagus and esophagogastric junction,and to analyze the impact of lymph node metastases on survival of the patients.Methods The study group comprised 121 patients with adenocarcinoma of the esophagus or esophagogastric junction,who underwent esophagectomy between January 1985 and December 2003 at either the Royal Adelaide Hospital or the Flinders Medical Center,Australia.Overall,there were 101 males and 20 females,with a mean age at surgery of 62 years(range 36-80).All of them were followed up for 6 months to 13 years(mean,6.5 years).The relationship between tumor invasion depth and lymph node metastasis,as well as between survival and lymph node metastasis in these patients were analyzed by Chi-square or Fisher's exact test.A P<0.05 was considered statistically significant.Results The tumors were located entirely within the esophagus in 83 patients,and involved the gastro-esophageal junction in 38.The overall resection rate was 96.7%(117/121).When tumor invasion was within mucosa or submucosa of the esophagus(T1),the lymph node metastasis rate was 22.2%(10/45),the mean number of metastatic lymph nodes was 0.3,and the proportion of more than 4 lymph nodess metastases was 0% (0/45).When tumor invaded the adjacent structures of the esophagus(T4),the lymph node metastasis rate was 85.7%(6/7);the mean number of metastatic lymph nodes was 5.1,and the proportion of more than 4 lymph nodes metastases was 71.4%(5/7).There was a significant difference between T1 and T4(P<0.01).The 5-year survival rate for patients without lymph node metastasis was 52.9%,for those with 1-4 nodes involved was 11.5%,and for patients with more than 4 positive

  17. A laser-induced pulsed water jet for layer-selective submucosal dissection of the esophagus.

    Science.gov (United States)

    Nakano, T; Sato, C; Yamada, M; Nakagawa, A; Yamamoto, H; Fujishima, F; Tominaga, T; Satomi, S; Ohuchi, N

    2016-10-01

    Background and aims: Conventional water jet devices have been used for injecting fluid to lift up lesions during endoscopic submucosal dissection or endoscopic mucosal resection procedures. However, these devices cannot dissect the submucosal layer effectively. Here we aim to elucidate the dissection capability of a laser-induced pulsed water jet and to clarify the mechanism of dissection with layer selectivity. Materials (Subjects) and methods: Pulsed water jets were ejected from a stainless nozzle by accelerating saline using the energy of a pulsed holmium: yttrium-aluminum-garnet laser. The impact force (strength) of the jet was evaluated using a force meter. Injection of the pulsed jet into the submucosal layer was documented by high-speed imaging. The physical properties of the swine esophagus were evaluated by measuring the breaking strength. Submucosal dissection of the swine esophagus was performed and the resection bed was evaluated histologically. Results: Submucosal dissection of the esophagus was accomplished at an impact force of 1.11-1.47 N/pulse (laser energy: 1.1-1.5 J/pulse; standoff distance: 60 mm). Histological specimens showed clear dissection at the submucosal layer without thermal injury. The mean static breaking strength of the submucosa (0.11 ± 0.04 MPa) was significantly lower than that of the mucosa (1.32 ± 0.18 MPa), and propria muscle (1.45 ± 0.16 MPa). Conclusions: The pulsed water jet device showed potential for achieving selective submucosal dissection. It could achieve mucosal, submucosal, and muscle layer selectivity owing to the varied breaking strengths.

  18. Modulation of gene expression in precancerous rat esophagus by dietary zinc deficit and replenishment.

    Science.gov (United States)

    Liu, Chang-Gong; Zhang, Liang; Jiang, Yubao; Chatterjee, Devjani; Croce, Carlo M; Huebner, Kay; Fong, Louise Y Y

    2005-09-01

    Zinc deficiency in rats enhances esophageal cell proliferation, causes alteration in gene expression, and promotes esophageal carcinogenesis. Zinc replenishment rapidly induces apoptosis in the esophageal epithelium thereby reversing cell proliferation and carcinogenesis. To identify zinc-responsive genes responsible for these divergent effects, we did oligonucleotide array-based gene expression profiling analyses in the precancerous zinc-deficient esophagus and in zinc-replenished esophagi after treatment with intragastric zinc compared with zinc-sufficient esophagi. Thirty-three genes (21 up-regulated and 12 down-regulated) showed a > or = 2-fold change in expression in the hyperplastic zinc-deficient versus zinc-sufficient esophageal epithelia. Expression of genes involved in cell division, survival, adhesion, and tumorigenesis were markedly changed. The zinc-sensitive gene metallothionein-1 (MT-1 was up-regulated 7-fold, the opposite of results for small intestine and liver under zinc-deficient conditions. Keratin 14 (KRT14, a biomarker in esophageal tumorigenesis), carbonic anhydrase II (CAII, a regulator of acid-base homeostasis), and cyclin B were up-regulated >4-fold. Immunohistochemistry showed that metallothionein and keratin 14 proteins were overexpressed in zinc-deficient esophagus, as well as in lingual and esophageal squamous cell carcinoma from carcinogen-treated rats, emphasizing their roles in carcinogenesis. Calponin 1 (CNN1, an actin cross-linking regulator) was down-regulated 0.2-fold. Within hours after oral zinc treatment, the abnormal expression of 29 of 33 genes returned to near zinc-sufficient levels, accompanied by reversal of the precancerous phenotype. Thus, we have identified new molecular markers in precancerous esophagus and showed their restoration by zinc replenishment, providing insights into the interaction between zinc and gene expression in esophageal cancer development and prevention.

  19. Acute Esophagus Toxicity in Lung Cancer Patients After Intensity Modulated Radiation Therapy and Concurrent Chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Kwint, Margriet [Department of Radiation Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Uyterlinde, Wilma [Department of Thoracic Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Nijkamp, Jasper; Chen, Chun; Bois, Josien de; Sonke, Jan-Jakob [Department of Radiation Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Heuvel, Michel van den [Department of Thoracic Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Knegjens, Joost; Herk, Marcel van [Department of Radiation Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Belderbos, Jose, E-mail: j.belderbos@nki.nl [Department of Radiation Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands)

    2012-10-01

    Purpose: The purpose of this study was to investigate the dose-effect relation between acute esophageal toxicity (AET) and the dose-volume parameters of the esophagus after intensity modulated radiation therapy (IMRT) and concurrent chemotherapy for patients with non-small cell lung cancer (NSCLC). Patients and Methods: One hundred thirty-nine patients with inoperable NSCLC treated with IMRT and concurrent chemotherapy were prospectively analyzed. The fractionation scheme was 66 Gy in 24 fractions. All patients received concurrently a daily dose of cisplatin (6 mg/m Superscript-Two ). Maximum AET was scored according to Common Toxicity Criteria 3.0. Dose-volume parameters V5 to V70, D{sub mean} and D{sub max} of the esophagus were calculated. A logistic regression analysis was performed to analyze the dose-effect relation between these parameters and grade {>=}2 and grade {>=}3 AET. The outcome was compared with the clinically used esophagus V35 prediction model for grade {>=}2 after radical 3-dimensional conformal radiation therapy (3DCRT) treatment. Results: In our patient group, 9% did not experience AET, and 31% experienced grade 1 AET, 38% grade 2 AET, and 22% grade 3 AET. The incidence of grade 2 and grade 3 AET was not different from that in patients treated with CCRT using 3DCRT. The V50 turned out to be the most significant dosimetric predictor for grade {>=}3 AET (P=.012). The derived V50 model was shown to predict grade {>=}2 AET significantly better than the clinical V35 model (P<.001). Conclusions: For NSCLC patients treated with IMRT and concurrent chemotherapy, the V50 was identified as most accurate predictor of grade {>=}3 AET. There was no difference in the incidence of grade {>=}2 AET between 3DCRT and IMRT in patients treated with concurrent chemoradiation therapy.

  20. Radiotherapy for Carcinoma of the Esophagus: Progress of Treatment and Research in China

    Institute of Scientific and Technical Information of China (English)

    Jie Jiang; Zefen Xiao; Weibo Yin

    2006-01-01

    Carcinoma of the esophagus is a common malignancy in China. Radiotherapy is one of the most important modalities of treatment.This article provides a review of the natural history of this disease, the results of radiotherapy for esophageal cancer and the recent advances in radiation techniques in China. Significant progress has been made in this area of research and treatment. Combined treatment modalities and new therapies are being evaluated and may be expected to contribute to improved patient outcomes and better palliation of symptoms in the future.

  1. Role of Confocal Laser Endomicroscopy in Detection of Residual Barrett's Esophagus after Radiofrequency Ablation

    Directory of Open Access Journals (Sweden)

    Giorgio Diamantis

    2011-01-01

    Full Text Available Endoscopic endoluminal radiofrequency ablation (RFA is a novel and promising modality for Barrett's esophagus (BE treatment. Actually the only surveillance method after the ablation treatment is random biopsies throughout the whole treated area. Confocal laser endomicroscopy (CLE is a new endoscopic imaging tool that permits high-resolution microscopic examination of the gastrointestinal tract. The technology has garnered increasing attention because of its ability to provide real-time “optical” biopsy specimens, with a very high sensitivity and specificity. This paper summarize the potential application of CLE in the surveillance of the reepithelialization of BE, after endoscopic RFA.

  2. A Battery in the Stenotic Esophagus of a Child with a Congenital Tracheoesophageal Fistula

    OpenAIRE

    Čolović, Zaviša; Račić, Goran; KOLJA POLJAK, NIKOLA; Sunara, Davor; Klančnik, Marisa; Despot, Ranka

    2012-01-01

    A case of a three-year-old male child who was admitted to our hospital with the suspicion that he had swallowed a battery approximately one hour before admittance. The parents believed that it was a button-shaped lithium battery approximately 12 mm in diameter. A chest X-ray was taken immediately, and a battery was identified in the esophagus at the fifth thoracic vertebra. By reviewing the child’s medical history, we found that the child had had surgery the day after birth due to congenital ...

  3. Embedded Pork Bone Causing Esophageal Perforation and an Esophagus-Innominate Artery Fistula

    Directory of Open Access Journals (Sweden)

    Andrew C. Berry

    2014-01-01

    Full Text Available Chronically embedded foreign bodies can lead to perforations, mediastinitis, and abscess, amongst a host of other complications. A 20-year-old mentally challenged female presented with “something stuck in her throat,” severe dysphagia, and recurrent vomiting. Initial imaging was unremarkable; however, subsequent imaging and esophagogastroduodenoscopy two weeks later revealed an embedded pork bone. Surgery was performed to remove the bone and fix the subsequent esophageal perforation and esophagus-innominate artery fistula. This case helps reinforce the urgency in removing an ingested foreign body and the ramifications that may arise with chronically embedded foreign bodies.

  4. Role of Obesity in the Pathogenesis and Progression of Barrett's Esophagus.

    Science.gov (United States)

    Chandar, Apoorva Krishna; Iyer, Prasad G

    2015-06-01

    Central obesity is involved in the pathogenesis and progression of Barrett's esophagus to esophageal adenocarcinoma. Involved are likely both mechanical and nonmechanical effects. Mechanical effects of increased abdominal fat cause disruption of the gastroesophageal reflux barrier leading to increased reflux events. Nonmechanical effects may be mediated by inflammation, via classically activated macrophages, pro-inflammatory cytokines, and adipokines such as Leptin, all of which likely potentiate reflux-mediated inflammation. Insulin resistance, associated with central obesity, is also associated with both Barrett's pathogenesis and progression to adenocarcinoma. Molecular pathways activated in obesity, inflammation and insulin resistance overlap with those involved in Barrett's pathogenesis and progression. Copyright © 2015 Elsevier Inc. All rights reserved.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-10-15

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

  6. RARE CASE OF ESOPHAGUS LESION IN PATTENT WITH BEHCET’S DISEASE

    Directory of Open Access Journals (Sweden)

    V. G. Barskova

    2001-01-01

    Full Text Available 33-year-old patient with Behcet's disease developed severe lesion of gastro-intestmal tract involving esophagus. Behcet’s disease diagnosis was verified by recurrent aphtous stomatitis, genital ulcers and erythema nodosum. Peculiarity of this case was wide involving of gastro-iniestinal tract with multiple ulcers in ileocecum and esophagitis leading to the development of diverticulum and gullet narrowing. This case demonstrates the results of late diagnosis of the disease as the diagnosis was determined in IS years after the onset of first symptoms.

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

    Institute of Scientific and Technical Information of China (English)

    ElfriedeBollschweiler; EvaWolfgarten

    2004-01-01

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

  8. Autofluorescence endoscopy in surveillance of Barrett's esophagus: a multicenter randomized trial on diagnostic efficacy.

    Science.gov (United States)

    Borovicka, J; Fischer, J; Neuweiler, J; Netzer, P; Gschossmann, J; Ehmann, T; Bauerfeind, P; Dorta, G; Zürcher, U; Binek, J; Meyenberger, C

    2006-09-01

    The reference surveillance method in patients with Barrett's esophagus is careful endoscopic observation, with targeted as well as random four-quadrant biopsies. Autofluorescence endoscopy (AFE) may make it easier to locate neoplasia. The aim of this study was to elucidate the diagnostic accuracy of surveillance with AFE-guided plus four-quadrant biopsies in comparison with the conventional approach. A total of 187 of 200 consecutive Barrett's esophagus patients who were initially enrolled (73 % male, mean age 67 years, mean Barrett's segment length 4.6 cm), who underwent endoscopy for Barrett's esophagus in four study centers, were randomly assigned to undergo either AFE-targeted biopsy followed by four-quadrant biopsies or conventional endoscopic surveillance, also including four-quadrant biopsies (study phase 1). After exclusion of patients with early cancer or high-grade dysplasia, who underwent endoscopic or surgical treatment, as well as those who declined to participate in phase 2 of the study, 130 patients remained. These patients were examined again with the alternative method after a mean of 10 weeks, using the same methods described. The main study parameter was the detection of early cancer/adenocarcinoma or high-grade dysplasia (HGD), comparing both approaches in study phase 1; the secondary study aim in phase 2 was to assess the additional value of the AFE-guided approach after conventional surveillance, and vice versa. Test accuracy measures were derived from study phase 1. In study phase 1, the AFE and conventional approaches yielded adenocarcinoma/HGD rates of 12 % and 5.3 %, respectively, on a per-patient basis. With AFE, four previously unrecognized adenocarcinoma/HGD lesions were identified (4.3 % of the patients); with the conventional approach, one new lesion (1.1 %) was identified. Of the 19 adenocarcinoma/HGD lesions detected during AFE endoscopy in study phase 1, eight were visualized, while 11 were only detected using untargeted four

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-07-15

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

  10. Nicotinic cholinergic receptors in esophagus: Early alteration during carcinogenesis and prognostic value

    Science.gov (United States)

    Chianello Nicolau, Marina; Pinto, Luis Felipe Ribeiro; Nicolau-Neto, Pedro; de Pinho, Paulo Roberto Alves; Rossini, Ana; de Almeida Simão, Tatiana; Soares Lima, Sheila Coelho

    2016-01-01

    AIM To compare expression of nicotinic cholinergic receptors (CHRNs) in healthy and squamous cell carcinoma-affected esophagus and determine the prognostic value. METHODS We performed RT-qPCR to measure the expression of CHRNs in 44 esophageal samples from healthy individuals and in matched normal surrounding mucosa, and in tumors from 28 patients diagnosed with esophageal squamous cell carcinoma (ESCC). Next, we performed correlation analysis for the detected expression of these receptors with the habits and clinico-pathological characteristics of all study participants. In order to investigate the possible correlations between the expression of the different CHRN subunits in both healthy esophagus and tissues from ESCC patients, correlation matrices were generated. Subsequently, we evaluated whether the detected alterations in expression of the various CHRNs could precede histopathological modifications during the esophageal carcinogenic processes by using receiver operating characteristic curve analysis. Finally, we evaluated the impact of CHRNA5 and CHRNA7 expression on overall survival by using multivariate analysis. RESULTS CHRNA3, CHRNA5, CHRNA7 and CHRNB4, but not CHRNA1, CHRNA4, CHRNA9 or CHRNA10, were found to be expressed in normal (healthy) esophageal mucosa. In ESCC, CHRNA5 and CHRNA7 were overexpressed as compared with patient-matched surrounding non-tumor mucosa (ESCC-adjacent mucosa; P < 0.0001 and P = 0.0091, respectively). Positive correlations were observed between CHRNA3 and CHRNB4 expression in all samples analyzed. Additionally, CHRNB4 was found to be differentially expressed in the healthy esophagus and the normal-appearing ESCC-adjacent mucosa, allowing for distinguishment between these tissues with a sensitivity of 75.86% and a specificity of 78.95% (P = 0.0002). Finally, CHRNA5 expression was identified as an independent prognostic factor in ESCC; patients with high CHRNA5 expression showed an increased overall survival, in comparison with

  11. Primary adenocarcinomas of lower esophagus, esophagogastric junction and gastric cardia: in special reference to China

    Institute of Scientific and Technical Information of China (English)

    Li-Dong Wang; Shu Zheng; Zuo-Yu Zheng; Alan G. Casson

    2003-01-01

    Gastric cardia adenocarcinoma (GCA) is an under-studied subject. The pathogenesis, molecular changes in the early stage of carcinogenesis and related risk factors have not been well characterized. There is evidence, however, that GCA differs from cancer of the rest of the stomach in terms of natural history and histopathogenesis. Adenocarcinomas of the lower esophagus, esophagogastric junction (EGJ)and gastric cardia have been given much attention because of their increasing incidences in the past decades, which is in striking contrast with the steady decrease in distal stomach adenocarcinoma. In China, epidemiologically, GCA shares very similar geographic distribution with esophageal squamous cell carcinoma (SCC), especially in Linzhou (formerly Linxian County), Henan Province, North China,the highest incidence area of esophageal SCC in the world.Historically, both GCA and SCC in these areas were referred to as esophageal cancer (EC) by the public because of the common syndrome of dysphagia. In Western countries,Barrett's esophagus is very common and has been considered as an important precancerous lesion of adenocarcinoma at EGJ. Because of the low incidence of Barrett's esophagus in China, it is unlikely to be an important factor in early stage of EGJ adenocarcinoma development.However, Z line up-growth into lower esophagus may be one of the characteristic changes in these areas in early stage of GCA development. Whether intestinal metaplasia (IM) is a premalignant lesion for GCA is still not clear. Higher frequency of IM observed at adjacent GCA tissues in Henan suggests the possibility of IM as a precancerous lesion for GCA in these areas. Molecular information on GCA,especially in early stage, is very limited. The accumulated data about the changes of tumor suppressor gene, such as p53 mutation, and ontogeny, such as C-erbB2, especially the similar alterations in GCA and SCC in the same patient,indicated that there might be some similar risk factors,such as

  12. Periprocedural 3D imaging of the left atrium and esophagus: comparison of different protocols of 3D rotational angiography of the left atrium and esophagus in group of 547 consecutive patients undergoing catheter ablation of the complex atrial arrhythmias.

    Science.gov (United States)

    Starek, Zdenek; Lehar, František; Jez, Jiri; Wolf, Jiri; Kulik, Tomas; Zbankova, Alena; Novak, Miroslav

    2016-07-01

    A new method in creating 3D models of the left atrium (LA) and esophagus before catheter ablation of atrial arrhythmias is 3D rotational angiography (3DRA) of the LA. The purpose of this retrospective study was to test various acquisition protocols of the 3DRA and attempt to define the parameters influencing the success of the protocols. From August 2010 to November 2014, 3DRA of the LA using the Philips Allura FD 10 X-ray system was performed in 547 consecutive patients using right atrial and left atrial protocols. Visualization of the esophagus was performed after oral administration of a contrast agent. Patients were monitored for success (creation of a useful 3D models) and evaluated for a number of parameters affecting the success of 3DRA. The success of the RA protocol was 88.89 % with and 91.91 % without esophagus imaging. The success of the LA protocol was 97.42 % with and 94.54 % without esophagus imaging. The only factor reducing the success of the RA protocol was BMI; the LA protocol was not influenced by any factor. Ventricular fibrillation induced in two patients was successfully treated with defibrillation. 3DRA of the LA is a reliable method that supports catheter ablation of complex atrial arrhythmias. The LA protocol with esophagus imaging was significantly more reliable than the RA protocol; the other protocols were comparable. The RA protocol may be negatively affected by high BMI. Simultaneous imaging of the esophagus is safe and feasible, and the LA protocol can be recommended.

  13. Cellular heterogeneity in the mouse esophagus implicates the presence of a non-quiescent epithelial stem cell population

    Science.gov (United States)

    DeWard, Aaron D.; Cramer, Julie; Lagasse, Eric

    2014-01-01

    SUMMARY Because the esophageal epithelium lacks a defined stem cell niche, it is unclear whether all basal epithelial cells in the adult esophagus are functionally equivalent. In this study, we showed that basal cells in the mouse esophagus contained a heterogeneous population of epithelial cells, similar to other rapidly cycling tissues such as the intestine or skin. Using a combination of cell surface markers, we separated primary esophageal tissue into distinct cell populations that harbored differences in stem cell potential. We also utilized an in vitro 3-D organoid assay to demonstrate that Sox2, Wnt, and bone morphogenetic protein (BMP) signaling regulate esophageal self-renewal. Finally, we labeled proliferating basal epithelial cells in vivo to show differing cell cycle profiles and proliferation kinetics. Based on our results, we propose that a non-quiescent stem cell population resides in the basal epithelium of the mouse esophagus. PMID:25373907

  14. Does Cytokeratin7/20 immunoreactivity help to distinguish Barrett's esophagus from gastric intestinal metaplasia? Results of a prospective study of 75 patients.

    Science.gov (United States)

    Schilling, D; Spiethoff, A; Rosenbaum, Anika; Hartmann, D; Eickhoff, A; Jakobs, R; Weickert, U; Rebe, M; Bohrer, M H; Riemann, J F

    2005-01-01

    Barrett's esophagus is a recognized risk factor for the development of esophageal dysplasia and carcinoma. Unfortunately, gastric incomplete intestinal metaplasia arising in Short Segment Barrett's esophagus can be indistinguishable histologically on hematoxylin/eosin stains. Distinct patterns of CK 7 and CK 20 immunohistochemical expression have been demonstrated to be both highly sensitive and specific for Barrett's esophagus, but have not been found in gastric metaplasia. The aim of our study was to test whether immunostaining with CK 7/20 helps to distinguish between Barrett's epithelium and gastric incomplete metaplasia. Cases of long segment Barrett's esophagus, short segment Barrett's esophagus, and cases with a normal gastroesophageal junction, as well as specimens with gastric antral intestninal metaplasia, were examined: three patterns were defined. Barrett's pattern (superficial CK 20 staining; superficial and crypt CK 7 staining); gastric pattern (superficial and crypt staining of both markers); other patterns (different from Barrett and gastric types). Seventy-five patients were enrolled in this study, 26 with long segment Barrett's esophagus, 21 with short segment esophagus, 13 with intestinal metaplasia of the cardia, and 18 with antral intestinal metaplasia. The Barrett pattern showed a high specificity of 97%, but a sensitivity of only 30% in patients with short segment Barrett esophagus. Our results do not confirm the hypothesis that CK 7/20 immunostaining can be used for a reliable differentiation between incomplete intestinal metaplasia and Barrett's epithelium.

  15. Cyclooxygenase-2 and epithelial growth factor receptor up-regulation during progression of Barrett's esophagus to adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    Yan Li; John M Wo; Mukunda B Ray; Whitney Jones; Ruifeng R Su; Susan Ellis; Robert C G Martin

    2006-01-01

    AIM: To investigate the expression of cyclooxygenase-2(COX-2) and epithelial growth factor receptor (EGFR)throughout the progression of Barrett's esophagus (BE).METHODS: COX-2 and EGFR protein expressions were detected by using immunohistochemical method. A detailed cytomorphological changes were determined.Areas of COX-2 and EGFR expression were quantified by using computer Imaging System.RESULTS: The expressions of both COX-2 and EGFR increased along with the progression from BE to esophagus adenocarcinoma (EAC). A positive correlation was found between COX-2 expression and EGFR expression.CONCLUSION: COX-2 and EGFR may be cooperative in the stepwise progression from BE to EAC, thereby leading to carcinogenesis.

  16. Lupus Gastrointestinal Tract Vasculopathy: Lupus “Enteritis” Involving the Entire Gastrointestinal Tract from Esophagus to Rectum

    Science.gov (United States)

    Bert, Joseph; Gertner, Elie

    2017-01-01

    Gastrointestinal symptoms are very common in systemic lupus erythematosus (SLE). Lupus “enteritis” is very responsive to treatment but can have devastating consequences if not detected. Most descriptions of enteritis involve the small and large bowel. This is the first report of lupus “enteritis” involving the entire gastrointestinal tract from the esophagus and stomach to the rectum. Lupus “enteritis” is another cause of upper gastrointestinal involvement in SLE (involving even the esophagus and stomach) in addition to involvement of the lower intestinal tract. PMID:28203138

  17. Lupus Gastrointestinal Tract Vasculopathy: Lupus “Enteritis” Involving the Entire Gastrointestinal Tract from Esophagus to Rectum

    Directory of Open Access Journals (Sweden)

    Joseph Bert

    2017-01-01

    Full Text Available Gastrointestinal symptoms are very common in systemic lupus erythematosus (SLE. Lupus “enteritis” is very responsive to treatment but can have devastating consequences if not detected. Most descriptions of enteritis involve the small and large bowel. This is the first report of lupus “enteritis” involving the entire gastrointestinal tract from the esophagus and stomach to the rectum. Lupus “enteritis” is another cause of upper gastrointestinal involvement in SLE (involving even the esophagus and stomach in addition to involvement of the lower intestinal tract.

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

    DEFF Research Database (Denmark)

    Wang, Fang

    Adipose-derived stem cells (ASCs) are increasingly being used for regenerative medicine and tissue engineering. Smooth muscle cells (SMCs) can be differentiated from ASCs. Oxygen is a key factor influencing the stem cell differentiation. Tissue engineered esophagus has been a preferred solution...... of esophagus was studied. Our results showed that both SMCs and ASCs could attach on the porcine esophageal acellular matrix (EAM) scaffold in vitro after 24 hours and survive until 7 days. Thus ASCs might be a substitute for SMCs in the construction of tissue engineered esophageal muscle layer....

  19. Idiopathic muscular hypertrophy of the esophagus. Postmortem incidental finding in six cases and review of the literature.

    Science.gov (United States)

    Demian, S D; Vargas-Cortes, F

    1978-01-01

    Six cases of idiopathic muscular hypertrophy of the esophagus were found at autopsy in a relatively short period of time. As has been the experience in previously reported cases, our finding was incidental at the autopsy in all of the cases. In only one of our patients were there relevant symptoms and radiographic changes that could be attributed to the disease. How often patients with muscular hypertrophy of the esophagus have the clinical syndrome of diffuse esophageal spasm remains unclear. It is therefore evident that only by awareness of this entity can studies of esophageal funtion, x-ray films, and appropriate treatment prevent serious morbidity and occasional mortality from the disease.

  20. Numb chin syndrome as a manifestation of metastatic squamous cell carcinoma of esophagus

    Directory of Open Access Journals (Sweden)

    Narendra H

    2009-01-01

    Full Text Available Numb chin syndrome (NCS is a sensory neuropathy presenting with numbness of the chin in the distribution of the mental nerve and the branches of the mandibular division of the trigeminal nerve. Though it can be caused by a benign process, NCS should be regarded as being due to malignancy until proven otherwise. Among the malignancies that cause NCS the most common are breast cancer, prostate cancer, and lymphoreticular malignancy. In squamous cell carcinoma (SCC of the esophagus, spread to the mandible is a rare and often late event. An often overlooked clinical sign in mandibular metastases is hypoesthesia or paresthesia over the peripheral distribution of the inferior alveolar nerve/mental nerve; this sign has been referred to in the literature as NCS or numb lip syndrome or mental nerve neuropathy. Rarely, this may be the first presentation of a disseminated malignancy. Prognosis is usually poor. The discovery of this symptom should alert the clinician to the possibility of disseminated disease. In this article we report a rare case of metastatic SCC of the esophagus in a 40-year-old male patient who presented with NCS. We also review the mechanism, causes, and evaluation of NCS.

