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1

Cdx1 and c-Myc Foster the Initiation of Transdifferentiation of the Normal Esophageal Squamous Epithelium toward Barrett's Esophagus  

Microsoft Academic Search

BackgroundBarrett's esophagus is a premalignant condition whereby the normal stratified squamous esophageal epithelium undergoes a transdifferentiation program resulting in a simple columnar epithelium reminiscent of the small intestine. These changes are typically associated with the stratified squamous epithelium chronically exposed to acid and bile salts as a result of gastroesophageal reflux disease (GERD). Despite this well-defined epidemiologic association between acid

Douglas B. Stairs; Hiroshi Nakagawa; Andres Klein-Szanto; Shukriyyah D. Mitchell; Debra G. Silberg; John W. Tobias; John P. Lynch; Anil K. Rustgi; Thomas Zwaka

2008-01-01

2

Characterization of the autofluorescence of normal and tumoral esophageal epithelium cells  

NASA Astrophysics Data System (ADS)

The objectives of this study are to characterize the autofluorescence spectra of normal and tumoral esophageal epithelial cells and to link the cellular spectra with a data basis of in vivo tissular spectra. Our preliminary results show that no difference in spectral distribution can be observed between squamous cell carcinoma, adenocarcinoma and normal cells. A statistical significant difference is observed between the average intensity of the raw spectra of the different cell types. Nucleus autofluorescence presents the same spectral shape as cytoplasm, but with lower intensity.

Villette, Sandrine; Bourg-Heckly, Genevieve; Pigaglio, Sophie; Validire, Pierre; Grichine, Alexei; Vever-Bizet, Christine

2003-10-01

3

Differential gene expression between squamous cell carcinoma of esophageus and its normal epithelium; altered pattern of mal, akr1c2, and rab11a expression  

Microsoft Academic Search

AIM: To identify the altered gene expression patterns in squamous cell carcinoma of esophagus (ESCC) in relation to adjacent normal esophageal epithelium. METHODS: Total RNA was extracted using SV total RNA isolation kit from snap frozen tissues of ESCC samples and normal esophageal epithelium far from the tumor. Radio- labeled cDNA were synthesized from equal quantities of total RNAs of

Sakineh Kazemi-Noureini; Sergio Colonna-Romano; Abed-Ali Ziaee; Mohammad-Ali Malboobi; Mansour Yazdanbod; Parviz Setayeshgar; Bruno Maresca

2004-01-01

4

[Epithelium constitution for esophageal tissue engineering using electrospinning technology].  

PubMed

The basement membrane (BM) is crucial in regulating the physical and biological activities of esophageal epithelial cells which attach to the underlying BM. In order to simulate the natural construction of BM, we prepared the fibrous scaffolds using biodegradable polylactide (PLA) and silk fibroin (SF) as the materials via electrospinning technology. BM's proteins containing collagen (IV), laminin, entactin and proteoglycan were extracted from porcine esophagus and coated on the eletrospun fibers. Morphology, mechanical strength, biodegradability and cytocompatibility of the coated and uncoated scaffolds were tested and evaluated using scanning electron micrography, mechanical test system, immunofluorescence assay and western blotting with CK14 as the primary antibody. The fibrous scaffold PLA or PLA/SF, generated from the present protocol had good formation and mechanical and biodegradable properties. After coating with BM's proteins, the scaffold could enhance the growth and differentiation of esophageal epithelial cells, which would contribute to remodel and regenerate the tissue engineered epithelium and further contribute to engineer the whole esophagus in future. PMID:24660627

Chen, Ling; Lv, Jingjing; Yu, Xuechan; Kang, Cheng; Zhu, Yabin

2013-12-01

5

Physiology of Normal Esophageal Motility  

PubMed Central

The esophagus consists of two different parts. In humans, the cervical esophagus is composed of striated muscles and the thoracic esophagus is composed of phasic smooth muscles. The striated muscle esophagus is innervated by the lower motor neurons and peristalsis in this segment is due to sequential activation of the motor neurons in the nucleus ambiguus. Both primary and secondary peristaltic contractions are centrally mediated. The smooth muscle of esophagus is phasic in nature and is innervated by intramural inhibitory (nitric oxide releasing) and excitatory (acetylcholine releasing) neurons that receive inputs from separate sets of preganglionic neurons located in the dorsal motor nucleus of vagus. The primary peristalsis in this segment involves both central and peripheral mechanisms. The primary peristalsis consist of inhibition (called deglutitive inhibition) followed by excitation. The secondary peristalsis is entirely due to peripheral mechanisms and also involves inhibition followed by excitation. The lower esophageal sphincter (LES) is characterized by tonic muscle that is different from the muscle of the esophageal body. The LES, like the esophageal body smooth muscle, is also innervated by the inhibitory and excitatory neurons. The LES maintains tonic closure due to its myogenic property. The LES tone is modulated by the inhibitory and the excitatory nerves. Inhibitory nerves mediate LES relaxation and the excitatory nerves mediate reflex contraction or rebound contraction of the LES. Clinical disorders of esophageal motility can be classified on the basis of disorders of the inhibitory and excitatory innervations and the smooth muscles. PMID:18364578

Goyal, Raj K; Chaudhury, Arun

2009-01-01

6

Expression analysis of Barrett's epithelium and normal gastrointestinal tissues  

E-print Network

and the surrounding normal tissues of the upper gastrointestinal tract. For example, although it arisesExpression analysis of Barrett's epithelium and normal gastrointestinal tissues Ka Yee Yeung gastrointestinal tissues Ka Yee Yeung Dept of Computer Science and Engineering, University of Washington kayee cs

Borenstein, Elhanan

7

Physicochemical basis for dilated intercellular spaces in non-erosive acid-damaged rabbit esophageal epithelium.  

PubMed

Dilated intercellular spaces (DIS) within esophageal epithelium (EE) is a histopathologic feature of non-erosive reflux disease and early lesion in acid-damaged rabbit EE associated with increased paracellular permeability. Its cause remains unknown, but the lesion's morphology suggests a significant fluid shift into the intercellular spaces (ICS). Since water follows osmotic forces and consequently ion movements, we explored the role of active (ion) transport and ion gradients in its pathogenesis. This was done by quantifying the effect of inhibited active transport and altered ion gradients on electrical resistance (R(T)) and ICS diameter in acid-exposed Ussing-chambered rabbit EE. Compared with normal Ringer, pH 7.5, 30 minutes of luminal HCl (100 mmol/L), pH 1.1, increased permeability (R(T): +5 +/- 4% vs-52 +/- 4%) and ICS diameter (0.25 +/- 0.01 microm vs 0.42 +/- 0.02 microm), but had no effect on cell morphology or diameter. Ouabain pretreatment significantly reduced active transport but had no effect on the acid-induced changes. However, negating the chloride gradient created by luminal HCl either by adding choline chloride, 100 mmol/L, serosally or by replacing luminal HCl, pH 1.1, with luminal H(2)SO(4), pH 1.1, prevented the development of DIS while maintaining the increase in permeability. DIS was also prevented in the presence of a 100 mmol/L (choline) chloride gradient by luminal exposure at neutral pH. DIS in HCl-damaged EE is caused by an H(+)-induced increase in epithelial permeability; this enables Cl(-) to diffuse along its gradient into the ICS, creating an osmotic force for water movement into and (hydrostatic) dilation of the ICS. PMID:18522636

Tobey, N A; Gambling, T M; Vanegas, X C; Carson, J L; Orlando, R C

2008-01-01

8

Transformations between epithelium and mesenchyme: Normal, pathological, and experimentally induced  

Microsoft Academic Search

In this review, we define the two major tissue types, epithelium and mesenchyme, and we describe the transformations (transdifferentiations) of epithelium to mesenchyme (EMT) and mesenchyme to epithelium (MET) that occur during embryonic development. The differentiation of the metanephric blastema provides a striking example of MET. Differentiation of metanephric epithelium is promoted by matrix molecules and receptors (nidogen, laminins, ?6

Elizabeth D. Hay; Anna Zuk

1995-01-01

9

Expression of Ki-67 in normal oral epithelium, leukoplakic oral epithelium and oral squamous cell carcinoma  

PubMed Central

Aims and Objective: To demonstrate the presence, location and pattern of cell proliferation in different histological grades of oral epithelial dysplasia (OED), oral squamous cell carcinoma (OSCC) and normal oral epithelium (NOE) using an antibody directed against the Ki-67 antigen and its intensity of staining evaluated respectively. Materials and Methods: A total number of 100 archival paraffin embedded blocks obtained from Department of Oral and Maxillofacial Pathology were studied. The case details were retrieved which consisted of histopathologically diagnosed cases of OSCC (n = 20), low risk OED (n = 30), high risk OED (n = 30) and normal appearing mucosa (n = 20) were taken as standard for comparison. Ki-67 immunostaining was detected. Ki-67 positive cells were counted in the five random high power fields in each case. Results: Ki-67 labeling Index (LI) was restricted to the basal and parabasal layers of the normal oral epithelium irrespective of age, sex and site whereas it was seen in the basal, suprabasal and spinous layers in OED. Ki-67 LI is increased in high risk cases than the low risk cases of OED. Ki-67 positive cells in OSCC were located in the periphery of the tumor nests than the center, where frequent mitoses were observed. Conclusion: The architectural alteration evaluated by Ki-67 antibody in proliferating cell distribution in the layers of epithelial dysplasias may provide useful information to evaluate the grading of OED. Ki-67 LI increased in high risk cases than low risk cases of OED. This study showed that over expression of Ki-67 antigen between well-differentiated and poorly differentiated OSCC was in accordance with histologic grade of malignancy but not in accordance with moderately differentiated OSCC. PMID:25328294

Birajdar, Smita Shrishail; Radhika, MB; Paremala, K; Sudhakara, M; Soumya, M; Gadivan, Mohsin

2014-01-01

10

Molecular and cellular features of esophageal cancer cells  

Microsoft Academic Search

More than 70 cell lines were established from esophageal cancer, including 15 TE-series cell lines established by the authors. This article reviews molecular and cellular features of esophageal cancer cells from studies using these cell lines as well as primary tumors. The subjects reviewed include primary cultures of normal epithelium of the esophagus and of esophageal tumors, their growth and

Tetsuro Nishihira; Yu Hashimoto; Masafumi Katayama; Shozo Mori; Toshio Kuroki

1993-01-01

11

Effect of atropine on the frequency of reflux and transient lower esophageal sphincter relaxation in normal subjects  

Microsoft Academic Search

Background & Aims Low basal lower esophageal sphincter (LES) pressure is believed to be an important mechanism of reflux. The effects of atropine on the frequency and mechanisms of gastroesophageal reflux under the experimental conditions of a low basal LES pressure in 13 normal subjects were studied. Methods LES pressure, esophageal pressures, esophageal pH, and crural diaphragm electromyogram were recorded

Ravinder K. Mittal; Richard Holloway; John Dent

1995-01-01

12

Prognostic Value and Targeted Inhibition of Survivin Expression in Esophageal Adenocarcinoma and Cancer-Adjacent Squamous Epithelium  

PubMed Central

Background Survivin is an inhibitor of apoptosis and its over expression is associated with poor prognosis in several malignancies. While several studies have analyzed survivin expression in esophageal squamous cell carcinoma, few have focused on esophageal adenocarcinoma (EAC) and/or cancer-adjacent squamous epithelium (CASE). The purpose of this study was 1) to determine the degree of survivin up regulation in samples of EAC and CASE, 2) to evaluate if survivin expression in EAC and CASE correlates with recurrence and/or death, and 3) to examine the effect of survivin inhibition on apoptosis in EAC cells. Methods Fresh frozen samples of EAC and CASE from the same patient were used for qRT-PCR and Western blot analysis, and formalin-fixed, paraffin-embedded tissue was used for immunohistochemistry. EAC cell lines, OE19 and OE33, were transfected with small interfering RNAs (siRNAs) to knockdown survivin expression. This was confirmed by qRT-PCR for survivin expression and Western blot analysis of cleaved PARP, cleaved caspase 3 and survivin. Survivin expression data was correlated with clinical outcome. Results Survivin expression was significantly higher in EAC tumor samples compared to the CASE from the same patient. Patients with high expression of survivin in EAC tumor had an increased risk of death. Survivin expression was also noted in CASE and correlated with increased risk of distant recurrence. Cell line evaluation demonstrated that inhibition of survivin resulted in an increase in apoptosis. Conclusion Higher expression of survivin in tumor tissue was associated with increased risk of death; while survivin expression in CASE was a superior predictor of recurrence. Inhibition of survivin in EAC cell lines further showed increased apoptosis, supporting the potential benefits of therapeutic strategies targeted to this marker. PMID:24223792

Malhotra, Usha; Zaidi, Ali H.; Kosovec, Juliann E.; Kasi, Pashtoon M.; Komatsu, Yoshihiro; Rotoloni, Christina L.; Davison, Jon M.; R, Clint; Irvin; Hoppo, Toshitaka; Nason, Katie S.; Kelly, Lori A.; Gibson, Michael K.; Jobe, Blair A.

2013-01-01

13

Aspiration cytology of radiation-induced changes of normal breast epithelium  

SciTech Connect

From a case illustrated, it appears that irradiation may induce changes in normal breast epithelium indistinguishable from malignancy by means of aspiration cytology. This fact must be considered in the choice of diagnostic methods for the evaluation of lesions in irradiated breast tissue.

Bondeson, L.

1987-05-01

14

Expression of EAAT-1 distinguishes choroid plexus tumors from normal and reactive choroid plexus epithelium  

Microsoft Academic Search

Microscopic distinction of normal choroid plexus (CP) from choroid plexus tumors (CPT) may be difficult, especially in small\\u000a samples of well-differentiated CP papillomas. So far, there are no established markers that reliably distinguish normal and\\u000a neoplastic CP epithelium. Recently, a correlation between expression\\/function of glial glutamate transporters EAAT-1 (GLAST)\\u000a and EAAT-2 (Glt-1) and tumor proliferation has been reported. Furthermore, we

Rudi Beschorner; Georgios Pantazis; Astrid Jeibmann; Jana Boy; Richard Meyermann; Michel Mittelbronn; Jens Schittenhelm

2009-01-01

15

Tissue Specific DNA Methylation in Normal Human Breast Epithelium and in Breast Cancer  

PubMed Central

Cancer is a heterogeneous and tissue-specific disease. Thus, the tissue of origin reflects on the natural history of the disease and dictates the therapeutic approach. It is suggested that tissue differentiation, mediated mostly by epigenetic modifications, could guide tissue-specific susceptibility and protective mechanisms against cancer. Here we studied breast specific methylation in purified normal epithelium and its reflection in breast cancers. We established genome wide methylation profiles of various normal epithelial tissues and identified 110 genes that were differentially methylated in normal breast epithelium. A number of these genes also showed methylation alterations in breast cancers. We elaborated on one of them, TRIM29 (ATDC), and showed that its promoter was hypo-methylated in normal breast epithelium and heavily methylated in other normal epithelial tissues. Moreover, in breast carcinomas methylation increased and expression decreased whereas the reverse was noted for multiple other carcinomas. Interestingly, TRIM29 regulation in breast tumors clustered according to the PAM50 classification. Thus, it was repressed in the estrogen receptor positive tumors, particularly in the more proliferative luminal B subtype. This goes in line with previous reports indicating tumor suppressive activity of TRIM29 in estrogen receptor positive luminal breast cells in contrast to oncogenic function in pancreatic and lung cancers. Overall, these findings emphasize the linkage between breast specific epigenetic regulation and tissue specificity of cancer. PMID:24651077

Avraham, Ayelet; Cho, Sean Soonweng; Uhlmann, Ronit; Polak, Mia Leonov; Sandbank, Judith; Karni, Tami; Pappo, Itzhak; Halperin, Ruvit; Vaknin, Zvi; Sella, Avishay; Sukumar, Saraswati; Evron, Ella

2014-01-01

16

Pigment Epithelium-Derived Factor Supports Normal Development of Photoreceptor Neurons and Opsin Expression after Retinal Pigment Epithelium Removal  

Microsoft Academic Search

Dysfunction of the retinal pigment epithelium (RPE), its loss, or separation from the underlying neural retina results in severe photoreceptor degeneration. Pigment epithelium-derived factor (PEDF) is a glycoprotein with reported neuroprotective and dif- ferentiation properties that is secreted in abundance by RPE cells. The \\

Monica M. Jablonski; Joyce Tombran-Tink; David A. Mrazek; Alessandro Iannaccone

2000-01-01

17

Multichannel intraluminal impedance and esophageal manometry data for unrestricted swallowing: establishing normal values.  

PubMed

Standard esophageal manometric testing evaluates swallowing in the supine position using small boluses, with a recovery period imposed between swallows. Manometric tests of more physiologic unrestricted swallowing have had limited practical application due to highly variable results. The purpose of this study is to apply multichannel intraluminal impedance and manometry (MII-EM) to test esophageal function during unrestricted upright meal consumption, and to assess results in a normal healthy population. Ten healthy volunteers with normal esophageal impedance and manometry by published criteria underwent MII-EM testing using a combined 5-channel catheter. After transnasal placement of the catheter, each subject sat upright and consumed a meal that consisted of two pieces of toasted bread and two ounces of Gatorade. There were no restrictions placed on chewing, swallowing, or eating time. All data assessed by the MII-EM meal test were normally distributed. Impedance results with limited variability included the meal duration, number of swallows, postprandial emptying time and the percent of bolus presence times at 15, 10, and 5 cm above the lower esophageal sphincter. Manometric results with limited variability included the number of peristaltic sequences, mean time between these sequences and their distal esophageal amplitudes. MII-EM can be used to collect data with minimal variability in healthy subjects during unrestricted upright meal consumption. This technique may be used to identify abnormal motility patterns during physiologic swallowing. PMID:18197939

Wilson, J A; Mainie, I; Tutuian, R; Agrawal, A; Castell, D O

2008-01-01

18

Cyclin dependent kinase inhibitor p27Kip1 expression in normal and neoplastic cervical epithelium.  

PubMed Central

AIM: To investigate whether there is loss of the p27Kip1 protein in developing cervical cancer and whether p27Kip1 immunoreactivity has any relation to the proliferative indicator Ki-67. METHODS: The expression of p27Kip1 and Ki-67 was assessed by immunohistochemistry in serial sections from normal epithelium (13), low grade (27) and high grade (19) squamous intraepithelial lesions (LSIL, HSIL), and invasive cervical cancer (23). In the SIL cases the presence of human papillomavirus (HPV) genomic sequences was assessed by in situ hybridisation. The results were evaluated by image analysis, and reported as mean score of the percentage of p27Kip1 and of Ki-67 positive cells in each histological group. RESULTS: In general, p27Kip1 immunostaining was related to squamous differentation, and was intense in normal epithelium (47%), while it was reduced in SIL lesions as an effect of the decreased number of differentiating cells. However, decrease in the p27Kip1 expression was more evident in LSIL (36%) than in HSIL (39%); in the latter, p27Kip1 had a different intraepithelial distribution in that the staining extended to the basal cells. The average levels of p27Kip1 were similar in SIL lesions associated to low, intermediate, and high risk HPV types. Compared with normal epithelium and dysplasia, invasive cancer showed significantly lower p27Kip1 levels (23%). There was no relation between p27Kip1 and Ki-67 labelling indices in any of the histological groups examined. CONCLUSIONS: A reduction in p27Kip1 protein occurs in cervical cancer independently of the proliferative status. The changes in p27Kip1 expression may be related to the unregulated kinetics of developing cervical cancer. Images PMID:10711250

Troncone, G; Vetrani, A; de Rosa, G; Gerbasio, D; Palombini, L

1999-01-01

19

Herpetic esophagitis  

SciTech Connect

Four patients with herpetic esophagitis were examined. In three of them, the presenting symptom was odynophagia. Early in the course of herpetic esophagitis, shallow round and oval ulcers were seen on barium esophagograms. Later, the ulcers filled with fibrinous exudate, forming nodular plaques that projected into the esophageal lumen. Although these findings are diagnostic of esophagitis, they are not specific for a herpes virus infection. The definitive diagnosis must be established by histologic examination, which demonstrates the cytopathic effect of the herpes virus infection within the squamous epithelium.

Shortsleeve, M.J.; Gauvin, G.P.; Gardner, R.C.; Greenberg, M.S.

1981-12-01

20

Expression of the BCL-2 protein in normal and dysplastic bronchial epithelium and in lung carcinomas.  

PubMed Central

Although expression of the bcl-2 protein has been investigated in a number of non-haematological malignancies, little is known of its distribution in premalignant lesions. Expression of bcl-2 was investigated immunohistochemically in archival biopsies of normal (n = 8) and dysplastic bronchial epithelium (n = 56) and in 31 bronchial resection margins and their corresponding carcinomas. All dysplasias had lost the prominent basal staining pattern seen in histologically normal epithelium. Two were negative and six had occasional basal positive cells. In 37 cases up to 66% of the epithelial cells throughout the full epithelial thickness were bcl-2 positive with weak to moderate staining intensity. In 11 cases, all severe dysplasias, strong expression was observed in > 90% of the epithelial cells. Four patterns of bcl-2 expression in dysplasias were identified and an increasingly aberrant pattern of bcl-2 expression correlated with an increasing grade of dysplasia (Spearman's rank correlation, P < or = 0.0001). Sixty-five per cent of the carcinomas contained bcl-2-positive cells. Patients with non-small-cell lung carcinomas (n = 27) in which > 50% of the tumour cells were bcl-2 positive showed a survival advantage compared with those with 0-25% bcl-2-positive cells (P = 0.02). No correlation was found between p53 expression (Walker et al., 1994) and bcl-2 expression in dysplasias or carcinomas. Images Figure 1 Figure 2 PMID:7599047

Walker, C.; Robertson, L.; Myskow, M.; Dixon, G.

1995-01-01

21

Genes Involved in Epithelial Differentiation and Development are Differentially Expressed in Oral and Genital Lichen Planus Epithelium Compared to Normal Epithelium.  

PubMed

Lichen planus (LP) is a chronic mucocutaneous disease with unknown cause. Patients with LP often have both oral and genital lesions, but these conditions are often considered as separate diseases and treated accordingly. To find out which genes are differently expressed in mucosal LP compared to normal mucosa and establish whether oral and genital LP are in fact the same disease, whole genome expression analysis was performed on epithelium from 13 patients diagnosed with oral and/or genital LP and normal controls. For confirmation of keratin 4 and corneodesmosin expression, quantitative reverse-transcription PCR and immunohistochemistry were used. Many genes involved in epithelial development and differentiation are differently expressed in epithelium from LP compared to normal epithelium. Several of the differentially expressed genes are common for oral and genital LP and the same biological processes are altered which supports the fact that oral and genital LP are manifestations of the same disease. The change in gene expression indicates that differentiation is altered leading to changes in the epithelial barrier. PMID:24626344

Danielsson, Karin; Coates, Philip J; Ebrahimi, Majid; Nylander, Elisabet; Wahlin, Ylva Britt; Nylander, Karin

2014-09-18

22

Immunolocalization of NLRP3 Inflammasome in Normal Murine Airway Epithelium and Changes following Induction of Ovalbumin-Induced Airway Inflammation  

PubMed Central

Little is known about innate immunity and components of inflammasomes in airway epithelium. This study evaluated immunohistological evidence for NLRP3 inflammasomes in normal and inflamed murine (Balb/c) airway epithelium in a model of ovalbumin (OVA) induced allergic airway inflammation. The airway epithelium of control mice exhibited strong cytoplasmic staining for total caspase-1, ASC, and NLRP3, whereas the OVA mice exhibited strong staining for active caspase-1, with redistribution of caspase-1, IL-1? and IL-18, indicating possible activation of the NLRP3 inflammasome. Active caspase-1, NLRP3, and other inflammasome components were also detected in tissue eosinophils from OVA mice, and may potentially contribute to IL-1? and IL-18 production. In whole lung, inRNA expression of NAIP and procaspase-1 was increased in OVA mice, whereas NLRP3, IL-1? and IL-18 decreased. Some OVA-treated mice also had significantly elevated and tightly correlated serum levels of IL-1? and TNF?. In cultured normal human bronchial epithelial cells, LPS priming resulted in a significant increase in NLRP3 and II-lp protein expression. This study is the first to demonstrate NLRP3 inflammasome components in normal airway epithelium and changes with inflammation. We propose activation and/or luminal release of the inflammasome is a feature of allergic airway inflammation which may contribute to disease pathogenesis. PMID:22523501

Tran, Hai B.; Lewis, Martin D.; Tan, Lor Wai; Lester, Susan E.; Baker, Leonie M.; Ng, Jia; Hamilton-Bruce, Monica A.; Hill, Catherine L.; Koblar, Simon A.; Rischmueller, Maureen; Ruffin, Richard E.; Wormald, Peter J.; Zalewski, Peter D.; Lang, Carol J.

2012-01-01

23

Absence of Runx3 expression in normal gastrointestinal epithelium calls into question its tumour suppressor function  

PubMed Central

The Runx3 transcription factor regulates cell fate decisions during embryonic development and in adults. It was previously reported that Runx3 is strongly expressed in embryonic and adult gastrointestinal tract (GIT) epithelium (Ep) and that its loss causes gastric cancer. More than 280 publications have based their research on these findings and concluded that Runx3 is indeed a tumour suppressor (TS). In stark contrast, using various measures, we found that Runx3 expression is undetectable in GIT Ep. Employing a variety of biochemical and genetic techniques, including analysis of Runx3-GFP and R26LacZ/Runx3Cre or R26tdTomato/Runx3Cre reporter strains, we readily detected Runx3 in GIT-embedded leukocytes, dorsal root ganglia, skeletal elements and hair follicles. However, none of these approaches revealed detectable Runx3 levels in GIT Ep. Moreover, our analysis of the original Runx3LacZ/LacZ mice used in the previously reported study failed to reproduce the GIT expression of Runx3. The lack of evidence for Runx3 expression in normal GIT Ep creates a serious challenge to the published data and undermines the notion that Runx3 is a TS involved in cancer pathogenesis. PMID:21786422

Levanon, Ditsa; Bernstein, Yael; Negreanu, Varda; Bone, Karen Rae; Pozner, Amir; Eilam, Raya; Lotem, Joseph; Brenner, Ori; Groner, Yoram

2011-01-01

24

Purification and characterization of a novel restricted antigen expressed by normal and transformed human colonic epithelium.  

PubMed

A cell surface antigen that is expressed by normal and 95% of transformed colonic epithelium and is recognized by the monoclonal antibody A33 (Welt, S., Divgi, C. R., Real, F. X., Yeh, S. D., Garin-Chesa, P., Finstad, C. L., Sakamoto, J., Cohen, A., Sigurdson, E. R., Kemeny, N., Carswell, E. A., Oettgen, H. F., and Old, L. J. (1990) J. Clin. Oncol. 8, 1894-1906) has been purified to homogeneity from the human colonic carcinoma cell line LIM1215. The A33 protein was purified from Triton X-114 extracts of LIM1215 cells under nondenaturing conditions. These extracts were applied sequentially to Green-Sepharose HE-4BD, Mono-Q HR 10/10, Superose 12 HR 10/30, and micropreparative Brownlee Aquapore RP 300. The purification was monitored by biosensor analysis using surface plasmon resonance detection with a F(ab')2 fragment of the humanized A33 monoclonal antibody immobilized on the sensor surface and Western blot analysis following SDS-polyacrylamide gel electrophoresis (PAGE) under nonreducing conditions using humanized A33 monoclonal antibody. The purified A33 antigen has a Mr on SDS-PAGE of 43,000 under nonreducing conditions. By contrast, the purified protein displayed a Mr of approximately 180,000 under native conditions on both size exclusion chromatography and native PAGE, possibly due to the formation of a homotetramer. N-terminal amino acid sequence analysis of the purified protein identified 34 amino acid residues of a unique sequence: ISVETPQDVLRASQGKSVTLPXTYHTSXXXREGLIQWD. A polyclonal antibody was raised against a synthetic peptide corresponding to residues 2-20 of this sequence. The antipeptide serum recognized the purified protein using Western blot analysis under both nonreducing (Mr 43,000) and reducing (Mr 49,000) conditions. PMID:8810343

Catimel, B; Ritter, G; Welt, S; Old, L J; Cohen, L; Nerrie, M A; White, S J; Heath, J K; Demediuk, B; Domagala, T; Lee, F T; Scott, A M; Tu, G F; Ji, H; Moritz, R L; Simpson, R J; Burgess, A W; Nice, E C

1996-10-11

25

Correlation of cyclooxygenase-2 and aromatase immunohistochemical expression in invasive ductal carcinoma, ductal carcinoma in situ , and adjacent normal epithelium  

Microsoft Academic Search

Summary  The purpose of our study was to evaluate the correlation between cyclooxygenase-2 (COX-2) and aromatase immunohistochemical\\u000a expression in ductal carcinoma in situ (DCIS) and invasive ductal carcinoma (IDC) present in the same breast, as well as in adjacent stroma and normal epithelium,\\u000a we still correlated with nuclear grade, histologic grade, presence or absence of comedonecrosis, tumor size, and age at

Vilmar Marques Oliveira; Sebastião Piato; Maria Antonieta Longo Galvão Silva

2006-01-01

26

Radiobiological Determination of Dose Escalation and Normal Tissue Toxicity in Definitive Chemoradiation Therapy for Esophageal Cancer?  

PubMed Central

Purpose This study investigated the trade-off in tumor coverage and organ-at-risk sparing when applying dose escalation for concurrent chemoradiation therapy (CRT) of mid-esophageal cancer, using radiobiological modeling to estimate local control and normal tissue toxicity. Methods and Materials Twenty-one patients with mid-esophageal cancer were selected from the SCOPE1 database (International Standard Randomised Controlled Trials number 47718479), with a mean planning target volume (PTV) of 327 cm3. A boost volume, PTV2 (GTV + 0.5 cm margin), was created. Radiobiological modeling of tumor control probability (TCP) estimated the dose required for a clinically significant (+20%) increase in local control as 62.5 Gy/25 fractions. A RapidArc (RA) plan with a simultaneously integrated boost (SIB) to PTV2 (RA62.5) was compared to a standard dose plan of 50 Gy/25 fractions (RA50). Dose-volume metrics and estimates of normal tissue complication probability (NTCP) for heart and lungs were compared. Results Clinically acceptable dose escalation was feasible for 16 of 21 patients, with significant gains (>18%) in tumor control from 38.2% (RA50) to 56.3% (RA62.5), and only a small increase in predicted toxicity: median heart NTCP 4.4% (RA50) versus 5.6% (RA62.5) P<.001 and median lung NTCP 6.5% (RA50) versus 7.5% (RA62.5) P<.001. Conclusions Dose escalation to the GTV to improve local control is possible when overlap between PTV and organ-at-risk (<8% heart volume and <2.5% lung volume overlap for this study) generates only negligible increase in lung or heart toxicity. These predictions from radiobiological modeling should be tested in future clinical trials. PMID:25304796

Warren, Samantha; Partridge, Mike; Carrington, Rhys; Hurt, Chris; Crosby, Thomas; Hawkins, Maria A.

2014-01-01

27

Differentiation of tracheal mucociliary epithelium in primary cell culture recapitulates normal fetal development and regeneration following injury in hamsters.  

PubMed Central

Hamster tracheal epithelial cells were grown in primary culture for 8 days on a collagen gel substrate, in hormone-supplemented serum-free medium (Ham's F-12). On Days 1-3 in culture, the colonies were composed of a monolayer of poorly-differentiated flattened cells. Most of these were large cells which appeared to be altered secretory (mucous) cells. On Days 4 and 5, many of the epithelial cells were cuboidal. The rough endoplasmic reticulum was moderately developed, and mucous granules were seen at the cell apices. Preciliated and newly formed ciliated cells were observed on Day 6, and a differentiated mucociliary epithelium was established by Day 7 in culture. The study shows that in the hamster tracheal epithelium, the stages of normal fetal development and regeneration following injury, which have been characterized previously in vivo, are recapitulated in vitro. Formation of a mucociliary tracheal epithelium occurs within 7 days in vito and in vitro. Images Figure 3 Figure 1 Figure 4 Figure 5 PMID:3425690

McDowell, E. M.; Ben, T.; Newkirk, C.; Chang, S.; De Luca, L. M.

1987-01-01

28

Aldehyde dehydrogenase and estrogen receptor define a hierarchy of cellular differentiation in the normal human mammary epithelium  

PubMed Central

Introduction Although estrogen and progesterone play a key role in normal mammary development and in breast cancer, the potential for proliferation and lineage differentiation as well as origin of cells that express the estrogen receptor (ER) in normal breast epithelium are not known. Some evidence suggests that normal human mammary stem/progenitor cells are ER–, but the identity of these cells and the cellular hierarchy of breast epithelium are still subjects of controversy. It is likely that elucidation of these aspects will bring insight into the cellular origin of breast cancer subtypes. Methods We used fluorescence-activated cell sorting of primary human mammary epithelial cells along with in vitro and in vivo functional assays to examine the hierarchic relation between cells with aldehyde dehydrogenase enzymatic activity (ALDH+ cells) and ER+ cells in the normal human breast epithelium. We assessed the proliferation and lineage differentiation potential of these cells in vitro and in vivo. A gene reporter assay was used to separate live ER+ and ER– mammary epithelial cells. With shRNA-mediated knockdown, we investigated the role of ALDH isoforms in the functionality of mammary epithelial progenitor cells. Results We describe a cellular hierarchy in the normal human mammary gland in which ER–/ALDH+ cells with functional properties of stem/progenitor cells generate ER+ progenitor cells, which in turn give rise to cells of luminal lineage. We show that the ALDH1A1 isoform, through its function in the retinoic acid metabolism, affects the proliferation and/or early differentiation of stem/progenitor cells and is important for branching morphogenesis. Conclusions This study presents direct evidence that ER+ cells are generated by ER–/ALDH+ stem/progenitor cells. We also show that ER+ cells are able to generate cell progeny of luminal lineage in vitro and in vivo. Loss of ALDH1A1 function impairs this process, as well as branching morphogenesis and clonogenicity in suspension culture. This latter effect is reversed by treatment with retinoic acid. PMID:24887554

2014-01-01

29

Endothelial-mesenchymal transition in normal human esophageal endothelial cells cocultured with esophageal adenocarcinoma cells: role of IL-1? and TGF-?2.  

PubMed

Endothelial-mesenchymal transition (EndoMT) has been recognized as a key determinant of tumor microenvironment in cancer progression and metastasis. Endothelial cells undergoing EndoMT lose their endothelial markers, acquire the mesenchymal phenotype, and become more invasive with increased migratory abilities. Early stages of esophageal adenocarcinoma (EAC) are characterized by strong microvasculature whose impact in tumor progression remains undefined. Our aim was to determine the role of EndoMT in EAC by investigating the impact of tumor cells on normal primary human esophageal microvascular endothelial cells (HEMEC). HEMEC were either cocultured with OE33 adenocarcinoma cells or treated with IL-1? and transforming growth factor-?2 (TGF-?2) for indicated periods and analyzed for EndoMT-associated changes by real-time PCR, Western blotting, immunofluorescence staining, and functional assays. Additionally, human EAC tissues were investigated for detection of EndoMT-like cells. Our results demonstrate an increased expression of mesenchymal markers [fibroblast-specific protein 1 (FSP1), collagen1?2, vimentin, ?-smooth muscle actin (?-SMA), and Snail], decreased expression of endothelial markers [CD31, von Willebrand factor VIII (vWF), and VE-cadherin], and elevated migration ability in HEMEC following coculture with OE33 cells. The EndoMT-related changes were inhibited by IL-1? and TGF-?2 gene silencing in OE33 cells. Recombinant IL-1? and TGF-?2 induced EndoMT in HEMEC. Although the level of VEGF expression was elevated in EndoMT cells, the angiogenic property of these cells was diminished. In vivo, by immunostaining EndoMT-like cells were detected at the invasive front of EAC. Our findings underscore a significant role for EndoMT in EAC and provide new insights into the mechanisms and significance of EndoMT in the context of tumor progression. PMID:25163519

Nie, Linghui; Lyros, Orestis; Medda, Rituparna; Jovanovic, Nebojsa; Schmidt, Jamie L; Otterson, Mary F; Johnson, Christopher P; Behmaram, Behnaz; Shaker, Reza; Rafiee, Parvaneh

2014-11-01

30

Similarity of aberrant DNA methylation in Barrett's esophagus and esophageal adenocarcinoma  

Microsoft Academic Search

BACKGROUND: Barrett's esophagus (BE) is the metaplastic replacement of squamous with columnar epithelium in the esophagus, as a result of reflux. It is the major risk factor for the development of esophageal adenocarcinoma (EAC). Methylation of CpG dinucleotides of normally unmethylated genes is associated with silencing of their expression, and is common in EAC. This study was designed to determine

Eric Smith; Neville J De Young; Sandra J Pavey; Nicholas K Hayward; Derek J Nancarrow; David C Whiteman; B Mark Smithers; Andrew R Ruszkiewicz; Andrew D Clouston; David C Gotley; Peter G Devitt; Glyn G Jamieson; Paul A Drew

2008-01-01

31

Limit dilution analysis of mast cell precursor frequency in the gut epithelium of normal and Trichinella spiralis infected mice.  

PubMed

Previous studies have established that the gut nematode Trichinella spiralis induces a dramatic thymus dependent intestinal mastocytosis which peaks within 6 to 12 days after primary oral infection. It is not known, however, if the increase in gut mast cells results from the influx of mast cells or their precursors, or from the expansion and differentiation of mast cell precursors (MCP) that are normally present in the small intestinal epithelium. In the present study, the number of mucosal MCP in the intraepithelial lymphocyte (IEL) population and in bone marrow (BM) cells from normal and 4 day T. spiralis infected mice was compared by culturing the cells at limiting dilutions in medium containing interleukin-3 (IL-3). While the MCP frequency in IEL from infected mice was found to be significantly increased in comparison with that found in normal mice, the numbers of MCP in BM from the two groups were equivalent. Resident intraepithelial mucosal MCP therefore undergo a local expansion before the occurrence of an overt T dependent intestinal mastocytosis. This finding lends support to the view that local mucosal T cells are involved in regulating mast cell numbers in response to intestinal helminth infection. PMID:3774378

Dillon, S B; MacDonald, T T

1986-09-01

32

Reversal of lower esophageal sphincter hypotension and esophageal aperistalsis after treatment for hypothyroidism  

SciTech Connect

A 65-year-old woman suffered from both chronic gastroesophageal reflux, which was complicated by columnar metaplasia (Barrett's epithelium), and profound hypothyroidism. An esophageal motility tracing showed absence of peristalsis in the lower esophagus and the lower esophageal sphincter (LES) could not be identified. Thyroid replacement therapy, in conjunction with antacid and cimetidine treatment, was associated not only with improvement in the gastroesophageal reflux symptoms, but also with a return of esophageal peristalsis and LES pressure to normal. To support our clinical observations, we rendered four cats hypothyroid with /sup 131/I and documented a fall in LES pressure. We propose that abnormal smooth-muscle function of the esophagus may be another manifestation of the gastrointestinal motility disturbances which are associated with hypothyroidism.

Eastwood, G.L.; Braverman, L.E.; White, E.M.; Vander Salm, T.J.

1982-08-01

33

Four-dimensional computed tomographic analysis of esophageal mobility during normal respiration  

SciTech Connect

Background: Chemo-radiotherapy for thoracic tumors can result in high-grade radiation esophagitis. Treatment planning to reduce esophageal irradiation requires organ motion to be accounted for. In this study, esophageal mobility was assessed using four-dimensional computed tomography (4DCT). Methods and Materials: Thoracic 4DCT scans were acquired on a 16-slice CT scanner in 29 patients. The outer esophageal wall was contoured in two extreme phases of respiration in 9 patients with nonesophageal malignancies. The displacement of the center of contour was measured at 2-cm intervals. In 20 additional patients with Stage I lung cancer, the esophagus was contoured in all 10 phases of each 4DCT at five defined anatomic levels. Both approaches were then applied to 4DCT scans of 4 patients who each had two repeat scans performed. A linear mixed effects model was constructed with fixed effects: measurement direction, measurement type, and measurement location along the cranio-caudal axis. Results: Measurement location and direction were significant descriptive parameters (Wald F-tests, p < 0.001), and the interaction term between the two was significant (p = 0.02). Medio-lateral mobility exceeded dorso-ventral mobility in the lower half of the esophagus but was of a similar magnitude in the upper half. Margins that would have incorporated all movement in medio-lateral and dorso-ventral directions were 5 mm proximally, 7 mm and 6 mm respectively in the mid-esophagus, and 9 mm and 8 mm respectively in the distal esophagus. Conclusions: The distal esophagus shows more mobility. Margins for mobility that can encompass all movement were derived for use in treatment planning, particularly for stereotactic radiotherapy.

Dieleman, Edith [Department of Radiation Oncology, VU University Medical Center, Amsterdam (Netherlands); Senan, Suresh [Department of Radiation Oncology, VU University Medical Center, Amsterdam (Netherlands)]. E-mail: s.senan@vumc.nl; Vincent, Andrew [Department of Bioinformatics, Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Lagerwaard, Frank J. [Department of Radiation Oncology, VU University Medical Center, Amsterdam (Netherlands); Slotman, Ben J. [Department of Radiation Oncology, VU University Medical Center, Amsterdam (Netherlands); Soernsen de Koste, John R. van [Department of Radiation Oncology, VU University Medical Center, Amsterdam (Netherlands)

2007-03-01

34

Clinical Value of Esophageal Motility Testing  

Microsoft Academic Search

Esophageal motility testing is the method of choice in evaluating esophageal motor disorders. Some physicians, however, question the clinical utility of esophageal motility testing, since the results are often normal in symptomatic patients. The clinical utility of esophageal motility testing is reviewed for patients with a complaint of noncardiac chest pain, dysphagia or symptoms of gastroesophageal reflux disease. Esophageal motility

Melvin L. Allen; Richard B. Lynn; Saeed Zamani

1998-01-01

35

Esophageal Cancer  

MedlinePLUS

Español Esophageal Cancer Definition Cancer that forms in tissues lining the esophagus (the muscular tube through which food passes from ... the upper digestive system. Prevention and Screening Esophageal Cancer Prevention (PDQ®) Esophageal Cancer Screening (PDQ®) Diagnosis and Treatment Esophageal Cancer ...

36

An Overview of Eosinophilic Esophagitis  

PubMed Central

Eosinophilic esophagitis (EoE) is a chronic, immune/antigen-mediated esophageal disease affecting both children and adults. The condition is characterized by an eosinophilic infiltration of the esophageal epithelium. Symptoms of esophageal dysfunction include dysphagia, food impaction and symptoms mimicking gastroesophageal reflux disease. Endoscopic examination typically reveals mucosal fragility, ring or corrugated mucosa, longitudinal furrows, whitish plaques or a small caliber esophagus. Histologic findings of >15 eosinophils per high-power field is the diagnostic hallmark of EoE. An elimination diet, topical corticosteroids or endoscopic dilation for fibrostenotic disease serve as effective therapeutic option. PMID:25368745

Park, Hyojin

2014-01-01

37

Cyclooxygenase-2 expression is related to nuclear grade in ductal carcinoma in situ and is increased in its normal adjacent epithelium  

NASA Technical Reports Server (NTRS)

Cyclooxygenase-2 (COX-2) is emerging as an important cancer biomarker and is now an experimental target for solid tumor treatment.However, no study has exclusively focused on COX-2 expression in early lesions such as ductal carcinoma in situ (DCIS). We examined COX-2 expression by immunohistochemistry in 46 cases of women undergoing surgical resection for DCIS. We found that COX-2 expression was detected in 85% of all DCIS specimens, with increased COX-2 staining correlating with higher nuclear grade. Strikingly, COX-2 staining intensity in the normal adjacent epithelium was stronger than in the DCIS lesion itself. Our observations demonstrate that COX-2 is up-regulated in the normal adjacent epithelium and supports the hypothesis that the surrounding epithelial tissue is part of the disease process in DCIS.

Shim, Veronica; Gauthier, Mona L.; Sudilovsky, Daniel; Mantei, Kristin; Chew, Karen L.; Moore, Dan H.; Cha, Imok; Tlsty, Thea D.; Esserman, Laura J.

2003-01-01

38

Expression of the carcinoma markers: the sialylated Lewis A and X carbohydrate antigens in normal laryngeal surface epithelium and submucosal glands from old humans.  

PubMed

Aberrant surface expression of the carbohydrate ABH and Lewis antigens are often used as markers for the diagnosis of cancer, but while the distribution of these histo-blood group antigens is relatively well-described in tissues and organs from young and middle-aged humans little is known of their expression in old age. The objective for this study was to estimate if the Lewis A and X antigens together with their sialylated modifications, are expressed in sections of normal laryngeal tissue from old humans. Antibodies directed against the tumor markers Sialyl Lewis A and Sialyl Lewis X showed positive reaction in the surface epithelia from normal larynx autopsies obtained from people aged 77-90 years. The sialylated and non-sialylated Lewis A antigens were more frequently expressed in the pseudostratified epithelium than in squamous surface epithelium. Both the sialylated and the non-sialylated carbohydrates were stained in the submucosal glands in all the autopsies. In conclusion, visualization of Lewis tumor markers in the larynx should be interpreted with great care, as they may be present in normal laryngeal epithelial cells from old humans. PMID:23030724

Kirkeby, Svend; Moe, Dennis

2013-03-01

39

Thoracoscopic stapled resection of multiple esophageal duplication cysts with different pathological findings  

Microsoft Academic Search

Esophageal duplication cyst is a rare congenital esophageal anomaly of the foregut. This cyst usually occurs in isolation, and thus far, was treated by enucleation through thoracoscopic or thoracotomic surgery. Here we report a case of multiple esophageal duplication cysts that showed different pathological findings, i.e., the cysts were lined with pseudostratified ciliated columnar and stratified squamous epithelium. Esophageal cysts

Chul Ung Kang; Deog Gon Cho; Kyu Do Cho; Min Seop Jo

2008-01-01

40

Thoracoscopic stapled resection of multiple esophageal duplication cysts with different pathological findings  

Microsoft Academic Search

Esophageal duplication cyst is a rare congenital esophageal anomaly of the foregut. This cyst usually occurs in isolation, and thus far, was treated by enucleation through thoracoscopic or thoracotomic surgery. Here we report a case of multiple esophageal duplication cysts that showed different pathological findings, i.e., the cysts were lined with pseudostratified ciliated columnar and stratified squamous epithelium. Esophageal cysts

Chul Ung Kang; Deog Gon Cho; Kyu Do Cho; Min Seop Jo

41

Water-perfused esophageal high-resolution manometry: normal values and validation.  

PubMed

Water-perfused high-resolution manometry (HRM) catheters with 36 unidirectional pressure channels have recently been developed, but normal values are not yet available. Furthermore, the technique has not been validated and compared with solid-state HRM. We therefore aimed to develop normal values for water-perfused HRM and to assess the level of agreement between water-perfused HRM and solid-state HRM. We included 50 healthy volunteers (mean age 35 yr, range 21-64 yr; 15 women, 35 men). Water-perfused HRM and solid-state HRM were performed in a randomized order. Normal values were calculated as 5th and 95th percentile ranges, and agreement between the two systems was assessed with intraclass correlation coefficient (ICC) statistics. The 5th-95th percentile range was 3.0-6.6 cm/s for contractile front velocity (CFV), 141.6-3,674 mmHg·s·cm for distal contractile integral (DCI), 6.2-8.7 s for distal contraction latency (DL), and 1.0-18.8 mmHg for integrated relaxation pressure (IRP 4s). Mean (SD) and ICC for water-perfused HRM and solid-state HRM were 4.4 (1.1) vs. 3.9 (0.9) cm/s, ICC: 0.49 for CFV; 1,189 (1,023) vs. 1,092 (1,019) mmHg·s·cm, ICC: 0.90 for DCI; 7.4 (0.8) vs. 6.9 (0.9) s, ICC: 0.50 for DL; and 8.1 (4.8) vs. 7.9 (5.1), ICC: 0.39 for IRP 4s. The normal values for this water-perfused HRM system are only slightly different from previously published values with solid-state HRM, and moderate to good agreement was observed between the two systems, with only small differences in outcome measures. PMID:24481604

Kessing, Boudewijn F; Weijenborg, Pim W; Smout, André J P M; Hillenius, Sem; Bredenoord, Albert J

2014-03-01

42

AFM stiffness nanotomography of normal, metaplastic and dysplastic human esophageal cells  

NASA Astrophysics Data System (ADS)

The mechanical stiffness of individual cells is important in tissue homeostasis, cell growth, division and motility, and the epithelial-mesenchymal transition in the initiation of cancer. In this work, a normal squamous cell line (EPC2) and metaplastic (CP-A) as well as dysplastic (CP-D) Barrett's Esophagus columnar cell lines are studied as a model of pre-neoplastic progression in the human esophagus. We used the combination of an atomic force microscope (AFM) with a scanning confocal fluorescence lifetime imaging microscope to study the mechanical properties of single adherent cells. Sixty four force indentation curves were taken over the nucleus of each cell in an 8 × 8 grid pattern. Analyzing the force indentation curves, indentation depth-dependent Young's moduli were found for all cell lines. Stiffness tomograms demonstrate distinct differences between the mechanical properties of the studied cell lines. Comparing the stiffness for indentation forces of 1 nN, most probable Young's moduli were calculated to 4.7 kPa for EPC2 (n = 18 cells), 3.1 kPa for CP-A (n = 10) and 2.6 kPa for CP-D (n = 19). We also tested the influence of nuclei and nucleoli staining organic dyes on the mechanical properties of the cells. For stained EPC2 cells (n = 5), significant stiffening was found (9.9 kPa), while CP-A cells (n = 5) showed no clear trend (2.9 kPa) and a slight softening was observed (2.1 kPa) in the case of CP-D cells (n = 16). Some force-indentation curves show non-monotonic discontinuities with segments of negative slope, resembling a sawtooth pattern. We found the incidence of these 'breakthrough events' to be highest in the dysplastic CP-D cells, intermediate in the metaplastic CP-A cells and lowest in the normal EPC2 cells. This observation suggests that the microscopic explanation for the increased compliance of cancerous and pre-cancerous cells may lie in their susceptibility to 'crumble and yield' rather than their ability to 'bend and flex'.

Fuhrmann, A.; Staunton, J. R.; Nandakumar, V.; Banyai, N.; Davies, P. C. W.; Ros, R.

2011-02-01

43

Methyl isocyanate induced morphological changes in the seminiferous epithelium of rats maintained on normal or protein deficient diets  

SciTech Connect

Methyl isocyanate (MIC), a pulmonary toxicant, is also reported to cause reproductive anomalies. MIC exposure decreased mating performance and fertility of mice and rats. However, the target cell type responsible for the decreased fertility could not be identified. Therefore, present studies are undertaken to analyze the action of MIC on spermatogenesis during one cycle of seminiferous epithelium. Protein deficiency, an important aspect of malnourishment, alter toxic potentials of various chemicals. About 90% of the affected people of Bhopal gas calamity belonged to low income group and were categorized as malnourished. Nutritional deficiency is also known to impair spermatogenesis and fertility. Therefore, experiments were designed to evaluate whether the protein deficiency influence the toxic potentials of MIC on testicular tissues.

Bose, M.; Vachhrajani, K.D.; Dutta, K.K. (Industrial Toxicology Research Centre, Lucknow (India)); Jha, B.S. (Mithila Univ., Darbhanga (India))

1994-05-01

44

IJC-08-1118 REVISED July 16, 2008 Estrogen alpha and progesterone receptor expression in the normal mammary epithelium in relation to breast cancer risk  

PubMed Central

Estrogens are central in the etiology of breast cancer and results from observational studies and randomized trials have also implicated progestins. The effects of these hormones in the mammary tissue are exerted through binding with specific receptor proteins in the cell nucleus. It has been proposed that higher estrogen receptor alpha expression in the normal breast epithelium may increase breast cancer risk. In a study in Greece, we determined estrogen alpha and progesterone receptor expression in normal mammary tissue adjacent to the pathological tissue from 267 breast cancer patients and 299 women with benign breast disease. Mouse monoclonal antibodies specific for estrogen receptor alpha and progesterone receptor, were applied. The H –index which incorporates frequency and intensity of staining of the cells and can range from 0 to 300 was deemed positive when it exceeded 9. Among premenopausal women, there was no evidence for an association with breast cancer risk for expression of either type of receptors. Among postmenopausal women, breast cancer risk was inversely associated with expression of both estrogen alpha (odds ratio = 0.39; p = 0.015) and progesterone (odds ratio = 0.40; p = 0.008) receptors. The hypothesis that over-expression of estrogen receptors alpha or progesterone receptors in normal breast epithelium may increase the risk of breast cancer was not supported by our data. Instead, we found evidence that over-expression of these receptors may be associated with reduced risk for breast cancer in line with the well known association of expression of these receptors in the malignant tissue and better breast cancer prognosis. PMID:18798271

Lagiou, Pagona; Georgila, Christina; Samoli, Evangelia; Lagiou, Areti; Zourna, Pantelina; Minaki, Ploumitsa; Vassilarou, Dorothy; Papadiamandis, Ioannis; Sfikas, Constantinos; Kalapothaki, Victoria; Sekeris, Constantine E.; Trichopoulos, Dimitrios

2008-01-01

45

Esophageal motility disorders.  

