MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Diseases of the Esophagus' source. Wed, 08 Feb 2012 16:28:14 +0100 http://www.medworm.com/index.php?rid=5667841&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01315.x (Source: Diseases of the Esophagus) Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5667841 Mon, 06 Feb 2012 05:00:00 +0100 5667841 http://www.medworm.com/index.php?rid=5667840&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01317.x SUMMARYGastroesophageal reflux disease (GERD) causes a wide range of symptoms. Some patients present with typical symptoms such as heartburn and regurgitation and others with atypical symptoms such as chest pain. The mechanism responsible for the varying clinical presentation of GERD is still not fully elucidated. The aim of this study was to prospectively evaluate differences in central and local intraesophageal factors between patients with typical GERD symptoms and those with noncardiac chest pain (NCCP). Patients presenting with typical and atypical symptoms suspicious of GERD underwent upper endoscopy and 24‐hour pH monitoring with four sensors, each positioned at a different esophageal level. All patients completed GERD symptom, Hospital Anxiety and Depression Scale, and Symptom St... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5667840 Mon, 06 Feb 2012 05:00:00 +0100 5667840 http://www.medworm.com/index.php?rid=5667839&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01318.x In conclusion, the pathophysiology of achalasia is therefore considered to be an impaired production of NO and VIP, which both affect interstitial cell of Cajal and smooth muscles, and this impairment is therefore considered to play a role in the pathophysiology of achalasia. (Source: Diseases of the Esophagus) Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5667839 Mon, 06 Feb 2012 05:00:00 +0100 5667839 http://www.medworm.com/index.php?rid=5667838&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01320.x SUMMARYIt has recently been suggested that angiotensin‐I converting enzyme (ACE) inhibitors decrease the risk of cancer. However, studies to date have not investigated esophageal carcinoma. Therefore, we investigated the inhibitory effect of ACE inhibitors on growth of esophageal carcinoma xenografts. We used the EC9706 cell line, which expresses the highest vascular endothelial growth factor (VEGF) mRNA level, to establish xenografts in 21 BALB/c nude mice. The mice were then randomly allocated to receive normal saline, perindopril (4 mg/kg), or benazepril (6 mg/kg). Five weeks later, the nude mice were sacrificed and all tumors were dissected and weighed. The number of microvessels was counted by immunostaining endothelial cells for CD31 and the microvessel density was assessed. Th... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5667838 Mon, 06 Feb 2012 05:00:00 +0100 5667838 http://www.medworm.com/index.php?rid=5648998&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01308.x This study evaluated the relationship between the expression of NF‐κB and the prognosis and sensitivity of esophageal squamous cell carcinoma (ESCC) to chemotherapy. One hundred and nine ESCC specimens, from patients who had undergone radical esophagectomy, were divided into two groups depending on the expression of NF‐κB. Surgical data and prognosis were compared between the two groups. NF‐κB‐positive tumors were detected in 61.5% of the cases. In 69 patients with stage II and III disease, 41 patients who were NF‐κB‐positive showed poor survival. The sensitivity of esophageal squamous cell carcinoma cell lines to 5‐fluorouracil (5‐FU) was analyzed by their NF‐κB expression, and the effect of 5‐FU was evaluated on the proliferation and activity of two cell lines of... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5648998 Tue, 31 Jan 2012 05:00:00 +0100 5648998 http://www.medworm.com/index.php?rid=5648997&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01309.x SUMMARYGastro‐tracheobronchial fistula (GTF) is a rare but life‐threatening complication specifically observed after esophagectomy and reconstruction using posterior mediastinal gastric tube. Ten cases of GTF were encountered in three hospitals in 2000–2009. Their clinicopathological, surgical, and postoperative care are summarized, together with a review of previously reported cases. GTF was classified as anastomotic leakage (n= 5), gastric necrosis (n= 4), and gastric ulcer type (n= 1). The anastomotic leakage type appeared about 2 weeks (postoperative day [POD]: 8–35) after esophagectomy, was located in the cervical or higher thoracic trachea. Breathing and pneumonia were controlled by tracheal tube placed in the distal of fistula. The gastric necrosis type was noted in patients... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5648997 Tue, 31 Jan 2012 05:00:00 +0100 5648997 http://www.medworm.com/index.php?rid=5648996&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01310.x SummaryOver half of patients with gastroesophageal reflux disease (GERD) report nocturnal symptoms. Proton pump inhibitors (PPIs) are the main medications used to treat GERD. Multichannel intraluminal impedance with pH (MII‐pH) monitoring is the most sensitive method for detection and characterization of GERD. The aim of this study was to assess and compare reflux frequency in patients with refractory GERD symptoms on and off PPI therapy during the nocturnal recumbent period, as assessed by MII‐pH testing. We analyzed 24‐hour MII‐pH studies performed in 200 patients monitored either on twice‐daily (n = 100) or off (n = 100) PPI therapy. Demographic analysis of the on‐therapy group revealed a mean age of 52 years (24–78 years) with 37% males, and the off‐therapy grou... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5648996 Tue, 31 Jan 2012 05:00:00 +0100 5648996 http://www.medworm.com/index.php?rid=5648995&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01311.x SummaryGastric interposition with intrathoracic or cervical esophagogastrostomy is currently the preferred operation for reconstruction after esophagectomy. Anastomotic leaks however result from poor vascular supply to the proximal stomach. They are responsible for significant morbidity and mortality. ‘Ischemic conditioning’ of the interposed stomach has been proposed as a technique where the ‘delay phenomenon’ aims at improving the microcirculation of the gastric conduit and preventing anastomotic leakage. Experimental observations and clinical studies have been conducted to document the immediate effects and results of this approach. The aim of this work is to review the principles, pathophysiology, experimental, and clinical evidence related to vascular conditioning of the stoma... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5648995 Tue, 31 Jan 2012 05:00:00 +0100 5648995 http://www.medworm.com/index.php?rid=5648993&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01312.x SUMMARYThe influence of social environment on survival in patients with cancer has been demonstrated in many studies, subjects living in the most deprived areas having a poorer prognosis. Geographic remoteness and limited access to specialized care centers are often associated with socioeconomic deprivation. The aim was to assess the influence of social environment and geographic remoteness on the relative survival of patients diagnosed with esophageal cancer between 1997 and 2004 in the department of Calvados in France. The study population, which was provided by the Calvados digestive cancer registry, included 629 patients. Relative survival was used to estimate the influence of social environment and geographic remoteness on patient survival. Five‐year survival rates were 14.1%, 15.1%... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5648993 Tue, 31 Jan 2012 05:00:00 +0100 5648993 http://www.medworm.com/index.php?rid=5583124&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01302.x We examined the value of impedance monitoring in measuring bolus volume compared with videoesophagram. Eighty consecutive subjects were studied with simultaneous impedance‐manometry‐videoesophagram. A catheter with both an impedance electrode pair and a pressure transducer at four sites (5, 10, 15, 20 cm above lower esophageal sphincter) was passed per nares. Six 10‐cc boluses of 45% barium mixed with 0.9% NaCl were swallowed at 20‐ to 30‐second intervals. When impedance fell to below 1000 ohms, other than that occurring during administered swallows, the videofluoroscopic image corresponding to the time of impedance nadir was reviewed. If barium was present at the impedance site, barium area was calculated. The video was reviewed for the cause of abnormal barium transit causi... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5583124 Fri, 13 Jan 2012 05:00:00 +0100 5583124 http://www.medworm.com/index.php?rid=5583123&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01304.x SUMMARYEsophagectomy has one of the highest mortality rates among all surgical procedures. We investigated the type and frequency of complications associated with perioperative mortality after esophagectomy. We performed a retrospective review of all perioperative deaths following esophagectomy for esophageal cancer at the Mayo Clinic, Rochester from 1993 through 2009. Of 1522 esophagectomies, perioperative mortality occurred in 45 (3.0%). The majority who died were male (82%); median age was 72 years (range 46–92). The median age‐adjusted Charlson comorbidity score was 6. Twenty‐three (51%) underwent neoadjuvant chemoradiotherapy. The type of esophagectomy was transthoracic in 27 patients (60%), transhiatal in eight (18%), tri‐incisional in seven (16%), left thoracoabdominal in on... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5583123 Fri, 13 Jan 2012 05:00:00 +0100 5583123 http://www.medworm.com/index.php?rid=5583122&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01305.x SUMMARYExtraesophageal (EE) symptoms such as cough and throat clearing are common in patients referred for reflux testing, but are less commonly associated with gastroesophageal reflux disease (GERD). Patients with reflux associated EE symptoms often lack typical GERD symptoms of heartburn and regurgitation. Our aim was to compare the frequency of proximal esophageal reflux between esophageal (typical) symptoms and EE (atypical) symptoms. Combined multichannel intraluminal impedance‐pH (MII‐pH) tracings were blinded by an investigator so that symptom markers were relabeled with a number without disclosure of symptom type. We selected 40 patients with at least five reflux‐related symptom events for one of four symptoms (heartburn, regurgitation, cough, or throat clearing). A blinded i... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5583122 Fri, 13 Jan 2012 05:00:00 +0100 5583122 http://www.medworm.com/index.php?rid=5583127&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01297.x (Source: Diseases of the Esophagus) Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5583127 Wed, 11 Jan 2012 05:00:00 +0100 5583127 http://www.medworm.com/index.php?rid=5583126&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01298.x SUMMARYIn the light of increasing evidence supporting cancer stem cells (CSCs) theory, the expression of two stem cell markers, CD133 and adenosine triphosphate‐binding cassette superfamily G member 2 (ABCG2), in esophageal squamous cell carcinoma (ESCC) was investigated, and their prognostic values were evaluated. Paraffin‐embedded tissue sections of 110 ESCC patients were investigated using Immunohistochemistry. The association of CD133 and ABCG2 expression with clinicopathologic characteristics was analyzed by χ2 test. Survival analysis was carried out using Kaplan–Meier method and Cox proportional hazards model. CD133 and ABCG2 expression were detected in 27.3% and 15.5% of ESCC patients, respectively. The presence of CD133‐positive cancer cells was associated with tumor cell ... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5583126 Wed, 11 Jan 2012 05:00:00 +0100 5583126 http://www.medworm.com/index.php?rid=5583125&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01301.x SUMMARYThe effect of antisecretory treatment on extraesophageal symptoms of gastroesophageal reflux disease was evaluated. Seventy‐eight children presenting with typical and extraesophageal symptoms of gastroesophageal reflux disease underwent a multichannel intraluminal impedance and pH monitoring (MII/pH). Children with a positive MII/pH were randomly treated with proton pump inhibitors (PPIs) or histamine H2‐receptor antagonists (H2RAs) during 3 months. At the end of the treatment period, all patients were recalled. A second treatment period of 3 months was given to those patients who were not symptom‐free after 3 months. Thirty‐five of the forty‐one (85.4%) children with a pathologic MII/pH presented with extraesophageal symptoms and were treated with PPIs (omeprazole; n:19) ... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5583125 Wed, 11 Jan 2012 05:00:00 +0100 5583125 http://www.medworm.com/index.php?rid=5667837&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01322.x SUMMARYUp to a third of the patients who receive proton pump inhibitor (PPI) once daily will demonstrate lack or partial response to treatment. There are various mechanisms that contribute to PPI failure and they include residual acid reflux, weakly acidic and weakly alkaline reflux, esophageal hypersensitivity, and psychological comorbidity, among others. Some of these underlying mechanisms may coincide in the same patient. Evaluation for proper compliance and adequate dosing time of PPIs should be the first management step before ordering invasive diagnostic tests. Doubling the PPI dose or switching to another PPI is the second step of management. Upper endoscopy and pH testing appear to have limited diagnostic value in patients who failed PPI treatment. In contrast, esophageal impedance... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5667837 Sun, 01 Jan 2012 05:00:00 +0100 5667837 http://www.medworm.com/index.php?rid=5648992&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01313.x SUMMARYComplications associated with gastroesophageal reflux disease (GERD) can include esophageal stricture, Barrett's esophagus, gastrointestinal hemorrhage, and extraesophageal symptoms. The impact of GERD‐associated complications on health‐care utilization deserves further evaluation. We identified commercial enrollees 18–75 years old with claims for GERD (International Classification of Diseases, Ninth Revision, Clinical Modification Codes: 530.81 or 530.11) and subsequent usage of proton pump inhibitors from 01/01/05 to 06/30/09. The initial GERD diagnosis date was designated as the index date, and patients were studied for 6 months preindex and postindex. Eligible patients were subsequently stratified based on medical claims for GERD‐associated complications as follows: stag... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5648992 Sun, 01 Jan 2012 05:00:00 +0100 5648992 http://www.medworm.com/index.php?rid=5583128&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2012.01250.x (Source: Diseases of the Esophagus) Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5583128 Sun, 01 Jan 2012 05:00:00 +0100 5583128 http://www.medworm.com/index.php?rid=5583121&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01307.x SUMMARYDetection of bone marrow micrometastases (BMMs) in patients with esophageal carcinoma may indicate a metastatic phenotype. We assessed if the presence of BMMs had adverse prognostic significance in a 10‐year follow‐up study. Patients undergoing surgery for esophageal cancer were prospectively recruited between February 1999 and August 2000. Bone marrow aspirates were obtained from the iliac crest of patients under general anesthesia at the time of surgery. Immunocytochemical analysis using anticytokeratin antibodies CAM 5.2 and AE1/AE3 was undertaken to determine the presence of BMMs. Union International Contre le Cancer staging was recorded for all patients. Patient follow‐up was completed over a 10‐year period through analysis of the Northern Ireland Cancer Registry. Forty... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5583121 Sun, 01 Jan 2012 05:00:00 +0100 5583121 http://www.medworm.com/index.php?rid=5552842&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01299.x In conclusion, this preliminary retrospective analysis demonstrated that patients who underwent long‐term treatment with a LTRA had low incidence of endoscopic minimal change esophagitis. (Source: Diseases of the Esophagus) Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5552842 Fri, 30 Dec 2011 05:00:00 +0100 5552842 http://www.medworm.com/index.php?rid=5505867&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01294.x SUMMARYEsophageal sensation is commonly assessed by barostat‐assisted balloon distension (BBD) or dynamic balloon distension (DBD) technique, but their relative merits are unknown. Our aim was to compare the usefulness and tolerability of both techniques. Sixteen healthy volunteers (male/female = 6/10) randomly underwent graded esophageal balloon distensions, using either BBD (n= 8) or DBD (n= 8). BBD was performed by placing a 5‐cm long highly compliant balloon attached to a barostat, and DBD by placing a 5‐cm long balloon attached to a leveling container. Intermittent phasic balloon distensions were performed in increments of 6 mm Hg. Sensory thresholds and biomechanical properties were assessed and compared. Sensory thresholds for first perception (mean ± standard deviation; ... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5505867 Tue, 13 Dec 2011 05:00:00 +0100 5505867 http://www.medworm.com/index.php?rid=5505866&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01295.x We report on esophageal tolerance to high‐dose hypofractionated radiation in patients treated with SABR. Thirty‐one patients with spine or lung tumors received single‐ or multiple‐fraction SABR to targets less than 1 cm from the esophagus. End points evaluated include D5cc (minimum dose in Gy to 5 cm3 of the esophagus receiving the highest dose), D2cc, D1cc, and Dmax (maximum dose to 0.01 cm3). Multiple‐fraction treatments were correlated using the linear quadratic and linear quadratic‐linear/universal survival models. Three esophageal toxicity events occurred, including esophagitis (grade 2), tracheoesophageal fistula (grade 4–5), and esophageal perforation (grade 4–5). Chemotherapy was a cofactor in the high‐grade events. The median time to development of esophage... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5505866 Tue, 13 Dec 2011 05:00:00 +0100 5505866 http://www.medworm.com/index.php?rid=5505865&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01296.x SUMMARYIn this article, we reviewed our experience of treatment of cervical esophageal perforation caused by foreign bodies. Between 1980 and 2010, 42 patients were included in this study. There were 18 women and 24 men with a median age of 54 years. We divided the patients into three groups: the patients whose foreign bodies could not be extracted by otolaryngologists using endoscope (n= 7), the patients who had some signs of abscess formation but the foreign bodies had been extracted using endoscope (n= 25), and the patients who had no signs of abscess formation and the foreign bodies had been extracted (n= 10). We treated the patients of the three groups with surgical treatment, drainage alone, and conservative treatment, respectively. The outcome of the current series was favorable. Ou... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5505865 Tue, 13 Dec 2011 05:00:00 +0100 5505865 http://www.medworm.com/index.php?rid=5487724&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01288.x The objective of this study was to compare the feasibility and safety of SEMS insertion under fluoroscopic control and endoscopic control. The study was performed through the retrospective analysis of patients who underwent SEMS insertion for malignant dysphagia between January 2005 and January 2010. Data concerning early and late complications and survival were retrieved. Early complications were defined as pain, vomiting, bleeding, malposition/migration, perforation, and/or dysphagia occurring until 30 days of SEMS insertion; and late complications as tumor ingrowth and overgrowth, migration, hemorrhage, fistulae, food impaction, and/or esophagitis occurring after 30 days. We placed 126 SEMS of which 87% for esophageal stricture, 8% for esophagus‐respiratory fistula, and 5% for extrins... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5487724 Fri, 09 Dec 2011 05:00:00 +0100 5487724 http://www.medworm.com/index.php?rid=5487723&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01289.x This study included all patients referred our center for treatment of esophageal carcinoma. Diagnostic staging was performed to determine treatment plan. Cervical lymph nodes were evaluated by external ultrasonography of the neck and PET‐CT. In case of suspect lymph nodes on external ultrasonography or PET‐CT, fine needle aspiration (FNA) was performed. Between 2008 and 2010, 170 out of 195 referred patients underwent both external ultrasonography of the neck and PET‐CT. Of all patients, 84% were diagnosed with a tumor at or below the distal esophagus. In 140 of 170 patients, the cervical region was not suspect; no FNA was performed. Seven out of 170 patients had suspect nodes on both PET‐CT and external ultrasonography. Five out of seven patients had cytologically confirmed malign... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5487723 Fri, 09 Dec 2011 05:00:00 +0100 5487723 http://www.medworm.com/index.php?rid=5487717&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01290.x SUMMARYHigh body mass index (H‐BMI; ≥25 kg/m2) is common in US adults. In a small cohort of esophageal cancer (EC) patients treated with surgery, H‐BMI and diagnosis of early stage EC appeared associated. We evaluated a much larger cohort of EC patients. From a prospectively maintained database, we analyzed 925 EC patients who had surgery with or without adjunctive therapy. Various statistical methods were used. Among 925 patients, 69% had H‐BMI, and 31% had normal body mass index (<25 kg/m2; N‐BMI). H‐BMI was associated with men (P < 0.001), Caucasians (P = 0.064; trend), lower esophageal localization (P < 0.001), adenocarcinoma histology (P < 0.001), low baseline cT‐stage (P = 0.003), low baseline overall clinical stage (P = 0.003), c... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5487717 Fri, 09 Dec 2011 05:00:00 +0100 5487717 http://www.medworm.com/index.php?rid=5487712&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01291.x This study aims to analyze the combined prognostic significance of cyclinD1 (CCND1) DNA amplification and the co‐alteration of CCND1/pRb/ppRB in patients with esophageal squamous cell carcinoma. CCND1 DNA amplification and the protein expression of CCND1, pRb, and ppRb on 100 tumor specimens and 11 normal tissues were detected using real‐time quantitative reverse transcription polymerase chain reaction and immunohistochemistry, respectively. Their prognosis significance was analyzed by Kaplan–Meier method. We found that 41% of the patients had CCND1 DNA amplification, which had a short survival time compared with the patients without CCND1 amplification (25.63 months vs. not reached, P = 0.007). The patients with the co‐alternation of CCND1+/pRb–/ppRb+ protein expression leve... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5487712 Fri, 09 Dec 2011 05:00:00 +0100 5487712 http://www.medworm.com/index.php?rid=5487725&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01306.x (Source: Diseases of the Esophagus) Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5487725 Thu, 08 Dec 2011 05:00:00 +0100 5487725 http://www.medworm.com/index.php?rid=5458651&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01285.x This study is to determine systematically the risk of EAC associated with individual medications which relax the LES and compare risks with esophageal squamous cell carcinoma (ESCC) and gastric cardia adenocarcinoma (GCA). Relevant published studies were identified by systematic searching PubMed for case‐control studies reporting on risk of EAC, ESCC or GCA with use of medications known to reduce LES pressure. Pooled odds ratios (ORs) were calculated for each malignancy. Data were analyzed from four case‐control studies involving 9,412 participants. EAC was significantly associated with theophylline use (OR 1.55, 95% confidence interval [CI] 1.05–2.28; P= 0.03, I2= 0%) and anticholinergic medications (OR 1.66, 95% CI 1.13–2.44; P= 0.01, I2= 84%). This effect was not observed in cas... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5458651 Wed, 30 Nov 2011 05:00:00 +0100 5458651 http://www.medworm.com/index.php?rid=5458653&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01282.x This study aims at determining the potential effect on disease‐free survival (DFS) of weight loss observed at 1 year in disease‐free survivors after curative esophageal resection. From a prospective single‐institution database, 304 patients having undergone a transthoracic esophagectomy with two‐field lymphadenectomy and gastric reconstruction between 1996 to 2008 were identified. Patients who died during the postoperative course (n= 24), patients who died within the first postoperative year (n= 12), patients who presented with an early recurrence within the first postoperative year (n= 20), and those who were lost to follow‐up (n= 22) were excluded from the study, as well as those for whom the follow‐up was shorter than 1 year (n= 21). The remaining 205 patients constituted a ... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5458653 Mon, 28 Nov 2011 05:00:00 +0100 5458653 http://www.medworm.com/index.php?rid=5458652&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01284.x In this report, upregulation of MMP10 mRNA was detected in 39/60 (65.0%) of primary ESCC tissues compared with their paired nontumor esophageal tissues. Tissue microarray (TMA) study found protein overexpression of MMP10 in 188/239 (78.7%) of primary ESCC tissues but not in their corresponding nontumor esophageal tissues, suggesting that overexpression of MMP10 may play important roles in ESCC development and progression. Although the overexpression of MMP10 was not significantly associated with disease‐specific survival rate (P= 0.182) for all tested ESCCs, it was significantly associated with poorer disease‐specific survival (P= 0.001) in early stage of ESCCs (I‐IIA). In addition, multivariate analysis found that MMP10 expression in tumor tissues was evaluated as a potential indepe... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5458652 Mon, 28 Nov 2011 05:00:00 +0100 5458652 http://www.medworm.com/index.php?rid=5422954&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01278.x SUMMARYCyclin D1 is one of the most commonly over‐expressed oncogenes; however, its role in esophageal squamous cell carcinoma (ESCC) remains controversial. We conducted a meta‐analysis of 20 studies, comprising 2,041 patients to clarify this issue. In all studies, paraffin‐embedded surgical specimens were collected and the status of cyclin D1 was determined by immunohistochemistry (IHC). The combined odds ratios (Ors) for cyclin D1 expression were 0.74 (95% confidence interval [CI]: 0.58–0.93) for well and moderately differentiated versus poorly differentiated tumors, 0.65 (95% CI: 0.45–0.94) for T1/T2 versus T3/ T4 tumors, 0.59 (95% CI: 0.39–0.90) for N0 versus N1 tumors, and 0.48 (95% CI: 0.33–0.71) for stage I/II versus stage III/IV diseases, respectively. The association... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5422954 Fri, 18 Nov 2011 05:00:00 +0100 5422954 http://www.medworm.com/index.php?rid=5422953&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01279.x SUMMARYTumor recurrence and metastasis is the leading cause of death in esophageal squamous cell carcinoma (ESCC). Cancer stem cell (CSC) may be responsible for tumor growth and maintenance of aggressive behavior. Aldehyde dehydrogenase 1 (ALDH1) has been proposed as one of the possible candidates for a CSC marker. The expression of ALDH1 may be correlated with the clinicopathologic factor and clinical outcome of patients with ESCC. The purpose of this study was to investigate the expression of ALDH1 protein in human ESCC tissues, and evaluated the clinical implication of ALDH1 expression for these patients. All 79 patients who underwent esophagectomy for ESCC between January 2005 and June 2006 were enrolled in this study. The expression of ALDH1 in ESCC and adjacent noncancerous tissues w... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5422953 Fri, 18 Nov 2011 05:00:00 +0100 5422953 http://www.medworm.com/index.php?rid=5388368&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01274.x This study aims to develop and pilot a question prompt sheet to assist esophageal cancer patients to obtain desired information in the consultation in which potentially curative esophagectomy is discussed. Whether a prompt sheet affected patients' question asking, the number and scope of topics discussed, the length of the consultation, and patients' satisfaction is investigated. Patients (n= 30) were randomized either to receive care as usual (control group) or to receive a prompt sheet (intervention group). All patients completed a baseline questionnaire, their consultations were audio‐recorded and content‐coded, and they received a structured telephone interview 2 days after the consultation to assess satisfaction. Patients provided with the prompt sheet marked a median of 19 questi... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5388368 Fri, 04 Nov 2011 04:00:00 +0100 5388368 http://www.medworm.com/index.php?rid=5388371&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01275.x SUMMARYThere are limited data concerning the effects of 5‐HT1A receptor activation on esophageal motility. Sumatriptan, a 5‐HT1A receptor agonist, was recently reported to enhance esophageal peristalsis after intravenous administration. Buspirone, an orally available 5‐HT1A receptor agonist, was shown to modulate gastroduodenal motor function. Our aim was to evaluate the effect of buspirone on esophageal motility of healthy volunteers. On two separate visits, 20 healthy volunteers aged 21–29 years (nine women) underwent esophageal manometry before and 10, 30, and 60 minutes after the administration of buspirone 20‐mg or placebo capsule, according to a double‐blind crossover design. At each time point, we compared buspirone and placebo effects on: resting pressure of the lower e... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5388371 Wed, 02 Nov 2011 04:00:00 +0100 5388371 http://www.medworm.com/index.php?rid=5388370&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01276.x In conclusion, omeprazole combined with sodium alginate was better than omeprazole alone in Japanese patients with NERD. (Source: Diseases of the Esophagus) Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5388370 Wed, 02 Nov 2011 04:00:00 +0100 5388370 http://www.medworm.com/index.php?rid=5388369&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01277.x SUMMARYThe etiology of primary esophageal achalasia is largely unknown. There is increasing evidence that genetic alterations might play an important but underestimated role. Current knowledge of the genetic base of Hirschsprung's disease in contrast is far more detailed. The two enteric neuropathies have several clinical features in common. This association may also exist on a cellular and molecular level. The aim of this review is to enlighten those etiopathogenetic concepts of Hirschsprung's disease that seem to be useful in uncovering the pathological processes causing achalasia. Three aspects are looked at: (i) the genetic base of Hirschsprung's disease, particularly its major susceptibility gene rearranged during transfection and its potential reference to achalasia; (ii) the altered... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5388369 Wed, 02 Nov 2011 04:00:00 +0100 5388369 http://www.medworm.com/index.php?rid=5560965&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01300.x This study shows the strength of molecular analysis as an adjunct to the histopathologic diagnosis for distinguishing between metastases of prior cancers and primary cancers. Furthermore, these cases imply that presence of BE is not protective with regards to developing ESCC in the lower one third of the esophagus. We suggest that their ESCCs arose from islets of squamous epithelium in BE. (Source: Diseases of the Esophagus) Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5560965 Tue, 01 Nov 2011 04:00:00 +0100 5560965 http://www.medworm.com/index.php?rid=5552841&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01303.x (Source: Diseases of the Esophagus) Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5552841 Tue, 01 Nov 2011 04:00:00 +0100 5552841 http://www.medworm.com/index.php?rid=5505864&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01293.x SUMMARYAn unbuffered layer of acidity that escapes neutralization by food has been demonstrated in volunteers and gastroesophageal reflux disease patients. This postprandial proximal gastric acid pocket (PPGAP) is manometrically defined by the presence of acid reading (pH < 4) in a segment of the proximal stomach between nonacid segments distally (food) and proximally (lower esophageal sphincter or distal esophagus). The PPGAP may have important clinical implications; however, it is still poorly understood. Gastric anatomy and physiology seem to be important elements for PPGAP genesis. Gastric operations and acid suppression medications may decrease distal – proximal intragastric acid reflux and help control gastroesophageal reflux. (Source: Diseases of the Esophagus) Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5505864 Tue, 01 Nov 2011 04:00:00 +0100 5505864 http://www.medworm.com/index.php?rid=5487711&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01292.x SUMMARYThe development of achalasia in a patient with a history of esophageal atresia (EA) is rare. Here, we report a patient who had undergone surgery for EA at birth and presented achalasia at 30 years of age. He was successfully treated with laparoscopic surgery. (Source: Diseases of the Esophagus) Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5487711 Tue, 01 Nov 2011 04:00:00 +0100 5487711 http://www.medworm.com/index.php?rid=5469574&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01286.x SUMMARYThe aim of this study was to assess the efficacy and prognostic factors of definitive radiochemotherapy (RCT) for inoperable esophageal cancer. Between 1995 and 2005 all patients with inoperable esophageal cancer that underwent concurrent RCT were included in this retrospective study. Conventional computed tomography‐based treatment planning as well as 3D‐conformal radiotherapy (RT) was used. Maximum radiotherapy dose was 63 Gy. Chemotherapy consisted of cisplatin (20 mg/m2 d1‐5 and 29–33) and 5‐FU (650–1000 mg/m2 d1‐5 and 29–33). Patients not suitable for RCT received radiotherapy alone. Toxicity was measured according to common toxicity criteria (CTC). Two hundred three consecutive patients with inoperable esophageal cancer that received definitive therapy we... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5469574 Tue, 01 Nov 2011 04:00:00 +0100 5469574 http://www.medworm.com/index.php?rid=5458650&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01287.x This study aimed to estimate the population prevalence and identify the determinants of frequent GER symptoms in the Australian population. Self‐reported information on the frequency of reflux symptoms were collected from 1,580 adults from a population register. We estimated age‐ and sex‐standardized prevalence of occasional (<weekly) and frequent (≥weekly) GER symptoms in the Australian population. We also estimated adjusted prevalence ratios (PR) for GER symptoms associated with demographic and lifestyle characteristics. The standardized prevalences of GER symptoms were 10.4% and 38.3% for frequent and occasional symptoms, respectively. Compared with participants with body mass index <25, those with body mass index ≥35 had almost 90% higher prevalence of frequent GER symp... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5458650 Tue, 01 Nov 2011 04:00:00 +0100 5458650 http://www.medworm.com/index.php?rid=5441811&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01281.x SummaryAlthough the pathogenesis of cervical inlet patch (CIP) is not fully understood, most authors consider it as a congenital abnormality, whereas others surmise it to be related to gastroesophageal reflux disease (GERD). We aimed to evaluate esophageal function and the prevalence of GERD and Barrett's esophagus in patients with CIP. GERD is defined by the presence of erosive esophagitis or an abnormal pH monitoring. Seventy‐one consecutive patients with endoscopic and histological evidence of CIP were prospectively evaluated. Esophageal symptom analysis, 24‐hour simultaneous biliary reflux and double‐channel pH‐monitoring, and esophageal manometry were carried out in 65/71 (92%) patients and in 25 matched controls. Six patients were not suitable for testing and were, therefore,... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5441811 Tue, 01 Nov 2011 04:00:00 +0100 5441811 http://www.medworm.com/index.php?rid=5432310&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01280.x SUMMARYThe prevalence of gastroesophageal (GE) mucosal prolapse in patients with gastroesophageal reflux disease (GERD) was investigated as well as the clinical profile and treatment outcome of these patients. Of the patients who were referred to our service between 1980 and 2008, those patients who received a complete diagnostic work‐up, and were successively treated and followed up at our center with interviews, radiology studies, endoscopy, and, when indicated, esophageal manometry and pH recording were selected. The prevalence of GE prolapse in GERD patients was 13.5% (70/516) (40 males and 30 females with a median age of 48, interquartile range 38–57). All patients had dysphagia and reflux symptoms, and 98% (69/70) had epigastric or retrosternal pain. Belching decreased the intens... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5432310 Tue, 01 Nov 2011 04:00:00 +0100 5432310 http://www.medworm.com/index.php?rid=5422952&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01283.x SummaryThe palisade vessels present at the distal end of the esophagus are considered to be a landmark of the esophagogastric junction and indispensable for diagnosis of columnar‐lined esophagus on the basis of the Japanese criteria. Here we clarified the features of normal palisade vessels at the esophagogastric junction using magnifying endoscopy. We prospectively studied palisade vessels in 15 patients undergoing upper gastrointestinal endoscopy using a GIF‐H260Z instrument (Olympus Medical Systems Co., Tokyo, Japan). All views of the palisade vessels were obtained at the maximum magnification power in the narrow band imaging mode. We divided the area in which palisade vessels were present into three sections: the area from the squamocolumnar junction (SCJ) to about 1 cm orad with... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5422952 Tue, 01 Nov 2011 04:00:00 +0100 5422952 http://www.medworm.com/index.php?rid=5388367&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01273.x SUMMARYThe introduction of new treatments for esophageal cancer including surgery, chemotherapy, radiotherapy, or a combination of these modalities has not only improved patient survival, but may also increase the risk of the second primary cancers. The available evidence is conflicting with most risk estimates based on sparse numbers. Here we estimated standardized incidence ratios (SIRs) of second cancer among 24,557 esophageal cancer survivors (at least 2 months) in the Surveillance, Epidemiology, and End Results (SEER) Program between 1973 and 2007, who had been followed up for median 6.5 years (range 2 months–29.3 years). Second cancer risk was statistically significantly elevated (SIR = 1.34, 95% confidence interval [CI]= 1.25–1.42) among the survivors compared with the general p... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5388367 Tue, 01 Nov 2011 04:00:00 +0100 5388367 http://www.medworm.com/index.php?rid=5286392&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01266.x SUMMARYAchalasia secondary to neoplasia is an uncommon entity, but recognition is paramount given the concern of missing a cancer diagnosis. Most case series of secondary achalasia occurred in prior decades raising the question of whether the underlying neoplastic causes have changed. All cases of achalasia secondary to neoplasia were reviewed at the Mayo Clinic from 2000 to the present. Cases were assessed for underlying cause of achalasia, whether achalasia was the primary presentation and demographic and clinical factors. Seventeen patients with achalasia secondary to neoplasia were identified. This was 1.5% of all patients with achalasia seen. The most common causes were adenocarcinoma of the esophagus, followed by breast and non‐small cell lung cancer. No cases of gastric cancer wer... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5286392 Mon, 03 Oct 2011 04:00:00 +0100 5286392 http://www.medworm.com/index.php?rid=5286391&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01268.x SUMMARYReflux esophagitis (RE) is a known complication disturbing patients' quality of life after esophageal resection. It is generally recognized that bile reflux as well as acid reflux cause RE. However, the clinical influence of acid and bile reflux, and Helicobacter pylori (H. pylori) infection on RE in the cervical esophagus after esophagectomy is not yet clarified. Sixty patients who underwent cervical esophagogastrostomy following esophagectomy were enrolled in this study. They underwent examination for H. pylori infection, endoscopic examination, and continuous 24‐hour pH and bilirubin monitoring, at 1 month after surgery. The influence of acid and/or bile reflux, H. pylori infection, and others on the development of RE were investigated. RE was observed in 19 patients (32%) ... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5286391 Mon, 03 Oct 2011 04:00:00 +0100 5286391 http://www.medworm.com/index.php?rid=5286390&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01269.x SUMMARYWith several small series examining minimally invasive Ivor Lewis esophagectomies, we look to contribute to a growing experience. In reporting our initial results, safety, initial oncologic completeness, and preliminary outcomes with a minimally invasive Ivor Lewis esophagectomy were demonstrated. From 2007 to 2010, 40 minimally invasive Ivor Lewis esophagectomies were carried out. The approach was a laparoscopic mobilization of the stomach and a thoracoscopic esophageal mobilization and creation of a high intrathoracic anastomosis. Indications included esophageal cancer in 39 patients and esophageal gastrointestinal stromal tumor in one patient. Median age was 62 (range 39–77) with 31 (78%) male patients. Non‐emergent conversion was required in two (5%) patients. Twenty‐five ... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5286390 Mon, 03 Oct 2011 04:00:00 +0100 5286390 http://www.medworm.com/index.php?rid=5286389&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01271.x SUMMARYAccording to the Montreal Consensus Group's classification, gastroesophageal reflux disease develops when the reflux of stomach contents causes troublesome symptoms and/or complications such as esophagitis. The characteristic gastroesophageal reflux disease symptoms included in this statement are retrosternal burning and regurgitation. Troublesome is meant to imply that these symptoms impact on the well‐being of affected individuals; in essence, quality of life (QOL). Whether heartburn and regurgitation symptoms would be characterized as more troublesome in those with confirmed pathologic acid reflux was determined. A second purpose was to assess how well troublesome scores correlated with the results of a validated, disease‐specific QOL instrument. Subjects who underwent esopha... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5286389 Mon, 03 Oct 2011 04:00:00 +0100 5286389 http://www.medworm.com/index.php?rid=5251395&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01240.x (Source: Diseases of the Esophagus) Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5251395 Fri, 23 Sep 2011 04:00:00 +0100 5251395 http://www.medworm.com/index.php?rid=5251394&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01243.x SUMMARYThe optimal treatment for patients with local esophageal cancer (cT2N0 disease) has not yet been defined. We sought to determine whether neoadjuvant chemoradiotherapy (CRT) can improve prognosis compared with direct esophagectomy in this patient group. Between 1994 and 2005, patients with cT2N0 esophageal squamous cell carcinoma who underwent either neoadjuvant CRT or surgery as first‐line treatment were retrospectively reviewed. We collected information on their demographic characteristics, staging modality, clinical and pathological stages, perioperative course, and survival. The study endpoints included tumor recurrence, disease‐specific survival (DSS), and overall survival rate. Of the 71 eligible patients, 14 received an esophagectomy first, whereas the remaining 57 receive... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5251394 Fri, 23 Sep 2011 04:00:00 +0100 5251394 http://www.medworm.com/index.php?rid=5251393&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01245.x SummaryEsophageal cancer (EC) is a common malignant cancer threatening people's health. There are no universally accepted parameters for its early diagnosis. The aim of this study was to observe the expression of human leukocyte antigen class I (HLA‐I) on peripheral blood mononuclear cells (PBMCs) of EC patients and in individuals of high‐incidence area of EC so as to evaluate the feasibility of using this parameter as a potential non‐invasive biomarker for the early diagnosis of EC. The present study enrolled 58 pathological confirmed EC patients, 46 patients with benign esophageal disease, and 65 healthy volunteers. Expression levels of HLA‐I protein and mRNA on PBMCs were determined by flow cytometry and quantitative reverse transcriptase polymerase chain reaction, respectively.... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5251393 Fri, 23 Sep 2011 04:00:00 +0100 5251393 http://www.medworm.com/index.php?rid=5251392&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01258.x SUMMARYDiffuse esophageal spasm (DES) remains insufficiently understood. Here we aimed to summarize the demographic, clinical, radiographic, and manometric features in a large cohort of patients with DES. We identified all consecutive patients diagnosed with DES from 2000 to 2006 at Mayo Clinic Florida. The computerized records of these patients were reviewed to extract relevant information. We performed 2654 esophageal motilities during that period. There were 108 patients with esophageal spasm, and 55% were female. Median age was 71 years. The most common leading symptom was dysphagia in 55, followed by chest pain in 31. Weight loss occurred in 28 patients. The median of time from onset of symptoms to diagnosis was 48 months (range 0–480), with a median of time from the first medical c... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5251392 Fri, 23 Sep 2011 04:00:00 +0100 5251392 http://www.medworm.com/index.php?rid=5251391&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01259.x SUMMARYWe used pathological examination as golden standard to determine whether 3‐deoxy‐3‐18F‐fluorothymidine positron emission tomography/computed tomography (FLT PET/CT) can detect regional lymph node metastasis in untreated thoracic esophageal squamous cell carcinoma and additionally performed 18F‐fluorodeoxyglucose (FDG) PET/CT for direct comparison with that of FLT. Twenty‐two patients with thoracic esophageal squamous cell carcinoma underwent dual‐tracer PET/CT examinations before surgery. The results of reviewing CT images and side‐by‐side FDG PET and FLT PET images for the diagnosis of locoregional lymph node metastasis were compared prospectively in relation to pathologic findings. All patients underwent esophagectomy and lymphadenectomy. Pathologic examination c... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5251391 Fri, 23 Sep 2011 04:00:00 +0100 5251391 http://www.medworm.com/index.php?rid=5251390&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01260.x SUMMARYRothmund–Thomson syndrome (RTS) is a rare autosomal recessive genodermatosis. While its incidence is unknown, approximately 300 cases have been reported in the literature. The syndrome typically presents with a characteristic facial rash (poikiloderma), its diagnostic hallmark, and heterogeneous clinical features including congenital skeletal abnormalities, sparse hair distribution, juvenile cataracts, and a predisposition to osteosarcoma. Gastrointestinal symptoms, such as pyloric stenosis, anal atresia, annular pancreas, and rectovaginal fistula, have also been reported sporadically. This is a report describing a patient diagnosed with RTS referred to us because of dysphagia caused by esophageal stenosis. Long‐term results of endoscopic dilation are also presented. (Source: Di... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5251390 Fri, 23 Sep 2011 04:00:00 +0100 5251390 http://www.medworm.com/index.php?rid=5251389&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01261.x In conclusion, these findings indicate that overexpression of myosin IIA may contribute to the progression and poor prognosis of esophageal squamous cancer, and this effect may be associated with increased cancer cell migration. (Source: Diseases of the Esophagus) Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5251389 Fri, 23 Sep 2011 04:00:00 +0100 5251389 http://www.medworm.com/index.php?rid=5251388&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01262.x In this study, we evaluated MTHFR C677T and A1298C polymorphisms, and vitamin B12, folate, and plasma homocystein levels in patients with esophageal adenocarcinoma (EAC), Barrett's esophagus (BE), chronic esophagitis, and healthy controls (n= 26, n= 14, n= 30, and n= 30, respectively). The mean age of patients in the EAC and BE groups was significantly higher compared with the control group (P < 0.001, P= 0.003, respectively). In all patient groups, serum folate levels were significantly lower than that of the control group (P < 0.01, P < 0.05, and P < 0.01, respectively). There was no statistically significant association between folate levels and MTHFR gene polymorphisms. No differences were found in terms of MTHFR gene polymorphisms, homocystein, and B12 levels among the gro... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5251388 Fri, 23 Sep 2011 04:00:00 +0100 5251388 http://www.medworm.com/index.php?rid=5251387&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01264.x (Source: Diseases of the Esophagus) Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5251387 Fri, 23 Sep 2011 04:00:00 +0100 5251387 http://www.medworm.com/index.php?rid=5209851&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01244.x SUMMARYThe purpose of this study was to report the outcome of radio(chemo)therapy in the curative management of esophageal squamous cell carcinoma (ESCC). We retrospectively analyzed 163 patients with T1‐T4, N0‐1, M0 ESCC who were treated between January 1988 and December 2006 at the Technische Universität München. One hundred sixty patients were inoperable due to a poor performance status, comorbidities or locally advanced unresectable disease. External beam radiation therapy (EBRT) was performed with (n= 146) or without (n= 17) systemic chemotherapy. Fifty‐four patients received an additional boost with intraluminal brachytherapy (IBT). Surviving patients were followed for a median of 72 months (range 10–173 months). The estimated overall survival (OS) at 2 and 5 years was 27 �... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5209851 Wed, 07 Sep 2011 04:00:00 +0100 5209851 http://www.medworm.com/index.php?rid=5209850&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01246.x SummaryThe use of the surgical robot has been increasing in thoracic surgery. Its three‐dimensional view and instruments with surgical wrists may provide advantages over traditional thoracoscopic techniques. Our initial experience with thoracoscopic robot‐assisted minimally invasive esophagectomy (RAMIE) for esophageal cancer was compared with our traditional thoracoscopic minimally invasive esophagectomy (MIE) approach for esophageal cancer. A retrospective review of a prospective database was performed. From July 2008 to October 2009, 43 patients underwent MIE resection. Patients who had benign disease and intrathoracic anastomosis were excluded. Results are presented as mean ± SD. Significance was set as P < 0.05. Eleven patients who underwent RAMIE and 26 who underwent MIE were... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5209850 Wed, 07 Sep 2011 04:00:00 +0100 5209850 http://www.medworm.com/index.php?rid=5209849&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01247.x SUMMARYProper anastomotic healing is dependent upon many factors including adequate blood flow to healing tissue. The aim of this study was to investigate the impact of vascular endothelial growth factor (VEGF165) transfection on anastomotic healing in an ischemic gastrointestinal anastomosis model. Utilizing an established opossum model of esophagogastrectomy followed by esophageal–gastric anastomosis, the gastric fundus was transfected with recombinant human vascular endothelial growth factor via direct injection of a plasmid‐based nonviral delivery system. Twenty‐nine animals were divided into three groups: two concentrations of VEGF and a control group. Outcomes included VEGF mRNA transcript levels, neovascularization, tissue blood flow, and anastomotic bursting pressure. To dete... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5209849 Wed, 07 Sep 2011 04:00:00 +0100 5209849 http://www.medworm.com/index.php?rid=5209848&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01248.x SUMMARYPrevious randomized studies comparing the two commonly used palliative treatments for incurable esophageal cancer, i.e. stent insertion and intraluminal brachytherapy, have revealed the pros and cons of each therapy. While stent treatment offers a more prompt effect, brachytherapy results in more long‐lasting relief of dysphagia and a better health‐related quality of life (HRQL) in those living longer. This prospective pilot study aimed to explore the feasibility and safety of combining these two regimes and incorporating a single high dose of internal radiation. Patients with newly diagnosed, incurable cancer of the esophagus and dysphagia were eligible for inclusion, and stent insertion followed by a single dose (12 Gy) of brachytherapy was performed as a two‐stage procedu... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5209848 Wed, 07 Sep 2011 04:00:00 +0100 5209848 http://www.medworm.com/index.php?rid=5184748&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01211.x SUMMARYLymphatic metastasis is the predominant cause of the low overall survival of patients with esophageal squamous cell carcinoma (ESCC), as there are no faithful methods available predicting early metastasis. Recent studies suggest an effect of podoplanin expression on metastatic spreading to lymph nodes. The purpose of this study was to investigate the influence of podoplanin expression on lymphatic metastasis and tumor cells, and to find the relationship between podoplanin expression and prognosis of patients with ESCC. We evaluated the level of podoplanin expression on tumor cells and the lymphatic vessel density change of tumor mass compared with normal tissue from the same patient through D2‐40 immunohistochemistry staining, and analyzed associations between these two variables ... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5184748 Thu, 01 Sep 2011 23:00:00 +0100 5184748 http://www.medworm.com/index.php?rid=5184747&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01238.x SummaryHiatal hernia is an underlying factor contributing to gastroesophageal reflux disease (GERD). However, it remains elusive whether the size of the esophageal hiatus has a de facto influence on the lower esophageal sphincter (LES), on the intensity of patient reflux, on GERD symptoms and on the quality of life (QoL). One hundred patients with documented chronic GERD underwent laparoscopic fundoplication. QoL was evaluated before surgery using the Gastrointestinal Quality of Life Index (GIQLI). Additionally, GERD symptoms and nonspecific gastrointestinal symptoms were documented using a standardized questionnaire (score 0–224). The size of the esophageal hiatus was measured during surgery by calculating the hiatal surface area (HSA). Correlation analysis between the preoperative QoL,... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5184747 Thu, 01 Sep 2011 23:00:00 +0100 5184747 http://www.medworm.com/index.php?rid=5184746&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01239.x SummaryPatients who have received subtotal esophagectomy for thoracic esophageal cancer must be closely monitored for second primary malignancies. The purpose of this study is to review and assess patients who developed a second primary esophageal cancer in the residual cervical esophagus. Between 1996 and 2010, 10 patients were diagnosed in our hospital with esophageal squamous cell cancer in the residual cervical esophagus after undergoing thoracic esophagectomy and were treated with endoscopic or surgical resection. Data from these patients were reviewed retrospectively. Seven of the 10 patients (70%) had multiple primary carcinoma lesions at the time of their esophagectomy. A second primary cancer in the residual cervical esophagus was detected in eight patients during follow‐up endo... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5184746 Thu, 01 Sep 2011 23:00:00 +0100 5184746 http://www.medworm.com/index.php?rid=5184745&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01241.x SummaryMagnification endoscopy enables in vivo evaluation of gastrointestinal mucosa. Furthermore, endocytoscopy (ECS) with ultra‐high magnification enables in vivo observation of cellular atypia during routine endoscopic examination. The purpose of this study is to clarify the efficacy of ECS and endocytoscopic atypia (ECA) classification in various types of benign and malignant pathology in the esophagus. Consecutive 110 patients, who underwent ECS in our institution from March 2003 to December 2009, were included in this study. One hundred and forty‐six esophageal lesions were classified according to ECA classification, and these endocytoscopic images were compared with histological images. We categorized endocytoscopic images into five categories according to size and uniformity of... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5184745 Thu, 01 Sep 2011 23:00:00 +0100 5184745 http://www.medworm.com/index.php?rid=5362346&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01270.x SUMMARYSpecialized intestinal metaplasia (SIM) is considered as a premalignant condition of the esophagus, but other types of esophageal metaplasia are commonly neglected. A standardized histopathological analysis was focused not only on SIM but also on the presence of metaplastic processes typical of additional glands. A morphological study using standardized histopathological tests was carried out between 2004 and 2007, with biopsies taken from esophageal mucosa of 826 consecutive patients. Mean age and male : female ratio of patients were 55.6 ± 14.7 and 1.1 : 1, respectively. Only 4.1% (n= 34) of all cases proved to have SIM. The remainder of the cases (n= 615; 74.4%) contained cardiac‐fundic mucosa without SIM. Some samples exhibited superficial mucous glands, pancreatic acinar... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5362346 Thu, 01 Sep 2011 04:00:00 +0100 5362346 http://www.medworm.com/index.php?rid=5348669&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01263.x SUMMARYOur understanding of esophageal disease and the foregut has evolved over the past 100 years, especially in recent times. Modern diagnostic technologies and new management paradigms have provided progressive insights into the anatomy, physiology, and normal and abnormal function of the esophagus, as well as improving patient care. Yet, the relationship between the esophagus and its close neighbor, the spine, is rarely discussed and likely underappreciated. Anatomic proximity and intertwined pathophysiology led early investigators to postulate relationships between esophageal disease and spinal abnormalities. More recent studies have illustrated a link between spinal disease and hiatal hernias. Objective radiographic measurements of kyphoscoliosis have correlated with increased hiatal... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5348669 Thu, 01 Sep 2011 04:00:00 +0100 5348669 http://www.medworm.com/index.php?rid=5297550&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01267.x SUMMARYTo examine the efficacy and potential cost implications of acetic acid (AA) chromoendoscopy in the assessment of Barrett's neoplasia. Our prospective database of patients referred between 2005 and 2010 with suspected early neoplasia was reviewed. High‐resolution Fujinon gastroscopes and EPX‐4400 processor were used. Inspection of Barrett's neoplasia was carried out using white light followed by AA. Neoplastic areas were noted, and targeted biopsy was carried out. This was followed by quadrantic biopsies of the remaining Barrett's neoplasia. The cost of protocol‐guided biopsies was compared with AA‐guided biopsy protocols. Two hundred sixty‐three procedures on 197 patients were examined. High‐risk neoplasia was found during 143 procedures. In 96% of cases it was identifie... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5297550 Thu, 01 Sep 2011 04:00:00 +0100 5297550 http://www.medworm.com/index.php?rid=5286388&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01272.x SUMMARYAlthough Iran is a high‐risk country for esophageal squamous cell carcinoma (ESCC), the contribution of overall nutrient intakes to this high incidence rate is not yet clear. The aim of this study was to examine the association between nutrient patterns and risk of ESCC in Iran. Forty‐seven patients with ESCC and 96 frequency‐matched hospital controls underwent private interviews, and dietary habits were collected using a validated food‐frequency questionnaire. Factor analysis was conducted and two major nutrient patterns were retained; factor 1 (high in pantothenic acid, vitamin C, potassium, vitamin B6, magnesium, folate, thiamin, copper, carbohydrate, vitamin K, niacin, α‐tocopherol, zinc, total fiber, fluoride, and polyunsaturated fatty acids) and factor 2 (high in sa... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5286388 Thu, 01 Sep 2011 04:00:00 +0100 5286388 http://www.medworm.com/index.php?rid=5251386&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01265.x SUMMARYThe closure of a large hiatal hernia still represents a challenge for the surgeon. Mesh reinforcement of a hiatoplasty generally decreases recurrence rate. An artificial mesh is cheaper compared with a biologic one, but has a higher complication rate. Our aim was to introduce a new biologic reinforcement method with less expenses. During organ donation for transplantation, tissue islets from pericardium and fascia lata were cryopreserved in a tissue bank. Later, the grafts were transplanted on the diaphragm of mongrel dogs. After 1, 3, and 6 months, the animals were sacrificed, and the transplanted patches were macroscopically and microscopically examined. There were no macroscopic signs of inflammation, abcedation, or significant adhesion formation. The grafts were well recognizabl... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5251386 Thu, 01 Sep 2011 04:00:00 +0100 5251386 http://www.medworm.com/index.php?rid=5163057&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01234.x SUMMARYAortic complications after esophageal cancer surgery are rare and usually fatal. Here, we report three patients who underwent thoracic endovascular aortic repair (TEVAR) for aortic complications after esophagectomy for cancer. In the first case, aortic rupture was caused by pyothorax due to residual tumor after esophagectomy. In the second case, aortic rupture was caused by pyothorax due to anastomotic leakage. In the third case, a pseudoaneurysm was caused by surgical injury during esophagectomy. TEVAR was safe and effective for severe aortic complications when graft infection was avoided. The first case died of sepsis on the 84th postoperative day, and the other two cases have survived 4 years and 2 years to date. (Source: Diseases of the Esophagus) Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5163057 Tue, 23 Aug 2011 23:00:00 +0100 5163057 http://www.medworm.com/index.php?rid=5163056&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01235.x SUMMARYAnterior partial fundoplication (AF) has been popularized by a lower risk of mechanical side effects. The question then emerges whether anterior partial wrap has a similar antireflux effect with Nissen fundoplication (NF). We therefore conducted a randomized study to compare the long‐term outcome of anterior fundoplication with NF. One hundred patients who enrolled in the trial from May 2003 to March 2005 were randomized to laparoscopic AF or laparoscopic NF. Endoscopy, pH monitoring, manometry, a detailed questionnaire, and a visual analog symptom score were completed preoperative at 6, 12, 24, and 60 months after surgical procedures. The postoperative adverse effects such as dysphagia and flatulence were compared between the two groups. Revision surgery or maintenance proton pum... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5163056 Tue, 23 Aug 2011 23:00:00 +0100 5163056 http://www.medworm.com/index.php?rid=5163055&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01236.x SUMMARYThe programmed cell death 4 (PDCD4) tumor suppressor is down‐regulated in several malignancies, and the (subcellular) expression of its protein product is modulated by both oncomiR miR‐21 and protein kinase B (Akt). PDCD4 and activated Akt (phosphorylated Akt [pAkt]) expression were assessed immunohistochemically in 53 tissue samples obtained from 25 endoscopic esophageal mucosal resections performed for squamous intraepithelial neoplasia (IEN) or squamous intramucosal carcinoma (IM‐SSC). In total, 33 IEN (low‐grade = 15; high‐grade = 15) and 20 IM‐SSC specimens were considered; 50 additional tissue samples of histologically proven normal esophageal mucosa were considered as normal controls. To further validate the results achieved, miR‐21 expression (as assessed by qu... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5163055 Tue, 23 Aug 2011 23:00:00 +0100 5163055 http://www.medworm.com/index.php?rid=5098514&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01228.x SUMMARYAnimal models of Barrett's metaplasia and esophageal adenocarcinoma are important to further characterize the disease and test potential therapies. This paper reviews the development of the surgical model of esophageal adenocarcinoma in the rat and considers whether this model provides a biologically accurate representation of Barrett's esophagus and esophageal adenocarcinoma in humans. (Source: Diseases of the Esophagus) Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5098514 Thu, 04 Aug 2011 23:00:00 +0100 5098514 http://www.medworm.com/index.php?rid=5098513&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01229.x SUMMARYReflux of gastroduodenal contents and delayed gastric emptying are the most common and serious problems after esophagectomy with gastric reconstruction. However, attempts to reduce the above symptoms, surgically as well as non‐surgically, had no or limited effect. To address this issue, we performed retrosternal gastric reconstruction with duodenal diversion plus Roux‐en‐Y anastomosis (RY) in eight patients with thoracic esophageal cancer and compared the outcomes with control patients who underwent standard reconstruction. The procedure is simple, safe, and not associated with any postoperative complications. The pancreatic amylase concentrations in the gastric juice samples on postoperative day 2 were slightly lower in the non‐RY group than in the RY group (1884 ± 2152 vs... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5098513 Thu, 04 Aug 2011 23:00:00 +0100 5098513 http://www.medworm.com/index.php?rid=5098512&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01230.x In conclusion, the F‐P fusion gene was not detected with increased frequency in EoE. Patients with EoE had a trend toward higher levels of pERK 1/2, but not STAT5, in the esophageal epithelium, with highest levels in steroid‐refractory EoE patients. (Source: Diseases of the Esophagus) Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5098512 Thu, 04 Aug 2011 23:00:00 +0100 5098512 http://www.medworm.com/index.php?rid=5098511&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01231.x SUMMARYAnkaferd Blood Stopper (ABS) is an herbal extract that enhances mucosal healing. The aim of this study was to investigate the efficacy of ABS on the healing of the esophagus and prevention of stricture development after esophageal caustic injuries in rats. The study included 50 rats. Rats were divided into five groups: group 1 (no injury, sham surgery), group 2 (injury + no ABS + study after 2 weeks of injury), group 3 (injury + ABS + study after 2 weeks of injury), group 4 (injury + no ABS + study after 4 weeks of injury), and group 5 (injury + ABS + study after 4 weeks of injury). Standard esophageal burn injury was created by applying 50% NaOH solution to distal esophagus of about 1.5 cm. To rats in the sham group, isotonic solution was given instead of NaOH. ABS (2 mL/day) w... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5098511 Thu, 04 Aug 2011 23:00:00 +0100 5098511 http://www.medworm.com/index.php?rid=5098510&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01232.x SUMMARYMany techniques have been proposed for esophageal reconstruction after esophagectomy when a gastric tube cannot be employed. There are two essential criteria for such a substitute: substitute length and sufficient blood supply. We propose ileocolic interposition as an easy and safe option. Two technical aspects contributing to the high success rate of this method are the preservation of an intact arterial network allowing normal blood flow to the ileocolic area, and the ability to quantify blood flow using a Doppler pulse flow meter in six cases. These are enabled by a long (up to 20 cm) ileocolic segment. The preservation of the right colic artery is important, because its interruption would reduce blood supply to the long ileum segment. Between July 2003 and October 2008, we use... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5098510 Thu, 04 Aug 2011 23:00:00 +0100 5098510 http://www.medworm.com/index.php?rid=5209846&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01249.x SUMMARYAchalasia is a rare disease of the esophagus that has an unknown etiology. Genetic, infectious, and autoimmune mechanisms have each been proposed. Autoimmune diseases often occur in association with one another, either within a single individual or in a family. There have been separate case reports of patients with both achalasia and one or more autoimmune diseases, but no study has yet determined the prevalence of autoimmune diseases in the achalasia population. This paper aims to compare the prevalence of autoimmune disease in patients with esophageal achalasia to the general population. We retrospectively reviewed the charts of 193 achalasia patients who received treatment at Toronto's University Health Network between January 2000 and May 2010 to identify other autoimmune diseas... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5209846 Mon, 01 Aug 2011 04:00:00 +0100 5209846 http://www.medworm.com/index.php?rid=5184744&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01242.x SUMMARYIt has been suggested that interleukin 6 (IL‐6) plays a potential role in the growth and progression of tumors, including esophageal cancer (EC). The aim of the study was to compare clinical significance of serum IL‐6 with classic tumor markers – carcinoembryonic antigen (CEA) and squamous cell cancer antigen (SCC‐Ag) – in EC patients in relation to its histological types – squamous cell carcinoma of esophagus (ESCC) and adenocarcinoma (AD) of esophagus. The study included 53 EC patients and 90 healthy subjects. Serum IL‐6 and CEA levels were determined using immunoenzyme assays, while SCC‐Ag – chemiluminescent assay. The diagnostic criteria and prognostic values for markers were defined. The levels of all proteins tested in EC, ESCC, and AD were higher than in hea... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5184744 Sun, 31 Jul 2011 23:00:00 +0100 5184744 http://www.medworm.com/index.php?rid=5163054&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01237.x SUMMARYNo conservative treatments for chylothorax have yet been established, and surgical ligation of the thoracic duct is required in many cases. In the present study, we investigated the management of body fluid in a canine chylothorax model. Twelve beagle dogs were divided evenly into three groups: A, B, and C. Under general anesthesia, the thoracic duct was cut and opened, and the amount of lymph fluid leakage was measured. Intravenous extracellular fluid infusion was started at 5 mL/kg/h for the first 2 h, and then between 2 and 4 h, the infusion rate was increased to 10 mL/kg/h in group A and to 20 mL/kg/h in group B. During the first 2 h after cutting the thoracic duct, the mean lymph fluid leakage rates in groups A, B, and C were 0.466, 0.635, and 0.575 mL/kg/h, respe... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5163054 Sun, 31 Jul 2011 23:00:00 +0100 5163054 http://www.medworm.com/index.php?rid=5132791&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2010.01166.x SUMMARYNonerosive reflux disease (NERD) is classified into grade M (minimal change, endoscopically; erythema without sharp demarcation, whitish turbidity, and/or invisibility of vessels due to these findings) and grade N (normal) in the modified Los Angeles classification system in Japan. However, the classification of grades M and N NERD is not included in the original Los Angeles system because interobserver agreement for the conventional endoscopic diagnosis of grades M or N NERD is poor. Flexible spectral imaging color enhancement (FICE) is a virtual chromoendoscopy technique that enhances mucosal and vascular visibility. The aim of this study is to evaluate whether the endoscopic diagnosis of grades M or N NERD using FICE images is feasible. Between April 2006 and May 2008, 26 NERD pa... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5132791 Sun, 31 Jul 2011 23:00:00 +0100 5132791 http://www.medworm.com/index.php?rid=5053547&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01223.x The objectives were to study the role of EUS in diagnosing esophageal tuberculosis, to differentiate primary from secondary form, and to assess the response. Retrospective analysis of data over 7 years (i.e. from 2003 to 2009) was used. The study was set in a tertiary care referral institute and focused on patients diagnosed with esophageal tuberculosis. Interventions used included endoscopy, EUS, EUS‐FNA (fine needle aspiration) followed by antituberculosis treatment. The main outcome measurements were symptoms, endoscopic features, EUS features, pathological yield, and response to treatment. There were 32 cases of esophageal tuberculosis. The primary symptom was dysphagia, and endoscopy showed ulcers in 18/32 (56.25%) and extrinsic bulge in 20/32 (62.5%) in middle one third of esopha... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5053547 Wed, 20 Jul 2011 23:00:00 +0100 5053547 http://www.medworm.com/index.php?rid=5053546&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01226.x SUMMARYEsophageal diverticula are rare. The association of cancer and diverticula has been described. Some authors adopt a conservative non‐surgical approach in selected patients with diverticula whereas others treat the symptoms by diverticulopexy or myotomy only, leaving the diverticulum in situ. However, the risk of malignant degeneration should be may be taken in account if the diverticulum is not resected. The correct evaluation of the possible risk factors for malignancy may help in the decision making process. We performed a literature review of esophageal diverticula and cancer. The incidence of cancer in a diverticulum is 0.3–7, 1.8, and 0.6% for pharyngoesophageal, midesophageal, and epiphrenic diverticula, respectively. Symptoms may mimic those of the diverticulum or underly... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5053546 Wed, 20 Jul 2011 23:00:00 +0100 5053546 http://www.medworm.com/index.php?rid=5053545&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01227.x SUMMARYTo assess adherence to proton pump inhibitor (PPI) treatment and associated variables in patients with gastroesophageal reflux disease (GERD). Cross‐sectional and prospective comprising 240 consecutive adult patients, diagnosed with GERD for whom continuous use of standard or double dose of omeprazole had been prescribed. Patients were ranked as ne‐GERD (162: 67.5%) or e‐GERD classified according to the Los Angeles classification as A (48:20.0%), B (21:8.6%), C (1:0.5%), D (1:0.5%), and Barrett's esophagus (7:2.9%). The Morisky questionnaire was applied to assess adherence to therapy and a GERD questionnaire to assess symptoms and their impact. Adherence was correlated with demographics, cotherapies, comorbidities, treatment duration, symptoms scores, endoscopic findings, and ... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5053545 Wed, 20 Jul 2011 23:00:00 +0100 5053545 http://www.medworm.com/index.php?rid=5031137&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01219.x SUMMARYThe aim of this study was to examine the expression of the molecular markers cyclooxygenase‐2 (COX‐2), Ki‐67, cyclin A, and p27 in patients with esophageal squamous cell carcinoma (ESCC), to ascertain the relationship of these makers with the clinicopathological significance of the patients, and to assess the additional prognostic value of the expression profile of these proteins for ESCC patients. The expression levels of COX‐2, Ki‐67, cyclin A, and p27 proteins of a series of primarily resected ESCC samples were determined by immunohistochemistry method. Clinicopathological and molecular factors affecting survival were analyzed by multivariate analysis. A total of 78 specimens were included in this study. Expression of COX‐2 was observed in 43 (55.1%) cases, and high l... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5031137 Thu, 14 Jul 2011 23:00:00 +0100 5031137 http://www.medworm.com/index.php?rid=5031136&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01220.x SummaryThis pooled analysis was performed using individual patient data from three phase II trials that included on the whole 113 esophageal cancer treated preoperatively with chemoradiotherapy (CRT), in order to analyze the efficacy and survival outcomes according to the achievement of the pathologic complete response (pCR). Thirty‐nine patients were treated with 5‐fluorouracil/cisplatin and RT (40 Gy), 33 patients received paclitaxel/cisplatin weekly during weeks 1–6 with and RT (46 Gy), 41 patients were treated with induction bio‐chemotherapy with cetuximab and FOLFOX‐4 followed by concomitant cetuximab and RT of 50.4 Gy. One hundred and two out of 113 resected patients were included in the survival analysis. The median overall survival (OS) time for the whole population... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5031136 Thu, 14 Jul 2011 23:00:00 +0100 5031136 http://www.medworm.com/index.php?rid=5031135&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01221.x This study aimed to determine the effects of perioperative feeding with an immuno‐enhanced diet on immune competence in patients treated with neoadjuvant therapy followed by surgery. Because an immuno‐enhanced diet that contained several antioxidants was used, perioperative oxidative stress and the effects of the immuno‐enhanced diet on this stress were also investigated. Of 39 patients with esophageal cancer who underwent similar surgical procedures, 26 patients who received chemotherapy or chemoradiation therapy before surgery were randomly divided into two groups: group 1 (n= 14) was given an immuno‐enhanced diet for 5 days before surgery, and group 2 (n= 12) received no enteral feeding products before surgery. Group 3 (n= 13) consisted of patients that did not receive neoadju... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5031135 Thu, 14 Jul 2011 23:00:00 +0100 5031135 http://www.medworm.com/index.php?rid=5031134&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01222.x SummaryPara‐aortic lymph node (PALN) recurrence is often seen in patients with lower thoracic esophageal cancer treated by esophagectomy with extended lymph node dissection. However, the clinicopathological characteristics of patients with PALN metastasis and the significance of PALN dissection are unknown. A total of 283 patients with lower thoracic esophageal cancer underwent esophagectomy with lymphadenectomy at our hospital between April 1984 and March 2007. Among these 283 patients, 60 patients were enrolled in this retrospective study according to following criteria: (i) clinical T2 to T4 tumor, (ii) no clinical PALN metastasis, and (iii) received PALN dissection. PALN dissection was indicated by a tumor depth of at least T2 and no severe complications. The clinicopathological data... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5031134 Thu, 14 Jul 2011 23:00:00 +0100 5031134 http://www.medworm.com/index.php?rid=5098509&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01233.x SUMMARYLeventhal's common sense model has provided a useful framework for explaining psychological distress in several chronic illnesses. The model indicates that a person's perception of their illness and their coping strategies are the key determinants of their experience of psychological distress. The present research examines whether illness perceptions and coping strategies are related to levels of psychological distress among survivors of esophageal cancer. Everyone registered with the Oesophageal Patients' Association in the UK was mailed a questionnaire booklet, which included the Illness Perception Questionnaire‐Revised, the Cancer Coping Questionnaire, and the Hospital Anxiety and Depression Scale. Complete responses were received from 484 people. Regression models indicated th... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5098509 Thu, 30 Jun 2011 23:00:00 +0100 5098509 http://www.medworm.com/index.php?rid=5053544&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01225.x SUMMARYNoncardiac chest pain (NCCP) is a common and challenging clinical problem. It is estimated that more than 70 million Americans (23% of the population) suffer from this condition yearly. Patients with NCCP represent a diagnostic dilemma. Their chest pain is often indistinguishable from cardiac pain leading to extensive and expensive evaluations. Once coronary artery disease and other cardiac and pulmonary sources of chest pain are excluded, patients are frequently referred to gastroenterologists to look primarily for esophageal sources of pain. A variety of diagnostic tests are available to the practicing clinician to identify the origin of pain, including ambulatory pH testing, esophageal motility, upper endoscopy, provocative testing and even therapeutic trials. (Source: Diseases o... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5053544 Thu, 30 Jun 2011 23:00:00 +0100 5053544 http://www.medworm.com/index.php?rid=4938466&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01215.x SUMMARYPrognosis of patients with recurrent esophageal cancer is usually unsatisfactory. We have successfully treated five patients with cervical node recurrence after esophagectomy with multimodal treatment including salvage lymphadenectomy. In order to clarify the efficacy of salvage surgery for cervical node recurrence, we have reviewed the clinical course and prognosis of these patients. From August 2004 to December 2007, 30 patients with 33 recurrent sites were treated in the Department of Surgery, Iizuka Hospital. Among these patients, there were five patients with recurrence limited within the cervical nodes. Salvage cervical lymphadenectomy was performed for all five patients. Curative resection was achieved in four patients and reduction surgery followed by planned chemoradiothera... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4938466 Tue, 14 Jun 2011 23:00:00 +0100 4938466 http://www.medworm.com/index.php?rid=4938465&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01216.x (Source: Diseases of the Esophagus) Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4938465 Tue, 14 Jun 2011 23:00:00 +0100 4938465 http://www.medworm.com/index.php?rid=4923774&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01213.x SUMMARYThe aim of the study was to evaluate the expression of tumor suppressor genes p53, fragile histidine triad gene (FHIT), and an oncogene insulin‐like growth factor 2 (IGF2) as prognostic markers in the etiology of esophageal cancer. Immunohistochemistry (IHC) was performed in 39 archival tissue samples of different esophageal pathologies for the three genes. Abnormal p53 expression was maximum in all the cases of squamous cell carcinoma, while IGF2 expression was enhanced in squamous cell carcinoma (81%), adenocarcinoma (100%), and dysplasia of squamous epithelium (75%) samples when compared with normals (50%). To our surprise, 75% of normal tissues did not show FHIT expression, which was also not seen in 40% of dysplasias of squamous epithelium, 33.3% of adenocarcinoma, and 41% of... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4923774 Thu, 09 Jun 2011 23:00:00 +0100 4923774 http://www.medworm.com/index.php?rid=4923773&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01212.x In conclusion, impedance‐barium esophagram concordance is high for swallows with normal esophageal emptying and for severe barium stasis in patients with dysphagia. (Source: Diseases of the Esophagus) Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4923773 Thu, 09 Jun 2011 23:00:00 +0100 4923773 http://www.medworm.com/index.php?rid=4923772&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2010.01136.x The objective of this study was to report the ECE findings in patients with GER symptoms and validate a new scoring system to assess ECE video quality. Five hundred two ECE were performed in patients with GER symptoms. We devised a new grading scale called ECE Utility score to assess the quality of images using five different parameters: anatomic landmarks visualized, esophageal transit time, image quality, illumination, and artifacts. The ECE cases were independently scored by two interpreters in a randomized, blinded fashion. Reflux esophagitis was diagnosed via ECE in 254 patients (50.5%). We identified 12 cases (2.4%) with suspected Barrett's esophagus and all of them had endoscopic evidence of Barrett's esophagus on esophagogastroduodenoscopy. Histologic confirmation Barrett's esophag... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4923772 Thu, 09 Jun 2011 23:00:00 +0100 4923772 http://www.medworm.com/index.php?rid=4843357&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01201.x SUMMARYEsophageal cancer is an extremely lethal human disease. Relatively little is known about the molecular mechanisms leading to esophageal cancers, nor the signaling pathways activated to maintain and augment the tumor growth. Esophageal cancer cell lines were evaluated to assess the effect of phorbol 12,13 dibutyrate on protein kinase C activity, indirectly using protein kinase D (formerly known as protein kinase C‐μ), Akt activity, and cell proliferation. Treatment of esophageal cancer cell lines with the phorbol ester phorbol 12,13 dibutyrate led to a rapid and dramatic increase in the activation of protein kinase D. In addition, administration of phorbol 12,13 dibutyrate also decreased the phosphorylation of Akt. Interestingly, in the OE19 esophageal adenocarcinoma cell line, tr... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4843357 Wed, 18 May 2011 23:00:00 +0100 4843357 http://www.medworm.com/index.php?rid=4843356&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01202.x SUMMARYEsophageal symptoms often co‐occur. A validated self‐report measure encompassing multiple esophageal symptoms is necessary to determine their frequency and severity both independently and in association with each other. Such a questionnaire could streamline the diagnostic process and guide patient management. We aimed to develop an integrative measure that provides a clinical ‘snapshot’ of common esophageal symptoms. Internal reliability and content validity of a 38‐item self‐report Esophageal Symptoms Questionnaire (ESQ), measuring the frequency and severity of typical esophageal symptoms using Likert‐rating scales were assessed in 211 patients presenting to gastroenterology and ENT outpatient tertiary care clinics. Reproducibility, concurrent and predictive validity ... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4843356 Wed, 18 May 2011 23:00:00 +0100 4843356 http://www.medworm.com/index.php?rid=4843355&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01203.x SUMMARYThe aim of this study was to assess whether p53 codon 72 polymorphism is associated with an increased risk of esophageal cancer (EC) in South Korea. We conducted a case‐control study including 340 patients with EC, and 1700 controls. P53 codon 72 polymorphism was determined by real‐time polymerase chain reaction. The frequencies of p53 codon 72 polymorphisms (Arg/Arg, Arg/Pro, and Pro/Pro) in EC were 39.4%, 45.6%, and 15.0%, respectively; frequencies in the controls were 43.2%, 45.6%, and 11.2%, respectively. Compared with the Arg/Arg genotype, the OR of the Arg/Pro genotype was 1.09 (95% CI = 0.85–1.41) and that of the Pro/Pro genotype was 1.47 (95% CI = 1.02–2.11) for EC overall. When adjusted by age, gender, and smoking status, the OR of the Arg/Pro genotype was 1... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4843355 Wed, 18 May 2011 23:00:00 +0100 4843355 http://www.medworm.com/index.php?rid=4843354&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01204.x SummaryTreatment strategy of esophageal cancer mainly depends on accurate staging. At present, no single ideal staging modality is superior to another in preoperative tumor‐node‐metastasis (TNM) staging of patients with esophageal cancer. We aimed to investigate the efficacy of endoscopic ultrasonography (EUS) and positron emission tomography‐computed tomography (PET‐CT) for staging of esophageal cancer. We retrospectively studied 118 consecutive patients with esophageal squamous cell carcinoma who underwent esophagectomy with or without neoadjuvant chemoradiotherapy (CRT) over a near 3‐year period between January 2005 and November 2008 at a tertiary hospital in Taiwan. Patients were separated into two groups: without neoadjuvant CRT (group 1, n= 28) and with CRT (group 2, n= 90)... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4843354 Wed, 18 May 2011 23:00:00 +0100 4843354 http://www.medworm.com/index.php?rid=4843353&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01205.x SUMMARYAlthough gastresophageal reflux disease (GERD) is highly prevalent in Western countries, we have very little data about it in African countries. The aim of the study is to determine the prevalence and severity of GERD symptoms among Tunisian subjects and report its characteristics, consultation rate, management modes, as well as patients' satisfaction. Five hundred subjects living in Tunisia were interviewed face to face. The study was conducted at seven centers of primary care at Monastir's department by six interviewer doctors. The questionnaire consisted of 30 questions relating to subject attributes, lifestyle factors, medical history, reflux‐related symptom characteristics, consultation behavior, previous treatments for GERD, and description of the last episode. Symptoms were... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4843353 Wed, 18 May 2011 23:00:00 +0100 4843353 http://www.medworm.com/index.php?rid=4843352&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01206.x SUMMARYPatients with esophageal cancer may present with dysphagia and weight loss. Resectable lesions require consideration of neoadjuvant chemotherapy, which improves survival but have side effects, which compound already poor intake. Prevention of malnutrition has historically required interventions such as surgical jejunostomy or percutaneous endoscopic gastrostomy, which carry associated morbidity. With established roles in palliation, self‐expanding removable metal stents (SERMS) may provide an alternative intervention in resectable disease. We sought to evaluate outcomes from our unit's introduction of SERMS in dysphagic patients prior to esophagectomy. All dysphagic patients presenting with esophageal cancer and considered for curative surgery between April 2006 and November 2008 ... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4843352 Wed, 18 May 2011 23:00:00 +0100 4843352 http://www.medworm.com/index.php?rid=4843351&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01207.x This article summarizes the most salient issues in the diagnosis and management of achalasia as discussed in a symposium that took place in Kagoshima, Japan, in September 2010 under the auspices of the International Society for Diseases of the Esophagus. (Source: Diseases of the Esophagus) Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4843351 Wed, 18 May 2011 23:00:00 +0100 4843351 http://www.medworm.com/index.php?rid=4843350&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01208.x SUMMARYMuscularis externa of mouse esophagus is composed of two skeletal muscle layers in the adult. But less attention is paid to the histogenesis of the muscularis externa of the esophagus, and controversies still exist about the developmental process and the spatio–temporal expression characteristics of muscle‐specific proteins during the development of esophageal muscularis externa. To further probe into the developmental pattern of muscularis externa of the mouse esophagus and the expression characteristics of different muscle‐specific proteins, immunohistochemical and terminal deoxyribonucleotidyl transferase‐mediated deoxyuridine triphosphate (dUTP)‐digoxigenin nick‐end labeling apoptotic staining methods are used to investigate the expression patterns of different muscl... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4843350 Wed, 18 May 2011 23:00:00 +0100 4843350 http://www.medworm.com/index.php?rid=4843349&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01209.x SUMMARYThe purpose of this study was to evaluate hypoxia in esophageal squamous cell carcinoma (SCC) with 18F‐fluoroerythronitroimidazole positron emission tomography/computed tomography (18F‐FETNIM PET/CT). We determined an imaging threshold for hypoxia, quantified the spatiotemporal variability of hypoxia in untreated tumor, and evaluated the ability of 18F‐FETNIM PET to predict clinical response following concurrent chemoradiotherapy (CCRT). Twenty‐eight consecutive patients with inoperable SCC of the esophagus were consecutively accrued between April 2007 and June 2010. The first 10 patients received two pretreatment 18F‐FETNIM PET/CT scans on separate days. The remaining 18 patients only underwent 18F‐FETNIM PET/CT once before CCRT. The ratio of the maximum standardized up... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4843349 Wed, 18 May 2011 23:00:00 +0100 4843349 http://www.medworm.com/index.php?rid=4783231&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01196.x (Source: Diseases of the Esophagus) Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4783231 Mon, 02 May 2011 23:00:00 +0100 4783231 http://www.medworm.com/index.php?rid=4783230&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01195.x This study evaluated the role of miniprobe endosonography (EUS) to predict the survival of ESCC patients after concurrent chemoradiation therapy (CCRT). This study prospectively enrolled ESCC patients to receive high‐frequency miniprobe EUS for the assessments of the tumor size and tumor–node–metastasis (TNM) stage. For the patients defined with advanced stages to receive CCRT as initial therapy, the tumor size parameters assessed by EUS were analyzed for their correlation with the treatment response and the patients' survivals. Fifty‐four patients, >96% with advanced TNM stage III or IV, were enrolled with a medium follow‐up of 320.5 days. Almost all of the 54 cases had partial or complete stricture of the esophageal lumens due to the tumor obstructions at enrollment. The ove... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4783230 Mon, 02 May 2011 23:00:00 +0100 4783230 http://www.medworm.com/index.php?rid=4783229&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01197.x SUMMARYGranular cell tumors (GCT) are uncommon neoplasms. There is controversy regarding the endoscopic diagnosis and treatment of esophageal GCT. We studied the endoscopic diagnosis and management of esophageal GCT among 23 patients identified in a single‐institution pathology database. Medical records, pathology, and endoscopic images were reviewed. All patients underwent endoscopy and endoscopic ultrasonography (EUS), and endoscopic resection was performed in 10 patients. Seven of 23 patients had more than one esophageal GCT. Only six lesions exhibited a classic yellow discoloration. Among patients with a single GCT, three, four, and nine lesions were located in the proximal, middle, and distal esophagus, respectively. EUS showed hypoechoic, smooth‐edged lesions usually confined to ... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4783229 Mon, 02 May 2011 23:00:00 +0100 4783229 http://www.medworm.com/index.php?rid=4783228&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01198.x SUMMARYThe relationship between non‐steroidal anti‐inflammatory drug (NSAID) use and esophageal squamous cell carcinoma (ESCC) has remained unclear. To evaluate the relationship between NSAID use and risk of ESCC, we searched the MEDLINE, Biosis, Web of Science and ISI proceedings databases up to September 2010, together with a manual search of reference lists of relevant articles. Studies evaluating the association between exposure to NSAIDs and risk of ESCC were included. The analyses used random‐effect or fixed‐effect model based on homogeneity analysis. Seven studies (six case‐control studies and one nested case‐control study) were included in this meta‐analysis. NSAID use was associated with a reduced risk of ESCC (odds ratio = 0.58, 95% confidence interval = 0.47 to 0.7... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4783228 Mon, 02 May 2011 23:00:00 +0100 4783228 http://www.medworm.com/index.php?rid=4783227&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01199.x SUMMARYTo explore the role of DNA methyltransferase 1 (DNMT1) in esophageal squamous cell carcinoma (ESCC) and the potential of DNMT1‐targeted small interfering RNA as ESCC therapy, we examined expression changes of DNMT1 in ESCC and investigated the effect of DNMT1 knockdown by RNA interference in a human ESCC cell line, KYSE30. DNMT1 messenger RNA was over‐expressed in seven out of 12 ESCC samples, and the percentage of cells expressing DNMT1 was significantly higher in ESCC tissues compared with paired non‐cancerous tissues. DNMT1 protein levels correlated with lymph node metastasis, but exhibited no correlation with sex, age, tumor site, or tumor differentiation. Knockdown of DNMT1 in KYSE30 cells using RNA interference resulted in a reduction of promoter methylation and re‐exp... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4783227 Mon, 02 May 2011 23:00:00 +0100 4783227 http://www.medworm.com/index.php?rid=5031133&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01224.x (Source: Diseases of the Esophagus) Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=5031133 Sat, 30 Apr 2011 23:00:00 +0100 5031133 http://www.medworm.com/index.php?rid=4946910&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01217.x SUMMARYThe prognostic effect of p21WAF1 expression on esophageal squamous cell carcinoma patients is controversial. Further clarifying the effect of this protein is beneficial for optimizing the patient outcomes. In the current study, we investigated the expression of p21WAF1 protein in 189 specimens of stage III ESCC by immunohistochemistry. As shown by the Kaplan–Meier curve, the overall survival rate of the positive‐expression group was significantly higher than that of the negative‐expression group (P < 0.05). No significant correlation was observed between p21WAF1 expression and clinicopathological parameters in terms of gender, age, tumor location, tumor grade, pathological stage, and number of regional lymph node metastases (P > 0.05). We concluded that p21WAF1 played an... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4946910 Sat, 30 Apr 2011 23:00:00 +0100 4946910 http://www.medworm.com/index.php?rid=4938464&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01218.x SUMMARYWireless pH studies are widely used to assess the presence and severity of gastroesophageal reflux disease. We hypothesized that sedation or air insufflation during a preceding endoscopy may systematically alter results. A retrospective review of ambulatory pH studies completed between January 2008 and April 2010 was performed. The pH capsule was placed 6 cm above the endoscopically determined location of the squamocolumnar junction or 5 cm above the manometrically localized upper border of the lower esophageal sphincter (LES). A total of 356 patients (65% women) underwent pH studies using the BRAVO system (GIVEN Imaging, Yoqneam, Israel). In 186 patients (E‐P), the capsule was placed during endoscopy. In 170 patients (M‐P), capsule placement was based on manometric determin... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4938464 Sat, 30 Apr 2011 23:00:00 +0100 4938464 http://www.medworm.com/index.php?rid=4923771&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01214.x SUMMARYMarkedly increased esophageal eosinophils are associated with allergy‐ or reflux‐based eosinophilic esophagitis. Other known disorders that cause this entity are unusual. To characterize the clinical, endoscopic, and histological findings of patients who develop marked esophageal eosinophilic infiltration after ablative therapy for Barrett's dysplasia. All patients who underwent endoscopic ablation of Barrett's esophagus between 1991 and 2009 with photodynamic therapy or radio frequency were screened for a pathologic descriptor of ‘eosinophils’ on biopsy. Patients whose biopsies demonstrated >15 eosinophils per high power (HPF) field in squamous epithelium after ablation were reviewed and included in the study group. Thirteen of 385 (3.4%) patients underwent ablation for ... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4923771 Sat, 30 Apr 2011 23:00:00 +0100 4923771 http://www.medworm.com/index.php?rid=4864954&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2010.01155.x In conclusion, the incidence of EGFR mutations in Chinese patients with ESCC was higher than that of previous reports, and the incidence of KRAS mutations was not low. EGFR and KRAS mutations were mainly located in exons 19 and 21 and codon 12, respectively. Unlike in NSCLC, concurrent EGFR and KRAS mutations existed. (Source: Diseases of the Esophagus) Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4864954 Sat, 30 Apr 2011 23:00:00 +0100 4864954 http://www.medworm.com/index.php?rid=4705680&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01192.x We reported a 14‐year‐old male who presented with 1‐year history of gradually worsening dysphagia and was found to have two salmon‐colored patches, which resemble gastric mucosa, in the proximal esophagus causing significant esophageal stricture. Gastric cardiac‐type mucosa with acute and chronic inflammation was documented on biopsy. After several sessions of balloon dilation and endoscopic treatment, the HGM and esophageal stricture resolved and he became asymptomatic. (Source: Diseases of the Esophagus) Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4705680 Tue, 12 Apr 2011 23:00:00 +0100 4705680 http://www.medworm.com/index.php?rid=4705679&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01193.x SUMMARYThe aim of this study was to determine the factors influencing acidity in the gastric conduit after esophagectomy for cancer. Acidity and bile reflux in the stomach and in the gastric conduit were examined by 24‐h pH monitoring and bilimetry in 40 patients who underwent transthoracic subtotal esophagectomy followed by esophageal reconstruction using a gastric conduit, which was pulled up to the neck through a posterior mediastinal route in 17 patients, through a retrosternal route in 10 patients, and through a subcutaneous route in 13 patients. They were examined at 1 week before surgery, at 1 month after surgery, and at 1 year after surgery. Helicobacter pylori infection was examined pathologically and using the 13C‐urea breath test. The factors influencing acidity of the gastr... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4705679 Tue, 12 Apr 2011 23:00:00 +0100 4705679 http://www.medworm.com/index.php?rid=4843348&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01210.x SUMMARYThe oropharyngeal swallow involves a rapid, highly coordinated set of neuromuscular actions beginning with lip closure and terminating with opening of the upper esophageal sphincter. Evaluation of the oropharyngeal swallow usually involves the use of a modified barium swallow radiographic study with the goals of (i) defining the patient's swallow anatomy and physiology causing the dysphagia; and (ii) evaluating the immediate effectiveness of treatment procedures including selected postures, sensory enhancement, swallow maneuvers, and diet changes. Exercise programs may be helpful, but their immediate effects cannot be examined during the initial modified barium swallow. Exercise programs can be evaluated on a second radiographic study 3–4 weeks later. The resultant report should i... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4843348 Thu, 31 Mar 2011 23:00:00 +0100 4843348 http://www.medworm.com/index.php?rid=4783226&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01200.x (Source: Diseases of the Esophagus) Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4783226 Thu, 31 Mar 2011 23:00:00 +0100 4783226 http://www.medworm.com/index.php?rid=4736628&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01186.x SUMMARYBarrett's esophageal (BE) metaplasia is a premalignant condition of the distal esophagus that develops as a consequence of gastroesophageal reflux disease. The progression to carcinogenesis results from progressive dysplastic changes of the metaplastic epithelium through low‐grade and then high‐grade dysplasia (HGD) to eventually adenocarcinoma of the esophagus. The management of HGD is controversial with proponents for each of the three major management strategies: endoscopic surveillance, endoscopic ablative therapies, and esophagectomy. The aim of the study was to define and discuss the various management strategies of HGD arising from BE metaplasia. There is a paucity of randomized controlled data from which to draw definitive conclusions. All strategies for the management o... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4736628 Thu, 31 Mar 2011 23:00:00 +0100 4736628 http://www.medworm.com/index.php?rid=4705678&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01194.x SUMMARYEsophageal cancer surgery is traditionally performed by a number of open surgical approaches. Open approaches require thoracotomy and laparotomy. Developments in instrumentation and optics have allowed the use of minimally invasive approaches to esophageal cancer, which had been traditionally managed by open operation. Minimally invasive surgery (MIS) avoids thoracotomy and laparotomy and results in quicker return to normal functions and less morbidity. In this prospective study, we compared the immediate surgical and oncologic outcomes of patients who have undergone MIS with those who have had open surgery. From November 1, 2003 to March 30, 2006, 62 cases of carcinoma esophagus were operated in Surgical unit 3 (MIS unit) in the institute. Out of the 62 patients, 34 (54.8%) underwe... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4705678 Thu, 31 Mar 2011 23:00:00 +0100 4705678 http://www.medworm.com/index.php?rid=4637194&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01190.x SUMMARYCeliac disease (CD) may often be associated with various motor disorders affecting the different segments of the digestive tract, including the esophagus. Although it has not been universally reported, some available evidences indicate that pediatric and adult celiac patients could manifest a higher frequency of esophagitis and gastroesophageal reflux disease‐related symptoms compared to nonceliac patients. In addition, several published studies have consistently shown the efficacy of a gluten‐free diet in rapidly controlling esophageal symptoms and in preventing their recurrence. Since the participation of gluten in the esophageal symptoms of CD seems clear, its intimate mechanisms have yet to be elucidated, and several hypothesis have been proposed, including the specific immu... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4637194 Fri, 25 Mar 2011 00:00:00 +0100 4637194 http://www.medworm.com/index.php?rid=4611694&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01185.x SUMMARYComplications occur frequently after esophagectomy. Identifying the risk of complications preoperatively may help in patient selection and postoperative management. We performed a retrospective review of patients who underwent esophagectomy between 1980 and 2009. A previously reported scoring system was used to estimate risk, and its ability to predict complications was assessed. A total of 514 patients (382 men; 74%) with a mean age of 59.0 ± 12.5 years underwent esophagectomy for cancer (398; 77%) or benign disease. Minor complications occurred in 224 patients (44%) and severe complications occurred in 134 patients (26%). The calculated risk score was based on weighted values for age, coronary artery disease, cerebrovascular disease, type of operation, and forced expiratory volum... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4611694 Fri, 18 Mar 2011 00:00:00 +0100 4611694 http://www.medworm.com/index.php?rid=4611693&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01187.x We report a case of exfoliative esophagitis with pemphigus vulgaris. A sloughing esophageal cast observed by endoscopy was dissected esophageal squamous epithelium in all layers. Our case is the fifth case of pemphigus vulgaris associated with esophageal cast formation recorded in the medical literature. Prednisolone was administered, and both the pemphigus vulgaris and exfoliative esophagitis improved. Upon findings of exfoliative esophagitis by endoscopic examination, we should consider the coexistence of blistering skin diseases, including pemphigus vulgaris. (Source: Diseases of the Esophagus) Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4611693 Fri, 18 Mar 2011 00:00:00 +0100 4611693 http://www.medworm.com/index.php?rid=4611692&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01188.x SUMMARYSuccessful palliation of dysphagia in patients with inoperable esophageal carcinoma has a major effect on quality of life. Self‐expanding metal stents (SEMS) are currently recommended for rapid symptomatic relief when life expectancy is less than 3 months. We assessed complication and reintervention rates along with survival outcomes in patients with inoperable esophageal carcinoma undergoing stent insertion. A retrospective audit was performed from April 2007 to June 2009 for all inoperable primary esophageal carcinoma patients who had an esophageal stent inserted for dysphagia. Case notes were reviewed for clinical, pathological, stent and complication details, while ICD‐10 causes of death were obtained from the Department of Health and Social Services, Northern Ireland. Fifty... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4611692 Fri, 18 Mar 2011 00:00:00 +0100 4611692 http://www.medworm.com/index.php?rid=4611691&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01189.x SUMMARYStudies in the United States have revealed that gastroesophageal reflux disease (GERD) patients often suffer from nocturnal symptoms, sleep disturbance, and impaired quality of life. In a large subset of patients, these symptoms persist in spite of acid suppressive therapy. The aim of the present study was to assess the prevalence of heartburn and associated sleep complaints and the response to standard medical therapy with pantoprazole in primary and secondary care esophagitis patients in Belgium. Questionnaires were provided to consecutive patients presenting to primary and secondary care physicians with esophagitis. The questionnaire evaluated the presence of typical reflux symptoms, alarm symptoms, risk factors, and sleep quality impairment as a result of reflux episodes. Result... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4611691 Fri, 18 Mar 2011 00:00:00 +0100 4611691 http://www.medworm.com/index.php?rid=4562095&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01179.x The objective of the study was to characterize the uses of EBUS‐FNA in the evaluation of gastrointestinal lesions in patients with esophageal narrowing. The study design was a single‐center case series. The setting was in a tertiary referral center. Four patients underwent EBUS‐FNA to evaluate gastrointestinal lesions; esophageal strictures prevented EUS passage in three, the fourth patient did not tolerate transbronchial EBUS but had abdominal lesions within reach of the EBUS scope. EBUS was used to evaluate the liver, adrenal gland, a retroperitoneal mass, and a celiac axis lymph node. EBUS‐FNA has greater potential to evaluate abdominal lesions than has been previously recognized. The EBUS scope represents a safe and readily available technology to evaluate patients with esophag... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4562095 Tue, 08 Mar 2011 00:00:00 +0100 4562095 http://www.medworm.com/index.php?rid=4562094&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01178.x SUMMARYEsophageal emptying assessed at the ‘timed barium’ esophagogram correlates well with symptomatic outcomes after pneumatic dilation for esophageal achalasia, although 30% of patients with satisfactory outcome exhibit partial improvement in emptying. The aim of the study was to investigate any correlation of esophageal emptying to symptomatic response after laparoscopic Heller's myotomy and Dor's fundoplication. ‘Bread and barium’ (transit time of a barium opaque bread bolus) and ‘timed barium’ (height of esophageal barium column 5 minutes after ingestion of 200–250 mL of barium suspension) esophagogram was used to assess esophageal emptying in 73 patients with esophageal achalasia before 1 and 5 years (31 cases) after laparoscopic myotomy and anterior fundoplication. ... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4562094 Tue, 08 Mar 2011 00:00:00 +0100 4562094 http://www.medworm.com/index.php?rid=4562093&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01180.x This article focused on anatomy and physiology of the esophageal body. (Source: Diseases of the Esophagus) Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4562093 Tue, 08 Mar 2011 00:00:00 +0100 4562093 http://www.medworm.com/index.php?rid=4562092&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01181.x SUMMARYBioimpedance spectroscopy can identify pathological changes related to precancerous lesions of the cervix uteri and esophagus. It therefore has the potential to detect early reflux‐related changes in the esophageal mucosa, such as dilated intercellular spaces. The reliable detection of dilated intercellular spaces at the time of endoscopy would yield a significant diagnostic advantage for separating patients with functional heartburn from the large proportion of patients with gastroesophageal reflux symptoms but no macroscopic esophagitis or pathological acid exposure. The bioimpedance of the esophageal mucosa, measured with a small caliber probe, was evaluated in a series of preclinical experiments. First, sections of rabbit esophageal epithelium were mounted in Ussing chambers a... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4562092 Tue, 08 Mar 2011 00:00:00 +0100 4562092 http://www.medworm.com/index.php?rid=4562091&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01182.x SUMMARYSymptomatic dysphagia is believed to be more common in the older population; however, the factors that predict age‐related dysphagia are less well‐understood. Here, we describe a questionnaire‐based survey of swallowing dysfunction in a large, otherwise ‘healthy’ community dwelling older population in the UK in whom additional cognitive and depression related scores were evaluated. A postal survey using Sydney oropharyngeal dysphagia questionnaire was sent to 800 residences in the North of England that formed part of the University of Manchester Age and Cognitive Performance Longitudinal Study. This cohort was composed of older individuals (mean age 81 [range 69–98 years]) who are otherwise healthy with no history of previous neurological disease. The postal questionnair... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4562091 Tue, 08 Mar 2011 00:00:00 +0100 4562091 http://www.medworm.com/index.php?rid=4562090&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01183.x SUMMARYIt is not known whether patients diagnosed with esophageal and junctional cancer aged younger than 50 years have a more aggressive disease phenotype and thus poorer outcomes following treatment. Prospectively maintained database records of all patients diagnosed with esophageal carcinoma (n= 2129) over a 20‐year period (1990–2009) in a single institution were analyzed. Patients aged less than 50 years at diagnosis (n= 170) were compared with those over 50 years with respect to clinicopathological stage and oncological outcomes. There was a significantly greater proportion of male patients (77.4 vs. 64.7%) among the younger group (P= 0.001). Patients were more likely to be diagnosed with an esophagogastric junction tumor (P= 0.002) and to have symptoms for a longer period prior t... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4562090 Tue, 08 Mar 2011 00:00:00 +0100 4562090 http://www.medworm.com/index.php?rid=4562089&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2011.01184.x SUMMARYThe purpose of this review is to consider the neuromuscular mechanism of LES contractility both by itself and in relation to the esophagogastric junction (EGJ) complex in order to appreciate the intricacies of EGJ valvular function. (Source: Diseases of the Esophagus) Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4562089 Tue, 08 Mar 2011 00:00:00 +0100 4562089 http://www.medworm.com/index.php?rid=4456339&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2010.01172.x SUMMARYDiffuse esophageal spasm (DES) is a rare primary motility disorder of unknown cause, that can be found in patients complaining of chest pain and dysphagia and in whom ischemic heart disease and GERD have been excluded. The manometric hallmark of DES is the presence of simultaneous contractions in the distal esophagus alternating with a normal peristalsis. Even at specialized esophageal motility laboratories, DES is considered an uncommon diagnosis.In this review, the authors discuss the clinical and diagnostic aspects of this disease, as well as the possible therapeutic options (medical, endoscopic or surgical therapy). Surgery (esophageal myotomy performed through a thoracotomy or with a thoracoscopic access) seems to have a better outcome than medical or endoscopic treatment, and ... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4456339 Thu, 10 Feb 2011 00:00:00 +0100 4456339 http://www.medworm.com/index.php?rid=4456338&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2010.01173.x SUMMARYPublished data on the long‐term survival results of patients with localized esophageal carcinoma receiving late course accelerated hyper‐fractionated radiotherapy (LCAF RT) versus conventional fractionated radiotherapy (CF RT) are inconclusive. In order to derive a more precise estimation of the both treatment‐regimes, a meta‐analysis based on systematic review of published articles was performed. A meta‐analysis was performed using trials identified through Pubmed and Chinese national knowledge infrastructure. Results in 5‐year survival and 5‐year local control were collected from randomized trials comparing LCAF RT with CF RT. Review Manager (The Cochrane Collaboration, Oxford, England) and Stata software (Stata Corporation, College Station, TX, USA) were used for da... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4456338 Thu, 10 Feb 2011 00:00:00 +0100 4456338 http://www.medworm.com/index.php?rid=4456337&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2010.01174.x In conclusion, symptoms, performance status, and use of analgesics seemed to better prognosticate survival than tumor characteristics other than stage of disease. Our study reveals that knowledge about prognostic factors is crucial for the choice of palliative treatment. Even though all of the different treatment modalities seemed to provide relief of dysphagia, several other factors should be considered when deciding which treatment modality to offer. The time to onset of relief, duration of response, level of complications, and time spent in hospital should be a part of the decision‐making process when selecting the appropriate treatment. (Source: Diseases of the Esophagus) Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4456337 Thu, 10 Feb 2011 00:00:00 +0100 4456337 http://www.medworm.com/index.php?rid=4456336&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2010.01175.x We describe a case of a neonate with EA with TEF in which the upper atretic esophageal pouch had grown long enough to reach up to the level of diaphragm, thus allowing the IFT to go up to significant distance from the alveolus giving the radiograph as if the tube is in the upper part of stomach, thus creating a diagnostic dilemma. (Source: Diseases of the Esophagus) Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4456336 Thu, 10 Feb 2011 00:00:00 +0100 4456336 http://www.medworm.com/index.php?rid=4456335&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2010.01176.x 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 expression profile of CIM and BE suggests that they may share a common etiology in the majority of patients with a similar biology, and calls into question the perception that CIM is an innocuous process. (Source: Diseases of the Esophagus) Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4456335 Thu, 10 Feb 2011 00:00:00 +0100 4456335 http://www.medworm.com/index.php?rid=4456334&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2010.01160.x The objective of the study was to compare acid exposition in three different levels: 5 cm above the upper border of the LES, 1 cm above the LES and in the intrasphincteric region. Eleven patients with Barrett's esophagus after Nissen fundoplication with no clinical, endoscopic and radiologic evidence of reflux were selected. Four‐channel pH monitoring took place: channel A, 5 cm above the upper border of the LES; channel B, 1 cm above the LES; channel C, intrasphincteric; channel D, intragastric. The results of channels A, B and C were compared. There was significant increase in number of reflux episodes and a higher fraction of time with pH <4.0 in channel B compared to channel A. There was significant decrease in fraction of time with pH <4.0 in channel B compared to chan... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4456334 Thu, 10 Feb 2011 00:00:00 +0100 4456334 http://www.medworm.com/index.php?rid=4456333&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2010.01161.x This study demonstrated that a CME course significantly enhanced the technical skills and knowledge of gastroenterology fellows in esophageal balloon dilation and HRM interpretation. CME courses such as this may be a valuable adjunct to standard fellowship training in gastroenterology. (Source: Diseases of the Esophagus) Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4456333 Thu, 10 Feb 2011 00:00:00 +0100 4456333 http://www.medworm.com/index.php?rid=4456332&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2010.01162.x This report summarizes the technical description of this procedure. TL and cervical esophagectomy were performed and bilateral PMCFs were harvested for reconstruction of hypopharyngeal and cervical esophageal defects in 25 patients aged between 46 and 73 years (mean 58.7 ± 16.2 years). All these patients had advanced‐stage (IV) cancer with involvement of the cervical esophagus. Operative time ranged from 176 to 382 minutes (average 243 ± 91 minutes) and the mean intraoperative blood loss was 294 ± 119 mL. There were six cases of anastomotic leak (24.0%) and two of them (8.0%) developed anastomotic stricture. Neither flap necrosis nor postoperative death was observed. The majority of our patients (68.0%) were restored to a normal unrestricted oral diet after surgery. The 3‐year and... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4456332 Thu, 10 Feb 2011 00:00:00 +0100 4456332 http://www.medworm.com/index.php?rid=4456331&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2010.01163.x In conclusion, surgery may become a standard treatment for cT1 esophageal cancer that can offer longer relapse‐free survival, particularly for patients with tumors that invade the submucosa. (Source: Diseases of the Esophagus) Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4456331 Thu, 10 Feb 2011 00:00:00 +0100 4456331 http://www.medworm.com/index.php?rid=4456330&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2010.01164.x The objective of this study were to compare the accuracy of white light, narrow band imaging (NBI), and Lugol to detect esophageal neoplasia in patients with a history of cured ESCC, in a prospective study. Thirty patients were prospectively included between June 2006 and June 2009. They all had a history of cured ESCC. Esophageal mucosa was examined first using white light, second NBI, and third after Lugol staining. Histology was obtained in all abnormalities detected by white light, NBI, and/or Lugol. Five neoplastic lesions in five different patients were identified at histology, four cancers, and one high‐grade dysplasia. NBI and Lugol both detected all esophageal neoplastic lesions, whereas white light detected the four cancers but missed the high‐grade dysplasia. In this feasibi... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4456330 Thu, 10 Feb 2011 00:00:00 +0100 4456330 http://www.medworm.com/index.php?rid=4456329&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2010.01165.x SUMMARYEsophagectomy is associated with substantial morbidity and mortality, yet it is the only modality that offers the possibility of cure for esophageal and gastroesophageal junction (E‐GEJ) adenocarcinoma. Several minimally invasive techniques have been developed to decrease the morbidity of the operation, but to date, the results have not led to its wide adoption in part due to their complexity. We developed a technique of laparoscopic‐assisted transhiatal esophagectomy (LA‐THE) with the idea of preserving some of the advantages of the minimally invasive approach while eliminating the degree of complexity and the time required to complete the operation solely using laparoscopy. The course of all patients who underwent LA‐THE for E‐GEJ adenocarcinoma at the University of Wash... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4456329 Thu, 10 Feb 2011 00:00:00 +0100 4456329 http://www.medworm.com/index.php?rid=4456328&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2010.01167.x SUMMARYEosinophilic esophagitis (EoE) has been associated with an increased risk of esophageal mucosal tears induced by vomiting to dislodge impacted food or following endoscopic procedures. However, Boerhaave's syndrome or transmural perforation of the organ resulting from vomiting induced to dislodge impacted food has rarely been reported. In this article, we present two male adult patients with long‐term esophageal symptoms who suffered from Boerhaave's syndrome after the impaction of food in the esophagus. Both patients required surgical management because of clinical and radiological signs of perforation. This rare complication of EoE has been documented in 11 other reports, predominantly affecting young men in whom EoE had not been previously diagnosed, despite the majority having ... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4456328 Thu, 10 Feb 2011 00:00:00 +0100 4456328 http://www.medworm.com/index.php?rid=4456327&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2010.01168.x SUMMARYTo evaluate the effect of different regimen of radiotherapy on multidrug resistance 1 (MDR1) expression and analyze the role hypoxia‐inducible factor 1α (HIF1α) played in the whole process. Fifty‐four cell lines established from 96 esophageal cancer biopsy samples were given various doses of fractioned irradiation. The mRNA and protein levels of HIF1α and MDR1 post‐irradiation were measured by quantitative reverse transcription–polymerase chain reaction and Western blot analysis, respectively. HIF1α–siRNA was used to verify the effect of HIF1α on radiation‐mediated MDR1 modulation. In esophageal cancer cells surviving 28 Gy irradiation (2 Gy/f, 14 fractions), MDR1 mRNA expression increased 65.27 ± 5.58%, and HIF1α was elevated by 27.21 ± 2.25%. Interestingly,... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4456327 Thu, 10 Feb 2011 00:00:00 +0100 4456327 http://www.medworm.com/index.php?rid=4456326&cid=s_30387_17_f&fid=30387&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1442-2050.2010.01169.x SUMMARYThe necessity of pyloroplasty after esophagectomy and gastric pull‐up is debated. Disadvantages of a standard pyloroplasty include the potential for leak, shortening of the length of the graft, and complexity when done during a minimally invasive procedure. The aim of this study is to report our experience with a novel internal pyloroplasty technique using a circular stapler (CS pyloroplasty), which is applicable for both laparoscopic and open esophagectomy. The records of all patients who underwent an esophagectomy with gastric pull‐up and pyloroplasty between 2002 and 2007 were reviewed. The CS pyloroplasty was performed through a lesser curve gastrotomy with a 21‐mm CS, while the standard pyloroplasty entailed a longitudinal full thickness incision through the pylorus with ... Diseases of the Esophagus journals http://www.medworm.com/rss/comments.php?id=4456326 Thu, 10 Feb 2011 00:00:00 +0100 4456326