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

    Institute of Scientific and Technical Information of China (English)

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

    2009-01-01

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

  2. Transepithelial leak in Barrett's esophagus patients: The role of proton pump inhibitors

    Institute of Scientific and Technical Information of China (English)

    Christopher Farrell; James M Mullin; Melissa Morgan; Owen Tully; Kevin Wolov; Keith Kearney; Benjamin Ngo; Giancarlo Mercogliano,; James J Thornton; Mary Carmen Valenzano

    2012-01-01

    AIM:To determine if the observed paracellular sucrose leak in Barrett's esophagus patients is due to their proton pump inhibitor (PPI) use.METHODS:The in vivo sucrose permeability test was administered to healthy controls,to Barrett's patients and to non-Barrett's patients on continuous PPI therapy.Degree of leak was tested for correlation with presence of Barrett's,use of PPIs,and length of Barrett's segment and duration of PPI use.RESULTS:Barrett's patients manifested a near 3-fold greater,upper gastrointestinal sucrose leak than healthy controls.A decrease of sucrose leak was observed in Barrett's patients who ceased PPI use for 7 d.Although initial introduction of PPI use (in a PPI-nafve population) results in dramatic increase in sucrose leak,long-term,continuous PPI use manifested a slow spontaneous decline in leak.The sucrose leak observed in Barrett's patients showed no correlation to the amount of Barrett's tissue present in the esophagus.CONCLUSION:Although future research is needed to determine the degree of paracellular leak in actual Barrett's mucosa,the relatively high degree of leak observed with in vivo sucrose permeability measurement of Barrett's patients reflects their PPI use and not their Barrett's tissue per se.

  3. Membrane potential and mechanical responses of the opossum esophagus to vagal stimulation and swallowing.

    Science.gov (United States)

    Rattan, S; Gidda, J S; Goyal, R K

    1983-10-01

    Studies were performed in anesthetized opossums. The electrical changes, recorded using a suction electrode applied to the outside of the esophagus, and mechanical activity, recorded by an intraluminal catheter, were monitored from 5 cm above the lower esophageal sphincter. Swallowing was associated with membrane hyperpolarization followed by depolarization and spike burst. Electrical stimulation of the decentralized vagus also caused a prompt hyperpolarization followed by an overshoot depolarization. Single pulses of stimulation caused primarily hyperpolarization. The amplitude and duration of hyperpolarization increased with increasing frequencies of vagal stimulation. Spike burst occurred as the membrane potential was recovering from the peak hyperpolarization and moving toward peak depolarization. The latency of onset of spike burst decreased with increasing frequency of vagal stimulation. The muscle contraction occurred after a latency. The latency of contractions, like the latency of spike burst, decreased with increased frequency of vagal stimulation. These studies show that (a) membrane hyperpolarization is present during the latent period of contraction associated with swallowing, suggesting that swallow-induced esophageal response may be mediated by vagal inhibitory pathway to the esophagus and (b) spike bursts can be temporally dissociated from depolarization by changing the vagal stimulation frequency, suggesting that spike burst and depolarization may be mediated by different excitatory mechanisms.

  4. Metastatic basaloid-squamous cell carcinoma of the esophagus treated by 5-fluorouracil and cisplatin

    Institute of Scientific and Technical Information of China (English)

    Yoshihiro Shibata; Hirokazu Noshiro; Takashi Yao; Shuji Nakano; Eishi Baba; Hiroshi Ariyama; Ryusuke Miki; Nobumichi Ogami; Shuji Arita; Baoli Qin; Hitoshi Kusaba; Kenji Mitsugi

    2007-01-01

    Basaloid squamous cell carcinoma (BSC) of the esophagus is a rare malignant disease. We report here a patient with recurrent esophageal BSC, who was successfully treated by systemic chemotherapy containing 5-fluorouracil (5-FU) and cisplatin (CDDP). A 57-year-old woman was diagnosed as having squamous cell carcinoma of the esophagus upon endoscopic examination. Curative esophagectomy with lymph node dissection was performed under the thoracoscope. The pathological diagnosis of the surgical specimen was BSC.Five months after operation, the patient was diagnosed as having a recurrence of the BSC with metastases to the liver and spleen, and a right paraclavicular lymph node. She was given systemic chemotherapy consisting ofcontinuous infusion of 800 mg/d of 5-FU and 3 h infusion of 20 mg/d of CDDP for 5 consecutive days every 4 wk. The metastatic lesions in the spleen and right paraclavicular lymph node disappeared, and the liver metastasis was apparently reduced in size after 2 courses of chemotherapy. The tumor regression was seen over 6 courses, with progression afterwards.Although subsequent treatment with CPT-11 and CDDP was not effective, docetaxel and vinorelbine temporarily controlled the tumor growth for 2 mo. 5-FU and CDDP combination may be useful for the patients with advanced BSC.

  5. Evaluation of the Sanitary Conditions of Head Meat, Esophagus, Diaphragm Meat, and Boning Scrap Processing

    Directory of Open Access Journals (Sweden)

    Elis Caroline Celestina dos Santos

    2017-01-01

    Full Text Available Enterobacteriaceae, coliforms, and Escherichia coli counts are important hygiene indicators and may be pathogenic. Thus, the aim of the present study was to determine microbiological contamination in head meat, the esophagus, diaphragm, and boning scraps and evaluate the hygienic conditions of the processing of these products. The Petrifilm® (3M method for determining Enterobacteriaceae, total coliforms, and E. coli was applied for 104 samples. APHA, European Union, PAHO/WHO, and Brazil/MAPA recommendations were followed. Bleeding and skinning knives were contaminated with E. coli (61.5%. Regarding the meat cuts, 30.76% samples from head meat, the esophagus and the boning flap showed the presence of E. coli in counts up to 2 log CFU/g, while 15.3% of the diaphragm samples showed up to 1.85 log CFU/g. The analyzed comminuted meat was, therefore, shown to be contaminated with E. coli during processing, indicating that end-products from this raw material can offer biological risks.

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

    Energy Technology Data Exchange (ETDEWEB)

    London, R A; Eichler, J; Liebetrudt, J; Ziegenhagen, L

    2000-02-01

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

  7. Long-term effect on carcinoma of esophagus of distal subtotal gastrectomy

    Institute of Scientific and Technical Information of China (English)

    Yu-Ping Chen; Jie-Sheng Yang; Di-Tian Liu; Yu-Quan Chen; Wei-Ping Yang

    2004-01-01

    AIM: To investigate the surgical treatment and long-term survival for patients with carcinoma of esophagus after distal subtotal gastrectomy.METHODS: Resections of the tumor through left thoracotomy were performed in 85 patients with esophageal carcinoma following distal subtotal gastrectomy. The procedure involved preserving the left short gastric artery and transporting the residual stomach, the spleen and tail of the pancreas into the left thoracic cavity, and using the residual stomach to reconstruct the alimentary tract.RESULTS: The resectable rate was 91.8%, complication rate 10.3%, and no death occurred in the postoperative period. The 1-, 3-, 5-, and 10-year survival rates were 85.7%, 50.7%, 30.6% and 18.8%, respectively.CONCLUSION: Surgical resection is the optimal management method for the patients with esophageal carcinoma after distaJ subtotal gastrectomy. The reconstruction of digestive tract using anastomosis of the esophagus and the residual stomach is not only simple but also can achieve a better curative effect, promoting the digestive function and improving the quality of life.

  8. Rebamipide Alters the Esophageal Microbiome and Reduces the Incidence of Barrett's Esophagus in a Rat Model.

    Science.gov (United States)

    Kohata, Yukie; Nakahara, Kenichi; Tanigawa, Tetsuya; Yamagami, Hirokazu; Shiba, Masatsugu; Watanabe, Toshio; Tominaga, Kazunari; Fujiwara, Yasuhiro; Arakawa, Tetsuo

    2015-09-01

    Barrett's esophagus (BE) is characterized by a distinct Th2-predominant cytokine profile. However, antigens that shift the immune response toward the Th2 profile are unknown. We examined the effects of rebamipide on the esophageal microbiome and BE development in a rat model. BE was induced by esophagojejunostomy in 8-week-old male Wistar rats. Rats were divided into control and rebamipide-treated group receiving either a normal or a 0.225 % rebamipide-containing diet, respectively, and killed 8, 16, 24, and 32 weeks after the operation. PCR-amplified 16S rDNAs extracted from esophageal samples were examined by terminal-restriction fragment length polymorphism (T-RFLP) analysis to assess microbiome composition. The dynamics of four bacterial genera (Lactobacillus, Clostridium, Streptococcus, and Enterococcus) were analyzed by real-time PCR. The incidences of BE in the control and rebamipide group at 24 and 32 weeks were 80 and 100, and 20 and 33 %, respectively. T-RFLP analysis of normal esophagus revealed that the proportion of Clostridium was 8.3 %, while that of Lactobacillales was 71.8 %. The proportions of Clostridium increased and that of Lactobacillales decreased at 8 weeks in both groups. Such changes were consistently observed in the control but not in the rebamipide group. Clostridium and Lactobacillus expression was lower and higher, respectively, in the rebamipide group than in the control group. Rebamipide reduced BE development and altered the esophageal microbiome composition, which might play a role in BE development.

  9. [Endoscopic palliation of malignant esophagus processes using a self-expanding metallic stent].

    Science.gov (United States)

    Binek, J; Eigenmann, F; Hammer, B

    1995-04-15

    We investigated the palliative effect of self-expanding metallic stents on malignant obstruction of the esophagus in 10 patients. All patients had high grade dysphagia and one had an esophago-bronchial fistula. Endoscopic insertions of the prosthesis was done under sedation. Dilatation of the stricture prior to insertion was rarely necessary. Coated stents were used as secondary treatment for patients with fistulae. The procedure related morbidity was low and no mortality was observed. The stents remained patent during the residual lifetime of the patients. Dislocation or perforation did not occur. The median survival of 8 deceased patients was 3.5 months (range 1.25-14.5 months). At present 2 patients are still alive 2.7 and 1.5 months after the procedure. Self-expanding stents in the esophagus provide good palliative therapy of dysphagia or fistulae caused by malignant tumors. Insertion is relatively simple and safer than in nonexpandable types. These improvements may justify the considerably higher price of these devices.

  10. Xenogenic Esophagus Scaffolds Fixed with Several Agents: Comparative In Vivo Study of Rejection and Inflammation

    Directory of Open Access Journals (Sweden)

    Holger Koch

    2012-01-01

    Full Text Available Most infants with long-gap esophageal atresia receive an esophageal replacement with tissue from stomach or colon, because the native esophagus is too short for true primary repair. Tissue-engineered esophageal conducts could present an attractive alternative. In this paper, circular decellularized porcine esophageal scaffold tissues were implanted subcutaneously into Sprague-Dawley rats. Depending on scaffold cross-linking with genipin, glutaraldehyde, and carbodiimide (untreated scaffolds : positive control; bovine pericardium : gold standard, the number of infiltrating fibroblasts, lymphocytes, macrophages, giant cells, and capillaries was determined to quantify the host response after 1, 9, and 30 days. Decellularized esophagus scaffolds were shown to maintain native matrix morphology and extracellular matrix composition. Typical inflammatory reactions were observed in all implants; however, the cellular infiltration was reduced in the genipin group. We conclude that genipin is the most efficient and best tolerated cross-linking agent to attenuate inflammation and to improve the integration of esophageal scaffolds into its surrounding tissue after implantation.

  11. Endoscopic mucosal resection of large hyperplastic polyps in 3 patients with Barrett's esophagus

    Institute of Scientific and Technical Information of China (English)

    Antonella De Ceglie; Gabriella Lapertosa; Sabrina Blanchi; Marcello Di Muzio; Massimo Picasso; Rosangela Filiberti; Francesco Scotto; Massimo Conio

    2006-01-01

    AIM: To report the endoscopic treatment of large hyperplastic polyps of the esophagus and esophagogastric junction (EGJ) associated with Barrett's esophagus (BE) with low-grade dysplasia (LGD), by endoscopic mucosal resection (EMR).METHODS: Cap fitted EMR (EMR-C) was performed in 3 patients with hyperplastic-inflammatory polyps (HIPs) and BE.RESULTS: The polyps were successfully removed in the 3 patients. In two patients, with short segment BE (SSBE)(≤ 3 cm), the metaplastic tissue was completely excised.A 2 cm circumferential EMR was performed in one patient with a polyp involving the whole EGJ. A simultaneous EMR-C of a BE-associated polypoid dysplastic lesion measuring 1cm × 10 cm, was also carried out. In the two patients, histologic assessment detected LGD in BE.No complications occurred. Complete neosquamous reepithelialization occurred in the two patients with SSBE.An esophageal recurrence occurred in the remaining one and was successfully retreated by EMR.CONCLUSION: EMR-C appears to be a safe and effective method for treating benign esophageal mucosal lesions, allowing also the complete removal of SSBE.

  12. Molecular markers and imaging tools to identify malignant potential in Barrett’s esophagus

    Institute of Scientific and Technical Information of China (English)

    Michael; Bennett; Hiroshi; Mashimo

    2014-01-01

    Due to its rapidly rising incidence and high mortality, esophageal adenocarcinoma is a major public health concern, particularly in Western countries. The steps involved in the progression from its predisposing condition, gastroesophageal reflux disease, to its premalignant disorder, Barrett’s esophagus, and to cancer, are incompletely understood. Current screening and surveillance methods are limited by the lack of population-wide utility, incomplete sampling of standard biopsies, and subjectivity of evaluation. Advances in endoscopic ablation have raised the hope of effective therapy for eradication of high-risk Barrett’s lesions, but improvements are needed in determining when to apply this treatment and how to follow patients clinically. Researchers have evaluated numerous potential molecular biomarkers with the goal of detecting dysplasia, with varying degrees of success. The combination of biomarker panels with epidemiologic risk factors to yield clinical risk scoring systems is promising. New approaches to sample tissue may also be combined with these biomarkers for less invasive screening and sur-veillance. The development of novel endoscopic imaging tools in recent years has the potential to markedly improve detection of small foci of dysplasia in vivo. Current and future efforts will aim to determine the combination of markers and imaging modalities that will most effectively improve the rate of early detection of highrisk lesions in Barrett’s esophagus.

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

    Directory of Open Access Journals (Sweden)

    Christiano da Silveira de Barcellos

    2008-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Fachzi Fitri

    2015-01-01

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

  15. Reversible stress softening in layered rat esophagus in vitro after potassium chloride activation.

    Science.gov (United States)

    Jiang, Hongbo; Liao, Donghua; Zhao, Jingbo; Wang, Guixue; Gregersen, Hans

    2017-01-23

    Significant stress softening recovery after potassium chloride (KCl) administration was previously demonstrated in the intact rat esophageal wall. The aim of this study is to investigate the effect of KCl activation on stress softening recovery in the separated mucosa-submucosa layer and muscle layer of rat esophagus. Three series of loading-unloading distensions were carried out on 10 rat esophagi where the two separated layers were distended at luminal pressure levels 0.5, 1.0 and 2.0 kPa. Numerous distension cycles were done in [Formula: see text]-free Krebs solution before and after activation with KCl (110 mmol) for 3 min in calcium-containing media. The diameter and luminal pressure were recorded for stress and strain calculation. During KCl activation, the muscle layer responded with a high-amplitude contraction, and the mucosa-submucosa layer responded with a longer-lasting low-amplitude contraction. The hysteresis loop areas from the muscle layer were significantly bigger than those from the mucosa-submucosa layer at distension pressures 1.0 and 2.0 kPa ([Formula: see text]). The calculated stiffness in the mucosa-submucosa layer was significantly higher than that in the muscle layer ([Formula: see text]). After activation with KCl, the stored energy and the stiffness after the stress and viscoelasticity softening increased in both layers, indicating that the reversible stress softening in esophagus after KCl activation is existed in both layers.

  16. Management of Esophageal Perforation after Foreign Body Removal from the Esophagus via Rigid Esophagoscopy

    Directory of Open Access Journals (Sweden)

    Reza Afghani

    2016-06-01

    Full Text Available Herein, we present the case of a 45-years-old woman with a foreign body (dental prosthesis ingestion lodged in the esophagus(Figure.1. The foreign body was extracted by rigid esophagoscopy after severe manipulation. In 24 hours, the patient became febrile with emphysema in the neck. laboratory data showed leukocytosis and CT scan revealed signs of esophageal perforation(Figure.2. Surgical exploration and drainage of the neck and mediastinum performed through  a collar incision in the neck extended to the anterior of SCM in both sides, but we didn't perform feeding jejunostomy. We inserted one corrugated drain in every side of the neck(Figure.3.Patient was NPO for two weeks and brief total parenteral nutrition (TPN provided her calory.Finally,we succeeded to fistulized the perforation to the skin and control the mediastinitis(Figure.4.Patient regained oral feeding gradually after two weeks NPO. The follow-up esophagogram revealed the passage of the contrast to the distal esophagus with no leak and fistula.Early recognition of perforation could interrupt major operation to control catastrophic complication.

  17. Genome-wide DNA methylation profiling of cell-free serum DNA in esophageal adenocarcinoma and Barrett esophagus.

    Science.gov (United States)

    Zhai, Rihong; Zhao, Yang; Su, Li; Cassidy, Lauren; Liu, Geoffrey; Christiani, David C

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Rihong Zhai

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    李明; 甘少光; 黄仕州; 陈容芳

    2002-01-01

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

  20. Epidemic status of esophagus cancer and etiological research of esophagus cancer in Chaoshan%食管癌流行现状及潮汕食管癌病因学研究

    Institute of Scientific and Technical Information of China (English)

    林璜; William W.Au; 欧利民

    2015-01-01

    This paper provided descriptive research for related conclusion in scientific research literature of esophagus cancer. It provided brief description for epidemic characteristics of esophagus cancer in Chaoshan, along with general summary of risk factors for esophagus cancer in Chaoshan and their treating strategy. It showed basic research data and reference in Chaoshan. The high occurrence rate of esophagus cancer in Chaoshan contained risk factors as genetic predisposition, living habit, and environmental pollution. Environmental improvement, healthy diet, and timely hospital visit contain practical significance for cancer prevention.%本文就食管癌科研文献相关结论作描述性研究,简述潮汕内外食管癌流行特征,综述潮汕地区食管癌危险因子并提出策略,提供了潮汕研究基础资料与借鉴。潮汕食管癌持续高发,存在遗传易感性、生活习惯和环境污染危险因素;改善环境,养成健康饮食与及时就医等生活习惯,具有现实的防癌意义。

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

    Directory of Open Access Journals (Sweden)

    Lau Darren

    2010-09-01

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

  2. Photodynamic therapy for Barrett's esophagus using a 20-mm diameter light-delivery balloon

    Science.gov (United States)

    Panjehpour, Masoud; Overholt, Bergein F.; Phan, Mary N.; Haydek, John M.; Robinson, Amy R.

    2002-06-01

    Background and Objective: Patients with high grade dysplasia (HGD) in Barrett's esophagus are at a high risk for developing esophageal adenocarcinoma. Esophagectomy is the standard treatment for such patients. The objective of this study was to evaluate the safety and efficacy of photodynamic therapy (PDT) using an improved light delivery balloon for ablation of Barrett's esophagus with high grade dysplasia and/or early cancer. Materials and Methods: 20 patients with HGD or early cancer (19 with HGD, 1 with T1 cancer) received 2 mg/kg of porfimer sodium, intravenously. Two to three days after the injection, laser light was delivered using a cylindrical diffuser inserted inside a 20-mm diameter reflective esophageal PDT balloon. Initially, the balloon was inflated to a pressure of 80 mm Hg. The balloon pressure was gradually reduced to 30 mm Hg. A KTP/dye laser at 630 nm was used as the light source. Light dose of 115 J/cm was delivered at an intensity of 270 mw/cm. Nodules were pre- treated with an extra 50 J/cm using a short diffuser inserted through the scope. Patients were maintained on PPI therapy to keep the gastric pH higher than 4. Eighteen patients required one treatment, while two patients were treated twice. Follow-up consisted of endoscopy with four quadrant biopsies at every 2 cm of the treated area. Thermal ablation was used to treat small residual islands on the follow-ups. The follow-up endoscopies ranged from 6 to 17 months. Results: On follow-up endoscopy, 12 patients had complete replacement of their Barrett's mucosa with neosquamous mucosa. Five patients had residual non-dysplastic Barrett's mucosa, one had indefinite dysplasia, two had low grad dysplasia. There were no residual HGD or cancers. The average length of Barrett's was reduced from 5.4 cm to 1.2 cm. High balloon pressure resulted in wide variation in PDT response among patients. Lower balloon pressures resulted in more consistent destruction of Barrett's mucosa among patients. Five

  3. Esophageal Acid Clearance During Random Swallowing Is Faster in Patients with Barrett’s Esophagus Than in Healthy Controls

    Science.gov (United States)

    Lottrup, Christian; Krarup, Anne L; Gregersen, Hans; Ejstrud, Per; Drewes, Asbjørn M

    2016-01-01

    Background/Aims Impaired esophageal acid clearance may be a contributing factor in the pathogenesis of Barrett’s esophagus. However, few studies have measured acid clearance as such in these patients. In this explorative, cross-sectional study, we aimed to compare esophageal acid clearance and swallowing rate in patients with Barrett’s esophagus to that in healthy controls. Methods A total of 26 patients with histology-confirmed Barrett’s esophagus and 12 healthy controls underwent (1) upper endoscopy, (2) an acid clearance test using a pH-impedance probe under controlled conditions including controlled and random swallowing, and (3) an ambulatory pH-impedance measurement. Results Compared with controls and when swallowing randomly, patients cleared acid 46% faster (P = 0.008). Furthermore, patients swallowed 60% more frequently (mean swallows/minute: 1.90 ± 0.74 vs 1.19 ± 0.58; P = 0.005), and acid clearance time decreased with greater random swallowing rate (P 0.3). Conclusions More frequent swallowing and thus faster acid clearance in Barrett’s esophagus may constitute a protective reflex due to impaired mucosal integrity and possibly acid hypersensitivity. Despite these reinforced mechanisms, acid clearance ability seems to be overthrown by repeated, retrograde acid reflux, thus resulting in increased esophageal acid exposure and consequently mucosal changes. PMID:27557545

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  5. [Safe extraction of an impacted open safety pin from the esophagus: a new technique and five case studies].

    Science.gov (United States)

    Golz, Avishay; Gordin, Arie; Netzer, Aviram

    2006-08-01

    Esophageal foreign bodies are common, especially in children less than 5 years old. However, the presence of an open safety pin in the esophagus is quite rare. When this occurs, immediate removal of the safety pin is recommended due to its propensity to pierce the esophagus and surrounding structures causing severe and sometimes even lethal complications. Between the years 1990 and 2003, fifteen infants were referred to the Department of Otolaryngology-Head and Neck Surgery at the Rambam Health Care Campus with a history of safety pin ingestion. Plain neck, chest and abdomen radiographs showed the presence of an open safety pin impacted in the esophagus and pointing upwards in nine of the cases, and in the remainder (six infants) a closed pin was demonstrated in the stomach or in the duodenum. This report focuses on five cases in which during esophagoscopy only the clasp of the safety pin was visible, whereas the sharp point was impossible to be grasped, as it seemed to be stuck in the mucosa of the esophagus. In these cases the pin was pushed into the stomach, where it was closed, and then it was pulled outside without any harm to the mucosa or the gastric and esophageal walls. We present a new technique on how to safely close an open safety pin in the stomach and remove it, without any complications, using a flexible endoscope.

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

    Directory of Open Access Journals (Sweden)

    Muhammad Shafique

    2013-01-01

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

  7. A novel manoeuvre in a case of foreign body esophagus: An unusual management of a usual presentation

    Directory of Open Access Journals (Sweden)

    Mridul Dhar

    2016-07-01

    Case: We describe a case of an eight year old male child, who presented to the emergency department with history of ingesting a marble, and a novel yet simple manoeuvre, to minimise chances of downward displacement and maximise chances of successful and atraumatic extraction with minimal manipulation of trachea and esophagus.

  8. Outcomes from a prospective trial of endoscopic radiofrequency ablation of early squamous cell neoplasia of the esophagus

    NARCIS (Netherlands)

    J.J.G.H.M. Bergman; Y.M. Zhang; S. He; B. Weusten; L. Xue; D.E. Fleischer; N. Lu; S.M. Dawsey; G.Q. Wang

    2011-01-01

    Background: Radiofrequency ablation (RFA) is safe and effective for eradicating neoplasia in Barrett's esophagus. Objective: To evaluate RFA for eradicating early esophageal squamous cell neoplasia (ESCN) defined as moderate-grade squamous intraepithelial neoplasia (MGIN) and high-grade squamous int

  9. New and safe treatment of food impacted in the esophagus: a single center experience of 100 consecutive cases.

    Science.gov (United States)

    Shafique, Muhammad; Yaqub, Sheraz; Lie, Erik S; Dahl, Vegard; Olsbø, Frode; Røkke, Ola

    2013-01-01

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

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

    NARCIS (Netherlands)

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

    2012-01-01

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

  11. Endoscopic video-autofluorescence imaging followed by narrow band imaging for detecting early neoplasia in Barrett's esophagus

    NARCIS (Netherlands)

    M.A. Kara; F.P. Peters; P. Fockens; F.J.W. ten Kate; J.J.G.H.M. Bergman

    2006-01-01

    Background: Video-autofluorescence imaging (AFI) and narrow band imaging (NBI) are new endoscopic techniques that may improve the detection of high-grade intraepithelial neoplasia (HGIN) in Barrett's esophagus (BE). AFI improves the detection of lesions but may give false-positive findings. NBI allo

  12. Macroscopic analysis of the esophagus-gastric transition area in horses submitted to different feeding management and physical activities

    Directory of Open Access Journals (Sweden)

    Eduardo Maurício Mendes de Lima

    2009-06-01

    Full Text Available The region of esophagus-gastric transition of equines was studied since distinct factors can cause injuries in this region as well as in the glandular region of the stomach of these animals. The objective of this work was to identify whether different types of physical and alimentary handling determine alterations in the macroscopic structure of the region of esophagus-gastric transition of the equines. We used 15 sets consisting of the regions of esophagus-gastric transition of adult equines whose race, sex and age were unidentified, divided into three groups in accordance with the diet and developed physical activity: Group I, five sets of equines in intensive training and fed mainly on the basis of concentrate; Group II, five sets of equines that did not engage in intense physical activity and were fed mainly on the basis of concentrate; and Group III with five sets of equines kept on pasture that did not engage in intense physical activity. The results showed that the staining of the mucosa, as well as the wall thickness of the region of transition, varied among groups. Gastric ulcers were found in all the groups studied, but most of them were identified in the transitions of the equines of Group II. The study concludes that no correlation existed between the macroscopic diet/physical activity and the presence of ulcers in the wall of esophagus-gastric transition of the equines.

  13. Impact of splenectomy on surgical outcome in patients with cancer of the distal esophagus and gastro-esophageal junction

    NARCIS (Netherlands)

    Pultrum, B. B.; van Bastelaar, J.; Schreurs, Liesbeth; van Dullemen, H. M.; Groen, H.; Nijsten, M. W. N.; van Dam, G. M.; Plukker, J. T. H. M.

    2008-01-01

    We aim to determine the effect of splenectomy on clinical outcome in patients with cancer of the distal esophagus and gastro-esophageal junction (GEJ) after a curative intended resection. From January 1991 to July 2004, 210 patients underwent a potentially curative gastroesophageal resection with an

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

    NARCIS (Netherlands)

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

    2012-01-01

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

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

    NARCIS (Netherlands)

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

    2012-01-01

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

  16. Experimental replacement of the thoracic esophagus with a bioabsorbable collagen sponge scaffold supported by a silicone stent in dogs.