PubMed

Esophageal motility disorders consist of a complex array of disturbances in normal esophageal function associated with dysphagia, gastroesophageal reflux, and noncardiac chest pain. A thorough knowledge of normal esophageal anatomy and physiology is important to a full understanding of these motility derangements. Through a complicated interaction of neuromuscular and hormonal influences, the voluntary act of swallowing transforms into an automated sequence of peristaltic waves propelling food and liquids into the stomach in concert with coordinated relaxation of the sphincters. Anatomic and physiologic barriers exist within the esophagus protecting against gastroesophageal reflux and aspiration. With improvements in diagnostic tools such as barium contrast radiography, scintigraphy, pH measurements, and esophageal manometrics with provocative testing, motility disorders have become better defined and understood. Primary motility disorders consist of achalasia, diffuse esophageal spasm (DES), "nutcracker esophagus," hypertensive lower esophageal sphincter, and nonspecific esophageal motility dysfunction (NEMD). A host of secondary and miscellaneous motility disorders also affect the esophagus, including scleroderma and other connective tissue diseases, diabetes mellitus, Chagas' disease, chronic idiopathic intestinal pseudo-obstruction, and neuromuscular disorders of striated muscle. Gastroesophageal reflux disease (GERD) may also be promoted by associated motility disturbances. Treatment modalities include surgical myotomy; dilatation; and pharmacologic manipulations, including use of nitrates, calcium-channel blockers, H2-blockers, and psychotropic drugs where appropriate. PMID:3292177

Nelson, J B; Castell, D O

1988-06-01

46

Repair of complete longitudinal esophageal rupture with preservation of esophageal motility.  

PubMed

There is no consensus on the ideal treatment for esophageal perforation and on the maximal extent of esophageal disruption amenable to primary repair. The effect of extensive esophageal injury on postoperative esophageal motility is also unknown. We report the case of a longitudinal iatrogenic esophageal laceration extending from the hypopharynx to the cardia in a morbidly obese patient treated with primary repair. The patient exhibited no postoperative esophageal leak or stricture and maintained a preserved esophageal peristalsis on manometry at 3 months. An extensively lacerated esophagus can be repaired primarily while maintaining a normal postoperative function. PMID:25282231

Frechette, Eric; Bolca, Ciprian; Lebel, Stefane

2014-10-01

47

Detection of Human Papillomavirus DNA and p53 Gene Mutations in Esophageal Cancer Samples and Adjacent Normal Mucosa  

Microsoft Academic Search

Background\\/Aim: There is evidence of a possible etiological role of human papillomaviruses (HPVs) in the development of esophageal tumors. Loss of function of the wild-type p53 tumor suppressor gene product by binding to E6 oncoproteins of high-risk HPVs is considered an important event in tumor development. The aim of this study was to verify the prevalence of HPV infection and

Giuseppe Astori; Sonia Merluzzi; Alessandra Arzese; Piero Brosolo; Giovanni de Pretis; Roberto Maieron; Corrado Pipan; Giuseppe A. Botta

2001-01-01

48

Endocrine cells in ectocervical epithelium  

Microsoft Academic Search

A systematic study of endocrine cells in the ectocervix was carried out using histochemical, immunohistochemical and ultrastructural techniques. Serotonin and calcitonin immunoreactive cells were demonstrated in this site. Serotonin and calcitonin immunoreactivities were coexpressed in the same endocrine cell. These distinctive cells were encountered in two main morphological varieties of ectocervical epithelium. Normal-appearing stratified squamous epithelium contained only very rare

F. Fetissof; B. Arbeille; F. Boivin; M. Sam-Giao; C. Henrion; J. Lansac

1987-01-01

49

Esophageal cancer  

MedlinePLUS

... There are two main types of esophageal cancer: squamous cell carcinoma and adenocarcinoma. These two types look different from each other under the microscope. Squamous cell esophageal cancer is linked to smoking and ...

50

Esophageal Cancer  

MedlinePLUS

... from your throat to your stomach. Early esophageal cancer usually does not cause symptoms. Later, you may ... You're at greater risk for getting esophageal cancer if you smoke, drink heavily, or have acid ...

51

Intensity-Modulated Proton Therapy Further Reduces Normal-Tissue Exposure During Definitive Therapy for Locally Advanced Distal Esophageal Tumors: A Dosimetric Study  

PubMed Central

Purpose We previously found that up to 75% of treatment failures after chemoradiation for unresectable esophageal cancer appear within the gross tumor volume (GTV) and that intensity-modulated [photon] radiation therapy (IMRT) may allow dose escalation to the tumor without increasing normal-tissue toxicity. Proton therapy may allow further dose escalation with even lower normal-tissue toxicity. Here we compared dosimetric parameters for photon IMRT with intensity-modulated proton therapy (IMPT) for unresectable, locally advanced distal esophageal cancer. Methods and Materials Four plans were created for each of 10 patients: IMPT delivered via anteroposterior/posteroanterior (AP/PA) beams, left posterior oblique/right posterior oblique (LPO/RPO) beams, or AP/LPO/RPO beams; and IMRT delivered with a concomitant boost to the GTV. Doses were 65.8 Gy to the GTV and 50.4 Gy to the planning target volume (PTV) in 28 fractions. Results Relative to IMRT, the IMPT (AP/PA) plan led to considerable reductions in mean lung dose (3.18 Gy vs 8.27 Gy, p<0.0001) and in lung V5, V10, and V20 (p?0.0006) but did not reduce cardiac dose; the IMPT LPO/RPO plan also reduced the mean lung dose (4.9 Gy vs 8.2 Gy, p<0.001) as well as reducing heart doses (mean cardiac dose and cardiac V10, V20, and V30, p?0.02) and liver doses (mean hepatic dose 5 Gy vs 14.9 Gy, p<0.0001). The IMPT AP/LPO/RPO plan led to considerable reductions in dose to the lung (p?0.005), heart (p?0.003), and liver (p?0.04). Conclusions Compared with IMRT, IMPT for distal esophageal cancer can lower the dose to the heart, lung, and liver. The AP/LPO/RPO beam arrangement was optimal for sparing all three organs. The dosimetric benefits of protons will need to tailored to each patient based on their specific cardiac and pulmonary risks. IMPT for esophageal cancer will soon be investigate further in a prospective trial at our institution. PMID:21470796

Welsh, James; Gomez, Daniel; Palmer, Matthew B.; Riley, Beverly A.; Mayankkumar, Amin V; Komaki, Ritsuko; Dong, Lei; Zhu, X. Ronald; Likhacheva, Anna; Liao, Zhongxing; Hofstetter, Wayne L.; Ajani, Jaffer A.; Cox, James D.

2014-01-01

52

Duplication cyst with esophageal mucosa at the floor of the mouth: a case report.  

PubMed

Intraoral localization of alimentary tract duplication is extremely rare. We report a duplication cyst at the floor of the mouth, lined by esophageal epithelium and treated successfully by surgical excision. To our knowledge, this is the third case of intraoral enteric duplication cysts lined with esophageal epithelium reported in the literature. PMID:24485518

Vlahovic, Aleksandar; Samardzija, Gordana; Haxhija, Emir

2014-06-01

53

The ER? coactivator, HER4/4ICD, regulates progesterone receptor expression in normal and malignant breast epithelium  

PubMed Central

The HER4 intracellular domain (4ICD) is a potent estrogen receptor (ER?) coactivator with activities in breast cancer and the developing mammary gland that appear to overlap with progesterone receptor (PgR). In fact, 4ICD has recently emerged as an important regulator and predictor of tamoxifen response, a role previously thought to be fulfilled by PgR. Here we investigated the possibility that the 4ICD coactivator regulates PgR expression thereby providing a mechanistic explanation for their partially overlapping activities in breast cancer. We show that 4ICD is both sufficient and necessary to potentiate estrogen stimulation of gene expression. Suppression of HER4/4ICD expression in the MCF-7 breast tumor cell line completely eliminated estrogen stimulated expression of PgR. In addition, the HER4/4ICD negative MCF-7 variant, TamR, failed to express PgR in response to estrogen. Reintroduction of wild-type HER4 but not the ?-secretase processing mutant HER4V673I into the TamR cell line restored PgR expression indicating that 4ICD is an essential PgR coactivator in breast tumor cells. These results were substantiated in vivo using two different physiologically relevant experimental systems. In the mouse mammary gland estrogen regulates expression of PgR-A whereas expression of PgR-B is estrogen independent. Consistent with a role for 4ICD in estrogen regulated PgR expression in vivo, PgR-A, but not PgR-B, expression was abolished in HER4-null mouse mammary glands during pregnancy. Coexpression of PgR and 4ICD is also commonly observed in ER? positive breast carcinomas. Using quantitative AQUA IHC technology we found that 4ICD potentiated PgR expression in primary breast tumors and the highest levels of PgR expression required coexpression of ER? and the 4ICD coactivator. In summary, our results provide compelling evidence that 4ICD is a physiologically important ER? coactivator and 4ICD cooperates with ER? to potentiate PgR expression in the normal and malignant breast. We propose that direct coupling of these signaling pathways may have important implications for mammary development, breast carcinogenesis, and patient response to endocrine therapy. PMID:20550710

2010-01-01

54

The ERalpha coactivator, HER4/4ICD, regulates progesterone receptor expression in normal and malignant breast epithelium.  

PubMed

The HER4 intracellular domain (4ICD) is a potent estrogen receptor (ERalpha) coactivator with activities in breast cancer and the developing mammary gland that appear to overlap with progesterone receptor (PgR). In fact, 4ICD has recently emerged as an important regulator and predictor of tamoxifen response, a role previously thought to be fulfilled by PgR. Here we investigated the possibility that the 4ICD coactivator regulates PgR expression thereby providing a mechanistic explanation for their partially overlapping activities in breast cancer. We show that 4ICD is both sufficient and necessary to potentiate estrogen stimulation of gene expression. Suppression of HER4/4ICD expression in the MCF-7 breast tumor cell line completely eliminated estrogen stimulated expression of PgR. In addition, the HER4/4ICD negative MCF-7 variant, TamR, failed to express PgR in response to estrogen. Reintroduction of wild-type HER4 but not the gamma-secretase processing mutant HER4V673I into the TamR cell line restored PgR expression indicating that 4ICD is an essential PgR coactivator in breast tumor cells. These results were substantiated in vivo using two different physiologically relevant experimental systems. In the mouse mammary gland estrogen regulates expression of PgR-A whereas expression of PgR-B is estrogen independent. Consistent with a role for 4ICD in estrogen regulated PgR expression in vivo, PgR-A, but not PgR-B, expression was abolished in HER4-null mouse mammary glands during pregnancy. Coexpression of PgR and 4ICD is also commonly observed in ERalpha positive breast carcinomas. Using quantitative AQUA IHC technology we found that 4ICD potentiated PgR expression in primary breast tumors and the highest levels of PgR expression required coexpression of ERalpha and the 4ICD coactivator. In summary, our results provide compelling evidence that 4ICD is a physiologically important ERalpha coactivator and 4ICD cooperates with ERalpha to potentiate PgR expression in the normal and malignant breast. We propose that direct coupling of these signaling pathways may have important implications for mammary development, breast carcinogenesis, and patient response to endocrine therapy. PMID:20550710

Rokicki, Jerzy; Das, Partha M; Giltnane, Jennifer M; Wansbury, Olivia; Rimm, David L; Howard, Beatrice A; Jones, Frank E

2010-01-01

55

Barrett's esophagus and reflux esophagitis: is there a missing link?  

Microsoft Academic Search

OBJECTIVES:Barrett's esophagus (BE) is associated with esophageal reflux. The development stage of BE is not well described. Epidemiological evidence indicates that the columnar epithelium in BE is acquired and reaches its full length rapidly. We tested the hypothesis that BE might result from direct replacement of erosions in reflux esophagitis (RE).METHODS:At endoscopy, we compared the length and distribution of esophageal

Alan J. Cameron; Amindra S. Arora

2002-01-01

56

[Computerized analysis of esophageal manometry].  

PubMed

Computerized analysis of esophageal manometry should consider the following objectives: a) objectivation of data acquisition; b) precision in calculating the various parameters; c) speed of analysis; d) an easy-to-read and promptly understandable graphic display of the manometric data; e) computation of new parameters capable of defining normal and pathologic function. It is with these objectives in mind that we launched our research project. Five normal subjects and 10 patients, of whom 5 presented esophageal achalasia and 5 gastroesophageal reflux disease, underwent computerized esophageal manometry and were evaluated on the basis of both traditional and innovative parameters, of our own inception. Among the various indexes tested, the "Esophageal transport" parameter, calculated as the ratio of momentum (dp*dT) over speed of propagation of the esophageal contractions, gave rise to particular interest. In our opinion, this parameter can be used as an index of the dynamic function of the organ. PMID:2067691

Spigno, L; Pandolfo, N; Guiddo, G; Calci, G; Mattioli, G; De Salvo, L

1991-04-15

57

Esophageal perforation.  

PubMed

Esophageal perforation is uncommon but carries a high morbidity and mortality, particularly if the injury is not detected early before the onset of systemic signs of sepsis. The fact that it is an uncommon problem and it produces symptoms that can mimic other serious thoracic conditions, such as myocardial infarction, contributes to the delay in diagnosis. Patients at risk for iatrogenic perforations (esophageal malignancy) frequently have comorbidities that increase their perioperative morbidity and mortality. The optimal treatment of esophageal perforation varies with respect to the time of presentation, the extent of the perforation, and the underlying esophageal pathologic conditions. PMID:24267495

Nirula, Raminder

2014-02-01

58

Esophageal Melanocytosis in Oral Opium Consumption  

PubMed Central

Esophageal melanocytosis is a rare and benign condition, characterized by melanocytic proliferation of the esophageal squamous epithelium with heavy melanin deposition. The etiology and pathogenesis has not been exactly known but it seems to be a chronic stimulus such as gastroesophageal reflux. This condition is very rare and about 35 cases have been reported so far, most of which have been from India and Japan. Herein, we present a case of esophageal melanocytosis in a patient with long history of oral opium consumption. To the best of our knowledge, such a history has not been reported. PMID:24719715

Geramizadeh, Bita; Asadian, Fatemeh; Taghavi, Alireza

2014-01-01

59

Eosinophilic esophagitis  

PubMed Central

Eosinophilic esophagitis (EoE) is an atopic condition of the esophagus that has become increasingly recognized over the last decade. Diagnosis of the disorder is dependent on the patient’s clinical manifestations and histologic findings on esophageal mucosal biopsies. Patients with eosinophilic esophagitis should be referred to both an allergist and gastroenterologist for optimal management, which may include dietary modifications, pharmacologic agents such as corticosteroids, leukotriene modifiers and biologics as well as mechanical dilatation of the esophagus. The epidemiology, pathophysiology, diagnosis, treatment, and prognosis of EoE are discussed in this review. PMID:22165816

2011-01-01

60

Circulating levels and subcutaneous adipose tissue gene expression of pigment epithelium-derived factor in polycystic ovary syndrome and normal women: a case control study  

PubMed Central

Background Polycystic ovary syndrome (PCOS) has been recognized as a metabolic disorder, manifested by abdominal obesity, insulin resistance, dyslipidemia and hypertension. Pigment epithelium-derived factor (PEDF), a member of the serine protease inhibitor family, is a pleiotropic protein known for its antiangiogenic, antioxidant, and neuroprotective properties and has been shown to induce insulin resistance and play a role in glucose metabolism. Recent studies investigating circulating PEDF levels show elevated serum PEDF in association with insulin resistance in normal-weight women with PCOS, but not in obese PCOS patients. The aims of this study were 1) to assess PEDF gene expression in subcutaneous adipose tissue (scAT) from women with PCOS and nonhirsute, ovulatory controls, and 2) to determine the circulating levels of PEDF in these groups. Methods Total RNA was extracted from adipose tissue biopsy samples and reverse-transcribed to cDNA. Real-time quantitative PCR was performed to determine relative gene expression levels. Results The 22 women with PCOS and 14 non-PCOS controls included in the study had similar age, BMI, and fasting glucose, triglycerides, and HDL-cholesterol levels. Participants with PCOS exhibited higher 2 h oral glucose tolerance test levels (p?=?0.006), total (p?=?0.026) and LDL-cholesterol (p?=?0.036), Ferriman-Gallwey score (p?=?0.003) and total testosterone (p?=?0.001) as compared to controls. BMI-adjusted PEDF serum levels and scAT gene expression were similar in the PCOS and control groups (p?=?0.622 and p?=?0.509, respectively). Circulating PEDF levels were not associated with scAT PEDF gene expression. Multiple regression analysis revealed that, in women with PCOS, insulin contributed positively and significantly to serum PEDF (p = 0.027), independently of testosterone. Conclusion Serum PEDF levels and scAT gene expression were associated with metabolic risk factors, but did not differ between women with PCOS and age- and BMI-matched controls. Circulating levels and scAT gene expression of PEDF were not associated in the study subjects, suggesting additional sources for PEDF in addition to or instead of fat tissue. PMID:23941060

2013-01-01

61

Eosinophilic esophagitis  

PubMed Central

Eosinophilic esophagitis (EoE) is a chronic immune-mediated condition where infiltration of eosinophils into the esophageal mucosa leads to symptoms of esophageal dysfunction. It has rapidly emerged as an important cause of upper GI morbidity in patients of all ages and is encountered in a substantial proportion of patients undergoing diagnostic upper endoscopy. This review discusses the clinical, endoscopic, and histologic features of EoE and presents the most recent guidelines for diagnosis of EoE. It describes selected diagnostic dilemmas including distinguishing EoE from gastroesophageal reflux disease and addressing the newly recognized clinical entity of proton pump inhibitor responsive esophageal eosinophilia. It also highlights evidence to support both pharmacologic and non-pharmacologic treatments, including topical corticosteroids, dietary elimination therapy, and endoscopic dilation. PMID:23452635

Dellon, Evan S.

2012-01-01

62

Esophageal cancer  

SciTech Connect

This book contains the proceedings on esophageal cancer. Topics covered include: Scope of the problem, Diagnostic considerations: Methods of early diagnosis, Staging criteria, Elective surgical management, and Postoperative complications.

Delarue, N.C. (Univ. of Toronto, Toronto (CA)); Wilkins, E.W. Jr. (Harvard Medical School, MA (US)); Wong, J. (Dept. of Surgery, Univ. of Hong Kong (HK))

1988-01-01

63

Eosinophilic Esophagitis  

Microsoft Academic Search

Eosinophilic esophagitis is a chronic inflammatory disorder characterized by dense eosinophilic infiltration of the esophageal\\u000a mucosa. The pathogenesis is incompletely understood and food allergies and aeroallergens have been implicated. The most common\\u000a clinical presentation in adults is dysphagia to solids. Its associated endoscopic findings are distinct and include concentric\\u000a rings and longitudinal furrows, although endoscopy may be unremarkable in a

Fouad J. Moawad; Ganesh R. Veerappan; Roy K. Wong

2009-01-01

64

Expression of basic fibroblast growth factor, CD31, and ?-smooth muscle actin and esophageal cancer recurrence after definitive chemoradiation.  

PubMed

There is cumulative evidence that stromal reaction in cancer has an important diagnostic and prognostic significance. The aims of this study were to analyze the expression of basic fibroblast growth factor (FGF-2), CD31, and ?-smooth muscle actin (SMA) in esophageal cancer patients and to establish their significance as indicators of disease recurrence after definitive chemoradiation (CRT). Protein expressions of FGF-2, CD31, and SMA were evaluated by immunohistochemistry and Western blot analysis in 70 patients, 20 with esophageal squamous cell carcinoma (ESCC) and 50 with locally recurrent ESCC after definitive CRT. Twenty matched normal esophageal squamous epithelium were also studied as controls. Esophageal cancer tissues showed positive expression of FGF-2, CD31, and SMA; in contrast, FGF-2 expression was not detected and only little staining for CD31 and SMA was noted in normal epithelium. Protein levels of FGF-2, CD31, and SMA were significantly elevated in recurrent ESCC. Among the patients with locally recurrent disease, expression of FGF-2 and SMA was notably high in whom the tumor recurred locally within 24 months after definitive CRT. The 2- and 5-year local recurrence-free survival rate was 15.4 % and 0 in patients with high FGF-2 expression, compared with 45.8 and 33.3 % in those who expressed low FGF-2, respectively (P = 0.005). Of patients who expressed high SMA, the 2- and 5-year local recurrence-free survival rate was 21.7 and 8.7 %, respectively, compared to those with low SMA expression which was 37.0 and 22.2 %, respectively (P = 0.016). Overexpression of FGF-2 and SMA is associated with local recurrence and reduced recurrence-free survival after definitive CRT for ESCC. The data also suggest that targeting stromal cells may be an attractive approach for esophageal cancer therapy strategies. PMID:24777337

Chen, Yongshun; Li, Xiaohong; Yang, Haijun; Xia, Yubing; Guo, Leiming; Wu, Xiaoyuan; He, Chunyu; Lu, You

2014-07-01

65

Whole Genome Expression Array Profiling Highlights Differences in Mucosal Defense Genes in Barrett's Esophagus and Esophageal Adenocarcinoma  

PubMed Central

Esophageal adenocarcinoma (EAC) has become a major concern in Western countries due to rapid rises in incidence coupled with very poor survival rates. One of the key risk factors for the development of this cancer is the presence of Barrett's esophagus (BE), which is believed to form in response to repeated gastro-esophageal reflux. In this study we performed comparative, genome-wide expression profiling (using Illumina whole-genome Beadarrays) on total RNA extracted from esophageal biopsy tissues from individuals with EAC, BE (in the absence of EAC) and those with normal squamous epithelium. We combined these data with publically accessible raw data from three similar studies to investigate key gene and ontology differences between these three tissue states. The results support the deduction that BE is a tissue with enhanced glycoprotein synthesis machinery (DPP4, ATP2A3, AGR2) designed to provide strong mucosal defenses aimed at resisting gastro-esophageal reflux. EAC exhibits the enhanced extracellular matrix remodeling (collagens, IGFBP7, PLAU) effects expected in an aggressive form of cancer, as well as evidence of reduced expression of genes associated with mucosal (MUC6, CA2, TFF1) and xenobiotic (AKR1C2, AKR1B10) defenses. When our results are compared to previous whole-genome expression profiling studies keratin, mucin, annexin and trefoil factor gene groups are the most frequently represented differentially expressed gene families. Eleven genes identified here are also represented in at least 3 other profiling studies. We used these genes to discriminate between squamous epithelium, BE and EAC within the two largest cohorts using a support vector machine leave one out cross validation (LOOCV) analysis. While this method was satisfactory for discriminating squamous epithelium and BE, it demonstrates the need for more detailed investigations into profiling changes between BE and EAC. PMID:21829465

Nancarrow, Derek J.; Clouston, Andrew D.; Smithers, B. Mark; Gotley, David C.; Drew, Paul A.; Watson, David I.; Tyagi, Sonika; Hayward, Nicholas K.; Whiteman, David C.

2011-01-01

66

Esophageal trauma.  

PubMed

The anatomy of the esophagus is unique in that it traverses the neck, chest, and abdomen. As a result, surgeons need to be familiar with the anatomy of all three of these areas to be facile and comfortable in performing esophageal surgery. Traumatic injuries to the esophagus encompass a heterogeneous group of injuries that can be iatrogenic, external, or from physiologic forces. Primary repair of traumatic injuries is preferred when possible; however, if systemic sepsis is present and esophageal resection becomes necessary due to extensive injury or inflammation, immediate reconstruction should be delayed in most cases. Successful management of traumatic esophageal injuries requires prompt and accurate diagnosis and treatment tailored specifically to both the type of injury as well as to the patient's overall clinical condition. PMID:18420126

Johnson, Scott B

2008-01-01

67

An experimental model of prolonged esophagitis with sphincter failure in the rat and the therapeutic potential of gastric pentadecapeptide BPC 157.  

PubMed

We report a simple novel rat model that combines prolonged esophagitis and parallel sphincters failure. The anti-ulcer gastric pentadecapeptide BPC 157, which was found to be stable in gastric juice, and is being evaluated in inflammatory bowel disease trials, is an anti-esophagitis therapy that recovers failed sphincters. Twelve or twenty months after the initial challenge (tubes sutured into sphincters for one week and then spontaneously removed by peristalsis), rats exhibit prolonged esophagitis (confluent hemorrhagic and yellowish lesions, thinner epithelium and superficial corneal layer, with stratification derangement); constantly lowered pressure of both sphincters (assessed by using a water manometer connected to the drainage port of a Foley catheter implanted into the stomach either through esophageal or duodenal incision); and both lower esophageal and pyloric sphincter failure. Throughout the esophagitis experiment, BPC 157 was given at either 10 micro g/kg, i.p., once a day (last application 24 h before assessment) or alternatively, it was given continuously in drinking water at 0.16 micro g/ml (12 ml/rat). This treatment recovers i) esophagitis (macroscopically and microscopically, at either region or investigated time period) and ii) pressure in both sphincters (cmH2O). In addition, BPC 157 (10 micro g/kg) or saline (1 ml/rat, 5 ml/kg) was specifically given directly into the stomach; pressure assessment was performed at 5 min thereafter. The effect of BPC 157 is specific because in normal rats, it increases lower esophageal sphincter-pressure, but decreases pyloric sphincter-pressure. Ranitidine, given as the standard drug using the same protocol (50 mg/kg, i.p., once daily; 0.83 mg/ml in drinking water; or 50 mg/kg directly into the stomach) had no effect. PMID:17116974

Petrovic, Igor; Dobric, Ivan; Drvis, Petar; Shejbal, Drazen; Brcic, Luka; Blagaic, Alenka Boban; Batelja, Lovorka; Kokic, Neven; Tonkic, Ante; Mise, Stjepan; Baotic, Tomislav; Staresinic, Mario; Radic, Bozo; Jakir, Ana; Vuksic, Tihomir; Anic, Tomislav; Seiwerth, Sven; Sikiric, Predrag

2006-11-01

68

Inconsistent association of esophageal symptoms, psychometric abnormalities and dysmotility  

Microsoft Academic Search

OBJECTIVES:The aim of this study was to characterize the psychometric profiles of symptomatic patients with abnormal esophageal motility and symptomatic patients with normal manometric findings compared to asymptomatic controls.METHODS:A total of 113 patients with abnormal esophageal motility (7 achalasia, 8 diffuse esophageal spasm, 27 nutcracker esophagus, 37 hypertensive lower esophageal sphincter, 21 hypotensive peristalsis, 13 failed peristalsis), 23 symptomatic controls

Chi W. Song; Seong J. Lee; Yoon T. Jeen; Hoon J. Chun; Soon H. Um; Chang D. Kim; Ho S. Ryu; Jin H. Hyun; Min S. Lee; Peter J. Kahrilas

2001-01-01

69

The effect of manometric assembly diameter on intraluminal esophageal pressure recording  

Microsoft Academic Search

Recent studies indicate that lower esophageal sphincter pressure is influenced by manometric assembly diameter. This study determines the effect of assembly diameter on both esophageal sphincter pressure and peristaltic pressure in the esophageal body. We performed esophageal manometric studies in 6 normal subjects using graded assembly diameters. High-fidelity recording was achieved by using a noncompliant catheter-infusion system. The results indicate

Sean B. Lydon; Wylie J. Dodds; Walter J. Hogan; Ronald C. Arndorfer

1975-01-01

70

[Esophageal diverticula].  

PubMed

Esophageal diverticula are classified by location-phrenoesophageal (Zenker's diverticulum-70%), thoracic and mediastinal (10%), and epiphrenic (20%). Almost all esophageal diverticula are acquired pulsion diverticula. The most common symptoms are dysphagia, regurgitation, thoracic pain, and pulmonary manifestations related to aspiration. Barium swallow and upper endoscopy will help to establish the diagnosis while esophageal manometry may reveal underlying dysmotility. Diverticula should not be treated unless they are symptomatic. The treatment of Zenker's diverticulum is surgical and consists of either diverticulectomy or diverticular suspension with a myotomy of the cricopharyngeus muscle via cervical approach. Transoral endoscopic stapled diverticulostomy is a new and simple approach which may become the treatment of choice, particularly in elderly and high-risk patients. Treatment of diverticula of the mid and low esophagus must take into account any motor anomalies or associated lesions. Diverticulectomy with esophageal myotomy and an anti-reflux procedure through a left thoracotomy is the standard approach, but endoscopic approaches seem feasible, particularly for epiphrenic diverticula, and may become the norm in years to come. PMID:15133431

Carrère, N; Pradère, B

2004-03-01

71

Esophageal tissue engineering: a new approach for esophageal replacement.  

PubMed

A number of congenital and acquired disorders require esophageal tissue replacement. Various surgical techniques, such as gastric and colonic interposition, are standards of treatment, but frequently complicated by stenosis and other problems. Regenerative medicine approaches facilitate the use of biological constructs to replace or regenerate normal tissue function. We review the literature of esophageal tissue engineering, discuss its implications, compare the methodologies that have been employed and suggest possible directions for the future. Medline, Embase, the Cochrane Library, National Research Register and ClinicalTrials.gov databases were searched with the following search terms: stem cell and esophagus, esophageal replacement, esophageal tissue engineering, esophageal substitution. Reference lists of papers identified were also examined and experts in this field contacted for further information. All full-text articles in English of all potentially relevant abstracts were reviewed. Tissue engineering has involved acellular scaffolds that were either transplanted with the aim of being repopulated by host cells or seeded prior to transplantation. When acellular scaffolds were used to replace patch and short tubular defects they allowed epithelial and partial muscular migration whereas when employed for long tubular defects the results were poor leading to an increased rate of stenosis and mortality. Stenting has been shown as an effective means to reduce stenotic changes and promote cell migration, whilst omental wrapping to induce vascularization of the construct has an uncertain benefit. Decellularized matrices have been recently suggested as the optimal choice for scaffolds, but smart polymers that will incorporate signalling to promote cell-scaffold interaction may provide a more reproducible and available solution. Results in animal models that have used seeded scaffolds strongly suggest that seeding of both muscle and epithelial cells on scaffolds prior to implantation is a prerequisite for complete esophageal replacement. Novel approaches need to be designed to allow for peristalsis and vascularization in the engineered esophagus. Although esophageal tissue engineering potentially offers a real alternative to conventional treatments for severe esophageal disease, important barriers remain that need to be addressed. PMID:23322987

Totonelli, Giorgia; Maghsoudlou, Panagiotis; Fishman, Jonathan M; Orlando, Giuseppe; Ansari, Tahera; Sibbons, Paul; Birchall, Martin A; Pierro, Agostino; Eaton, Simon; De Coppi, Paolo

2012-12-21

72

DNA methylation profiling in Barrett's esophagus and esophageal adenocarcinoma reveals unique methylation signatures and molecular subclasses.  

PubMed

Barrett's esophagus (BE) is a metaplastic process whereby the normal stratified, squamous esophageal epithelium is replaced by specialized intestinal epithelium. Barrett's is the only accepted precursor lesion for esophageal adenocarcinoma (EAC), a solid tumor that is rapidly increasing in incidence in western countries. BE evolves into EAC through intermediate steps that involve increasing degrees of dysplasia. Current histologic criteria are quite subjective and the clinical behavior of BE is highly variable and difficult to predict using these standards. It is widely believed that molecular alterations present in BE and EAC will provide more precise prognostic and predictive markers for these conditions than the current clinical and histologic features in use. In order to further define molecular alterations that can classify unique groups of BE and EAC, we utilized methylation microarrays to compare the global gene methylation status of a collection of normal squamous, BE, BE + high-grade dysplasia (HGD), and EAC cases. We found distinct global methylation signatures, as well as differential methylation of specific genes, that discriminated these histological groups. We also noted high and low methylation epigenotypes among the BE and EAC cases. Additional validation of those CpG sites that distinguished BE from BE + HGD and EAC may lead to the discovery of useful biomarkers with potential clinical applications in the diagnosis and prognosis of BE and EAC. PMID:22139570

Kaz, Andrew M; Wong, Chao-Jen; Luo, Yanxin; Virgin, Jeffrey B; Washington, M Kay; Willis, Joseph E; Leidner, Rom S; Chak, Amitabh; Grady, William M

2011-12-01

73

The functional interplay between EGFR overexpression, hTERT activation, and p53 mutation in esophageal epithelial cells with activation of stromal fibroblasts induces tumor development, invasion, and differentiation  

PubMed Central

Esophageal cancer is a prototypic squamous cell cancer that carries a poor prognosis, primarily due to presentation at advanced stages. We used human esophageal epithelial cells as a platform to recapitulate esophageal squamous cell cancer, thereby providing insights into the molecular pathogenesis of squamous cell cancers in general. This was achieved through the retroviral-mediated transduction into normal, primary human esophageal epithelial cells of epidermal growth factor receptor (EGFR), the catalytic subunit of human telomerase (hTERT), and p53R175H, genes that are frequently altered in human esophageal squamous cell cancer. These cells demonstrated increased migration and invasion when compared with control cells. When these genetically altered cells were placed within the in vivo-like context of an organotypic three-dimensional (3D) culture system, the cells formed a high-grade dysplastic epithelium with malignant cells invading into the stromal extracellular matrix (ECM). The invasive phenotype was in part modulated by the activation of matrix metalloproteinase-9 (MMP-9). Using pharmacological and genetic approaches to decrease MMP-9, invasion into the underlying ECM could be suppressed partially. In addition, tumor differentiation was influenced by the type of fibroblasts within the stromal ECM. To that end, fetal esophageal fibroblasts fostered a microenvironment conducive to poorly differentiated invading tumor cells, whereas fetal skin fibroblasts supported a well-differentiated tumor as illustrated by keratin “pearl” formation, a hallmark feature of well-differentiated squamous cell cancers. When inducible AKT was introduced into fetal skin esophageal fibroblasts, a more invasive, less-differentiated esophageal cancer phenotype was achieved. Invasion into the stromal ECM was attenuated by genetic knockdown of AKT1 as well as AKT2. Taken together, alterations in key oncogenes and tumor suppressor genes in esophageal epithelial cells, the composition and activation of fibroblasts, and the components of the ECM conspire to regulate the physical and biological properties of the stroma. PMID:17974918

Okawa, Takaomi; Michaylira, Carmen Z.; Kalabis, Jiri; Stairs, Douglas B.; Nakagawa, Hiroshi; Andl, Claudia; Johnstone, Cameron N.; Klein-Szanto, Andres J.; El-Deiry, Wafik S.; Cukierman, Edna; Herlyn, Meenhard; Rustgi, Anil K.

2007-01-01

74

Barrett’s esophagus and reflux esophagitis: is there a missing link?  

Microsoft Academic Search

OBJECTIVES:Barrett’s esophagus (BE) is associated with esophageal reflux. The development stage of BE is not well described. Epidemiological evidence indicates that the columnar epithelium in BE is acquired and reaches its full length rapidly. We tested the hypothesis that BE might result from direct replacement of erosions in reflux esophagitis (RE).METHODS:At endoscopy, we compared the length and distribution of esophageal

Alan J Cameron; Amindra S Arora

2002-01-01

75

Evaluation of Esophageal Motor Function With High-resolution Manometry  

PubMed Central

For several decades esophageal manometry has been the test of choice to evaluate disorders of esophageal motor function. The recent introduction of high-resolution manometry for the study of esophageal motor function simplified performance of esophageal manometry, and revealed previously unidentified patterns of normal and abnormal esophageal motor function. Presentation of pressure data as color contour plots or esophageal pressure topography led to the development of new tools for analyzing and classifying esophageal motor patterns. The current standard and still developing approach to do this is the Chicago classification. While this methodical approach is improving our diagnosis of esophageal motor disorders, it currently does not address all motor abnormalities. We will explore the Chicago classification and disorders that it does not address. PMID:23875094

2013-01-01

76

Esophageal Cancer  

Microsoft Academic Search

\\u000a Treatment of esophageal cancer by surgery alone, radiotherapy alone, or chemotherapy alone has not given satisfactory results.\\u000a In recent years integrated treatment schedules have been studied including first using intra-arterial chemotherapy as induction\\u000a treatment delivered in greater concentration and more directly to the cancer region. \\u000a Combined simultaneous chemo-radiation achieved a significantly higher rate of complete pCRs in comparison to chemotherapy

Tetsuo Taguchi

77

A Sequence Variant in the Phospholipase C Epsilon C2 Domain Is Associated With Esophageal Carcinoma and Esophagitis  

PubMed Central

A single-nucleotide polymorphism (rs2274223: A5780G:His1927Arg) in the phospholipase C epsilon gene (PLC?) was recently identified as a susceptibility locus for esophageal cancer in Chinese subjects. To determine the underlying mechanisms of PLC? and this SNP in esophageal carcinogenesis, we analyzed PLC? genotypes, expression, and their correlation in esophageal cancer cell lines, non-transformed esophageal cells, 58 esophageal squamous cell carcinomas and 10,614 non-cancer subjects from China. We found that the G allele (AG or GG) was associated with increased PLC? mRNA and protein expression in esophageal cancer tissues and in esophageal cancer cell lines. G allele was also associated with higher enzyme activity, which might be associated with increased protein expression. Quantitative analysis of the C2 domain sequences revealed that A:G allelic imbalance was strongly linked to esophageal malignancy. Moreover, the analysis of 10,614 non-cancer subjects demonstrated that the G allele was strongly associated with moderate to severe esophagitis in the subjects from the high-incidence areas of China (OR 6.03, 95% CI 1.59–22.9 in high-incidence area vs. OR 0.74, 95% CI 0.33–1.64 in low-incidence area; P = 0.008). In conclusion, the PLC? gene, particularly the 5780G allele, might play a pivotal role in esophageal carcinogenesis via upregulating PLC? mRNA, protein, and enzyme activity, and augmenting inflammatory process in esophageal epithelium. Thus, 5780G allele may constitute a promising biomarker for esophageal squamous cell carcinoma risk stratification, early detection, and progression prediction. PMID:23390063

Wang, Li-Dong; Bi, Xiuli; Song, Xin; Pohl, Nicole M.; Cheng, Yulan; Zhou, Yixing; Shears, Stephen; Ansong, Emmanuel; Xing, Mengtao; Wang, Shaomeng; Xu, Xiao-Chun; Huang, Peng; Xu, Liyan; Wang, Liang; Fan, Zongmin; Zhao, Xueke; Dong, Huali; Meltzer, Stephen J.; Ding, Ivan; Yang, Wancai

2014-01-01

78

Changes in cytokeratin expression accompany squamous metaplasia of the human respiratory epithelium  

Microsoft Academic Search

Summary To determine the characteristics of metaplastic changes of the nasal respiratory epithelium, the distribution of individual cytokeratins (CKs) was studied immunohistochemically and by two-dimensional gel electrophoresis. The authors define four types of changes of the normal pseudostratified columnar epithelium: (1) transitional pseudostratified epithelium (first unusual CK.: no. 13); (2) stratified columnar epithelium (increased expression of CKs 4 and 13;

P. Stosiek; M. Kasper; R. Moll

1992-01-01

79

Influence of Ionizing Radiation on Stromal-Epithelial Communication in Esophageal Carcinogenesis  

NASA Astrophysics Data System (ADS)

Esophageal cancer is the 6th leading cause of cancer death worldwide and is associated with a variety of risk factors including tobacco use, heavy alcohol consumption, human papilloma virus infection, and certain dietary factors such as trace mineral and vitamin deficiencies. A connection with ionizing radiation exposure is revealed by the high excess relative risk for esophageal squamous cell carcinoma observed in the survivors of the atomic bomb detonations in Japan. Esophageal carcinomas are also seen as secondary malignancies in patients who received radiotherapy for breast and thoracic cancers; additionally, patients with head/neck and oral squamous cell cancers are at increased risk for metachronous esophageal squamous cell cancers. This malignancy is rapidly fatal, mainly because it remains asymptomatic until late, advanced stages when the disease is rarely responsive to treatment. In normal epithelium, the stromal microenvironment is essential for the maintenance and modulation of cell growth and differentiation. Cross talk between the epithelial and stromal compartments can influence many aspects of malignant progression, including tumor cell proliferation, migration, invasion and recruitment of new blood vessels. To test the hypothesis that radiation exposure plays a role in esophageal carcinogenesis via non-targeted mechanisms involving stromal-epithelial cell communication, we are studying radiation effects on hTERT-immortalized human esophageal epithelial cells and genetic variants grown in co-culture with human esophageal stromal fibrob-lasts (Okawa et al., Genes Dev. 2007. 21: 2788-2803). We examined how irradiation of stromal fibroblasts affected epithelial migration and invasion, behaviors associated with cancer promotion and progression. These assays were conducted in modified Boyden chambers using conditioned media from irradiated fibroblasts. Our results using low LET gamma radiation showed a dose-dependent increase in migration of epithelial cells when exposed to conditioned media from irradiated vs. non-irradiated fibroblasts. We also observed enhanced invasion through a basement membrane matrix in similarly treated cells. Candidate factors that me-diate these effects were identified using antibody capture arrays, and their increased secretion in irradiated fibroblasts was confirmed using ELISAs. We are currently analyzing the effect of these individual factors on epithelial migration and invasion, as well as their influence on cell survival and DNA repair. Our current studies using high-LET radiation will elucidate radiation quality effects on these processes. These results should further our understanding of the mechanisms by which radiation impacts the tissue microenvironment and how it influences cancer development processes.

Huff, Janice; Patel, Zarana; Grugan, Katharine; Rustgi, Anil; Cucinotta, Francis A.

80

Zn concentration in esophageal tissue in patients with and without upper gastrointestinal disease  

SciTech Connect

Measurements of tissue Zn in humans with upper gastrointestinal disease could provide information about underlying pathophysiology but these data have never been obtained. With recent endoscopic methods they obtained 2-6 mg pinch mucosal biopsies of epithelium and lamina propria from proximal (P), middle (M) and distal (D) areas of esophagus under direct vision through a flexible 1 cm endoscope in 35 subjects without gastrointestinal disease (N) and in 35 patients with the following endoscopically proven gastrointestinal pathology: 12 with esophagitis (E), 14 with duodenal ulcer disease (DU) and 9 with gastritis (G). Samples were dried, weighed, digested with HNO/sub 3/, dried, resuspended in 3% HNO/sub 3/ and Zn estimated by flame atomic absorption spectrophotometry. Esophageal Zn in N decreased progressively as biopsies extended from P to D (P, 108 +/- 29 ..mu..g/g dry weight, Mean +/- SEM; M, 158 +/- 23; D, 134 +/- 16) but this pattern was generally reversed in patients, with D consistently demonstrating Zn elevated 50-120% above normal. The greatest increase was in G in whom Zn in D was more than twice normal (DU, 290 +/- 76, p < 0.01). These are the first Zn levels obtained from esophagus in living human subjects and indicate (1) a specific pattern of Zn distribution in normal esophagus and (2) a significantly altered pattern in D in several diseases of the upper gastrointestinal tract.

Wong, R.K.H.; Kadakia, S.C.; Maydonovitch, C.; Johnson, L.F.; Nelson, N.; Henkin, R.I.

1986-03-05

81

Snapshot of Esophageal Cancer  

MedlinePLUS

... NCI Budget (Billions of $) NCI Esophageal Cancer Research Investment Source: NCI Office of Budget and Finance. If ... which include the Asian Barrett’s Consortium and the International Barrett’s and Esophageal Adenocarcinoma Consortium (BEACON), were formed ...

82

Effect of polyunsaturated fatty acids on tight junctions in a model of the human intestinal epithelium under normal and inflammatory conditions.  

PubMed

Owing to their immune-modulatory action on the intestinal mucosa immune cells, the n-3 and n-6 polyunsaturated fatty acids (PUFA) have been suggested to modulate the risk and development of inflammatory bowel diseases. Failure in the intestinal barrier is an important hallmark of inflammatory bowel diseases. This study aimed at evaluating the impact of dietary PUFA on tight junction protein localisation and on the modulation of epithelial permeability under physiological conditions or under an inflammatory stress. For this purpose, we first confirmed the accumulation of PUFA in phospholipid fractions of Caco-2 cells upon 7 days of incubation with specific PUFA. Thereafter, Caco-2 cells were cultured in inserts, which provide a model of the human intestinal barrier. Accumulation of dietary n-3 PUFA in phospholipids did not affect the presence of occludin in tight junction complexes, while that of dietary n-6 PUFA decreased it. Whatever the PUFA, at 30 ?M, no distortion of the Caco-2 barrier function was observed. Otherwise, 150 ?M of docosahexaenoic acid (DHA) affected ZO-1 intensity under normal conditions, but not occludin or the barrier function parameters. Finally, to simulate an inflammatory state, cells were exposed for 24 h to interleukin-1?, tumor necrosis factor-?, interferon-? at their basolateral side and to lypopolysaccharides at both sides. DHA limited the effect of inflammatory stimulus on occludin, ZO-1 and barrier function. In conclusion, this study has evidenced the specific effect of individual PUFA to modulate occludin and ZO-1 localization, according to the inflammatory status of this in vitro model of the intestinal barrier. PMID:23660640

Beguin, Pauline; Errachid, Abdelmounaim; Larondelle, Yvan; Schneider, Yves-Jacques

2013-06-01

83

Robotic benign esophageal procedures.  

PubMed

Robotic master-slave devices can assist surgeons to perform minimally invasive esophageal operations with approaches that have already been demonstrated using laparoscopy and thoracoscopy. Robotic-assisted surgery for benign esophageal disease is described for the treatment of achalasia, epiphrenic diverticula, refractory reflux, paraesophageal hernias, duplication cysts, and benign esophageal masses, such as leiomyomas. Indications and contraindications for robotic surgery in benign esophageal disease should closely approximate the indications for laparoscopic and thoracoscopic procedures. Given the early application of the technology and paucity of clinical evidence, there are currently no procedures for which robotic esophageal surgery is the clinically proven preferred approach. PMID:24780427

Hanna, Jennifer M; Onaitis, Mark W

2014-05-01

84

Integrin Expression in Esophageal Squamous Cell Carcinoma: Loss of the Physiological Integrin Expression Pattern Correlates with Disease Progression  

PubMed Central

The integrins are a family of heterodimeric transmembrane signaling receptors that mediate the adhesive properties of epithelial cells affecting cell growth and differentiation. In many epithelial malignancies, altered integrin expression is associated with tumor progression and often correlates with unfavorable prognosis. However, only few studies have investigated the role of integrin expression in esophageal squamous cell carcinoma (ESCC). Using a novel quantifying immunofluorescence-staining assay, we investigated the expression of the integrins ?2?1, ?3?1, ?6?1, and ?6?4 in primary ESCC of 36 patients who underwent surgical resection. Magnitude and distribution of expression were analyzed in primary tumor samples and autologous esophageal squamous epithelium. The persistence of the physiologically polarized expression of the subunits ?6, ?1, and ?4 in the tumor tissue was significantly associated with prolonged relapse-free survival (p?=?0.028, p?=?0.034, p?=?0.006). In contrast, patients with reduced focal ?6 expression at the tumor invasion front shared a significantly shortened relapse-free survival compared to patients with strong ?6 expression at their stromal surfaces, as it was regularly observed in normal esophageal epithelium (p?=?0.001). Multivariate regression analysis identified the maintenance of strong ?6 immunoreactivity at the invasion front as an independent prognostic factor for increased relapse-free and disease-specific survival (p?=?0.003; p?=?0.003). Our findings suggest that alterations in both pattern and magnitude of integrin expression may play a major role in the disease progression of ESCC patients. Particularly, the distinct expression of the integrins ?6?4 and ?6?1 at the invasion front as well as the maintenance of a polarized integrin expression pattern in the tumor tissue may serve as valuable new markers to assess the aggressiveness of ESCC. PMID:25398092

Vay, Christian; Hosch, Stefan B.; Stoecklein, Nikolas H.; Klein, Christoph A.; Vallböhmer, Daniel; Link, Björn-Christian; Yekebas, Emre F.; Izbicki, Jakob R.; Knoefel, Wolfram T.; Scheunemann, Peter

2014-01-01

85

Inflammation-Related Carcinogenesis and Prevention in Esophageal Adenocarcinoma Using Rat Duodenoesophageal Reflux Models  

PubMed Central

Development from chronic inflammation to Barrett's adenocarcinoma is known as one of the inflammation-related carcinogenesis routes. Gastroesophageal reflux disease induces regurgitant esophagitis, and esophageal mucosa is usually regenerated by squamous epithelium, but sometimes and somewhere replaced with metaplastic columnar epithelium. Specialized columnar epithelium, so-called Barrett's epithelium (BE), is a risk factor for dysplasia and adenocarcinoma in esophagus. Several experiments using rodent model inducing duodenogastroesophageal reflux or duodenoesophageal reflux revealed that columnar epithelium, first emerging at the proliferative zone, progresses to dysplasia and finally adenocarcinoma, and exogenous carcinogen is not necessary for cancer development. It is demonstrated that duodenal juice rather than gastric juice is essential to develop esophageal adenocarcinoma in not only rodent experiments, but also clinical studies. Antireflux surgery and chemoprevention by proton pump inhibitors, nonsteroidal anti-inflammatory drugs, selective cyclooxygenase-2 inhibitors, green tea, retinoic acid and thioproline showed preventive effects on the development of Barrett's adenocarcinoma in rodent models, but it remains controversial whether antireflux surgery could regress BE and prevent esophageal cancer in clinical observation. The Chemoprevention for Barrett's Esophagus Trial (CBET), a phase IIb, multicenter, randomized, double-masked study using celecoxib in patients with Barrett's dysplasia failed to prove to prevent progression of dysplasia to cancer. The AspECT (Aspirin Esomeprazole Chemoprevention Trial), a large multicenter phase III randomized trial to evaluate the effects of esomeprazole and/or aspirin on the rate of progression to high-grade dysplasia or adenocarcinoma in patients with BE is now ongoing. PMID:24212953

Fujimura, Takashi; Oyama, Katsunobu; Sasaki, Shozo; Nishijima, Koji; Miyashita, Tomoharu; Ohta, Tetsuo; Koichi, Miwa; Takanori, Hattori

2011-01-01

86

Inflammation-related carcinogenesis and prevention in esophageal adenocarcinoma using rat duodenoesophageal reflux models.  

PubMed

Development from chronic inflammation to Barrett's adenocarcinoma is known as one of the inflammation-related carcinogenesis routes. Gastroesophageal reflux disease induces regurgitant esophagitis, and esophageal mucosa is usually regenerated by squamous epithelium, but sometimes and somewhere replaced with metaplastic columnar epithelium. Specialized columnar epithelium, so-called Barrett's epithelium (BE), is a risk factor for dysplasia and adenocarcinoma in esophagus. Several experiments using rodent model inducing duodenogastroesophageal reflux or duodenoesophageal reflux revealed that columnar epithelium, first emerging at the proliferative zone, progresses to dysplasia and finally adenocarcinoma, and exogenous carcinogen is not necessary for cancer development. It is demonstrated that duodenal juice rather than gastric juice is essential to develop esophageal adenocarcinoma in not only rodent experiments, but also clinical studies. Antireflux surgery and chemoprevention by proton pump inhibitors, nonsteroidal anti-inflammatory drugs, selective cyclooxygenase-2 inhibitors, green tea, retinoic acid and thioproline showed preventive effects on the development of Barrett's adenocarcinoma in rodent models, but it remains controversial whether antireflux surgery could regress BE and prevent esophageal cancer in clinical observation. The Chemoprevention for Barrett's Esophagus Trial (CBET), a phase IIb, multicenter, randomized, double-masked study using celecoxib in patients with Barrett's dysplasia failed to prove to prevent progression of dysplasia to cancer. The AspECT (Aspirin Esomeprazole Chemoprevention Trial), a large multicenter phase III randomized trial to evaluate the effects of esomeprazole and/or aspirin on the rate of progression to high-grade dysplasia or adenocarcinoma in patients with BE is now ongoing. PMID:24212953

Fujimura, Takashi; Oyama, Katsunobu; Sasaki, Shozo; Nishijima, Koji; Miyashita, Tomoharu; Ohta, Tetsuo; Miwa, Koichi; Hattori, Takanori

2011-01-01

87

The expression of ?-catenin in esophageal squamous cell carcinoma and its correlations with prognosis of patients.  

PubMed

As a member of the catenin family, expression of ?-catenin and its clinical implication in numerous tumors remain unclear. In the present study, expression of ?-catenin in esophageal squamous cell carcinoma (ESCC) and its correlations with patient prognosis were explored. We detected the expression of ?-catenin, by immunohistochemistry, in ESCC tissues from 299 cases and analyzed the correlation between ?-catenin expression and patient clinicopathological features. Compared with a lack of expression in adjacent normal esophageal epithelium (0%, 0/47), the frequency of ?-catenin protein was increased in ESCC tissues to 41.5% (124/299, P < .001) and expression correlated with TNM stage and lymph node metastasis (P = .025 and .019, respectively). Furthermore, Kaplan-Meier survival analysis revealed that patients with high ?-catenin expression had shorter survival than patients with low expression (P = .010), and multivariate Cox analysis revealed that high ?-catenin expression was also an independent prognostic factor (P = .001). In transwell assays, migration of ESCC cells was enhanced by ?-catenin overexpression, whereas proliferation of ESCC cells was unchanged. Together, our results suggest that ?-catenin acts as an oncoprotein when overexpressed in ESCC, and its expression is associated with poor prognosis and malignant cell behavior. PMID:25090917

Zhang, Jun-Yi; Bai, Chun-Ying; Bai, Yu-Qin; Zhang, Jing-Yi; Wu, Zhi-Yong; Wang, Shao-Hong; Xu, Xiu-E; Wu, Jian-Yi; Zhu, Ying; Rui, Yun; Li, En-Min; Xu, Li-Yan

2014-10-01

88

Developmental origin of vaginal epithelium  

Microsoft Academic Search

The developmental origin of vaginal epithelium has been controversial for nearly a century, with speculation that vaginal epithelium originates from the Müllerian duct, Wolffian duct, and\\/or urogenital sinus. None of these possibilities have been definitively proven or disproven by direct scientific data. To define precisely the origin of vaginal epithelium, epithelial cells of the Müllerian duct, Wolffian duct, or urogenital

Takeshi Kurita

2010-01-01

89

Esophageal schwannoma: a case report  

PubMed Central

Most tumorous lesions of the esophagus are esophageal cancers. Benign primary tumors of the esophagus are uncommon, and account for approximately 2% of all esophageal tumors. More than 80% of benign esophageal tumors are leiomyomas, with schwannomas being rare. A 55-year-old woman visited our internal medicine department with complaints of palpitations and discomfort during swallowing. A chest computed tomography scan showed a lobulated tumor (75 × 57 × 80 mm) in the upper to middle mediastinum, with homogenous inner opacity, compressing the esophagus. Upper gastrointestinal endoscopy revealed a smooth-surfaced elevated lesion covered with normal mucosa, and a schwannoma was diagnosed based on the biopsy result. The tumor was large. It was thus considered to be difficult to repair the esophagus by direct anastomosis after tumor resection. Therefore, subtotal esophagectomy and esophagogastrostomy in the right thorax were performed. Histopathological examination revealed spindle-shaped cells in a fasciculated and disarrayed architecture and nuclei in a palisading pattern. Immunohistochemical studies revealed S100 protein positivity and the absence of staining for ? smooth muscle actin (?SMA), CD34 and CD117, thereby establishing the diagnosis of benign schwannoma. Her postoperative course was uneventful and there has been no evidence of recurrence to date. PMID:24088647

2013-01-01

90

Matrilysin expression and function in airway epithelium.  

PubMed Central

We report that matrilysin, a matrix metalloproteinase, is constitutively expressed in the epithelium of peribronchial glands and conducting airways in normal lung. Matrilysin expression was increased in airway epithelial cells and was induced in alveolar type II cells in cystic fibrosis. Other metalloproteinases (collagenase-1, stromelysin-1, and 92-kD gelatinase) were not produced by normal or injured lung epithelium. These observations suggest that matrilysin functions in injury-mediated responses of the lung. Indeed, matrilysin expression was increased in migrating airway epithelial cells in wounded human and mouse trachea. In human tissue, epithelial migration was reduced by > 80% by a hydroxamate inhibitor, and in mouse tissue, reepithelialization in trachea from matrilysin-null mice was essentially blocked. In vivo observations and cell culture studies demonstrated that matrilysin was secreted lumenally by lung epithelium, but upon activation or while migrating over wounds, some matrilysin was released basally. The constitutive production of matrilysin in conducting airways, its upregulation after injury, its induction by alveolar epithelium, and its release into both lumenal and matrix compartments suggest that this metalloproteinase serves multiple functions in intact and injured lung, one of which is to facilitate reepithelialization. PMID:9769324

Dunsmore, S E; Saarialho-Kere, U K; Roby, J D; Wilson, C L; Matrisian, L M; Welgus, H G; Parks, W C

1998-01-01

91

Stomach-Esophageal Cancer  

Cancer.gov

Stomach and esophageal cancers are close in anatomical location and have been combined into one project within TCGA. Although they are two separate cancer types, TCGA is collecting samples from various anatomic subsites along the esophageal and gastric tracts for analysis.

92

5-ALA/PpIX fluorescence detection of esophageal and stomach neoplasia: effects of autofluorescence background from normal and inflammatory areas  

NASA Astrophysics Data System (ADS)

Delta-aminolevulinic acid / protoporphyrin IX is applied for exogenous fluorescent tumor detection in the upper part of gastrointestinal tract. The 5-ALA is administered per os six hours before measurements at dose 20mg/kg weight. Highpower light-emitting diode at 405 nm is used as a source and the excitation light is passed through the light-guide of standard video-endoscopic system to obtain 2-D visualization. Through endoscopic instrumental channel a fiber is applied to return information about fluorescence to microspectrometer. In such way 1-D detection and 2-D visualization of the lesions' fluorescence are received. The results from in vivo detection show significant differentiation between normal and abnormal tissues in 1-D spectroscopic regime, but only moderate discrimination in 2-D imaging. In the case of 2-D video visualization the problem of relatively high levels of the autofluorescence signal in the red spectral region gives low contrast between normal and abnormal mucosa when standard CCD camera of the endoscope is applied. Sensitized inflammatory areas also give to the observer in 2-D mode low contrast between malignant areas and benign tissues and finally the emission signals are additionally altered from the re-absorption of the chromophores accumulated in the tissue investigated. The possibilities for proper discrimination between normal, inflammatory and malignant tissues using 5-ALA/PpIX and both - advantages and limitations of 1-D and 2-D fluorescent detection modes are discussed in relation to their clinical applicability.

Borisova, Ekaterina; Vladimirov, Borislav; Avramov, Lachezar

2008-12-01

93

Treatment and long-term outcome of chronic radiation esophagitis after radiation therapy for head and neck tumors  

Microsoft Academic Search

The natural history of chronic radiation esophagitis occuring in previously normal esophagus is still unknown. We describe here the long-term outcome of chronic esophagitis arising after neck irradiation for oropharynx and larynx carcinomas in 13 consecutive adult patients. The first clinical signs of radiation esophagitis were dysphagia or impossibility of oral intake, which appeared within 26 months (range 2–120 months)

Christine Silvain; Thierry Barrioz; Isabelle Besson; Philippe Babin; Jean Pierre Fontanel; Alain Daban; Claude Matuchansky; Michel Beauchant

1993-01-01

94

Transhiatal Esophageal Resection for Corrosive Injury  

PubMed Central

Objectives: To analyze the feasibility and safety of transhiatal approach for resection of corrosively scarred esophagus. Background Summary Data: The unrelenting corrosive strictures of esophagus merit esophageal substitution. Because of the risk of complications in the retained esophagus, such as malignancy, mucocele, gastroesophageal reflux, and bleeding, esophageal resection is deemed necessary. Transthoracic approach for esophageal resection is considered safe. The safety and feasibility of transhiatal resection of the esophagus is not established in corrosive injury of the esophagus. Patients and Methods: Transhiatal approach was used for resection of the scarred esophagus for all patients between January 1986 and December 2001. The intraoperative complications, indications for adding thoracotomy, and postoperative outcome were studied in 51 patients. Follow-up period varied from minimum of 6 months to 15 years. Results: Esophageal resection was achieved in 49 of 51 patients whereas thoracotomy was added in 2 patients. In 1 of the patients tracheal injury occurred whereas in other patient there were dense adhesions between tracheal membrane and esophagus. Gastric tube was used for esophageal substitution in 40 (78.4%) patients whereas colon was transplanted in 11 (21.6%) patients. Colon was used only when stomach was not available. One patient (1.9%) had tracheal membrane injury whereas 4 patients (7.8%) had recurrent laryngeal nerve palsy. One patient each had thoracic duct injury and intrathoracic gastric tube leak. There was no operative mortality. Anastomotic complications like leak were present in 19.6% and stricture in 58.8% patients. All the patients were able to resume their normal duties and swallow normal food within 6 months of the surgery. Conclusion: One-stage transhiatal esophageal resection and reconstruction could be safely used for the extirpation of scarred esophagus. Use of gastric conduit was technically simple, quicker, and offered good functional outcome. Postoperative anastomotic stricture amenable to dilatations was the commonest complication. PMID:15075652

Gupta, Narendar Mohan; Gupta, Rajesh

2004-01-01

95

Comparison of long non-coding RNAs, microRNAs and messenger RNAs involved in initiation and progression of esophageal squamous cell carcinoma  

PubMed Central

Traditionally, cancer research has focused on protein-coding genes, which are considered the principal effectors and regulators of tumorigenesis. Non-coding RNAs, in particular microRNAs (miRNAs) and long non-coding RNAs (lncRNAs), have been widely reported to be important in the regulation of tumorigenesis and cancer development. However, to the best of our knowledge, investigation of the expression profiles of lncRNAs and a comparison of the involvement of lncRNAs, miRNAs and messenger RNAs (mRNAs) in esophageal tumorigenesis and development have not previously been performed. In the current study, intrinsic associations among the expression profiles of lncRNAs, miRNAs and mRNAs from normal esophageal tissues and those from cancer tissues were investigated. Oligonucleotide microarrays were used to detect the expression profiles of the three types of RNA in the canceration processes of human esophageal squamous cell carcinoma (ESCC) tissues. It was demonstrated that the different RNAs exhibit associated patterns of expression among normal esophageal epithelium, low-grade intraepithelial neoplasia (LGIN), high-grade intraepithelial neoplasia (HGIN), and carcinoma tissues, particularly in the critical period of canceration (HGIN to ESCC). Furthermore, the results indicated a high level of similarity in the potential function of lncRNAs, miRNAs and mRNAs in the processes of ESCC development. In the current study, a first generation atlas of lncRNA profiling and its association with miRNAs and mRNAs in the canceration processes of ESCC were presented. PMID:24888564

LI, SU-QING; LI, FENG; XIAO, YUN; WANG, CHUN-MEI; TUO, LEI; HU, JING; YANG, XIAO-BIN; WANG, JIN-SONG; SHI, WEI-HONG; LI, XIA; CAO, XIU-FENG

2014-01-01

96

Prevalence of human papillomavirus infection in esophageal and cervical cancers in the high incidence area for the two diseases from 2007 to 2009 in Linzhou of Henan Province, Northern China.  

PubMed

The etiological role of human papillomavirus (HPV) in cervical cancer has been well established. However, it is inconclusive whether HPV plays the same role in esophageal carcinogenesis. In this study, we detected HPV infection in 145 frozen esophageal tissues, including 30 normal epithelium (ENOR), 37 dysplasia (DYS) and 78 invasive squamous cell carcinoma (ESCC), and in 143 frozen cervical tissues composed of 30 normal epithelium (CNOR), 38 intraepithelial neoplasia (CIN) and 75 invasive squamous cell carcinoma (CSCC). The patients and symptom-free subjects enrolled in this study were from a high-incidence area for both ESCC and CSCC, Linzhou City, Northern China, from 2007 to 2009. The HPV infection analysis was conducted by using an HPV GenoArray Test Kit. We found that the high-risk HPV types accounted for more than 90 % of the HPV-positive lesions of esophagus and cervix tissues. The prevalence of high-risk HPV types increased significantly during the progression of both esophageal and cervical carcinogenesis (positive rate in esophageal tissues: 33 % ENOR, 70 % in DYS and 69 % in ESCC; positive rate in cervical tissues: 27 % in CNOR, 82 % in CIN and 88 % in CSCC; P < 0.001, respectively). Infection with the high-risk HPV types increased the risk for both DYS and ESCC by 4-fold (DYS vs. ENOR: OR = 4.73, 95 %CI = 1.68-13.32; ESCC vs. ENOR: OR = 4.50, 95 %CI = 1.83-11.05) and increased the risk for both CIN and CSCC by 12-fold and 20-fold (CIN vs. CNOR: OR = 12.18, 95 %CI = 3.85-38.55; CSCC vs. CNOR: OR = 20.17, 95 %CI = 6.93-58.65), respectively. The prevalence of high-risk types in ESCC patients was lower than that in CSCC patients (P = 0.005) and was significantly associated with the degree of ESCC tumor infiltration (P = 0.001). HPV 16 was the most prevalent subtype in both esophageal and cervical tissues. Single HPV infection increased significantly along with the progression of ESCC and maintained a high level in cervical tissues, regardless of whether they were CNOR or CSCC tissues. Our results showed that infection with HPV, especially the high-risk types, was positively associated with both esophageal and cervical cancers, suggesting that HPV also plays a role in the etiology of ESCC in the high-incidence area. PMID:24385156

Liu, Hong Yan; Zhou, Sheng Li; Ku, Jian Wei; Zhang, Dong Yun; Li, Bei; Han, Xue Na; Fan, Zong Min; Cui, Ji Li; Lin, Hong Li; Guo, Er Tao; Chen, Xi; Yuan, Yuan; Han, Jing Jing; Zhang, Wei; Zhang, Lian Qun; Zhou, Fu You; Liao, Shi Xiu; Hong, Jun Yan; Wang, Li Dong

2014-06-01

97

Treatment-related esophagitis.  

PubMed

Current therapeutic approaches for lung cancer favor treatment intensification, with the presumption that dose-intense chemotherapy regimens and/or higher radiation therapy (RT) doses or novel fractionation schemes will result in increased patient survival. Also, the trend for non-operative therapy has favored concurrent over sequential regimens. The incidence of severe acute esophagitis in patients treated for lung cancer with standard (once daily) RT alone is 1.3%, and induction chemotherapy increases the risk of severe acute esophagitis slightly over that of standard RT alone. In contrast, a strong radiosensitizing effect of chemotherapy given concurrently with standard thoracic RT (chemoRT) is associated with an incidence of severe esophagitis of 14% to 49%. Acute esophagitis may be severe and disabling, and result in hospitalization, placement of a feeding tube in the stomach or intravenous feedings, and steady supportive care. Also, RT may need to be halted temporarily to allow for healing of the esophageal lining; treatment breaks in turn decrease survival of patients with unresectable lung cancer. Therefore, esophagitis as a dose-limiting toxicity of chemoRT may have a direct impact on tumor control and survival. Aggressive types of RT fractionation have also been associated with worsening esophagitis grades and duration. Moreover, it is commonly assumed in the radiation oncology clinic that the longer the length of the esophagus segment included in the RT field the higher the probability of esophageal toxicity, although differing opinions are commonly expressed. Recent advances in 3-dimensional conformal RT allow a unique chance to gain volumetric data pertaining to organ damage rather than rely on older estimates based on organ length (eg, esophagus) or portion (ie, lung, spinal cord). The Radiation Therapy Oncology Group (RTOG) conducted a large phase III, randomized study RTOG 98-01 examining chemoRT with or without the amifostine (Ethyol; MedImmune, Inc, Gaithersburg, MD), a cyto- and radioprotectant in locally advanced non-small cell lung cancer (n = 243). While amifostine did not significantly reduce severe esophagitis based on National Cancer Institute Common Toxicity Criteria and weekly physician dysphagia logs, swallowing dysfunction over time (based on patient diaries, the equivalent of Esophagitis Index) was significantly lower in the amifostine arm ( P = .03). Therefore, significant progress has been accomplished in our understanding of the basis of esophageal injury resulting from thoracic RT, and future effort may find other effective strategies to either minimize or eliminate esophagitis. PMID:16015537

Werner-Wasik, Maria

2005-04-01

98

Expression and significance of heat shock protein 70 and glucose-regulated protein 94 in human esophageal carcinoma  

Microsoft Academic Search

AIM: To investigate the expression and significance of heat shock protein 70 (HSP70) and glucose-regulated protein 94 (grp94) in human esophageal carcinoma and adjacent normal tissues. METHODS: The expression of HSP70 and grp94 in 78 human esophageal cancer and adjacent normal tissues was studied by immunohistochemistry and pathology photograph analysis. RESULTS: Both esophageal cancer and adjacent normal tissues could express

Xiao-Ping Wang; Guo-Zhen Liu; Ai-Li Song; Rui-Fen Chen; Hai-Yan Li; Yu Liu

99

Esophageal Cancer Prevention  

MedlinePLUS

... the type of cells that become malignant (cancerous): Squamous cell carcinoma : Cancer that begins in squamous cells , the thin, ... chance of developing esophageal cancer increases with age. Squamous cell carcinoma of the esophagus is more common in blacks ...

100

Epigenetics in esophageal cancers.  

PubMed

Esophageal cancers are a challenging upper gastrointestinal tract tumor entity for interdisciplinary oncology. For the two main histotypes, namely esophageal squamous cell carcinomas and Barrett's adenocarcinomas, several genetic aberrations have been shown to contribute to carcinogenesis and progression as well as to represent potential novel targets for therapeutic intervention. This is paralleled by growing insight into epigenetic alterations of esophageal cancers. Studies involving the analyses of human tissue specimens predominantly describe altered patterns of miRNA expression, DNA methylation patterns, and histone marks levels. This review provides a critical update on this increasing knowledge of epigenetic alteration in esophageal cancers by specifically focusing on the translational aspects of epigenetic analyses from human tissue specimens. PMID:24816987

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

2014-06-01

101

Thoracoabdominal foregut duplication cyst with respiratory epithelium and alimentary epithelium.  

PubMed

Thoracoabdominal foregut duplication is a rare congenital abnormality. The authors report a case of thoracoabdominal foregut duplication cyst in a 13-year-old male patient. The pathologic report revealed that a thoracic mass with a pseudostratified, ciliated, columnar epithelial lining (respiratory tract epithelium), an abdominal mass with gastric mucosa (alimentary tract epithelium), and the cyst originated from the foregut. PMID:20466096

Zhang, Juan; Zhang, Ke Ren; Bai, Yu Zuo; Song, Dan; Wang, Weilin

2010-05-01

102

Thoracoabdominal foregut duplication cyst with respiratory epithelium and alimentary epithelium  

Microsoft Academic Search

Thoracoabdominal foregut duplication is a rare congenital abnormality. The authors report a case of thoracoabdominal foregut duplication cyst in a 13-year-old male patient. The pathologic report revealed that a thoracic mass with a pseudostratified, ciliated, columnar epithelial lining (respiratory tract epithelium), an abdominal mass with gastric mucosa (alimentary tract epithelium), and the cyst originated from the foregut.

Juan Zhang; Ke Ren Zhang; Yu Zuo Bai; Dan Song; Weilin Wang

2010-01-01

103

Twenty-Four-Hour Ambulatory versus Stationary Esophageal Manometry in the Evaluation of Esophageal Motility in Patients with Gastroesophageal Reflux Disease  

Microsoft Academic Search

Background: Although stationary manometry commonly reveals esophageal body motility disorders in patients with gastroesophageal reflux disease (GERD), esophageal function cannot be fully and precisely assessed during normal daily activities by this investigatory modality. Aim: To compare the results of 24-hour ambulatory manometry with those of stationary manometry and to determine the specificity and accuracy of the former to detect motility

Emmanuel Chrysos; Elias H. Athanasakis; Odysseus John Zoras; John Tsiaoussis; Evaghelos Xynos

2002-01-01

104

Esophageal tissue engineering.  

PubMed

Esophageal tissue engineering is still in an early state, and ideal methods have not been developed. Since the beginning of the 20th century, advances have been made in the materials that can be used to produce an esophageal substitute. Three approaches to scaffold-based tissue engineering have yielded good results. The first development concerned non-absorbable constructs based on silicone and collagen. The need to remove the silicone tube is the main disadvantage of this material. Polymeric absorbable scaffolds have been used since the 1990s. The main polymeric material used is poly (glycolic) acid combined with collagen. The problem of stenosis remains prevalent in most studies using an absorbable construct. Finally, decellularized scaffolds have been used since 2000. The promises of this new approach are unfulfilled. Indeed, stenosis occurs when the esophageal defect is circumferential regardless of the scaffold materials. Cell supplementation can decrease the rate of stenosis, but the type(s) of cells and their roles have not been defined. Finally, esophageal tissue engineering cannot provide a functional esophageal substitute, and further development is necessary prior to conducting human clinical studies. PMID:24387697

Luc, Guillaume; Durand, Marlène; Collet, Denis; Guillemot, Fabien; Bordenave, Laurence

2014-03-01

105

Functional esophageal disorders.  

PubMed

Functional esophageal disorders represent processes accompanied by typical esophageal symptoms (heartburn, chest pain, dysphagia, globus) that are not explained by structural disorders, histopathology-based motor disturbances, or gastroesophageal reflux disease. Gastroesophageal reflux disease is the preferred diagnosis when reflux esophagitis or excessive esophageal acid exposure is present or when symptoms are closely related to acid reflux events or respond to antireflux therapy. A singular, well-defined pathogenetic mechanism is unavailable for any of these disorders; combinations of sensory and motor abnormalities involving both central and peripheral neural dysfunction have been invoked for some. Treatments remain empirical, although the efficacy of several interventions has been established in the case of functional chest pain. Management approaches that modulate central symptom perception or amplification often are required once local provoking factors (eg, noxious esophageal stimuli) have been eliminated. Future research directions include further determination of fundamental mechanisms responsible for symptoms, development of novel management strategies, and definition of the most cost-effective diagnostic and treatment approaches. PMID:16678559

Galmiche, Jean Paul; Clouse, Ray E; Bálint, András; Cook, Ian J; Kahrilas, Peter J; Paterson, William G; Smout, Andre J P M

2006-04-01

106

The intelligibility of time-domain-edited esophageal speech.  

PubMed

The intelligibility of esophageal speech has been shown to be significantly lower than that of normal laryngeal speech. The current study investigated the possibility of enhancing the intelligibility of esophageal speech by manipulating samples in the time domain. Specifically, injection noises and nonphrasal pauses were digitally edited from the speech samples of 5 esophageal talkers. Twenty-five sentences were selected and edited in the time domain and presented to 15 naive listeners who were instructed to write down the words that they heard. The percentage of correct words heard for each sentence was determined and compared across listeners, sentences, and talkers. The overall effect of the editing was a small but significant gain in the intelligibility of the esophageal speech. The improvement in intelligibility, however, depended on the individual talker, the speech material, and the number of editing changes made to a particular sample. PMID:11407558

Prosek, R A; Vreeland, L L

2001-06-01

107

Treatment and long-term outcome of chronic radiation esophagitis after radiation therapy for head and neck tumors: A report of 13 cases  

Microsoft Academic Search

The natural history of chronic radiation esophagitis occurring in previously normal esophagus is still unknown. The authors describe here the long-term outcome of chronic esophagitis arising after neck irradiation for oropharynx and larynx carcinomas in 13 consecutive adult patients. The first clinical signs of radiation esophagitis were dysphagia or impossibility of oral intake, which appeared within 26 months (range 2--120

C. Silvain; T. Barrioz; I. Besson; P. Babin; J. P. Fontanel; A. Daban; C. Matuchansky; M. Beauchant

1993-01-01

108

A Case of Esophageal Candidiasis in an Adolescent Who Had Frequently Received Budesonide Nebulizing Therapy  

PubMed Central

Corticosteroid (budesonide) nebulizer therapy is commonly performed. Its side effects have been considered as being safe or ignorable. The authors present a case of esophageal candidiasis in a healthy female adolescent who was treated with budesonide nebulizer therapy a few times for a cough during the previous winter season. This child presented with dysphagia and epigastric pain for 1 month. Esophageal endoscopy showed a whitish creamy pseudomembrane and erosions on the esophageal mucosa. Pathologic findings showed numerous candidal hyphae. She did not show any evidence of immunodeficiency, clinically and historically. The esophageal lesion did not resolve naturally. The esophageal lesion completely improved with the antifungal therapy for 2 weeks; the symptoms disappeared, and the patient returned to normal health. It is important that frequent esophageal exposure to topical corticosteroids application can cause unexpected side effects. PMID:24224152

Kang, Hae Ryong; Kwon, Yong Hoon

2013-01-01

109

Virological Diagnosis of Herpes Simplex Virus 1 Esophagitis by Quantitative Real-Time PCR Assay  

PubMed Central

Herpes simplex virus 1 (HSV-1) esophagitis diagnosis is routinely based on the endoscopic findings confirmed by histopathological examination of the esophagitis lesions. Virological diagnosis is not systematically performed and restricted to viral culture or to qualitative PCR assay from esophagitis biopsy specimens. The aim of this study was to assess the interest of quantitative real-time PCR assay in HSV-1 esophagitis diagnosis by comparing the results obtained to those of histological examination associated with immunohistochemical staining, which is considered the “gold standard.” From 53 esophagitis biopsy specimens, the PCR assay detected HSV-1 in 18 of 19 histologically proven to have herpetic esophagitis and in 9 of 34 that had esophagitis related to other causes, demonstrating sensitivity, specificity, positive predictive value, and negative predictive value of 94.7%, 73%, 66.7%, and 96%, respectively. Interestingly, HSV-1 was not detected in 16 specimens without the histological aspect of esophagitis. The viral loads normalized per ?g of total extracted DNA in each biopsy specimen detected positive by HSV PCR were then compared and appeared to be significantly higher in histopathologically positive herpetic esophagitis (median = 2.9 × 106 ± 1.1 × 108) than in histopathologically negative herpetic esophagitis (median = 3.1 × 103 ± 6.2 × 103) (P = 0.0009). Moreover, a receiver operating characteristics analysis revealed that a viral load threshold greater than 2.5 × 104 copies would allow an HSV-1 esophagitis diagnosis with a sensitivity and specificity of 83.3% and 100%, respectively. In conclusion, this work demonstrated that HSV quantitative PCR results for paraffin-embedded esophageal tissue was well correlated to histopathological findings for an HSV-1 esophagitis diagnosis and could be diagnostic through viral load assessment when histopathological results are missing or uncertain. PMID:22170921

Jazeron, Jean-Francois; Barbe, Coralie; Frobert, Emilie; Renois, Fanny; Talmud, Deborah; Brixi-Benmansour, Hedia; Brodard, Veronique; Andreoletti, Laurent; Diebold, Marie-Daniele

2012-01-01

110

Epidemiology of esophageal cancer  

PubMed Central

Esophageal cancer (EsC) is one of the least studied and deadliest cancers worldwide because of its extremely aggressive nature and poor survival rate. It ranks sixth among all cancers in mortality. In retrospective studies of EsC, smoking, hot tea drinking, red meat consumption, poor oral health, low intake of fresh fruit and vegetables, and low socioeconomic status have been associated with a higher risk of esophageal squamous cell carcinoma. Barrett’s esophagus is clearly recognized as a risk factor for EsC, and dysplasia remains the only factor useful for identifying patients at increased risk, for the development of esophageal adenocarcinoma in clinical practice. Here, we investigated the epidemiologic patterns and causes of EsC. Using population based cancer data from the Surveillance, Epidemiology and End Results Program of the United States; we generated the most up-to-date stage distribution and 5-year relative survival by stage at diagnosis for 1998-2009. Special note should be given to the fact that esophageal cancer, mainly adenocarcinoma, is one of the very few cancers that is contributing to increasing death rates (20%) among males in the United States. To further explore the mechanism of development of EsC will hopefully decrease the incidence of EsC and improve outcomes. PMID:24039351

Zhang, Yuwei

2013-01-01

111

Effect of bolus composition on esophageal transit: concise communication  

SciTech Connect

The technique of esophageal scintigraphy was developed as a sensitive, quantitative, noninvasive test of esophageal transit. Esophageal scintigraphy was performed in 40 asymptomatic normal volunteers in order to determine the effect on esophageal transit of the following: body posture (sitting vs. supine), liquid vs. solid, the solid being either a standard number4 gelatin capsule of the size used for antibiotic capsules, or a cube of solid food such as cooked chicken liver. The results showed that liquids emptied completely from the esophagus after one swallow, whether supine or sitting. Capsules or liver cubes, when ingested without water, frequently remained in the esophagus for up to two hours without the subject's having any sensation that the solid had not left the esophagus. Both capsules and liver cubes cleared the esophagus better in the upright than in the supine position. When gelatin capsules were swallowed with as little as 15 ml of water, but after a preliminary sip of water, there was complete transit in each case. The study suggests that the practice of assisting patients into a sitting position and instructing them to take a sip of water before attempting to swallow a capsule will assure better transit of the capsule even when swallowed with as little as 15 ml of water. This may reduce the incidence of esophagitis following oral antibiotics, and of esophageal erosions from aspirin-containing medications.

Fisher, R.S.; Malmud, L.S.; Applegate, G.; Rock, E.; Lorber, S.H.

1982-10-01

112

Effect of bolus composition on esophageal transit: concise communication  

SciTech Connect

The technique of esophageal scintigraphy was developed as a sensitive, quantitative, noninvasive test of esophageal transit. Esophageal scintigraphy was performed in 40 asymptomatic normal volunteers in order to determine the effect on esophageal transit of the following: body posture (sitting vs. supine), liquid vs. solid, the solid being either a standard gelatin capsule of the size used for antibiotic capsules, or a cube of solid food such as cooked chicken liver. The results showed that liquids emptied completely from the esophagus after one swallow whether supine or sitting. Capsules or liver cubes, when ingested without water, frequently remained in the esophagus for up to two hours without the subject's having any sensation that the solid had not left the esophagus. Both capsules and liver cubes cleared the esophagus better in the upright than in the supine position. When gelatin capsules were swallowed with as little as 15 ml of water, but after a preliminary sip of water, there was complete transit in each case. The study suggests that the practice of assisting patients into a sitting position and instructing them to take a sip of water before attempting to swallow a capsule will assure better transit of the capsule even when swallowed with as little as 15 ml of water. This may reduce the incidence of esophagitis following oral antibiotics, and of esophageal erosions from aspirin-containing medications.

Fisher, R.S.; Malmud, L.S.; Appelgate, G.; Rock, E.; Lorber, S.H.

1982-10-01

113

Further studies on the differentiation of the epithelium in the mouse vaginal anlage  

Microsoft Academic Search

Summary The authors have studied the occurrence of PAS positive substances during the differentiation of the vaginal epithelium in fetuses and neonatal mice. The material consists of normal mice, mice that have received estradiol injections for the first five days after birth, and mice that have received both estradiol and colchicine injections. The cranial 3\\/5 of the mouse vaginal epithelium

John Gunnar Forsberg; Hans Olivecrona

1965-01-01

114

Current strategies in chemoradiation for esophageal cancer  

PubMed Central

Chemoradiotherapy (CRT) has an important role in the treatment of esophageal cancer in both the inoperable and the pre-operative settings. Pre-operative chemoradiation therapy is generally given to 41.4-50.4 Gy with platinum or paclitaxel based chemotherapy. The most common definitive dose in the U.S. is 50-50.4 Gy. New advances in CRT for esophageal cancer have come from looking for ways to minimize toxicity and maximize efficacy. Recent investigations for minimizing toxicity have focused advanced radiation techniques such as IMRT and proton therapy, have sought to further define normal tissue tolerances, and have examined the use of tighter fields with less elective clinical target volume coverage. Efforts to maximize efficacy have included the use of early positron emission tomography (PET) response directed therapy, molecularly targeted therapies, and the use of tumor markers that predict response. PMID:24982764

Lloyd, Shane

2014-01-01

115

Esophageal disruption: evaluation with iohexol esophagography.  

PubMed

Twenty-six patients with possible esophageal disruption who were also at risk for aspiration or direct communication of the esophagus with the tracheobronchial tree were examined with iohexol esophagography. Fifteen patients had normal studies confirmed by findings at a barium examination performed immediately after. In 11 patients abnormalities were diagnosed on the basis of iohexol esophagograms; the abnormalities included extraluminal extravasation of contrast material (n = 7), aspiration (n = 1), esophageal stricture with intramural diverticulosis (n = 1), edema of the gastroesophageal junction (n = 1), and epiphrenic diverticulum (n = 1). Eight of these patients were immediately reexamined with barium esophagography, which yielded no additional information. Low-osmolality, water-soluble contrast agents are a safe alternative for patients in whom barium esophagography poses a risk of mediastinitis and esophagography with diatrizoate meglumine and diatrizoate sodium (Gastrografin) poses a risk of pulmonary edema. PMID:3420250

Brick, S H; Caroline, D F; Lev-Toaff, A S; Friedman, A C; Grumbach, K; Radecki, P D

1988-10-01

116

[The ciliated epithelium in the efferent ducts of the submandibular gland].  

PubMed

The examination of 442 bioptic and necroptic submandibular salivary glands revealed that in cases of chronic inflamation of the gland (125 cases) the epithelial lining of its ducts contained ciliated colummar epithelium in 57% of cases. The finding of ciliated epithelium was associated with lithiasis of the gland in nearly 79% of cases. Normal submandibular glands or glands affected with pathological conditions other than chronic inflammation did not contain ciliated epithelium. The present paper is the first one in the literature purposedly dealing with the presence of ciliated epithelium within the ducts of the submandibular gland. PMID:616330

Vortel, V; Sazama, L

1977-08-01

117

Tracheo-esophageal fistula: Successful palliation after failed esophageal stent  

PubMed Central

The incidence of tracheo-esophageal (TO) fistula is on the rise, especially after palliative management for esophageal malignancies. We report a case of cancer of esophagus who after chemotherapy and radiotherapy developed TO fistula. Placement of an esophageal stent helped him in taking food orally, but his cough and dyspnoea continued to worsen. Fibreoptic bronchoscopy demonstrated a severely compressed trachea secondary to protrusion of esophageal stent which responded very well to an Ultraflex-covered tracheal stent and the patient achieved relief from cough and dyspnoea. PMID:22919174

Chawla, Rakesh K.; Madan, Arun; Chawla, Kiran

2012-01-01

118

Practical management of eosinophilic esophagitis.  

PubMed

CME EDUCATIONAL OBJECTIVES 1. Determine the clinical presentation and diagnostic criteria for eosinophilic esophagitis in children. 2. Discuss the three major treatment strategies for eosinophilic esophagitis. 3. Provide key strategies for practical identification and management of eosinophilic esophagitis in children and adolescents. Eosinophilic esophagitis (EoE) is a recently discovered disease that affects patients worldwide. The conceptual definition of EoE is a chronic, immune/antigen-mediated esophageal disease characterized clinically by symptoms related to esophageal dysfunction and histologically by eosinophil-predominant inflammation. As a chronic, antigen-mediated disease causing eosinophilic inflammation in the esophagus, EoE symptoms are similar to gastroesophageal reflux disease (GERD) and it results in significant morbidity. PMID:23805960

Davis, Carla M

2013-07-01

119

21 CFR 876.5365 - Esophageal dilator.  

Code of Federal Regulations, 2011 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5365 Esophageal dilator. (a) Identification. An esophageal...

2011-04-01

120

21 CFR 876.5365 - Esophageal dilator.  

Code of Federal Regulations, 2013 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5365 Esophageal dilator. (a) Identification. An esophageal...

2013-04-01

121

21 CFR 876.5365 - Esophageal dilator.  

Code of Federal Regulations, 2012 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5365 Esophageal dilator. (a) Identification. An esophageal...

2012-04-01

122

21 CFR 876.5365 - Esophageal dilator.  

Code of Federal Regulations, 2010 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5365 Esophageal dilator. (a) Identification. An esophageal...

2010-04-01

123

21 CFR 876.5365 - Esophageal dilator.  

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5365 Esophageal dilator. (a) Identification. An esophageal...

2014-04-01

124

Proton pump inhibitor resistance, the real challenge in gastro-esophageal reflux disease  

PubMed Central

Gastro-esophageal reflux disease (GERD) is one of the most prevalent chronic diseases. Although proton pump inhibitors (PPIs) represent the mainstay of treatment both for healing erosive esophagitis and for symptom relief, several studies have shown that up to 40% of GERD patients reported either partial or complete lack of response of their symptoms to a standard PPI dose once daily. Several mechanisms have been proposed as involved in PPIs resistance, including ineffective control of gastric acid secretion, esophageal hypersensitivity, ultrastructural and functional changes in the esophageal epithelium. The diagnostic evaluation of a refractory GERD patients should include an accurate clinical evaluation, upper endoscopy, esophageal manometry and ambulatory pH-impedance monitoring, which allows to discriminate non-erosive reflux disease patients from those presenting esophageal hypersensitivity or functional heartburn. Treatment has been primarily based on doubling the PPI dose or switching to another PPI. Patients with proven disease, not responding to PPI twice daily, are eligible for anti-reflux surgery. PMID:24151377

Cicala, Michele; Emerenziani, Sara; Guarino, Michele Pier Luca; Ribolsi, Mentore

2013-01-01

125

Esophageal smooth muscle dysfunction in oculopharyngeal muscular dystrophy.  

PubMed

Oculopharyngeal muscular dystrophy (OPMD) is a rare genetic disorder with late-onset progressive myopathy affecting mainly head and neck striated muscles. It is more common in certain ethnic communities. Dysphagia was usually attributed to the malfunction of striated pharyngeal muscles. We studied a group of Bukharan immigrants affected by this disorder (N = 13). Esophageal studies, including endoscopy, manometry, and scintigraphic emptying were performed. Very low pharyngeal pressures were measured. Upper esophageal pressures (UEP) were in the normal range in eight patients, and above normal in three patients. Four also had low lower esophageal sphincter pressure. Esophageal body peristaltic activity was grossly impaired in all patients: mainly nonpropulsive, simultaneous, retrograde, and failed activity was recorded. Marked retention of isotopic material was demonstrated in all patients studied, usually in the middle and lower parts of the body, ranging from 17 to 100% retention. The dysphagia in OPMD is due not only to dysfunction of pharyngeal and upper esophageal striated muscle, but also has a significant smooth muscle component. PMID:8689911

Tiomny, E; Khilkevic, O; Korczyn, A D; Kimmel, R; Hallak, A; Baron, J; Blumen, S; Asherov, A; Gilat, T

1996-07-01

126

Radiochemotherapy of esophageal cancer.  

PubMed

Cancer of the esophagus continues to be a threat to public health. The common practice is esophagectomy for surgically resectable tumors and radiochemotherapy for locally advanced, unresectable tumors. However, local regional tumor control and overall survival of esophageal cancer patients after the standard therapies remain poor, approximately 30% of patients treated with surgery only will develop local recurrence, and 50% to 60% patients treated with radiochemotherapy only fail local regionally due to persistent disease or local recurrence. Esophagectomy after radiochemotherapy or preoperative radiochemotherapy has increased the complete surgical resection rate and local regional control without a significant survival benefit. Induction chemotherapy followed by preoperative radiochemotherapy has produced encouraging results. In addition to patient-, tumor-, and treatment-related factors, involvement of celiac axis nodes, number of positive lymph nodes after preoperative radiochemotherapy, incomplete pathologic response, high metabolic activity on positron emission tomography scan after radiochemotherapy, and incomplete surgical resection are factors associated with a poor outcome. Radiochemotherapy followed by surgery is associated with significant adverse effects, including treatment-related pneumonitis, postoperative pulmonary complications, esophagitis and pericarditis. The incidence and severity of the adverse effects are associated with chemotherapy and radiotherapy dosimetric factors. Innovative treatment strategies including physically and biologically molecular targeted therapy is needed to improve the treatment outcome of patients with esophageal cancer. PMID:17545853

Liao, Zhongxing; Cox, James D; Komaki, Ritsuko

2007-06-01

127

ATF3 functions as a novel tumor suppressor with prognostic significance in esophageal squamous cell carcinoma  

PubMed Central

ATF3 was a transcription factor involved in the progression of certain cancers. Here, we sought to explore the expression and biological function of ATF3 in esophageal squamous cell carcinomas (ESCC). The prognostic significance of ATF3 expression was evaluated in 150 ESCC samples and 21 normal squamous cell epithelium tissues. Results showed that ATF3 was down-regulated in ESCC lesions compared with paired non-cancerous tissues and low tumorous ATF3 expression significantly correlated with shorter overall survival (OS) and disease-free survival (DFS). Cox regression analysis confirmed that ATF3 expression was an independent prognostic factor. Experimentally, forced expression of ATF3 led to decreased growth and invasion properties of ESCC cells in vitro and in vivo, whereas knockdown of ATF3 did the opposite. Furthermore, ATF3 upregulated the expression of MDM2 by increasing the nuclear translocation of P53 and formed an ATF3/MDM2/MMP-2 complex that facilitated MMP-2 degradation, which subsequently led to inhibition of cell invasion. Finally, we showed that Cisplatin could restrain the invasion of ESCC cells by inducing the expression of ATF3 via P53 signaling. Combined, our findings highlight a suppressed role for ATF3 in ESCC and targeting ATF3 might be a potential therapeutic strategy. PMID:25149542

Xie, Jian-Jun; Xie, Yang-Min; Chen, Bo; Pan, Feng; Guo, Jin-Cheng; Zhao, Qing; Shen, Jin-Hui; Wu, Zhi-Yong; Wu, Jian-Yi; Xu, Li-Yan; Li, En-Min

2014-01-01

128

Preoperative chemotherapy in esophageal carcinoma  

Microsoft Academic Search

Preoperative chemotherapy for localized esophageal cancer is an area of increasing interest because neither surgery nor radiation has had a major impact on disease-free or overall survival. This is probably because, as several autopsy series have demonstrated, esophageal cancer is a systemic disease. Preoperative chemotherapy thus, in theory, allows a simultaneous attack on both the primary and metastatic disease. A

D. P. Kelsen

1987-01-01

129

Bile salts disrupt human esophageal squamous epithelial barrier function by modulating tight junction proteins.  

PubMed

Reflux of acid and bile acids contributes to epithelial tissue injury in gastro-esophageal reflux disease. However, the influence of refluxed material on human esophageal stratified epithelial barrier function and tight junction (TJ) proteins has not been fully elucidated. Here, we investigated the influence of acid and bile acids on barrier function and TJ protein distribution using a newly developed air-liquid interface (ALI) in vitro culture model of stratified squamous epithelium based on primary human esophageal epithelial cells (HEECs). Under ALI conditions, HEECs formed distinct epithelial layers on Transwell inserts after 7 days of culture. The epithelial layers formed TJ, and the presence of claudin-1, claudin-4, and occludin were detected by immunofluorescent staining. The NP-40-insoluble fraction of these TJ proteins was significantly higher by day 7 of ALI culture. Exposure of HEECs to pH 2, and taurocholic acid (TCA) and glycocholic acid (GCA) at pH 3, but not pH 4, for 1 h decreased transepithelial electrical resistance (TEER) and increased paracellular permeability. Exposure of cell layers to GCA (pH 3) and TCA (pH 3) for 1 h also markedly reduced the insoluble fractions of claudin-1 and -4. We found that deoxycholic acid (pH 7.4 or 6, 1 h) and pepsin (pH 3, 24 h) significantly decreased TEER and increased permeability. Based on these findings, ALI-cultured HEECs represent a new in vitro model of human esophageal stratified epithelium and are suitable for studying esophageal epithelial barrier functions. Using this model, we demonstrated that acid, bile acids, and pepsin disrupt squamous epithelial barrier function partly by modulating TJ proteins. These results provide new insights into understanding the role of TJ proteins in esophagitis. PMID:22575221

Chen, Xin; Oshima, Tadayuki; Shan, Jing; Fukui, Hirokazu; Watari, Jiro; Miwa, Hiroto

2012-07-15

130

Transport of acebutolol through rabbit corneal epithelium.  

PubMed

The purpose of this study is to characterize transport of acebutolol through the corneal epithelium. Cultured normal rabbit corneal epithelial cells (RCEC) were used to investigate the drug transport. Primary RCEC were seeded on a filter membrane of Transwell-COL insert coated with fibronectin and were grown in Dulbecco's modified Eagle's medium/nutrient mixture F-12 with various supplements. Measurements of acebutolol permeability through RCEC layer were carried out to assess transcellular permeability coefficient (P(transcell)) in the absence or presence of inhibitors. Paracellular permeability coefficient (P(paracell)) was calculated by permeability coefficient of hydrophilic drugs (P(cell)). The transcellular permeability of acebutolol from apical side to basal side (A-to-B) showed concentration-dependency. The acebutolol flux in the A-to-B direction was smaller than that of opposite direction. Sodium azide, verapamil, and cyclosporin A enhanced the transcellular permeability of acebutolol in the A-to-B direction. Acebutolol permeability through an excised rabbit cornea was also increased by verapamil. Thus, it was suggested that acebutolol was actively secreted via P-glycoprotein in a corneal epithelium. PMID:16595934

Kawazu, Kouichi; Oshita, Akemi; Nakamura, Tadahiro; Nakashima, Mikiro; Ichikawa, Nobuhiro; Sasaki, Hitoshi

2006-04-01

131

Metastatic esophageal carcinoma masquerading as inflammatory breast carcinoma.  

PubMed

A 50-year-old Caucasian woman with a history of esophageal adenocarcinoma presented with a 3-week history of right breast swelling and progressive erythema. Twenty-two months prior to presentation, she had been diagnosed with adenocarcinoma of the esophagus (T3,N1,M1a) and underwent neoadjuvant chemoradiotherapy followed by surgical resection. On physical examination, the right breast was red, swollen (40% larger than the contralateral breast), tender to palpation, and warm to the touch (Fig. 1). No mass was palpable. On the basis of the clinical findings, inflammatory breast carcinoma was suspected. A punch biopsy revealed a poorly differentiated adenocarcinoma with extensive involvement of dermal lymphatics (Fig. 2). The clinical and histologic differential diagnosis included inflammatory breast carcinoma vs. metastatic esophageal adenocarcinoma to the skin of the breast. To resolve this question, immunohistochemical stains for estrogen and progesterone receptors and CDX-2 (BioGenex, San Ramon, CA, USA) were performed. CDX-2 is an intestinal homeobox gene expressed in gastrointestinal epithelium and gastrointestinal tumors. The tumor nuclei were positive for CDX-2 but negative for both steroid receptors (Fig. 3), confirming the diagnosis of metastatic esophageal adenocarcinoma. PMID:17343591

Nebesio, Christy L; Goulet, Robert J; Helft, Paul R; Billings, Steven D

2007-03-01

132

Epithelium percentage estimation facilitates epithelial quantitative protein measurement in tissue specimens  

PubMed Central

Background The rapid advancement of high-throughput tools for quantitative measurement of proteins has demonstrated the potential for the identification of proteins associated with cancer. However, the quantitative results on cancer tissue specimens are usually confounded by tissue heterogeneity, e.g. regions with cancer usually have significantly higher epithelium content yet lower stromal content. Objective It is therefore necessary to develop a tool to facilitate the interpretation of the results of protein measurements in tissue specimens. Methods Epithelial cell adhesion molecule (EpCAM) and cathepsin L (CTSL) are two epithelial proteins whose expressions in normal and tumorous prostate tissues were confirmed by measuring staining intensity with immunohistochemical staining (IHC). The expressions of these proteins were measured by ELISA in protein extracts from OCT embedded frozen prostate tissues. To eliminate the influence of tissue heterogeneity on epithelial protein quantification measured by ELISA, a color-based segmentation method was developed in-house for estimation of epithelium content using H&E histology slides from the same prostate tissues and the estimated epithelium percentage was used to normalize the ELISA results. The epithelium contents of the same slides were also estimated by a pathologist and used to normalize the ELISA results. The computer based results were compared with the pathologist’s reading. Results We found that both EpCAM and CTSL levels, measured by ELISA assays itself, were greatly affected by epithelium content in the tissue specimens. Without adjusting for epithelium percentage, both EpCAM and CTSL levels appeared significantly higher in tumor tissues than normal tissues with a p value less than 0.001. However, after normalization by the epithelium percentage, ELISA measurements of both EpCAM and CTSL were in agreement with IHC staining results, showing a significant increase only in EpCAM with no difference in CTSL expression in cancer tissues. These results were obtained with normalization by both the computer estimated and pathologist estimated epithelium percentage. Conclusions Our results show that estimation of tissue epithelium percentage using our color-based segmentation method correlates well with pathologists' estimation of tissue epithelium percentages. The epithelium contents estimated by color-based segmentation may be useful in immuno-based analysis or clinical proteomic analysis of tumor proteins. The codes used for epithelium estimation as well as the micrographs with estimated epithelium content are available online. PMID:24289299

2013-01-01

133

Congenital esophageal webs 1 Presented as a poster at the 24th Annual Meeting of the Society for Ear, Nose and Throat Advances in Children (SENTAC), Cincinnati, OH, USA, 3–6 December 1996. 1  

Microsoft Academic Search

Congenital esophageal webs are rare entities. These lesions generally occur in the upper one third of the esophagus and present symptomatically in early childhood. Dysphagia and `feeding' difficulties are characteristic presenting symptoms. Radiographic studies generally reveal a normal appearing esophageal lumen with the exception of a single thin indentation of the esophageal lumen that is located either anteriorly or circumferential

Pranay C Patel; Jay A Yates; William S Gibson; William E Wood

1997-01-01

134

Cytoprotective Effects of Hydrogen Sulfide in Novel Rat Models of Non-Erosive Esophagitis  

PubMed Central

Non-erosive esophagitis is a chronic inflammatory condition of the esophagus and is a form of gastroesophageal reflux disease. There are limited treatment options for non-erosive esophagitis, and it often progresses to Barrett’s esophagus and esophageal carcinoma. Hydrogen sulfide has been demonstrated to be a critical mediator of gastric and intestinal mucosal protection and repair. However, roles for H2S in esophageal mucosal defence, inflammation and responses to injury have not been reported. We therefore examined the effects of endogenous and exogenous H2S in rat models of non-erosive esophagitis. Mild- and moderate-severity non-erosive esophagitis was induced in rats through supplementation of drinking water with fructose, plus or minus exposure to water-immersion stress. The effects of inhibitors of H2S synthesis or of an H2S donor on severity of esophagitis was then examined, along with changes in serum levels of a pro- and an anti-inflammatory cytokine (IL-17 and IL-10, respectively). Exposure to water-immersion stress after consumption of the fructose-supplemented water for 28 days resulted in submucosal esophageal edema and neutrophil infiltration and the development of lesions in the muscular lamina and basal cell hyperplasia. Inhibition of H2S synthesis resulted in significant exacerbation of inflammation and injury. Serum levels of IL-17 were significantly elevated, while serum IL-10 levels were reduced. Treatment with an H2S donor significantly reduced the severity of esophageal injury and inflammation and normalized the serum cytokine levels. The rat models used in this study provide novel tools for studying non-erosive esophagitis with a range of severity. H2S contributes significantly to mucosal defence in the esophagus, and H2S donors may have therapeutic value in treating esophageal inflammation and injury. PMID:25333941

Zayachkivska, Oksana; Havryluk, Olena; Hrycevych, Nazar; Bula, Nazar; Grushka, Oksana; Wallace, John L.

2014-01-01

135

Cytoprotective effects of hydrogen sulfide in novel rat models of non-erosive esophagitis.  

PubMed

Non-erosive esophagitis is a chronic inflammatory condition of the esophagus and is a form of gastroesophageal reflux disease. There are limited treatment options for non-erosive esophagitis, and it often progresses to Barrett's esophagus and esophageal carcinoma. Hydrogen sulfide has been demonstrated to be a critical mediator of gastric and intestinal mucosal protection and repair. However, roles for H2S in esophageal mucosal defence, inflammation and responses to injury have not been reported. We therefore examined the effects of endogenous and exogenous H2S in rat models of non-erosive esophagitis. Mild- and moderate-severity non-erosive esophagitis was induced in rats through supplementation of drinking water with fructose, plus or minus exposure to water-immersion stress. The effects of inhibitors of H2S synthesis or of an H2S donor on severity of esophagitis was then examined, along with changes in serum levels of a pro- and an anti-inflammatory cytokine (IL-17 and IL-10, respectively). Exposure to water-immersion stress after consumption of the fructose-supplemented water for 28 days resulted in submucosal esophageal edema and neutrophil infiltration and the development of lesions in the muscular lamina and basal cell hyperplasia. Inhibition of H2S synthesis resulted in significant exacerbation of inflammation and injury. Serum levels of IL-17 were significantly elevated, while serum IL-10 levels were reduced. Treatment with an H2S donor significantly reduced the severity of esophageal injury and inflammation and normalized the serum cytokine levels. The rat models used in this study provide novel tools for studying non-erosive esophagitis with a range of severity. H2S contributes significantly to mucosal defence in the esophagus, and H2S donors may have therapeutic value in treating esophageal inflammation and injury. PMID:25333941

Zayachkivska, Oksana; Havryluk, Olena; Hrycevych, Nazar; Bula, Nazar; Grushka, Oksana; Wallace, John L

2014-01-01

136

Chemoprevention of Esophageal Adenocarcinoma  

PubMed Central

The incidence of esophageal adenocarcinoma (EAC) is rising rapidly in Western countries, and effective chemoprevention for this malignancy is lacking. Endoscopic surveillance of patients with Barrett's esophagus is currently employed to diagnose EAC at earlier stages, but this strategy has several limitations. Non-steroidal anti-inflammatory drugs and proton pump inhibitors are the most promising agents for prevention of EAC, and a randomized controlled trial of aspirin and esomeprazole is ongoing. Other agents under investigation include green tea, berries, and antioxidants. Cost-effectiveness analyses have shown that chemopreventive agents need to be highly effective at preventing EAC in order to have benefit beyond endoscopic surveillance. PMID:21180511

2008-01-01

137

Drugs, Bugs, and Esophageal pH Profiles  

E-print Network

Until relatively recently, gastroesophageal reflux disease (GERD) was thought to be a relatively trivial problem, and pharmaceutical companies initially had remarkably little interest in clinical trials for GERD. Over the last ten years, GERD therapy has become the subject of intense interest, since reflux disease is now recognized as a major market for antisecretory and prokinetic drugs. Even low-technology antacids are now known to effectively neutralize esophageal acid prevent acid reflux for up to 90 minutes. Esophageal pH profiling is known to be an excellent surrogate for clinical efficacy of GERD drugs, particularly in erosive esophagitis. Years ago, famotidine normalized esophageal mucosal exposure to pH < 4.0 only when administered in doses of 40 mg twice a day. Subsequent studies confirmed that multiple daily dosing of histamine-2 receptor antagonists (H2RAs) was mandatory for GERD treatment, with clear dose-response relationships for each agent. Proton pump inhibitors (PPIs) have each been carefully assessed in terms esophageal and gastric pH profiles. Omeprazole has a particularly flat dose response curve, making it difficult to differentiate pH or clinical effects of20 vs. 40 mg doses. Improved rapidity of onset and/or enhanced potency is demonstrable in pH data obtained with lansoprazole, rabeprazole and pantoprazole. Such differences

Malcolm Robinson

138

A Unique Esophageal Motor Pattern That Involves Longitudinal Muscles is Responsible for Emptying in Achalasia Esophagus  

PubMed Central

Background & Aims Achalasia esophagus is characterized by loss of peristalsis and incomplete esophago-gastric junction (EGJ) relaxation. We studied mechanisms of esophageal emptying in patients with achalasia using simultaneous high-resolution manometery (HRM), multiple intra-luminal impedance (MII), and high frequency intra-luminal ultrasound (HFIUS) image recordings. Methods Achalasia was categorized into 3 subtypes, based on the esophageal response to swallows: types 1 and 2 were defined by simultaneous pressure waves of < 30 mmHg and > 30 mmHg, respectively, and type 3 was defined by spastic simultaneous esophageal contractions. Results Based on HRM, a predominant achalasia pattern of type 2 was characterized by a unique motor pattern that consisted of upper esophageal sphincter contraction, simultaneous esophageal pressure (panesophageal pressurization), and EGJ contraction, following swallows. HFIUS identified longitudinal muscle contraction of the distal esophagus as the cause of panesophageal pressurization in type 2 achalasia. MII revealed that esophageal emptying occurred intermittently (36% swallows) during periods of panesophageal pressurization. Patients with achalasia of types 1 and 3 had no emptying or relatively normal emptying during most swallows, respectively. Conclusion In achalasia, esophageal emptying results from swallow-induced longitudinal muscle contraction of the distal esophagus; which increases esophageal pressure and allows flow across the non relaxed EGJ to take place PMID:20381493

Hong, Su Jin; Bhargava, Valmik; Jiang, Yanfen; DenBoer, Debbie; Mittal, Ravinder K.