    Science.gov (United States)

    Yamamoto, Y; Nakamura, T; Shimizu, Y; Takimoto, Y; Matsumoto, K; Kiyotani, T; Yu, L; Ueda, H; Sekine, T; Tamura, N

    1999-01-01

    We manufactured an esophageal prosthesis made of a collagen sponge supported by an inner silicone tube. The collagen was derived from porcine skin and was crosslinked by dehydrothermal treatment. We implanted our prosthesis in nine dogs after resecting a 5 cm length of the thoracic esophagus. Intravenous hyperalimentation was performed for 4 weeks after the surgery. After 29 days, the inner silicone tube was removed endoscopically and oral feeding was restarted immediately. All nine dogs survived more than 1 month, and three of the nine dogs survived for more than 1 year. Endoscopically, the luminal surface of the regenerated esophagus was covered with a lustrous, smooth mucosa, but stenosis was observed in the midregion of the regenerated esophagus. Microscopically, no foreign material remained at the reconstructed site 1 month after surgery; the collagen sponge was absorbed and replaced by host tissue. Complete epithelization was observed within 3 months. Regeneration of the lamina muscularis mucosae, esophageal glands, and skeletal muscle were observed near the anastomoses. Our artificial esophagus holds promise for esophageal reconstruction in a clinical setting, even in the thorax.

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

    Science.gov (United States)

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

    2013-05-10

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

  18. The molecular basis for carcinogenesis in metaplastic columnar-lined esophagus.

    Science.gov (United States)

    Souza, R F; Meltzer, S J

    1997-09-01

    A wide variety of biologic events and mechanisms appear to have roles in the development and progression of Barrett's esophagus-associated neoplastic lesions. Figure 5 is a schematic depiction of these events. This is known as an infernogram (named after Dante's Inferno) (S. Kern, unpublished presentations, 1996). Events at the bottom rings of the inferno are high-frequency mutations; nearer to the top of the inferno are the less common events. The next several years promise many further discoveries of not only high-frequency and low-frequency events, but also their application. Some of the molecular alterations already studied show promise as markers for early cancer detection or prognostication. Eventually, applications of these discoveries should yield new and more effective means of preventing and treating the deadly complications of this troublesome premalignant condition.

  19. Cryospray ablation (CSA in the palliative treatment of squamous cell carcinoma of the esophagus

    Directory of Open Access Journals (Sweden)

    Johnston Mark H

    2007-03-01

    Full Text Available Abstract Background Esophageal carcinoma is the ninth most prevalent cancer worldwide with squamous cell carcinoma (SCCA and adenocarcinoma accounting for the vast majority of new cases (13,900 in 2003. Cure rates in the U.S. are less than 10%, similar to lung cancer. More than 50% of patients with esophageal carcinoma present with unresectable or metastatic disease, are not surgical candidates, or display disease progression despite the addition of neoadjuvant chemoradiotherapy to surgery. Need for improved palliation exits. Case presentation This case describes a 73-year-old African American male who presented with recurrent squamous cell carcinoma (SCCA of the esophagus who has a achieved complete remission for 24 months via endoscopic cryospray ablation. Conclusion Endoscopic cryo spray ablation warrants further investigation as a palliative treatment modality for esophageal cancer. This is the first reported case in the medical literature.

  20. [Relationship between Helicobacter pylori status and the development of reflux esophagitis or Barrett's esophagus].

    Science.gov (United States)

    Watari, Jiro; Tomita, Toshihiko; Oshima, Tadayuki; Fukui, Hirokazu; Miwa, Hiroto

    2013-08-01

    To date, there are many studies on the association between Helicobacter pylori (H. pylori) infection and gastroesophageal reflux disease. Here we reviewed the relationship between H. pylori status and the development of reflux esophagitis (RE) or Barrett's esophagus (BE). According to many case-controlled studies, H. pylori infection may play a protective role in the development of RE. However, the frequency of RE development does not increase following successful H. pylori treatment based on the previous studies including meta-analysis and systematic review. Even though RE newly develops after H. pylori eradication, endoscopic findings reveal mild such as grade A or B according to the Los Angeles Classification System. With regard to BE, there is an inverse significant relationship. Since there are few studies indicating that BE increases after treatment of H. pylori, the eradication should be recommended for patients with H. pylori infection irrespective of the presence of RE or BE even in terms of the prevention of gastric cancer.

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

    Directory of Open Access Journals (Sweden)

    W. Meyer

    2013-05-01

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

  2. Low grade dysplasia in Barrett’s esophagus:Should we worry?

    Institute of Scientific and Technical Information of China (English)

    Vamshi; P; Jagadesham; Clive; J; Kelty

    2014-01-01

    The optimal management for low-grade dysplasia(LGD)in Barrett’s esophagus is unclear.In this article the importance of LGD is discussed,including the significant risk of progression to esophageal adenocarcinoma.Endoscopic surveillance is a management option but is plagued by sampling error and issues of suboptimal endoscopy.Furthermore endoscopic surveillance has not been demonstrated to be cost-effective or to reduce cancer mortality.The emergence of endoluminal therapy over the past decade has resulted in a paradigm shift in the management of LGD.Ablative therapy,including radiofrequency ablation,has demonstrated promising results in the management of LGD with regards to safety,cost-effectiveness,durability and reduction in cancer risk.It is,however,vital that a shareddecision making process occurs between the physician and the patient as to the preferred management of LGD.As such the management of LGD should be"individualised."

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

    Institute of Scientific and Technical Information of China (English)

    Bryan H Burmeister

    2015-01-01

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

  4. An unusual foreign body tooth brush in esophagus: a case report

    Directory of Open Access Journals (Sweden)

    Shashidhar K

    2013-08-01

    Full Text Available We report a rare case of accidental toothbrush swallowing by a normal adult which was successfully removed by rigid esophagoscope. A 25 year young man presented to casualty of KIMS, Hubli, with ingestion of toothbrush accidentally half an hour before. Patient’s general physical examination and systemic examination was normal. Oral cavity, oropharynx and indirect laryngoscopic findings were normal. An emergency upper GI Endoscopy was done and foreign body was confirmed to be present at 35 cm from upper incisor teeth. Foreign body was removed by rigid esophagoscope under GA. Otolaryngologist is the most common medical faculty consulted for management of aero digestive foreign bodies. Toothbrush swallowing in normal adults is a rare accident. Most of them are found in esophagus and spontaneous passage is unknown and hence the need for early removal. [Int J Res Med Sci 2013; 1(4.000: 574-575

  5. Barrett's esophagus with high-grade dysplasia: Focus on current treatment options

    Institute of Scientific and Technical Information of China (English)

    Leonidas Lekakos; Nikolaos P Karidis; Dim itrios Dimitroulis; Christos Tsigris; Gregory Kouraklis; Nikolaos Nikiteas

    2011-01-01

    High-grade dysplasia (HGD) in Barrett's esophagus (BE) is the critical step before invasive esophageal adeno-carcinoma. Although its natural history remains unclear, an aggressive therapeutic approach is usually indicated. Esophagectomy represents the only treatment able to reliably eradicate the neoplastic epithelium. In healthy patients with reasonable life expectancy, vagal-sparing esophagectomy, with associated low mortality and low early and late postoperative morbidity, is considered the treatment of choice for BE with HGD. Patients unfit for surgery should be managed in a less aggressive manner, using endoscopic ablation or endoscopic mu-cosal resection of the entire BE segment, followed by lifelong surveillance. Patients eligible for surgery who present with a long BE segment, multifocal dysplastic lesions, severe reflux symptoms, a large fixed hiatal hernia or dysphagia comprise a challenging group with regard to the appropriate treatment, either surgical or endoscopic.

  6. Analysis of tissue and circulating microRNA expression during metaplastic transformation of the esophagus.

    Science.gov (United States)

    Cabibi, Daniela; Caruso, Stefano; Bazan, Viviana; Castiglia, Marta; Bronte, Giuseppe; Ingrao, Sabrina; Fanale, Daniele; Cangemi, Antonina; Calò, Valentina; Listì, Angela; Incorvaia, Lorena; Galvano, Antonio; Pantuso, Gianni; Fiorentino, Eugenio; Castorina, Sergio; Russo, Antonio

    2016-07-26

    Genetic changes involved in the metaplastic progression from squamous esophageal mucosa toward Barrett's metaplasia and adenocarcinoma are almost unknown. Several evidences suggest that some miRNAs are differentially expressed in Barrett's esophagus (BE) and esophageal adenocarcinoma. Among these, miR-143, miR-145, miR-194, miR-203, miR-205, miR-215 appear to have a key role in metaplasia and neoplastic progression. The aim of this study was to analyze deregulated miRNAs in serum and esophageal mucosal tissue biopsies to identify new biomarkers that could be associated with different stages of esophageal disease. Esophageal mucosal tissue biopsies and blood samples were collected and analyzed for BE diagnosis. Quantitative Real-time PCR was used to compare miRNA expression levels in serum and 60 disease/normal-paired tissues from 30 patients diagnosed with esophagitis, columnar-lined esophagus (CLO) or BE. MiRNA expression analysis showed that miR-143, miR-145, miR-194 and miR-215 levels were significantly higher, while miR-203 and miR-205 were lower in BE tissues compared with their corresponding normal tissues. Esophageal mucosa analysis of patients with CLO and esophagitis showed that these miRNAs were similarly deregulated but to a lesser extent keeping the same trend and CLO appeared as intermediate step between esophagitis and BE. Analysis on circulating miRNA levels confirmed that miR-194 and miR-215 were significantly upregulated in both BE and CLO compared to esophagitis, while miR-143 was significantly upregulated only in the Barrett group. These findings suggest that miRNAs may be involved in neoplastic/metaplastic progression and miRNA analysis might be useful for progression risk prediction as well as for monitoring of BE/CLO patients.

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

    Institute of Scientific and Technical Information of China (English)

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

    2005-01-01

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

  8. Warburg and Crabtree effects in premalignant Barrett's esophagus cell lines with active mitochondria.

    Directory of Open Access Journals (Sweden)

    Martin T Suchorolski

    Full Text Available BACKGROUND: Increased glycolysis is a hallmark of cancer metabolism, yet relatively little is known about this phenotype at premalignant stages of progression. Periodic ischemia occurs in the premalignant condition Barrett's esophagus (BE due to tissue damage from chronic acid-bile reflux and may select for early adaptations to hypoxia, including upregulation of glycolysis. METHODOLOGY/PRINCIPAL FINDINGS: We compared rates of glycolysis and oxidative phosphorylation in four cell lines derived from patients with BE (CP-A, CP-B, CP-C and CP-D in response to metabolic inhibitors and changes in glucose concentration. We report that cell lines derived from patients with more advanced genetically unstable BE have up to two-fold higher glycolysis compared to a cell line derived from a patient with early genetically stable BE; however, all cell lines preserve active mitochondria. In response to the glycolytic inhibitor 2-deoxyglucose, the most glycolytic cell lines (CP-C and CP-D had the greatest suppression of extra-cellular acidification, but were able to compensate with upregulation of oxidative phosphorylation. In addition, these cell lines showed the lowest compensatory increases in glycolysis in response to mitochondrial uncoupling by 2,4-dinitrophenol. Finally, these cell lines also upregulated their oxidative phosphorylation in response to glucose via the Crabtree effect, and demonstrate a greater range of modulation of oxygen consumption. CONCLUSIONS/SIGNIFICANCE: Our findings suggest that cells from premalignant Barrett's esophagus tissue may adapt to an ever-changing selective microenvironment through changes in energy metabolic pathways typically associated with cancer cells.

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

    Science.gov (United States)

    Yu, Shaoyong; Ouyang, Ann

    2011-12-01

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

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

    Science.gov (United States)

    Yu, Xiaoyun; Hu, Youtian; Yu, Shaoyong

    2014-08-15

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

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

    Science.gov (United States)

    Boschetto, Davide; Gambaretto, Gloria; Grisan, Enrico

    2016-03-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2014-01-01

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

  13. Clinical value of multiband mucosectomy for the treatment of squamous intraepithelial neoplasia of the esophagus.

    Science.gov (United States)

    Jin, Xi-Feng; Sun, Qing-Yan; Chai, Tong-Hai; Li, Shu-hui; Guo, Yan-li

    2013-04-01

    To evaluate the clinical value of multiband mucosectomy (MBM) for the treatment of squamous intraepithelial neoplasia of the esophagus. A total of 51 lesions located at esophagus from 43 patients were treated with MBM, among which 11 were diagnosed as middle-grade intraepithelial neoplasia, 25 as high-grade intraepithelial neoplasia, and 15 as early esophageal cancer pathologically. Primary end-points were the rate of complete endoscopic resection and the mean operation time; the second end-points were the postoperative local recurrence rate and acute plus early complications. The histopathological results were compared between pre-MBM biopsy and MBM specimens. All patients were followed up endoscopically. A total of 52 MBM procedures with 180 resections were performed in 43 patients. The complete endoscopic resection was achieved in 92.3% (95% confidence interval [CI] 81.8-96.9%). The sizes of the lesions ranged from 10 × 8 mm to 25 × 23 mm. The mean operation time is 37 ± 5 min. The operative acute bleeding complication was 7.6% (95% CI 3-18.1%); no perforations occurred. Early complications consisted of delayed bleeding (one patient 1.9%; 95% CI 0.3-10.1%) and slight esophageal stenosis (one patient). The histopathological diagnosis of 26 cases (51%) was consistent between biopsy and MBM samples, while 20 lesions exhibited higher grade dysplasia. The local recurrence rate was 6.9% (3/43) at 1 year, 9.3% (4/43) at 2 years, and 9.3% at 2.5 years. No death occurred during follow-up. MBM is a safe and effective technique for the treatment of early esophageal cancer and precancerous lesions. © 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

  14. Reconstruction of trachea-esophagus vocalization by tunnel method in 12 cases%隧道法气管食管发音重建术12例

    Institute of Scientific and Technical Information of China (English)

    黄维平; 闫玉纪; 王晓红

    2002-01-01

    Objective To study the therapeutic effect of reconstruction in improving trachea esophagus vocalization after total laryngectomy.Method We reviewed the reconstruction of vocalization with trachea esophagus tunnel in 12 cases patients of total laryngectomy,i.e. a triangular mucous valve was made by incision of the posterior wall of the trachea with the correlative anterior wall of the esophagus made into a tunnel and the mucous valve would vocalize.Result 11 of the 12 cases obtained successful vocalization,counting for 91% of the total. Atresia of the vocalizing valve occurred in one case.Conclusion Trachea esophagus tunnel vocalization reconstruction has better therapeutic effect with good vocalization effect and fewer complications and easily performed.It avoided the shortcomings of necrosis and atresia of the vocalization valve and pharyngeal fistula formation,and the complexity of exchange of artificial vocalization tube again and again.

  15. BOB CAT: A Large-Scale Review and Delphi Consensus for Management of Barrett's Esophagus With No Dysplasia, Indefinite for, or Low-Grade Dysplasia

    NARCIS (Netherlands)

    Bennett, C.; Moayyedi, P.; Corley, D.A.; DeCaestecker, J.; Falck-Ytter, Y.; Falk, G.; Vakil, N.; Sanders, S.; Vieth, M.; Inadomi, J.; Aldulaimi, D.; Ho, K.Y.; Odze, R.; Meltzer, S.J.; Quigley, E.; Gittens, S.; Watson, P.; Zaninotto, G.; Iyer, P.G.; Alexandre, L.; Ang, Y.; Callaghan, J.; Harrison, R.; Singh, R.; Bhandari, P.; Bisschops, R.; Geramizadeh, B.; Kaye, P.; Krishnadath, S.; Fennerty, M.B.; Manner, H.; Nason, K.S.; Pech, O.; Konda, V.; Ragunath, K.; Rahman, I.; Romero, Y.; Sampliner, R.; Siersema, P.D.; Tack, J.; Tham, T.C.; Trudgill, N.; Weinberg, D.S.; Wang, J; Wang, K.; Wong, J.Y.; Attwood, S.; Malfertheiner, P.; MacDonald, D.; Barr, H.; Ferguson, M.K.; Jankowski, J.

    2015-01-01

    OBJECTIVES: Barrett's esophagus (BE) is a common premalignant lesion for which surveillance is recommended. This strategy is limited by considerable variations in clinical practice. We conducted an international, multidisciplinary, systematic search and evidence-based review of BE and provided

  16. CLINICAL STUDY ON THE PATTERN OF LYMPHNODE METASTASIS IN CARCINOMA OF ESOPHAGUS (AN ANALYSIS OF 200 CASES)

    Institute of Scientific and Technical Information of China (English)

    Lin Ruobai; Lin Peiqiu; Zhou Lun; Chen Chun; Kang Mingqiang; Zheng Wei

    1998-01-01

    Objective: To study the pattern of lymphnode metastasis in carcinoma of esophagus. Methods: 200cases of resected esophageal cancer specimens were carefully examined pathologically. Lymphnode metastasis,its pathway and extent in relation to pathological changes were analyzed. Results: Lymphnode metastasis was mainly regional and extended vertically in both directions.Leaping-over metastasis was another feature. The deeper invasion by the tumor, the higher frequencies of metastasis development , and vice versa. However,leaping-over metastasis was more likely to occur where tumor invasion was less severe. Conclusion: Owing to the high frequency of lymphnode metastasis in the superior mediastinum and the widely spanned leapingover metastasis, an operative approach by three incisions through right thoracotomy with excision of the whole segment of esophagus and anastomosis at cervical region was recommended, in order to dissect lymphnodes in the cervical, thoracic and abdominal regions and to leave less or no metastatic lymphnodes behind.

  17. Diptera Brachycera found inside the esophagus of a mummified adult male from the early XIX century, Lisbon, Portugal

    Directory of Open Access Journals (Sweden)

    Márcia Souto Couri

    2008-03-01

    Full Text Available Fly puparia and adult fragments of diptera muscid were found inside the esophagus of a mummified body from the early XIX century, buried inside the crypt of the Sacrament Church (Lisbon, Portugal. The identification of the material revealed a monospecific colonization by Ophyra capensis (Wiedemann (Diptera: Muscidae, a species known to invade corpses in the ammoniacal fermentation wave. This species can be found in corpses kept indoors, not available to the early waves of blowflies (Diptera: Calliphoridae. In the present case, the number of pupae and their developmental stage suggest that the female invaded the mummified corpse through the partially opened mouth and the oviposition took place directly inside the esophagus. This is the first case of O. capensis infesting internal organs of an intact corpse. The use of chemical products for the embalming process probably explains why external colonization did not occur.

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

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Ji Young [Chosun University College of Medicine, Gwangju (Korea, Republic of)

    2008-03-15

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

  19. Similarity of aberrant DNA methylation in Barrett's esophagus and esophageal adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Gotley David C

    2008-10-01

    Full Text Available Abstract Background Barrett's esophagus (BE is the metaplastic replacement of squamous with columnar epithelium in the esophagus, as a result of reflux. It is the major risk factor for the development of esophageal adenocarcinoma (EAC. Methylation of CpG dinucleotides of normally unmethylated genes is associated with silencing of their expression, and is common in EAC. This study was designed to determine at what stage, in the progression from BE to EAC, methylation of key genes occurs. Results We examined nine genes (APC, CDKN2A, ID4, MGMT, RBP1, RUNX3, SFRP1, TIMP3, and TMEFF2, frequently methylated in multiple cancer types, in a panel of squamous (19 biopsies from patients without BE or EAC, 16 from patients with BE, 21 from patients with EAC, BE (40 metaplastic, seven high grade dysplastic and 37 EAC tissues. The methylation frequency, the percentage of samples that had any extent of methylation, for each of the nine genes in the EAC (95%, 59%, 76%, 57%, 70%, 73%, 95%, 74% and 83% respectively was significantly higher than in any of the squamous groups. The methylation frequency for each of the nine genes in the metaplastic BE (95%, 28%, 78%, 48%, 58%, 48%, 93%, 88% and 75% respectively was significantly higher than in the squamous samples except for CDKN2A and RBP1. The methylation frequency did not differ between BE and EAC samples, except for CDKN2A and RUNX3 which were significantly higher in EAC. The methylation extent was an estimate of both the number of methylated alleles and the density of methylation on these alleles. This was significantly greater in EAC than in metaplastic BE for all genes except APC, MGMT and TIMP3. There was no significant difference in methylation extent for any gene between high grade dysplastic BE and EAC. Conclusion We found significant methylation in metaplastic BE, which for seven of the nine genes studied did not differ in frequency from that found in EAC. This is also the first report of gene silencing

  20. Role of intraoperative sentinel lymph node mapping in the management of carcinoma of the esophagus

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    Bhat Mohammad

    2010-01-01

    Full Text Available Background/Aim: Precise evaluation of lymph node status is one of the most important factors in determining clinical outcome in treating gastro-intestinal (GI cancer. Sentinel lymph node (SLN mapping clearly has become highly feasible and accurate in staging GI cancer. This study aims to investigate the feasibility and accuracy of detection of SLN using methylene blue dye in patients with carcinoma of the esophagus and assess its potential role in determining the rational extent of lymphadenectomy in esophageal cancer surgery. Materials and Methods: Thirty-two patients of esophageal cancer diagnosed on endoscopic biopsy were enrolled in this prospective study. After laparotomy, patent methylene blue was injected into the subserosal layer adjacent to the tumor. SLNs were defined as blue stained nodes within a period of 5 min. Standard radical esophagogastrectomy with lymphadenectomy was performed in all the patients. All the resected nodes were examined postoperatively by routine hematoxylin and eosin stain for elucidating the presence of metastasis, and the negative SLNs were examined further with cytokeratin immunohistochemical staining. Results: SLNs were detected in 26 (81.25% patients out of 32 patients who were studied. The number of SLNs ranged from 1 to 4 with a mean value of 1.7 per case. The SLNs of esophageal cancer were only found in N1 area in 21 (80.77% cases, and in N2 or N3 area in only 19.33%. The overall accuracy of the procedure was 75% in predicting nodal metastasis. SLN had a sensitivity of 85.71% in mid esophageal tumors and 93.33% in lower esophageal tumors. The SLN biopsy had sensitivity of 87.5% in the case of squamous cell carcinoma and 92.86% in the cases of adenocarcinoma of the esophagus. The accuracy of the procedure for squamous cell carcinoma and adenocarcinoma was 60% and 76.47%, respectively. Conclusion: SLN mapping is an accurate diagnostic procedure for detecting lymph node metastasis in patients with

  1. Histopathologic aspects of photodynamic therapy for dysplasia and early adenocarcinoma arising in Barrett's esophagus.

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    Ban, Shinichi; Mino, Mari; Nishioka, Norman S; Puricelli, William; Zukerberg, Lawrence R; Shimizu, Michio; Lauwers, Gregory Y

    2004-11-01

    The efficacy of photodynamic therapy (PDT) is currently evaluated for the treatment of superficial neoplasms arising in Barrett's esophagus (BE). An accurate assessment of this technique requires the evaluation of biopsies before and after treatment. However, despite the importance of pathology, only a limited number of studies have systematically assessed the mucosal changes after PDT. To evaluate mucosal changes after PDT, and pathologic variables that may impact on the success of this therapy, we analyzed the pre- and post-PDT biopsies of a cohort of patients treated by this modality. Thirty-three patients (mean age, 71 years) with high-grade dysplasia (HGD) and/or intramucosal carcinoma (IMC) arising in BE and followed up after PDT using Porfimer sodium form the basis of this study. In all patients, a review of all pre- and post-PDT biopsies was performed. The variables recorded included the histologic grade and architecture of neoplasms, the distribution of neoplasms, and squamous re-epithelialization. IMC and HGD coexisted in the pre-PDT biopsies of 18 patients (54.5%). IMC and HGD showed a prominent tubular proliferation in 14 patients and displayed a papillary pattern (at least partially) in 19 patients. In post-PDT, patches of specialized columnar epithelium were buried under squamous epithelium in 17 patients (51.5%), and foci of dysplasia/carcinoma covered by squamous epithelium were found in 9 patients (27.3%). HGD and/or IMC were eradicated in 17 patients (eradicated group) and persisted in 16 patients (persistent group). In the persistent group, grade and architecture were unchanged after PDT in 62.5% and 87.5% of patients, respectively. The persistent group was characterized by: 1) a more frequent papillary architecture (P < 0.05), and 2) a diffuse distribution of the neoplasms on pre-PDT biopsies (P = 0.05). Singularly, the persistent neoplastic lesions were observed in the distal esophagus (P < 0.05). A systematic histopathologic evaluation allowed

  2. Gene expression changes associated with Barrett's esophagus and Barrett's-associated adenocarcinoma cell lines after acid or bile salt exposure

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    Sahbaie Peyman

    2007-06-01

    Full Text Available Abstract Background Esophageal reflux and Barrett's esophagus represent two major risk factors for the development of esophageal adenocarcinoma. Previous studies have shown that brief exposure of the Barrett's-associated adenocarcinoma cell line, SEG-1, or primary cultures of Barrett's esophageal tissues to acid or bile results in changes consistent with cell proliferation. In this study, we determined whether similar exposure to acid or bile salts results in gene expression changes that provide insights into malignant transformation. Methods Using previously published methods, Barrett's-associated esophageal adenocarcinoma cell lines and primary cultures of Barrett's esophageal tissue were exposed to short pulses of acid or bile salts followed by incubation in culture media at pH 7.4. A genome-wide assessment of gene expression was then determined for the samples using cDNA microarrays. Subsequent analysis evaluated for statistical differences in gene expression with and without treatment. Results The SEG-1 cell line showed changes in gene expression that was dependent on the length of exposure to pH 3.5. Further analysis using the Gene Ontology, however, showed that representation by genes associated with cell proliferation is not enhanced by acid exposure. The changes in gene expression also did not involve genes known to be differentially expressed in esophageal adenocarcinoma. Similar experiments using short-term primary cultures of Barrett's esophagus also did not result in detectable changes in gene expression with either acid or bile salt exposure. Conclusion Short-term exposure of esophageal adenocarcinoma SEG-1 cells or primary cultures of Barrett's esophagus does not result in gene expression changes that are consistent with enhanced cell proliferation. Thus other model systems are needed that may reflect the impact of acid and bile salt exposure on the esophagus in vivo.

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

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    Johnny eKao

    2015-06-01

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

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

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    Tadashi Terada

    2009-01-01

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

  6. NHE-1 isoform of the Na+/H+ antiport is expressed in the rat and rabbit esophagus.

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    Shallat, S; Schmidt, L; Reaka, A; Rao, D; Chang, E B; Rao, M C; Ramaswamy, K; Layden, T J

    1995-11-01

    Rabbit esophageal cells show an amiloride-sensitive Na+/H+ antiporter activity. Several distinct molecular isoforms of the Na+/H+ exchanger family (NHE) are reported to be present in the gastrointestinal tract of rats and rabbits. The aim of this study was to examine which isoforms are present in rabbit and rat esophageal cells and whether this isoform could be up-regulated by serum factors. Specific primers designed from the rat NHE-1-4 and the rabbit NHE-1-3 isoform sequences were used for reverse-transcription polymerase chain reaction analysis with RNA from rabbit and rat esophageal cells. Ribonuclease protection assay was used to determine the serum-induced up-regulation of NHE-1. Antibodies raised against the NHE-1 C-terminal fragment were used for Western blotting with rabbit esophageal membranes. In both the rat and rabbit esophagus, only the NHE-1 isoform messenger RNA could be detected. The NHE-1 messenger RNA, detected in rabbit esophageal cells grown from tissue explants, was up-regulated by serum factors. The antibody detected a 95-kilodalton protein in esophageal cell membranes. The rabbit and rat esophagus exclusively express the NHE-1 isoform, hypothesized to be involved in cytoplasmic pH regulation. Therefore, the results of this study suggest a role for NHE-1 in protecting cells against gastric acid that is refluxed into the esophagus.

  7. Ewing sarcoma and primitive neuroectodermal tumor of the esophagus: report of a case and review of literature.

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    Johnson, Andrew D; Pambuccian, Stefan E; Andrade, Rafael S; Dolan, Michelle M; Aslan, Deniz L

    2010-10-01

    This study presents a case of Ewing sarcoma and primitive neuroectodermal tumor arising in the esophagus of a 44-year-old woman who presented with progressive dysphagia. Imaging studies demonstrated a polypoid lesion in the esophagus. The tumor was characterized by corded and pseudopapillary architecture, cytologic monotony, and low proliferative activity. Immunohistochemical stains were positive for CD99, neuron-specific enolase, vimentin, cyclin D1, p53, and FLI1 gene product. Fluorescence in situ hybridization demonstrated a 22q12 translocation, associated with primitive neuroectodermal tumor in the tumor cells, whereas reverse transcription polymerase chain reaction conformed expression of Ewing sarcoma/FLI1 fusion transcript in the patient's bone marrow aspirate. Although this is a rare site for this type of tumor to occur, primitive neuroectodermal tumor should be considered in the differential diagnosis of mesenchymal tumors of the esophagus. Genetic analysis is crucial to establish the diagnosis and can be successfully performed on formalin-fixed, paraffin-embedded material and hematopoietic tissue.

  8. Colon Carcinoma with Unusual Metastasis to the Esophagus Manifesting as Multiple Nodules and Dysphagia: Management with Systemic Chemotherapy

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    Pankaj G. Vashi

    2012-07-01

    Full Text Available We present here the rare clinical case of a 44-year-old gentleman with metastasis from colon carcinoma to the esophagus presenting with multiple nodules and dysphagia, which was successfully managed with systemic chemotherapy. The patient presented at our institution with 3-month history of dysphagia almost 4 years after being operated for stage III carcinoma in the sigmoid colon. Endoscopic findings showed multiple nodules at the gastroesophageal junction and mid esophagus. Histological features and immunostains confirmed the diagnosis of metastatic colon carcinoma. Because of evidence of extensive metastatic disease in the spine and liver requiring systemic therapy, the patient was treated with chemotherapy with irinotecan and cetuximab, with subsequent improvement in tumor markers, liver metastasis and symptoms of dysphagia. Even though repeat endoscopy showed no improvement in esophageal nodules, the overall response to chemotherapy was positive. In conclusion, we present a very rare, previously unreported case of metastases from colon cancer to the esophagus presenting as non-obstructive nodules and dysphagia that responded to systemic chemotherapy.

  9. CYR61 and TAZ Upregulation and Focal Epithelial to Mesenchymal Transition May Be Early Predictors of Barrett's Esophagus Malignant Progression.

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    Cardoso, Joana; Mesquita, Marta; Dias Pereira, António; Bettencourt-Dias, Mónica; Chaves, Paula; Pereira-Leal, José B

    2016-01-01

    Barrett's esophagus is the major risk factor for esophageal adenocarcinoma. It has a low but non-neglectable risk, high surveillance costs and no reliable risk stratification markers. We sought to identify early biomarkers, predictive of Barrett's malignant progression, using a meta-analysis approach on gene expression data. This in silico strategy was followed by experimental validation in a cohort of patients with extended follow up from the Instituto Português de Oncologia de Lisboa de Francisco Gentil EPE (Portugal). Bioinformatics and systems biology approaches singled out two candidate predictive markers for Barrett's progression, CYR61 and TAZ. Although previously implicated in other malignancies and in epithelial-to-mesenchymal transition phenotypes, our experimental validation shows for the first time that CYR61 and TAZ have the potential to be predictive biomarkers for cancer progression. Experimental validation by reverse transcriptase quantitative PCR and immunohistochemistry confirmed the up-regulation of both genes in Barrett's samples associated with high-grade dysplasia/adenocarcinoma. In our cohort CYR61 and TAZ up-regulation ranged from one to ten years prior to progression to adenocarcinoma in Barrett's esophagus index samples. Finally, we found that CYR61 and TAZ over-expression is correlated with early focal signs of epithelial to mesenchymal transition. Our results highlight both CYR61 and TAZ genes as potential predictive biomarkers for stratification of the risk for development of adenocarcinoma and suggest a potential mechanistic route for Barrett's esophagus neoplastic progression.

  10. Emergent treatment of button batteries in the esophagus: evolution of management and need for close second-look esophagoscopy.

    Science.gov (United States)

    Ruhl, Douglas S; Cable, Benjamin B; Rieth, Katherine K S

    2014-03-01

    The evolving epidemiology of pediatric button battery ingestion is alarming. Currently, assessment of the degree of damage relies heavily on the initial esophagoscopy in a manner similar to the management of caustic ingestion. We have noted that use of this classic approach may delay the return to normal oral intake. Using several cases treated at our institution, we illustrate the value of "close second-look esophagoscopy" (CSLE) in expediting a return to normal oral intake after button battery ingestion. We present a retrospective case series. Five patients (11 to 18 months of age) with button batteries trapped in the cervical esophagus were recently managed at our institution. The batteries were lodged in the esophagus for durations ranging from 6 hours to 4 months. Three cases of initial grade III circumferential necrotic injury were downgraded to grade IIa after a CSLE performed 2 to 4 days after removal, and their management was appropriately changed. The injury and healing of cases of button batteries in the proximal esophagus appear to be variable; caustic injury, electrical mucosal damage, and direct pressure are thought to be several contributory factors. Performing a CSLE within 2 to 4 days after battery removal may provide more useful prognostic information. In certain cases, downgrading of the injury may facilitate an earlier return to an oral diet, use of fewer diagnostic tests, and a shorter hospital stay. The utility and timing of imaging, management of diet and medications, and acceptable follow-up plans are discussed within the context of guiding future research.

  11. Barrett食管的诊疗进展%Advances in study on diagnosis and treatment of barrett esophagus

    Institute of Scientific and Technical Information of China (English)

    刘思齐; 詹俊

    2015-01-01

    Nowadays, the incidence of oesophageal adenocarcinoma (OAC) has kept increasing which nearly exceeds oesophageal squamous cell carcinoma in some western countries. Being the risk factor of OAC, Barrett’s esophagus has attracted more and more attention in the industry. To distinguish, diagnose and manage early truly make sense of better prognosis of Barrett’s esophagus. This article reviewed the advancing literature on the definition, diagnostic technologies and management of Barrett’s esophagus.%近年来食管腺癌的发病率不断增高,在某些西方国家甚至超过了食管鳞状细胞癌。Barrett食管是食管腺癌的高危因素,因此受到业界越来越多的关注。早期识别Barrett食管、早期诊断、早期治疗对于食管腺癌预后的改善意义重大。本文就Barrett食管的定义、诊断手段及治疗措施作一综述。

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

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    Maria Aparecida Coelho de Arruda Henry

    2013-05-01

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

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

    Science.gov (United States)

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

    2016-03-01

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

  14. Cost-effectiveness of endoscopic screening followed by surveillance for Barrett's esophagus: a review.

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    Barbiere, Josephine M; Lyratzopoulos, Georgios

    2009-12-01

    Screening interventions for Barrett's esophagus (BE) are appealing, but there is little supporting evidence. We reviewed health economics studies about BE endoscopic screening followed by, as required, endoscopic surveillance ("screening and surveillance" hereafter) to help inform the design and conduct of future research. Health economics studies about BE screening and surveillance were identified using electronic database searches and personal contact with authors of identified studies. No studies examined general population screening. Five US studies published between 2003 and 2007 examined the cost effectiveness of screening and surveillance (against no intervention) in patients with chronic gastroesophageal reflux disease (GERD). There was no randomized trial evidence to inform model construction. Assumptions about prevalence and transition probabilities between BE histologic subtypes and about surveillance and treatment protocols varied substantially between studies. Parameters such as potential BE diagnosis-related reduction in quality of life or increase in health care use, diagnostic accuracy, and infrastructural costs (for quality assurance) were considered either "optimistically" or not at all. Only 2 studies considered endoscopic treatments. No study considered the recently introduced radiofrequency ablation technique, or the potential for biomarker-based risk stratification of surveillance interval or duration. Current health economics evidence is likely to have provided optimistic cost-effectiveness estimates and is not sufficient to support introduction of endoscopic BE screening programs among GERD patients. The evidence does not adequately incorporate novel (endoscopic) treatments and the potential for (clinical, endoscopic, or biomarker-based) risk stratification of surveillance. Future research should aim to encompass both these factors.

  15. DNA Damage in CD133-Positive Cells in Barrett’s Esophagus and Esophageal Adenocarcinoma

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    Raynoo Thanan

    2016-01-01

    Full Text Available Barrett’s esophagus (BE caused by gastroesophageal reflux is a major risk factor of Barrett’s esophageal adenocarcinoma (BEA, an inflammation-related cancer. Chronic inflammation and following tissue damage may activate progenitor cells under reactive oxygen/nitrogen species-rich environment. We previously reported the formation of oxidative/nitrative stress-mediated mutagenic DNA lesions, 8-oxo-7,8-dihydro-2′-deoxyguanosine (8-oxodG and 8-nitroguanine, in columnar epithelial cells of BE tissues and cancer cells of BEA tissues. We investigated the mechanisms of BEA development in relation to oxidative/nitrative DNA damage and stem cell hypothesis. We examined 8-nitroguanine and 8-oxodG formation and the expression of stem cell marker (CD133 in biopsy specimens of patients with BE and BEA by immunohistochemical analysis in comparison with those of normal subjects. CD133 was detected at apical surface of columnar epithelial cells of BE and BEA tissues, and the cytoplasm and cell membrane of cancer cells in BEA tissues. DNA lesions and CD133 were colocalized in columnar epithelial cells and cancer cells. Their relative staining intensities in these tissues were significantly higher than those in normal subjects. Our results suggest that BE columnar epithelial cells with CD133 expression in apical surface undergo inflammation-mediated DNA damage, and mutated cells acquire the property of cancer stem cells with cytoplasmic CD133 expression.

  16. Adenocarcinoma of the cervical esophagus arising in heterotopic gastric mucosa: exclusive chemoradiotherapy following a mucosal resection

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    Jestin-Letallec, V.; Muller, M.; Metges, J.P.; Bouchekoua, M.; Albarghach, N.; Pradier, O. [Departement de Cancerologie, 29 - Brest (France)

    2007-11-15

    Esophagus adenocarcinomas developing within heterotopic gastric mucosa are very rare and described to be found endoscopically in a prevalence of .29%. We report a case of cervical adenocarcinoma arising in ectopic gastric mucosa in a fifty-four year old man. The patient underwent a mucosal resection followed with exclusive chemoradiotherapy because of infiltration of the sub mucosa layer. A radiotherapy dose of 60 Gy ( 2 Gy/Fr, 30 Fr) was realized with a reduction of the fields at 50 Gy associated with a continuous 5FU-cisplatin combination after eliminating known mutation in the dihydro-pyrimidine of the dehydrogenase gene. for this tumor, surgery is the main treatment, (oesophagectomy associated with laryngo-pharyngectomy) and has an important repercussion on the quality of life. Because of the refusal of our patient, after a mucosal resection attempt, we proposed our patient a chemoradiotherapy. For the first time in the literature, we report the results of radio chemotherapy for this rare tumor. Eighteen months after the treatment, the patient is alive without sign of recurrence. The radio chemotherapy could be a safety treatment for this rare tumor associated with a good quality of life. A review of the literature since 1950 will be shown. (authors)

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

    Institute of Scientific and Technical Information of China (English)

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

    2013-01-01

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

  18. Viscosity of food boluses affects the axial force in the esophagus

    Institute of Scientific and Technical Information of China (English)

    Flemming Gravesen; Niall Behan; Asbjorn Drewes; Hans Gregersen

    2011-01-01

    AIM: To study the effect of viscosity on axial force in the esophagus during primary peristalsis using a newly vali-dated impedance-based axial force recording technique. METHODS: A probe able to simultaneously measure both axial force and manometry was positioned above the lower esophageal sphincter. Potable tap water and three thickened fluids were used to create boluses of different viscosities. Water has a viscosity of 1 mPa·s. The three thickened fluids were made with different concentrations of Clinutren Instant thickener. The vis-cous fluids were in appearance comparable to pudding (2 kPa·s), yogurt (6 kPa·s) and slush ice (10 kPa·s). Six healthy volunteers swallowed 5 and 10 mL of bo-luses multiple times. RESULTS: The pressure amplitude did not increase with the bolus viscosity nor with the bolus volume whereas the axial force increased marginally with bo-lus volume (0.1 > P > 0.05). Both techniques showed that contraction duration increased with bolus viscosity (P < 0.01). Association was found between axial force and pressure but the association became weaker with increasing viscosity. The pressure amplitude did not in-crease with the viscosity or bolus volume whereas the axial force increased marginally with the bolus size. CONCLUSION: This indicates a discrepancy between the physiological functions that can be recorded with axial force measurements and pressure measurements.

  19. A model of the anterior esophagus in snakes, with functional and developmental implications.

    Science.gov (United States)

    Cundall, David; Tuttman, Cassandra; Close, Matthew

    2014-03-01

    The gross anatomy of the mouth of snakes has always been interpreted as an evolutionary response to feeding demands. In most alethinophidian species, their anatomy allows limited functional independence of right and left sides and the roof and floor of the mouth as well as wide separation of the tips of the mandibles. However, locations of the tongue and glottis in snakes suggest extraordinary rearrangement of pharyngeal structures characteristic of all vertebrates. Serial histological sections through the heads of a number of colubroid species show muscularis mucosal smooth muscle fibers appearing in the paratracheal gutter of the lower jaw at varying levels between the eye and ear regions. Incomplete muscularis externa elements appear beneath the paratracheal gutter more caudally but typically at otic levels. Both muscle layers encompass more of the gut wall at more posterior levels, encircling the gut at the level of the atlas or axis. The pattern in snakes suggests developmental dissociation of dorsal and ventral splanchnic derivatives and extensive topological rearrangements of some ventral pharyngeal arch derivatives typical of most tetrapods. When snakes swallow large prey, the effective oral cavity becomes extremely short ventrally. The palatomaxillary arches function as ratchets packing the prey almost directly into the esophagus. Our findings raise questions about germ layer origins and regulation of differentiation of gut regions and derivatives in snakes and suggest that significant aspects of the evolution of lepidosaurs may be difficult to recover from bones or molecular sequence data alone.

  20. Epidemiologic aspects in esophageal pathology focusing on gastroesophageal reflux disease and Barrett’s esophagus

    Directory of Open Access Journals (Sweden)

    George Săraci

    2011-11-01

    Full Text Available Objective: To determine the main epidemiologic characteristics of esophageal pathology,insisting on gastroesophageal reflux disease (GERD, Barrett’s esophagus (BE and to evaluate therelationship between these conditions and some widely spread risk factors. Material and methods: Datawere collected from clinical file records archive, endoscopy reports and histopatologic reports and slidesfor 8225 patients (01.01.2005-31.07.2007 who presented esophageal changes during upper digestiveendoscopy. We used Kolmogorov-Smirnov test to assess the normality of variables distribution and thenwe used parametric or non-parametric tests along with multivariate analysis. Results: BE is associatedwith male sex (r=0.039; pHelicobacter pylori (Hp infection(r=0.024; p=0.02. Age is not an important factor (OR=0.99; p=0.03. Presence of sliding hiatal hernia(SHH is influenced by body mass index (r=0.533; p<0.001 and female sex (p=0.001. SHH sizeinfluences the severity of esophagitis (r=0.04; p<0.01. The most frequent type of metaplasia is theincomplete intestinal one and the most frequent form of esophageal cancer is adenocarcinoma.Conclusion: BE is associated positively with GERD, esophagitis, male sex and negatively with Hp andesophageal varices. SHH influences severity of esophagitis and is more frequent in female patients.Adenocarcinoma is more frequent that squamous esophageal cancer.

  1. Small-cell neuroendocrine carcinoma of the esophagus: an autopsy case report

    Directory of Open Access Journals (Sweden)

    Mariana Bellaguarda de Castro Sepulvida

    2014-03-01

    Full Text Available Small-cell neuroendocrine carcinoma is a well-known aggressive neoplasia, which is usually associated with a poor prognosis. The lung is the most common primary site, but other organs may be involved, especially those of the digestive tract. The authors report the case of a 71-year-old Caucasian, male patient who was admitted because of congestive heart failure and loss of vision accompanied by right proptosis. Skull and sinuses computed tomography showed a tumoral mass involving the posterior region of the right eye, local bones, and paranasal sinuses. Because of severe hemodynamic instability, the patient died and no diagnostic investigation could be performed. Autopsy findings revealed small-cell neuroendocrine carcinoma of the esophagus and metastases to the posterior region of the right ocular globe, which affected the sinuses, the muscles of the ocular region, the orbit bones, the skull, the meninges and the brain, plus the liver, adrenal glands, and the pericardium. This case called the author’s attention to the extent of the metastatic disease in a patient who was firstly interpreted as presenting solely with congestive heart failure. The autopsy findings substantially aid the understanding of the immediate cause of death.

  2. Smoking Exposure and Survival of Patients with Esophagus Cancer: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Jun-jie Kuang

    2016-01-01

    Full Text Available Smoking is a well-known major risk factor in development of esophageal cancer, but few studies have reported the association between smoking status and prognosis of these patients. We conduct the present study to summarize current evidence. A computerized search of the PubMed and EMBASE was performed up to April 30, 2015. Eight studies, containing 4,286 patients, were analyzed. In the grouping analysis, among esophageal squamous-cell carcinoma patients, current and former smokers, compared to those who have never smoked, seemed to have a poorer prognosis (HR = 1.41, 95% CI 1.22–1.64, and HR = 1.35, 95% CI 0.92–1.97, resp.. In the subgroup analysis, adverse effects on current smoker compared with never smoker were also observed in China and the other countries (HR = 1.5, 95% CI 1.18–1.92, and HR = 1.36, 95% CI 1.12–1.65, resp.. In the group that ever smoked, we could not get a similar result. No significantly increased risk was found in esophageal adenocarcinoma patients compared to the squamous-cell histology ones. In the smoking intensity analysis, heavy smoking was associated with poor survival in esophageal squamous-cell carcinoma. Our pooled results supported the existence of harmful effects of smoking on survival after esophagus cancer diagnosis.

  3. Megaesophagus in Friesian horses associated with muscular hypertrophy of the caudal esophagus.

    Science.gov (United States)

    Komine, M; Langohr, I M; Kiupel, M

    2014-09-01

    Friesian horses have a perceived high rate of congenital or hereditary diseases, including megaesophagus, that may lead to choke and death. A retrospective study was performed to determine the prevalence and pathologic characteristics of esophageal disease in 852 horses, including 17 Friesians, that had been necropsied over a 6-year period at the Diagnostic Center for Population and Animal Health. Forty-two horses had grossly described esophageal lesions (25 muscular hypertrophy, 7 hemorrhage, 6 megaesophagus, 4 erosion/ulceration, 3 obstruction, 2 tears, 2 secondary neoplasms, 2 lymphoid patches, 1 thin wall, 1 esophagitis). Some of these lesions occurred concurrently in the same horse. Ten of these horses died or were euthanatized because of severe esophageal disease (6 megaesophagus causing tears in 2 horses, 3 esophageal obstruction with food bolus, and 1 esophagitis). All 6 horses with megaesophagus were Friesians. No cause for megaesophagus was noted in the necropsy reports; however, 5 of these 6 Friesians had marked caudal esophageal muscular hypertrophy (wall thickness: 1.9 ± 0.3 cm). Microscopic review of the esophagus of these Friesians confirmed smooth muscle hypertrophy, with no obvious fibrosis, degeneration, or loss of myenteric plexi. Unlike the Friesians, the 4 non-Friesian horses with severe esophageal disease had esophageal obstruction with an intraluminal food bolus or severe esophagitis. None had caudal esophageal muscular hypertrophy. It is concluded that in comparison to other horse breeds, Friesians have a higher prevalence of severe esophageal disease, specifically megaesophagus, that is commonly associated with marked caudal muscular hypertrophy.

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

    Institute of Scientific and Technical Information of China (English)

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

    2008-01-01

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

  5. Effects of the Learning Curve on Efficacy of Radiofrequency Ablation for Barrett's Esophagus.

    Science.gov (United States)

    Pasricha, Sarina; Cotton, Cary; Hathorn, Kelly E; Li, Nan; Bulsiewicz, William J; Wolf, W Asher; Muthusamy, V Raman; Komanduri, Srinadh; Wolfsen, Herbert C; Pruitt, Ron E; Ertan, Atilla; Chmielewski, Gary W; Shaheen, Nicholas J

    2015-10-01

    Complete eradication of Barrett's esophagus (BE) often requires multiple sessions of radiofrequency ablation (RFA). Little is known about the effects of case volume on the safety and efficacy of RFA or about the presence or contour of learning curves for this procedure. We collected data from the US RFA Patient Registry (from 148 institutions) for patients who underwent RFA for BE from July 2007 to July 2011. We analyzed the effects of the number of patients treated by individual endoscopists and individual centers on safety and efficacy outcomes of RFA. Outcomes, including stricture, bleeding, hospitalization, and complete eradication of intestinal metaplasia (CEIM), were assessed using logistic regression. The effects of center and investigator experience on numbers of treatment sessions to achieve CEIM were examined using linear regression. After we controlled for potential confounders, we found that as the experience of endoscopists and centers increased with cases, the numbers of treatment sessions required to achieve CEIM decreased. This relationship persisted after adjusting for patient age, sex, race, length of BE, and presence of pretreatment dysplasia (P .05). Based on analysis of a large multicenter registry, efficiency of the treatment, as measured by number of sessions needed to achieve CEIM, increased with case volume, indicating a learning curve effect. This trend began to disappear after treatment of approximately 30 patients by the center or individual endoscopist. However, there was no significant association between safety or efficacy outcomes and previous case volume. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

  6. Expression of EpCam and Villin in Barrett’s Esophagus and in Gastric Cardia

    Directory of Open Access Journals (Sweden)

    Mario Anders

    2008-01-01

    Full Text Available In the current study we aimed to clarify the potential of EpCAM and villin as in vivo biomarkers for both Barrett esophagus (BE-associated neoplasia and BE versus cardiac mucosa. Immunohistochemical staining in BE with various degrees of intraepithelial neoplasia (IN, Barrett carcinoma (BC and in normal cardiac mucosa (CM revealed a lack of EpCam and villin in squamous esophageal epithelium. All specimens of IN and BC showed EpCam with varying staining intensities. In 57% of CM samples a weak signal was detected; the remainder displayed strong EpCam expression. Villin was found in 97% of BE specimens and in all those with IN; 37% of BC and 75% of CM specimens were also positive. We conclude that expression of EpCam and villin differs only between squamous epithelium and BE. Determination of these proteins does not allow discrimination between different degrees of neoplasia or between esophageal intestinal metaplasia and cardiac mucosa.

  7. Reconstructive Trends in Post-Ablation Patients with Esophagus and Hypopharynx Defect.

    Science.gov (United States)

    Ki, Sae Hwi; Choi, Jong Hwan; Sim, Seung Hyun

    2015-12-01

    The main challenge in pharyngoesophageal reconstruction is the restoration of swallow and speech functions. The aim of this paper is to review the reconstructive options and associated complications for patients with head and neck cancer. A literature review was performed for pharynoesophagus reconstruction after ablative surgery of head and neck cancer for studies published between January 1980 to July 2015 and listed in the PubMed database. Search queries were made using a combination of 'esophagus' and 'free flap', 'microsurgical', or 'free tissue transfer'. The search query resulted in 123 studies, of which 33 studies were full text publications that met inclusion criteria. Further review into the reference of these 33 studies resulted in 15 additional studies to be included. The pharyngoesophagus reconstruction should be individualized for each patient and clinical context. Fasciocutaneous free flap and pedicled flap are effective for partial phayngoesophageal defect. Fasciocutaneous free flap and jejunal free flap are effective for circumferential defect. Pedicled flaps remain a safe option in the context of high surgical risk patients, presence of fistula. Among free flaps, anterolateral thigh free flap and jejunal free flap were associated with superior outcomes, when compared with radial forearm free flap. Speech function is reported to be better for the fasciocutaneous free flap than for the jejunal free flap.

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

    Science.gov (United States)

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

    2016-05-01

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

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

    Science.gov (United States)

    Elsadek, Hany M; Radwan, Mamdouh M

    2015-01-01

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

  10. [Esophageal adenoma-carcinoma and Barrett's esophagus. Gastric adenocarcinoma and Helicobacter pylori].

    Science.gov (United States)

    Andreu Garcia, Montserrat

    2008-10-01

    In the last two decades, the incidence of esophageal cancer has progressively increased, especially that of adenocarcinomas localized in the esophagogastric junction. The incidence of gastric cancer has decreased in the last few decades, although this decrease shows wide geographical variations. Thus, the prevalence of gastric cancer continues to be high in countries such as Chile, Colombia and Ireland and this disease remains the most frequent neoplasm in both sexes in China and Japan. In the meeting of the American Gastroenterological Association, notable among all the studies presented on the prevention and treatment of esophageal and gastric cancer were the following contributions: the use of clinical practice guidelines for the prevention and surveillance of Barrett's esophagus (BE) should be improved; treatment with proton pump inhibitors does not seem to reduce the risk of esophageal cancer; endoscopic therapy of intramucosal cancer through complete mucosal resection is effective; Helicobacter pylori eradication prevents the development of metachronous gastric cancer in patients treated for a first intramucosal adenocarcinoma through endoscopic resection; the risk of developing gastric cancer is 6 times higher in patients with mucosa-associated lymphoid tissue (MALT) lymphoma than in the general population; and photodynamic therapy may be an alternative for the treatment of "invisible" gastric adenocarcinoma, which should be followed-up endoscopically.

  11. Animal Models of Barrett's Esophagus and Esophageal Adenocarcinoma%Barrett食管和食管腺癌的动物模型

    Institute of Scientific and Technical Information of China (English)

    房渝; 任冬仁; 陈浩; 胡建国; 陈晓欣

    2012-01-01

    Barrett食管(BE)和食管腺癌(EAC)在西方国家具有较高的发病率.随着中国人饮食结构的变化,可以预见BE和EAC也将是未来威胁中国人健康的疾病.动物模型是研究人类疾病的重要工具之一,可用于研究病因学、发病学和发病机制.本文阐述不同模型动物的食管特征,藉此反映不同动物作为BE和EAC研究模型的优势和潜力;介绍主要BE和EAC的动物模型,这些模型包括以外科手术为基础的动物模型、以基因改造为基础的动物模型以及外科手术联合基因改造为基础的动物模型等;着重强调大动物,包括犬和猪在BE和EAC研究领域中所担当的角色;提出动物模型本身存在的一些问题以及采用多个动物模型研究疾病的必要性.%The prevalences of Barrett' s esophagus (BE) and esophageal adenocarcinoma (EAC) are high in Western countries. BE and EAC are predicted to be the threatening of health in Chinese people in future because of dietary change. Animal models are important tools for the investigation of human diseases, including etiology, pathology and mechanism. This review focused on the characteristics of esophagus of various kinds of animal model, exploring their potential of being used as the research models for BE and EAC. Existing models established on the basis of surgery, genetic modification, and a combination of surgery and genetic modification were summarized, and the potential roles played by large animals, such as dog or pig, in the research of BE and EAC were emphasized. Intrinsic drawbacks of animal models and the advantage of using multiple animal models for studies on BE and EAC were discussed.

  12. Transitioning from preclinical to clinical chemopreventive assessments of lyophilized black raspberries: interim results show berries modulate markers of oxidative stress in Barrett's esophagus patients.

    Science.gov (United States)

    Kresty, Laura A; Frankel, Wendy L; Hammond, Cynthia D; Baird, Maureen E; Mele, Jennifer M; Stoner, Gary D; Fromkes, John J

    2006-01-01

    Increased fruit and vegetable consumption is associated with decreased risk of a number of cancers of epithelial origin, including esophageal cancer. Dietary administration of lyophilized black raspberries (LBRs) has significantly inhibited chemically induced oral, esophageal, and colon carcinogenesis in animal models. Likewise, berry extracts added to cell cultures significantly inhibited cancer-associated processes. Positive results in preclinical studies have supported further investigation of berries and berry extracts in high-risk human cohorts, including patients with existing premalignancy or patients at risk for cancer recurrence. We are currently conducting a 6-mo chemopreventive pilot study administering 32 or 45 g (female and male, respectively) of LBRs to patients with Barrett's esophagus (BE), a premalignant esophageal condition in which the normal stratified squamous epithelium changes to a metaplastic columnar-lined epithelium. BE's importance lies in the fact that it confers a 30- to 40-fold increased risk for the development of esophageal adenocarcinoma, a rapidly increasing and extremely deadly malignancy. This is a report on interim findings from 10 patients. To date, the results support that daily consumption of LBRs promotes reductions in the urinary excretion of two markers of oxidative stress, 8-epi-prostaglandin F2alpha (8-Iso-PGF2) and, to a lesser more-variable extent, 8-hydroxy-2'-deoxyguanosine (8-OHdG), among patients with BE.