2010-01-01

139

[Esophageal scintigraphy during endoscopic treatment of reflux esophagitis].  

PubMed

The paper is concerned with analysis of a method of dynamic esophageal scintigraphy modified by the authors for diagnosis and control of therapy of reflux esophagitis combined with duodenal ulcer in 33 patients aged 17 to 72. The proposed method is technically simple, highly effective and can be recommended for use in hospitals equipped with computer-assisted gamma-cameras. Indices of radionuclide clearance of the esophagus reflect its function of self-purification and well correlate with a degree of inflammatory changes of esophageal mucosa. They disappear more rapidly in patients receiving multimodality therapy including selective drug denervation of the stomach than in patients on conservative therapy alone. PMID:3262191

Glazov, A V; Zubovski?, L G; Sineev, Iu V; Kerin, V V; Rodchenko, Z P

1988-09-01

140

Correlation of CD146 expression and clinicopathological characteristics in esophageal squamous cell carcinoma  

PubMed Central

CD146, a cell adhesion molecule, is found in normal and tumor tissues. The level of its expression has been found to directly correlate with tumor progression and metastatic potential. The objective of this study was to investigate the expression of CD146 in esophageal squamous cell carcinoma (ESCC) and its correlation with clinicopathological parameters. Tumor specimens were collected from 63 patients with ESCC who underwent complete resection. We analyzed the CD146 expression levels in ESCC by immunohistochemistry. The expression of CD146 was detected and it was observed to correlate with clinicopathological parameters. Sixty-three cases of normal squamous mucosa were included for comparison. CD146 expression was identified in 46.0% (29/63) of the ESCC samples, and no positive (weak to moderate or moderate to strong) expression was found in the normal squamous epithelium samples (?2=27.248; P<0.0001). CD146 expression was associated with lymph node metastasis (?2=5.117; P=0.024) and advanced clinical stage (?2=4.661; P=0.031). CD146 expression was one of the significant predictors of survival (hazard ratio, 2.838; 95% confidence interval 1.102–7.305). The overexpression of the CD146 gene was one of the important phenotypes and characteristics in ESCC carcinomatous change. We found that CD146 expression was associated with lymph node metastasis and advanced clinical stage, and was an indicator of poor prognosis in ESCC patients. CD146 may prove to be an important tumor marker for the individualized treatment for ESCC. PMID:25009662

LI, YAN; YU, JIN-MING; ZHAN, XUE-MEI; LIU, LI-LI; JIN, NING; ZHANG, YAN-XIA

2014-01-01

141

Gene expression profiles of primary HPV16- and HPV18-infected early stage cervical cancers and normal cervical epithelium: identification of novel candidate molecular markers for cervical cancer diagnosis and therapy.  

PubMed

With the goal of identifying genes with a differential pattern of expression between invasive cervical carcinomas (CVX) and normal cervical keratinocytes (NCK), we used oligonucleotide microarrays to interrogate the expression of 14,500 known genes in 11 primary HPV16 and HPV18-infected stage IB-IIA cervical cancers and four primary normal cervical keratinocyte cultures. Hierarchical cluster analysis of gene expression data identified 240 and 265 genes that exhibited greater than twofold up-regulation and down-regulation, respectively, in primary CVX when compared to NCK. Cyclin-dependent kinase inhibitor 2A (CDKN2A/p16), mesoderm-specific transcript, forkhead box M1, v-myb myeloblastosis viral oncogene homolog (avian)-like2 (v-Myb), minichromosome maintenance proteins 2, 4, and 5, cyclin B1, prostaglandin E synthase (PTGES), topoisomerase II alpha (TOP2A), ubiquitin-conjugating enzyme E2C, CD97 antigen, E2F transcription factor 1, and dUTP pyrophosphatase were among the most highly overexpressed genes in CVX when compared to NCK. Down-regulated genes in CVX included transforming growth factor beta 1, transforming growth factor alpha, CFLAR, serine proteinase inhibitors (SERPING1 and SERPINF1), cadherin 13, protease inhibitor 3, keratin 16, and tissue factor pathway inhibitor-2 (TFPI-2). Differential expression of some of these genes including CDKN2A/p16, v-Myb, PTGES, and TOP2A was validated by quantitative real-time PCR. Flow cytometry on primary CVX and NCK and immunohistochemical staining of formalin fixed paraffin-embedded tumor specimens from which primary CVX cultures were derived as well as from a separate set of invasive cervical cancers confirmed differential expression of the CDKN2A/p16 and PTGES markers on CVX versus NCK. These results identify several genes that are coordinately disregulated in cervical cancer, likely representing common signaling pathways triggered by HPV transformation. Moreover, these data obtained with highly purified primary tumor cultures highlight novel molecular features of human cervical cancer and provide a foundation for the development of new type-specific diagnostic and therapeutic strategies for this disease. PMID:15629771

Santin, Alessandro D; Zhan, Fenghuang; Bignotti, Eliana; Siegel, Eric R; Cané, Stefania; Bellone, Stefania; Palmieri, Michela; Anfossi, Simone; Thomas, Maria; Burnett, Alexander; Kay, Helen H; Roman, Juan J; O'Brien, Timothy J; Tian, Erming; Cannon, Martin J; Shaughnessy, John; Pecorelli, Sergio

2005-01-20

142

Pharmacologic treatments for esophageal disorders.  

PubMed

The following, from the 12th OESO World Conference: Cancers of the Esophagus, includes commentaries on the role for ketamine and other alternative treatments in esophageal disorders; the use of linaclotide in the treatment of esophageal pain; the alginate test as a diagnostic criterion in gastroesophageal reflux disease (GERD); the use of baclofen in treatment of GERD; the effects of opioids on the esophagus; the use of antagonists on the receptor level in GERD; the effect of local formulation of drugs on the esophageal mucosa; and the use of electroencephalographic fingerprints to predict the effect of pharmacological treatment. PMID:25266012

Blackshaw, L Ashley; Bordin, Dmitry S; Brock, Christina; Brokjaer, Anne; Drewes, Asbjørn Mohr; Farmer, Adam D; Krarup, Anne Lund; Lottrup, Christian; Masharova, Antonina A; Moawad, Fouad J; Olesen, Anne Estrup

2014-09-01

143

Esophageal Lipoma: A Rare Tumor  

PubMed Central

Esophageal lipomas are rare tumors, making up 0.4% of all digestive tract benign neoplasms. Most of these lesions are clinically silent as a result of their small size, however, the majority of lesions over 4 cm have been reported to cause dysphagia, regurgitation and/or epigastralgia. We report a case of a 53 year-old African American female who presented with dysphagia. Computed tomography of the chest and esophagram confirmed esophageal lipoma as the cause of the patient’s symptoms. Accurately diagnosing an esophageal lipoma is crucial in order to rule out potential malignant lesions, relieve patient symptoms and plan the appropriate treatment. PMID:23365708

Feldman, Jeremy; Tejerina, Manfred; Hallowell, Michael

2012-01-01

144

Treatment of advanced esophageal cancer  

SciTech Connect

When radiation therapy is used for palliation of obstruction in patients with advanced esophageal carcinoma, an improvement in dysphagia can be expected in approximately 50% of patients. Major objective responses have rarely been quantitied but, in one study, were seen in 33% patients. Recurrence of dysphagia is usually seen within 2-6 months of treatment. Radiation toxicities and complications, even when used with palliative intent, can be substantial and include esophagitis, tracheoesophageal or esophageal-aortic fistula, mediastinitis, hemorrhage, pneumonitis, and myelosuppression. (JMT)

Kelsen, D.

1982-12-01

145

Evaluation of Esophageal Contractile Propagation using Esophageal Pressure Topography  

PubMed Central

Background High-resolution manometry and esophageal pressure topography have ienhanced our ability to analyze esophageal motor disturbances by improving the detail and accuracy of measurements of peristaltic activity. This has been extremely helpful in the evaluation of disorders of rapid propagation as the technique is able to define important time points and physiologic landmarks that are crucial in defining peristaltic velocity and latency intervals. Purpose The goal of the current review will be to assess how esophageal pressure topography has impacted our ability to define important phenotypes of rapid propagation. Additionally, this review will also be utilized to complement the description of the Chicago Classification of Esophageal Motor Disorders, which is presented in this supplement issue. PMID:22248104

Pandolfino, J.E.; Sifrim, D.

2013-01-01

146

Relevance of N-nitrosamines to esophageal cancer in China  

SciTech Connect

Studies on the relevance of the N-nitrosamines to esophageal cancer in China are reviewed. Although a causal association between nitrosamines exposure and esophageal cancer in China has not yet been rigorously established, exposure of Lin-Xian subjects to nitrosamines either directly or as a result of their in vivo formation has been detected in our study. Several N-nitrosamines (NDMA, NDEA, NMBzA, NPyr, NPip, and NSAR) in gastric juice collected from Lin-Xian inhabitants have been detected. A correlation was found between the lesions of esophageal epithelium and the amount of nitrosamines present. In addition, the amounts of N-nitrosamino acids excreted in 24-hr urine of subjects in Lin-Xian were significantly higher than those in Fan-Xian, indicating a higher exposure to N-nitroso compound and their precursors of the inhabitants in the high-risk area. The effect of nitrosamines on human esophagus has been investigated at the cellular levels. The amounts of O/sup 6/-MedG in DNA of esophageal or stomach mucosa of patients from Lin-Xian were higher than that from Europe. The presence of O/sup 6/-MedG in the human fetal esophagus cultured with NMBzA was also detected. These findings indicate that the elevated levels of O/sup 6/-MedG in esophageal DNA could be the result of a recent exposure to N-nitroso compounds or a genetically determined reduced cellular capacity for repair of O/sup 6/-MedG from DNA. The hyperplasia was induced in the esophagus of human fetus that cultured with NMBzA for 2 weeks to 2 months. The intervention studies of esophageal cancer in Lin-Xian have been pursued. Intake of moderate doses of ascorbic acids by Lin-Xian subjects effectively reduced the urinary levels of N-nitrosamino acids to those found in undosed subjects in the low-risk area.

Lu, S.H.; Montesano, R.; Zhang, M.S.; Feng, L.; Luo, F.J.; Chui, S.X.; Umbenhauer, D.; Saffhill, R.; Rajewsky, M.F.

1986-01-01

147

Clinical Impact of Tumor-Infiltrating Inflammatory Cells in Primary Small Cell Esophageal Carcinoma  

PubMed Central

Primary small cell esophageal carcinoma is a rare and aggressive type of gastrointestinal cancer with poor prognosis. In the present study, the impact of tumour infiltrating inflammatory cells on clinico-pathological characteristics and the patients’ prognosis were analysed. A total of 36 small cell esophageal carcinomas, 19 adjacent normal tissues and 16 esophageal squamous cell carcinoma samples were collected. Qualified pathologists examined eosinophils, neutrophils, lymphocytes and macrophages on histochemical slides. The infiltration of eosinophils and macrophages in small cell esophageal carcinoma was significantly increased as compared with tumor adjacent normal tissues, and was significantly less in esophageal squamous cell carcinoma. Macrophage count was significantly associated with (p = 0.015) lymph node—stage in small cell esophageal carcinoma. When we grouped patients into two groups by counts of infiltrated inflammatory cells, Kaplan-Meier analysis revealed that high macrophage infiltration group (p = 0.004) and high eosinophil infiltration group (p = 0.027) had significantly enhanced survival. In addition, multivariate analysis unveiled that eosinophil count (p = 0.002) and chemotherapy (Yes vs. No, p = 0.001) were independent prognostic indicators. Taken together, infiltration of macrophages and eosinophils into the solid tumor appear to be important in the progression of small cell esophageal carcinoma and patients’ prognosis. PMID:24886814

Zhang, Yuling; Ren, Hongzheng; Wang, Lu; Ning, Zhifeng; Zhuang, Yixuan; Gan, Jinfeng; Chen, Shaobin; Zhou, David; Zhu, Hua; Tan, Dongfeng; Zhang, Hao

2014-01-01

148

Heat treatment of human esophageal tissues: Effect on esophageal cancer detection using oxygenated hemoglobin diffuse reflectance ratio  

NASA Astrophysics Data System (ADS)

The main objective of the present work is to study the influence of heat treatment on the esophageal cancer detection using the diffuse reflectance (DR) spectral intensity ratio R540/R575 of oxygenated hemoglobin (HbO2) absorption bands to distinguish the epithelial tissues of normal human esophagus and moderately differentiated esophageal squamous cell carcinoma (ESCC) at different heat treatment temperature of 20, 37, 42, 50, and 60°C, respectively. The DR spectra for the epithelial tissues of the normal esophagus and ESCC in vitro at different heat-treatment temperature in the wavelength range 400-650 nm were measured with a commercial optical fiber spectrometer. The results indicate that the average DR spectral intensity overall enhancement with concomitant increase of heat-treatment temperature for the epithelial tissues of normal esophagus and ESCC, but the average DR spectral intensity for the normal esophageal epithelial tissues is relatively higher than that for ESCC epithelial tissues at the same heat-treatment temperature. The mean R540/R575 ratios of ESCC epithelial tissues were always lower than that of normal esophageal epithelial tissues at the same temperature, and the mean R540/R575 ratios of the epithelial tissues of the normal esophagus and ESCC were decreasing with the increase of different heat-treatment temperatures. The differences in the mean R540/R575 ratios between the epithelial tissues of normal esophagus and ESCC were 13.33, 13.59, 11.76, and 11.11% at different heat-treatment temperature of 20, 37, 42, and 50°C, respectively. These results also indicate that the DR intensity ratio R540/R575 of the hemoglobin bands is a useful tool for discrimination between the epithelial tissues of normal esophagus and ESCC in the temperature range from room temperature to 50°C, but it was non-effective at 60°C or over 60°C.

Zhao, Q. L.; Guo, Z. Y.; Si, J. L.; Wei, H. J.; Yang, H. Q.; Wu, G. Y.; Xie, S. S.; Guo, X.; Zhong, H. Q.; Li, L. Q.; Li, X. Y.

2011-03-01

149

Ki-67 and ProExC are useful immunohistochemical markers in esophageal squamous intraepithelial neoplasia.  

PubMed

Esophageal squamous intraepithelial neoplasia has been widely recognized as a precursor lesion for esophageal squamous cell carcinoma. Early detection offers the best prognosis for esophageal squamous cell carcinoma. The differentiation of squamous dysplasia from reactive change and the classification of squamous dysplasia into high-grade or low-grade are sometimes subjective and challenging. In this study, we sought to evaluate multiple biomarkers and to develop clinically useful adjunct tools for difficult esophageal squamous intraepithelial neoplasia cases. Immunohistochemical stains using antibodies against Ki-67, ProExC, p16, and p53 were performed on esophageal biopsy or resection specimens from 25 patients including 35 foci of high-grade dysplasia and 25 foci of low-grade dysplasia, and from 10 control cases containing 52 foci of normal/reactive hyperplasia. In situ hybridization tests for human papillomavirus were performed in 11 cases. The immunostains for all 4 markers were scored as negative, intermediate, and strong according to established criteria. Intermediate and strong Ki-67 and ProExC staining showed similar detecting power and exhibited very high sensitivity and specificity for distinguishing normal/reactive hyperplasia from esophageal squamous intraepithelial neoplasia and normal/reactive hyperplasia from low-grade esophageal squamous intraepithelial neoplasia. Strong Ki-67 staining was exclusively seen in high-grade esophageal squamous intraepithelial neoplasia, which provided additional value in distinguishing high-grade from low-grade esophageal squamous intraepithelial neoplasia. Strong ProExC staining was also seen in most high-grade esophageal squamous intraepithelial neoplasia foci (80%). Although the frequencies of intermediate/strong staining patterns of p53 increased with increasing degree of dysplasia, the sensitivity of p53 was much lower than that of Ki-67 and ProExC. p16 did not show consistent immunostain pattern in the normal/reactive hyperplasia and esophageal squamous intraepithelial neoplasia. Two (18%) of 11 tested cases were positive for human papillomavirus infection. This study demonstrates that both Ki-67 and ProExC can be used as an adjunct tool for diagnosing difficult cases of esophageal squamous intraepithelial neoplasia. PMID:21420715

Wang, Wen-Chuang; Wu, Tsung-Teh; Chandan, Vishal S; Lohse, Christine M; Zhang, Lizhi

2011-10-01

150

Esophageal Cancer - Featured Clinical Trials  

Cancer.gov

Esophageal Cancer - Featured Clinical Trials The following list shows Featured Clinical Trials for a specific type of cancer. You may also want to view: Multiple Cancer Types - Featured Clinical Trials Supportive Care - Featured Clinical Trials

151

Esophageal stenting in cancer therapy.  

PubMed

The following, from the 12th OESO World Conference: Cancers of the Esophagus, includes commentaries on nutritional support during chemoradiation, esophageal stents before surgery, and stenting the cervical esophagus. PMID:25266018

Goenka, Mahesh Kumar; White, Russell E

2014-09-01

152

Effect of bolus taste on the esophageal transit of patients with stroke.  

PubMed

Stroke is a frequent cause of oropharyngeal dysphagia but may also cause alterations in esophageal motility. The aim of this investigation was to evaluate the effect of bolus taste on the esophageal transit of patients with stroke and controls. Esophageal transit and clearance were evaluated by scintigraphy in 36 patients in the chronic phase of stroke (44-82 years, mean: 63 years) and in 30 controls (33-85 years, mean: 59 years). The patients had a stroke 1-84 months (median: 5.5 months) before the evaluation of esophageal transit. Eight had dysphagia. Each subject swallowed in random order and in the sitting position 5 mL of liquid boluses with bitter (pH=6.0), sour (pH=3.0), sweet (pH=6.9), and neutral (pH=6.8) taste. Transit and clearance duration and the amount of residues were measured in the proximal, middle, and distal esophageal body. There was no difference between patients and controls in esophageal transit or clearance duration. In the distal esophagus, the transit and clearance durations were longer with the sour bolus than with the other boluses in both patients and controls. The amount of residues in the esophageal body was greater in patients than in controls after swallows of the neutral bolus. In control subjects, after swallows of a sour bolus, there was an increase in the amount of residues in the middle and distal esophagus compared with the other boluses. In conclusion, a sour bolus with low pH causes a longer transit and clearance duration in the distal esophageal body. There was no effect of bolus taste or pH on the esophageal transit of patients in the chronic phase of stroke compared with normal volunteers. The longer transit and clearance duration in the distal esophageal body with the sour bolus appears to be a consequence of the low pH of the bolus. PMID:22642501

Alves, L M T; Fabio, S R C; Dantas, R O

2013-04-01

153

CT evaluation of thickened esophageal walls  

SciTech Connect

A study of 200 consecutive chest computed tomographic (CT) examinations revealed thickened esophageal walls (over 3 mm) in 35%. While this is the earliest finding of carcinoma of the esophagus on CT, only half of the cases of thickened walls were due to esophageal carcinoma. Other mediastinal malignancies as well as benign inflammatory, vascular, and fibrotic conditions such as reflux and monilial esophagitis, esophageal varices, and postirradiation scarring were found to cause thickened esophageal walls. Distension with air and intravenous enhancement aid in the optimal evaluation of the esophagus by CT. The thickened esophageal wall is always abnormal, but it is nonspecific, seen in both malignant and nonmalignant conditions.

Reinig, J.W.; Stanley, J.H.; Schabel, S.I.

1983-05-01

154

Uses of esophageal function testing: dysphagia.  

PubMed

Esophageal function testing should be used for differential diagnosis of dysphagia. Dysphagia can be the consequence of hypermotility or hypomotility of the muscles of the esophagus. Decreased esophageal or esophagogastric junction distensibility can provoke dysphagia. The most well established esophageal dysmotility is achalasia. Other motility disorders can also cause dysphagia. High-resolution manometry (HRM) is the gold standard investigation for esophageal motility disorders. Simultaneous measurement of HRM and intraluminal impedance can be useful to assess motility and bolus transit. Impedance planimetry measures distensibility of the esophageal body and gastroesophageal junction in patients with achalasia and eosinophilic esophagitis. PMID:25216909

Yazaki, Etsuro; Woodland, Philip; Sifrim, Daniel

2014-10-01

155

Upper esophageal and pharyngeal cancers.  

PubMed

The following, from the 12th OESO World Conference: Cancers of the Esophagus, includes commentaries on laryngopharyngeal reflux as a risk factor for laryngeal cancer; the role of pepsin in laryngopharyngeal neoplasia; natural fruit and vegetable compounds for the prevention and treatment of pharyngeal and esophageal cancers; and evaluation of cranberry constituents as inhibitors of esophageal adenocarcinoma utilizing in vitro assay and in vivo models. PMID:25266014

Bock, Jonathan M; Howell, Amy B; Johnston, Nikki; Kresty, Laura A; Lew, Daniel

2014-09-01

156

Interactions of oxygen radicals with airway epithelium.  

PubMed Central

Reactive oxygen species (ROS) have been implicated in the pathogenesis of numerous disease processes. Epithelial cells lining the respiratory airways are uniquely vulnerable regarding potential for oxidative damage due to their potential for exposure to both endogenous (e.g., mitochondrial respiration, phagocytic respiratory burst, cellular oxidases) and exogenous (e.g., air pollutants, xenobiotics, catalase negative organisms) oxidants. Airway epithelial cells use several nonenzymatic and enzymatic antioxidant mechanisms to protect against oxidative insult. Nonenzymatic defenses include certain vitamins and low molecular weight compounds such as thiols. The enzymes superoxide dismutase, catalase, and glutatione peroxidase are major sources of antioxidant protection. Other materials associated with airway epithelium such as mucus, epithelial lining fluid, and even the basement membrane/extracellular matrix may have protective actions as well. When the normal balance between oxidants and antioxidants is upset, oxidant stress ensues and subsequent epithelial cell alterations or damage may be a critical component in the pathogenesis of several respiratory diseases. Oxidant stress may profoundly alter lung physiology including pulmonary function (e.g., forced expiratory volumes, flow rates, and maximal inspiratory capacity), mucociliary activity, and airway reactivity. ROS may induce airway inflammation; the inflammatory process may serve as an additional source of ROS in airways and provoke the pathophysiologic responses described. On a more fundamental level, cellular mechanisms in the pathogenesis of ROS may involve activation of intracellular signaling enzymes including phospholipases and protein kinases stimulating the release of inflammatory lipids and cytokines. Respiratory epithelium may be intimately involved in defense against, and pathophysiologic changes invoked by, ROS. PMID:7705313

Wright, D T; Cohn, L A; Li, H; Fischer, B; Li, C M; Adler, K B

1994-01-01

157

Velocity Fields in a Collectively Migrating Epithelium  

PubMed Central

Abstract We report quantitative measurements of the velocity field of collectively migrating cells in a motile epithelium. The migration is triggered by presenting free surface to an initially confluent monolayer by using a microstencil technique that does not damage the cells. To avoid the technical difficulties inherent in the tracking of single cells, the field is mapped using the technique of particle image velocimetry. The main relevant parameters, such as the velocity module, the order parameter, and the velocity correlation function, are then extracted from this cartography. These quantities are dynamically measured on two types of cells (collectively migrating Madin-Darby canine kidney (MDCK) cells and fibroblastlike normal rat kidney (NRK) cells), first as they approach confluence, and then when the geometrical constraints are released. In particular, for MDCK cells filling up the patterns, we observe a sharp decrease in the average velocity after the point of confluence, whereas the densification of the monolayer is much more regular. After the peeling off of the stencil, a velocity correlation length of ?200 ?m is measured for MDCK cells versus only ?40 ?m for the more independent NRK cells. Our conclusions are supported by parallel single-cell tracking experiments. By using the biorthogonal decomposition of the velocity field, we conclude that the velocity field of MDCK cells is very coherent in contrast with the NRK cells. The displacements in the fingers arising from the border of MDCK epithelia are very oriented along their main direction. They influence the velocity field in the epithelium over a distance of ?200 ?m. PMID:20441742

Petitjean, L.; Reffay, M.; Grasland-Mongrain, E.; Poujade, M.; Ladoux, B.; Buguin, A.; Silberzan, P.

2010-01-01

158

Tumor-specific apoptotic gene targeting overcomes radiation resistance in esophageal adenocarcinoma  

Microsoft Academic Search

Purpose: To overcome radiation resistance in esophageal adenocarcinoma by tumor-specific apoptotic gene targeting using tumor necrosis factor-related apoptosis-inducing ligand (TRAIL). Methods and Materials: Adenoviral vector Ad\\/TRAIL-F\\/RGD with a tumor-specific human telomerase reverse transcription promoter was used to transfer TRAIL gene to human esophageal adenocarcinoma and normal human lung fibroblastic cells (NHLF). Activation of apoptosis was analyzed by Western blot, fluorescent

Joe Y.. Chang; Zhang Xiaochun; Ritsuko Komaki; Rex Cheung; Fang Bingliang

2006-01-01

159

Timing and intensity of changes in FDG uptake with symptomatic esophagitis during radiotherapy or chemo-radiotherapy  

PubMed Central

Purpose To study whether esophageal FDG activity changes by time of mid-course of fractionated radiotherapy (RT), and whether these changes are associated with radiation esophagitis in patients with non-small cell lung cancer (NSCLC). Methods Fifty patients with stage I-III NSCLC were enrolled prospectively and, all received ?60 Gy RT. FDG-PET/CT scans were acquired prior to, and during-RT after delivery of 45 Gy. Normalized standardized uptake values (NSUV), defined by the esophageal maximum SUV relative to intravascular background level in the aortic arch, were sampled in the esophagus at the level of the primary tumor, sternal notch, aortic arch, carina, and gastro-esophageal junction. Symptomatic radiation esophagitis was defined as an event. Results Compared to baseline, esophageal NSUV increased significantly during-RT at the level of the primary tumor (1.09?±?0.05 vs.1.28?±?0.06, p?=?0.001), but did not change at other levels in the esophagus. 16 patients had radiation esophagitis events and these patients had significantly higher during-RT to baseline NSUV ratios than those without esophagitis (1.46?±?0.12, 95% CI 1.20-1.71; vs. 1.11?±?0.05, 95% CI 1.01-1.21, p?=?0.002). Maximum esophageal dose (p?=?0.029), concurrent chemotherapy (p?=?0.022) and esophageal FDG PET NSUV ratio (during-RT to baseline, p?=?0.007), were independent factors associated with esophagitis and area under curves (AUC) were 0.76, 0.70 and 0.78, respectively. Combining esophageal maximum dose and FDG PET NSUV Ratio at the tumor level increased AUC to 0.85 (p?=?0.016). Conclusion FDG uptake increased in esophagus during-RT and this increase may predict radiation esphagitis during later course of treatment. PMID:24467939

2014-01-01

160

Wound epithelium function in axolotl limb regeneration.  

PubMed

Axolotls (Ambystoma mexicanum) have the ability to regenerate amputated limbs. The amputation surface is promptly covered by wound epithelium (WE), which is significant for the initiation of limb regeneration. In the present study, we investigated the formation of functional WE by analyzing the migration of WE after amputation. In the center of the amputation surface, epithelial cells migrated from surrounding epidermis to form WE. Therefore, WE around the center of the amputation surface was composed of the cells with dorsal, ventral, anterior and posterior identities, and we tentatively called this WE with radial positional identities, "central WE". When regeneration was complete, central WE became the epidermis around the bifurcation between the first and second digits. In addition, when the artificial rotation of epidermis was performed before amputation, all examined limbs regenerated normally, and central WE formed the epidermis at the bifurcation between first and second digits, similarly to that in normal regeneration. On the basis of our observations, the most important factor for the initiation of regeneration is considered to be the discontinuity of positional identity existing in WE. It is possible that the location of bifurcation between first and second digits is specified by the positional discontinuity in WE. PMID:23429052

Shimokawa, Takashi; Yasutaka, Satoru; Kominami, Rieko; Shinohara, Harumichi

2012-01-01

161

Esophageal Helicobacter pylori colonization aggravates esophageal injury caused by reflux  

PubMed Central

AIM: To investigate esophageal Helicobacter pylori (H. pylori) colonization on esophageal injury caused by reflux and the related mechanisms. METHODS: An esophagitis model, with acid and bile reflux, was surgically produced in male rats. The rats were randomly divided into either: (1) an esophagogastroduodenal anastomosis (EGDA) group; (2) an EGDA with H. pylori infection group; (3) a pseudo-operation with H. pylori infection group; or (4) a pseudo-operation group. All rats were kept for 36 wk. Based on the location of H. pylori colonization, the EGDA rats with H. pylori infection were subdivided into those with concomitant esophageal H. pylori colonization or those with only gastric H. pylori colonization. The esophageal injuries were evaluated grossly and microscopically. The expressions of CDX2 and MUC2 were determined by real-time polymerase chain reaction (RT-PCR) and immunohistochemistry. Ki-67 antigen expression was determined by immunohistochemistry. The mRNA levels of cyclin D1, c-Myc, Bax and Bcl-2 were determined by RT-PCR. Cell apoptosis was evaluated using the TdT-mediated dUTP nick-end labeling method. RESULTS: Esophagitis, Barrett’s esophagus (BE), and esophageal adenocarcinoma (EAC) developed in rats that underwent EGDA. When comparing rats with EGDA and concomitant esophageal H. pylori colonization to EGDA-only rats, the severity of injury (87.9 ± 5.2 vs 77.2 ± 8.6, macroscopically, 92.5 ± 8.0 vs 83.8 ± 5.5, microscopically, both P < 0.05) and the incidences of BE (80.0% vs 33.3%, P = 0.055) and EAC (60.0% vs 11.1%, P < 0.05) were increased. These increases were associated with upregulation of CDX2 and MUC2 mRNA (10.1 ± 5.4 vs 3.0 ± 2.9, 8.4 ± 4.6 vs 2.0 ± 3.2, respectively, Ps < 0.01) and protein (8.1 ± 2.3 vs 3.3 ± 3.1, 7.3 ± 4.0 vs 1.8 ± 2.7, respectively, all P < 0.05). The expression of Ki-67 (8.9 ± 0.7 vs 6.0 ± 1.7, P < 0.01) and the presence of apoptotic cells (8.3 ± 1.1 vs 5.3 ± 1.7, P < 0.01) were also increased significantly in rats with EGDA and concomitant esophageal H. pylori colonization compared with rats with EGDA only. The mRNA levels of cyclin D1 (5.8 ± 1.9 vs 3.4 ± 1.3, P < 0.01), c-Myc (6.4 ± 1.7 vs 3.7 ± 1.2, P < 0.01), and Bax (8.6 ± 1.6 vs 5.1 ± 1.3, P < 0.01) were significantly increased, whereas the mRNA level of Bcl-2 (0.6 ± 0.3 vs 0.8 ± 0.3, P < 0.01) was significantly reduced in rats with EGDA and concomitant esophageal H. pylori colonization compared with rats with EGDA only. CONCLUSION: Esophageal H. pylori colonization increases esophagitis severity, and facilitates the development of BE and EAC with the augmentation of cell proliferation and apoptosis in esophageal mucosa.

Chu, Yun-Xiang; Wang, Wei-Hong; Dai, Yun; Teng, Gui-Gen; Wang, Shu-Jun

2014-01-01

162

Hypermethylation of the AKAP12 promoter is a biomarker of Barrett's-associated esophageal neoplastic progression.  

PubMed

The A-kinase anchoring protein 12 (AKAP12) is a kinase scaffold protein with known tumor suppressor activity. Recently, AKAP12 promoter hypermethylation was reported in gastric and colorectal cancers. We examined AKAP12 promoter hypermethylation using real-time methylation-specific PCR in 259 human esophageal tissues. AKAP12 hypermethylation showed highly discriminative receiver-operator characteristic (ROC) curve profiles, clearly distinguishing esophageal adenocarcinoma (EAC) from esophageal squamous cell carcinoma and normal esophagus (P < 0.0001). AKAP12-normalized methylation values were significantly higher in Barrett's metaplasia (BE), dysplastic Barrett's, and EAC than in normal esophagus (P < 0.0000001). AKAP12 hypermethylation frequency was zero in normal esophagus but increased early during neoplastic progression, to 38.9% in BE from patients with Barrett's alone, 52.5% in dysplastic Barrett's metaplasia, and 52.2% in EAC. AKAP12 hypermethylation levels were significantly higher in normal esophageal epithelia from patients with EAC (mean = 0.00082) than in normal esophagi from patients without Barrett's or esophageal cancer (mean = 0.00007; P = 0.006). There was a significant correlation between AKAP12 hypermethylation and BE segment length, a known clinical neoplastic progression risk factor. In contrast, only 2 (7.7%) of 26 esophageal squamous cell carcinomas exhibited AKAP12 hypermethylation. Treatment of BIC and OE33 EAC cells with 5-aza-2'-deoxycytidine reduced AKAP12 methylation and increased AKAP12 mRNA expression. AKAP12 mRNA levels in EACs with unmethylated AKAP12 (mean = 0.1663) were higher than in EACs with methylated AKAP12 (mean = 0.0668). We conclude that promoter hypermethylation of AKAP12 is a common, tissue-specific event in human EAC, occurs early during Barrett's-associated esophageal neoplastic progression, and is a potential biomarker for the early detection of EAC. PMID:18199717

Jin, Zhe; Hamilton, James P; Yang, Jian; Mori, Yuriko; Olaru, Alexandru; Sato, Fumiaki; Ito, Tetsuo; Kan, Takatsugu; Cheng, Yulan; Paun, Bogdan; David, Stefan; Beer, David G; Agarwal, Rachana; Abraham, John M; Meltzer, Stephen J

2008-01-01

163

Esophageal perforation during or after conformal radiotherapy for esophageal carcinoma  

PubMed Central

The aim of this study was to analyze the risk factors and prognosis for patients with esophageal perforation occurring during or after radiotherapy for esophageal carcinoma. We retrospectively analyzed 322 patients with esophageal carcinoma. These patients received radiotherapy for unresectable esophageal tumors, residual tumors after operation, or local recurrence. Of these, 12 had radiotherapy to the esophagus before being admitted, 68 patients had concurrent chemoradiotherapy (CRT), and 18 patients had esophageal perforation after RT (5.8%). Covered self-expandable metallic stents were placed in 11 patients. Two patients continued RT after stenting and control of infection; one of these suffered a new perforation, and the other had a massive hemorrhage. The median overall survival was 2 months (0–3 months) compared with 17 months in the non-perforation group. In univariate analysis, the Karnofsky performance status (KPS) being ?70, age younger than 60, T4 stage, a second course of radiotherapy to the esophagus, extracapsular lymph nodes (LN) involving the esophagus, a total dose >100 Gy (biologically effective dose?10), and CRT were risk factors for perforation. In multivariate analysis, age younger than 60, extracapsular LN involving the esophagus, T4 stage, and a second course of radiotherapy to the esophagus were risk factors. In conclusion, patients with T4 stage, extracapsular LN involving the esophagus, and those receiving a second course of RT should be given particular care to avoid perforation. The prognosis after perforation was poor. PMID:24914102

Chen, Hai-yan; Ma, Xiu-mei; Ye, Ming; Hou, Yan-li; Xie, Hua-Ying; Bai, Yong-rui

2014-01-01

164

Ferric ammonium citrate-cellulose paste for opacification of the esophageal lumen on MRI  

SciTech Connect

A new ferric ammonium citrate-cellulose mixture for use in MRI of the esophagus was evaluated for its ability to opacify the esophageal lumen. Thirty-two patients with esophageal disorders and ten patients with normal esophagus undergoing MRI at 1.5 T were given {approx} 100 ml of the newly developed high-viscosity esophageal contrast preparation. Moreover, six of the patients with esophageal cancer were subjected to a second examination after radiation therapy. A total of 48 MR imaging were performed. Of the patients examined, successful esophageal opacification, graded as excellent, was obtained in 84.2, 78.9, and 57.9%, of the sagittal, axial, and coronal images, respectively. In cases of extrinsic disease involving the esophagus the contrast medium administration allowed the easy differentiation of the esophagus from adjacent mass lesions and proved very useful in identifying displacement and compression. In cases of esophageal carcinoma the contrast medium administration assisted in the measurement of wall thickness and length of the lesion as well as in the identification of the site of origin of the tumor. The results indicate that this product effectively specifies the esophageal lumen in the majority of patients. We found that it is easy to use, is well tolerated, and does not produce artifacts. 12 refs., 5 figs., 1 tab.

Ogawa, Yasuhiro; Noda, Yoshihiro; Morio, Kazuo [Kochi Medical School (Japan)] [and others] [Kochi Medical School (Japan); and others

1996-05-01

165

Screening and selection of peptides specific for esophageal cancer cells from a phage display peptide library  

PubMed Central

Background Esophageal cancer is a common malignant tumor of the gastrointestinal tract and is typically diagnosed at an advanced stage due to the absence of early clinical symptoms. Although surgery, chemotherapy, and radiotherapy represent the major treatment methods employed for this cancer, the prognosis of esophageal cancer remains poor. Methods A Ph.D.-12TM Phage Display Peptide Library was screened using an esophageal cancer cell line, Eca109, and a normal esophageal epithelial cell line to identify novel ligands that selectively bind the surface of esophageal cancer cells with high affinity. Results Two polypeptides were isolated that exhibited higher binding affinities and specificity for the Eca109 cells. These peptides were further validated using enzyme-linked immunosorbent assays (ELISAs), immunofluorescence assays, and immunohistochemistry assays. Conclusion Two polypeptides with high binding affinities to esophageal cancer cells were isolated from the Ph.D.-12TM Phage Display Peptide Library. Further studies are needed to characterize the biological effects of these polypeptides and to explore the potential for these peptides to be used for the early screening of esophageal cancer or for cell-targeted therapies that would reduce the toxic side effects of cancer treatment. PMID:24779651

2014-01-01

166

Prevention and Treatment of Esophageal Stenosis after Endoscopic Submucosal Dissection for Early Esophageal Cancer  

PubMed Central

Endoscopic submucosal dissection (ESD) for the treatment of esophageal mucosal lesions is associated with a risk of esophageal stenosis, especially for near-circumferential or circumferential esophageal mucosal defects. Here, we review historic and modern studies on the prevention and treatment of esophageal stenosis after ESD. These methods include prevention via pharmacological treatment, endoscopic autologous cell transplantation, endoscopic esophageal dilatation, and stent placement. This short review will focus on direct prevention and treatment, which may help guide the way forward. PMID:25386186

Wen, Jing; Lu, Zhongsheng; Liu, Qingsen

2014-01-01

167

Radiation-induced esophageal injury: A spectrum from esophagitis to cancer  

SciTech Connect

Radiation esophagitis is a common but frequently unrecognized complication of therapeutic radiation to the neck, chest, or mediastinum. The spectrum of injury ranges from acute self-limited esophagitis to life-threatening esophageal perforation. Complications such as stricture or primary esophageal cancer may occur many years after irradiation, and their linkage to radiation may not be considered. Five cases of radiation-induced injury are described, and the spectrum of radiation-induced esophageal injury is reviewed.

Vanagunas, A.; Jacob, P.; Olinger, E. (Northwestern Univ. Medical School, Chicago, IL (USA))

1990-07-01

168

A Comprehensive Review of Esophageal Stents  

PubMed Central

Esophageal stents are important tools for palliative treatment of inoperable esophageal malignancies. With the development of multiple self-expandable stents, there are now several therapeutic options for managing benign and malignant esophageal diseases. This paper discusses the various types of esophageal stents currently available, indications for their placement, challenges and complications that gastroenterologists face when placing these stents, and some of the innovations that will become available in the near future. PMID:23293566

Hong, Jinwha; Lam-Tsai, Yvette; Gress, Frank

2012-01-01

169

Esophageal pathology: a brief guide and atlas.  

PubMed

This article contains a brief atlas for esophageal dysphagia, with an emphasis on endoscopic evaluation. Dysphagia refers to an abnormality with food propulsion, and it may be caused by oropharyngeal or esophageal disorders. Radiological modalities, endoscopy, and manometry play an important role in both the diagnosis and management of esophageal disorders. PMID:24262958

Chokhavatia, Sita; Alli-Akintade, Latifat; Harpaz, Noam; Stern, Richard

2013-12-01

170

Esophageal motor function: technical aspects of manometry.  

PubMed

High-resolution manometry (HRM) has advanced the understanding of esophageal peristaltic mechanisms and has simplified esophageal motor testing. In this article the technical aspects of HRM are addressed, focusing on test protocols, in addition to concerns and pitfalls in performing esophageal motor studies. Specifically, catheter positioning, equipment-related artifacts, basal data acquisition, adequate swallows, and provocative maneuvers are discussed. PMID:25216901

Gyawali, C Prakash; Patel, Amit

2014-10-01

171

Genetic landscape of esophageal squamous cell carcinoma.  

PubMed

Esophageal squamous cell carcinoma (ESCC) is one of the deadliest cancers. We performed exome sequencing on 113 tumor-normal pairs, yielding a mean of 82 non-silent mutations per tumor, and 8 cell lines. The mutational profile of ESCC closely resembles those of squamous cell carcinomas of other tissues but differs from that of esophageal adenocarcinoma. Genes involved in cell cycle and apoptosis regulation were mutated in 99% of cases by somatic alterations of TP53 (93%), CCND1 (33%), CDKN2A (20%), NFE2L2 (10%) and RB1 (9%). Histone modifier genes were frequently mutated, including KMT2D (also called MLL2; 19%), KMT2C (MLL3; 6%), KDM6A (7%), EP300 (10%) and CREBBP (6%). EP300 mutations were associated with poor survival. The Hippo and Notch pathways were dysregulated by mutations in FAT1, FAT2, FAT3 or FAT4 (27%) or AJUBA (JUB; 7%) and NOTCH1, NOTCH2 or NOTCH3 (22%) or FBXW7 (5%), respectively. These results define the mutational landscape of ESCC and highlight mutations in epigenetic modulators with prognostic and potentially therapeutic implications. PMID:25151357

Gao, Yi-Bo; Chen, Zhao-Li; Li, Jia-Gen; Hu, Xue-Da; Shi, Xue-Jiao; Sun, Zeng-Miao; Zhang, Fan; Zhao, Zi-Ran; Li, Zi-Tong; Liu, Zi-Yuan; Zhao, Yu-Da; Sun, Jian; Zhou, Cheng-Cheng; Yao, Ran; Wang, Su-Ya; Wang, Pan; Sun, Nan; Zhang, Bai-Hua; Dong, Jing-Si; Yu, Yue; Luo, Mei; Feng, Xiao-Li; Shi, Su-Sheng; Zhou, Fang; Tan, Feng-Wei; Qiu, Bin; Li, Ning; Shao, Kang; Zhang, Li-Jian; Zhang, Lan-Jun; Xue, Qi; Gao, Shu-Geng; He, Jie

2014-10-01

172

Emerging management concepts for eosinophilic esophagitis in children.  

PubMed

Eosinophilic esophagitis (EoE) is a newly recognized condition that appears to be increasing in incidence for as yet unknown reasons. It can occur at any age and presents both to gastroenterologists and allergists. Clinical manifestations range from gastrointestinal symptoms (vomiting, feeding difficulties, dysphagia or food bolus impaction) to co-existing atopic conditions (asthma, allergic rhinitis or eczema). The diagnosis requires demonstration of at least 15 eosinophils per high power field on esophageal histology, usually in the context of resistance to proton pump inhibitor treatment or a normal 24-h esophageal pH monitoring study. The differential diagnosis between EoE and gastroesophageal reflux disease (GERD) can be problematic as there is significant clinical overlap between both conditions. Although difficult-to-manage esophageal strictures are well recognized in patients with long-standing EoE, little is known about risk factors for the development of this complication. There is a paucity of data on both the natural history and optimal long-term management of EoE. Current treatment options include food allergen elimination diets, use of topical aerosolized corticosteroids, or a combination of the two. Pediatric case studies have been provided to illustrate the complexity of decision points that often arise in the management of these patients. This paper aims to discuss the various strategies currently available to clinicians in the management of EoE and highlights gaps in the current evidence base that urgently require further research. PMID:21545525

Heine, Ralf G; Nethercote, Mark; Rosenbaum, Jeremy; Allen, Katrina J

2011-07-01

173

Characteristics of the Human Ocular Surface Epithelium  

Microsoft Academic Search

An appreciation of the biological characteristics of the human ocular surface epithelium affords us a great insight into the physiology of the human ocular surface in health and disease. Here, we review five important aspects of the human ocular surface epithelium. First, we recognize the discovery of corneal epithelial stem cells, and note how the palisades of Vogt have been

Shigeru Kinoshita; Wakako Adachi; Chie Sotozono; Kohji Nishida; Norihiko Yokoi; Andrew J. Quantock; Kousaku Okubo

2001-01-01

174

Eosinophilic esophagitis and allergy.  

PubMed

Eosinophilic esophagitis (EoE) has been associated with allergic diseases of the airways and skin. Here, we review the current literature on the sensitization pattern of adult EoE patients and critically discuss the diagnostic and therapeutic tools available. Most EoE patients have elevated total IgE levels in serum and are sensitized to aero- and food allergens as assessed by measuring specific IgE levels and/or the skin prick test. Whereas in children with EoE sensitization to food allergens predominate, in adults EoE symptoms do not correlate with IgE sensitization to specific food allergens. However, in two thirds of adult EoE patients, sensitization to cross-reactive plant allergen components have been be detected, mainly to profilins and PR10 proteins. So far, food triggering EoE can only be identified by an elimination diet and following reintroduction controlled by endoscopy and histology. Further research is required to elucidate the role of allergens in the pathogenesis of EoE and develop appropriate tools for diagnostic and specific treatment. PMID:24603377

Simon, Dagmar; Straumann, Alex; Simon, Hans-Uwe

2014-01-01

175

Surgical treatments for esophageal cancers.  

PubMed

The following, from the 12th OESO World Conference: Cancers of the Esophagus, includes commentaries on the role of the nurse in preparation of esophageal resection (ER); the management of patients who develop high-grade dysplasia after having undergone Nissen fundoplication; the trajectory of care for the patient with esophageal cancer; the influence of the site of tumor in the choice of treatment; the best location for esophagogastrostomy; management of chylous leak after esophagectomy; the optimal approach to manage thoracic esophageal leak after esophagectomy; the choice for operational approach in surgery of cardioesophageal crossing; the advantages of robot esophagectomy; the place of open esophagectomy; the advantages of esophagectomy compared to definitive chemoradiotherapy; the pathologist report in the resected specimen; the best way to manage patients with unsuspected positive microscopic margin after ER; enhanced recovery after surgery for ER: expedited care protocols; and long-term quality of life in patients following esophagectomy. PMID:25266029

Allum, William H; Bonavina, Luigi; Cassivi, Stephen D; Cuesta, Miguel A; Dong, Zhao Ming; Felix, Valter Nilton; Figueredo, Edgar; Gatenby, Piers A C; Haverkamp, Leonie; Ibraev, Maksat A; Krasna, Mark J; Lambert, René; Langer, Rupert; Lewis, Michael P N; Nason, Katie S; Parry, Kevin; Preston, Shaun R; Ruurda, Jelle P; Schaheen, Lara W; Tatum, Roger P; Turkin, Igor N; van der Horst, Sylvia; van der Peet, Donald L; van der Sluis, Peter C; van Hillegersberg, Richard; Wormald, Justin C R; Wu, Peter C; Zonderhuis, Barbara M

2014-09-01

176

Esophageal transection may well be the approach of choice for patient with portal venous obstruction and esophageal varices.  

PubMed

Thirty patients with esophageal varices, portal venous obstruction and a histologically proven normal liver underwent either one of 2 different types of surgery. Shunt surgery was performed on 20 patients: 9 had a mesocaval shunt, 3, a splenorenal shunt, 4, a left gastric venacaval shunt, and 4, a distal splenorenal shunt. Conversely, direct interruption was performed on the other 10 patients; 6 underwent an esophageal transection, and 4 underwent a resection of the proximal stomach. Re-hemorrhage occurred in 7 of the former 20 patients but not in any of the 10 on whom the direct interruption method was used. In 6 of these 7 patients who experienced rebleeding, subsequent direct interruption surgery led to control of the bleeding. One patient died of a variceal hemorrhage one month postoperatively. The total 10 year cumulative survival rate was 86.3 per cent. In the light of these findings, we believe that methods of direct interruption, such as esophageal transection, may well be the approach of choice for patients with esophageal varices caused by extrahepatic portal venous obstruction. PMID:2810956

Kitano, S; Iso, Y; Iwanaga, T; Koyanagi, N; Sugimachi, K

1989-07-01

177

Esophageal replacement in rat using porcine intestinal submucosa as a patch or a tube-shaped graft.  

PubMed

This study compares the efficacy of porcine intestinal submucosa (SIS) patch graft versus SIS-tube graft in esophageal replacement, using a novel esophageal regeneration model. Clinical function, as well as macroscopic and microscopic morphology were evaluated in both SIS-treated groups. We performed semi-circumferential esophageal excision followed by repair of the defect using either a SIS-patch graft (group I) or segmental esophageal excision followed by a SIS-tube interposition graft (group II) in rats. The 28-day survival rate was significantly different between the SIS-treated groups (100% in group I vs. 0% in group II). Unlike the rats in group II, which died within the first postoperative month due to esophageal dysfunction, all surviving animals in group I resumed a normal solid diet within a few days after surgery, without signs of esophageal dysfunction and gained weight. Barium swallow studies showed no evidence of fistula, significant stenosis or diverticula. No hematological or serum biochemistry abnormalities were found. By day 150 the SIS patch was replaced by esophageal-derived tissues. In the rat model, a patch graft technique using SIS appeared to induce esophageal regrowth and provided an initial and long-term satisfactory function, while a tube-shaped graft technique using SIS was unsuccessful. PMID:16866856

Lopes, M F; Cabrita, A; Ilharco, J; Pessa, P; Paiva-Carvalho, J; Pires, A; Patrício, J

2006-01-01

178

Respiratory epithelium inhibits bronchial smooth muscle tone.  

PubMed

The aim of the present study was to determine whether or not the respiratory epithelium can modulate the responsiveness of bronchial smooth muscle. Paired rings of canine bronchi (4-6 mm OD), in some of which the epithelium had been removed mechanically (by rubbing the luminal surface), were mounted in physiological saline solution, gassed with 95% O2-5% CO2, and maintained at 37 degrees C. The presence or absence of the epithelium was confirmed by histological examination. Removal of the epithelium increased the contractile responses evoked by acetylcholine, histamine, and 5-hydroxytryptamine. Transmural nerve stimulation evoked similar peak responses in the presence and absence of epithelium. In unrubbed preparations, the peak response was followed by a gradual decrease when the stimulation was continued. This decrease, which persisted in the presence of propranolol, was not observed in epithelium-denuded preparations. In bronchial rings contracted with acetylcholine, isoproterenol produced concentration-dependent relaxations which were significantly greater in rings with epithelium compared with denuded rings. These results suggest that respiratory epithelial cells may generate an inhibitory signal to decrease the responsiveness of bronchial smooth muscle to contractile agonists and augment the effectiveness of inhibitory stimuli. PMID:3980388

Flavahan, N A; Aarhus, L L; Rimele, T J; Vanhoutte, P M

1985-03-01

179

The 3-layered ductal epithelium in gynecomastia.  