  13. Long-term follow-up after complete ablation of Barrett's esophagus with argon plasma coagulation

    Institute of Scientific and Technical Information of China (English)

    Ahmed Madisch; Stephan Miehlke; Ekkehard Bayerd(o)rffer; Birgit Wiedemann; David Antos; Anke Sievert; Michael Vieth; Manfred Stolte; Heinrich Schulz

    2005-01-01

    AIM: To report the long-term outcome of patients after complete ablation of non-neoplastic Barrett's esophagus (BE) with respect to BE relapse and development of intraepithelial neoplasia or esophageal adenocarcinoma.METHODS: In 70 patients with histologically proven nonneoplastic BE, complete BE ablation was achieved by argon plasma coagulation (APC) and high-dose proton pump inhibitor therapy (120 mg omeprazole daily). Sixty-six patients (94.4%) underwent further surveillance endoscopy. At each surveillance endoscopy four-quadrant biopsies were taken from the neo-squamous epithelium at 2 cm intervals depending on the pre-treatment length of BE mucosa beginning at the neo-Z-line, and from any endoscopically suspicious lesion.RESULTS: The median follow-up of 66 patients was 51 mo (range 9-85 mo) giving a total of 280.5 patient years.A mean of 6 biopsies were taken during surveillance endoscopies. In 13 patients (19.7%) tongues or islands suspicious for BE were found during endoscopy. In 8 of these patients (12.1%) non-neoplastic BE relapse was confirmed histologically giving a histological relapse rate of 3% per year. In none of the patients, intraepithelial neoplasia nor an esophageal adenocarcinoma was detected.Logistic regression analysis identified endoscopic detection of islands or tongues as the only positive predictor of BE relapse (P = 0.0004).CONCLUSION: The long-term relapse rate of nonneoplastic BE following complete ablation with high-power APC is low (3% per year).

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

    Science.gov (United States)

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

    2013-02-01

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

  15. Inverse Association Between Gluteofemoral Obesity and Risk of Barrett's Esophagus in a Pooled Analysis.

    Science.gov (United States)

    Kendall, Bradley J; Rubenstein, Joel H; Cook, Michael B; Vaughan, Thomas L; Anderson, Lesley A; Murray, Liam J; Shaheen, Nicholas J; Corley, Douglas A; Chandar, Apoorva K; Li, Li; Greer, Katarina B; Chak, Amitabh; El-Serag, Hashem B; Whiteman, David C; Thrift, Aaron P

    2016-10-01

    Gluteofemoral obesity (determined by measurement of subcutaneous fat in the hip and thigh regions) could reduce risks of cardiovascular and diabetic disorders associated with abdominal obesity. We evaluated whether gluteofemoral obesity also reduces the risk of Barrett's esophagus (BE), a premalignant lesion associated with abdominal obesity. We collected data from non-Hispanic white participants in 8 studies in the Barrett's and Esophageal Adenocarcinoma Consortium. We compared measures of hip circumference (as a proxy for gluteofemoral obesity) from cases of BE (n = 1559) separately with 2 control groups: 2557 population-based controls and 2064 individuals with gastroesophageal reflux disease (GERD controls). Study-specific odds ratios (ORs) and 95% confidence intervals (95% CIs) were estimated using individual participant data and multivariable logistic regression and combined using a random-effects meta-analysis. We found an inverse relationship between hip circumference and BE (OR per 5-cm increase, 0.88; 95% CI, 0.81-0.96), compared with population-based controls in a multivariable model that included waist circumference. This association was not observed in models that did not include waist circumference. Similar results were observed in analyses stratified by frequency of GERD symptoms. The inverse association with hip circumference was statistically significant only among men (vs population-based controls: OR, 0.85; 95% CI, 0.76-0.96 for men; OR, 0.93; 95% CI, 0.74-1.16 for women). For men, within each category of waist circumference, a larger hip circumference was associated with a decreased risk of BE. Increasing waist circumference was associated with an increased risk of BE in the mutually adjusted population-based and GERD control models. Although abdominal obesity is associated with an increased risk of BE, there is an inverse association between gluteofemoral obesity and BE, particularly among men. Copyright © 2016 AGA Institute. Published by

  16. Premature Birth and Large for Gestational Age Are Associated with Risk of Barrett's Esophagus in Adults.

    Science.gov (United States)

    Shiota, Seiji; El-Serag, Hashem B; Thrift, Aaron P

    2016-04-01

    Birth characteristics, including weight and gestational age, may be associated with risk of Barrett's esophagus (BE), the only known precursor for esophageal adenocarcinoma; however, data are limited. To examine associations between various birth characteristics and BE, and whether these associations are mediated by known risk factors for BE. Data were obtained from a cross-sectional study among eligible Veterans Affairs patients scheduled for an upper endoscopy, and a sample identified from primary care clinics. Participants underwent an esophagogastroduodenoscopy and completed a survey that captured information on sociodemographic and clinical factors, as well as birth information. We compared 263 patients with histologically confirmed BE to 1416 controls without BE on endoscopy. Odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated using multivariate logistic regression. Premature birth was independently associated with risk of BE after adjusted by age, sex, race, and other birth characteristics (OR 3.28, 95 % CI 1.22-8.79). On the other hand, large for gestational age was inversely associated with risk of BE (OR 0.46, 95 % CI 0.21-0.98). These effects were stronger for patients with long-segment BE than with short-segment BE. The associations were not mediated by gastroesophageal reflux disease symptoms, use of proton pump inhibitors, Helicobacter Pylori infection, waist-hip-ratio, height or the presence of hiatus hernia. Premature birth and large for gestational age may be associated with risk of BE in adults. These associations do not appear to be mediated through known risk factors for BE; however, additional studies are required to confirm our findings.

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

    Science.gov (United States)

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

    2014-08-01

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

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

    Science.gov (United States)

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

    2015-03-15

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

  19. A Molecular Clock Infers Heterogeneous Tissue Age Among Patients with Barrett's Esophagus.

    Directory of Open Access Journals (Sweden)

    Kit Curtius

    2016-05-01

    Full Text Available Biomarkers that drift differentially with age between normal and premalignant tissues, such as Barrett's esophagus (BE, have the potential to improve the assessment of a patient's cancer risk by providing quantitative information about how long a patient has lived with the precursor (i.e., dwell time. In the case of BE, which is a metaplastic precursor to esophageal adenocarcinoma (EAC, such biomarkers would be particularly useful because EAC risk may change with BE dwell time and it is generally not known how long a patient has lived with BE when a patient is first diagnosed with this condition. In this study we first describe a statistical analysis of DNA methylation data (both cross-sectional and longitudinal derived from tissue samples from 50 BE patients to identify and validate a set of 67 CpG dinucleotides in 51 CpG islands that undergo age-related methylomic drift. Next, we describe how this information can be used to estimate a patient's BE dwell time. We introduce a Bayesian model that incorporates longitudinal methylomic drift rates, patient age, and methylation data from individually paired BE and normal squamous tissue samples to estimate patient-specific BE onset times. Our application of the model to 30 sporadic BE patients' methylomic profiles first exposes a wide heterogeneity in patient-specific BE onset times. Furthermore, independent application of this method to a cohort of 22 familial BE (FBE patients reveals significantly earlier mean BE onset times. Our analysis supports the conjecture that differential methylomic drift occurs in BE (relative to normal squamous tissue and hence allows quantitative estimation of the time that a BE patient has lived with BE.

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

    Science.gov (United States)

    Jang, Bo Gun; Lee, Byung Lan; Kim, Woo Ho

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Bo Gun Jang

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

  2. Impact of laparoscopic nissen fundoplication on non-Complicated Barrett′s esophagus

    Directory of Open Access Journals (Sweden)

    Ashraf A Mohamed

    2011-01-01

    Full Text Available Background/Aim: Laparoscopic fundoplication can alter the natural course of Barrett′s esophagus (BE. This study was undertaken to assess this role in patients with non-complicated BE. Materials and Methods: From October 2004 to October 2009, 43 patients with BE (32 men and 11 women underwent laparoscopic Nissen fundoplication surgery in the Department of Surgery at Minia University Hospital. The median age of these patients was 46 years (range: 22-68 years. Patients with high-grade dysplasia, invasive cancer, or previous antireflux surgery were excluded. All 43 patients had gastroesophageal reflux symptoms. Heartburn was present in all patients, regurgitation in 41 (95.3%, dysphagia in 8 (18.6%, retrosternal pain in 30 (69.8%, upper gastrointestinal hemorrhage in 6 (13.9%, and respiratory symptoms in 19 (44.2%. Nissen fundoplication was performed in all patients. Thirty-four patients (79.1% had concomitant hiatal hernia and nine patients (20.9% had low-grade dysplasia. Results: The median follow-up period was 25.6 months. There was significant improvement of symptoms after surgery (P<0.05. Eight (18.6% of those with short-segment BE had total regression and four (9.3% of those with long-segment BE had a decrease in total length. Among the nine patients with preoperative low-grade dysplasia, dysplasia disappeared in seven, remained unchanged in one, and progressed to in situ adenocarcinoma in one patient. Conclusions: laparoscopic fundoplication succeeded in controlling symptoms but had unpredictable effect on dysplasia and regression of BE. Laparoscopic fundoplication does not eliminate the risk of developing esophageal adenocarcinoma and therefore, endoscopic follow-up should be continued in these patients.

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

    Science.gov (United States)

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

    2014-02-01

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

  4. Incidence of Esophageal Adenocarcinoma and Causes of Mortality After Radiofrequency Ablation of Barrett's Esophagus.

    Science.gov (United States)

    Wolf, W Asher; Pasricha, Sarina; Cotton, Cary; Li, Nan; Triadafilopoulos, George; Muthusamy, V Raman; Chmielewski, Gary W; Corbett, F Scott; Camara, Daniel S; Lightdale, Charles J; Wolfsen, Herbert; Chang, Kenneth J; Overholt, Bergein F; Pruitt, Ron E; Ertan, Atilla; Komanduri, Srinadh; Infantolino, Anthony; Rothstein, Richard I; Shaheen, Nicholas J

    2015-12-01

    Radiofrequency ablation (RFA) is commonly used to treat Barrett's esophagus (BE). We assessed the incidence of esophageal adenocarcinoma (EAC) after RFA, factors associated with the development of EAC, and EAC-specific and all-cause mortality. We collected data for outcomes of patients who underwent RFA for BE from July 2007 through July 2011 from US multicenter RFA Patient Registry. Patients were followed until July 2014. Kaplan-Meier curves of EAC incidence were stratified by baseline histology. Crude EAC incidence and mortality (all-cause and EAC-specific) were calculated, and adjusted all-cause mortality was assessed. Logistic regression models were constructed to assess predictors of EAC and all-cause mortality. Among 4982 patients, 100 (2%) developed EAC (7.8/1000 person-years [PY]) and 9 patients (0.2%) died of EAC (0.7/1000 PY) in a mean 2.7 ± 1.6 years. The incidence of EAC in nondysplastic BE was 0.5/1000 PY. Overall, 157 patients (3%) died during follow-up (all-cause mortality, 11.2/1000 PY). On multivariate logistic regression, baseline BE length (odds ratio, 1.1/ cm) and baseline histology (odds ratios, 5.8 and 50.3 for low-grade dysplasia and high-grade dysplasia [HGD] respectively) predicted EAC incidence. Among 9 EAC deaths, 6 (67%) had baseline HGD, and 3 (33%) had baseline intramucosal EAC. The most common causes of death were cardiovascular (15%) and extraesophageal cancers (15%). No deaths were associated with RFA. Based on analysis of a multicenter registry of patients who underwent RFA of BE, less than 1% died from EAC. The incidence of EAC was markedly lower in this study than in other studies of disease progression, with the greatest absolute benefit observed in patients with HGD. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

  5. Durability and Predictors of Successful Radiofrequency Ablation for Barrett’s Esophagus

    Science.gov (United States)

    Pasricha, Sarina; Bulsiewicz, William J.; Hathorn, Kelly E.; Komanduri, Srinadh; Muthusamy, V. Raman; Rothstein, Richard I.; Wolfsen, Herbert C.; Lightdale, Charles J.; Overholt, Bergein F.; Camara, Daniel S.; Dellon, Evan S.; Lyday, William D.; Ertan, Atilla; Chmielewski, Gary W.; Shaheen, Nicholas J.

    2014-01-01

    Background & Aims Following radiofrequency ablation (RFA), patients may experience recurrence of Barrett’s esophagus (BE) after complete eradication of intestinal metaplasia (CEIM). Rates and predictors of recurrence after successful eradication are poorly described. Methods We used the U.S. RFA Registry, a nationwide registry of BE patients receiving RFA, to determine rates and factors that predicted recurrence of IM. We assessed recurrence by Kaplan-Meier analysis for the overall cohort and by worst pretreatment histology. Characteristics associated with recurrence were included in a logistic regression model to identify independent predictors. Results Among 5521 patients, 3728 had biopsies ≥12 months after initiation of RFA. Of these, 3169 (85%) achieved CEIM, and 1634 (30%) met inclusion criteria. Average follow-up was 2.4 years after CEIM. IM recurred in 334 (20%), and was non-dysplastic or indefinite for dysplasia in 86% (287/334); the average length of recurrent BE was 0.6 cm. In Kaplan-Meier analysis, more advanced pretreatment histology was associated with an increased yearly recurrence rate. Compared to patients without recurrence, patients with recurrence were more likely, based on bi-variate analysis, to be older, have longer BE segments, be non-Caucasian, have dysplastic BE before treatment, and require more treatment sessions. In multivariate analysis, likelihood for recurrence was associated with increasing age and BE length, and non-Caucasian race. Conclusion BE recurred in 20% of patients followed for an average of 2.4 years after CEIM. Most recurrences were short segments and were non-dysplastic or indefinite for dysplasia. Older age, non-Caucasian race, and increasing length of BE length were all risk factors. These risk factors should be considered when planning post-RFA surveillance intervals. PMID:24815329

  6. Randomized comparison of 3 different-sized biopsy forceps for quality of sampling in Barrett's esophagus.

    Science.gov (United States)

    Gonzalez, Susana; Yu, Woojin M; Smith, Michael S; Slack, Kristen N; Rotterdam, Heidrun; Abrams, Julian A; Lightdale, Charles J

    2010-11-01

    Several types of forceps are available for use in sampling Barrett's esophagus (BE). Few data exist with regard to biopsy quality for histologic assessment. To evaluate sampling quality of 3 different forceps in patients with BE. Single-center, randomized clinical trial. Consecutive patients with BE undergoing upper endoscopy. Patients randomized to have biopsy specimens taken with 1 of 3 types of forceps: standard, large capacity, or jumbo. Specimen adequacy was defined a priori as a well-oriented biopsy sample 2 mm or greater in diameter and with at least muscularis mucosa present. A total of 65 patients were enrolled and analyzed (standard forceps, n = 21; large-capacity forceps, n = 21; jumbo forceps, n = 23). Compared with jumbo forceps, a significantly higher proportion of biopsy samples with large-capacity forceps were adequate (37.8% vs 25.2%, P = .002). Of the standard forceps biopsy samples, 31.9% were adequate, which was not significantly different from specimens taken with large-capacity (P = .20) or jumbo (P = .09) forceps. Biopsy specimens taken with jumbo forceps had the largest diameter (median, 3.0 mm vs 2.5 mm [standard] vs 2.8 mm [large capacity]; P = .0001). However, jumbo forceps had the lowest proportion of specimens that were well oriented (overall P = .001). Heterogeneous patient population precluded dysplasia detection analyses. Our results challenge the requirement of jumbo forceps and therapeutic endoscopes to properly perform the Seattle protocol. We found that standard and large-capacity forceps used with standard upper endoscopes produced biopsy samples at least as adequate as those obtained with jumbo forceps and therapeutic endoscopes in patients with BE. Copyright © 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

  7. MicroRNA Expression Signatures During Malignant Progression From Barrett's Esophagus.

    Science.gov (United States)

    Bansal, Ajay; Gupta, Vijayalaxmi; Wang, Kenneth

    2016-06-01

    The rapid increase and poor survival of esophageal adenocarcinoma (EAC) have led to significant efforts to promote early detection. Given that the premalignant lesion of Barrett's esophagus (BE) is the major known risk factor for EAC, multiple investigators have studied biomarker signatures that can predict malignant progression of BE to EAC. MicroRNAs, a novel class of gene regulators, are small non-coding RNAs and have been associated with carcinogenesis. MicroRNAs are ideal biomarkers because of their remarkable stability in fixed tissues, a common method for collection of clinical specimens, and in blood either within exosomes or as microRNA-protein complexes. Multiple studies show potential of microRNAs as tissue and blood biomarkers for diagnosis and prognosis of EAC but the results need confirmation in prospective studies. Although head-to-head comparisons are lacking, microRNA panels require less genes than messenger RNA panels for diagnosis of EAC in BE. MicroRNA diagnostic panels will need to be compared for accuracy against global measures of genome instability that were recently shown to be good predictors of progression but require sophisticated analytic techniques. Early studies on blood microRNA panels are promising but have found microRNA markers to be inconsistent among studies. MicroRNA expression in blood is different between various microRNA sub-compartments such as exosomes and microRNA-protein complexes and could affect blood microRNA measurements. Further standardization is needed to yield consistent results. We have summarized the current understanding of the tissue and blood microRNA signatures that may predict the development and progression of EAC.

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

    LENUS (Irish Health Repository)

    2012-01-31

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

  9. A Molecular Clock Infers Heterogeneous Tissue Age Among Patients with Barrett's Esophagus.

    Science.gov (United States)

    Curtius, Kit; Wong, Chao-Jen; Hazelton, William D; Kaz, Andrew M; Chak, Amitabh; Willis, Joseph E; Grady, William M; Luebeck, E Georg

    2016-05-01

    Biomarkers that drift differentially with age between normal and premalignant tissues, such as Barrett's esophagus (BE), have the potential to improve the assessment of a patient's cancer risk by providing quantitative information about how long a patient has lived with the precursor (i.e., dwell time). In the case of BE, which is a metaplastic precursor to esophageal adenocarcinoma (EAC), such biomarkers would be particularly useful because EAC risk may change with BE dwell time and it is generally not known how long a patient has lived with BE when a patient is first diagnosed with this condition. In this study we first describe a statistical analysis of DNA methylation data (both cross-sectional and longitudinal) derived from tissue samples from 50 BE patients to identify and validate a set of 67 CpG dinucleotides in 51 CpG islands that undergo age-related methylomic drift. Next, we describe how this information can be used to estimate a patient's BE dwell time. We introduce a Bayesian model that incorporates longitudinal methylomic drift rates, patient age, and methylation data from individually paired BE and normal squamous tissue samples to estimate patient-specific BE onset times. Our application of the model to 30 sporadic BE patients' methylomic profiles first exposes a wide heterogeneity in patient-specific BE onset times. Furthermore, independent application of this method to a cohort of 22 familial BE (FBE) patients reveals significantly earlier mean BE onset times. Our analysis supports the conjecture that differential methylomic drift occurs in BE (relative to normal squamous tissue) and hence allows quantitative estimation of the time that a BE patient has lived with BE.

  10. 食管癌术后管道护理风险因素分析及防范对策%An analysis of the risk factors in the post-operative nursing care of the esophagus cancer for esophagus as well as precautions and countermeasures

    Institute of Scientific and Technical Information of China (English)

    赵红凤; 陈东桂; 谢秀萍

    2011-01-01

    Objective To summarize the risk factors in the post - operative nursing care of the esophagus cancer for the esophagus as well as the precautions and countermeasures. Methods A retrospective analysis of 35 cases of the post - operative nursing care for the esophagus was carried out. Results It turns out that the factors in the patients themselves, the esophagus and the nursing staff were the main factors which contributed to the risks of post - operative nursing care for the esophagus. Conclusion In conclusion, good management of post- operative patients, esophagus and the staff are key factors to prevent the risks of the esophagus cancer caused by post- operative nursing care for the esophagus and reduce the fatality rates and postoperative complications.%目的 总结食管癌术后管道护理风险因素及防范对策.方法 对35例食管癌术后管道护理进行回顾性总结分析.结果 患者本身因素、管道因素、护理人员因素是导致食管癌术后管道护理风险发生的主要因素.结论 加强术后患者、管道和护理人员管理,能有效预防食管癌术后管道护理风险发生,降低术后并发症和病死率发生.

  11. Characterization of the Distal Esophagus High-Pressure Zone with Manometry, Ultrasound and Micro-Computed Tomography

    Science.gov (United States)

    Vegesna, Anil K.; Sloan, Joshua A.; Singh, Baltej; Phillips, Steven J; Braverman, Alan S.; Barbe, Mary F.; Ruggieri, Michael R.; Miller, Larry S.

    2012-01-01

    Background We sought to determine how the individual components of the distal esophagus and proximal stomach form the gastroesophageal junction high-pressure zone (GEJHPZ) anti-reflux barrier. Methods An endoscopic ultrasound/manometry catheter was pulled through the proximal stomach and distal esophagus in 20 normal subjects. The axial length and width of individual structures on endoscopic ultrasound were measured. The anatomic orientation of gastroesophageal junction (GEJ) components was examined in two organ donor specimens using micro-computed tomography (micro-CT). Key Results The three distinct structures identified within the GEJHPZ, from distal to proximal, were: the gastric clasp and sling muscle fiber complex, crural diaphragm, and lower esophageal circular smooth muscle fibers (LEC). The LEC was statistically significantly thicker than adjacent esophageal muscles. These structures were associated with 3 pressure peaks. The pressure peak produced by the clasp/sling fiber complex often overlapped with the pressure peak from the crural diaphragm. The most proximal peak, associated with the LEC, was significantly greater and bimodal in 9 of 20 subjects. This bimodal LEC pressure peak correlated with two areas of thickened muscle observed with ultrasound. Micro-CT of GEJ from organ donors confirmed the two areas of thickened muscle. Conclusions and inferences Three distinct anatomic structures, the clasp and sling muscle fibers, crural diaphragm, and LEC combine to form the anti-reflux barrier of the proximal stomach and distal esophagus. The clasp and sling muscle fibers combine with the crural diaphragm to form a distal pressure profile. The more proximal LEC has a bimodal pressure profile in some patients. PMID:22998376

  12. Sox9 drives columnar differentiation of esophageal squamous epithelium: a possible role in the pathogenesis of Barrett's esophagus.

    Science.gov (United States)

    Clemons, Nicholas J; Wang, David H; Croagh, Daniel; Tikoo, Anjali; Fennell, Christina M; Murone, Carmel; Scott, Andrew M; Watkins, D Neil; Phillips, Wayne A

    2012-12-15

    The molecular mechanism underlying the development of Barrett's esophagus (BE), the precursor to esophageal adenocarcinoma, remains unknown. Our previous work implicated sonic hedgehog (Shh) signaling as a possible driver of BE and suggested that bone morphogenetic protein 4 (Bmp4) and Sox9 were downstream mediators. We have utilized a novel in vivo tissue reconstitution model to investigate the relative roles of Bmp4 and Sox9 in driving metaplasia. Epithelia reconstituted from squamous epithelial cells or empty vector-transduced cells had a stratified squamous phenotype, reminiscent of normal esophagus. Expression of Bmp4 in the stromal compartment activated signaling in the epithelium but did not alter the squamous phenotype. In contrast, expression of Sox9 in squamous epithelial cells induced formation of columnar-like epithelium with expression of the columnar differentiation marker cytokeratin 8 and the intestinal-specific glycoprotein A33. In patient tissue, A33 protein was expressed specifically in BE, but not in normal esophagus. Expression of Cdx2, another putative driver of BE, alone had no effect on reconstitution of a squamous epithelium. Furthermore, epithelium coexpressing Cdx2 and Sox9 had a phenotype similar to epithelium expressing Sox9 alone. Our results demonstrate that Sox9 is sufficient to drive columnar differentiation of squamous epithelium and expression of an intestinal differentiation marker, reminiscent of BE. These data suggest that Shh-mediated expression of Sox9 may be an important early event in the development of BE and that the potential for inhibitors of the hedgehog pathway to be used in the treatment of BE and/or esophageal adenocarcinoma could be tested in the near future.

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

    Science.gov (United States)

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

    2016-10-15

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

  14. Endoscopic ablation of Barrett's esophagus using the second generation argon plasma coagulation: a prospective randomized controlled trail

    Institute of Scientific and Technical Information of China (English)

    Li Zhang; Lei Dong; Jia Liu; Xiaolan Lu; Jun Zhang

    2009-01-01

    Objective:To investigate the efficacy and safety of the second generation argon plasma coagulation(VIO APC) in the ablation of Barrett's Esophagus. Methods:A total of 35 patients with uncomplicated Barrett's esophagus entered into a prospective, randomized, unblinded study comparing the treatment VIO APC combined with a proton pump inhibiter with a proton pump inhibiter administered alone. VIO APC was performed at a power setting of 40W, and argon gas flow at 1.5-2.0 L/min, and "forced" mode. Ablative treatment was repeated until either no Barrett's epithelium remained or a maximum of 5 treatment sessions occurred. Results:In the ablation group, macroscopic complete ablation was achieved in 14 of 18 patients, and complete ablation confirmed by histology in 12 of 18 patients (P<0.01). Buried glands were observed in 2 patients who had achieved macroscopic ablation. The Barrett's mucosa averaged a reduction of 65%(range 50-75%) in the remaining 4 patients. In the control group, only 2 patients had partial regression, median 30%(range 20-40%).In the ablation group, post-treatment 4 patients had transient retrosternal pain, and 3 patients had mild epigastric discomfort. One patient had a small hemorrhage during the procedure, which ceased after norepinephrine and thrombosin were administered through the endoscope biopsy channel. No adverse events were observed in the control group. During 11.8(4-15) months follow-up, patients who had achieved the complete ablation have no evidence of relapse of Barrett's esophagus. Conclusion:VIO APC with a relatively low power setting can effectively ablate the Barrett's mucosa. No severe adverse events were observed. Long-term follow-up is needed to assess cancer prevention and the durability of the neo-squamous epithelium.

  15. Mucin pattern reflects the origin of the adenocarcinoma in Barrett's esophagus: a retrospective clinical and laboratorial study

    Directory of Open Access Journals (Sweden)

    Corbett Carlos

    2009-03-01

    Full Text Available Abstract Background Mucin immunoexpression in adenocarcinoma arising in Barrett's esophagus (BE may indicate the carcinogenesis pathway. The aim of this study was to evaluate resected specimens of adenocarcinoma in BE for the pattern of mucins and to correlate to the histologic classification. Methods Specimens were retrospectively collected from thirteen patients who underwent esophageal resection due to adenocarcinoma in BE. Sections were scored for the grade of intestinal metaplasia. The tissues were examined by immunohistochemistry for MUC2 and MUC5AC antibodies. Results Eleven patients were men. The mean age was 61 years old (varied from 40 to 75 years old. The tumor size had a mean of 4.7 ± 2.3 cm, and the extension of BE had a mean of 7.7 ± 1.5 cm. Specialized epithelium with intestinal metaplasia was present in all adjacent mucosas. Immunohistochemistry for MUC2 showed immunoreactivity in goblet cells, while MUC5AC was extensively expressed in the columnar gastric cells, localizing to the surface epithelium and extending to a variable degree into the glandular structures in BE. Tumors were classified according to the mucins in gastric type in 7/13 (MUC5AC positive and intestinal type in 4/13 (MUC2 positive. Two tumors did not express MUC2 or MUC5AC proteins. The pattern of mucin predominantly expressed in the adjacent epithelium was associated to the mucin expression profile in the tumors, p = 0.047. Conclusion Barrett's esophagus adenocarcinoma shows either gastric or intestinal type pattern of mucin expression. The two types of tumors developed in Barrett's esophagus may reflect the original cell type involved in the malignant transformation.