PubMed

Gynecomastia is the most common abnormality in the male breast and has been associated with male breast cancer, but whether there is an etiological role remains unknown. In the present study we conducted an immunohistochemical investigation to further characterize gynecomastia. A total of 46 cases of gynecomastia were immunohistochemically stained on tissue microarrays for estrogen receptor (ER), progesterone receptor, HER2, androgen receptor, cytokeratins (CK5, CK14, CK7, and CK8/18), p63, E-cadherin, BRST2, cyclin D1, Bcl-2, p53, p16, p21, and Ki67. In addition, 8 cases of male ductal carcinoma in situ and normal breast tissue obtained from autopsies (n=10) and adjacent to male breast cancer (n=5) were studied. Normal ductal male breast epithelial cells were very often ER and Bcl-2 positive (>69%), and progesterone receptor and androgen receptor expression was also common (>39%). Gynecomastia showed a consistent 3-layered pattern: 1 myoepithelial and 2 epithelial cell layers with a distinctive immunohistochemical staining pattern. The intermediate luminal layer, consisting of vertically oriented cuboidal-to-columnar cells, is hormone receptor positive and expresses Bcl-2 and cyclin D1. The inner luminal layer is composed of smaller cells expressing CK5 and often CK14 but is usually negative for hormone receptors and Bcl-2. Male ductal carcinoma in situ was consistently ER positive and CK5/CK14 negative. In conclusion, for the first time we describe the 3-layered ductal epithelium in gynecomastia, which has a distinctive immunohistochemical profile. These results indicate that different cellular compartments exist in gynecomastia, and therefore gynecomastia does not seem to be an obligate precursor lesion of male breast cancer. PMID:22314184

Kornegoor, Robert; Verschuur-Maes, Anoek H J; Buerger, Horst; van Diest, Paul J

2012-05-01

180

Efficacy of Intensity Modulated Radiation Therapy After Surgery in Early Stage of Esophageal Carcinoma;  

ClinicalTrials.gov

Esophageal Neoplasm; Esophageal Cancer TNM Staging Primary Tumor (T) T2; Esophageal Cancer TNM Staging Primary Tumor (T) T3; Esophageal Cancer TNM Staging Regional Lymph Nodes (N) N0; Esophageal Cancer TNM Staging Distal Metastasis (M) M0

2012-12-28

181

Radiation Therapy, Paclitaxel, and Carboplatin With or Without Trastuzumab in Treating Patients With Esophageal Cancer  

ClinicalTrials.gov

Adenocarcinoma of the Esophagus; Adenocarcinoma of the Gastroesophageal Junction; Stage IB Esophageal Cancer; Stage IIA Esophageal Cancer; Stage IIB Esophageal Cancer; Stage IIIA Esophageal Cancer; Stage IIIB Esophageal Cancer

2014-10-30

182

Immunological characteristics of amniotic epithelium.  

PubMed

We review recent experimental evidence of the immunosuppressive and immunogenic potential of amniotic epithelial cells. Since cryopreserved amniotic membrane (AM) has been used in clinical applications, much research has focused on the beneficial effects of amniotic stromal matrix rather than on the function of viable amniotic cells. However, viable human amniotic epithelial cells (HAECs) have been shown to elicit beneficial effects on secretion of anti-inflammatory factors. Topical application of culture supernatant from HAECs leads to profound suppression of suture-induced neovascularization in cornea and fewer major histocompatibility complex (MHC) class II antigen-presenting cells (APCs) in inflamed cornea after thermal cautery. Furthermore, expression of interleukin (IL)-1beta mRNA was suppressed in cauterized cornea. These results suggest that HAECs are a source of soluble anti-inflammatory factors that suppress corneal inflammation. However, viable amniotic epithelial cells display antigenicity and immunogenicity as allografts. Fresh allogeneic amniotic epithelium (AE) expresses MHC class I antigens and sensitizes recipients when placed in the eye, although long-term memory of allo-specific delayed hypersensitivity (DH) was not acquired. Allogeneic AE was clearly vulnerable to acute immune rejection in specifically sensitized recipients and recipients of repeated AE transplantation. We therefore suggest that immunogenicity of AE should not be ignored, and use of AM from different donor placentas should be emphasized when repeated AM transplantation is required in patients clinically. PMID:17001194

Hori, Junko; Wang, Mingcong; Kamiya, Kazutaka; Takahashi, Hiroshi; Sakuragawa, Norio

2006-12-01

183

Pathological characteristics of esophageal cancer  

PubMed Central

The pathological characteristics of esophageal squamous cell carcinoma, which include regularly occurring multiple carcinogenic lesions (MLs), severe dysplasia (SD) and direct intramural infiltration (DI), were investigated using large pathological sections. A total of 52 esophageal cancer patients underwent surgical resection and were diagnosed with esophageal squamous cell carcinoma. Large sections of the surgical resection specimens were then made for pathological examination. The actual length of the carcinoma was calculated during surgery from the length determined microscopically. ML, SD and DI were identified during pathological examination of the large sections by microscope and were statistically analyzed. The lesion lengths obtained by the various inspection methods differed from each other. ML, SD and DI were identified in 15, 28 and 41 patients, respectively. Furthermore, a higher incidence of DI was observed in patients with lymphatic infiltration or those with a later stage of disease. ML, SD and DI were identified as characteristics of esophageal squamous cell carcinoma, and ML and DI were found to correlate with lymphatic infiltration. PMID:25013466

SHI, HONG-YUN; ZHU, SHU-CHAI; SHEN, WEN-BIN; LIU, MIAO-LING

2014-01-01

184

Surgical Management of Esophageal Carcinoma  

Microsoft Academic Search

Surgical management of esophageal carcinoma is reviewed. The anatomy and biology are briefly mentioned, since these factors mitigate against the success of surgery. Staging, the key to proper treatment allocation and prog- nosis, is discussed, including the use of endoscopic ultra- sonography, positron emission tomography, and thoracoscopy\\/laparoscopy. Patient selection and preparation for surgery are important considerations. Surgical tech- niques are

CAROLYN E. REED

185

Treatment of localized esophageal cancer  

Microsoft Academic Search

The treatment of localized esophageal cancer (LEC) is controversial. The approaches that are used in daily practice include surgery or radiation alone, preoperative or postoperative radiation, preoperative or postoperative chemotherapy, and definitive or preoperative chemoradiation. The varied modalities used to treat LEC reflect both the lack of randomized trial data and the suboptimal results with current therapy. Nonetheless, the available

Baruch Brenner; David H. Ilson; Bruce D. Minsky

2004-01-01

186

[Acute necrotizing esophagitis. Case report].  

PubMed

Acute necrotizing esophagitis, also known as black esophagus, represents an extremely rare clinical entity, defined by the black pigmentation of the esophagus, secondary to necrosis of the mucosa and detected at endoscopy. We present a clinical case of this rare disease, with its manifestation, diagnosis, treatment, and we perform a review of the literature. PMID:23940914

Pierini, Angel; Imhof, Hugo; Burlando, Eduardo; Gianinetti, Leonardo; Pierini, Leandro

2013-06-01

187

Activin Potentiates Proliferation in Mature Avian Auditory Sensory Epithelium  

PubMed Central

Humans and other mammals are highly susceptible to permanent hearing and balance deficits due to an inability to regenerate sensory hair cells lost to inner ear trauma. In contrast, nonmammalian vertebrates, such as birds, robustly regenerate replacement hair cells and restore hearing and balance functions to near-normal levels. There is considerable interest in understanding the cellular mechanisms responsible for this difference in regenerative capacity. Here we report on involvement of the TGF? superfamily type II activin receptors, Acvr2a and Acvr2b, in regulating proliferation in mature avian auditory sensory epithelium. Cultured, posthatch avian auditory sensory epithelium treated with Acvr2a and Acvr2b inhibitors shows decreased proliferation of support cells, the cell type that gives rise to new hair cells. Conversely, addition of activin A, an Acvr2a/b ligand, potentiates support cell proliferation. Neither treatment (inhibitor or ligand) affected hair cell survival, suggesting a specific effect of Acvr2a/b signaling on support cell mitogenicity. Using immunocytochemistry, Acvr2a, Acvr2b, and downstream Smad effector proteins were differentially localized in avian and mammalian auditory sensory epithelia. Collectively, these data suggest that signaling through Acvr2a/b promotes support cell proliferation in mature avian auditory sensory epithelium and that this signaling pathway may be incomplete, or actively blocked, in the adult mammalian ear. PMID:20071511

McCullar, Jennifer S.; Ty, Sidya; Campbell, Sean; Oesterle, Elizabeth C.

2010-01-01

188

Mechanics and hemodynamics of esophageal varices during peristaltic contraction  

E-print Network

Mechanics and hemodynamics of esophageal varices during peristaltic contraction Larry S. Miller,1 Ahmed, and James G. Brasseur. Mechanics and hemodynamics of esophageal varices dur- ing peristaltic hypothesis states that variceal pressure and wall tension increase dramatically during esophageal peristaltic

Brasseur, James G.

189

Stepwise Expression of CDKN2A and RB1 Proteins in Esophageal Mucosa From Patients at High Risk for Squamous Cell Carcinoma.  

PubMed

Squamous cell carcinoma of the esophagus is a lethal cancer and carries a poor prognosis because of late diagnosis. Identification of molecular markers may aid early diagnosis. We assessed the expression of CDKN2A/RB1 in the esophageal mucosa and its association with the histology. Esophageal biopsies were collected from 38 patients with no esophageal lesion (group 1), from iodine-negative areas of 108 alcoholics/smokers (group 2), and from tumor and nontumor areas in 41 patients with squamous cell carcinoma (group 3). The histologic diagnosis was compared with immunoexpression of CDKN2A/RB1. In group 1, histology showed normal mucosa/mild esophagitis and no expression of CDKN2A/RB1. In groups 2 and 3, the diagnosis was: normal mucosa (38.4%), esophagitis (44.4%), dysplasia and carcinoma in situ (2.8%), and carcinoma (14.3%). The immunoexpression of CDKN2A/RB1 increased in a stepwise manner from the normal mucosa, to esophagitis, dysplasia/carcinoma in situ, and carcinoma (P<0.01). CDKN2A/RB1 was not expressed in the esophageal mucosa of patients without risk factors. p16/pRb expression increased in a stepwise manner, according to the severity of histologic lesions, in biopsies from patients exposed to risk factors or with carcinoma. Esophageal mucosa exposed to risk factors with the expression of those proteins may be at risk for malignant transformation. PMID:25046224

Müller, Leandro B; Meurer, Luise; Lopes, Antônio Barros; Antunes, Luis C M; Vanazzi, Sara; Fagundes, Renato B

2014-10-01

190

Thymic epithelium in AIDS. An immunohistologic study.  

PubMed Central

The authors investigated by immunofluorescence the thymic epithelium from AIDS patients, using several structural and functional markers of this tissue. In AIDS thymus, the epithelial reticular pattern was lost; and instead, clusters of round or spindle-shaped cells (assessed by their keratin content) were found. In addition, regions of epithelial necrosis, with loss of cell limits, were frequently observed. Thymulin content was decreased, and a partial loss of differentiation antigens of the thymic epithelium was also detected. The authors showed the presence of immunoglobulins and elements of the complement system directly bound to AIDS thymic epithelium, but not in any of the controls studied, including thymuses from patients who died after a long period of agony. These data suggest that the thymic epithelium can be included among the target tissues in AIDS, possibly by an indirect mechanism of autoimmune destruction. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 PMID:3511724

Savino, W.; Dardenne, M.; Marche, C.; Trophilme, D.; Dupuy, J. M.; Pekovic, D.; Lapointe, N.; Bach, J. F.

1986-01-01

191

Radiation-induced esophageal injury: A spectrum from esophagitis to cancer  

Microsoft Academic Search

Radiation esophagitis is a common but frequently unrecognized complication of therapeutic radiation to the neck, chest, or mediastinum. The spectrum of injury ranges from acute self-limited esophagitis to life-threatening esophageal perforation. Complications such as stricture or primary esophageal cancer may occur many years after irradiation, and their linkage to radiation may not be considered. Five cases of radiation-induced injury are

A. Vanagunas; P. Jacob; E. Olinger

1990-01-01

192

Esophageal wall blood perfusion during contraction and transient lower esophageal sphincter relaxation in humans  

PubMed Central

We recently reported that esophageal contraction reduces esophageal wall perfusion in an animal study. Our aim was to determine esophageal wall blood perfusion (EWBP) during esophageal contraction and transient lower esophageal sphincter relaxations (TLESRs) in humans. We studied 12 healthy volunteers. A custom-designed laser Doppler probe was anchored to the esophageal wall, 4–6 cm above the LES, by use of the Bravo pH system so that the laser light beam stay directed toward the esophageal mucosa. A high-resolution manometry equipped with impedance electrodes recorded esophageal pressures and reflux events. Synchronized pressure, impedance, pH, and EWBP recordings were obtained during dry and wet swallows and following a meal. Stable recordings of laser Doppler EWBP were only recorded when the laser Doppler probe was firmly anchored to the esophageal wall. Esophageal contractions induced by dry and wet swallows resulted in 46 ± 9% and 60 ± 10% reduction in the EWBP, respectively (compared to baseline). Reduction in EWBP was directly related to the amplitude (curvilinear fit) and duration of esophageal contraction. Atropine reduced the esophageal contraction amplitude and decreased the EWBP reduction associated with esophageal contraction. TLESRs were also associated with reduction in the EWBP, albeit of smaller amplitude (29 ± 3%) but longer duration (19 ± 2 s) compared with swallow-induced esophageal contractions. We report 1) an innovative technique to record EWBP for extended time periods in humans and 2) contraction of circular and longitudinal muscle during peristalsis and selective longitudinal muscle contraction during TLESR causes reduction in the EWBP; 3) using our innovative technique, future studies may determine whether esophageal wall ischemia is the cause of esophageal pain/heartburn. PMID:22790599

Jiang, Yanfen; Bhargava, Valmik; Kim, Young Sun

2012-01-01

193

Preoxygenation and Pulse Oximetry May Delay Detection of Esophageal Intubation  

PubMed Central

A case of delayed detection of esophageal intubation is described. Preoxygenation and pulse oximetry were used, and the first indication of tube misplacement was arterial desaturation indicated by the pulse oximeter. The combination of preoxygenation and pulse oximetry may contribute to delays in early detection of endotracheal tube misplacement for the following reasons: (1) preoxygenation results in a pulmonary reservoir of oxygen sufficient to maintain arterial hemoglobin saturation for an extended period of time; and (2) the maintenance of normal arterial saturations for an extended period after inadvertent esophageal tube placement may lead the practitioner to initially seek other causes of declining oxygen saturations. Although pulse oximetry is an acknowledged advance in patient monitoring, it must not be utilized as an early indication of correct endotracheal tube placement. PMID:3669093

McShane, Alan J.; Martin, Jackie L.

1987-01-01

194

A rare cause of dysphagia: Herpes simplex esophagitis  

PubMed Central

Herpes simplex esophagitis (HSE) is well documented in immunosuppressed patients. However, it is rare in the immunocompetent host. We present a case of HSE in a 21 year-old healthy lady who was admitted to our unit with dysphagia, odynophagia and chest pain. Clinical examination revealed mild epigastric tenderness and admission bloods including full blood picture, electrolytes and inflammatory markers were normal. She underwent an esophagogastroduodenoscopy (EGD) which revealed severe exudative, well-circumscribed ulcerations in her distal esophagus. Biopsies confirmed severe esophagitis with acute ulceration and subsequent polymerase chain reaction (PCR) confirmed herpes simplex virus (HSV) type 1. Subsequent assessment failed to identify an immune disorder. HSE should be suspected when faced with characteristic endoscopic findings, even if the patient is immunocompetent. When the diagnosis of HSE is confirmed, an immune deficiency should be sought. PMID:17569149

Lee, Bee; Caddy, Grant

2007-01-01

195

Effect of monotherapy and combination therapy of pantoprazole and aprepitant in gastric esophageal reflux disease in albino rats.  

PubMed

The present study was undertaken to elucidate the effect of pantoprazole and aprepitant on experimental esophagitis in albino rats. Groups of rats, fasted overnight, received normal saline (3 mL/kg, sham control) or toxic control (3 mL/kg) or pantoprazole (30 mg/kg) or aprepitant (10 mg/kg), or their combinations and were subjected to pylorus and forestomach ligation. Animals were sacrificed after 8 h and evaluated for the gastric pH, volume of gastric juices, total acidity, esophagitis index, and free acidity. Esophageal tissues were further subjected to estimations of TBARS, GSH, catalase, and SOD. Treatment with pantoprazole and aprepitant significantly inhibited the gastric secretion, total acidity, and esophagitis index. The treatment also helped to restore the altered levels oxidative stress parameters to normal. PMID:24790551

Shukla, Kamleshwar; Raj, Prince; Kumar, Arun; Kumar, Mukesh; Kaithwas, Gaurav

2014-01-01

196

Pneumatic dilatation in patients with symptomatic diffuse esophageal spasm and lower esophageal sphincter dysfunction  

Microsoft Academic Search

Nine patients with severe symptoms of diffuse esophageal spasm and lower esophageal sphincter dysfunction who were unresponsive to medical therapy and bougienage dilatation were treated by forceful pneumatic dilatation. Treatment with pneumatic dilatation in eight of the nine patients produced a marked improvement in dysphagia and regurgitation (average follow-up of 37.4 months). Esophageal motility performed up to three years (average

E. C. Ebert; A. Ouyang; S. H. Wright; S. Cohen; W. H. Lipshutz

1983-01-01

197

Abnormalities of cornified cell envelopes isolated from human papillomavirus type 11-infected genital epithelium.  

PubMed

Keratinocytes are the predominant cells in human skin. As keratinocytes differentiate, the nuclei are lost and the cornified cell envelope (CCE) develops, forming a covalently cross-linked, insoluble structure under the cell membrane. Layers of anuclear CCEs in the stratum corneum provide a barrier against water loss and mechanical damage and are a first line of immunologic defense. Infection of keratinocytes with human papillomaviruses (HPVs) induces proliferation and abnormalities including retention of nuclei in the stratum corneum and perinuclear halo formation. For effective transmission, HPV virions must be released from the CCE, a normally very durable structure. Therefore, it is likely that HPV infection affects the CCE in a manner that would facilitate virion release. To investigate the effects of HPV 11 infection on morphology and fragility, CCEs were purified from infected and uninfected epithelium. CCEs isolated from uninfected epithelium were smooth, cuboidal, and sonicated into long coiled structures. In contrast, CCEs from HPV 11-infected epithelium were irregular in size and shape, with rough edges, and sonicated into small fragments. In addition, the thickness of CCEs from HPV 11-infected tissue was 65% that of uninfected epithelium. Immunohistochemical analysis demonstrated that in contrast to uninfected epithelium, loricrin, the major component of the CCE, was abnormally distributed in the differentiated layers of HPV 11-infected epithelium. We conclude that in addition to the previously described epithelial abnormalities induced by HPV, the CCE is also affected by infection in ways that may facilitate transmission of virus from person to person. PMID:10814571

Brown, D R; Bryan, J T

2000-05-25

198

Current Management of Cervical Esophageal Cancer  

Microsoft Academic Search

Background  Pharyngo-laryngo-esophagectomy (PLE) has been regarded as a standard treatment for cervical esophageal cancer, but the morbidity\\u000a and mortality rates associated with PLE are substantial. Chemoradiation (CTRT) is widely used to treat esophageal cancer;\\u000a however, its role in managing cervical esophageal cancer has not been fully elucidated. It was hypothesized that up-front\\u000a CTRT could be an effective alternative treatment option to

Daniel King Hung Tong; Simon Law; Dora Lai Wan Kwong; William I. Wei; Raymond Wai Man Ng; Kam Ho Wong

2011-01-01

199

Esophageal leiomyoma detected by transesophageal contrast echocardiography.  

PubMed

Transesophageal echocardiography (TEE) provides valuable information in the evaluation of intra- and extracardiac masses. There is no report demonstrating its usefulness in identifying esophageal mass lesions. This is because generally it is contraindicated in patients with esophageal diseases. However, endoscopic ultrasound is used in the evaluation of gastrointestinal pathology. We report a case of an esophageal tumor detected by TEE and the value of contrast echocardiography in further definition of the tumor. PMID:18177392

Meng, Hong; Lee, Pui Wai; Mathieu, Bernier; Chandrasekaran, Krishnaswamy

2008-03-01

200

Radiation esophagitis: Predictive factors and preventive strategies.  

PubMed

Radiation esophagitis remains the primary dose-limiting acute toxicity in the radiotherapeutic management of thoracic neoplasms. Improved understanding of this toxicity will facilitate dose escalation and enhancement of the therapeutic ratio. This article reviews the predictive factors and preventive strategies for radiation esophagitis. In particular, clinical and dosimetric studies predicting the risk of radiation esophagitis are analyzed. The critical impact of chemotherapy on radiation esophagitis is characterized. Preventive strategies to minimize this toxicity also are explored. Overall, this article reviews the current understanding of radiation toxicity for the esophagus. PMID:15558501

Bradley, Jeffrey; Movsas, Benjamin

2004-10-01

201

Brain abscess after esophageal dilatation: case report.  

PubMed

Brain abscess formation is a serious disease often seen as a complication to other diseases and to procedures. A rare predisposing condition is dilatation therapy of esophageal strictures. A case of brain abscess formation after esophageal dilatations is presented. A 59-year-old woman was admitted with malaise, progressive lethargy, fever, aphasia and hemiparesis. Six days before she had been treated with esophageal dilatation for a stricture caused by accidental ingestion of caustic soda. The brain abscess was treated with surgery and antibiotics. She recovered completely. This clinical case illustrates the possible association between therapeutic esophageal dilatation and the risk of brain abscess formation. PMID:17710371

Gaïni, S; Grand, M; Michelsen, J

2008-02-01

202

Pathophysiology of Portal Hypertension and Esophageal Varices  

PubMed Central

Esophageal varices are the major complication of portal hypertension. It is detected in about 50% of cirrhosis patients, and approximately 5–15% of cirrhosis patients show newly formed varices or worsening of varices each year. The major therapeutic strategy of esophageal varices consists of primary prevention, treatment for bleeding varices, and secondary prevention, which are provided by pharmacological, endoscopic, interventional and surgical treatments. Optimal management of esophageal varices requires a clear understanding of the pathophysiology and natural history. In this paper, we outline the current knowledge and future prospect in the pathophysiology of esophageal varices and portal hypertension. PMID:22666604

Maruyama, Hitoshi; Yokosuka, Osamu

2012-01-01

203

Esophageal motility abnormalities in gastroesophageal reflux disease.  

PubMed

Esophageal motility abnormalities are among the main factors implicated in the pathogenesis of gastroesophageal reflux disease. The recent introduction in clinical and research practice of novel esophageal testing has markedly improved our understanding of the mechanisms contributing to the development of gastroesophageal reflux disease, allowing a better management of patients with this disorder. In this context, the present article intends to provide an overview of the current literature about esophageal motility dysfunctions in patients with gastroesophageal reflux disease. Esophageal manometry, by recording intraluminal pressure, represents the gold standard to diagnose esophageal motility abnormalities. In particular, using novel techniques, such as high resolution manometry with or without concurrent intraluminal impedance monitoring, transient lower esophageal sphincter (LES) relaxations, hypotensive LES, ineffective esophageal peristalsis and bolus transit abnormalities have been better defined and strongly implicated in gastroesophageal reflux disease development. Overall, recent findings suggest that esophageal motility abnormalities are increasingly prevalent with increasing severity of reflux disease, from non-erosive reflux disease to erosive reflux disease and Barrett's esophagus. Characterizing esophageal dysmotility among different subgroups of patients with reflux disease may represent a fundamental approach to properly diagnose these patients and, thus, to set up the best therapeutic management. Currently, surgery represents the only reliable way to restore the esophagogastric junction integrity and to reduce transient LES relaxations that are considered to be the predominant mechanism by which gastric contents can enter the esophagus. On that ground, more in depth future studies assessing the pathogenetic role of dysmotility in patients with reflux disease are warranted. PMID:24868489

Martinucci, Irene; de Bortoli, Nicola; Giacchino, Maria; Bodini, Giorgia; Marabotto, Elisa; Marchi, Santino; Savarino, Vincenzo; Savarino, Edoardo

2014-05-01

204

Temporal evolution in caveolin 1 methylation levels during human esophageal carcinogenesis  

PubMed Central

Background Esophageal cancer ranks eighth among frequent cancers worldwide. Our aim was to investigate whether and at which neoplastic stage promoter hypermethylation of CAV1 is involved in human esophageal carcinogenesis. Methods Using real-time quantitative methylation-specific PCR (qMSP), we examined CAV1 promoter hypermethylation in 260 human esophageal tissue specimens. Real-time RT-PCR and qMSP were also performed on OE33 esophageal cancer cells before and after treatment with the demethylating agent, 5-aza-2’-deoxycytidine (5-Aza-dC). Results CAV1 hypermethylation showed highly discriminative ROC curve profiles, clearly distinguishing esophageal adenocarcinomas (EAC) and esophageal squamous cell carcinomas (ESCC) from normal esophagus (NE) (EAC vs. NE, AUROC?=?0.839 and p?normalized methylation value (NMV) were significantly higher in Barrett’s metaplasia (BE), low-grade and high-grade dysplasia occurring in BE (D), EAC, and ESCC than in NE (all p?esophageal carcinomas and is associated with early neoplastic progression in Barrett’s esophagus. PMID:24885118

2014-01-01

205

Neoadjuvant therapy for esophageal cancer  

PubMed Central

Esophageal cancer is increasing in incidence more than any other visceral malignancy in North America. Adenocarcinoma has become the most common cell type. Surgery remains the primary treatment modality for locoregional disease. Overall survival with surgery alone has been dismal, with metastatic disease the primary mode of treatment failure after an R0 surgical resection. Cure rates with chemotherapy or radiation therapy alone have been disappointing as well. For these reasons, over the last decade multi-modality treatment has gained increasing acceptance as the standard of care. This review examines the present data and role of neoadjuvant treatment using chemotherapy and radiation therapy followed by surgery for the treatment of esophageal cancer. PMID:25320656

Shah, Rachit D; Cassano, Anthony D; Neifeld, James P

2014-01-01

206

Management of Esophageal Variceal Bleeding  

Microsoft Academic Search

\\u000a Esophageal variceal bleeding is a potentially life-threatening complication of portal hypertension. One-third of cirrhotic\\u000a patients with documented varices bleed within 2 years from the time of initial diagnosis. Mortality rates from an initial\\u000a episode of bleeding are 20–35% and approximately 30% with each additional episode of bleeding. Risk factors for acute bleeding\\u000a episodes include advanced cirrhosis, large or proximal extension

Keki Balsara; Lisa Pickett

207

Radiation-induced esophageal carcinoma  

Microsoft Academic Search

Radiation-induced carcinoma of the esophagus is rare and only 8 cases have been reported since 1957. This article presents 2 additional patients in whom esophageal carcinoma developed in segments previously exposed to large therapeutic doses of irradiation. The first patient had received 5,000 rads to her mediastinum and the second patient 3,200 rads to her neck region. The latent intervals

Elizabeth W. O'Connell; William B. Seaman; Gary G. Ghahremani

1984-01-01

208

Prolonged esophagitis after primary dysfunction of the pyloric sphincter in the rat and therapeutic potential of the gastric pentadecapeptide BPC 157.  

PubMed

Seven or fourteen days or twelve months after suturing one tube into the pyloric sphincter (removed by peristalsis by the seventh day), rats exhibit prolonged esophagitis with a constantly lowered pressure not only in the pyloric, but also in the lower esophageal sphincter and a failure of both sphincters. Throughout the esophagitis experiment, gastric pentadecapeptide BPC 157 (PL 14736) is given intraperitoneally once a day (10 microg/kg, 10 ng/kg, last application 24 h before assessment), or continuously in drinking water at 0.16 microg/ml, 0.16 ng/ml (12 ml/rat per day), or directly into the stomach 5 min before pressure assessment (a water manometer connected to the drainage port of a Foley catheter implanted into the stomach either through an esophageal or duodenal incision). This treatment alleviates i) the esophagitis (macroscopically and microscopically, at either region or interval), ii) the pressure in the pyloric sphincter, and iii) the pressure in the lower esophageal sphincter (cmH2O). In the normal rats it increases lower esophageal sphincter pressure, but decreases the pyloric sphincter pressure. Ranitidine, given using the same protocol (50 mg/kg, intraperitoneally, once daily; 0.83 mg/ml in drinking water; 50 mg/kg directly into the stomach) does not have an effect in either rats with esophagitis or in normal rats. PMID:17452811

Dobric, Ivan; Drvis, Petar; Petrovic, Igor; Shejbal, Drazen; Brcic, Luka; Blagaic, Alenka Boban; Batelja, Lovorka; Sever, Marko; Kokic, Neven; Tonkic, Ante; Zoricic, Ivan; Mise, Sandro; Staresinic, Mario; Radic, Bozo; Jakir, Ana; Babel, Jaksa; Ilic, Spomenko; Vuksic, Tihomir; Jelic, Ivan; Anic, Tomislav; Seiwerth, Sven; Sikiric, Predrag

2007-05-01

209

Effects of castration and androgen-substitution on the morphology of the epididymal epithelium of the Japanese monkey, Macacus fuscatus , as revealed by scanning electron microscopy  

Microsoft Academic Search

The caput epididymidis from castrated and androgen-supplemented, castrated Japanese monkeys was observed with the scanning electron microscope. The experimental findings were compared with the normal structures in control animals. The epididymal lumen of control animals was lined by a tall, pseudostratified columnar epithelium possessing long, slender stereocilia which were densely arranged in a tuft-like form. After castration, the epididymal epithelium

Masahiro Murakami; Tatsuo Shimada; Shinshi Noda; Toshiaki Kawano

1976-01-01

210

Current knowledge on esophageal atresia  

PubMed Central

Esophageal atresia (EA) with or without tracheoesophageal fistula (TEF) is the most common congenital anomaly of the esophagus. The improvement of survival observed over the previous two decades is multifactorial and largely attributable to advances in neonatal intensive care, neonatal anesthesia, ventilatory and nutritional support, antibiotics, early surgical intervention, surgical materials and techniques. Indeed, mortality is currently limited to those cases with coexisting severe life-threatening anomalies. The diagnosis of EA is most commonly made during the first 24 h of life but may occur either antenatally or may be delayed. The primary surgical correction for EA and TEF is the best option in the absence of severe malformations. There is no ideal replacement for the esophagus and the optimal surgical treatment for patients with long-gap EA is still controversial. The primary complications during the postoperative period are leak and stenosis of the anastomosis, gastro-esophageal reflux, esophageal dysmotility, fistula recurrence, respiratory disorders and deformities of the thoracic wall. Data regarding long-term outcomes and follow-ups are limited for patients following EA/TEF repair. The determination of the risk factors for the complicated evolution following EA/TEF repair may positively impact long-term prognoses. Much remains to be studied regarding this condition. This manuscript provides a literature review of the current knowledge regarding EA. PMID:22851858

Pinheiro, Paulo Fernando Martins; Simoes e Silva, Ana Cristina; Pereira, Regina Maria

2012-01-01

211

Pharmacologic influence on esophageal varices  

SciTech Connect

Selective catherization of the left gastric vein was performed after percutaneous transhepatic portography (PTP) in patients with portal hypertension and esophageal varices. Following the hypothesis that drugs increasing the lower esophageal sphincter (LES) pressure may obstruct the variceal blood flow throught the lower esophagus, the effect of different drugs (i.e., intravenous injection of vasopressin, pentagastrin, domperidone and somatostatin and subcutaneous injection of metacholine) on the variceal blood flow was examined. Vasopressin did not change the variceal blood flow; pentagastrine, with its known effect of increasing the LES pressure produced a total interruption of the flow in four of eight patients; domperiodone, also known to increase the LES pressure obstructed the variceal blood flow in the only patient examined with this drug; somatostatin has no reported action on the LES but blocked the flow in one of two patients; and metacholine, reported to increase the LES pressure did not produce any change in the flow in the three patients examined. LES pressure was recorded before and during vasopressin infusion in seven patients with portal hypertension and esophageal varices. No reaction on the pressure was found. The patient number in the study is small and the results are nonuniform but still they suggest that drugs increasing the LES tonus might be useful to control variceal blood flow.

Lunderquist, A.; Owman, T.; Alwmark, A.; Gullstrand, P.; Hall-Angeras, M.; Joelsson, B.; Tranberg, K.G.; Pettersson, K.I.

1983-06-01

212

Polymorphic Expression of the Glutathione S-Transferase P1 Gene and Its Susceptibility to Barrett's Esophagus and Esophageal Carcinoma 1  

Microsoft Academic Search

Factors determining individual susceptibility to esophageal cancer or premalignant Barrett's epithelium are still largely unclear. An imbalance between phase I drug metabolism (e.g., cytochrome P450 (CYP)) and phase II detoxification (e.g., glutathione S-transferase (GST)) may con- tribute to the development of these diseases. Polymorphic variants in the CYPIA1 gene were described leading to increased levels of bioactive compounds, whereas polymorphisms

Esther M. M. van Lieshout; Hennie M. J. Roelofs; Simone Dekker; Chris J. J. Mulder; Theo Wobbes; Jan B. M. J. Jansen; Wilbert H. M. Peters

213

Lymphocytic Infiltration of Epithelium in Diagnosis of Gluten-sensitive Enteropathy  

Microsoft Academic Search

The macroscopic appearance of the mucosa of the small intestine and the lymphocytic infiltration of the epithelium were studied in 27 patients with dermatitis herpetiformis and in 11 control subjects. The mucosa was abnormal in appearance in 13 of the patients and normal in 14 patients and in all the controls. In 25 (93%) of the patients the intraepithelial lymphocyte

Lionel Fry; P. P. Seah; R. M. H. McMinn; A. V. Hoffbrand

1972-01-01

214

THE EFFECT OF SO2 ON THE UPTAKE OF PARTICLES BY MOUSE BRONCHIAL EPITHELIUM  

EPA Science Inventory

In three experiments, the authors have explored the uptake and transport of collidal gold (Au) and iron oxide (Fe2O3) by normal and SO2-injured bronchial epithelium. In the first experiment mice were exposed to a 2-hr aerosol of Au; in the second experiment, mice were exposed to ...

215

Light dosimetry calculations for esophageal photodynamic therapy using porfimer sodium  

NASA Astrophysics Data System (ADS)

Background: Photodynamic therapy using porfimer sodium (Ps-PDT) is approved for use in patients with Barrett's highgrade dysplasia and esophageal carcinoma. Ps-PDT light dosimetry, however, is critically important to treatment outcomes since insufficient ablation results in residual dysplasia and carcinoma while excessive treatment results in stricture formation. Aim: The aim of this study was to model esophageal PDT with optical absorption and scattering coefficients derived from an ex-vivo porcine multilayer esophagus model. Methods: Optical coefficients were derived for the mucosal and muscle layers of normal pig esophagus. The mucosal layer (mucosa, muscularis mucosa and submucosa) was separated from the muscle layer. Diffuse reflectance and transmittance were measured with an integrating sphere spectrophotometer. Absorption and reduced scattering coefficients were determined with the inverse adding doubling method. (Table not available in abstract, see pdf of paper) Multilayer Monte Carlo simulation and single-layer mathematical dosimetry equations were employed to model esophageal PDT with the derived coefficients. Porfimer sodium addition was modeled with an increase in both absorption and scattering. Depth of injury, assumed to require a threshold light dose, was estimated for various light doses commonly used in clinical practice. Depth of injury was then compared to clinical outcomes reported in the literature for various light doses.

Jones, Linda R.; Preyer, Norris W., Jr.; Davis, Monica A.; Grimes, Carson; Edling, Kristie; Holdgate, Nicholas; Wallace, Michael B.; Wolfsen, Herbert C.

2006-02-01

216

Multinucleated epithelial giant cell changes in esophagitis: a clinicopathologic study of 14 cases.  

PubMed

We describe the clinical and pathologic features of a hitherto unreported finding in patients with esophagitis: the presence of multinucleated squamous epithelial giant cells simulating viral cytopathic effect and/or dysplasia. Routinely processed hematoxylin and eosin (H&E)-stained slides of esophageal mucosal biopsies from 14 patients with both active esophagitis and multinucleated epithelial giant cells were evaluated for a variety of inflammatory and epithelial features. Clinical, endoscopic, and follow-up data were collected and correlated with the histologic findings. Immunostaining (ABC method) for cytokeratin AE1/AE3, S-100, MIB-1, herpes simplex virus 1 and 2 (HSV), cytomegalovirus (CMV), as well as DNA in situ hybridization for human papilloma virus (HPV-ISH) was performed in all cases. Electron microscopic evaluation for viral particles was performed in three cases. The study group consisted of nine men and five women (mean age 59 years; range 23-87 years; 12 white, one black, one Hispanic). Patients presented with dysphagia or odynophagia (n = 5), upper gastrointestinal bleeding (n = 5), heartburn (n = 2), or abdominal pain (n = 2). The etiology of esophagitis was attributed to gastroesophageal reflux in 10, radiotherapy in one, Candida infection in one, drug-induced (alendronate) in one, and unknown in 1. Endoscopically, seven patients had an ulcer or erosion, four erythema, two stricture formation, and one white mucosal plaques. Microscopically, all cases showed multiple multinucleated (mean three nuclei per cell, range two to nine) squamous epithelial cells (range 2 to 11 cells per biopsy) confined to the basal zone in nine of 14 cases and involving the basal and superficial epithelium in the remainder. The nuclei contained a single or multiple eosinophilic nucleoli with a perinucleolar halo, but no inclusions, hyperchromaticity, or atypical mitoses. All cases showed associated nonspecific features of active esophagitis such as ulceration, neutrophilic and eosinophilic inflammation, basal cell hyperplasia, and elongation of the lamina propria papillae. The multinucleated giant cells, in all cases, were strongly positive for cytokeratin AE1/AE3 and were negative for S-100, HSV I and II, CMV, and HPV-ISH. MIB-1 positivity was observed in all basally located multinucleated giant cells, whereas those in the more superficial layers were negative. Electron microscopy failed to show viral particles in three of three cases. After treatment, all patients demonstrated clinical improvement. Three patients in whom follow-up biopsies were performed showed no evidence of esophagitis, epithelial cell multinucleation, or dysplasia. Multinucleated epithelial giant cell changes may rarely be seen in patients with esophagitis of varying etiology and probably represent a regenerative response to injury. This feature is important to distinguish from either viral cytopathic effect or dysplasia. PMID:9422321

Singh, S P; Odze, R D

1998-01-01

217

Videoendoscopic diagnosis of esophageal motility disorders  

Microsoft Academic Search

Background: Esophageal motility disorders are usually diagnosed by manometry. We evaluated videoendoscopy as a diagnostic test. Methods: In this study, 20 patients with achalasia, 13 with scleroderma, and 33 control subjects had a standard endoscopic examination followed by protocol videotaping of swallows to observe contractions in the esophagus and in the lower esophageal sphincter. Tapes were later reviewed by 2

Alan J. Cameron; Allison Malcolm; Charlene M. Prather; Sidney F. Phillips

1999-01-01

218

CONCURRENT CHEMORADIATION FOR ESOPHAGEAL CARCINOMA: PRELIMINARY RESULTS  

Microsoft Academic Search

Despite all advances, treatment of esophageal carcinoma is still unsatisfactory. Currently the standard non-surgical treatment of esophageal cancer is concurrent chemotherapy and radiotherapy (chemoradiation), with results comparable to best surgical series. A few years ago, we started a chemoradiation protocol for the cancer of esophagus as a curative treatment, of which we present the preliminary results here. Files of all

P. Haddad; F. Amouzgar-Hashemi

219

Esophageal Cancer: A Review and Update  

Microsoft Academic Search

Although significant advancements have been made in the treatment of esophageal cancer, this aggressive malignancy commonly presents as locally advanced disease with a poor prognosis. Despite improvements in the detection of premalignant pathology, newer preventative strate- gies, and the development of more effective combination therapies, the overall incidence of esophageal carcinomas has risen. A clear association has been established between

JOHN C. LAYKE; DeWitt Daughtry

2006-01-01

220

Laser-induced fluorescence in the detection of esophageal carcinoma  

NASA Astrophysics Data System (ADS)

Laser induced fluorescence (LIF) is a technique which can perform an 'optical biopsy' of gastrointestinal mucosa. LIF was performed in resected specimens using a pulsed N2-laser coupled fiberoptically to a probe. Fluorescence was measured using a 0.2 meter spectroscope with an intensified photodiode array. Measurements were made on fresh (<30 minutes after resection) esophageal specimens containing normal mucosa, Barrett's esophagus, and adenocarcinoma. Each tissue section was examined using an optical probe consisting of a central fiber for delivering the excitation energy and a 6 fiber bundle surrounding the central fiber for detection of the fluorescence. An excitation wavelength of 337 nm was used which generated 3-ns pulses while fluorescence intensities were acquired from 300-800 nm. Spectra were obtained from each section in a standardized fashion and background spectra subtracted. Fluorescence readings were taken from 54 normal esophageal sections and 32 sections of adenocarcinoma. A fluorescence index obtained from the tumor sections was 0.68+/- 0.01 compared with 0.51+/- 0.01 for the normal sections (p<0.001). Using a discriminant value of 0.65, this technique had a sensitivity of 81% and a specificity of 100% for detection of malignant tissue. The positive predictive value was 100% and the negative predictive value was 90% for an overall accuracy of 93%. LIF is a promising technique which has the capability of distinguishing normal versus malignant tissue in the esophagus with good accuracy.

Wang, Kenneth K.; Gutta, Kumar; Laukka, Mark A.; Densmore, John

1995-01-01

221

Physiology of the esophageal pressure transition zone: separate contraction waves above and below  

E-print Network

between tone and bolus transport through the TZ. Eighteen normal barium swallows were analyzed in 6 FUNCTION of the esophagus is the effective trans- port of a bolus from the oral cavity into the stomach" when minimal bolus material is retained within the esophageal body. Contractions of the circular muscle

Brasseur, James G.

222

Radiation therapy of esophageal carcinoma: Correlation of clinical and radiographic findings  

Microsoft Academic Search

Seventeen patients with esophageal carcinoma treated by radiation therapy (RT) at our hospital between 1981 and 1984 had initial diagnostic esophagrams and 1 or more repeat esophagrams after completing RT. Total regression of the tumor was observed radiographically in 10 patients (59%) with a normal esophagus (24%) or benign-appearing residual stricture (35%) at the site of the previous lesion. Partial

Marc S. Levine; Jill Langer; Igor Laufer; Morton M. Kligerman

1987-01-01

223

Serum pepsinogens and risk of esophageal squamous dysplasia  

PubMed Central

Pepsinogens are a class of endopeptidases that are secreted by the gastric epithelium and released into the circulation. Low serum pepsinogen I (PGI) and low serum pepsinogen I / pepsinogen II ratio (PGI/II ratio) are markers of gastric fundic atrophy, and have recently been shown to be associated with increased risk of esophageal squamous cell carcinoma (ESCC). We conducted the current study to test whether these markers are also associated with esophageal squamous dysplasia (ESD), the precursor lesion of ESCC. We measured serum PGI and PGII, using enzyme-linked immunosorbent (ELISA) assays, in 125 case subjects (patients with moderate or severe ESD) and 250 sex-matched control subjects (no ESD) selected from an endoscopic screening study in Linxian, China. We used conditional logistic regression models adjusted for age, smoking, and place of residence to calculate odds ratios (ORs) and 95% confidence intervals (95% CIs). Serum PGI showed no statistically significant association with ESD, whether analyzed as a dichotomous, ordinal (quartiles), or continuous variable. Lower serum PGI/II ratio, however, showed a dose-response association with increased risk of ESD, with an adjusted OR (95% CI) of 2.12 (1.08 ? 4.18), comparing the lowest versus the highest quartile. The association between lower serum PGI/II ratio and log OR of ESD was nearly linear, and the p-value for the continuous association was 0.03. Lower serum PGI/II ratio was linearly associated with higher risk of ESD. This result is consistent with recent findings that gastric atrophy may increase the risk of ESCC. PMID:18844222

Kamangar, Farin; Diaw, Lena; Wei, Wen-Qiang; Abnet, Christian C.; Wang, Guo-Qing; Roth, Mark J.; Liu, Bing; Lu, Ning; Giffen, Carol; Qiao, You-Lin; Dawsey, Sanford M.

2008-01-01

224

Eosinophilic esophagitis, celiac disease, and immunoglobulin E-mediated allergy in a 2-year-old child.  

PubMed

Celiac disease, eosinophilic esophagitis, and urticaria are 3 manifestations of food allergy with different pathogenic mechanisms. We report the case of a 2-year-old child with digestive symptoms, slow growth, and severe asthma. The results of skin prick tests were positive to several foods. Endoscopy revealed eosinophilic esophagitis and celiac disease. Treatment consisted of a gluten-free diet and a 1-month course of oral corticosteroids. Endoscopy and biopsy findings were normal at 5 years of age. A gluten-free diet is the basis of treatment of celiac disease, but the role of an elimination diet in eosinophilic esophagitis is not well established. Our patient also developed urticaria when exposed to milk and egg.We present, to our knowledge, the first report of a patient with celiac disease, eosinophilic esophagitis, and immediate-type immunoglobulin E-mediated food allergy. PMID:21370728

Sánchez-García, S; Ibáñez, M D; Martinez-Gómez, M J; Escudero, C; Vereda, A; Fernández-Rodríguez, M; Rodríguez del Río, P

2011-01-01

225

Esophageal early basaloid squamous carcinoma with unusual narrowband imaging magnified endoscopy findings.  

PubMed

Basaloid squamous carcinoma (BSC) is a rare variant of esophageal cancer. There are very few reports of "early" BSC. Here we report a case of early BSC with unusual findings by narrowband imaging magnified endoscopy (NBI-ME). A 70-year-old man with a middle thoracic esophageal tumor was referred to our hospital. White-light endoscopy revealed a reddish depressed lesion 5 mm in diameter having a subepithelial tumor-like prominence with a gentle rising slope. NBI-ME revealed irregular loop-shaped microvessels coexistent with thick irregularly branched non-looped vessels. Iodine staining revealed a pale brown lesion. We performed endoscopic submucosal dissection for diagnostic treatment. Histologic examination showed the proliferation of basal cell-like hyperchromatic tumor cells in the lamina propria and with slight invasion into the submucosa at a depth of 320 ?m. The tumor cells formed solid nests and microcystic structures, containing an Alcian blue-positive mucoid matrix. The surface was covered with squamous epithelium without cellular atypia. Thin vessels were observed in the intra-epithelial papilla and thick vessels were observed around the solid nests beneath the epithelium. Based on these findings together, we diagnosed the lesion as BSC. In this case, the NBI-ME findings differed from those of typical squamous cell carcinoma in that both non-invasive cancer-like irregular loop-shaped microvessels coexisted with massively invasive cancer-like thick non-looped vessels. We speculate that the looped and non-looped vessels observed by NBI-ME histologically corresponded to thin vessels in the intra-epithelial papilla and thick vessels around the tumor nests, respectively. These NBI-ME findings might be a feature of early esophageal BSC. PMID:25253974

Kai, Yugo; Kato, Motohiko; Hayashi, Yoshito; Akasaka, Tomofumi; Shinzaki, Shinichiro; Nishida, Tsutomu; Tsujii, Masahiko; Morii, Eiichi; Takehara, Tetsuo

2014-09-21

226

Association of esophageal candidiasis and squamous cell carcinoma  

PubMed Central

Chronic esophageal candidiasis is an infection that is mostly seen in immunocompromised conditions, among which is chronic mucocutaneous candidiasis (CMC). Recently an association between CMC and esophageal carcinoma has been reported. Here we present two patients with chronic esophageal candidiasis who developed esophageal squamous cell carcinoma and we discuss the etiologic role of Candida-induced nitrosamine production, the loss of STAT1 function and impaired tumor surveillance and T-lymphocyte function in the development of esophageal carcinoma. PMID:24371724

Delsing, C.E.; Bleeker-Rovers, C.P.; van de Veerdonk, F.L.; Tol, J.; van der Meer, J.W.M.; Kullberg, B.J.; Netea, M.G.

2012-01-01

227

[Non-neoplastic esophageal stenosis: not always so benign].  

PubMed

Esophageal intramural pseudodiverticulosis is a rare pathology whose etiology is unknown, but which is frequently associated with three highly prevalent entities: esophageal reflux disease, esophageal candidosis and alcoholic esophagitis. With conservative treatment the course of these pathologies is usually benign. However, some severe cases are resistant to conservative treatment and may require more aggressive management. We here present the case of patient suffering from a severe esophagitis complicated by chronic mediastinitis with life-threatening repercussions, requiring esophagectomy as treatment. PMID:24088236

Lorenz, Julie; Vollenweider, Peter; Vuilleumier, Henri; Schwab, Marcos

2013-10-01

228

Thoracoscopic elongation of the esophagus in long gap esophageal atresia.  

PubMed

Long gap esophageal atresia in which a primary anastomosis cannot be achieved remains a challenge. Elongation of the esophagus by traction on the 2 ends has been previously described. With the advent of thoracoscopic repair of esophageal atresia, there have thus far been no reports of thoracoscopic repair of long gap esophageal atresia. This paper describes the first successful repair of long gap esophageal atresia by thoracoscopic traction of the 2 esophageal ends and delayed thoracoscopic anastomosis. PMID:17923217

van der Zee, David C; Vieirra-Travassos, Daisy; Kramer, William L M; Tytgat, Stefaan H A J

2007-10-01

229

Intra-abdominal Esophageal Duplication Cysts: A Review  

Microsoft Academic Search

Esophageal duplication cysts (EDCs) are well described within the literature, normally occurring within the mediastinum. Intra-abdominal\\u000a EDCs are rare and typically occur near the intra-abdominal esophagus. Herein, we describe two cases of intra-abdominal EDCs:\\u000a a 60-year-old man who was incidentally found to have a retro-duodenal cystic mass and a 50-year-old woman with a cystic lesion\\u000a near the body and tail

Niels D. Martin; Judith C. Kim; Sachit K. Verma; Raphael Rubin; Donald G. Mitchell; Diane Bergin; Charles J. Yeo

2007-01-01

230

The electrical potential profile of gallbladder epithelium  

Microsoft Academic Search

Summary In this study the relative ionic permeabilities of the cell membranes ofNecturus gallbladder epithelium have been determined by means of simultaneous measurement of transmural and transmucosal membrane potential differences (PD) and by ionic substitution experiments with sodium, potassium and chloride ions. It is shown that the mucosal membrane is permeable to sodium and to potassium ions. The baso-lateral membrane

C. H. van Os; J. F. G. Slegers

1975-01-01

231

[Multimodal treatment of esophageal carcinoma].  

PubMed

Despite major progress in clinical diagnostics and therapy, esophageal carcinoma represents a tumor entity with limited prognosis. In case of carcinoma restricted to mucosa endoscopic resection has developed into an important therapeutic method. Surgical resection represents the standard procedure for patients with locally limited (cT1/T2, N0) and advanced carcinoma (cT3, T4, Nx). In multimodal therapy neoadjuvant treatment concepts with chemotherapy or radiochemotherapy for patients with locally advanced tumors are well established. In case of metastatic disease palliative radio- and chemotherapy represent a treatment concept, however therapy efficiency is very limited. This review reflects the current status of multimodal therapy. PMID:25289924

Graf, D; Vallböhmer, D; Knoefel, W T; Budach, W; Häussinger, D

2014-10-01

232

Phase-contrast X-ray CT Imaging of Esophagus and Esophageal Carcinoma  

PubMed Central

The electron density resolution is 1000 times higher for synchrotron-radiation phase-contrast CT imaging than conventional X-ray absorption imaging in light elements, with which high-resolution X-ray imaging of biological soft tissue can be achieved. In the present study, we used phase-contrast X-ray CT to investigate human resected esophagus and esophageal carcinoma specimens. This technology revealed the three-layer structure of the esophageal wall-- mucous, submucosa and muscular layers. The mucous and muscular layers were clearly separated by a loose submucosa layer with a honeycomb appearance. The surface of the mucous layer was smooth. In esophageal carcinoma, because of tumor tissue infiltration, the submucosa layer was absent, which indicated destruction of the submucosa. The boundary between normal tissue and tumor was comparatively fuzzy, the three-layer structure of the esophageal wall was indistinct. The surface of the mucous layer was rugose. The technology might be helpful in tumor staging of esophageal carcinoma. PMID:24939041

Zhang, Jianfa; Tian, Dongping; Lin, Runhua; zhou, Guangzhao; Peng, Guanyun; Su, Min

2014-01-01

233

Transport of timolol and tilisolol in rabbit corneal epithelium.  