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

    Institute of Scientific and Technical Information of China (English)

    Gary D STONER; Robeena M AZIZ

    2007-01-01

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

  17. Multiband Mucosectomy Versus Endoscopic Submucosal Dissection for Treatment of Squamous Intraepithelial Neoplasia of the Esophagus.

    Science.gov (United States)

    Jin, Xi-Feng; Chai, Tong-Hai; Gai, Wei; Chen, Zhao-Sheng; Guo, Jian-Qiang

    2016-07-01

    We compared the efficacy and safety of multiband mucosectomy (MBM) vs endoscopic submucosal dissection (ESD) for the treatment of squamous intraepithelial neoplasia of the esophagus. We performed a retrospective study of 78 patients with squamous intraepithelial neoplasia of the esophagus who received either ESD or MBM between January 2009 and January 2011 at the Tengzhou Central People's Hospital in China. We compared rates of bloc resection and curative resection, as well as complications and local recurrence, between groups. Overall, there was no statistical difference in the rate of complete resection between patients who received ESD (95.8%) vs MBM (93%) (P > .05). For tumors less than 15 mm in width, ESD produced a significantly higher rate of en bloc resection (100%) and curative resection (92.3%) than MBM (44.8% and 41%; P lesions less than 15 mm. MBM had a significantly shorter procedure time (38 ± 11 min) than ESD (84 ± 35 min) (P .05). ESD led to perforations in 8.3% of cases, whereas MBM did not lead to any perforations (P .05) or the 3-year rate of local recurrence (P > .05). Based on a retrospective comparison of patients who underwent ESD vs MBM for squamous intraepithelial neoplasia of the esophagus, ESD should be reserved for patients with larger neoplastic lesions (>15 mm), with respect to the success of attempted en bloc resection and the number of curative resections achieved. However, ESD has longer procedure times and higher rates of complication. MBM allows for safe and easy piecemeal resections, and is associated with similar levels of clinical success as ESD for lesions less than 15 mm. Large, randomized, controlled studies are needed to determine which endoscopic resection modality is superior for patients with high-grade intraepithelia neoplasms. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

  18. [Lateral pharyngotomy--a rare method of access for removing foreign bodies from the upper third of the esophagus].

    Science.gov (United States)

    Punke, C; Dommerich, S; Pau, H W; Kramp, B

    2008-01-01

    Esophageal foreign body impaction is a serious emergency. Diagnostic workup includes an exact history and physical examination as well as several imaging modalities. The extraction of an esophageal foreign body can be done using nonflexible or flexible esophagoscopy. We report on a 43-year-old patient with typical symptoms of esophageal foreign body impaction. The x-ray overview upon admission showed the adjustment wires of one component of a metal denture in the area of the upper esophagus. Extraction by nonflexible esophagoscopy was rendered impossible because parts of the denture had speared themselves into the esophageal wall. Safe and uncomplicated removal was then performed through a lateral pharyngotomy.

  19. Supplementation of strontium to a chondrogenic medium promotes chondrogenic differentiation of human dedifferentiated fat cells.

    Science.gov (United States)

    Okita, Naoya; Honda, Yoshitomo; Kishimoto, Naotaka; Liao, Wen; Azumi, Eiko; Hashimoto, Yoshiya; Matsumoto, Naoyuki

    2015-05-01

    Dedifferentiated fat cells (DFAT cells) isolated from adipose tissue have been demonstrated to differentiate into chondrogenic cells in vitro. Nevertheless, an efficient method to facilitate its chondrogenic differentiation is still unexplored, hampering the extensive application of these cells in cartilage regeneration therapies. Here we provide the evidence that supplementation of strontium ions (Sr) in a chondrogenic medium (CM) significantly promotes early chondrogenic differentiation of DFAT cells. Human DFAT cells and the mesenchymal stem cell line (RCB2153) were subjected to the CM supplemented with/without Sr. After 14 days, alcian blue staining intensity significantly increased in DFAT cells, but not in RCB2153, subjected to CM with Sr. mRNA expression analysis revealed that the CM with 1.5 mM Sr increased the expression of chondrogenic marker, collagen type 2 alpha 1, whereas there was no significant change in osteogenic markers, collagen type 1 alpha 1, runt-related transcription factor 2, and osteocalcin, and hypertrophic chondrogenic marker, collagen type 10 alpha 1. Inhibitors for extracellular signal-regulated kinase 1/2 (ERK1/2), Akt, and calcium-sensing receptor (CaSR) pathways significantly diminished the alcian blue staining intensity, providing the first evidence that these signal pathways are associated with chondrogenic differentiation of DFAT cells. CaSR and ERK1/2 pathways independently induced Sr-mediated early chondrogenic differentiation. These results suggest that Sr supplementation into the CM may provide a powerful platform for preparing chondrogenically differentiated DFAT cells for cartilage regeneration.

  20. Knockin mouse with mutant Gα11 mimics human inherited hypocalcemia and is rescued by pharmacologic inhibitors

    Science.gov (United States)

    Roszko, Kelly L.; Bi, Ruiye; Gorvin, Caroline M.; Xiong, Xiao-Feng; Inoue, Asuka; Thakker, Rajesh V.; Strømgaard, Kristian; Gardella, Thomas

    2017-01-01

    Heterotrimeric G proteins play critical roles in transducing extracellular signals generated by 7-transmembrane domain receptors. Somatic gain-of-function mutations in G protein α subunits are associated with a variety of diseases. Recently, we identified gain-of-function mutations in Gα11 in patients with autosomal-dominant hypocalcemia type 2 (ADH2), an inherited disorder of hypocalcemia, low parathyroid hormone (PTH), and hyperphosphatemia. We have generated knockin mice harboring the point mutation GNA11 c.C178T (p.Arg60Cys) identified in ADH2 patients. The mutant mice faithfully replicated human ADH2. They also exhibited low bone mineral density and increased skin pigmentation. Treatment with NPS 2143, a negative allosteric modulator of the calcium-sensing receptor (CASR), increased PTH and calcium concentrations in WT and mutant mice, suggesting that the gain-of-function effect of GNA11R6OC is partly dependent on coupling to the CASR. Treatment with the Gα11/q-specific inhibitor YM-254890 increased blood calcium in heterozygous but not in homozygous GNA11R60C mice, consistent with published crystal structure data showing that Arg60 forms a critical contact with YM-254890. This animal model of ADH2 provides insights into molecular mechanism of this G protein–related disease and potential paths toward new lines of therapy. PMID:28194446

  1. Quality indicators for the management of Barrett's esophagus, dysplasia, and esophageal adenocarcinoma: international consensus recommendations from the American Gastroenterological Association Symposium.

    Science.gov (United States)

    Sharma, Prateek; Katzka, David A; Gupta, Neil; Ajani, Jaffer; Buttar, Navtej; Chak, Amitabh; Corley, Douglas; El-Serag, Hashem; Falk, Gary W; Fitzgerald, Rebecca; Goldblum, John; Gress, Frank; Ilson, David H; Inadomi, John M; Kuipers, Ernest J; Lynch, John P; McKeon, Frank; Metz, David; Pasricha, Pankaj J; Pech, Oliver; Peek, Richard; Peters, Jeffrey H; Repici, Alessandro; Seewald, Stefan; Shaheen, Nicholas J; Souza, Rhonda F; Spechler, Stuart J; Vennalaganti, Prashanth; Wang, Kenneth

    2015-11-01

    The development of and adherence to quality indicators in gastroenterology, as in all of medicine, is increasing in importance to ensure that patients receive consistent high-quality care. In addition, government-based and private insurers will be expecting documentation of the parameters by which we measure quality, which will likely affect reimbursements. Barrett's esophagus remains a particularly important disease entity for which we should maintain up-to-date guidelines, given its commonality, potentially lethal outcomes, and controversies regarding screening and surveillance. To achieve this goal, a relatively large group of international experts was assembled and, using the modified Delphi method, evaluated the validity of multiple candidate quality indicators for the diagnosis and management of Barrett's esophagus. Several candidate quality indicators achieved >80% agreement. These statements are intended to serve as a consensus on candidate quality indicators for those who treat patients with Barrett's esophagus.

  2. [Reconstruction of the hypopharynx and cervical esophagus using a free jejunal graft].

    Science.gov (United States)

    Pesko, P; Bumbasirević, M; Knezević, J; Dunjić, M; Djukić, V; Simić, A; Stojakov, D; Sabljak, P; Bjelović, M; Janković, Z; Micev, M; Saranović, D

    2000-01-01

    Extensive malignant tumors of the hypopharynx and cervical esophagus continue to challenge surgeons in respect to both type and extent of resection as well as type of reconstruction. In the period between November 1st, 1996 and November 1st, 1998, at our Department, five patients have been operated due to squamocellular carcinoma of the hypopharynx using a free jejunal graft reconstruction method. The first free jejunal graft operation due to hypopharyngeal carcinoma, at the same time the first operation of this kind ever done in our Country, was performed on November 13th, 1998. There were 4 female and one male patient, average age 47.75 years. Disfagia for solid foods was a leading symptom in all patients (mean duration of 3.5 months) and was always accompanied with weight loss (average of 8 kg for two months). In all patients barium swallow, endoscopy, CT as well as intraoperative endoscopy was performed. Radical surgical procedure was always accompanied with the bilateral modified lympf node neck dissection. As a arterial donor vessel superior thyroid artery was used in all patients. As a venous drainage in three patients a external jugular vein was used and in two facial vein. Reconstruction using a free jejunal graft of approximately 25 cm long was performed in all patients creating upper, oropharingeal, anastomosis end to side and distal, esophageal, end to end (in only one patients side to end) using 3/0 apsorbable sutures. Mean duration of the operation was six hours. The postoperative course in all patients was uneventful. On the 9th postoperative day gastrografin and three days later barium swallow radiography was performed as a standard control study. Regular check ups were done on three, six, nine months, year and two years. On all controls all patients were symptom free and feeling well. It is our opinion that in the patients with isolated carcinoma of the hypopharynx due to low morbidity and mortality rate, free jejunal graft method is the surgical

  3. Metformin does not reduce markers of cell proliferation in esophageal tissues of patients with Barrett's esophagus.

    Science.gov (United States)

    Chak, Amitabh; Buttar, Navtej S; Foster, Nathan R; Seisler, Drew K; Marcon, Norman E; Schoen, Robert; Cruz-Correa, Marcia R; Falk, Gary W; Sharma, Prateek; Hur, Chin; Katzka, David A; Rodriguez, Luz M; Richmond, Ellen; Sharma, Anamay N; Smyrk, Thomas C; Mandrekar, Sumithra J; Limburg, Paul J

    2015-04-01

    Obesity is associated with neoplasia, possibly via insulin-mediated cell pathways that affect cell proliferation. Metformin has been proposed to protect against obesity-associated cancers by decreasing serum insulin. We conducted a randomized, double-blind, placebo-controlled, phase 2 study of patients with Barrett's esophagus (BE) to assess the effect of metformin on phosphorylated S6 kinase (pS6K1), a biomarker of insulin pathway activation. Seventy-four subjects with BE (mean age, 58.7 years; 58 men [78%; 52 with BE >2 cm [70%]) were recruited through 8 participating organizations of the Cancer Prevention Network. Participants were randomly assigned to groups given metformin daily (increasing to 2000 mg/day by week 4, n = 38) or placebo (n = 36) for 12 weeks. Biopsy specimens were collected at baseline and at week 12 via esophagogastroduodenoscopy. We calculated and compared percent changes in median levels of pS6K1 between subjects given metformin vs placebo as the primary end point. The percent change in median level of pS6K1 did not differ significantly between groups (1.4% among subjects given metformin vs -14.7% among subjects given placebo; 1-sided P = .80). Metformin was associated with an almost significant reduction in serum levels of insulin (median -4.7% among subjects given metformin vs 23.6% increase among those given placebo, P = .08) as well as in homeostatic model assessments of insulin resistance (median -7.2% among subjects given metformin vs 38% increase among those given placebo, P = .06). Metformin had no effects on cell proliferation (on the basis of assays for KI67) or apoptosis (on the basis of levels of caspase 3). In a chemoprevention trial of patients with BE, daily administration of metformin for 12 weeks, compared with placebo, did not cause major reductions in esophageal levels of pS6K1. Although metformin reduced serum levels of insulin and insulin resistance, it did not discernibly alter epithelial proliferation or apoptosis in

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

    Energy Technology Data Exchange (ETDEWEB)

    Zimmermann, F.B.; Geinitz, H.; Feldmann, H.J. [Klinik und Poliklinik fuer Strahlentherapie und Radiologische Onkologie, Klinikum rechts der Isar, Muenchen (Germany)

    1998-11-01

    Background: Radiation-induced esophagitis is a frequent acute side effect in curative and palliative radiotherapy of thoracal and cervical tumors. Late reactions are rare but might be severe. Methods: A resarch for reports on prophylactic and supportive therapies of radiation-induced esophagitis was performed (Medline, Cancerlit, and others). Results: Nutrition must be ensured and symptomatic relief of sequelae is important, especially in the case of dysphagia. The latter can be improved by topic or systemic analgetics. If esophageal spasm occurs, calcium antagonists might help. In case of gastro-esophageal reflux proton pump inhibitors should be used. There is no effective prophylactic measure for radiation esophagitis. Late side effects with clinical relevance are rare in conventional radiotherapy. Chronic ulcera, fistula or stenosis may develop. Before any treatment, a tumor infiltration of the esophagus should be excluded by biopsy. This can lead more often to late complications than radiation therapy itself. Nutrition should be ensured by endoscopic dilation, stent-implantation, or endoscopic percutaneous gastrostomy. Local injection of steroids might be used to avoid an early restenosis. Conclusions: An intensive symptomatic therapy of acute esophagitis is reasonable. Effective prophylaxis do not exist. Late radiation induced sequelae is rare. Therefore, a tumor recurrenc e should be excluded in cases of dysphagia. Securing nutrition by PEG, stent, or port is well in the fore. (orig.) [Deutsch] Hintergrund: Die radiogene Oesophagitis ist eine haeufige akute Nebenwirkung bei kurativen wie palliativen Bestrahlungen thorakaler und zervikaler Tumoren. Spaete Gewebereaktionen sind selten, koennen aber schwerwiegend sein. Methode: Es wurde eine Literaturrecherche nach prophylaktischen und supportiven Therapien der radiogen verursachten Oesophagitis durchgefuehrt (Medline, Cancerlit und andere). Ergebnisse: Therapeutisch stehen die Sicherung der Ernaehrung und die

  5. Factors predicting survival in patients with proximal gastric carcinoma involving the esophagus

    Institute of Scientific and Technical Information of China (English)

    Yi-Fen Zhang; Jiong Shi; Hui-Ping Yu; An-Ning Feng; Xiang-Shan Fan; Gregory Y Lauwers; Hiroshi Mashimo

    2012-01-01

    AIM:To investigate the clinicopathologic features which predict surgical overall survival in patients with proximal gastric carcinoma involving the esophagus (PGCE).METHODS:Electronic pathology database established in the Department of Pathology of the Nanjing Drum Tower Hospital was searched for consecutive resection cases of proximal gastric carcinoma over the period from May 2004 through July 2009.Each retrieved pathology report was reviewed and the cases with tumors crossing the gastroesophageal junction line were selected as PGCE.Each tumor was re-staged,following the guidelines on esophageal adenocarcinoma,according to the 7th edition of the American Joint Commission on Cancer Staging Manual.All histology slides were studied along with the pathology report for a retrospective analysis of 13 clinicopathologic features,i.e.,age,gender,Helicobacter pylori (H.pylori) infection,surgical modality,Siewert type,tumor Bormann's type,size,differentiation,histology type,surgical margin,lymphovascular and perineural invasion,and pathologic stage in relation to survival after surgical resection.Prognostic factors for overall survival were assessed with uniand multi-variate analyses.RESULTS:Patients' mean age was 65 years (range:47-90 years).The male:female ratio was 3.3.The 1-,3-and 5-year overall survival rates were 87%,61% and 32%,respectively.By univariate analysis,age,male gender,H,pylori,tumor Bormann's type,size,histology type,surgical modality,positive surgical margin,lymphovascular invasion,and pT stage were not predictivefor overall survival; in contrast,perineural invasion (P =0.003),poor differentiation (P =0.0003),> 15 total lymph nodes retrieved (P =0.008),positive lymphnodes (P =0.001),and distant metastasis (P =0.005)predicted poor post-operative overall survival.Celiac axis nodal metastasis was associated with significantly worse overall survival (P =0.007).By multivariate analysis,≥ 16 positive nodes (P =0.018),lymph node ratio > 0.2 (P =0

  6. Verrucous carcinoma of the esophagus: a rare variant of squamous cell carcinoma for which a preoperative diagnosis can be a difficult one to make.

    Science.gov (United States)

    Chu, Quyen; Jaganmohan, Sathya; Kelly, Brandi; Hobley, James

    2011-01-01

    Verrucous carcinoma of the esophagus is an extremely rare entity. It is associated with severe epithelial hyperplasia and parakeratosis of the epithelial layers. Superficial biopsies are usually falsely negative for malignant cells, as the biopsied mucosa usually demonstrates the hyperplastic epithelium. The tumor spread is through submucosal and paraesophageal infiltration. Endoscopically, verrucous carcinoma appears as a wartlike, exophytic lesion, hence the name verrucous. The diagnosis can be difficult to make, even after repeated endoscopic biopsies. We report a rare case of verrucous carcinoma of the esophagus in a 45-year-old man whose final pathologic diagnosis was confirmed only after an Ivor-Lewis esophagectomy was performed.

  7. Comparison between esophageal Wallstent and Ultraflex stents in the treatment of malignant stenoses of the esophagus and cardia.

    Science.gov (United States)

    Dorta, G; Binek, J; Blum, A L; Bühler, H; Felley, C P; Koelz, H R; Lammer, F; Lang, C; Meier, R; Meyenberger, C; Meyer-Wyss, B; Michetti, P; Protiva, P; Scheurer, U; Weber, B; Wiesel, P; Vogel, S

    1997-03-01

    Several published studies have examined various self-expanding metal esophageal stents for use in the palliative treatment of esophageal or cardiac neoplasia, but few have compared different self-expanding metal stents. The aim of this study was to evaluate non-covered Wallstent and Ultraflex prostheses in the treatment of malignancies in the esophagus and the cardiac region. In a retrospective study, the effectiveness of non-covered Wallstents (46 patients) and Ultraflex stents (36 patients) was compared in the treatment of malignancies in the esophageal and cardiac regions. Reintervention procedures were necessary in 16 of the 46 Wallstent patients (six patients during an early phase) and in 22 of the 36 Ultraflex patients (13 during an early phase) (overall P = 0.022; early P = 0.018). The major complication in the Wallstent group was tumor ingrowth (12 of 35 complications), while in the Ultraflex group, it was incomplete deployment (18 of 49 complications). Incomplete stent deployment occurred more often in patients treated with Ultraflex (P = 0.01), and food impaction was more often observed in the Wallstent group (P = 0.001). In addition, in patients with Ultraflex stents, more complex reinterventions were necessary than those required with Wallstents (four vs. 13 complex reinterventions, P = 0.0046). Wallstents tended to improve dysphagia better than Ultraflex stents. Compared to Ultraflex stents, Wallstents have several significant short-term and long-term advantages in the palliative treatment of malignancy of the esophagus and cardia.

  8. A phase I pilot study evaluating the beneficial effects of black raspberries in patients with Barrett's esophagus.

    Science.gov (United States)

    Kresty, Laura A; Fromkes, John J; Frankel, Wendy L; Hammond, Cynthia D; Seeram, Navindra P; Baird, Maureen; Stoner, Gary D

    2016-07-07

    Black raspberries inhibit a broad range of cancers in preclinical models which has led to clinical evaluations targeting premalignant lesions of the colon, oral cavity and esophagus. A phase I pilot study was conducted in twenty Barrett's esophagus (BE) patients to investigate the effect of lyophilized black raspberries (LBR) on urinary metabolites and markers of lipid peroxidation, DNA damage and tissue markers of cellular proliferation, detoxification, and inflammation. Surveys, biopsies, blood and urine samples were collected before and after 6 months of LBR treatment (32 or 45 g). LBR significantly reduced urinary excretion of 8-epi-prostaglandin F2α, a marker of lipid peroxidation linked to oxidative stress and free radical damage. Urinary levels of the ellagitannin metabolites, urolithin A-glucuronide, urolithin A-sulfate and dimethylellagic acid glucuronide were significantly increased following 12 and 26 weeks of LBR consumption and may prove useful as indicators of compliance in future clinical studies. Immunohistochemical staining of BE biopsies following LBR treatment showed significant increases in mean GST-pi levels, with 55.6% of subjects responding favorably. In summary, LBR significantly decreased urinary lipid peroxidation levels and significantly increased GST-pi, a marker of detoxification, in BE epithelium. Still, LBR may need to be formulated differently, administered at higher concentrations or multiple times a day to increase efficacy.

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

    Directory of Open Access Journals (Sweden)

    Shaveta Mehta

    2008-01-01

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

  10. Application of the Prague C and M criteria for endoscopic description of columnar-lined esophagus in South Korea

    Institute of Scientific and Technical Information of China (English)

    Jung Wan Choe; Young Choon Kim; Moon Kyung Joo; Hyo Jung Kim; Beom Jae Lee; Ji Hoon Kim; Jong Eun Yeon; Jong-Jae Park; Jae Seon Kim; Kwan Soo Byun; Young-Tae Bak

    2016-01-01

    AIM:To ascertain whether the Prague circumferential(C) length and maximal(M) length criteria for grading the extent of Barrett’s esophagus can be applied prior to its widespread application in South Korea.METHODS:Two hundred and thirteen consecutive cases with endoscopic columnar-lined esophagus(CLE) were included and classified according to the Prague C and M criteria.RESULTS:Of 213 cases with CLE, the distribution of maximum CLE lengths was: 0.5-0.9 cm in 99 cases(46.5%); 1.0-1.4 cm in 63 cases(29.6%); 1.5-1.9 cm in 15 cases(7.0%); 2.0-2.4 cm in 14 cases(6.6%); 2.5-2.9 cm in 1 case(0.5%); and 7.0 cm in 1 case(0.5%). Twenty cases(9.4%) had columnar islands alone. Two hundred and eight cases(97.7%) lacked the circumferential CLE component(C0Mx). Columnar islands were found in 70 cases(32.9%), of which 20 cases(9.4%) had columnar islands alone.CONCLUSION:In regions where most CLE patients display short or ultrashort tongue-like appearance, more detailed descriptions of CLE’s in < 1.0 cm lengths and columnar islands, as well as avoidance of repeating the prefix "C0" need to be considered in parallel with the widespread application of the Prague system in South Korea.

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

    Directory of Open Access Journals (Sweden)

    Dino Antonio Oswaldo Altmann

    1999-10-01

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

  12. MicroRNA alterations in Barrett′s esophagus, esophageal adenocarcinoma, and esophageal adenocarcinoma cell lines following cranberry extract treatment: Insights for chemoprevention

    Directory of Open Access Journals (Sweden)

    Laura A Kresty

    2011-01-01

    Full Text Available Background: Aberrant expression of small noncoding endogenous RNA molecules known as microRNAs (miRNAs is documented to occur in multiple cancer types including esophageal adencarcinoma (EAC and its only known precursor, Barrett′s esophagus (BE. Recent studies have linked dysregulation of specific miRNAs to histological grade, neoplastic progression and metastatic potential. Materials and Methods: Herein, we present a summary of previously reported dysregulated miRNAs in BE and EAC tissues as well as EAC cell lines and evaluate a cranberry proanthocyanidin rich extract′s (C-PAC ability to modulate miRNA expression patterns of three human EAC cell lines (JHEso-Ad-1, OE33 and OE19. Results: A review of 13 published studies revealed dysregulation of 87 miRNAs in BE and EAC tissues, whereas 52 miRNAs have been reported to be altered in BE or EAC cell lines, with 48% overlap with miRNA changes reported in tissues. We report for the first time C-PAC-induced modulation of five miRNAs in three EAC cell lines resulting in 26 validated gene targets and identification of key signaling pathways including p53, angiogenesis, T-cell activation and apoptosis. Additionally, mutiple cancer related networks were ideintified as modulated by C-PAC utilizing Kyoto Encyclopedia of Genes and Genomes (KEGG, Protein Analysis Through Evolutionary Relationships (PANTHER, and MetaCore analysis tools. Conclusions: Study results support the cancer inhibitory potential of C-PAC is in part attributable to C-PAC′s ability to modify miRNA profiles within EAC cells. A number of C-PAC-modulated miRNAs have been been identified as dysregulated in BE and EAC. Further insights into miRNA dysregulation and modulation by select cancer preventive agents will support improved targeted interventions in high-risk cohorts.

  13. The improvement of living quality for the patient with carcinoma of esophagus: Reconstruction for the defect of pharynx and cervical esophagus with inferior antebrachial skin flap on the basis of retaining the laryngeal function%改善食道癌患者生存质量 :保留喉功能下前臂皮瓣重建咽及颈段食管缺损

    Institute of Scientific and Technical Information of China (English)

    李庆生; 王跃建; 陈伟雄; 杜学亮

    2001-01-01

    Objective To investigate the effect of reconstruction for inferior pharyngeal and cervical esophagus defect with inferior antebrachial skin flaps on the living quality of patients after surgery. Method Perform radical operation of the tumor, but retain larynx and trachea. Free antebrchial skin flaps were used to reconstruct the defect of inferior pharynx and cervical esophagus. Roll the skin flap to form a skin tube, and then carry out anastomosis with floor of mouth and cervical esophagus. Result The laryngeal function was retained after surgery. And permanent orifice of trachea was unnecessary. The effect was satisfying. The vocalization wasn't affected and food- intake through oral was normal in the 2 patients followed up. Conclusion It is a feasible way to reconstruct the inferior pharynx and cervical esophagus defect caused by radical operation of the tumor at pharynx and cervical esophagus. It can improve the living quality of patients effectively.

  14. Distinct afferent innervation patterns within the human proximal and distal esophageal mucosa.

    Science.gov (United States)

    Woodland, Philip; Aktar, Rubina; Mthunzi, Engelbert; Lee, Chung; Peiris, Madusha; Preston, Sean L; Blackshaw, L Ashley; Sifrim, Daniel

    2015-03-15

    Little is known about the mucosal phenotype of the proximal human esophagus. There is evidence to suggest that the proximal esophagus is more sensitive to chemical and mechanical stimulation compared with the distal. This may have physiological relevance (e.g., in prevention of aspiration of gastroesophageal refluxate), but also pathological relevance (e.g., in reflux perception or dysphagia). Reasons for this increased sensitivity are unclear but may include impairment in mucosal barrier integrity or changes in sensory innervation. We assessed mucosal barrier integrity and afferent nerve distribution in the proximal and distal esophagus of healthy human volunteers. In 10 healthy volunteers baseline proximal and distal esophageal impedance was measured in vivo. Esophageal mucosal biopsies from the distal and proximal esophagus were taken, and baseline transepithelial electrical resistance (TER) was measured in Ussing chambers. Biopsies were examined immunohistochemically for presence and location of calcitonin gene-related peptide (CGRP)-immunoreactive nerve fibers. In a further four healthy volunteers we investigated for colocalization of CGRP and protein gene product (PGP) 9.5 immunoreactivity in nerve fibers. Baseline impedance was higher in the proximal than in the distal esophagus [2,936 Ω (SD578) vs. 2,229 Ω (SD821); P = 0.03], however, baseline TER was not significantly different between them. Mucosal CGRP-immunoreactive nerves were found in the epithelium of both proximal and distal esophagus, but were located more superficially in the proximal mucosa compared with the distal [11.5 (SD7) vs. 21.7 (SD5) cell layers from lumen, P = 0.002] 19% of proximal, and 10% of distal mucosal PGP-immunoreactive fibers colocalized with CGRP. PGP-immunoreactive fibers were also significantly closer to the luminal surface in the proximal compared with the distal esophagus (P integrity is similar in proximal and distal esophagus, but proximal mucosal afferent nerves are in

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

    Directory of Open Access Journals (Sweden)

    José Carlos Pachón Mateos

    2015-04-01

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

  16. Radiological imaging of the upper gastrointestinal tract. Pt. 1. The esophagus; Radiologische Bildgebung des oberen Gastrointestinaltrakts. T. 1. Oesophagus

    Energy Technology Data Exchange (ETDEWEB)

    Hansmann, J.; Grenacher, L. [Radiologische Universitaetsklinik, Abteilung Radiodiagnostik, Heidelberg (Germany)

    2006-12-15

    In the diagnosis of diseases of the esophagus, conventional x-ray evaluation still plays a more important role than endoscopy in the visualization of stenoses. CT plays a major role in the staging of malignancies of the esophagus, while MRI plays does not play a major part in the diagnostic evaluation of the upper GI-tract but is equal to CT for the staging and evaluation of the extent of local infiltration. The main indication for the radiological examination of the esophagus by barium studies is dysphagia. The use of barium allows a functional examination of esophageal motility. Swallow motility disorders can be diagnosed by videofluorography using high frame rate imaging. Zenker's diverticulum and other pulsion diverticula should also be investigated by functional esophageal imaging. Candida esophagitis can be identified by its characteristic ulcerations using barium swallow. The extension of gastroesophageal hernias are more accurately evaluated with barium studies than with endoscopy. The diagnosis of gastroesophageal reflux disease should be made by barium studies, but discrete inflammation as well as epithelial dysplasia are best investigated by classic endoscopy and modern endoscopic techniques. In cases of esophageal carcinoma, radiology adds to the findings of endoscopy and endosonography. (orig.) Mit konventionellem Roentgen kann die Funktion des Oesophagus untersucht werden, zudem sind Stenosen besser darstellbar als in der Endoskopie. Die CT liefert beim Staging des Oesophaguskarzinoms gute Ergebnisse. Die MRT wird im oberen Gastrointestinaltrakt kaum mehr diagnostisch verwendet, ist aber im Umfeldstaging und fuer die lokale Infiltrationsausdehnung dem CT gleichwertig. Hauptindikation zur radiologischen Oesophagusdiagnostik ist die Dysphagie. Der Oesophagusbreischluck dient der morphologischen Diagnostik, die Motilitaet kann in Bauchlage mit Barium untersucht werden. Schluckstoerungen werden mit der Roentgenkinematographie abgeklaert. Das Zenker

  17. BMP4 Signaling Is Able to Induce an Epithelial-Mesenchymal Transition-Like Phenotype in Barrett's Esophagus and Esophageal Adenocarcinoma through Induction of SNAIL2

    NARCIS (Netherlands)

    Kestens, C.; Siersema, P.D.; Offerhaus, G.J.; Baal, J.W.P.M. van

    2016-01-01

    BACKGROUND: Bone morphogenetic protein 4 (BMP4) signaling is involved in the development of Barrett's esophagus (BE), a precursor of esophageal adenocarcinoma (EAC). In various cancers, BMP4 has been found to induce epithelial-mesenchymal transition (EMT) but its function in the development of EAC

  18. BMP4 signaling is able to induce an epithelial-mesenchymal transition-like phenotype in Barrett's esophagus and esophageal adenocarcinoma through induction of SNAIL2

    NARCIS (Netherlands)

    Kestens, Christine; Siersema, Peter D; Offerhaus, G Johan A; van Baal, Jantine W P M

    2016-01-01

    Background: Bone morphogenetic protein 4 (BMP4) signaling is involved in the development of Barrett's esophagus (BE), a precursor of esophageal adenocarcinoma (EAC). In various cancers, BMP4 has been found to induce epithelial-mesenchymal transition (EMT) but its function in the development of EAC

  19. BOB CAT: A Large-Scale Review and Delphi Consensus for Management of Barrett's Esophagus With No Dysplasia, Indefinite for, or Low-Grade Dysplasia

    NARCIS (Netherlands)

    Bennett, C.; Moayyedi, P.; Corley, D.A.; DeCaestecker, J.; Falck-Ytter, Y.; Falk, G.; Vakil, N.; Sanders, S.; Vieth, M.; Inadomi, J.; Aldulaimi, D.; Ho, K.Y.; Odze, R.; Meltzer, S.J.; Quigley, E.; Gittens, S.; Watson, P.; Zaninotto, G.; Iyer, P.G.; Alexandre, L.; Ang, Y.; Callaghan, J.; Harrison, R.; Singh, R.; Bhandari, P.; Bisschops, R.; Geramizadeh, B.; Kaye, P.; Krishnadath, S.; Fennerty, M.B.; Manner, H.; Nason, K.S.; Pech, O.; Konda, V.; Ragunath, K.; Rahman, I.; Romero, Y.; Sampliner, R.; Siersema, P.D.; Tack, J.; Tham, T.C.; Trudgill, N.; Weinberg, D.S.; Wang, J; Wang, K.; Wong, J.Y.; Attwood, S.; Malfertheiner, P.; MacDonald, D.; Barr, H.; Ferguson, M.K.; Jankowski, J.

    2015-01-01

    OBJECTIVES: Barrett's esophagus (BE) is a common premalignant lesion for which surveillance is recommended. This strategy is limited by considerable variations in clinical practice. We conducted an international, multidisciplinary, systematic search and evidence-based review of BE and provided conse

  20. Aberrant TP53 detected by combining immunohistochemistry and DNA-FISH improves Barrett's esophagus progression prediction : A prospective follow-up study

    NARCIS (Netherlands)

    Davelaar, Akueni L.; Calpe, Silvia; Lau, Liana; Timmer, Margriet R.; Visser, Mike; ten Kate, Fiebo J.; Parikh, Kaushal B.; Meijer, Sybren L.; Bergman, Jacques J.; Fockens, Paul; Krishnadath, Kausilia K.

    2015-01-01

    Barrett's esophagus (BE) goes through a sequence of low grade dysplasia (LGD) and high grade dysplasia (HGD) to esophageal adenocarcinoma (EAC). The current gold standard for BE outcome prediction, histopathological staging, can be unreliable. TP53 abnormalities may serve as prognostic biomarkers. T

  1. SUPRACLAVICULAR LYMPH-NODE METASTASES IN CARCINOMA OF THE ESOPHAGUS AND GASTROESOPHAGEAL JUNCTION - ASSESSMENT WITH CT, US, AND US-GUIDED FINE-NEEDLE ASPIRATION BIOPSY

    NARCIS (Netherlands)

    VANOVERHAGEN, H; LAMERIS, JS; BERGER, MY; VANDERVOORDE, F; TILANUS, HW; KLOOSWIJK, AIJ; ZONDERLAND, HM; VANPEL, R

    The preoperative assessment of supraclavicular lymph node metastases was prospectively studied in 100 patients with carcinoma of the esophagus and gastroesophageal junction. Findings at computed tomography (CT), ultrasound (US), and palpation were compared, and US-guided fine-needle aspiration

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-10-15

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

  3. Gains and amplifications of c-myc, EGFR, and 20.q13 loci in the no dysplasia-dysplasia-adenocarcinoma sequence of Barrett's esophagus

    NARCIS (Netherlands)

    Rygiel, Agnieszka M.; Milano, Francesca; ten Kate, Fibo J.; Schaap, Annet; Wang, Kenneth K.; Peppelenbosch, Mackel P.; Bergman, Jacques J. G. H. M.; Krishnadath, Kausillia K.

    2008-01-01

    The progression of Barrett's esophagus to esophageal adenocarcinoma is often characterized by the accumulation of genetic abnormalities. The goal was to evaluate the copy number alterations of several oncogene loci, including 7p12 [epidermal growth factor receptor (EGFR)], 8q24 (c-myc), and 20q13 in

  4. SUPRACLAVICULAR LYMPH-NODE METASTASES IN CARCINOMA OF THE ESOPHAGUS AND GASTROESOPHAGEAL JUNCTION - ASSESSMENT WITH CT, US, AND US-GUIDED FINE-NEEDLE ASPIRATION BIOPSY

    NARCIS (Netherlands)

    VANOVERHAGEN, H; LAMERIS, JS; BERGER, MY; VANDERVOORDE, F; TILANUS, HW; KLOOSWIJK, AIJ; ZONDERLAND, HM; VANPEL, R

    1991-01-01

    The preoperative assessment of supraclavicular lymph node metastases was prospectively studied in 100 patients with carcinoma of the esophagus and gastroesophageal junction. Findings at computed tomography (CT), ultrasound (US), and palpation were compared, and US-guided fine-needle aspiration biops

  5. Assessment of chromosomal gains as compared to DNA content changes is more useful to detect dysplasia in Barrett's esophagus brush cytology specimens

    NARCIS (Netherlands)

    Rygiel, Agnieszka M.; Milano, Francesca; Ten Kate, Febo J.; de Groot, John G; Peppelenbosch, Maikel R.; Bergman, Jacques J. G. H. M.; Krishnadath, Kauslillia K.

    Abnormal DNA ploidy status has been suggested as a prognostic factor for Barrett's esophagus progression into esophageal adenocarcinoma (EAC). The aim of the study was to compare image cytometry DNA analysis (ICDA) and fluorescent in situ hybridization (FISH) in the assessment of DNA ploidy status

  6. SUPRACLAVICULAR LYMPH-NODE METASTASES IN CARCINOMA OF THE ESOPHAGUS AND GASTROESOPHAGEAL JUNCTION - ASSESSMENT WITH CT, US, AND US-GUIDED FINE-NEEDLE ASPIRATION BIOPSY

    NARCIS (Netherlands)

    VANOVERHAGEN, H; LAMERIS, JS; BERGER, MY; VANDERVOORDE, F; TILANUS, HW; KLOOSWIJK, AIJ; ZONDERLAND, HM; VANPEL, R

    1991-01-01

    The preoperative assessment of supraclavicular lymph node metastases was prospectively studied in 100 patients with carcinoma of the esophagus and gastroesophageal junction. Findings at computed tomography (CT), ultrasound (US), and palpation were compared, and US-guided fine-needle aspiration biops

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2013-01-01

    Background. Gastroesophageal reflux disease (GERD) may present with gastroesophageal and extraesophageal symptoms. Currently, the frequencies of gastroesophageal and extragastroesophageal symptoms in Asian patients with different categories of GERD remain unclear. Aim. To investigate the frequencies of gastroesophageal and extragastroesophageal symptoms in patients with mild erosive esophagitis, severe erosive esophagitis, and Barrett's esophagus of GERD. Methods. The symptoms of symptomatic subjects with (1) Los Angeles grade A/B erosive esophagitis, (2) Los Angeles grade C/D erosive esophagitis, and (3) Barrett's esophagus proven by endoscopy were prospectively assessed by a standard questionnaire for gastroesophageal and extragastroesophageal symptoms. The frequencies of the symptoms were compared by Chi-square test. Result. Six hundred and twenty-five patients (LA grade A/B: 534 patients; LA grade C/D: 37 patients; Barrett's esophagus: 54 patients) were assessed for gastroesophageal and extragastroesophageal symptoms. Patients with Los Angeles grade A/B erosive esophagitis had higher frequencies of symptoms including epigastric pain, epigastric fullness, dysphagia, and throat cleaning than patients with Los Angeles grade C/D erosive esophagitis. Patients with Los Angeles grade A/B erosive esophagitis also had higher frequencies of symptoms including acid regurgitation, epigastric acidity, regurgitation of food, nausea, vomiting, epigastric fullness, dysphagia, foreign body sensation of throat, throat cleaning, and cough than patients with Barrett's esophagus. Conclusion. The frequencies of some esophageal and extraesophageal symptoms in patients with Los Angeles grade A/B erosive esophagitis were higher than those in patients with Los Angeles grade C/D erosive esophagitis and Barrett's esophagus. The causes of different symptom profiles in different categories of GERD patients merit further investigations.

  9. Frequencies of poor metabolizers of cytochrome P450 2C19 in esophagus cancer, stomach cancer, lung cancer and bladder cancer in Chinese population

    Institute of Scientific and Technical Information of China (English)

    Wei-Xing Shi; Shu-Qing Chen

    2004-01-01

    AIM: To investigate the association between cytochrome P450 2C19 (CYP2C19) gene polymorphism and cancer susceptibility by genotyping of CYP2C19 poor metabolizers (PMs) in cancer patients.METHODS: One hundred and thirty-five cases of esophagus cancer, 148 cases of stomach cancer, 212 cases of lung cancer, 112 cases of bladder cancer and 372 controls were genotyped by allele specific amplification-polymerase chain reaction (ASA-PCR) for CYP2C19 PMs. The frequencies of PMs in cancer groups and control group were compared.RESULTS: The frequencies of PMs of CYP2C19 were 34.1%(46/135) in the group of esophagus cancer patients, 31.8%(47/148) in the stomach cancer patients, 34.4%(73/212) in the group of lung cancer patients, only 4.5% (5/112) in the bladder cancer patients and 14.0%(52/372) in control group.There were statistical differences between the cancer groups and control group (esophagus cancer, x2=25.65, P<0.005,OR=3.18, 95% CI=2.005-5.042; stomach cancer, x2=21.70,P<0.005, OR=2.86, 95%CI=1.820-4.501; lung cancer,x2=33.58, P<0.005, OR=3.23, 95%CI=1.503-6.906; bladder cancer, x2=7.50, P<0.01, OR=0.288, 95%CI=0.112-0.740).CONCLUSION: CYP2C19 PMs have a high incidence of esophagus cancer, stomach cancer and lung cancer, conversely they have a low incidence of bladder cancer. It suggests that CYP2C19 may participate in the activation of procarcinogen of esophagus cancer, stomach cancer and lung cancer, but may involve in the detoxification of carcinogens of bladder cancer.

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

    Directory of Open Access Journals (Sweden)

    Fausto Orsi

    2003-02-01

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

  11. Gaseous distention of the hypopharynx and cervical esophagus with nasal CPAP: a mimicker of pharyngeal perforation and esophageal atresia

    Energy Technology Data Exchange (ETDEWEB)

    Walor, David; Berdon, Walter; Holt, Peter D.; Fox, Matthew [Columbia University Medical Center, Department of Radiology, New York, NY (United States); Children' s Hospital of New York, New York, NY (United States); Anderson, Nicole [Columbia University Medical Center, Department of Neonatology, New York, NY (United States); Children' s Hospital of New York, New York, NY (United States)

    2005-12-01

    Nasal continuous positive airway pressure (CPAP) has been used since 1975 as the initial treatment for respiratory distress syndrome (RDS) in very premature infants. Gaseous distention of the abdomen (CPAP belly) is a common secondary effect of CPAP. Gaseous distention of the hypopharynx is also common. To determine the incidence of hypopharyngeal distention in infants on CPAP. We performed a retrospective review of the chest radiographs of 57 premature infants treated with CPAP during a 4-week period to find the presence and degree of hypopharyngeal distention. Of the 57 radiographs, 14 (25%) revealed gaseous distention of the hypopharynx and/or cervical esophagus. On occasion, this raised concern for pharyngeal perforation or esophageal atresia. Awareness that CPAP-related hypopharyngeal distention is common should help radiologists avoid erroneous consideration of esophageal atresia or hypopharyngeal perforation. (orig.)

  12. Stress Softening Behavior in the Mucosa-Submucosa and Muscle Layers in Normal and Diabetic Rat Esophagus

    DEFF Research Database (Denmark)

    Jiang, Hongbo; Liao, Donghua; Zhao, Jingbo

    2015-01-01

    Background & aims: Stress softening is a feature of mechanical preconditioning in soft tissue. Previously, we demonstrated that esophageal stress softening is reversible by muscle activation with KCl. Since the esophagus consists of muscle and mucosa-submucosa layers, the aim was to study......M KCl was added for maximum contraction for 3min. KCl was washed out to permit relaxation and contractions were eliminated by immersion into Ca2+-free solution. After 1h rest, the tubes were exposed to five repeated ramp distensions conformed to the aforesaid two series. Stress-strain curves were used...... losses due to stress softening were recovered by KCl-induced contraction. Such losses could not be recovered by KCl in the diabetic esophageal muscle layer. The normal esophageal mucosa-submucosa layer obtained extra energy gain by KCl activation whereas the diabetic mucosa-submucosa layer became softer...

  13. Injection of sup 32 P colloid into squamous cell carcinoma of the esophagus for local disease control

    Energy Technology Data Exchange (ETDEWEB)

    Perakos, P.G.; Scheer, T.F. (Memorial Hospital of Laramie County and Wyoming College of Human Medicine, Wyoming (USA))

    1989-10-01

    Local treatment of squamous cell carcinoma of the esophagus is only modestly successful. To increase local control, we have developed a procedure to inject a boost dose of radiation into the tumor bed after completion of external beam radiotherapy. The boost dose is given with {sup 32}P, a readily available radiocolloid. {sup 32}P is a pure emitter and poses no significant radiation hazards. It can penetrate 10approx15 mm into the tumor mass and has a half-life of 14.3 days. After determination of the volume to be treated, the colloid is injected with endoscopic guidance using the same technique as used in injection scierotherapy of esophageal varices. We use the Pentax FG 34 JA operating gastroscope and a Bard disposable 0.5 cm 25 Ga retractable injection sclerotherapy needle. We deliver 150approx200 microCurie of {sup 32}P colloid diluted to 20 ml with normal saline at 10 to 20 injection sites. This boosts the radiotherapy dose of 5,500approx6,000 cGy to the range of 7,500approx8,000 cGy. We have treated five patients so far, with length of follow-up ranging from 8approx28 months. Local control and survival results have been excellent and no complications have been associated with the procedure. A combination of external beam radiotherapy and interstitial boost treatment with colloidal {sup 32}P appears to be a safe and effective method of managing squamous cell carcinoma of the esophagus. (author).

  14. The role of argon plasma coagulation in the management of Barrett's esophagus: a single-center experience

    Directory of Open Access Journals (Sweden)

    Gad YZ

    2011-04-01

    Full Text Available Yahia Z Gad1, Adel A Zeid21Associate Professor of Internal Medicine, Mansoura Specialized Medical Hospital, Mansoura University, Mansoura, Egypt; 2Consultant Surgeon, Al Nil Hospital, Mansaura, EgyptBackground/aim: Patients with Barrett's esophagus (BE are 30 times more likely to develop esophageal adenocarcinoma (EAC than the general population. Data regarding the use of argon plasma coagulation (APC for treatment of patients with BE in Egypt are still limited. This article discusses the efficacy and safety of APC as a thermoablative modality in Egyptian patients with BE.Materials and methods: A total of 73 referred eligible patients with a confirmed endoscopic and histopathologic diagnosis of BE were enrolled in this study and subjected to thermoablation by high-power (hp-APC equipment at a 60 W setting until complete ablation or a maximum of five sessions and were followed up clinically and endoscopically at 3-month intervals. Computer-generated randomization allocated patients into APC-treated and control groups (n = 75, all of whom were treated with a proton pump inhibitor.Results: Minor and major complications occurred in 8 of 73 (10.95% and 1 of 73 (1.36% patients, respectively. Macroscopic ablation was achieved after one session in 37 of 73 (50.63% patients, and complete histologic ablation was confirmed after 167 sessions in 69 of 73 (94.52% patients. At 1-year follow-up, no relapses of BE or progression to EAC were observed.Conclusion: hp-APC at a medium-energy setting of 60 W in an acid-reduced environment can ablate BE effectively and safely with promising initial results.Keywords: Barrett's esophagus, argon plasma coagulation

  15. Gastro-esophageal reflux disease symptoms and demographic factors as a pre-screening tool for Barrett's esophagus.

    Directory of Open Access Journals (Sweden)

    Xinxue Liu

    Full Text Available BACKGROUND: Barrett's esophagus (BE occurs as consequence of reflux and is a risk factor for esophageal adenocarcinoma. The current "gold-standard" for diagnosing BE is endoscopy which remains prohibitively expensive and impractical as a population screening tool. We aimed to develop a pre-screening tool to aid decision making for diagnostic referrals. METHODOLOGY/PRINCIPAL FINDINGS: A prospective (training cohort of 1603 patients attending for endoscopy was used for identification of risk factors to develop a risk prediction model. Factors associated with BE in the univariate analysis were selected to develop prediction models that were validated in an independent, external cohort of 477 non-BE patients referred for endoscopy with symptoms of reflux or dyspepsia. Two prediction models were developed separately for columnar lined epithelium (CLE of any length and using a stricter definition of intestinal metaplasia (IM with segments ≥ 2 cm with areas under the ROC curves (AUC of 0.72 (95%CI: 0.67-0.77 and 0.81 (95%CI: 0.76-0.86, respectively. The two prediction models included demographics (age, sex, symptoms (heartburn, acid reflux, chest pain, abdominal pain and medication for "stomach" symptoms. These two models were validated in the independent cohort with AUCs of 0.61 (95%CI: 0.54-0.68 and 0.64 (95%CI: 0.52-0.77 for CLE and IM ≥ 2 cm, respectively. CONCLUSIONS: We have identified and validated two prediction models for CLE and IM ≥ 2 cm. Both models have fair prediction accuracies and can select out around 20% of individuals unlikely to benefit from investigation for Barrett's esophagus. Such prediction models have the potential to generate useful cost-savings for BE screening among the symptomatic population.

  16. Probe-Based Confocal Laser Endomicroscopy to Guide Real-Time Endoscopic Therapy in Barrett’s Esophagus with Dysplasia

    Directory of Open Access Journals (Sweden)

    Eric A. Johnson

    2012-05-01

    Full Text Available Probe-based confocal laser endomicroscopy (pCLE is a novel imaging technique which utilizes a low-power laser light passed through a fiber-optic bundle, within a miniprobe that is advanced into the working channel, to obtain microscopic images of the mucosa. This allows the endoscopist to evaluate the microarchitecture of the gastrointestinal epithelium in real time. At this time pCLE cannot replace histopathology, but it can provide diagnostic information as well as guide therapeutic management in patients with Barrett’s esophagus (BE with high-grade dysplasia (HGD. We describe a retrospective case series in which four patients with BE and biopsy-proven HGD underwent endoscopy with pCLE to direct real-time endoscopic ablation therapy and/or endoscopic mucosal resection (EMR, which was performed in conjunction with pCLE. All four patients had pCLE showing features of HGD. After either EMR or radiofrequency ablation (RFA, pCLE was again used to evaluate the margins after therapy to assure accuracy. In one case, pCLE had features of dysplasia at the margin and further repeat EMR was immediately performed. Another case had a normal-appearing esophagus, but pCLE found features of BE in discrete areas and targeted biopsies were performed, which confirmed BE. This patient subsequently underwent RFA therapy of the residual areas of BE. In conclusion, in patients with BE and dysplasia, pCLE is an effective tool used to target biopsies, guide endoscopic therapy and assess the accuracy of EMR or RFA.

  17. Toward More Efficient Surveillance of Barrett's Esophagus: Identification and Exclusion of Patients at Low Risk of Cancer.

    Science.gov (United States)

    Lindblad, Mats; Bright, Tim; Schloithe, Ann; Mayne, George C; Chen, Gang; Bull, Jeff; Bampton, Peter A; Fraser, Robert J L; Gatenby, Piers A; Gordon, Louisa G; Watson, David I

    2017-04-01

    Endoscopic surveillance of Barrett's esophagus (BE) is probably not cost-effective. A sub-population with BE at increased risk of high-grade dysplasia (HGD) or esophageal adenocarcinoma (EAC) who could be targeted for cost-effective surveillance was sought. The outcome for BE surveillance from 2003 to 2012 in a structured program was reviewed. Incidence rates and incidence rate ratios for developing HGD or EAC were calculated. Risk stratification identified individuals who could be considered for exclusion from surveillance. A health-state transition Markov cohort model evaluated the cost-effectiveness of focusing on higher-risk individuals. During 2067 person-years of follow-up of 640 patients, 17 individuals progressed to HGD or EAC (annual IR 0.8%). Individuals with columnar-lined esophagus (CLE) ≥2 cm had an annual IR of 1.2% and >8-fold increased relative risk of HGD or EAC, compared to CLE surveillance cohort after the first endoscopy to individuals with CLE ≥2 cm, or dysplasia, followed by a further restriction after the second endoscopy-exclusion of patients without intestinal metaplasia-removed 296 (46%) patients, and 767 (37%) person-years from surveillance. Limiting surveillance to the remaining individuals reduced the incremental cost-effectiveness ratio from US$60,858 to US$33,807 per quality-adjusted life year (QALY). Further restrictions were tested but failed to improve cost-effectiveness. Based on stratification of risk, the number of patients requiring surveillance can be reduced by at least a third. At a willingness-to-pay threshold of US$50,000 per QALY, surveillance of higher-risk individuals becomes cost-effective.

  18. The influence of distal colon irritation on the changes of cystometry parameters to esophagus and colon distentions.

    Science.gov (United States)

    Kaddumi, Ezidin G

    2016-01-01

    The co-occurrence of multiple pathologies in the pelvic viscera in the same patient, such as, irritable bowel syndrome and interstitial cystitis, indicates the complexity of viscero-visceral interactions and the necessity to study these interactions under multiple pathological conditions. In the present study, the effect of distal colon irritation (DCI) on the urinary bladder interaction with distal esophagus distention (DED), distal colon distention (DCD), and electrical stimulation of the abdominal branches of vagus nerve (abd-vagus) were investigated using cystometry parameters. The DCI significantly decreased the intercontraction time (ICT) by decreasing the storage time (ST); nonetheless, DED and Abd-vagus were still able to significantly decrease the ICT and ST following DCI. However, DCD had no effect on ICT following the DCI. The DCI, also, significantly decreased the Intravesical pressure amplitude (P-amplitude) by increasing the resting pressure (RP). Although DED has no effect on the P-amplitude, both in the intact and the irritated animals, the abd-vagus significantly increased the P-amplitude following DCI by increasing the maximum pressure (MP). In the contrary, 3mL DCD significantly increased the P-amplitude by increasing the MP and lost that effect following the DCI. Concerning the pressure threshold (PT), none of the stimuli had any significant changes in the intact animals. However, DCI significantly decreased the PT, also, the abd-vagus and 3mL DCD significantly decreased the PT. The results of this study indicate that chemical irritation of colon complicates the effects of mechanical irritation of esophagus and colon on urinary bladder function.

  19. The influence of distal colon irritation on the changes of cystometry parameters to esophagus and colon distentions

    Directory of Open Access Journals (Sweden)

    Ezidin G. Kaddumi

    2016-06-01

    Full Text Available ABSTRACT The co-occurrence of multiple pathologies in the pelvic viscera in the same patient, such as, irritable bowel syndrome and interstitial cystitis, indicates the complexity of viscero-visceral interactions and the necessity to study these interactions under multiple pathological conditions. In the present study, the effect of distal colon irritation (DCI on the urinary bladder interaction with distal esophagus distention (DED, distal colon distention (DCD, and electrical stimulation of the abdominal branches of vagus nerve (abd-vagus were investigated using cystometry parameters. The DCI significantly decreased the intercontraction time (ICT by decreasing the storage time (ST; nonetheless, DED and Abd-vagus were still able to significantly decrease the ICT and ST following DCI. However, DCD had no effect on ICT following the DCI. The DCI, also, significantly decreased the Intravesical pressure amplitude (P-amplitude by increasing the resting pressure (RP. Although DED has no effect on the P-amplitude, both in the intact and the irritated animals, the abd-vagus significantly increased the P-amplitude following DCI by increasing the maximum pressure (MP. In the contrary, 3mL DCD significantly increased the P-amplitude by increasing the MP and lost that effect following the DCI. Concerning the pressure threshold (PT, none of the stimuli had any significant changes in the intact animals. However, DCI significantly decreased the PT, also, the abd-vagus and 3mL DCD significantly decreased the PT. The results of this study indicate that chemical irritation of colon complicates the effects of mechanical irritation of esophagus and colon on urinary bladder function.

  20. The gene expression profile of cardia intestinal metaplasia is similar to that of Barrett's esophagus, not gastric intestinal metaplasia.