PubMed

The purpose of this study is to characterize the transport of tilisolol and timolol through the corneal epithelium, which is believed to be a tight barrier of ocular drug absorption. Cultured normal rabbit corneal epithelial cells (RCEC) were used to investigate drug transport. Primary RCEC were seeded on a filter membrane of Transwell-COL insert coated with fibronectin and grown in Dulbecco's modified Eagle's medium/nutrient mixture F-12 with various supplements. Beta-blocker permeability through the RCEC layer was measured to assess the transcellular permeability coefficient (P(transcell)) in the absence or presence of inhibitors. The transcellular permeability of tilisolol was dependent on drug concentration although timolol showed no concentration dependency. Tilisolol flux from the apical to the basal side was larger than in the opposite direction although timolol showed no direction dependency. The transcellular permeability of tilisolol from the apical to the basal side was inhibited by sodium azide, tetraethylammonium, quinidine, taurocholic acid, guanidine and carnitine. Tilisolol had an active mechanism in uptake to the corneal epithelium, probably by the organic cation transporter family, although timolol predominantly permeated via passive diffusion. This RCEC system was useful to characterize the ocular permeation mechanism of drugs. PMID:17015968

Sakanaka, Koji; Kawazu, Kouichi; Nishida, Koyo; Nakamura, Junzo; Nakashima, Mikiro; Nakamura, Tadahiro; Oshita, Akemi; Ichikawa, Nobuhiro; Sasaki, Hitoshi

2006-10-01

234

Esophageal motility abnormalities in gastroesophageal reflux disease  

PubMed Central

Esophageal motility abnormalities are among the main factors implicated in the pathogenesis of gastroesophageal reflux disease. The recent introduction in clinical and research practice of novel esophageal testing has markedly improved our understanding of the mechanisms contributing to the development of gastroesophageal reflux disease, allowing a better management of patients with this disorder. In this context, the present article intends to provide an overview of the current literature about esophageal motility dysfunctions in patients with gastroesophageal reflux disease. Esophageal manometry, by recording intraluminal pressure, represents the gold standard to diagnose esophageal motility abnormalities. In particular, using novel techniques, such as high resolution manometry with or without concurrent intraluminal impedance monitoring, transient lower esophageal sphincter (LES) relaxations, hypotensive LES, ineffective esophageal peristalsis and bolus transit abnormalities have been better defined and strongly implicated in gastroesophageal reflux disease development. Overall, recent findings suggest that esophageal motility abnormalities are increasingly prevalent with increasing severity of reflux disease, from non-erosive reflux disease to erosive reflux disease and Barrett’s esophagus. Characterizing esophageal dysmotility among different subgroups of patients with reflux disease may represent a fundamental approach to properly diagnose these patients and, thus, to set up the best therapeutic management. Currently, surgery represents the only reliable way to restore the esophagogastric junction integrity and to reduce transient LES relaxations that are considered to be the predominant mechanism by which gastric contents can enter the esophagus. On that ground, more in depth future studies assessing the pathogenetic role of dysmotility in patients with reflux disease are warranted. PMID:24868489

Martinucci, Irene; de Bortoli, Nicola; Giacchino, Maria; Bodini, Giorgia; Marabotto, Elisa; Marchi, Santino; Savarino, Vincenzo; Savarino, Edoardo

2014-01-01

235

Long-term evaluation of esophageal function in patients treated at birth for esophageal atresia  

Microsoft Academic Search

Dysphagia, gastroesophageal reflux (GER) and esophageal metaplasia are reported with various incidence in the long term follow-up of patients treated at birth for esophageal atresia (EA). To evaluate the long term outcomes 26 patients treated at birth for EA with Tracheo Esophageal Fistula (TEF) were examined 8-28 (mean 15.8) years later by clinical evaluation, including barium meal, fiberoptic upper GI

V. Tomaselli; M. Volpi; M. Bini; A. Rossi; A. Indriolo

2003-01-01

236

Gastro-esophageal Reflux and Esophageal Motility Disorders in Morbidly Obese Patients  

Microsoft Academic Search

Background: Morbid obesity has long been considered as a contributing factor to gastro-esophageal reflux, but the literature\\u000a contains conflicting data on the subject. The authors studied a large number of morbidly obese candidates for bariatric surgery\\u000a with objective means, in order to better define the incidence of gastro-esophageal reflux disease (GERD) and esophageal motility\\u000a disorders in this population. Methods: Morbidly

M. Suter; G. Dorta; V. Giusti; J. M. Calmes

2004-01-01

237

Vitamin D receptor is highly expressed in precancerous lesions and esophageal adenocarcinoma with significant sex difference.  

PubMed

Bile acid reflux into the esophagus is important in the development of esophageal adenocarcinoma (EAC). Recently, vitamin D receptor (VDR) was recognized as a bile acid receptor as well as a vitamin receptor. Expression of VDR is reported to influence the development of various types of cancer, such as those of the breast, liver, and colon. However, little is known about the role of VDR in esophageal neoplasms. We investigated the clinicopathological role of VDR in esophageal tumors. We analyzed genomic DNA from 116 EACs for copy number aberrations. The VDR locus was amplified in 7% of EACs. Expression of the VDR protein was also detected by immunohistochemistry from tissue microarrays created from tissues of Barrett esophagus (BE), low-grade (LGD) and high-grade dysplasia (HGD), columnar cell metaplasia (CCM), squamous epithelium (SE), EAC, and esophageal squamous cell carcinoma (ESCC). The protein was highly expressed in 88% of CCM (58/66), 95% of BE (35/37), 100% of the 19 LGD, 94% of HGD (15/16), and 79% of EAC (86/109), but expression in SE and ESCC was rare. Female patients with EAC and CCM were significantly less likely to have high VDR expression than male patients. The overall survival rate was significantly different for patients with tumors exhibiting VDR amplification versus nonamplification. Our findings suggest that VDR plays a role in the early development of EAC through a bile acid ligand. The sex difference in VDR expression may help to explain why men have a high incidence of EAC. PMID:24951052

Zhou, Zhongren; Xia, Yinglin; Bandla, Santhoshi; Zakharov, Vladislav; Wu, Shaoping; Peters, Jeffery; Godfrey, Tony E; Sun, Jun

2014-08-01

238

[Infectious complications after esophageal surgery].  

PubMed

The incidence of wound infection, which is an intrasurgical field infection, is lower than the incidence of pneumonia, which is an extrasurgical field infection, after esophageal cancer surgery. Several trials predicting postoperative infectious complications have been reported. One measured the phytohemagglutinin- and concanavalin A-induced proliferation of peripheral blood mononuclear cells in patients; one measured the white blood cell (WBC) count 2 h after surgery and the decrease in WBC count on first postoperative day; and another showed that the decrease in serum IgG2 level can predict the occurrence of methicillin-resistant Staphylococcus aureus (MRSA) infections. Useful strategies for managing infectious complications have also been reported. Applying mupirocin calcium hydrate ointment to the nasal cavity decreases the incidence of MRSA infections. Autologous blood collection reduces the need for allogeneic transfusion in patients undergoing resection of esophageal cancer, and avoidance of allogeneic transfusion may reduce the risk of postoperative infection. The total exposure to preoperative chemoradiotherapy should be limited to 40 Gy or less to prevent postoperative pneumonia. PMID:12599924

Ozawa, Soji; Kitagawa, Yuko; Okamoto, Nobuhiko; Shimizu, Yoshimasa; Kitajima, Masaki

2002-12-01

239

Colonic interposition and supercharge for esophageal reconstruction  

Microsoft Academic Search

Aims  We evaluated the techniques of colonic interposition and supercharge for esophageal reconstruction and discussed the main\\u000a considerations related to these procedures.\\u000a \\u000a \\u000a \\u000a Patients and methods  In this study, we performed 51 esophageal reconstructions using colonic interposition. Twenty-eight of the 51 patients had\\u000a synchronous or allochronic gastric malignancy. We selected colonic interposition for high anastomosis in 11 patients and also\\u000a for esophageal bypass

Yasuhiro Shirakawa; Yoshio Naomoto; Kazuhiro Noma; Kazufumi Sakurama; Toshio Nishikawa; Tetsuji Nobuhisa; Masahiko Kobayashi; Takaomi Okawa; Shinya Asami; Tomoki Yamatsuji; Minoru Haisa; Junji Matsuoka; Motohiko Hanazaki; Kiyoshi Morita; Takao Hiraki; Noriaki Tanaka

2006-01-01

240

Esophageal schwannoma: report of a case.  

PubMed

We report a case of esophageal schwannoma in a 46-year-old woman who presented with rapidly progressive dyspnea and dysphagia. Chest computed tomography showed a large mediastinal mass, which was extrinsically compressing the trachea, widely adjacent to the upper thoracic esophagus. We performed an axillary right thoracotomy to enucleate the tumor, which was located in the esophageal muscle layer. A definite diagnosis of esophageal schwannoma was made from the pathologic findings, which included positive immunohistochemical staining for S-100 protein and negative staining for c-kit and CD34. PMID:17522770

Tokunaga, Toshiteru; Takeda, Shin-ichi; Sumimura, Jun-ichi; Maeda, Hajime

2007-01-01

241

Ambulatory High Resolution Manometry, Lower Esophageal Sphincter Lift and Transient Lower Esophageal Sphincter Relaxation  

PubMed Central

Introduction Lower esophageal sphincter (LES) lift seen on high resolution manometry (HRM) is a possible surrogate marker of the longitudinal muscle contraction of the esophagus. Recent studies suggest that longitudinal muscle contraction of the esophagus induces LES relaxation. Aim Our goal was to determine, 1) the feasibility of prolonged ambulatory HRM and 2) to detect LES lift with LES relaxation using ambulatory HRM color isobaric contour plots. Methods In vitro validation studies were performed to determine the accuracy of HRM technique in detecting axial movement of the LES. Eight healthy normal volunteers were studied using a custom designed HRM catheter and a 16 channel data recorder, in the ambulatory setting of subject’s home environment. Color HRM plots were analyzed to determine the LES lift during swallow-induced LES relaxation as well as during complete and incomplete transient LES relaxations. Results Satisfactory recordings were obtained for 16 hours in all subjects. LES lift was small (2 mm) in association with swallow-induced LES relaxation. LES lift could not be measured during complete transient LES relaxations (TLESR) because the LES is not identified on the HRM color isobaric contour plot once it is fully relaxed. On the other hand, LES lift, mean 7.6 ± 1.4 mm, range 6–12 mm was seen with incomplete TLESRs (n = 80). Conclusions Our study demonstrates the feasibility of prolonged ambulatory HRM recordings. Similar to a complete TLESR, longitudinal muscle contraction of the distal esophagus occurs during incomplete TLESRs, which can be detected by the HRM. Using prolonged ambulatory HRM, future studies may investigate the temporal correlation between abnormal longitudinal muscle contraction and esophageal symptoms. PMID:22074595

Mittal, Ravinder K.; Karstens, Anna; Leslie, Eric; Babaei, Arash; Bhargava, Valmik

2011-01-01

242

Objectivity in the classification of tumours of the nasal epithelium  

Microsoft Academic Search

A survey of tumours derived from each of the four cell types of nasal epithelium is presented. Criticism is levelled at the adoption of additional terms for tissue types such as lympho-epithelium and transitional cell epithelium and tumours said to be derived from them. Electron microscopy is of assistance in classification particularly in the detection of evidence of keratin synthesis.

L. Michaels; V. J. Hyams

1975-01-01

243

Patients with established gastro-esophageal reflux disease might benefit from Helicobacter pylori eradication  

PubMed Central

Background The aim of this study was to investigate the effect of Helicobacter pylori (H. pylori) eradication in selected H. pylori-positive patients with a primary diagnosis of gastro-esophageal reflux disease (GERD) by using the 3-h postprandial esophageal pH monitoring. Methods We recruited patients with erosive esophagitis at endoscopy and H. pylori infection at histology, successfully cured following eradication therapy; the selected H. pylori-positive patients had weekly reflux symptoms for at least six months and endoscopically established Grade A or B esophagitis. Twenty-nine eligible patients were initially subjected to esophageal manometry and ambulatory 3-h postprandial esophageal pH monitoring. All patients received H. pylori triple eradication therapy accompanied by successful H. pylori eradication. After successful eradication of H. pylori (confirmed by 13C urea breath test), a second manometry and 3-h postprandial esophageal pH monitoring were introduced to assess the results of eradication therapy, after a 3-month post-treatment period. Results All 29 selected H. pylori-positive patients became negative due to successful H. pylori eradication, evaluated by 13C urea breath test after a 4-week post-treatment period. Post-eradication, 62.1% patients showed similar manometric pattern at baseline; 17.2% showed improvement; 17.2% normalization; and 3.4% deterioration of the manometric patterns. The DeMeester symptom scoring in the 3-h postprandial ambulatory esophageal pH monitoring was improved after eradication of H. pylori (median 47.47 vs. 22.00, Wilcoxon’s singed rank; P=0.016). On comparing the pH monitoring studies for each patient at baseline and post-eradication period, 82.8% patients showed improvement and 17.2% deterioration of the DeMeester score. Conclusion By using 3-h postprandial esophageal pH monitoring, this study showed, for the first time, that H. pylori eradication may positively influence GERD symptoms. Large-scale controlled relative studies are warranted to confirm these findings.

Moschos, John M.; Kouklakis, George; Vradelis, Stergios; Zezos, Petros; Pitiakoudis, Michael; Chatzopoulos, Dimitrios; Zavos, Christos; Kountouras, Jannis

2014-01-01

244

Esophageal ulceration induced by intracavitary irradiation for esophageal carcinoma  

SciTech Connect

Twenty-two patients with esophageal carcinoma had no local recurrence after external and intracavitary radiation treatment, but all developed ulcers in the field of intracavitary irradiation. Ten were linear ulcers that appeared 3-12 months after radiation treatment (mean, 5.3 months); the other 12 were the long circumferential type and appeared 1-8 months after irradiation (mean, 3.7 months). Esophagobronchial fistulae developed in two cases in which deep ulcer had been found between the completion of external irradiation and the beginning of intracavitary irradiation. In these cases with deep ulcer, intracavitary irradiation should not be done. For patients receiving intracavitary radiation, the total dosage should be less than 20 Gy.

Hishikawa, Y.; Tanaka, S.; Miura, T.

1984-08-01

245

Overexpression of FOXO3, MYD88, and GAPDH Identified by Suppression Subtractive Hybridization in Esophageal Cancer Is Associated with Autophagy  

PubMed Central

To find genes involved in tumorigenesis and the development of esophageal cancer, the suppression subtractive hybridization (SSH) method was used to identify genes that are overexpressed in esophageal cancer tissues compared to normal esophageal tissues. In our SSH library, the forkhead box O3 (FOXO3), glyceraldehyde-3-phosphate dehydrogenase (GAPDH), and myeloid differentiation primary response 88 (MYD88) genes were the most highly upregulated genes, and they were selected for further studies because of their potential role in the induction of autophagy. Upregulation of these genes was also observed in clinical samples using qRT-PCR. In addition, coexpression analysis of the autophagy-related genes Beclin1, ATG12, Gabarapl, PIK3C3, and LC3 demonstrated a significant correlation between the differentially overexpressed genes and autophagy. Autophagy is an important mechanism in tumorigenesis and the development of chemoresistance in cancer cells. The upregulation of FOXO3, GAPDH, and MYD88 variants in esophageal cancer suggests a role for autophagy and provides new insight into the biology of esophageal cancer. We propose that FOXO3, GAPDH, and MYD88 are novel targets for combating autophagy in esophageal cancer. PMID:24527027

Mottaghi-Dastjerdi, Negar; Setayesh, Neda; Roshandel, Gholamreza; Ebrahimifard, Farzaneh; Sepehrizadeh, Zargham

2014-01-01

246

Genetic and Cellular Mechanisms Regulating Anterior Foregut and Esophageal Development  

PubMed Central

Separation of the single anterior foregut tube into the esophagus and trachea involves cell proliferation and differentiation, as well as dynamic changes in cell-cell adhesion and migration. These biological processes are regulated and coordinated at multiple levels through the interplay of the epithelium and mesenchyme. Genetic studies and in vitro modeling have shed light on relevant regulatory networks that include a number of transcription factors and signaling pathways. These signaling molecules exhibit unique expression patterns and play specific functions in their respective territories before the separation process occurs. Disruption of regulatory networks inevitably leads to defective separation and malformation of the trachea and esophagus and results in the formation of a relatively common birth defect, esophageal atresia with or without tracheoesophageal fistula (EA/TEF). Significantly, some of the signaling pathways and transcription factors involved in anterior foregut separation continue to play important roles in the morphogenesis of the individual organs. In this review, we will focus on new findings related to these different developmental processes and discuss them in the context of developmental disorders (or birth defects) commonly seen in clinics. PMID:22750256

Jacobs, Ian J.; Ku, Wei-Yao; Que, Jianwen

2012-01-01

247

[Esophageal wall structure in people of elderly and senile age].  

PubMed

Using histological methods, the esophageal wall structure and the cytoarchitectonics of mucous membrane were studied in the individuals of elderly (n = 5) and senile (n = 10) age. The control group included the individuals of I (n = 3) and II (n = 3) periods of mature age. It was demonstrated that with advancing age in most cases the destructive processes took place in the epithelium (delamination of the layer, separation of large fragments, formation of microerosions etc.) in most of the studied cases. Lymphocytes, neutrophils and eosinophils were found between the epithelial cells; the numbers of infiltrating cells was increased 2-3 times during aging. Mucosal lamina propria and the submucosa, in particular, were characterized by the thickening of the bundles of collagen fibers. A two-fold increase in the number of the cells of the fibroblast lineage was found. The number of leukocytes in the lamina propria was increased by the eldery age in the upper and lower parts of the esophagus (3.5 and 1.75 times respectively). The changes in lamina muscularis were manifested by its thinning, delamination and myocyte dissociation. Remodeling of the muscular tunic was less pronounced. The degree of changes increased distally and varied widely depending on the individual peculiarities. PMID:25282822

aminova, G G; Grigorenko, D E; Sapin, M R; Mkhitarov, V A

2014-01-01

248

X-ray microanalysis of hamster tracheal epithelium  

SciTech Connect

Studies of ion transport across respiratory epithelia are of great interest if we are to understand the pathophysiology of diseases such as cystic fibrosis in which ion transport is abnormal. Concentrations of elements were determined in various subcellular regions of normal or isoproterenol-treated hamster tracheal epithelium, using X-ray microanalysis of freeze-dried cryosections. Samples of trachea were taken from animals under anesthesia and either frozen in situ or dissected and plunge frozen. Concentrations of Mg, P, S, Cl, K and Ca were higher in cytoplasm and nuclei of control epithelial cells in dissected samples than in cryoneedle samples. Following treatment with isoproterenol, a large decrease in the concentration of Cl was observed. The results confirm that cyclic AMP-regulated chloride secretion is unaffected by anesthesia.

Spencer, A.J.; Roomans, G.M. (Univ. of Uppsala (Sweden))

1989-06-01

249

21 CFR 868.1910 - Esophageal stethoscope.  

Code of Federal Regulations, 2013 CFR

...stethoscope. (a) Identification. An esophageal stethoscope is a nonpowered device that is inserted into a patient's esophagus to enable the user to listen to heart and breath sounds. (b) Classification. Class I (general controls)....

2013-04-01

250

21 CFR 868.1910 - Esophageal stethoscope.  

Code of Federal Regulations, 2012 CFR

...stethoscope. (a) Identification. An esophageal stethoscope is a nonpowered device that is inserted into a patient's esophagus to enable the user to listen to heart and breath sounds. (b) Classification. Class I (general controls)....

2012-04-01

251

21 CFR 868.1910 - Esophageal stethoscope.  

Code of Federal Regulations, 2011 CFR

...stethoscope. (a) Identification. An esophageal stethoscope is a nonpowered device that is inserted into a patient's esophagus to enable the user to listen to heart and breath sounds. (b) Classification. Class I (general controls)....

2011-04-01

252

21 CFR 868.1910 - Esophageal stethoscope.  

Code of Federal Regulations, 2010 CFR

...stethoscope. (a) Identification. An esophageal stethoscope is a nonpowered device that is inserted into a patient's esophagus to enable the user to listen to heart and breath sounds. (b) Classification. Class I (general controls)....

2010-04-01

253

21 CFR 868.1910 - Esophageal stethoscope.  

...stethoscope. (a) Identification. An esophageal stethoscope is a nonpowered device that is inserted into a patient's esophagus to enable the user to listen to heart and breath sounds. (b) Classification. Class I (general controls)....

2014-04-01

254

21 CFR 878.3610 - Esophageal prosthesis.  

...SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3610 Esophageal...rigid, flexible, or expandable tubular device made of a plastic, metal, or polymeric material that is...

2014-04-01

255

21 CFR 878.3610 - Esophageal prosthesis.  

Code of Federal Regulations, 2012 CFR

...SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3610 Esophageal...rigid, flexible, or expandable tubular device made of a plastic, metal, or polymeric material that is...

2012-04-01

256

21 CFR 878.3610 - Esophageal prosthesis.  

Code of Federal Regulations, 2011 CFR

...SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3610 Esophageal...rigid, flexible, or expandable tubular device made of a plastic, metal, or polymeric material that is...

2011-04-01

257

21 CFR 878.3610 - Esophageal prosthesis.  

Code of Federal Regulations, 2013 CFR

...SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3610 Esophageal...rigid, flexible, or expandable tubular device made of a plastic, metal, or polymeric material that is...

2013-04-01

258

Odors Discrimination by Olfactory Epithelium Biosensor  

NASA Astrophysics Data System (ADS)

Humans are exploring the bionic biological olfaction to sense the various trace components of gas or liquid in many fields. For achieving the goal, we endeavor to establish a bioelectronic nose system for odor detection by combining intact bioactive function units with sensors. The bioelectronic nose is based on the olfactory epithelium of rat and microelectrode array (MEA). The olfactory epithelium biosensor generates extracellular potentials in presence of odor, and presents obvious specificity under different odors condition. The odor response signals can be distinguished with each other effectively by signal sorting. On basis of bioactive MEA hybrid system and the improved signal processing analysis, the bioelectronic nose will realize odor discrimination by the specific feature of signals response to various odors.

Liu, Qingjun; Hu, Ning; Ye, Weiwei; Zhang, Fenni; Wang, Hua; Wang, Ping

2011-09-01

259

Multimodality Therapy of Nonmetastatic Esophageal Cancer  

Microsoft Academic Search

SummaryEsophageal cancer is a highly aggressive malignancy with an exceedingly poor prognosis. Despite improved surgical techniques over the past decades, which increased the rate of complete tumor resection, improved the perioperative management and reduced the perioperative morbidity and mortality,still less than 10% of patients in the Western World with esophageal cancer will survive more than 5 years. Similar unsatisfactory results

M. Schmücking; T. G. Wendt

1998-01-01

260

Bleeding esophageal ulcers caused by NSAIDs  

Microsoft Academic Search

.   This report describes four patients with NSAID-induced esophageal ulcers documented by endoscopy. The cause of injury was\\u000a ibuprofen alone in two patients, aspirin in one patient, and a combination of aspirin and ibuprofen in one patient. The most\\u000a common findings were anemia, retrosternal pain, and dysphagia. Three patients had bleeding esophageal ulcers requiring blood\\u000a transfusions. One patient had massive

C. Sugawa; Y. Takekuma; C. E. Lucas; H. Amamoto

1997-01-01

261

Scanning electron microscopy of odontogenic cyst epithelium.  

PubMed

The epithelial lining of 8 odontogenic keratocysts (OKC), 9 radicular (RC) and 3 dentigerous cysts (DC) were examined in SEM in order to study the ultrastructural surface topography of the lumenal surface cells. The orthokeratinized OKC showed a reticular network of intercommunicating microridges surrounding micropits giving a honeycombed appearance to the entire surface. The deep surface of these cells was covered by a complementary array of short stubby microvilli. This pattern was identical to that described for oral epithelium in areas of masticatory mucosa. The parakeratinized OKC showed a complex pattern of microplications (MP) on both upper and deep cell surfaces. The non-keratinized linings of RC and DC revealed a similar MP pattern but of a less complex nature. The MP pattern of cells from para- and non-keratinized cysts was identical to that described for oral epithelial cells from lining mucosa. The surface ultrastructure of ciliated, mucus and brush cells occurring in RC was found to be indistinguishable from that described in the mammalian respiratory tract. The MP pattern forms part of the cellular interdigitation mechanisms in stratified squamous epithelium. Differences in the ultrastructural configuration are related to the type of epithelium in terms of keratinization rather than to protective functions. PMID:1383303

Philipsen, H P; Chan, L S; Reichart, P A; Pang, M K

1992-05-01

262

SOX2 Is an Amplified Lineage Survival Oncogene in Lung and Esophageal Squamous Cell Carcinomas  

PubMed Central

Lineage survival oncogenes are activated by somatic DNA alterations in cancers arising from the cell lineages in which these genes play a role in normal development.1,2 Here we show that a peak of genomic amplification on chromosome 3q26.33, found in squamous cell carcinomas (SCCs) of the lung and esophagus, contains the transcription factor gene SOX2—which is mutated in hereditary human esophageal malformations3 and necessary for normal esophageal squamous development4, promotes differentiation and proliferation of basal tracheal cells5 and co-operates in induction of pluripotent stem cells.6,7,8 SOX2 expression is required for proliferation and anchorage-independent growth of lung and esophageal cell lines, as shown by RNA interference experiments. Furthermore, ectopic expression of SOX2 cooperated with FOXE1 or FGFR2 to transform immortalized tracheobronchial epithelial cells. SOX2-driven tumors show expression of markers of both squamous differentiation and pluripotency. These observations identify SOX2 as a novel lineage survival oncogene in lung and esophageal SCC. PMID:19801978

Bass, Adam J.; Watanabe, Hideo; Mermel, Craig H.; Yu, Soyoung; Perner, Sven; Verhaak, Roel G.; Kim, So Young; Wardwell, Leslie; Tamayo, Pablo; Gat-Viks, Irit; Ramos, Alex H.; Woo, Michele S.; Weir, Barbara A.; Getz, Gad; Beroukhim, Rameen; O'Kelly, Michael; Dutt, Amit; Rozenblatt-Rosen, Orit; Dziunycz, Piotr; Komisarof, Justin; Chirieac, Lucian R.; LaFargue, Christopher J.; Scheble, Veit; Wilbertz, Theresia; Ma, Changqing; Rao, Shilpa; Nakagawa, Hiroshi; Stairs, Douglas B.; Lin, Lin; Giordano, Thomas J.; Wagner, Patrick; Minna, John D.; Gazdar, Adi F.; Zhu, Chang Qi; Brose, Marcia S.; Cecconello, Ivan; Ribeiro, Ulysses; Marie, Suely K.; Dahl, Olav; Shivdasani, Ramesh A.; Tsao, Ming-Sound; Rubin, Mark A.; Wong, Kwok K.; Regev, Aviv; Hahn, William C.; Beer, David G.; Rustgi, Anil K.; Meyerson, Matthew

2009-01-01

263

[Clinicopathological study of acute esophageal mucosal lesion].  

PubMed

Acute esophageal mucosal lesion (AEML) is a comprehensive disease that includes necrotizing esophagitis and acute erosive esophagitis, which result in upper gastrointestinal bleeding. However, little is known about AEML. We examined the clinicopathological features of 57 AEML cases. AEML presented as acute diffuse esophagitis showing an endoscopically erosive mucosa. The disease did not include corrosive injury, radiation-induced damage, infectious esophagitis, or acute exacerbation of chronic gastroesophageal reflux disease. AEML predominantly affected elderly men, and upper gastrointestinal bleeding was the frequent presenting symptom. Severe underlying diseases such as cranial nerve disease or pneumonia were observed in 98% of the patients. Esophageal sliding hernia and gastroduodenal ulcers were endoscopically observed in 67% and 63% of the patients, respectively. Deaths due to exacerbation of the underlying diseases accounted for 16%. Most cases rapidly improved with conservative management using a proton pump inhibitor or an H2 blocker. Therefore, AEML should be considered a disease having characteristics different from those of common gastroesophageal reflux disease. PMID:23831655

Kawauchi, Hirohito; Ohta, Tomoyuki; Matsubara, Yu; Yoshizaki, Koji; Sakamoto, Jun; Amitsuka, Hisato; Kimura, Keisuke; Maemoto, Atsuo; Orii, Fumika; Ashida, Toshifumi

2013-07-01

264

Role of Proton Pump Inhibitor on Esophageal Carcinogenesis and Pancreatic Acinar Cell Metaplasia Development: An Experimental In Vivo Study  

PubMed Central

Chronic gastro-duodenal reflux in the esophagus is a major risk for intestinal metaplasia and Barrett’s adenocarcinoma. A role for chronic use of proton pump inhibitor (PPI) in the increased incidence of esophageal adenocarcinoma in Western countries has been previously suggested. The aim of this work was to study the effect of chronic administration of omeprazole (a proton pump inhibitor) per os in a model of reflux induced esophageal carcinogenesis. One week after esophago-gastro-jejunostomy, 115 Sprague-Dawley rats were randomized to receive 10 mg/Kg per day of omeprazole or placebo, 5 days per week. The esophago-gastric specimens were collected 28±2 weeks after randomization and analyzed in a blinded fashion. Mortality and esophageal metaplasia rates did not differ between the two groups (p?=?0.99 for mortality, p?=?0.36 for intestinal metaplasia and p?=?0.66 for multi-layered epithelium). Gastric pancreatic acinar cell metaplasia (PACM) was more frequently observed in PPI-treated rats (p?=?0.003). Severe ulcer lesions significantly prevailed in the placebo group (p?=?0.03). Locally invasive esophageal epithelial neoplasia were observed in 23/39 PPI-treated versus 14/42 placebo-animals (p?=?0.03). In conclusion, chronic omeprazole treatment improved the healing of esophageal ulcerative lesions. Locally invasive neoplastic lesions and PACM prevailed among PPI-treated animals. However, neither an effect on the overall mortality nor on the incidence of pre-neoplastic lesions was observed in this work. PMID:25415190

Dall’Olmo, Luigi; Fassan, Matteo; Dassie, Elisa; Scarpa, Marco; Realdon, Stefano; Cavallin, Francesco; Cagol, Matteo; Battaglia, Giorgio; Pizzi, Marco; Guzzardo, Vincenza; Franceschinis, Erica; Pasut, Gianfranco; Rugge, Massimo; Zaninotto, Giovanni; Realdon, Nicola; Castoro, Carlo

2014-01-01

265

Pharyngo-Enteral Anastomosis for Esophageal Reconstruction in Diffuse Corrosive Esophageal Stricture  

Microsoft Academic Search

Background. Diseases involving the entire esophagus usually require extensive surgical procedures to accom- plish functional reconstruction. These procedures are extremely stressful for undernourished patients. We have utilized a simpler procedure for total esophageal reconstruction. Methods. This retrospective report reviews the experi- ence in 8 patients who underwent esophageal reconstruc- tion by pharyngo-colo-gastrostomy or jejunostomy with- out any resection of bony

Jae K. Park; Sung B. Sim; Sun H. Lee; Hae M. Jeon; Moon S. Kwack

266

Chronic xerostomia increases esophageal acid exposure and is associated with esophageal injury  

SciTech Connect

OBJECTIVES: To assess the effects of chronic xerostomia on parameters of gastroesophageal reflux and esophagitis. DESIGN: Observational study of a cohort of male patients with xerostomia and age-matched control subjects. SETTING: Tertiary-care Veterans Affairs Medical Center. SUBJECTS: Sixteen male patients with chronic xerostomia secondary to radiation for head and neck cancers or medications. Nineteen age-matched male control subjects with comparable alcohol and smoking histories. MEASUREMENTS AND MAIN RESULTS: Esophageal motility was similar in patients with xerostomia and controls. Clearance of acid from the esophagus and 24-hour intraesophageal pH were markedly abnormal in patients with xerostomia. Symptoms and signs of esophagitis were significantly more frequent in subjects with xerostomia. CONCLUSIONS: Chronic xerostomia may predispose to esophageal injury, at least in part, by decreasing the clearance of acid from the esophagus and altering 24-hour intraesophageal pH. Esophageal injury is a previously unreported complication of long-term salivary deficiency.

Korsten, M.A.; Rosman, A.S.; Fishbein, S.; Shlein, R.D.; Goldberg, H.E.; Biener, A. (Gastrointestinal Section, Veterans Affairs Medical Center, Bronx, New York (USA))

1991-06-01

267

Esophageal varix predictive performance of lower esophageal Doppler signals during the swallowing process.  

PubMed

The objective of this study was to assess whether the swallowing action can improve the display of lower esophageal Doppler signals (LEDS) during transabdominal ultrasound (TUS). Eighty-four patients with cirrhosis underwent both TUS and endoscopic examination for esophageal varices (EVs). LEDS were assessed under the esophageal resting state and during the swallowing process. Univariate analysis indicated that spleen diameter, spleen vein diameter, portal vein diameter, LEDS and left gastric vein hepatofugal flow were significantly associated with the presence of EVs. No LEDS were detected in patients without EVs at rest or during swallowing. Of the 69 patients with EVs, LEDS could be detected in 21 cases (30.4%) in the esophageal resting state and in 58 cases (84.1%) during the swallowing process. Compared with the esophageal resting state, the swallowing action can significantly improve display of LEDS during TUS (p = 0.000), which may be beneficial for TUS detection of EVs. PMID:24951299

Zhang, Chao-Xue; Xu, Xiao-Yong; Wang, Ling; Huang, Meng; Li, Liang

2014-09-01

268

Optimization of dose-time factors for a tumor and multiple associated normal tissues  

SciTech Connect

This study explores the feasibility of identifying, for a given tumor and its associated normal tissues, that combination of dosimetric and technical factors which will provide the best chance of achieving local control of the tumor without significant complications. Tumor control probability depends on the number of clonogenic cells surviving the course of treatment, which is a function of the initial tumor volume and the computed cellular surviving fraction. This in turn depends on the physical dose, number of fractions, and overall time. Similarly, the risk of injury to any one associated normal tissue is also a function of dose, field-size, fractions, and time. The best treatment scheme is assumed to be one which maximizes the chance both of tumor control and of avoiding complications. Computer programs can achieve this end by searching a wide range of fractionation schemes and selecting that with the largest therapeutic ratio or probit difference (difference between tumor control and normal tissue damage probabilities). When two or more normal tissues are involved, this process is much more complex. Fractionation schemes that reduce the risk of injury in one tissue may be worse for another. The safest procedure is then one which reconciles these conflicting requirements, searching for that combination of factors which will maximize the conditional probability of controlling the tumor and avoiding injury in any of the several tissues concerned. Results of a computer-derived solution for this type of problem: control of a hypothetical lung cancer associated with lung parenchyma, late-reacting stroma, and acutely reacting esophageal epithelium, are presented.

Cohen, L.

1987-02-01

269

Blunt traumatic esophageal injury: Unusual presentation and approach?  

PubMed Central

INTRODUCTION Blunt esophageal injury is extremely rare event. However, it is a potential morbid injury unless managed early. PRESENTATION OF CASE We report a rare case of blunt esophageal injury for a 28-year old male who presented with history of fall of heavy object over the right side of the chest. Diagnostic work up including chest X-ray, computerized tomography scans and gastrografin esophagogram revealed lower esophageal rupture. Right mini-thoracotomy with esophageal repair was performed. Postoperative course was uneventful. DISCUSSION The exact mechanism of blunt esophageal injury remains uncertain. This report described a unique location of esophageal rupture after blunt trauma that happened on the right side. Diagnosis of esophageal injury needs high index of suspicion and accurate diagnostic workup. CONCLUSION Prompt diagnosis and management are the key for better prognosis in patients with blunt esophageal injury. PMID:24394856

Abdulrahman, Husham; Ajaj, Ahmad; Shunni, Adam; El-Menyar, Ayman; Chaikhouni, Amer; Al-Thani, Hassan; Latifi, Rifat

2013-01-01

270

Refining the criterion for an abnormal Integrated Relaxation Pressure in esophageal pressure topography based on the pattern of esophageal contractility using a classification and regression tree model  

PubMed Central

Background The Integrated Relaxation Pressure (IRP) is the esophageal pressure topography (EPT) metric used for assessing the adequacy of esophagogastric junction (EGJ) relaxation in the Chicago Classification of motility disorders. However, because the IRP value is also influenced by distal esophageal contractility, we hypothesized that its normal limits should vary with different patterns of contractility. Methods 522 selected EPT studies were used to compare the accuracy of alternative analysis paradigms to that of a motility expert (the ‘gold standard’). Chicago Classification metrics were scored manually and used as inputs for MATLAB™ programs that utilized either strict algorithm-based interpretation (fixed abnormal IRP threshold of 15 mmHg) or a classification and regression tree (CART) model that selected variable IRP thresholds depending on the associated esophageal contractility. Results The sensitivity of the CART model for achalasia (93%) was better than that of the algorithm-based approach (85%) on account of using variable IRP thresholds that ranged from a low value of >10 mmHg to distinguish type I achalasia from absent peristalsis to a high value of >17 mmHg to distinguish type III achalasia from distal esophageal spasm. Additionally, type II achalasia was diagnosed solely by panesophageal pressurization without the IRP entering the algorithm. Conclusion Automated interpretation of EPT studies more closely mimics that of a motility expert when IRP thresholds for impaired EGJ relaxation are adjusted depending on the pattern of associated esophageal contractility. The range of IRP cutoffs suggested by the CART model ranged from 10 to 17 mmHg. PMID:22716041

Lin, Zhiyue; Kahrilas, Peter J.; Roman, Sabine; Boris, Lubomyr; Carlson, Dustin; Pandolfino, John E.

2013-01-01

271

Comparison of Expression Profiles in Ovarian Epithelium In Vivo and Ovarian Cancer Identifies Novel Candidate Genes Involved in Disease Pathogenesis  

PubMed Central

Molecular events leading to epithelial ovarian cancer are poorly understood but ovulatory hormones and a high number of life-time ovulations with concomitant proliferation, apoptosis, and inflammation, increases risk. We identified genes that are regulated during the estrous cycle in murine ovarian surface epithelium and analysed these profiles to identify genes dysregulated in human ovarian cancer, using publically available datasets. We identified 338 genes that are regulated in murine ovarian surface epithelium during the estrous cycle and dysregulated in ovarian cancer. Six of seven candidates selected for immunohistochemical validation were expressed in serous ovarian cancer, inclusion cysts, ovarian surface epithelium and in fallopian tube epithelium. Most were overexpressed in ovarian cancer compared with ovarian surface epithelium and/or inclusion cysts (EpCAM, EZH2, BIRC5) although BIRC5 and EZH2 were expressed as highly in fallopian tube epithelium as in ovarian cancer. We prioritised the 338 genes for those likely to be important for ovarian cancer development by in silico analyses of copy number aberration and mutation using publically available datasets and identified genes with established roles in ovarian cancer as well as novel genes for which we have evidence for involvement in ovarian cancer. Chromosome segregation emerged as an important process in which genes from our list of 338 were over-represented including two (BUB1, NCAPD2) for which there is evidence of amplification and mutation. NUAK2, upregulated in ovarian surface epithelium in proestrus and predicted to have a driver mutation in ovarian cancer, was examined in a larger cohort of serous ovarian cancer where patients with lower NUAK2 expression had shorter overall survival. In conclusion, defining genes that are activated in normal epithelium in the course of ovulation that are also dysregulated in cancer has identified a number of pathways and novel candidate genes that may contribute to the development of ovarian cancer. PMID:21423607

Emmanuel, Catherine; Gava, Natalie; Kennedy, Catherine; Balleine, Rosemary L.; Sharma, Raghwa; Wain, Gerard; Brand, Alison; Hogg, Russell; Etemadmoghadam, Dariush; George, Joshy; Birrer, Michael J.; Clarke, Christine L.; Chenevix-Trench, Georgia; Bowtell, David D. L.; Harnett, Paul R.; deFazio, Anna

2011-01-01

272

Secondary esophageal contractions are abnormal in chronic alcoholics  

Microsoft Academic Search

It is known that primary (swallow-induced) esophageal contractions are abnormal in alcoholics. Data concerning acid-induced esophageal contractions, which appear to be important in cleansing refluxed acid from the esophagus, are lacking. To determine whether acid-induced esophageal contractions are also affected by chronic ethanol exposure, we studied secondary (acid or saline-induced) esophageal motor events in 19 male alcoholics [6 actively drinking

A. Keshavarzian; C. Polepalle; F. L. Iber; M. Durkin

1992-01-01

273

Broken Esophageal Stent Successfully Treated by Interventional Radiology Technique  

SciTech Connect

Esophageal stent fractures occur quite rarely. A 61-year-old male patient was previously treated for rupture of benign stenosis, occurring after dilatation, by implanting an esophageal stent. However, a year after implantation, the patient suffered from dysphagia caused by the broken esophageal stent. He was treated with the interventional radiology technique, whereby a second implantation of the esophageal stent was carried out quite successfully.

Zelenak, Kamil, E-mail: zelenak@mfn.s [University Hospital, Department of Radiology (Slovakia); Mistuna, Dusan; Lucan, Jaroslav [University Hospital, Department of Surgery (Slovakia); Polacek, Hubert [University Hospital, Department of Radiology (Slovakia)

2010-06-15

274

Synthesis of renin by tubulocystic epithelium in autosomal-dominant polycystic kidney disease  

Microsoft Academic Search

Synthesis of renin by tubulocystic epithelium in autosomal-dominant polycystic kidney disease. Evidence suggests an important role for the renin-angiotensin system in the pathogenesis of autosomal-dominant polycystic kidney disease (ADPKD). Therefore, we studied the presence of immunoreactive renin in renal biopsies and measured the concentrations of renin in cyst fluids. Normal kidneys and kidneys with renal artery stenosis were used for

Vicente E Torres; Kathleen A Donovan; Gloria Scicli; Keith E Holley; Stephen N Thibodeau; Oscar A Carretero; Tadashi Inagami; James A McAteer; Christopher M Johnson

1992-01-01

275

Retinoid Status Controls the Appearance of Reserve Cells and Keratin Expression in Mouse Cervical Epithelium  

Microsoft Academic Search

We describe an animai model to induce the histogenesis of squamous metaplasia of the cervical columnar epithelium, a condition usually pre ceding cervical neoplasia. This model is based on dietary retinoid deple tion in female mice. Control sibling mice fed the same diet but with all-irans-retinoic acid (at 3 ug\\/g diet) showed the normal endocervical epithelial and glandular columnar morphology,

Nadine Darwiche; Giulia Celli; Linda Sly; Francesca Lancillotti; Luigi M. De Luca

276

Treatment and long-term outcome of chronic radiation esophagitis after radiation therapy for head and neck tumors: A report of 13 cases  

SciTech Connect

The natural history of chronic radiation esophagitis occurring in previously normal esophagus is still unknown. The authors describe here the long-term outcome of chronic esophagitis arising after neck irradiation for oropharynx and larynx carcinomas in 13 consecutive adult patients. The first clinical signs of radiation esophagitis were dysphagia or impossibility of oral intake, which appeared within 26 months (range 2--120 months) after the end of radiation for pyriform fossae carcinoma (N = 5), tonsil carcinoma (N = 2), larynx carcinoma (N = 2), pharynx carcinoma (N = 2), base of the tongue (N = 1), and thyroid carcinomas (N = 1). During upper endoscopy, an esophageal stenosis was found in 11 cases and was associated with ulceration in three cases. An isolated esophageal ulceration was present in only two cases. Chronic radiation esophagitis diagnosis was confirmed by histology and surgery in seven cases. In the last six cases, diagnosis was supported by the absence of first cancer relapses within a median follow-up of two years (16 months to nine years) and by endoscopic findings. Seven patients received parenteral or enteral nutrition. Ten patients were treated by peroral dilatations. These treatments allowed nearly normal oral diet in 11/13 patients. Only one patient was lost of follow-up after 20 months. Four patients died from chronic radiation esophagitis. One of these patients died from massive hemorrhage after peroral dilatation. Four patients died of a second carcinoma with no first cancer recurrence. Four patients were alive after six months to nine years of follow-up. Moderate dysphagia was still present, allowing nearly normal oral feeding. In conclusion, chronic radiation esophagitis is a severe disease with an underestimated frequency. In this study, peroral dilatations appeared to be necessary and were not associated with an increased morbidity. 21 refs., 1 tab.

Silvain, C.; Barrioz, T.; Besson, I.; Babin, P.; Fontanel, J.P.; Daban, A.; Matuchansky, C.; Beauchant, M. (CHU J Bernard, Poitiers (France))

1993-05-01

277

Activation of the EGFR/Akt/NF-?B/cyclinD1 survival signaling pathway in human cholesteatoma epithelium.  

PubMed

Cholesteatoma is a benign keratinizing squamous epithelial lesion characterized by the hyper-proliferation of keratinocytes with abundant production of keratin debris in the middle ear. The epidermal growth factor receptor (EGFR)/Akt/nuclear factor-kappa B (NF-?B)/cyclinD1 signaling pathway is one of the most important pathways in regulating cell survival and proliferation. We hypothesized that the EGFR/Akt/NF-?B/cyclinD1 signaling pathway may be activated and involved in the cellular hyperplasia mechanism in acquired cholesteatoma epithelium. Immunohistochemical staining of phosphorylated EGFR (p-EGFR), phosphorylated Akt (p-Akt), activated NF-?B and cyclinD1 protein was performed in 40 cholesteatoma samples and 20 samples of normal external auditory canal (EAC) epithelium. Protein expression of p-EGFR, p-Akt, activated NF-?B and cyclinD1 in cholesteatoma epithelium was significantly increased when compared with normal EAC epithelium (p < 0.01). In cholesteatoma epithelium, a significant positive association was observed between p-EGFR and p-Akt expression and between the expressions of p-Akt and NF-?B, NF-?B and cyclinD1, respectively (p < 0.01). No significant relationships were observed between the levels of investigated proteins and the degree of bone destruction (p > 0.05). The increased protein expression of p-EGFR, p-Akt, NF-?B and cyclinD1 and their associations in cholesteatoma epithelium suggest that the EGFR/Akt/NF-?B/cyclinD1 survival signaling pathway is active and may be involved in the regulatory mechanisms of cellular hyperplasia in cholesteatoma epithelium. PMID:23463347

Liu, Wei; Yin, Tuanfang; Ren, Jihao; Li, Lihua; Xiao, Zian; Chen, Xing; Xie, Dinghua

2014-02-01

278

Allelic imbalance of 14q32 in esophageal carcinoma  

Microsoft Academic Search

It has been demonstrated that the accumulation of alterations in several oncogenes and tumor suppressor genes plays a role in the initiation and progression of esophageal carcinoma. However, to our knowledge, very few studies have described the molecular genetic changes of chromosome arm 14q in esophageal carcinoma. In this study, we examined 35 primary esophageal carcinomas for allelic imbalance on

Yuji Ihara; Yuji Kato; Tadashi Bando; Fuminori Yamagishi; Tetsuji Minamimura; Takashi Sakamoto; Kazuhiro Tsukada; Masaharu Isobe

2002-01-01

279

ESOPHAGEAL LICHEN PLANUS: A CASE REPORT AND REVIEW OF LITERATURE  

PubMed Central

Lichen planus is a rare cause of esophagitis and esophageal stricture. It is invariably associated with oral mucosal involvement and the diagnosis has to be considered in these patients who present with dysphagia. We present a case of esophageal stricture secondary to lichen planus. PMID:19967015

Madhusudhan, K S; Sharma, Raju

2008-01-01

280

Corrosive esophageal strictures: Predictors of response to endoscopic dilation  

Microsoft Academic Search

Twenty-one patients with corrosive esophageal strictures underwent contrast-enhanced CT of the chest to determine (1) the esophageal wall thickness at the stricture site and (2) its correlation with number of sessions required for adequate dilation. Average esophageal wall thickness was defined as the mean thickness of all four walls at the site of the stricture, whereas the size of the

Deepak Lahoti; Sohan L. Broor; Partha P. Basu; Ajay Gupta; Rajesh Sharma; Chandra S. Pant

1995-01-01

281

Esophageal motor abnormalities in scleroderma and related diseases  

Microsoft Academic Search

Esophageal motor activity was measured by intra-esophageal pressure recordings in 53 patients with scleroderma and 29 patients with other collagen diseases. The purpose of the study was to determine the relationship of motor abnormalities to esophageal symptoms, to compare the abnormalities in scleroderma with those in other collagen diseases, and to try to increase understanding of the responsible mechanism. Methacholine

Thomas A. Saladin; Arthur B. French; Chris J. D. Zarafonetis; H. Marvin Pollard

1966-01-01

282

Is the small intestinal epithelium truly "tight" to inulin permeation?  

PubMed

In this study, we evaluated the "leakiness" of intestinal epithelium through examination of small intestinal absorption of inulin in vivo by perfusing rat jejunum with 10 microM inulin. In physiological conditions, we found significant absorption of inulin at a rate of 44.6 nmol.100 cm-1.h-1 or absorption of 14.7%.100 cm-1.h-1 of the amount perfused. Increasing water flux by changing the luminal osmolarity resulted in linear (y = 31.1 + 2.4x, r = 0.97) increase in absorption of inulin, indicating a significant convective component of inulin absorption. There was large permeation of inulin at net water secretion and at zero net water fluxes (31.1 nmol.100 cm-1.h-1), indicating significant absorption of inulin by diffusive movement as well. The small intestinal tissue retention of inulin occurred rapidly within the first 15 min of perfusion, and the total tissue retention remained unchanged thereafter at approximately 10.8 nmol/100 cm. 16,16-Dimethylprostaglandin E2 decreased water flux, whereas cyclooxygenase inhibitors, indomethacin and acetylsalicylate, increased water flux. Inulin absorption closely paralleled changes in water flux induced by these agents. Taurocholate also caused parallel decrease in water and inulin absorption. Varying the resistance of unstirred water layer with changing luminal flow rate, the addition of mucolytic agent acetylcysteine, or alterations of luminal pH did not affect water or inulin absorption. We conclude that inulin permeates the small intestinal epithelium in significant amounts under normal physiological conditions, presumably through the paracellular pathways utilizing aqueous channels. PMID:2035637

Ma, T Y; Hollander, D; Erickson, R A; Truong, H; Krugliak, P

1991-05-01

283

Endolymphatic sodium homeostasis by extramacular epithelium of the saccule.  

PubMed

The saccule is a vestibular sensory organ that depends upon regulation of its luminal fluid, endolymph, for normal transduction of linear acceleration into afferent neural transmission. Previous studies suggested that endolymph in the saccule was merely derived from cochlear endolymph. We developed and used a preparation of isolated mouse saccule to measure transepithelial currents from the extramacular epithelium with a current density probe. The direction and pharmacology of transepithelial current was consistent with Na(+) absorption by the epithelial Na(+) channel (ENaC) and was blocked by the ENaC-specific inhibitors benzamil and amiloride. Involvement of Na(+),K(+)-ATPase and K(+) channels was demonstrated by reduction of the current by ouabain and the K(+) channel blockers Ba(2+), XE991, and 4-AP. Glucocorticoids upregulated the current via glucocorticoid receptors. Dexamethasone stimulated the current after 24 h and the stimulation was blocked by mifepristone but not spironolactone. No acute response was observed to elevated cAMP in the presence of amiloride nor to bumetanide, a blocker of Na(+),K(+),2Cl(-) cotransporter. The results are consistent with a canonical model of corticosteroid-regulated Na(+) absorption that includes entry of luminal Na(+) through apical membrane Na(+) channels and active basolateral exit of Na(+) via a Na(+) pump, with recycling of K(+) at the basolateral membrane via K(+)-permeable channels. These observations provide our first understanding of the active role played by saccular epithelium in the local regulation of the [Na(+)] of endolymph for maintenance of our sense of balance. PMID:20016101

Kim, Sung Huhn; Marcus, Daniel C

2009-12-16

284

Proton Beam Therapy and concurrent chemotherapy for esophageal cancer  

PubMed Central

Purpose/Objective Proton beam therapy (PBT) is a promising modality for the management of thoracic malignancies. We report our preliminary experience of treating esophageal cancer patients with concurrent chemotherapy (CChT) and PBT at MD Anderson Cancer Center. Materials/Methods This is an analysis of 62 esophageal cancer patients enrolled on a prospective study evaluating normal tissue toxicity from CChT/PBT from 2006 to 2010. Patients were treated with Passive Scattering PBT with 2 or 3 field beam arrangement using 180–250 MV protons. We used the method of Kaplan and Meier to assess time to event outcomes and compared the distributions between groups using the log-rank test. Results The median follow-up time was 20.1 months for survivors. The median age was 68 years (range 38–86). Most were males (82%), had adenocarcinomas (76%) and had stage II-III disease (84%). The median radiation dose was 50.4 Gray-Equivalence (Gy(RBE)) (range 36–57.6). The most common grade 2–3 acute toxicities from CChT/PBT were esophagitis (46.8%), fatigue (43.6%), nausea (33.9%), anorexia (30.1%), and radiation dermatitis (16.1%). There were two cases of grade 2 and 3 radiation pneumonitis and two grade 5 toxicities. A total of 29 patients (46.8%) received preoperative CChT/PBT with one postoperative death. The pathologic complete response (pCR) rate for the surgical cohort was 28%, and the pCR and near CR rate (0–1% residual cells) was 50%. While there were significantly fewer local-regional recurrences in the preoperative group (3/29) as compared to the definitive CChT/PBT group (16/33) (log-rank test p=0.005), there were no differences in DM free interval or OS between the two groups. Conclusions This is the first report of patients treated with PBT/CChT for esophageal cancer. Our data suggest that this modality is associated with a few severe toxicities but the pathologic response and clinical outcomes are encouraging. Prospective comparison with more traditional approach is warranted. PMID:22417808

Lin, Steven H.; Komaki, Ritsuko; Liao, Zhongxing; Wei, Caimiao; Myles, Bevan; Guo, Xiaomao; Palmer, Matthew; Mohan, Radhe; Swisher, Stephen G.; Hofstetter, Wayne L.; Ajani, Jaffer A.; Cox, James D.

2014-01-01

285

Esophageal Bezoar in a Patient with Achalasia: Case Report and Literature Review  

PubMed Central

Esophageal bezoars are rare, but are recognized as a distinct clinical entity. They are known to occur in patients with esophageal structural and functional abnormalities, but only a few cases of the development of esophageal bezoars in patients with esophageal motility disorders have only been described. We report a rare case of an esophageal bezoar that developed in a patient with achalasia, and review the literature concerning esophageal bezoars associated with esophageal motility disorders. PMID:20479921

Kim, Ki Hoon; Seo, Geom Seog; Kim, Yong Sung; Choi, Chang Soo; Im, Chong Ju

2010-01-01

286

Activation of the IL-6/JAK/STAT3 signaling pathway in human middle ear cholesteatoma epithelium  

PubMed Central

Interleukin-6 (IL-6) is one of the most important cytokines which has been shown to play a critical role in the pathogenesis of cholesteatoma. In this study, we aimed to investigate the expression of interleukin-6 (IL-6) and phosphorylated signal transducer and activator of transcription 3 (p-STAT3) in middle ear cholesteatoma epithelium in an effort to determine the role of IL-6/JAK/STAT3 signaling pathway in the pathogenesis of cholesteatoma. Immunohistochemistry was used to examine the expression of IL-6 and p-STAT3 in 25 human middle ear cholesteatoma samples and 15 normal external auditory canal (EAC) epithelium specimens. We also analyzed the relation of IL-6 and p-STAT3 expression levels to the degree of bone destruction in cholesteatoma. We found that the expression of IL-6 and p-STAT3 were significantly higher in cholesteatoma epithelium than in normal EAC epithelium (p<0.05). In cholesteatoma epithelium, a significant positive association was observed between IL-6 and p-STAT3 expression (p<0.05). However, no significant relationships were observed between the degree of bone destruction and the levels of IL-6 and p-STAT3 expression (p>0.05). To conclude, our results support the concept that IL-6/JAK/STAT3 signaling pathway is active and may play an important role in the mechanisms of epithelial hyper-proliferation responsible for cholesteatoma. PMID:24551293

Liu, Wei; Xie, Shumin; Chen, Xing; Rao, Xingwang; Ren, Hongmiao; Hu, Bing; Yin, Tuanfang; Xiang, Yuyan; Ren, Jihao

2014-01-01

287

Surgical treatment of an oral cyst with respiratory epithelium.  

PubMed

Cysts with respiratory epithelium are rare entities in the oral cavity. In the literature, there are only few cases of oral cystic masses lined by respiratory epithelium but lacking gastrointestinal epithelium. In this paper, we present the surgical treatment of a cyst with respiratory epithelium in the floor of the mouth affecting a 35-year-old woman. The asymptomatic lesion was noticed 6 years previously. On histopathologic examination, the cyst showed walls that were composed of connective tissue covered by pseudostratified ciliated columnar epithelium, interspersed by a few goblet cells. Oral cysts lined by respiratory epithelium are benign lesions. Cure is effected by surgical excision. This lesion should be considered in the differential diagnosis of masses involving the anterior tongue or the floor of the mouth. PMID:19625847

Boffano, Paolo; Zavattero, Emanuele; Campisi, Paola; Gallesio, Cesare

2009-07-01

288

Pharmacological Management of Esophageal Food Bolus Impaction  

PubMed Central

Background. Soft esophageal bolus impaction is an emergency that requires skilled endoscopic removal if persistent obstructive symptoms do not resolve spontaneously after careful observation. Expedited care of these patients is crucial to avoid respiratory and mechanical complications. Other possible options for management include medical agents used to manage it prior to performing endoscopy if access to endoscopy was not available or declined by the patient. Aim. To review the available pharmacological and other nonmedicinal options and their mechanism of relief for soft esophageal impaction. Method. Pubmed, Medline and Ovid were used for search of MESH terms pertinent including “foreign body, esophageal, esophageal bolus and medical” for pharmacological and non medicinial agents used for management of esophageal soft bolus impaction as well as manual review of the cross-references. Results. Several agents were identified including Buscopan, Glucagon, nitrates, calcium channel blockers, and papaveretum. Non medicinal agents are water, effervescent agents, and papain. No evidence was found to suggest preference or effectiveness of use of a certain pharmacological agent compared to others. Buscopan, Glucagon, benzodiazepines, and nitrates were studied extensively and may be used in selected patients with caution. Use of papain is obsolete in management of soft bolus impaction. PMID:23738071

Khayyat, Yasir Mohammed

2013-01-01

289

Multidisciplinary approach for patients with esophageal cancer  

PubMed Central

Patients with esophageal cancer have a poor prognosis because they often have no symptoms until their disease is advanced. There are no screening recommendations for patients unless they have Barrett’s esophagitis or a significant family history of this disease. Often, esophageal cancer is not diagnosed until patients present with dysphagia, odynophagia, anemia or weight loss. When symptoms occur, the stage is often stage III or greater. Treatment of patients with very early stage disease is fairly straight forward using only local treatment with surgical resection or endoscopic mucosal resection. The treatment of patients who have locally advanced esophageal cancer is more complex and controversial. Despite multiple trials, treatment recommendations are still unclear due to conflicting data. Sadly, much of our data is difficult to interpret due to many of the trials done have included very heterogeneous groups of patients both histologically as well as anatomically. Additionally, studies have been underpowered or stopped early due to poor accrual. In the United States, concurrent chemoradiotherapy prior to surgical resection has been accepted by many as standard of care in the locally advanced patient. Patients who have metastatic disease are treated palliatively. The aim of this article is to describe the multidisciplinary approach used by an established team at a single high volume center for esophageal cancer, and to review the literature which guides our treatment recommendations. PMID:23239911

Villaflor, Victoria M; Allaix, Marco E; Minsky, Bruce; Herbella, Fernando A; Patti, Marco G

2012-01-01

290

Identification of human papillomavirus in esophageal squamous papillomas  

PubMed Central

AIM: To investigate the presence of human papillomavirus (HPV) in esophageal squamous papilloma (ESP) and determine p16, p53 and Ki67 expression in a Mexican cohort. METHODS: Nineteen cases diagnosed as ESP, corresponding to 18 patients were reviewed; nineteen cases of normal esophageal mucosa were used as negative controls. HPV detection was performed by amplified chromogenic in situ hybridization (ACISH) using a wide spectrum-cocktail probe and PCR. RESULTS: The average age at presentation was 46.3 years (range 28-72 years). Patients included four (22.22%) males and 14 (77.77%) females. The most frequent location was upper third (11 cases), followed by middle third (3 cases) and unknown site (5 cases). Immunohistochemistry (IHC) revealed basal and focal p53 expression in 17 cases (89%); p16 was expressed in eight cases (42.10%) and the Ki67 index ranged from 10% to 30%. HPV was detected in 14 out of 16 cases (87.5%) by ACISH: Twelve showed diffuse nuclear patterns and two showed granular patterns. HPV DNA was identified by PCR in 12 out of 14 cases (85.7%). Low-risk HPV types were detected in the most of the cases. CONCLUSION: This study provides identification of HPV infection in almost 80% of ESP using either ACISH or PCR; overall, all of these lesions show low expression of cell-cycle markers. We suggest ACISH as an alternative diagnostic tool for HPV detection in ESP. PMID:19084918

Bohn, Olga L; Navarro, Leticia; Saldivar, Jesus; Sanchez-Sosa, Sergio

2008-01-01

291

FOLFOX-6 Induction Chemotherapy Followed by Esophagectomy and Post-operative Chemoradiotherapy in Patients With Esophageal Adenocarcinoma  

ClinicalTrials.gov

Adenocarcinoma of the Esophagus; Adenocarcinoma of the Gastroesophageal Junction; Adenocarcinoma of the Gastric Cardia; Stage IIIA Esophageal Cancer; Stage IIIB Esophageal Cancer; Stage IIIC Esophageal Cancer

2014-07-21

292

Analysis of acute radiation-induced esophagitis in non-small-cell lung cancer patients using the Lyman NTCP model  

Microsoft Academic Search

PurposeTo analyze acute esophagitis (AE) in a Chinese population receiving 3D conformal radiotherapy (3DCRT) for non-small cell lung cancer (NSCLC), combined or not with chemotherapy (CT), using the Lyman–Kutcher–Burman (LKB) normal tissue complication probability (NTCP) model.

Jian Zhu; Zi-Cheng Zhang; Bao-Sheng Li; Min Liu; Yong Yin; Jin-Ming Yu; Li-Min Luo; Hua-Zhong Shu; Renaud De Crevoisier

2010-01-01

293

Epithelium and Bowman's layer thickness and light scatter in keratoconic cornea evaluated using ultrahigh resolution optical coherence tomography.  

PubMed

A custom-developed ultrahigh resolution optical coherence tomography with an axial resolution of 1.1 ?m in corneal tissue was used to characterize thickness and light scatter of the epithelium and Bowman's layer in keratoconic (KC) cornea noninvasively. A 4-mm wide vertical corneal section around the apex in nine KC and eight normal eyes was imaged in vivo. The epithelium and Bowman's layer were visualized and their thickness profiles were quantified. Scatter was quantified based on the sensitivity normalized mean signal intensity distribution. Average mean thickness of the epithelium and Bowman's layer in KC eyes was significantly smaller (p<0.05) than the normal eyes. The epithelium thickness variation across a central 3-mm cornea was significantly larger in KC eyes than in normal eyes. The scatter in KC eyes was significantly increased only for Bowman's layer. The changes observed in this study could improve our understanding of the underlying disease mechanism of KC and can provide new indications for early disease diagnosis. PMID:23117805

Yadav, Rahul; Kottaiyan, Ranjini; Ahmad, Kamran; Yoon, Geunyoung

2012-11-01

294

2011 update on esophageal achalasia  

PubMed Central

There have been some breakthroughs in the diagnosis and treatment of esophageal achalasia in the past few years. First, the introduction of high-resolution manometry with pressure topography plotting as a new diagnostic tool has made it possible to classify achalasia into three subtypes. The most favorable outcome is predicted for patients receiving treatment for type II achalasia (achalasia with compression). Patients with typeI(classic achalasia) and type III achalasia (spastic achalasia) experience a less favorable outcome. Second, the first multicenter randomized controlled trial published by the European Achalasia Trial group reported 2-year follow-up results indicating that laparoscopic Heller myotomy was not superior to endoscopic pneumatic dilation (PD). Although the follow-up period was not long enough to reach a convincing conclusion, it merits the continued use of PD as a generally available technique in gastroenterology. Third, the novel endoscopic technique peroral endoscopic myotomy is a promising option for treating achalasia, but it requires increased experience and cautious evaluation. Despite all this good news, the bottom line is a real breakthrough from the basic studies to identify the actual cause of achalasia that may impede treatment success is still anticipated. PMID:22529685

Chuah, Seng-Kee; Hsu, Pin-I; Wu, Keng-Liang; Wu, Deng-Chyang; Tai, Wei-Chen; Changchien, Chi-Sin

2012-01-01

295

Congenital esophageal stenosis owing to tracheobronchial remnants  

PubMed Central

OBJECTIVE To emphasize the need of an accurate diagnosis of congenital esophageal stenosis due to tracheobronchial remnants, since its treatment differs from other types of congenital narrowing. CASE DESCRIPTION Four cases of lower congenital esophageal stenosis due to tracheobronchial remnants, whose definitive diagnosis was made by histopathology. Except for the last case, in which a concomitant anti-reflux surgery was not performed, all had a favorable outcome after resection and anastomosis of the esophagus. COMMENTS The congenital esophageal stenosis is an intrinsic narrowing of the organâ€(tm)s wall associated with its structural malformation. The condition can be caused by tracheobronchial remnants, fibromuscular stenosis or membranous diaphragm and the first symptom is dysphagia after the introduction of solid food in the diet. The first-choice treatment to tracheobronchial remnants cases is the surgical resection and end-to-end anastomosis of the esophagus. PMID:24142326

Rebelo, Priscila Guyt; Ormonde, Joao Victor C.; Ormonde, Joao Baptista C.

2013-01-01

296

Early esophageal carcinoma treated with intracavitary irradiation  

SciTech Connect

Five patients with early esophageal carcinoma were treated by 6-12 Gy of intracavitary irradiation following 50-60 Gy of external irradiation as a boost therapy. Surgery was not performed in these cases. None of the patients had local recurrence after radiation therapy, as demonstrated by esophagography and endoscopy. Three patients have been alive for 1-3 years 10 months. Esophageal ulceration induced by intracavitary irradiation has occurred in three of the five patients; however, intracavitary irradiation is still a beneficial treatment because of its efficacy in controlling local lesions and because radiation ulceration can eventually be cured. Intracavitary irradiation is recommended to follow external irradiation as a boost therapy for the treatment of early esophageal carcinoma.

Hishikawa, Y.; Tanaka, S.; Miura, T.

1985-08-01

297

MicroRNA involvement in esophageal carcinogenesis.  

PubMed

MicroRNAs (miRs) have recently emerged as a novel class of gene expression regulators. The number of studies documenting an altered miR expression pattern in cancer continues to expand rapidly. Critical information is continuously gained regarding how aberrantly expressed miRs contribute to carcinogenesis. Current studies provide evidence that analyses of miR expression patterns have potential clinical applications toward developing tumor biomarkers to identify the presence and dissemination of esophageal cancer, as well as to assess tumor chemosensitivity or radiosensitivity. The incidence of esophageal cancer is on the rise, and this disease continues to portend a poor prognosis. The current review addresses ways in which altered miR expression contributes to esophageal carcinogenesis, along with how recent discoveries may be applied clinically. PMID:21992930

David, Stefan; Meltzer, Stephen J

2011-12-01

298

Herpetic Esophagitis in Immunocompetent Medical Student  

PubMed Central

Esophagitis caused by herpes simplex virus (HSV) is often documented during periods of immunosuppression in patients infected with human immunodeficiency virus (HIV); it is rare in immunocompetent diagnosed patients. Case reports of herpetic esophagitis in students of health sciences are extremely rare. The disease presents with a clinical picture characterized by acute odynophagia and retrosternal pain without obvious causes and ulcers, evidenced endoscopically in the middistal esophagus. Diagnosis depends on endoscopy, biopsies for pathology studies, and immunohistochemistry techniques. The disease course is often benign; however, treatment with acyclovir speeds the disappearance of symptoms and limits the severity of infection. In this report, we present a case of herpetic esophagitis in an immunocompetent medical student, with reference to its clinical features, diagnosis, and treatment. The disease may have manifested as a result of emotional stress experienced by the patient. PMID:24707416

Marinho, Andreia Vidica; Bonfim, Vinicius Mendes; de Alencar, Luciana Rodrigues; Pinto, Sebastiao Alves; de Araujo Filho, Joao Alves

2014-01-01

299

Cineradiography identifies esophageal candidiasis in progressive systemic sclerosis.  

PubMed

Cineradiography of the esophagus showed signs of esophageal candidiasis in 11 out of 71 patients with progressive systemic sclerosis (PSS) - both in diffuse scleroderma and the CREST syndrome. Culture of esophageal brushings confirmed the presence of Candida albicans in eight of these 11 patients. Antimycotic treatment decreased the cineradiographic signs of candidiasis and the degree of dysphagia. Since impaired esophageal motility and treatment with immunosuppressive drugs may predispose to candida esophagitis, and since dysphagia will decrease after antimycotic treatment esophageal mycosis should always be sought in patients with PSS. PMID:2706818

Geirsson, A J; Akesson, A; Gustafson, T; Elner, A; Wollheim, F A

1989-01-01

300

Abnormal enteric nerve morphology in atretic esophagus of fetal rats with adriamycin-induced esophageal atresia  

Microsoft Academic Search

Gastroesophageal reflux is common in children after successful repair of esophageal atresia (EA), and may be related to a\\u000a congenital neuronal abnormality of the esophagus. This study employed a fetal rat model of adriamycin-induced EA to investigate\\u000a whether the innervation of the esophagus is abnormal in EA. The fetal rats were divided into four groups: (1) normal controls;\\u000a (2) a

W. Cheng; A. E. Bishop; L. Spitz; J. M. Polak

1999-01-01

301

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

Microsoft Academic Search

The clearance of acid from the esophagus and esophageal emptying in normal subjects was studied. A 15-ml bolus of 0.1 N hydrochloric acid (pH 1.2) radiolabeled with (\\/sup -99m\\/Tc)sulfur colloid was injected into the esophagus, and the subject swallowed every 30 seconds. Concurrent manometry and radionuclide imaging showed nearly complete emptying of acid from the esophagus by an immediate secondary

James F. Helm; Wylie J. Dodds; Lorie R. Pelc; David W. Palmer; Walter J. Hogan; Bruce C. Teeter

1984-01-01

302

Diet and vitamin nutrition of the high esophageal cancer risk population in Linxian, China  

Microsoft Academic Search

In order to examine the nutritional status of the population of Linxian (in Henan, China) known to be at high risk for esophageal cancer (EC), we analyzed blood samples and conducted 3?day dietary surveys on 3 groups of normal adults, age 40–50, from Henan province. Two groups were from Linxian, where the EC mortality rate is about 138\\/100,000 (Group C,

Chung S. Yang; Jian Miao; Wenxian Yang; Mei Huang; Tianyuan Wang; Hongji Xue; Shuheng You; Jianbang Lu; Jinming Wu

1982-01-01

303

Role of microRNA21 and effect on PTEN in Kazakh’s esophageal squamous cell carcinoma  

Microsoft Academic Search

The aim of this study was investigate the role of microRNA-21 (miR-21) and its regulation on phosphatase and tensin homolog\\u000a deleted from chromosome-10 (PTEN) in Kazakh’s esophageal squamous cell carcinoma (ESCC). MiR-21 expressions were investigated\\u000a in esophageal cancer cell line Eca109, and 18 pairs of Kazakh’s ESCC and adjacent normal tissues by real-time quantitative\\u000a PCR (qRT-PCR). To evaluate the role

Wen-jing Ma; Guo-dong Lv; Aerziguli Tuersun; Qing Liu; Hui Liu; Shu-tao Zheng; Cong-gai Huang; Jun-guo Feng; Xing Wang; Ren-yong Lin; Ilyar Sheyhidin; Xiao-mei Lu

2011-01-01

304

K-ras Mutation, HPV Infection and Smoking or Alcohol Abuse Positively Correlate with Esophageal Squamous Carcinoma  

Microsoft Academic Search

The Ras\\/Raf\\/MEK\\/ERK (MAPK) signal transduction cascade is an important mediator of a number of cellular fates including growth,\\u000a survival and apoptosis. The aim of this study was to determine the incidence of B-raf, Kirsten-ras (K-ras) and Neuroblastoma-ras\\u000a (N-ras) gene mutations in esophageal squamous cell carcinoma (ESCC) in the Greek population. DNA was extracted from 30 ESCC\\u000a and 32 normal esophageal

Ioannis D. Lyronis; Stavroula Baritaki; Ioannis Bizakis; Elias Krambovitis; Demetrios A. Spandidos

2008-01-01

305

Ingestion of thioproline suppresses rat esophageal adenocarcinogenesis caused by duodenogastroesophageal reflux.  

PubMed

Duodenogastroesophageal reflux causes esophageal adenocarcinoma in rats without the use of a carcinogen. This etiology is unclear, but may be associated with endogenous nitrosation in the gastrointestinal tract. Thioproline (TPRO) is an effective nitrite-trapping agent and blocks endogenous nitrosation. We investigated how ingested TPRO affected esophageal adenocarcinogenesis in rats with duodenogastroesophageal reflux (DGER) or gastroesophageal reflux (GER). A series of 200 male Fischer 344 rats received surgery to induce reflux of duodenogastric contents or gastric contents alone into the esophagus. The rats were separated into two divisions according to the surgical procedure employed (DGER or GER), and each division was further subdivided into two groups: one group was fed a special diet (CRF-1 containing 0.5% of TPRO); the other group was fed a standard diet (CRF-1). The rats were given no carcinogen and sacrificed at ten-week intervals from the 25th to the 45th week after surgery. Pathological examination was carried out using hematoxylin-eosin or immunohistochemical staining. Erosion, regenerative thickening, basal cell hyperplasia and columnar-lined epithelium (CLE) were found in both groups of the DGER rats. Adenocarcinoma (AC) appeared only in the DGER rats sacrificed at 35 and 45 weeks following surgery. The incidence of AC at the 45th week was significantly lower in the group of rats fed the diet containing TPRO, as compared to those fed the standard diet, whereas the incidences of CLE were the same for both groups. iNOS protein and nitrotyrosine protein were identified in the CLE and macrophages of the DGER group using immunohistochemical staining. There were no remarkable pathological changes in the esophagi of the rats which underwent the GER procedure. In conclustion, TPRO has an inhibitory effect on esophageal reflux-induced adenocarcinogenesis in rats in that it prevents the progression from CLE to AC. PMID:17982628

Sasaki, Shozo; Miwa, Koichi; Fujimura, Takashi; Oba, Masaru; Miyashita, Tomoharu; Kinami, Shinichi

2007-12-01

306

Etiology, diagnosis and treatment of infectious esophagitis.  

PubMed

Infectious esophagitis may be caused by fungal, viral, bacterial or even parasitic agents. Risk factors include antibiotics and steroids use, chemotherapy and/or radiation therapy, malignancies and immunodeficiency syndromes including acquired immunodeficiency syndrome. Acute onset of symptoms such as dysphagia and odynophagia is typical. It can coexist with heartburn, retrosternal discomfort, nausea and vomiting. Abdominal pain, anorexia, weight loss and even cough are present sometimes. Infectious esophagitis is predominantly caused by Candida species. Other important causes include cytomegalovirus and herpes simplex virus infection. PMID:24868280

Roso?owski, Mariusz; Kierzkiewicz, Maciej

2013-01-01

307

Technological advances in radiotherapy for esophageal cancer  

PubMed Central

Radiotherapy with concurrent chemotherapy and surgery represent the main treatment modalities in esophageal cancer. The goal of modern radiotherapy approaches, based on recent technological advances, is to minimize post-treatment complications by improving the gross tumor volume definition (positron emission tomography-based planning), reducing interfraction motion (image-guided radiotherapy) and intrafraction motion (respiratory-gated radiotherapy), and by better dose delivery to the precisely defined planning target volume (intensity-modulated radiotherapy and proton therapy). Reduction of radiotherapy-related toxicity is fundamental to the improvement of clinical results in esophageal cancer, although the dose escalation concept is controversial. PMID:21105188

Vosmik, Milan; Petera, Jiri; Sirak, Igor; Hodek, Miroslav; Paluska, Petr; Dolezal, Jiri; Kopacova, Marcela

2010-01-01

308

Relationship among esophageal dysfunction, diabetic gastro-enteropathy, and autonomic neuropathy  

SciTech Connect

This study assessed the relationship of esophageal radionuclide transit (RT) to diabetic gastroenteropethy (CEP) and autonomic neuropathy (AN). Data were acquired in list mode after an oral dose of 0.5 mCi Tc-99m sulfur colloid in 10 ml of water in the supine position. A modified computer routine was used to calculate: (A) total mean transit time (TMTT) in sec, (B) residual fraction after the first swallow (RF), and )C) retrograde index (RI). Twenty-one patients (pts) with diabetes and 25 normal subjects (N) were studied. Eleven pts belonged to Group 1 with symptomatic GEP and AN; 5, Group 2 with no GEP but with AN; and 5, Group 3 with neither. Abnormal RT mainly occurred in Group 1. RI was the best parameter with respective sensitivity and specificity of 0.91 (10/110 and 0.96 (24/25. RI was abnormal in 10/11 pts with GEP (Group 1), but normal in all 10 pts without GEP (Groups 2 and 3). All 5 pts only with AN (group 2) had normal RI. The authors conclude that esophageal dysfunction is present in nearly all pts with diabetic GEP. However, the presence of AN alone will not explain esophageal transit abnormality.

Yeh, S.H.; Liu, R.S.; Wu, L.C.; Lin, H.D.; Wang, S.J.; Lin, W.H.

1985-05-01

309

In vivo ?-defensin gene expression in rat gingival epithelium in response to Actinobacillus actinomycetemcomitans infection  

PubMed Central

Background and Objective Human ?-defensins have been identified in the oral cavity and are predicted to play a role in the defense against pathogenic bacteria. Homologous rat ?-defensins (RBDs) have been identified, but their expression in the oral cavity has not been examined. Therefore, the aim of this study was to investigate the expression of innate immune mediators in the rat gingival epithelium. Material and Methods Rats were pretreated with antibiotics to depress the normal oral flora, followed by the introduction of Actinobacillus actinomycetemcomitans in their food to allow colonization and the development of periodontal disease. At various time points, animals were killed and the gingival epithelium was extracted. Semiquantitative reverse transcription–polymerase chain reaction was performed to measure RBD and Toll-like receptor (TLR) mRNA levels. Results Three ?-defensins (RBD-1, -2 and -5) and two TLRs (TLR-3 and -4) are expressed in normal rat gingival epithelium. After the introduction of A. actinomycetemcomitans, RBD-1 and RBD-2 mRNA levels increased for the first week followed by a return to basal levels. No change in TLR mRNA levels was observed. Conclusion The rat model provides a good system for experimental analysis of the innate immune response to periopathogenic bacteria in the oral cavity, as well as the potential role of ?-defensins in the host response to colonization. PMID:17076783

Kurland, A. R.; Schreiner, H.; Diamond, G.

2007-01-01

310

A comparative light-microscopic, electron-microscopic and chemical study of human vaginal and buccal epithelium.  

PubMed

The scarcity of sizeable specimens of normal oral mucosa for experimental purposes has hampered research on oral epithelium. Because large specimens of viable human vaginal mucosa are readily available and because vaginal and buccal epithelia are microscopically similar, vaginal mucosa has been used successfully to establish a human cyst model in experimental animals. The ultrastructure and distribution of keratin filaments in these epithelia are also similar, as is their permeability to water and a number of chemical substances. Therefore, if vaginal mucosa could be substituted for buccal mucosa it would expedite research on the epithelium of buccal mucosa. To strengthen further the concept that vaginal epithelium could replace buccal epithelium in certain experimental studies, the thickness of these epithelia, their patterns of surface keratinization, the presence or absence of intercellular lipid lamellae and their lipid contents were now compared. Thirty-three specimens of vaginal mucosa from postmenopausal women and 36 of buccal mucosa were investigated. To compare the thickness of the epithelial layers the number of cell layers in sections of 20 vaginal and 20 buccal mucosal specimens were counted in the three thickest and three thinnest regions of each specimen. Surface keratinization was evaluated on sections stained with the Picro-Mallory method. To demonstrate lipid lamellae two vaginal and two buccal mucosa specimens were examined electron microscopically after normal fixation and postfixation in ruthenium tetroxide. Following solvent extraction of 11 vaginal and 14 buccal epithelia, quantitative lipid analyses were performed using thin-layer chromatography. No statistically significant differences were found between the maximum and minimum number of epithelial cell layers. The patterns of surface keratinization and the distribution and appearance of the lipid lamellae in the intercellular spaces were similar. The lipid composition of the two epithelia corresponded, except for the cholesterol esters and glycosylceramides, which were higher in buccal epithelium. Ceramides for vaginal epithelium and triglycerides for buccal epithelium were not determined. Based on structural similarities, a similar lipid composition and earlier findings, it is concluded that vaginal epithelium can be used as a substitute for buccal epithelium in certain in vitro, and possibly for in vivo, studies. PMID:11684027

Thompson, I O; van der Bijl, P; van Wyk, C W; van Eyk, A D

2001-12-01

311

Symptom hypersensitivity to acid infusion is associated with hypersensitivity of esophageal contractility.  

PubMed

Several investigators have observed that repeated acid infusions induce stronger symptoms (symptom hypersensitivity). The goal of our study was to determine whether symptom hypersensitivity is associated with esophageal contractile hypersensitivity. Subjects with chronic heartburn symptoms underwent simultaneous pressure and ultrasound imaging of esophagus. Normal saline and 0.1 N HCl were sequentially infused into the esophagus, and subjects scored heartburn symptoms on a 1-10 scale. Saline and HCl infusions were repeated in 10 subjects with a positive Bernstein test. Esophageal contraction amplitude and duration and muscularis propria thickness were measured using a computerized method during recording. Acid infusion induced heartburn. Esophageal contractions had higher amplitudes (pressure 114.2 +/- 7.0%) and longer duration (116.8 +/- 4.4%) during acid infusion compared with saline infusion. Average muscle thickness was greater during acid infusion than saline infusion (107.0 +/- 2.0%). Sustained esophageal contractions (SECs) were identified during acid infusion. A second acid infusion (acid-2) induced heartburn with shorter latency (93.0 +/- 15.0 vs. 317.0 +/- 43.0 s) and stronger severity (8.5 +/- 0.5 vs. 5.3 +/- 0.8) than the first acid infusion (acid-1). Contraction amplitudes (140.2 +/- 13.0%), average muscle thickness (118.0 +/- 3.3%), and contraction duration (148.5 +/- 5.6 vs. 116.8 +/- 4.4%) were higher during acid-2 than acid-1. Also, numbers of SECs were greater during acid-2 than acid-1 (31 in 8 subjects vs. 11 in 6 subjects). Our data show that acid infusion into esophagus induces esophageal hypersensitivity and that a close temporal correlation exists between symptom hypersensitivity and contractility hypersensitivity. PMID:14977636

Bhalla, Vikas; Liu, Jianmin; Puckett, James L; Mittal, Ravinder K

2004-07-01

312

Inter-observer Variability in Esophageal Body Measurements with High Resolution Manometry among New Physician Users  

PubMed Central

Goals To evaluate inter-observer variability among four new physician users on measures of esophageal body function. Background Esophageal high resolution manometry (HRM) allows observation of esophageal motility via pressure topography plots. Little is known about the inter-observer variability among physicians. Study Two resident and two fellow level physicians each interpreted 10 liquid swallows of 20 esophageal HRM studies (n=200 swallows) using the BioVIEW Analysis Suite (Sandhill Scientific, Inc.). Studies evaluated were from patients referred for evaluation of dysphagia but found to have normal esophageal manometry and complete liquid bolus transit. Physicians received an orientation session and reviewed recent literature. Each physician recorded contractile front velocity (CFV) and distal contractile integral (DCI) for each liquid swallow. STATISTICS: Inter-observer agreements for CFV and DCI were assessed by intraclass correlation (ICC) values. Linear correlations between measurements by two readers were assessed using linear regression modeling techniques. Results CFV and DCI values of up to 200 data points were analyzed. Four reader results for CFV and DCI showed strong agreement although stronger for DCI measures (ICC=0.94; 0.91 - 0.98) in comparison to CFV (ICC=0.79; 0.52 - 0.82). Further correlation was performed with two readers; readers 1 and 2 revealed excellent correlation for DCI (r=0.95, p<0.001) and good correlation for CFV (r=0.61, p<0.001). Conclusions With a thorough orientation session, good to excellent agreement for CFV and DCI measurements can be obtained from new physician users. CFV measures exhibit greater inter-observer variability possibly due to the artifact produced by intraesophageal pressurization. PMID:22647828

Singh, Erick; Rife, Christopher; Clayton, Steven; Naas, Peter; Nietert, Paul; Castell, Donald

2012-01-01

313

Cell Signaling and Ion Transport Across the Fish Gill Epithelium  

E-print Network

Cell Signaling and Ion Transport Across the Fish Gill Epithelium DAVID H. EVANS1,2* 1 Department, Salsbury Cove, Maine 04672 ABSTRACT A large array of circulating and local signaling agents modulate the size and distribution of transporting cells in the epithelium. In some cases, these transport effects

Evans, David H.

314

Spectral domain optical coherence tomography of combined hamartoma of the retina and retinal pigment epithelium.  

PubMed

A 17-year-old girl presented with slow, progressive, painless visual deterioration in the left eye. Fundus examination and fluorescein angiography findings were consistent with combined hamartoma of the retina and retinal pigment epithelium. Spectral domain optical coherence tomography (SD-OCT) displayed a preretinal membrane, retinal disorganization, and thickened retina drawn into folds. Partial posterior vitreous detachment was noted. The higher-resolution scans delineated the transition between the tumor and normal retina. The higher resolution of SD-OCT allows detailed observation of the vitreoretinal interface abnormalities and retinal disorganization present in combined hamartomas of the retina and retinal pigment epithelium and aids in the differential diagnosis and management of pigmented fundus lesions. PMID:19485302

Huot, Christopher S; Desai, Komal B; Shah, Vinay A

2009-01-01

315

Inductive differentiation of conjunctival goblet cells by ?-secretase inhibitor and construction of recombinant conjunctival epithelium.  

PubMed

?-secretase inhibitor has been shown to promote intestinal goblet cell differentiation. We now demonstrated that the in vitro addition of ?-secretase inhibitor in the culture of human conjunctival epithelial cells significantly promoted the differentiation of conjunctival goblet cells with typical droplet-like phenotype, positive periodic acid-Schiff and goblet cell-specific Muc5Ac, cytokeratin 7 and Helix pomatia agglutinin lectin staining. Moreover, topical application of ?-secretase inhibitor promoted the differentiation of mouse conjunctival goblet cells in vivo. Furthermore, the expression of Notch target gene HES-1 was down-regulated during the differentiation of conjunctival goblet cells. In addition, we found that the recombinant conjunctival epithelium on amniotic membrane showed less goblet cell density and abnormal location when compared with normal conjunctival epithelium, which were improved by the addition of ?-secretase inhibitor in the final induction. PMID:24746620

Tian, Le; Qu, Mingli; Wang, Yao; Duan, Haoyun; Di, Guohu; Xie, Lixin; Zhou, Qingjun

2014-06-01

316

Phenotypes and clinical context of hypercontractility in high resolution esophageal pressure topography (EPT)  

PubMed Central

Backgrounds & Aims This study aimed to refine the criteria for esophageal hypercontractility in high resolution esophageal pressure topography (EPT) and examine the clinical context in which it occurs. Subjects & Methods 72 control subjects were used to define the threshold for hypercontractility as a distal contractile integral (DCI) greater than observed in normals. 2,000 consecutive EPT studies were reviewed to find patients exceeding this threshold. Concomitant EPT and clinical variables were explored. Results The greatest DCI value observed in any swallow among the control subjects was 7,732 mmHg-s-cm; the threshold for hypercontractility was established as a swallow with DCI >8,000 mmHg-s-cm. 44 patients were identified with a median maximal DCI of 11,077 mmHg-s-cm, all with normal contractile propagation and normal distal contractile latency, thereby excluding achalasia and distal esophageal spasm. Hypercontractility was associated with multipeaked contractions in 82% of instances leading to the name Jackhammer Esophagus . Dysphagia was the dominant symptom although subsets of patients had hypercontractility in the context of EGJ outflow obstruction, reflux disease, or as an apparent primary motility disorder. Conclusion We describe an extreme phenotype of hypercontractility characterized in EPT by the occurrence of at least a single contraction with DCI > 8,000 mmHg-s-cm, a value not encountered in control subjects. This phenomenon, branded Jackhammer Esophagus was usually accompanied by dysphagia and occurred both in association with other esophageal pathology (EGJ outflow obstruction, reflux disease) or as an isolated motility disturbance. Further studies are required to define the pathophysiology and treatment of this disorder. PMID:21931377

Roman, Sabine; Pandolfino, John E; Chen, Joan; Boris, Lubomyr; Luger, Daniel; Kahrilas, Peter J

2013-01-01

317

An overview of esophageal sensory receptors  

Microsoft Academic Search

The neurophysiological basis of esophageal pain and discomfort is not well known. Functional disorder, such as noncardiac chest pain, is thought to be associated with hypersensitivity of primary afferents innervating the esophagus and\\/or sensitization of spinal dorsal horn cells receiving input from the organ. Although we have accumulated a large body of information about the morphologic structure and neuropeptide contents

J. N Sengupta

2000-01-01

318

Protection by Indomethacin against Acute Radiation Esophagitis  

Microsoft Academic Search

The mechanism of radiation induced damage to the mucosal lining of the gastrointestinal tract, as well as mucositis, is not fully characterized. Prostaglandins may partially mediate the inflammatory response to radiation damage. The effect of the prostaglandin synthetase inhibitor indomethacin on radiation induced esophagitis, pneumonitis, and tumor response was evaluated in the C3H mouse. The effects of indomethacin on radiation

Zelig Tochner; Margaret Barnes; James B. Mitchell; Kathy Orr; Eli Glatstein; Angelo Russo

1990-01-01

319

Combined modality therapy for esophageal cancer  

Microsoft Academic Search

Treatment approaches for esophageal cancer include primary treatment (surgical or nonsurgical) or adjuvant treatment (preoperative or postoperative). Primary treatments include surgery alone, radiation therapy alone, and radiation therapy plus chemotherapy (combined modality therapy). Adjuvant therapies include preoperative or postoperative radiation therapy, preoperative chemotherapy, and preoperative combined modality therapy. There is considerable controversy as to the ideal therapeutic approach. This review

Bruce D Minsky

2003-01-01

320

Pharmacokinetics and pharmacogenomics in esophageal cancer chemoradiotherapy  

Microsoft Academic Search

Esophageal cancer is one of the most lethal malignancies. Surgical resection of the tumor from the primary site has been the standard treatment, especially for localized squamous cell carcinoma, but considerable clinical efforts during the last decade have resulted in novel courses of treatment. These options include chemoradiotherapy, consisting of a continuous infusion of 5-fluorouracil (5-FU), cisplatin (CDDP), and concurrent

Toshiyuki Sakaeda; Motohiro Yamamori; Akiko Kuwahara; Kohshi Nishiguchi

2009-01-01

321

Thoracoscopic treatment of benign esophageal tumors  

PubMed Central

Introduction Gastrointestinal stromal tumors are among the most frequent mesenchymal tumors of the gastrointestinal tract; the incidence of these tumors in the esophagus is less than 5%. Prognosis depends on localization, size, mitotic activity and possible invasion of surrounding structures. Minimally invasive surgery may be maximally utilized for removal of these tumors from the esophageal wall. This operation is usually performed thoracoscopically or laparoscopically and using the “rendez-vous” method – with endoscopic navigation. Aim To evaluate a set of patients with benign tumor of the esophagus who were operated on at the First Department of Surgery from 2006 to 2011. Material and methods In the years 2006-2011 a total of 11 patients with benign tumors of the esophagus underwent operation. Results Of the 11 patients with esophageal tumor, 5 were diagnosed with gastrointestinal stromal tumor, 5 with leiomyoma and in one patient the lesion was described as heterotopy of the pancreas. We used the minimally invasive rendez-vous method with endoscopic navigation in 9 cases. All patients healed primarily and were released from hospital on the 4th-7th day. These patients are being followed up as outpatients and recurrence of the tumor has not been observed in any of them. Conclusions Minimally invasive treatment of benign tumors of the esophageal wall is considered to the method of choice. Due to possible complications and the need for subsequent therapy in some patients, these procedures should be centralized to departments with experience in esophageal, thoracic and minimally invasive surgery. PMID:23362430

Neoral, Cestmir; Aujesky, Rene; Skarda, Jozef; Vrba, Radek; Chudacek, Josef; Vomackova, Katherine

2012-01-01

322

Barrett’s and Esophageal Adenocarcinoma Consortium  

Cancer.gov

An international consortium with epidemiologic studies of Barrett's Esophagus and esophageal adenocarcinoma. Analyses so far have included alcohol consumption, anthropometry, cigarette smoking, excess risk models, gastroesophageal reflux disease, non-steroidal anti-inflammatory drugs, reproductive factors, and genome-wide studies to identify susceptibility loci associated with Barrett’s esophagus and/or adenocarcinomas of the esophagus.

323

The Effect of an Effortful Swallow on the Normal Adult Esophagus  

Microsoft Academic Search

The effect of an effortful swallow on the healthy adult esophagus was investigated using concurrent oral and esophageal manometry\\u000a (water perfusion system) on ten normal adults (5 males and 5 females, 20–35 years old) while swallowing 5-ml boluses of water.\\u000a The effects of gender, swallow condition (effortful versus noneffortful swallows), and sensor site within the oral cavity,\\u000a esophageal body, and

Teresa E. Lever; Kathleen T. Cox; Donald Holbert; Mamun Shahrier; Monica Hough; Kristine Kelley-Salamon

2007-01-01

324

Identification of novel inducible genes in airway epithelium.  

PubMed

DNA differential display analysis (DD-PCR) was utilized to identify genes that are expressed in airway epithelium and are relevant to airway inflammation; cytokine-mediated induction of gene expression and inhibition of that induction by glucocorticoids were the criteria for selection. The IB3-1 cell line was cultured in the presence of tumor necrosis factor-alpha (TNF-alpha), dexamethasone, or dimethyl sulfoxide (DMSO) as a control, and analyzed via DD-PCR and Northern blot analyses. With this approach, two TNF-alpha-inducible and dexamethasone (DEX)-sensitive expressed sequence tags (EST8 and EST19) were identified. In IB3-1 cells, TNF-alpha increased messenger RNA (mRNA) expression of EST8 (34%, P < or = 0.005) and EST19 (41%, P < or = 0.01), whereas dexamethasone reduced this expression to resting levels. This pattern of mRNA expression was also observed in normal human bronchial epithelial cells (EST8: 21%, P < or = 0.009; EST19: 11%, P < or = 0.02) and in the basophil leukemia cell line KU812 (EST8: 34%, P < or = 0.01). Through basic local alignment search tool (BLAST) analysis, it was determined that these ESTs exhibited significant homology with the monomeric G protein rhoC (EST8: 100% homology, P = 1.6 x 10(-100)) and the UFO tyrosine kinase receptor (EST19: 86% homology, 5.3 x 10(-28). PMID:9224216

Schwiebert, L M; Mooney, J L; Van Horn, S; Gupta, A; Schleimer, R P

1997-07-01

325

Surface characteristics of isopod digestive gland epithelium studied by SEM.  

PubMed

The structure of the digestive gland epithelium of a terrestrial isopod Porcellio scaber has been investigated by conventional scanning electron microscopy (SEM), focused ion beam-scanning electron microscopy (FIB/SEM), and light microscopy in order to provide evidence on morphology of the gland epithelial surface in animals from a stock culture. We investigated the shape of cells, extrusion of lipid droplets, shape and distribution of microvilli, and the presence of bacteria on the cell surface. A total of 22 animals were investigated and we found some variability in the appearance of the gland epithelial surface. Seventeen of the animals had dome-shaped digestive gland "normal" epithelial cells, which were densely and homogeneously covered by microvilli and varying proportions of which extruded lipid droplets. On the surface of microvilli we routinely observed sparsely distributed bacteria of different shapes. Five of the 22 animals had "abnormal" epithelial cells with a significantly altered shape. In three of these animals, the cells were much smaller, partly or completely flat or sometimes pyramid-like. A thick layer of bacteria was detected on the microvillous border, and in places, the shape and size of microvilli were altered. In two animals, hypertrophic cells containing large vacuoles were observed indicating a characteristic intracellular infection. The potential of SEM in morphological investigations of epithelial surfaces is discussed. PMID:20155290

Millaku, Agron; Leser, Vladka; Drobne, Damjana; Godec, Matjaz; Torkar, Matjaz; Jenko, Monika; Milani, Marziale; Tatti, Francesco

2010-05-01

326

Roles of lung epithelium in neutrophil recruitment during pneumococcal pneumonia.  

PubMed

Epithelial cells line the respiratory tract and interface with the external world. Epithelial cells contribute to pulmonary inflammation, but specific epithelial roles have proven difficult to define. To discover unique epithelial activities that influence immunity during infection, we generated mice with nuclear factor-?B RelA mutated throughout all epithelial cells of the lung and coupled this approach with epithelial cell isolation from infected and uninfected lungs for cell-specific analyses of gene induction. The RelA mutant mice appeared normal basally, but in response to pneumococcus in the lungs they were unable to rapidly recruit neutrophils to the air spaces. Epithelial cells expressed multiple neutrophil-stimulating cytokines during pneumonia, all of which depended on RelA. Cytokine expression by nonepithelial cells was unaltered by the epithelial mutation of RelA. Epithelial cells were the predominant sources of CXCL5 and granulocyte-macrophage colony-stimulating factor (GM-CSF), whereas nonepithelial cells were major sources for other neutrophil-activating cytokines. Epithelial RelA mutation decreased whole lung levels of CXCL5 and GM-CSF during pneumococcal pneumonia, whereas lung levels of other neutrophil-recruiting factors were unaffected. Defective neutrophil recruitment in epithelial mutant mice could be rescued by administration of CXCL5 or GM-CSF. These results reveal a specialized immune function for the pulmonary epithelium, the induction of CXCL5 and GM-CSF, to accelerate neutrophil recruitment in the infected lung. PMID:24010952

Yamamoto, Kazuko; Ahyi, Ayele-Nati N; Pepper-Cunningham, Zachary A; Ferrari, Joseph D; Wilson, Andrew A; Jones, Matthew R; Quinton, Lee J; Mizgerd, Joseph P

2014-02-01

327

Tubular (acinar) transformation of the choroid plexus epithelium.  

PubMed

The choroid plexus in the normal state shows a beautiful papillary (or villous) architecture supported by the intricately ramifying, thin fibrovascular stroma. This configuration is retained in benign and malignant neoplasms derived therefrom. The choroid plexus was involved in the pathological process of leukemic cell infiltration in one case reported here and in chronic cryptococcal leptomeningitis in the other case. The epithelial cells of the choroid plexus of the lateral ventricle were arranged extensively in a tubular (acinar) configuration, in association with remarkable stromal fibrosis caused by an infiltration of leukemic or inflammatory cells. In addition, choroid plexus epithelial cells in the first case contained a moderate amount of intracytoplasmic glycogen. These two cases indicate that the non-neoplastic choroid plexus epithelium can undergo transformation into a tubular (acinar) structure as a response or adaptation to the fibrotic processes of the stroma. This finding should be differentiated from metastatic adenocarcinoma. This finding also provides some suggestions as to the pathogenesis of "tubular (acinar) adenoma," a rare variant of benign choroid plexus neoplasm. PMID:12455886

Shintaku, Masayuki

2002-01-01

328

Measurement of the human esophageal cancer in an early stage with Raman spectroscopy  

NASA Astrophysics Data System (ADS)

The esophageal cancer has a tendency to transfer to another part of the body and the surgical operation itself sometimes gives high risk in vital function because many delicate organs exist near the esophagus. So the esophageal cancer is a disease with a high mortality. So, in order to lead a higher survival rate five years after the cancer's treatment, the investigation of the diagnosis methods or techniques of the cancer in an early stage and support the therapy are required. In this study, we performed the ex vivo experiments to obtain the Raman spectra from normal and early-stage tumor (stage-0) human esophageal sample by using Raman spectroscopy. The Raman spectra are collected by the homemade Raman spectrometer with the wavelength of 785 nm and Raman probe with 600-um-diameter. The principal component analysis (PCA) is performed after collection of spectra to recognize which materials changed in normal part and cancerous pert. After that, the linear discriminant analysis (LDA) is performed to predict the tissue type. The result of PCA indicates that the tumor tissue is associated with a decrease in tryptophan concentration. Furthermore, we can predict the tissue type with 80% accuracy by LDA which model is made by tryptophan bands.

Maeda, Yasuhiro; Ishigaki, Mika; Taketani, Akinori; Andriana, Bibin B.; Ishihara, Ryu; Sato, Hidetoshi

2014-02-01

329

Downregulated expression of PTK6 is correlated with poor survival in esophageal squamous cell carcinoma.  

PubMed

To investigate the clinical prognostic value of protein tyrosine kinase 6 (PTK6) in patients with esophageal squamous cell carcinoma (ESCC), quantitative RT-PCR and Western blotting were utilized to measure the mRNA and protein expression levels of PTK6 in 29 and eight pairs of ESCC and peritumoral normal esophageal tissues, respectively. Furthermore, the expression of PTK6 protein in 210 ESCCs was examined with immunohistochemistry (IHC), and its clinical value was analyzed using Kaplan-Meier plots and the Cox proportional hazards regression model. The results found that the expression levels of both PTK6 mRNA and protein in ESCC tissues were significantly lower than those in peritumoral normal esophageal tissues. Regarding the IHC analysis of ESCC, the cytoplasmic expression of PTK6 was significantly correlated with tumor grade (P < 0.001). Compared with patients with low PTK6 expression, ESCC patients with overexpression of PTK6 displayed preferable disease-free survival (DFS) and overall survival (OS) (P < 0.001 and P = 0.001, respectively), especially in stage II disease (P = 0.002 and P = 0.021, respectively). PTK6 was evaluated as an independent prognostic factor for ESCC using multivariate Cox regression analysis. All data demonstrated that the expression level of PTK6 is an independent prognostic factor in ESCCs. Low expression of PTK6 is correlated with poor DFS and OS in ESCCs. PMID:25377660

Chen, You-Fang; Ma, Gang; Cao, Xun; Huang, Zhi-Liang; Zeng, Mu-Sheng; Wen, Zhe-Sheng

2014-12-01

330

Esophageal perforation post pneumatic dilatation for achalasia managed by esophageal stenting  

PubMed Central

Patient: Female, 82 Final Diagnosis: Achalasia Symptoms: Nocturnal regurgtation • weight loss Medication: — Clinical Procedure: Esophageal stenting Specialty: Gastroenterology • Hepatology Objective: Unusual or unexpected effect of treatment Background: Pneumatic dilatation is one of the most effective methods for treating achalasia. Esophageal perforation is the most serious complication after pneumatic dilatation and has been reported to occur in the range of 1 to 4.3%. The appropriate management of esophageal perforation can range from conservative medical treatment to surgical intervention. Case Report: We report a case of an 82-year-old male who had an 8 month history of dysphagia for solid and liquids, a 10 lb weight loss and nocturnal regurgitation. The diagnosis of achalasia was established by endoscopic; barium and manometric criteria. He underwent a pneumatic dilation with a 30 mm Rigiflex balloon. A confined or limited esophageal perforation projecting into the mediastinum and located 1–2 cm above the diaphragm was confirmed by a gastrografin swallow study performed immediately after the procedure. There was some accompanying epigastric abdominal pain. Patient was treated later that day by placing a fully covered metallic esophageal stent in addition to antibiotics, proton pump inhibitor, and fasting. Patient was discharged home 3 days later able to eat liquid-soft foods. Follow up endoscopy 2 weeks later and a gastrografin swallow showed a completely healed perforation and the stent was removed. Symptomatically he has done well, with no dysphagia or heartburn at six and twelve months follow up. Conclusions: Early esophageal stenting for esophageal perforation after pneumatic dilation for achalasia is a treatment option which accelerates healing shortens recovery period, as well as decreasing hospital stay and costs. PMID:24349606

Elhanafi, Sherif; Othman, Mohamed; Sunny, Joseph; Said, Sarmad; Cooper, Chad J.; Alkhateeb, Haider; Quansah, Raphael; McCallum, Richard

2013-01-01

331

VEGF Modulation of Retinal Pigment Epithelium Resistance  

PubMed Central

Fluid accumulation into the subretinal space and the development of macular edema is a common condition in age-related macular degeneration, diabetic retinopathy, and following ocular surgery, or injury. Vascular endothelial growth factor (VEGF) and other cytokines have been implicated in the disruption of retinal pigment epithelium (RPE) barrier function and a reduction in the regulated removal of subretinal fluid; however, the cellular and molecular events linking these agents to the disruption of barrier function have not been established. In the current study, cultures of ARPE-19 and primary porcine retinal pigment epithelium (RPE) cells were utilized to investigate the effects of the VEGF-induced modifications to the barrier properties of the RPE. The barrier function was determined by transepithelial resistance (TER) measurements and morphology of the RPE monolayers. In both ARPE-19 and primary porcine RPE cells the administration of VEGF produced a significant drop in TER, and this response was only observed following apical administration. Maximum reduction in TER was reached 5 hours post VEGF administration. These responses were concentration-dependent with an EC50 of 502 pg/mL in ARPE-19 cells and 251 pg/mL in primary porcine cells. In both ARPE-19 and primary RPE cells, the response to VEGF was blocked by pretreatment with the relatively selective VEGF-R2 antagonists, SU5416 or ZM323881, or the protein tyrosine kinase inhibitor, genistein. Administration of the relatively selective VEGF-R2 agonist, VEGF-E, also reduced TER in a concentration-dependent manner (EC50 of 474 pg/mL), while VEGF-R1 agonist, placental growth factor (PlGF), did not significantly alter the TER. Immunolocalization studies demonstrated that confluent monolayers exhibited continuous cell-to-cell ZO-1 protein contacts and apical localization of the VEGF-R2 receptors. These data provide evidence that the VEGF-induced breakdown of RPE barrier function is mediated by the activation of apically-oriented VEGF-R2 receptors. Thus, VEGF-mediated increases in RPE permeability are initiated by a rise in intraocular levels of VEGF. PMID:17915218

Ablonczy, Zsolt; Crosson, Craig E.