    Science.gov (United States)

    Oh, D S; DeMeester, S R; Tanaka, K; Marjoram, P; Kuramochi, H; Vallbohmer, D; Danenberg, K; Chandrasoma, P T; DeMeester, T R; Hagen, J A

    2011-09-01

    The etiology and significance of cardia intestinal metaplasia (CIM) is disputed. CIM may represent a form of Barrett's esophagus due to reflux or could reflect generalized gastric intestinal metaplasia due to Helicobacter pylori. The aim of this study was to utilize gene expression data to compare CIM to Barrett's and gastric intestinal metaplasia. Endoscopic biopsies were classified by endoscopic and histologic criteria as CIM (n= 33), Barrett's (n= 25), or gastric intestinal metaplasia of the antrum or body (n= 18). The squamocolumnar and gastroesophageal junctions were aligned in CIM patients and patients with diffuse gastric intestinal metaplasia were excluded. H. pylori was tested for in the biopsies of all patients. After laser-capture microdissection, quantitative reverse transcription-polymerase chain reaction (RT-PCR) was used to measure the mRNA expression of a panel of nine genes that has been shown to differentiate Barrett's from other foregut mucosa. Cluster analysis with linear discriminant analysis of the expression data was used to classify each sample into groups based solely on similarity of gene expression. Cluster analysis was performed for three groups (CIM vs. Barrett's vs. gastric intestinal metaplasia) and two groups (CIM + Barrett's vs. gastric intestinal metaplasia). There was no difference in H. pylori infection among groups (P= 0.66). Clustering into three groups resulted in frequent misclassification between CIM and Barrett's while misclassification of gastric intestinal metaplasia was uncommon. The CIM and Barrett's groups were then combined for two group clustering and linear discriminant analysis correctly predicted 95% of CIM and Barrett's samples and 83% of gastric intestinal metaplasia samples based on gene expression alone. In conclusion, the gene expression profiles of CIM and Barrett's esophagus were similar in 95% of biopsies and differed significantly from that of gastric intestinal metaplasia. The indistinguishable gene

  1. Relationship of a hiatal hernia to the function of the body of the esophagus and the gastroesophageal junction

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    DeMeester, T.R.; Lafontaine, E.; Joelsson, B.E.; Skinner, D.B.; Ryan, J.W.; O' Sullivan, G.C.; Brunsden, B.S.; Johnson, L.F.

    1981-10-01

    One hundred two patients referred to our Esophageal Function Laboratory without endoscopic evidence of esophagitis were divided into two groups on the basis of the presence of a hiatal hernia on endoscopic examination. Fifty-three patients had a hiatal hernia and 49 did not. Both groups and 30 normal volunteer subjects had esophageal manometry and 24 hour esophageal pH monitoring. The incompetency of the cardia in patients with a hiatal hernia was dependent upon loss of components responsible for the antireflux mechanism, mainly a decrease in distal esophageal sphincter pressure and a decrease in the length of the sphincter exposed to the positive-pressure environment of the abdomen. These deficiencies were not related to the presence of a hiatal hernia and were similar to those of patients with an incompetent cardia without a hiatal hernia. Patients with a hiatal hernia and an incompetent cardia had significantly more esophageal exposure to refluxed acid than without a hiatal hernia. On the basis of the number of reflux episodes that lasted 5 minutes or longer and radioisotope transit studies, this increased acid exposure was due to both a loss of competency of the cardia and poor esophageal clearance secondary to the presence of a hiatal hernia. Reduction of the hernia and anchoring the distal esophagus into the abdomen not only may improve the antireflux mechanism, but corrects the clearance abnormality as well. The presence of a hiatal hernia has a detrimental effect on the clearance function of the body of the esophagus and may aggravate the effects of gastroesophageal reflux due to an incompetent cardia.

  2. G protein-coupled receptor mutations and human genetic disease.

    Science.gov (United States)

    Thompson, Miles D; Hendy, Geoffrey N; Percy, Maire E; Bichet, Daniel G; Cole, David E C

    2014-01-01

    Genetic variations in G protein-coupled receptor genes (GPCRs) disrupt GPCR function in a wide variety of human genetic diseases. In vitro strategies and animal models have been used to identify the molecular pathologies underlying naturally occurring GPCR mutations. Inactive, overactive, or constitutively active receptors have been identified that result in pathology. These receptor variants may alter ligand binding, G protein coupling, receptor desensitization and receptor recycling. Receptor systems discussed include rhodopsin, thyrotropin, parathyroid hormone, melanocortin, follicle-stimulating hormone (FSH), luteinizing hormone, gonadotropin-releasing hormone (GNRHR), adrenocorticotropic hormone, vasopressin, endothelin-β, purinergic, and the G protein associated with asthma (GPRA or neuropeptide S receptor 1 (NPSR1)). The role of activating and inactivating calcium-sensing receptor (CaSR) mutations is discussed in detail with respect to familial hypocalciuric hypercalcemia (FHH) and autosomal dominant hypocalemia (ADH). The CASR mutations have been associated with epilepsy. Diseases caused by the genetic disruption of GPCR functions are discussed in the context of their potential to be selectively targeted by drugs that rescue altered receptors. Examples of drugs developed as a result of targeting GPCRs mutated in disease include: calcimimetics and calcilytics, therapeutics targeting melanocortin receptors in obesity, interventions that alter GNRHR loss from the cell surface in idiopathic hypogonadotropic hypogonadism and novel drugs that might rescue the P2RY12 receptor congenital bleeding phenotype. De-orphanization projects have identified novel disease-associated receptors, such as NPSR1 and GPR35. The identification of variants in these receptors provides genetic reagents useful in drug screens. Discussion of the variety of GPCRs that are disrupted in monogenic Mendelian disorders provides the basis for examining the significance of common

  3. A Contralateral Esophagus-Sparing Technique to Limit Severe Esophagitis Associated With Concurrent High-Dose Radiation and Chemotherapy in Patients With Thoracic Malignancies

    Energy Technology Data Exchange (ETDEWEB)

    Al-Halabi, Hani; Paetzold, Peter; Sharp, Gregory C.; Olsen, Christine; Willers, Henning, E-mail: hwillers@mgh.harvard.edu

    2015-07-15

    Purpose: Severe (Radiation Therapy Oncology Group [RTOG] grade 3 or greater) esophagitis generally occurs in 15% to 25% of non–small cell lung cancer (NSCLC) patients undergoing concurrent chemotherapy and radiation therapy (CCRT), which may result in treatment breaks that compromise local tumor control and pose a barrier to dose escalation. Here, we report a novel contralateral esophagus-sparing technique (CEST) that uses intensity modulated radiation therapy (IMRT) to reduce the incidence of severe esophagitis. Methods and Materials: We reviewed consecutive patients with thoracic malignancies undergoing curative CCRT in whom CEST was used. The esophageal wall contralateral (CE) to the tumor was contoured as an avoidance structure, and IMRT was used to guide a rapid dose falloff gradient beyond the target volume in close proximity to the esophagus. Esophagitis was recorded based on the RTOG acute toxicity grading system. Results: We identified 20 consecutive patients treated with CCRT of at least 63 Gy in whom there was gross tumor within 1 cm of the esophagus. The median radiation dose was 70.2 Gy (range, 63-72.15 Gy). In all patients, ≥99% of the planning and internal target volumes was covered by ≥90% and 100% of prescription dose, respectively. Strikingly, no patient experienced grade ≥3 esophagitis (95% confidence limits, 0%-16%) despite the high total doses delivered. The median maximum dose, V45, and V55 of the CE were 60.7 Gy, 2.1 cc, and 0.4 cc, respectively, indicating effective esophagus cross-section sparing by CEST. Conclusion: We report a simple yet effective method to avoid exposing the entire esophagus cross-section to high doses. By using proposed CE dose constraints of V45 <2.5 cc and V55 <0.5 cc, CEST may improve the esophagus toxicity profile in thoracic cancer patients receiving CCRT even at doses above the standard 60- to 63-Gy levels. Prospective testing of CEST is warranted.

  4. Spleen and pancreatic tail thorax translocation facilitating residual stomach esophagus anastomosis%胰脾胸腔易位在残胃食管吻合术中的应用

    Institute of Scientific and Technical Information of China (English)

    Haizhou Guo; Fuyou Zhou; Weijie Wang; Jianyun Guan; Weimin Zhang

    2007-01-01

    Objective: To investigate the value of spleen and pancreatic tail thorax translocation on the residual stomach esophagus anastomosis. Methods: 10 patients with esophageal carcinoma after gastrectomy were enrolled in this study.Lesions were removed through left thoracotomy and residual stomach was fully mobilized, with short gastric artery being reserved. Spleen and pancreatic tail were dissected from the back of peritoneum and transposed into thorax. Residual stomach esophagus anastomosis was performed. Results: All the operation went favorably. Patients were recovered rapidly and a relatively good prognosis was acquired. Late leakage and pleural effusion happened in one case respectively, but these complications were cured through conservative management without operation death. Conclusion: Residual stomach is an ideal candidate for the replacement of esophagus and residual stomach esophagus anastomosis is a simple operative alternative with few trauma and good results for the treatment of esophageal carcinoma after gastrectomy.

  5. Using the methylome to identify aggressive Barrett’s esophagus — EDRN Public Portal

    Science.gov (United States)

    OVERALL STRATEGY: Our strategy will consist of using HumanMethylation450 arrays to identify methylation profiles and/or candidate methylated genes that distinguish BE from BE+LGD, BE+HGD and EAC (Aim 1). We will then assess whether these genes are predictive markers for aggressive BE (Aim 2)

  6. Fluorescence spectroscopy incorporated in an Optical Biopsy System for the detection of early neoplasia in Barrett's esophagus.

    Science.gov (United States)

    Boerwinkel, D F; Holz, J A; Hawkins, D M; Curvers, W L; Aalders, M C; Weusten, B L; Visser, M; Meijer, S L; Bergman, J J

    2015-01-01

    Endoscopic surveillance is recommended for patients with Barrett's esophagus (BE) to detect high-grade intraepithelial neoplasia (HGIN) or early cancer (EC). Early neoplasia is difficult to detect with white light endoscopy and random biopsies are associated with sampling error. Fluorescence spectroscopy has been studied to distinguish non-dysplastic Barrett's epithelium (NDBE) from early neoplasia. The Optical Biopsy System (OBS) uses an optical fiber integrated in a regular biopsy forceps. This allows real-time spectroscopy and ensures spot-on correlation between the spectral signature and corresponding physical biopsy. The OBS may provide an easy-to-use endoscopic tool during BE surveillance. We aimed to develop a tissue-differentiating algorithm and correlate the discriminating properties of the OBS with the constructed algorithm to the endoscopist's assessment of the Barrett's esophagus. In BE patients undergoing endoscopy, areas suspicious for neoplasia and endoscopically non-suspicious areas were investigated with the OBS, followed by a correlating physical biopsy with the optical biopsy forceps. Spectra were correlated to histology and an algorithm was constructed to discriminate between HGIN/EC and NDBE using smoothed linear dicriminant analysis. The constructed classifier was internally cross-validated and correlated to the endoscopist's assessment of the BE segment. A total of 47 patients were included (39 males, age 66 years): 35 BE patients were referred with early neoplasia and 12 patients with NDBE. A total of 245 areas were investigated with following histology: 43 HGIN/EC, 66 low-grade intraepithelial neoplasia, 108 NDBE, 28 gastric or squamous mucosa. Areas with low-grade intraepithelial neoplasia and gastric/squamous mucosa were excluded. The area under the receiver operating characteristic curve of the constructed classifier was 0.78. Sensitivity and specificity for the discrimination between NDBE and HGIN/EC of OBS alone were 81% and 58

  7. Comparison of prognostic compatibility between seventh AJCC/TNM of the esophagus and 14th JCGC staging systems in Siewert type II adenocarcinoma.

    Science.gov (United States)

    Kawaguchi, Tsutomu; Komatsu, Shuhei; Ichikawa, Daisuke; Kubota, Takeshi; Okamoto, Kazuma; Shiozaki, Atsushi; Fujiwara, Hitoshi; Konishi, Hirotaka; Morimura, Ryo; Murayama, Yasutoshi; Kuriu, Yoshiaki; Ikoma, Hisashi; Nakanishi, Masayoshi; Sakakura, Chohei; Otsuji, Eigo

    2013-08-01

    The Seventh American Joint Committee on Cancer (AJCC)/TNM classification defined that the classification for adenocarcinoma of the esophagogastric junction (AEG) was included in the esophageal category. However, there still remain various classifications in AEG such as the Seventh AJCC/TNM of the esophagus and the 14th Japanese Classification of Gastric Cancer staging system (JCGC) in Japan. This study was designed to evaluate the compatibility of both the Seventh AJCC/TNM of the esophagus and the 14th JCGC staging systems in Siewert type II adenocarcinoma. Between 1999 and 2011, 47 consecutive patients with Siewert type II adenocarcinoma underwent curative surgery at our Institution. We reviewed their hospital records retrospectively. Overall survival rates at 3 and 5 years were 44.3% and 33.4%, respectively. Multivariate analyses revealed that the extent of lymph node metastasis was the only independent prognostic factor (p=0.0194, HR=12.927). In the ≤pN2 group by 14th JCGC, deeper tumor depth was significantly correlated with poor prognosis, whereas in the ≥pN3 group, deeper tumor depth did not affect prognosis, suggesting a strong effect of nodal factor on prognosis and more similar prognostic stratification to the Seventh edition of the AJCC/TNM classification of the esophagus. Nodal involvement status might be a more important prognostic factor than tumor depth in patients with Siewert type II adenocaricinoma. The Seventh classification of AJCC/TNM of the esophagus might be more compatible with Siewert type II adenocarcinoma.

  8. Structural abnormalities of the myenteric (Auerbach's) plexus in familial dysautonomia (Riley-Day syndrome) as demonstrated by flat-mount preparation of the esophagus and stomach.

    Science.gov (United States)

    Ariel, I; Wells, T R

    1985-01-01

    The esophageal and gastric myenteric (Auerbach's) plexus were studied by a flat-mount preparation in 3 patients with familial dysautonomia. In 1 patient a typical esophageal network was found in the stomach. In another patient both esophageal and gastric plexus patterns were significantly different from normal. These changes, by producing abnormal nervous stimulation, may explain disturbed motility of the esophagus and stomach in familial dysautonomia.

  9. Is there an advantage to be gained from adding digital image cytometry of brush cytology to a standard biopsy protocol in patients with Barrett's esophagus?

    Science.gov (United States)

    Borovicka, J; Schönegg, R; Hell, M; Kradolfer, D; Bauerfeind, P; Dorta, G; Netzer, P; Binek, J; Meyenberger, C; Fischer, J E; Spieler, P

    2009-05-01

    The current gold standard in Barrett's esophagus monitoring consists of four-quadrant biopsies every 1-2 cm in accordance with the Seattle protocol. Adding brush cytology processed by digital image cytometry (DICM) may further increase the detection of patients with Barrett's esophagus who are at risk of neoplasia. The aim of the present study was to assess the additional diagnostic value and accuracy of DICM when added to the standard histological analysis in a cross-sectional multicenter study of patients with Barrett's esophagus in Switzerland. One hundred sixty-four patients with Barrett's esophagus underwent 239 endoscopies with biopsy and brush cytology. DICM was carried out on 239 cytology specimens. Measures of the test accuracy of DICM (relative risk, sensitivity, specificity, likelihood ratios) were obtained by dichotomizing the histopathology results (high-grade dysplasia or adenocarcinoma vs. all others) and DICM results (aneuploidy/intermediate pattern vs. diploidy). DICM revealed diploidy in 83% of 239 endoscopies, an intermediate pattern in 8.8%, and aneuploidy in 8.4%. An intermediate DICM result carried a relative risk (RR) of 12 and aneuploidy a RR of 27 for high-grade dysplasia/adenocarcinoma. Adding DICM to the standard biopsy protocol, a pathological cytometry result (aneuploid or intermediate) was found in 25 of 239 endoscopies (11%; 18 patients) with low-risk histology (no high-grade dysplasia or adenocarcinoma). During follow-up of 14 of these 18 patients, histological deterioration was seen in 3 (21%). DICM from brush cytology may add important information to a standard biopsy protocol by identifying a subgroup of BE-patients with high-risk cellular abnormalities.

  10. Compositional change in hu-man enamel irradiated with MIR free electron laser

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    The purpose of this study was to investigate compositional changes in human enamel irradiated with the free electron laser (FEL). The exposure on dental enamel at the wavelength of 9.64 ?m was observed with the Beijing free electron laser. The distribution of elements in the irradiated or non-irradiated enamel was measured by scanning electron microscope (SEM) with energy-dispersive spectroscopy and synchrotron radiation X-ray fluorescence (SRXRF) in Beijing Synchrotron Radiation Facility (BSRF). The results showed that the P/Ca ratio in the ablation region of enamel at the maximum wavelength of infrared absorption was obviously smaller than that at the non-maximum wavelength. In the ablation region the ratios of P/Ca and Ca/Sr were smaller than those in the non-ablation region. The distributions of P, Ca and Sr in the ablation region were heterogeneous due to the element change caused by FEL irradiation.

  11. Detecting p53 immunoexpression in esophageal mucosa with exfoliative cytology in individuals at risk for squamous cell carcinoma of the esophagus.

    Science.gov (United States)

    Lopes, Antônio B; Müller, Leandro B; Reichert, Roberta; Moraes, Cláudia M; Capra, Anderson M; Prolla, João Carlos; Diehl, Ada R S; Meurer, Luise; de Barros, Sergio G Silva; Fagundes, Renato B

    2010-01-01

    To determine the prevalence of p53 expression in cytologic smear collected by the RS Balloon in high-risk individuals, and test its yield in the cytologic screening of squamous cell carcinoma of the esophagus (SCCE). Asymptomatic individuals at risk for SCCE underwent esophageal exfoliative cytology with the RS Balloon immediately followed by upper gastrointestinal endoscopy with biopsies of unstained areas after iodine mucosal staining of the esophagus. For each patient, cytologic expression of p53 was compared with the worst endoscopic biopsy diagnosis and the histologic expression of p53. One hundred seventy-one individuals were submitted to the study's protocol. There were 8 lost cases (4.7%) due to inadequate cytologic samples. The final sample consisted of 163 individuals where 150 were male (92%), mean age of 52.6 +/- 12.0 years old. There were 3 cases of dysplasia/SCCE. Immunohistochemical expression of p53 protein was positive in 38 patients (23.6%), with basal layer expression in 29 (76.3%), middle layer expression in 8 (21.1%) and superficial layer in 1 (2.6%). All patients with dysplasia/SCCE had positive immunohistochemical expression of p53 protein. Immunocytochemical expression of p53 protein in cytologic smear was negative in all cytology samples. The negative results of immunocytochemical expression of p53 protein suggest that its use does not contribute to improving the performance of conventional cytology of the esophagus in the screening for SCCE and its precursor lesions.

  12. A patient with spontaneous rupture of the esophagus and concomitant gastric cancer whose life was saved: case of report and review of the literature in Japan

    Directory of Open Access Journals (Sweden)

    Matsuhashi Nobuhisa

    2011-12-01

    Full Text Available Abstract A 71-year-old man suddenly developed abdominal pain and vomiting on drinking soda after a meal, and visited a physician. Cervical subcutaneous and mediastinal emphysemas were observed on CT, and the patient was transferred to the emergency medical center of our hospital on the same day. Esophagography was performed at our department. A ruptured region was identified on the left side of the lower thoracic esophagus, and surgery was emergently performed employing sequential left thoracoabdominal incision. The chest wall was adhered due to inflammation, and large amounts of residual food and sloughing were present in the thoracic cavity and mediastinum. Moreover, necrotic changes were noted in the superior through inferior mediastinum. An about 2-cm rupture site was confirmed on the left side of the lower thoracic esophagus and closed by suture and filling with pediculate omentum. The presence of a tumorous lesion located mainly in the body of the stomach and lymph node enlargement were also diagnosed before surgery, for which gastric and intestinal fistulae were inserted to prepare for the second-stage surgery. The patient was admitted to an ICU after surgery. ARDS and MRSA-induced pneumonia and enteritis concomitantly developed but remitted. Curative surgery for gastric cancer was performed at 40 POD. Spontaneous rupture of the esophagus is relatively rare and that complicated by gastric caner is very rare, with only six cases being reported in Japan. Herein, we report the case.

  13. The Prevalence, Risk Factors, and Clinical Correlates of Erosive Esophagitis and Barrett’s Esophagus in Iranian Patients with Reflux Symptoms

    Directory of Open Access Journals (Sweden)

    Alireza Sharifi

    2014-01-01

    Full Text Available Background. Erosive esophagitis (EE and Barrett’s esophagus (BE are the two important complications of gastroesophageal reflux disease. We aimed to investigate the prevalence of and the risk factors for EE and BE in an Iranian group of patients with reflux symptoms. We also examined the relationship between reflux symptoms and endoscopic findings. Methods. A total of 736 patients with gastroesophageal reflux disease (GERD symptoms were enrolled and all underwent upper gastrointestinal endoscopy. Diagnosis of Barrett’s esophagus was confirmed by pathologic examination and Helicobacter pylori (H. pylori infection was demonstrated by rapid urease test. Results. Two hundred eighty-three and 34 patients were found to have EE and BE, respectively. Multivariate analysis showed that hiatal hernia (P<0.001 and H. pylori infection (P<0.002 were the two significantly related risk factors for esophagitis. Only age was related to BE, with BE patients being more likely to be older (P<0.001 than others. Conclusions. Prevalence of EE and BE in Iranian reflux patients is similar to that seen in western countries. H. pylori infection and the presence of hiatal hernia may be strong risk factors for esophagitis as does older age for Barrett’s esophagus. Finally, reflux symptoms have no significant relationship with endoscopic findings.

  14. Duodenal-content reflux into the esophagus leads to expression of Cdx2 and Muc2 in areas of squamous epithelium in rats.

    Science.gov (United States)

    Pera, Manuel; Pera, Miguel; de Bolós, Carmen; Brito, Maria J; Palacín, Antonio; Grande, Luis; Cardesa, Antonio; Poulsom, Richard

    2007-07-01

    The molecular events responsible for the transdifferentiation of epithelial cells of the esophagus to a columnar cell type are not well understood. Cdx2 has been detected in Barrett's esophagus, so we sought evidence of Cdx2 expression during the process of transdifferentiation of the esophageal squamous epithelium into a glandular phenotype. Thirty-two rats underwent an esophago-jejunostomy to produce esophagitis of 20, 25, 30, or 35 weeks of duration. The spectrum of esophageal lesions induced by chronic reflux was examined for expression of Cdx2 and Muc2 by immunohistochemistry. Five animals developed glandular metaplasia and adenosquamous carcinoma, two developed only glandular metaplasia, and two had adenosquamous carcinoma alone. Nuclear Cdx2 expression was detected in 57% (four of seven) and 43% (three of seven) of foci of glandular metaplasia and adenosquamous carcinomas, respectively. Cdx2 staining was detectable in some squamous and some mucus secreting cells. Perinuclear and perivacuolar staining of Muc2 was detected focally in 71% (five of seven) and 57% (four of seven) of areas with glandular metaplasia and adenosquamous carcinoma, respectively. We show that duodenal-content reflux into the esophagus switches on the expression of Cdx2 protein in esophageal keratinocytic cells, promoting a mucinous transdifferentiation process with secretion of intestinal mucin Muc2.

  15. Normal tissue tolerance to external beam radiation therapy: Esophagus; Dose de tolerance a l'irradiation des tissus sains: l'oesophage

    Energy Technology Data Exchange (ETDEWEB)

    Bera, G.; Pointreau, Y. [Clinique d' oncologie-radiotherapie, centre Henry-S.-Kaplan, hopital Bretonneau, CHU de Tours, 37 - Tours (France); Denis, F.; Dupuis, O. [Centre Jean-Bernard, clinique Victor-Hugo, 72 - Le-Mans (France); Orain, I. [Service d' anatomie et cytologie pathologiques, hopital Trousseau, CHU de Tours, 37 - Tours (France); Crehange, G. [Departement de radiotherapie, centre Georges-Francois-Leclerc, 21 - Dijon (France)

    2010-07-15

    The esophagus is a musculo-membranous tube through which food passes from the pharynx to the stomach. Due to its anatomical location, it can be exposed to ionizing radiation in many external radiotherapy indications. Radiation-induced esophageal mucositis is clinically revealed by dysphagia and odynophagia, and usually begins 3 to 4 weeks after the start of radiation treatment. With the rise of multimodality treatments (e.g., concurrent chemoradiotherapy, dose escalation and accelerated fractionation schemes), esophageal toxicity has become a significant dose-limiting issue. Understanding the predictive factors of esophageal injury may improve the optimal delivery of treatment plans. It may help to minimize the risks, hence increasing the therapeutic ratio. Based on a large literature review, our study describes both early and late radiation-induced esophageal injuries and highlights some of the predictive factors for cervical and thoracic esophagus toxicity. These clinical and dosimetric parameters are numerous but none is consensual. The large number of dosimetric parameters strengthens the need of an overall analysis of the dose/volume histograms. The data provided is insufficient to recommend their routine use to prevent radiation-induced esophagitis. Defining guidelines for the tolerance of the esophagus to ionizing radiation remains essential for a safe and efficient treatment. (authors)

  16. Dietary fiber and the risk of precancerous lesions and cancer of the esophagus: a systematic review and meta-analysis.

    Science.gov (United States)

    Coleman, Helen G; Murray, Liam J; Hicks, Blanaid; Bhat, Shivaram K; Kubo, Ai; Corley, Douglas A; Cardwell, Chris R; Cantwell, Marie M

    2013-07-01

    Dietary fiber has several anticarcinogenic effects and is thought to be protective against esophageal cancer. The aim of this systematic review was to quantify the association between dietary fiber and the risk of esophageal cancer by investigating histological subtypes of esophageal cancer and the stage at which fiber may influence the carcinogenic pathway. Systematic search strategies were used to identify relevant studies, and adjusted odds ratios (ORs) were combined using random-effects meta-analyses to assess the risk of cancer when comparing extreme categories of fiber intake. Ten relevant case-control studies were identified within the timeframe searched. Pooled estimates from eight studies of esophageal adenocarcinoma revealed a significant inverse association with the highest fiber intakes (OR 0.66; 95% confidence interval [CI] 0.44-0.98). Two studies also identified protective effects of dietary fiber against Barrett's esophagus. Similar, though nonsignificant, associations were observed when results from five studies of fiber intake and risk of squamous cell carcinoma were combined (OR 0.61; 95%CI 0.31-1.20). Dietary fiber is associated with protective effects against esophageal carcinogenesis, most notably esophageal adenocarcinoma. Potential methods of action include modification of gastroesophageal reflux and/or weight control.

  17. The Prevalence of Barrett Esophagus Diagnosed in the Second Endoscopy: A Retrospective, Observational Study at a Tertiary Center.

    Science.gov (United States)

    Suna, Nuretdin; Parlak, Erkan; Kuzu, Ufuk Baris; Yildiz, Hakan; Koksal, Aydin Seref; Oztas, Erkin; Sirtas, Zeliha; Yuksel, Mahmut; Aydinli, Onur; Bilge, Zulfikar; Taskiran, Ismail; Sasmaz, Nurgul

    2016-04-01

    At present, we do not know the exact prevalence of Barrett esophagus (BE) developing later in patients without BE in their first endoscopic screening. The purpose of this study was to determine the prevalence of BE on the second endoscopic examination of patients who had no BE in their first endoscopic examination.The data of the patients older than 18 years who had undergone upper gastrointestinal system endoscopy more than once at the endoscopy unit of our clinic during the last 6 years were retrospectively analyzed.During the last 6 years, 44,936 patients had undergone at least one endoscopic examination. Among these patients, 2701 patients who had more than one endoscopic screening were included in the study. Of the patients, 1276 (47.3%) were females and 1425 (52.7%) were males, with an average age of 54.9 (18-94) years. BE was diagnosed in 18 (0.66%) of the patients who had no BE in the initial endoscopic examin