2008-01-01

332

Detection of esophageal ulcerations with technetium-99m albumin sucralfate  

SciTech Connect

Technetium-99m albumin-sucralfate ((/sup 99m/Tc)Su) can be used to demonstrate peptic ulcer disease in man and animals. We evaluated the usefulness of (/sup 99m/Tc)Su for detecting various grades of esophagitis. (/sup 99m/Tc)Su adhered to the distal esophagus for up to 3 hr in five of six patients with esophageal ulcers but adhered to only two of nine with lesser degrees of esophagitis. No adherence was seen in five patients without esophagitis. Thus, (/sup 99m/Tc)Su may not be useful for detecting any but the most severe grade of esophagitis. Based on these results, we speculate that the previously documented beneficial effects of sucralfate on mild to moderate esophagitis may be due to other mechanisms besides adherence to the ulcerated mucosa.

Goff, J.S.; Adcock, K.A.; Schmelter, R.

1986-07-01

333

Endoglin Promoter Hypermethylation Identifies a Field Defect in Human Primary Esophageal Cancer  

PubMed Central

Endoglin (ENG) is a 180-kDa transmembrane glycoprotein that functions as a component of the transforming growth factor-? receptor complex. Recently, ENG promoter hypermethylation was reported in several human cancers. We examined ENG promoter hypermethylation using real-time quantitative methylation-specific PCR in 260 human esophageal tissues. ENG hypermethylation showed highly discriminative receiver-operator characteristic curve profiles, clearly distinguishing esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC) from normal esophagus (N) (p<0.01). Interestingly, ENG normalized methylation values were significantly higher in ESCC than in N (p<0.01) or EAC (p<0.01). ENG hypermethylation frequency was 46.2% in ESCC and 11.9% in N, but increased early and sequentially during EAC-associated neoplastic progression, to 13.3% in Barrett’s metaplasia (BE), 25% in dysplastic BE (D), and 26.9% in frank EAC. ENG hypermethylation was significantly higher in N from ESCC patients (mean = 0.0186) than in N from EAC patients (mean = 0.0117; p < 0.05). Treatment of KYSE220 ESCC cells with the demethylating agent, 5-aza-2?-deoxycytidine, reversed ENG methylation and reactivated ENG mRNA expression. We conclude that promoter hypermethylation of ENG is a frequent, tissue-specific event in human ESCC and exhibits a field defect with promising biomarker potential for the early detection of ESCC. In addition, ENG hypermethylation occurs in a subset of human EAC, and early during BE-associated esophageal neoplastic progression. PMID:23893879

Jin, Zhe; Zhao, Zhenfu; Cheng, Yulan; Dong, Ming; Zhang, Xiaojing; Wang, Liang; Fan, Xinmin; Feng, Xianling; Mori, Yuriko; Meltzer, Stephen J

2013-01-01

334

Gene expression profile of esophageal cancer in North East India by cDNA microarray analysis  

PubMed Central

AIM: To identify alterations in genes and molecular functional pathways in esophageal cancer in a high incidence region of India where there is a widespread use of tobacco and betel quid with fermented areca nuts. METHODS: Total RNA was isolated from tumor and matched normal tissue of 16 patients with esophageal squamous cell carcinoma. Pooled tumor tissue RNA was labeled with Cy3-dUTP and pooled normal tissue RNA was labeled with Cy5-dUTP by direct labeling method. The labeled probes were hybridized with human 10K cDNA chip and expression profiles were analyzed by Genespring GX V 7.3 (Silicon Genetics). RESULTS: Nine hundred twenty three genes were differentially expressed. Of these, 611 genes were upregulated and 312 genes were downregulated. Using stringent criteria (P ? 0.05 and ? 1.5 fold change), 127 differentially expressed genes (87 upregulated and 40 downregulated) were identified in tumor tissue. On the basis of Gene Ontology, four different molecular functional pathways (MAPK pathway, G-protein coupled receptor family, ion transport activity, and serine or threonine kinase activity) were most significantly upregulated and six different molecular functional pathways (structural constituent of ribosome, endopeptidase inhibitor activity, structural constituent of cytoskeleton, antioxidant activity, acyl group transferase activity, eukaryotic translation elongation factor activity) were most significantly downregulated. CONCLUSION: Several genes that showed alterations in our study have also been reported from a high incidence area of esophageal cancer in China. This indicates that molecular profiles of esophageal cancer in these two different geographic locations are highly consistent. PMID:17457978

Chattopadhyay, Indranil; Kapur, Sujala; Purkayastha, Joydeep; Phukan, Rupkumar; Kataki, Amal; Mahanta, Jagadish; Saxena, Sunita

2007-01-01

335

Building and maintaining the epithelium of the lung  

PubMed Central

Airspaces of the lung are lined by an epithelium whose cellular composition changes along the proximal-to-distal axis to meet local functional needs for mucociliary clearance, hydration, host defense, and gas exchange. Advances in cell isolation, in vitro culture techniques, and genetic manipulation of animal models have increased our understanding of the development and maintenance of the pulmonary epithelium. This review discusses basic cellular mechanisms that regulate establishment of the conducting airway and gas exchange systems as well as the functional maintenance of the epithelium during postnatal life. PMID:22850882

Rackley, Craig R.; Stripp, Barry R.

2012-01-01

336

Changes in the adult vertebrate auditory sensory epithelium after trauma.  

PubMed

Auditory hair cells transduce sound vibrations into membrane potential changes, ultimately leading to changes in neuronal firing and sound perception. This review provides an overview of the characteristics and repair capabilities of traumatized auditory sensory epithelium in the adult vertebrate ear. Injured mammalian auditory epithelium repairs itself by forming permanent scars but is unable to regenerate replacement hair cells. In contrast, injured non-mammalian vertebrate ear generates replacement hair cells to restore hearing functions. Non-sensory support cells within the auditory epithelium play key roles in the repair processes. PMID:23178236

Oesterle, Elizabeth C

2013-03-01

337

Mechanism of enhancement of esophageal tumorigenesis by 6-phenylhexyl isothiocyanate  

Microsoft Academic Search

6-Phenylhexyl isothiocyanate (PHITC) enhances esophageal tumorigenesis induced by the carcinogen N-nitrosomethylben-zylamine (NMBA) in rats while its shorter chain analog, phenethyl isothiocyanate (PEITC), inhibits NMBA-induced esophageal tumorigenesis. A significant increase in O6-methylguanine levels in esophageal DNA at 72 h after NMBA administration to rats pretreated with PHITC suggested that PHITC might enhance NMBA metabolic activation or inhibit DNA repair. To test

Mark A. Morse; Jerry Lu; Rajaram Gopalakrishnan; Lisa A. Peterson; Gulzar Wani; Gary D. Stoner

1997-01-01

338

Role of Positron Emission Tomography in Staging Esophageal Cancer  

Microsoft Academic Search

Background. Conventional noninvasive staging of esophageal cancer is inaccurate. This study investigated the role of positron emission tomography (PET) in staging esophageal cancer.Methods. Patients with potentially resectable esophageal cancer were included. A whole-body PET scan was acquired after injection of 18F-fluorodeoxyglucose and was evaluated for areas of increased focal uptake. Accuracy was determined by comparing PET with surgical staging.Results. Potentially

James D Luketich; Philip R Schauer; Carolyn Cidis Meltzer; Rodney J Landreneau; G. Kathleen Urso; David W Townsend; Peter F Ferson; Robert J Keenan; Chandra P Belani

1997-01-01

339

HER2 amplification, overexpression and score criteria in esophageal adenocarcinoma  

PubMed Central

The HER2 oncogene was recently reported to be amplified and overexpressed in esophageal adenocarcinoma. However, the relationship of HER2 amplification in esophageal adenocarcinoma with prognosis has not been well defined. The scoring systems for clinically evaluating HER2 in esophageal adenocarcinoma are not established. The aims of the study were to establish a HER2 scoring system and comprehensively investigate HER2 amplification and overexpression in esophageal adenocarcinoma and its precursor lesion. Using a tissue microarray, containing 116 cases of esophageal adenocarcinoma, 34 cases of BE, 18 cases of low grade dysplasia and 15 cases of high grade dysplasia, HER2 amplification and overexpression were analyzed by HercepTest and CISH methods. The amplification frequency in an independent series of 116 esophageal adenocarcinoma samples was also analyzed using Affymetrix SNP 6.0 microarrays. In our studies, we have found that HER2 amplification does not associate with poor prognosis in total 232 esophageal adenocarcinoma patients by CISH and high density microarrays. We further confirm the similar frequency of HER2 amplification by CISH (18.10%; 21/116) and SNP 6.0 microarrays (16.4%, 19/116) in esophageal adenocarcinoma. HER2 protein overexpression was observed in 12.1 % (14/116) of esophageal adenocarcinoma and 6.67% (1/15) of HGD. No HER2 amplification or overexpression was identified in BE or LGD. All HER2 protein overexpression cases showed HER2 gene amplification. Gene amplification was found to be more frequent by CISH than protein overexpression in esophageal adenocarcinoma (18.10% vs 12.9%). A modified two-step model for esophageal adenocarcinoma HER-2 testing is recommend for clinical esophageal adenocarcinoma HER-2 trial. PMID:21460800

Hu, Yingchuan; Bandla, Santhoshi; Godfrey, Tony E.; Tan, Dongfeng; Luketich, James D.; Pennathur, Arjun; Qiu, Xing; Hicks, David G.; Peters, Jeffrey; Zhou, Zhongren

2011-01-01

340

Dosimetric and clinical predictors for radiation-induced esophageal injury  

Microsoft Academic Search

Purpose: To evaluate the clinical and three-dimensional dosimetric parameters associated with esophageal injury after radiotherapy (RT) for non-small-cell lung cancer. Methods and materials: The records of 254 patients treated for non-small-cell lung cancer between 1992 and 2001 were reviewed. A variety of metrics describing the esophageal dose were extracted. The Radiation Therapy Oncology Group toxicity criteria for grading of esophageal

Sung-Ja Ahn; Daniel Kahn; Sumin Zhou; Xiaoli Yu; Donna M. S. Hollis; Timothy D. Shafman; Lawrence B.. Marks

2005-01-01

341

Radiation-induced esophageal strictures in children with cancer  

Microsoft Academic Search

.   The purpose of this study was to determine the long-term esophageal side effects of irradiation and (doxorubicin) chemotherapy\\u000a given to children with cancer. Barium esophagograms and medical records of 18 patients with esophagitis who received between\\u000a 1200 and 5580 cGy to the chest and chemotherapy were reviewed. The age range was 3–14 years. Esophageal strictures occuring\\u000a 1–10 years after

S. Mahboubi; J. H. Silber

1997-01-01

342

Multielectrode array recordings of the vomeronasal epithelium.  

PubMed

Understanding neural circuits requires methods to record from many neurons simultaneously. For in vitro studies, one currently available technology is planar multielectrode array (MEA) recording. Here we document the use of MEAs to study the mouse vomeronasal organ (VNO), which plays an essential role in the detection of pheromones and social cues via a diverse population of sensory neurons expressing hundreds of types of receptors. Combining MEA recording with a robotic liquid handler to deliver chemical stimuli, the sensory responses of a large and diverse population of neurons can be recorded. The preparation allows us to remove the intact neuroepithelium of the VNO from the mouse and stimulate with a battery of chemicals or potential ligands while monitoring the electrical activity of the neurons for several hours. Therefore, this technique serves as a useful method for assessing ligand activity as well as exploring the properties of receptor neurons. We present the techniques needed to prepare the vomeronasal epithelium, MEA recording, and chemical stimulation. PMID:20195238

Arnson, Hannah A; Fu, Xiaoyan; Holy, Timothy E

2010-01-01

343

Macrophage and Retinal Pigment Epithelium Phagocytosis  

PubMed Central

Noninflammatory monocyte macrophages use ?v?3 integrin to selectively bind apoptotic cells, initiating their phagocytic removal. In a related process, the retinal pigment epithelium (RPE) employs ?v?5 integrin to recognize spent photoreceptor outer segment particles (OS). Here, we show that apoptotic cells and OS compete for binding to these receptors, indicating that OS and apoptotic cells expose surface signals recognizable by ?v?3 and ?v?5. Particle binding to ?v?5 required protein kinase C (PKC) activation. In RPE, ?v?5 binding was maximally activated even before any phagocytic challenge and was reduced by PKC inhibitors. In macrophages, it was dormant but became activated upon PKC stimulation. PKC-activated ?v?5-mediated binding in macrophages differed from constitutive binding to the same integrin receptor in RPE cells in that the former followed much faster kinetics, similar to particle binding mediated by ?v?3. Activation of ?v?5 for particle binding correlated with its recruitment into a detergent-insoluble fraction, a process sensitive to pharmacological modulation of PKC in both types of phagocytes. Furthermore, ?v?5 but not ?v?3 particle binding required actin microfilaments. These data constitute the first evidence that noninflammatory phagocytes actively regulate the earliest phase of phagocytic clearance, particle binding, by controlling receptor activity. PMID:10499924

Finnemann, Silvia C.; Rodriguez-Boulan, Enrique

1999-01-01

344

Desmoglein-1 regulates esophageal epithelial barrier function and immune responses in eosinophilic esophagitis.  

PubMed

The desmosomal cadherin desmoglein-1 (DSG1) is an essential intercellular adhesion molecule that is altered in various human cutaneous disorders; however, its regulation and function in allergic disease remains unexplored. Herein, we demonstrate a specific reduction in DSG1 in esophageal biopsies from patients with eosinophilic esophagitis (EoE), an emerging allergic disorder characterized by chronic inflammation within the esophageal mucosa. Further, we show that DSG1 gene silencing weakens esophageal epithelial integrity, and induces cell separation and impaired barrier function (IBF) despite high levels of desmoglein-3. Moreover, DSG1 deficiency induces transcriptional changes that partially overlap with the transcriptome of inflamed esophageal mucosa; notably, periostin (POSTN), a multipotent pro-inflammatory extracellular matrix molecule, is the top induced overlapping gene. We further demonstrate that IBF is a pathological feature in EoE, which can be partially induced through the downregulation of DSG1 by interleukin-13 (IL-13). Taken together, these data identify a functional role for DSG1 and its dysregulation by IL-13 in the pathophysiology of EoE and suggest that the loss of DSG1 may potentiate allergic inflammation through the induction of pro-inflammatory mediators such as POSTN. PMID:24220297

Sherrill, J D; Kc, K; Wu, D; Djukic, Z; Caldwell, J M; Stucke, E M; Kemme, K A; Costello, M S; Mingler, M K; Blanchard, C; Collins, M H; Abonia, J P; Putnam, P E; Dellon, E S; Orlando, R C; Hogan, S P; Rothenberg, M E

2014-05-01

345

Characterization of Matriptase Expression in Normal Human Tissues  

Microsoft Academic Search

Matriptase is a type II transmembrane serine protease that has been implicated in the progression of epithelium-derived tumors. The role of this protease in the biology of normal epithelial cells remains to be elucidated. Matriptase mRNA has been detected by Northern analysis in tissues rich in epithelial cells, and the protein is expressed in vivo in normal and cancerous breast,

Michael D. Oberst; Baljit Singh; Metin Ozdemirli; Robert B. Dickson; Michael D. Johnson; Chen-Yong Lin

2003-01-01

346

Innovative techniques in evaluating the esophagus; imaging of esophageal morphology and function; and drugs for esophageal disease.  

PubMed

This paper reporting on techniques for esophageal evaluation and imaging and drugs for esophageal disease includes commentaries on endoscopy techniques including dye-based high-resolution and dye-less high-definition endoscopy; the shift from CT to MRI guidance in tumor delineation for radiation therapy; the role of functional lumen imaging in measuring esophageal distensibility; electrical stimulation of the lower esophageal sphincter (LES) as an alternative to fundoduplication for treatment of gastroesophageal reflux disease (GERD); the morphological findings of reflux esophagitis and esophageal dysmotility on double-contrast esophagography; the value of videofluoroscopy in assessing protecting mechanisms in patients with chronic reflux or swallowing disorders; targeting visceral hypersensitivity in the treatment of refractory GERD; and the symptoms and treatments of nighttime reflux and nocturnal acid breakthrough (NAB). PMID:24117631

Neumann, Helmut; Neurath, Markus F; Vieth, Michael; Lever, Frederiek M; Meijer, Gert J; Lips, Irene M; McMahon, Barry P; Ruurda, J P; van Hillegersberg, R; Siersema, P; Levine, Marc S; Scharitzer, Martina; Pokieser, Peter; Zerbib, Frank; Savarino, Vincenzo; Zentilin, Patrizia; Savarino, Edoardo; Chan, Walter W

2013-10-01

347

Esophageal cancer: Recent advances in screening, targeted therapy, and management  

PubMed Central

The incidence of esophageal cancer remains on the rise worldwide and despite aggressive research in the field of gastrointestinal oncology, the survival remains poor. Much remains to be defined in esophageal cancer, including the development of an effective screening tool, identifying a good tumor marker for surveillance purposes, ways to target esophageal cancer stem cells as well as circulating tumor cells, and developing minimally invasive protocols to treat early-stage disease. The goal of this chapter is to highlight some of the recent advances and ongoing research in the field of esophageal cancer.

Gaur, Puja; Kim, Min P.; Dunkin, Brian J.

2014-01-01

348

A Case of Esophageal Squamous Cell Carcinoma with Pancreatic Metastasis  

PubMed Central

Solitary pancreatic metastasis of esophageal cancer is extremely rare. We report the case of a 58-year-old male admitted with esophageal cancer. Additional asymptomatic solitary hepatic and pancreatic masses were observed in the staging work-up for esophageal cancer. The hepatic mass was confirmed as a primary hepatocellular carcinoma with an ultrasound-guided needle biopsy. An esophagectomy with a distal pancreatectomy and radiofrequency ablation for hepatocellular carcinoma were performed. Histologically, the pancreatic mass was confirmed to be a metastasis from the esophageal cancer. The patient has been followed up with chemotherapy. PMID:23614134

Park, Choulki; Kim, Youn Hwa; Hwang, Eun Jung; Na, Ki Yong; Kim, Kyung-Yup; Park, Jae Hyun; Chang, Young Woon

2013-01-01

349

Intramural esophagic hematoma secondary to coumarinic anticoagulation: a case report  

PubMed Central

Esophagic Intramural Hematoma is an uncommon clinical condition, with a prognosis which is essentially benign. On most cases, a predisposing or precipitating factor may be seen, with the most common ones being the history of esophagic instrumentation, food impactations and thrombocytopenia. In the following manuscript, the authors present the case of a 54-years-old male with history of valve replacement surgery, who was treated at the Clinica Cardiovascular (Medellin, Colombia), with a clinical case of Intramural Esophagic Hematoma that was later confirmed to be due to a Coumarinic overanticoagulation. On this case, it is evidenced that Intramural Esophagic Hematoma is an unrecognized complication of Courmarinic anticoagulation therapy. PMID:20069068

2009-01-01

350

Laparoscopic surgery for gastro-esophageal acid reflux disease.  

PubMed

Gastro-esophageal reflux disease is a troublesome disease for many patients, severely affecting their quality of life. Choice of treatment depends on a combination of patient characteristics and preferences, esophageal motility and damage of reflux, symptom severity and symptom correlation to acid reflux and physician preferences. Success of treatment depends on tailoring treatment modalities to the individual patient and adequate selection of treatment choice. PubMed, Embase, The Cochrane Database of Systematic Reviews, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched for systematic reviews with an abstract, publication date within the last five years, in humans only, on key terms (laparosc* OR laparoscopy*) AND (fundoplication OR reflux* OR GORD OR GERD OR nissen OR toupet) NOT (achal* OR pediat*). Last search was performed on July 23nd and in total 54 articles were evaluated as relevant from this search. The laparoscopic Toupet fundoplication is the therapy of choice for normal-weight GERD patients qualifying for laparoscopic surgery. No better pharmaceutical, endoluminal or surgical alternatives are present to date. No firm conclusion can be stated on its cost-effectiveness. Results have to be awaited comparing the laparoscopic 180-degree anterior fundoplication with the Toupet fundoplication to be a possible better surgical alternative. Division of the short gastric vessels is not to be recommended, nor is the use of a bougie or a mesh in the vast majority of GERD patients undergoing surgery. The use of a robot is not recommended. Anti-reflux surgery is to be considered expert surgery, but there is no clear consensus what is to be called an 'expert surgeon'. As for setting, ambulatory settings seem promising although high-level evidence is lacking. PMID:24485258

Schijven, Marlies P; Gisbertz, Suzanne S; van Berge Henegouwen, Mark I

2014-02-01

351

Effects of Vitamin D Receptor Knockout on Cornea Epithelium Gap Junctions  

PubMed Central

Purpose. Gap junctions are present in all corneal cell types and have been shown to have a critical role in cell phenotype determination. Vitamin D has been shown to influence cell differentiation, and recent work demonstrates the presence of vitamin D in the ocular anterior segment. This study measured and compared gap junction diffusion coefficients among different cornea epithelium phenotypes and in keratocytes using a noninvasive technique, fluorescence recovery after photobleaching (FRAP), and examined the influence of vitamin D receptor (VDR) knockout on epithelial gap junction communication in intact corneas. Previous gap junction studies in cornea epithelium and keratocytes were performed using cultured cells or ex vivo invasive techniques. These invasive techniques were unable to measure diffusion coefficients and likely were disruptive to normal cell physiology. Methods. Corneas from VDR knockout and control mice were stained with 5(6)-carboxyfluorescein diacetate (CFDA). Gap junction diffusion coefficients of the corneal epithelium phenotypes and of keratocytes, residing in intact corneas, were detected using FRAP. Results. Diffusion coefficients equaled 18.7, 9.8, 5.6, and 4.2 ?m2/s for superficial squamous cells, middle wing cells, basal cells, and keratocytes, respectively. Corneal thickness, superficial cell size, and the superficial squamous cell diffusion coefficient of 10-week-old VDR knockout mice were significantly lower than those of control mice (P < 0.01). The superficial cell diffusion coefficient of heterozygous mice was significantly lower than control mice (P < 0.05). Conclusions. Our results demonstrate differences in gap junction dye spread among the epithelial cell phenotypes, mirroring the epithelial developmental axis. The VDR knockout influences previously unreported cell-to-cell communication in superficial epithelium. PMID:24722695

Lu, Xiaowen; Watsky, Mitchell A.

2014-01-01

352

Impairment of ocular surface epithelium barrier function in patients with atopic dermatitis  

PubMed Central

AIMS—To assess the integrity of the ocular surface epithelium in patients with atopic dermatitis from the viewpoint of its barrier function.?METHODS—49 patients with atopic dermatitis with blepharoconjunctivitis (ABC group), 27 age matched patients with seasonal or perennial allergic conjunctivitis (AC group), and 20 volunteers with normal healthy eyes (NH group) were assigned to this study. Ocular surface epithelium barrier function was evaluated by the fluorophotometric method using a slit lamp fluorophotometer. 3 µl of 0.5% sodium fluorescein was instilled into the conjunctival sac of the right eye and fluorescein uptake (ng/ml) 30 minutes later (20 minutes after eye washing) was measured in the central cornea and the temporal bulbar conjunctiva. Fluorophoto metric measurements performed were analysed in each group and compared between the groups.?RESULTS—The ABC group showed significantly higher fluorescein uptake (mean 28.2 (SEM 3.3) ng/ml) in the cornea than the AC (11.4 (2.2), p=0.001) and NH groups (9.3 (2.1), p=0.001). There was no significant difference between the AC and NH groups (p=0.930). The ABC group also showed significantly higher fluorescein uptake in the bulbar conjunctiva (393.4 (54.0)) than the AC (182.9 (24.6), p=0.011) and NH groups (169.3 (29.1), p=0.012). There was also no significant difference in fluorescein uptake between the AC group and the NH group (p=0.987).?CONCLUSION—This study suggested that ocular surface epithelium barrier function is impaired in patients with atopic dermatitis with blepharoconjunctivitis. ?? Keywords: atopic blepharoconjunctivitis; ocular surface epithelium; barrier function; fluorophotometry PMID:9924375

Yokoi, K.; Yokoi, N.; Kinoshita, S.

1998-01-01

353

Radiation-Induced Esophagitis Exacerbated by Everolimus  

PubMed Central

Background Everolimus, a potent mammalian target of rapamycin (mTOR) inhibitor, has shown anticancer activity against various types of cancer, including renal cell carcinoma (RCC); however, little information is available on the efficacy and safety of the combination of everolimus and radiotherapy. We report a case of radiation-induced esophagitis that might have been exacerbated by the sequential administration of everolimus. Case Presentation A 63-year-old Japanese man with RCC complained of back pain, and magnetic resonance imaging revealed vertebral metastases. He received radiotherapy (30 Gy/10 fractions) to the T6–10 vertebrae. Everolimus was administered immediately after the completion of radiotherapy. One week later, he complained of dysphagia, nausea and vomiting. An endoscopic examination of the esophagus showed erosive esophagitis in the middle to lower portions of his thoracic esophagus, corresponding to the irradiation field. Conclusion Clinicians should be aware that everolimus might lead to the unexpected exacerbation of radiation toxicities. PMID:23898276

Miura, Yuji; Suyama, Koichi; Shimomura, Akihiko; Miyakawa, Jimpei; Kobayashi, Hiroki; Uki, Akiyoshi; Okaneya, Toshikazu; Takano, Toshimi

2013-01-01

354

Peroral endoscopic myotomy for esophageal achalasia  

PubMed Central

Peroral endoscopic myotomy (POEM) is one of the alternative treatment for achalasia. Due to concept of natural orifice transluminal endoscopic surgery (NOTES), it becomes popular and widely accepted. With the endoluminal technique, submucosal tunnel was created followed by endoscopic myotomy. POEM is not only indicated in classical achalasia but also other abnormal esophageal motility disorders. Moreover, failures of endoscopic treatment or surgical attempted cases are not contraindicated for POEM. The second attempted POEM is also safe and technically feasible. Even though the legend of success of POEM is fruitful, the possible complications are very frightened. Good training and delicate practice will reduce rate of complications. This review provides a summary of current state-of-the-art of POEM, including indication equipments, technique and complications. This perfect procedure may become the treatment of choice of achalasia and some esophageal motility disorders in the near future. PMID:25333007

Inoue, Haruhiro; Ikeda, Haruo; Sato, Hiroki; Sato, Chiaki; Hokierti, Chananya

2014-01-01

355

Biological effects of singlet delta oxygen on respiratory tract epithelium  

Microsoft Academic Search

Summary Exposure of hamster tracheal organ cultures to gas phase singlet delta oxygen,1O2, at atmospheric pressure produced significant alterations in the mucociliary epithelium resulting in changes in ciliary activity and cellular morphology.

W. C. Eisenberg; K. Taylor; L. J. Schiff

1984-01-01

356

Effect of acetic acid on optical coherence tomography (OCT) images of cervical epithelium.  

PubMed

Optical coherence tomography (OCT) can be used as an adjunct to colposcopy in the identification of precancerous and cancerous cervical lesions. The purpose of this study was to investigate the effect of acetic acid on OCT imaging. OCT images were taken from unsuspicious and suspicious areas of fresh conization specimens immediately after resection and 3 and 10 min after application of 6 % acetic acid. A corresponding histology was obtained from all sites. The images taken 3 and 10 min after application of acetic acid were compared to the initial images with respect to changes in brightness, contrast, and scanning depth employing a standard nonparametric test of differences of proportions. Further, mean intensity backscattering curves were calculated from all OCT images in the histological groups CIN3, inflammation, or normal epithelium. Mean difference profiles within each of these groups were determined, reflecting the mean differences between the condition before application of acetic acid and the exposure times 3 and 10 min, respectively. According to the null hypothesis, the difference profiles do not differ from profiles fluctuating around zero in a stationary way, which implies that the profiles do not differ significantly from each other. The null hypothesis was tested employing the KPSS test. The visual analysis of 137 OCT images from 46 sites of 10 conization specimens revealed a statistically significant increase in brightness for all three groups and a statistically significant decrease in contrast for normal epithelium after 10 min. Further, an increase in scanning depth was noted for normal epithelium after 10 min and for CIN3 after 3 min. The analysis of mean intensity profiles showed an increased backscattering intensity after application of acetic acid. Acetic acid significantly affects the quality of OCT images. Overall brightness and scanning depth increase with the opposite effect regarding the image contrast. Whether the observed changes facilitate the distinction between dysplastic lesions in a clinical setting needs to be shown in further studies. PMID:24828107

Gallwas, Julia; Stanchi, Anna; Dannecker, Christian; Ditsch, Nina; Mueller, Susanna; Mortensen, Uwe; Stepp, Herbert

2014-11-01

357

Eosinophilic Esophagitis: update on treatment approaches  

PubMed Central

?osinophilic esophagitis (EoE) is a clinical entity with continuously increasing incidence in children and adults. Diet therapy and corticosteroids are the most important therapeutic interventions currently used, while new therapies are being developed, based on the research of the disease mechanisms. In this review we assess the results of the latest clinical trials on management of patients with EoE, and the advances in the development of novel drug therapies. Hippokratia 2012; 16 (3): 200-204 PMID:23935283

Fotis, L; Xatzipsalti, M; Papadopoulou, A

2012-01-01

358

Advances in Barrett's esophagus and esophageal adenocarcinoma.  

PubMed

Despite advances in diagnosis and therapy, esophageal adenocarcinoma remains an aggressive and usually lethal tumor. This review focuses on the epidemiology of esophageal adenocarcinoma and its presumed precursor lesion, Barrett's esophagus; the pathogenesis of the cancer; advances in treatment of adenocarcinoma and Barrett's esophagus; and strategies for cancer prevention. Emphasis is placed on recent literature. Although the absolute number of cases of adenocarcinoma in the United States is still small, the incidence of this cancer has increased dramatically in the last 40 years, and adenocarcinoma is now the predominant form of esophageal cancer in this country. Recent evidence suggests that Barrett's esophagus is more prevalent in asymptomatic individuals than previously appreciated. The pathogenesis of Barrett's esophagus is poorly understood. Given that some subjects will have repeated bouts of severe erosive esophagitis and never develop Barrett's esophagus, host factors must play an important role. The utility of neoadjuvant radiation and chemotherapy in those with adenocarcinoma, although they are widely practiced, is not of clear benefit, and some authorities recommend against it. Ablative therapies, as well as endoscopic mucosal resection, hold promise for those with superficial cancer or high-grade dysplasia. Most series using these modalities feature relatively short follow-up, and longer-term data will be necessary to better describe the effects of these therapies. The value of chemoprevention in subjects with dysplastic Barrett's esophagus by use of cyclooxygenase 2 inhibitors, nonsteroidal anti-inflammatory drugs, or proton pump inhibitors is unknown. Similarly, although endoscopic screening is widely practiced, its value in patients with chronic gastroesophageal reflux disease symptoms is of unproven value, and recommending bodies are divided as to its practice. PMID:15887151

Shaheen, Nicholas J

2005-05-01

359

Diagnostic and therapeutic strategies for eosinophilic esophagitis  

PubMed Central

Eosinophilic esophagitis (EoE) is a recently recognized allergic disorder, characterized by eosophageal dysfunction, accumulation of ?15 eosinophils/high-powered field, eosinophil microabssess, basal cell hyperplasia, extracellular eosinophilic granules in the esophageal epithelial mucosal biopsy and a lack of response to a 8-week proton pump inhibitor treatment. Despite the increased incidences and considerable progress made in understanding EoE pathogenesis, there are limited diagnostic and therapeutic options available for EoE. Currently, the only criterion for diagnosing EoE is repetitive esophageal endoscopic biopsies and histopathological evaluation. Antigen elimination or corticosteroid therapies are effective therapies for EoE but are expensive and have limitations, if continued in the long term. Hence, there is a great necessity for novel noninvasive diagnostic biomarkers that can easily diagnose EoE and assess effectiveness of therapy. Herein, we have provided an update on key molecules involved in the disease initiation, and progression and proposed novel noninvasive diagnostic molecules and strategies for EoE therapy.

Zaidi, Asifa K; Mussarat, Ahad; Mishra, Anil

2014-01-01

360

Treatment of early and delayed esophageal perforation.  

PubMed

Esophageal perforations are life threatening emergencies associated with high morbidity and mortality. We report on 22 consecutive patients (age 20-86; 13 female and 9 male) with an oesophageal perforation treated at the university hospital Duesseldorf. The patients' charts were reviewed and follow-up was completed for all patients until demission, healed reconstruction or death. Patients' history, clinical presentation, time interval to surgical presentation, and treatment modality were recorded and correlated with patients' outcome. Six esophageal perforations were due to a Boerhaave-syndrome, eleven caused by endoscopic perforation, two after osteosynthesis of the cervical spine and three foreign body induced. In 7 patients a primary local suture was performed, in 4 cases a supplemental muscle flap was interposed, and 7 patients underwent an oesophageal resection. Four patients were treated without surgery (three esophageal stent implantations, one conservative treatment). Eleven patients (50 %) were presented within 24 h of perforation, and 11 patients (50 %) afterwards. Time delay correlates with survival. In 17 (80.9 %) cases a surgical sufficient reconstruction could be achieved. One (4.7 %) patient is waiting for reconstruction after esophagectomy. Four (18.2 %) patients died. A small subset of patients can be treated conservatively by stenting of the Esophagus, if the patient presents early. In the majority of patients a primary repair (muscle flap etc.) can be performed with good prognosis. If the patient presents delayed with extensive necrosis or mediastinitis, oesophagectomy and secondary repair is the only treatment option with high mortality. PMID:24465104

Kroepil, F; Schauer, M; Raffel, A M; Kröpil, P; Eisenberger, C F; Knoefel, W T

2013-12-01

361

Analysis of esophageal-sparing treatment plans for patients with high-grade esophagitis.  

PubMed

We retrospectively generated IMRT plans for 14 NSCLC patients who had experienced grade 2 or 3 esophagitis (CTCAE version 3.0). We generated 11-beam and reduced esophagus dose plan types to compare changes in the volume and length of esophagus receiving doses of 50, 55, 60, 65, and 70 Gy. Changes in planning target volume (PTV) dose coverage were also compared. If necessary, plans were renormalized to restore 95% PTV coverage. The critical organ doses examined were mean lung dose, mean heart dose, and volume of spinal cord receiving 50 Gy. The effect of interfractional motion was determined by applying a three-dimensional rigid shift to the dose grid. For the esophagus plan, the mean reduction in esophagus V50, V55, V60, V65, and V70 Gy was 2.8, 4.1, 5.9, 7.3, and 9.5 cm(3), respectively, compared with the clinical plan. The mean reductions in LE50, LE55, LE60, LE65, and LE70 Gy were 2.0, 3.0, 3.8, 4.0, and 4.6 cm, respectively. The mean heart and lung dose decreased 3.0 Gy and 2.4 Gy, respectively. The mean decreases in 90% and 95% PTV coverage were 1.7 Gy and 2.8 Gy, respectively. The normalized plans' mean reduction of esophagus V50, V55, V60, V65, and V70 Gy were 1.6, 2.0, 2.9, 3.9, and 5.5 cm(3), respectively, compared with the clinical plans. The normalized plans' mean reductions in LE50, LE55, LE60, LE65, and LE70 Gy were 4.9, 5.2, 5.4, 4.9, and 4.8 cm, respectively. The mean reduction in maximum esophagus dose with simulated interfractional motion was 3.0 Gy and 1.4 Gy for the clinical plan type and the esophagus plan type, respectively. In many cases, the esophagus dose can be greatly reduced while maintaining critical structure dose constraints. PTV coverage can be restored by increasing beam output, while still obtaining a dose reduction to the esophagus and maintaining dose constraints. PMID:23835390

Niedzielski, Joshua; Bluett, Jaques B; Williamson, Ryan T; Liao, Zhongxing; Gomez, Daniel R; Court, Laurence E

2013-01-01

362

Breast cancer resistance protein (BCRP) and excision repair cross complement-1 (ERCC1) expression in esophageal cancers and response to cisplatin and irinotecan based chemotherapy  

PubMed Central

Background Esophageal cancer patients face a dismal outcome despite tri-modality management and median survival remains 15-18 months. Breast cancer resistance protein (BCRP) is an ATP-dependent efflux protein associated with chemotherapy resistance. The role of BCRP expression in esophageal cancer and normal esophageal cells is not known. Excision repair cross complement-1 (ERCC1) overexpression has been correlated with poorer response to cisplatin based chemotherapy. We examined the expression of BCRP and ERCC1 in patients with esophageal cancer and correlated it with survival in patients receiving irinotecan and cisplatin based chemotherapy. Methods With IRB approval, 40 cases of esophageal cancer diagnosed from 2004-2008, were stained for BCRP and ERCC1 expression by immunohistochemistry and scored by a pathologist blinded to clinical data. Baseline demographics, therapy given and survival data were collected and correlated with BCRP and ERCC1 expression. Fisher’s exact test was used to determine association between BCRP and ERCC1 expression and demographics. Cox proportional hazards model was used for association of BCRP and ERCC1 with survival. Results On immunohistochemistry, 30/40 cancers (75%) expressed BCRP. Interestingly, down-regulation of BCRP expression in tumor compared with normal cells was seen in 40% of patients. ERCC1 positivity was seen in 15/30 cases (50%). Median overall survival (OS) was 19 months with no difference in survival between BCRP positive and negative patients (P=0.13) or ERCC1 positive and negative patients (P=0.85). Estimated hazard ratio (HR) of death for BRCP positive patients was 2.29 (95% CI: 0.79-6.64) and for ERCC1 positive patients was 1.09 (95% CI: 0.46-2.56). There was no association of BCRP and ERCC1 expression with disease stage, age, gender or histology. For patients who received cisplatin and irinotecan as first line chemotherapy, there was no difference in survival based on BCRP or ERCC1 status. Conclusions BCRP expression is seen in a majority of esophageal cancers and normal esophageal mucosa. ERCC1 expression is seen in about half of the patients with esophageal cancer. Irinotecan based studies with esophageal and gastric cancer suggest response rates of 14-65%. Whether the 40% of tumors in our study found with down regulation of BCRP expression, constitute a majority of these responders needs to be prospectively validated in a larger data set. It should include markers such as ERCC1 predicting response to 5-fluorouracil and platinum based chemotherapy, to enable individualizing therapy for this cancer. PMID:25083297

Bharthuar, Anubha; Black, Jennifer D.; Levea, Charles; Malhotra, Usha; Mashtare, Terry L.; Iyer, Renuka

2014-01-01

363

Extracellular matrix stiffness and composition jointly regulate the induction of malignant phenotypes in mammary epithelium  

NASA Astrophysics Data System (ADS)

In vitro models of normal mammary epithelium have correlated increased extracellular matrix (ECM) stiffness with malignant phenotypes. However, the role of increased stiffness in this transformation remains unclear because of difficulties in controlling ECM stiffness, composition and architecture independently. Here we demonstrate that interpenetrating networks of reconstituted basement membrane matrix and alginate can be used to modulate ECM stiffness independently of composition and architecture. We find that, in normal mammary epithelial cells, increasing ECM stiffness alone induces malignant phenotypes but that the effect is completely abrogated when accompanied by an increase in basement-membrane ligands. We also find that the combination of stiffness and composition is sensed through ?4 integrin, Rac1, and the PI3K pathway, and suggest a mechanism in which an increase in ECM stiffness, without an increase in basement membrane ligands, prevents normal ?6?4 integrin clustering into hemidesmosomes.

Chaudhuri, Ovijit; Koshy, Sandeep T.; Branco da Cunha, Cristiana; Shin, Jae-Won; Verbeke, Catia S.; Allison, Kimberly H.; Mooney, David J.

2014-10-01

364

Expression of migfilin is increased in esophageal cancer and represses the Akt-?-catenin activation  

PubMed Central

Cell adhesion proteins that connect each cell to neighboring cells and the extracellular matrix are an important determinant of cell morphology and metastasis. Migfilin is a member of LIM-containing protein family, mediated the linkage between cytoskeleton and focal adhesion through interacting with other proteins and involved in cell adhesion and motility. The present study used immunohistochemistry and Western blot analysis of migfilin in clinical specimens of esophageal squamous cell carcinoma (ESCC) to identify that the expression of migfilin was significantly upregulated in ESCC in concomitance with a nuclear-cytoplasm translocation compared to normal adjacent tissue. Alternately, using the published datasets we identified that the expression of ?-catenin was upregulated in esophageal cancer cells with focal invasion, while inversely correlated with migfilin in esophageal cancer cell lines. We demonstrated that the reduced expression of ?-catenin by migfilin was through the inhibition of Akt activation. In conclusion, these results illustrated that migfilin upregulated in ESCCs and repressed ?-catenin in an Akt-GSK3? signaling dependent manner. PMID:24959381

He, Huan; Ding, Fang; Li, Sheng; Chen, Hongyan; Liu, Zhihua

2014-01-01

365

Gastroesophageal reflux symptoms not responding to proton pump inhibitor: GERD, NERD, NARD, esophageal hypersensitivity or dyspepsia?  

PubMed

Gastroesophageal reflux (GER) is a common gastrointestinal process that can generate symptoms of heartburn and chest pain. Proton pump inhibitors (PPIs) are the gold standard for the treatment of GER; however, a substantial group of GER patients fail to respond to PPIs. In the past, it was believed that acid reflux into the esophagus causes all, or at least the majority, of symptoms attributed to GER, with both erosive esophagitis and nonerosive outcomes. However, with modern testing techniques it has been shown that, in addition to acid reflux, the reflux of nonacid gastric and duodenal contents into the esophagus may also induce GER symptoms. It remains unknown how weakly acidic or alkaline refluxate with a pH similar to a normal diet induces GER symptoms. Esophageal hypersensitivity or functional dyspepsia with superimposed heartburn may be other mechanisms of symptom generation, often completely unrelated to GER. Detailed studies investigating the pathophysiology of esophageal hypersensitivity are not conclusive, and definitions of the various disease states may overlap and are often confusing. The authors aim to clarify the pathophysiology, definition, diagnostic techniques and medical treatment of patients with heartburn symptoms who fail PPI therapy. PMID:24719900

Bashashati, Mohammad; Hejazi, Reza A; Andrews, Christopher N; Storr, Martin A

2014-06-01

366

DADS suppresses human esophageal xenograft tumors through RAF/MEK/ERK and mitochondria-dependent pathways.  

PubMed

Diallyl disulfide (DADS) is a natural organosulfur compound isolated from garlic. DADS has various biological properties, including anticancer, antiangiogenic, and antioxidant effects. However, the anticancer mechanisms of DADS in human esophageal carcinoma have not been elucidated, especially in vivo. In this study, MTT assay showed that DADS significantly reduced cell viability in human esophageal carcinoma ECA109 cells, but was relatively less toxic in normal liver cells. The pro-apoptotic effect of DADS on ECA109 cells was detected by Annexin V-FITC/propidium iodide (PI) staining. Flow cytometry analysis showed that DADS promoted apoptosis in a dose-dependent manner and the apoptosis rate could be decreased by caspase-3 inhibitor Ac-DEVD-CHO. Xenograft study in nude mice showed that DADS treatment inhibited the growth of ECA109 tumor in both 20 and 40 mg/kg DADS groups without obvious side effects. DADS inhibited ECA109 tumor proliferation by down-regulating proliferation cell nuclear antigen (PCNA). DADS induced apoptosis by activating a mitochondria-dependent pathway with the executor of caspase-3, increasing p53 level and Bax/Bcl-2 ratio, and downregulating the RAF/MEK/ERK pathway in ECA109 xenograft tumosr. Based on studies in cell culture and animal models, the findings here indicate that DADS is an effective and safe anti-cancer agent for esophageal carcinoma. PMID:25026173

Yin, Xiaoran; Zhang, Jun; Li, Xiaoning; Liu, Dong; Feng, Cheng; Liang, Rongrui; Zhuang, Kun; Cai, Chenlei; Xue, Xinghuan; Jing, Fuchun; Wang, Xijing; Wang, Jun; Liu, Xinlian; Ma, Hongbing

2014-01-01

367

Irinotecan, cisplatin, and radiation in esophageal cancer.  

PubMed

The limited effectiveness of currently available chemotherapy in the treatment of advanced esophageal cancer, and the poor survival achieved in locally advanced disease with combined chemoradiotherapy with or without surgery, have prompted the evaluation of new agents. Irinotecan (CPT-11, Camptosar) has promising single-agent activity in gastrointestinal cancers. In phase II evaluation of weekly irinotecan plus cisplatin, response rates have exceeded 30% in esophageal and gastric cancers. Irinotecan is an active radiosensitizer in preclinical studies and clinical trials in lung cancer. We performed a phase I trial of weekly irinotecan, cisplatin, and concurrent radiotherapy in locally advanced esophageal cancer. Induction chemotherapy with irinotecan and cisplatin was given prior to radiotherapy, over 6 weeks, cycled on a 2-week-on, 1-week-off schedule to relieve dysphagia. Radiotherapy was given subsequently in 180-cGy daily fractions to a total dose of 5,040 cGy. Doses of chemotherapy, when given with concurrent radiotherapy, were cisplatin at 30 mg/m2 followed by irinotecan at escalated doses (40, 50, 65, and 80 mg/m2), on days 1, 8, 22, and 29. Among 18 patients entered in the trial, minimal toxicity has been observed, with no grade 3/4 esophagitis or diarrhea. Hematologic toxicity has been minimal. Dose-limiting toxicity (ie, requiring more than a 2-week delay in radiotherapy) has been seen in one of three patients at the 80-mg/M2 irinotecan dose level, and accrual continues at this dose level. Among 13 evaluable patients, five complete responses have been seen (38%), including three pathologic complete responses in 10 patients undergoing surgery (30%). Asymptomatic pulmonary emboli were noted on the posttreatment computed tomography scan in 3 of 15 patients, prompting the addition of warfarin sodium (Coumadin) prophylaxis on protocol. Full doses of weekly irinotecan (65 mg/ m2) and cisplatin (30 mg/m2) can be combined safely with concurrent radiotherapy in patients with locally advanced esophageal cancer. PMID:12109799

Ilson, David H; Minsky, Bruce; Kelsen, David

2002-05-01

368

The Prevalence and Diagnostic Utility of Endoscopic Features of Eosinophilic Esophagitis: A Meta-Analysis  

PubMed Central

Background & Aims Endoscopic findings such as esophageal rings, strictures, narrow-caliber esophagus, linear furrows, white plaques, and pallor or decreased vasculature might indicate the presence of eosinophilic esophagitis (EoE). We aimed to determine the prevalence and diagnostic utility of endoscopic features of EoE. Methods We conducted a systematic review and meta-analysis. PubMed, EMBASE, and GI meeting abstracts were searched to identify studies that included ? 10 patients with EoE and reported endoscopic findings. Pooled prevalence, sensitivity, specificity, and predictive values were calculated using random- and mixed-effects models. Results The search yielded 100 articles and abstracts on 4678 patients with EoE and 2742 without (controls). In subjects with EoE, the overall pooled prevalence of esophageal rings was 44%, strictures 21%, narrow-caliber esophagus 9%, linear furrows 48%, white plaques 27%, and pallor/decreased vasculature 41%. Substantial heterogeneity existed among studies. Results from endoscopy examinations were normal in 17% of patients, but this number decreased to 7% when the analysis was limited to prospective studies (P<.05). Overall levels of sensitivity were modest, ranging from 15% to 48%, whereas levels of specificity were greater, ranging from 90% to 95%. Positive predictive values ranged from 51% to 73% and negative predictive values ranged from 74% to 84%. Conclusions There is heterogeneity among studies in the reported prevalence of endoscopic findings in patients with EoE, but in prospective studies, at least 1 abnormality was detected by endoscopy in 93% of patients. The operating characteristics of endoscopic findings alone are inadequate for diagnosis of EoE. Esophageal biopsies should be obtained from all patients with clinical features of EoE, regardless of the endoscopic appearance of the esophagus. PMID:22610003

Kim, Hannah P.; Vance, R. Brooks; Shaheen, Nicholas J.; Dellon, Evan S.

2012-01-01

369

Complications following Video-Assisted Transhiatal Esophagectomy for Esophageal Cancer  

Microsoft Academic Search

Background: The aim of the study was to evaluate the clinical safety and usefulness of esophageal dissection under laparoscopic monitoring during transhiatal esophagectomy for esophageal cancer. Patients and Methods: The study group of 115 patients included 102 men and 13 women. The mean age was 57 (range 32-79) years. Tumor histology showed a squamous cell carcinoma in 75% and an

Pawel Lampe; Marek Olakowski; Andrzej Wojtyczka; Andrzej Lekstan; Alex Alli-Balogun

2005-01-01

370

Blood Supply Routes of Recurrent Esophageal Varices following Endoscopic Embolization  

Microsoft Academic Search

Background\\/Aim: The blood supply routes of recurrent esophageal varices following complete endoscopic embolization (EE) are not yet known. The purpose of this study is to identify these blood supply routes by comparing endoscopic varicography and percutaneous transhepatic portography (PTP). Methods: Eleven cases of recurrent esophageal varices following EE are included in this study. The blood supply routes of primary and

Fumio Chikamori; Sadao Nishio; Nobutoshi Kuniyoshi; Susumu Shibuya; Yasuhiro Takase

2000-01-01

371

Proposed Revision Of The Staging Classification For Esophageal Cancer  

Microsoft Academic Search

Objectives: This study analyzed survival with respect to lymph node involvement to develop a new staging system for patients with esophageal cancer that accurately reflects prognosis. Methods: The records of patients undergoing resection of primary esophageal cancer from 1989 to 1993 were reviewed. The data collected included patient age and sex, tumor histologic characteristics and location, the use of preoperative

Robert J. Korst; Valerie W. Rusch; Ennapadam Venkatraman; Manjit S. Bains; Michael E. Burt; Robert J. Downey; Robert J. Ginsberg

1998-01-01

372

Peptidergic and nitrinergic denervation in congenital esophageal stenosis  

Microsoft Academic Search

Congenital esophageal stenosis (CES) is a rare disorder with narrowed esophageal lumen that presents as dysphagia from childhood and that is often associated with tracheobronchial remnants or webs. The pathogenesis of CES is unknown. The aim of this study was to examine the histological and immunohistochemical features of CES. Esophagi from 2 young adults with CES and 3 controls with

Chandar Singaram; Mark A. Sweet; Eric A. Gaumnitz; Alan J. Cameron; Michael Camilleri

1995-01-01

373

Long-term survival after photodynamic therapy for esophageal cancer  

Microsoft Academic Search

Background\\/Aims: Photodynamic therapy (PDT) has been adapted to the endoscopic treatment of digestive cancer, but its indications and efficacy remain uncertain. The aim of this study was to assess its feasibility in the curative treatment of small esophageal tumors. Methods: From 1983 to 1991, PDT was used to treat 123 patients with esophageal cancer who were recommended for nonsurgical treatment

Alain Sibille; René Lambert; Jean-Christophe Souquet; Ghislaine Sabben; Françoise Descos

1995-01-01

374

Enucleation of a giant esophageal gastrointestinal stromal tumor.  

PubMed

Despite development of novel chemotherapy for gastrointestinal stromal tumors (GISTs), complete resection remains the gold standard treatment. Because of the small number of reported esophageal gastrointestinal stromal tumors, the optimal extent of resection is not well defined. We present a case of an 82-year-old man with an 11-cm esophageal gastrointestinal stromal tumor who was successfully treated with enucleation. PMID:19379921

Milman, Steven; Kim, Anthony W; Farlow, Erin; Liptay, Michael J

2009-05-01

375

Concurrent Chemoradiotherapy for Esophageal Cancer With Malignant Fistula  

Microsoft Academic Search

Background: We reviewed clinical results of chemoradiotherapy (CRT) in the treatment of patients with advanced esophageal cancer with fistulae that developed before or during CRT. Methods and Materials: The study group included 16 patients with fistulous esophageal cancer treated by means of CRT between 1999 and 2006. Nine patients had fistulae before CRT, whereas 7 developed fistulae during CRT. The

Ryuta Koike; Yasumasa Nishimura; Kiyoshi Nakamatsu; Shuichi Kanamori; Toru Shibata

2008-01-01

376

Esophageal Carcinoma with Celiac Nodal Metastases; Curative or Palliative?  

Microsoft Academic Search

Introduction: To determine the prognostic value of celiac lymph- adenopathy for patients with esophageal or gastroesophageal junc- tion carcinomas treated with neoadjuvant or definitive chemoradio- therapy. Methods: The records of patients undergoing chemoradiation ther- apy for esophageal cancer, who received a dose of at least 45 Gy, were retrospectively reviewed. Results: One hundred forty-four patients were eligible for this retrospective

Marco Trovo; Jeffrey Bradley; Issam El Naqa; Ethan Foster; Bryan Meyers; Ramaswamy Govindan; Alexander Patterson

2008-01-01

377

Endoscopic Management of Difficult or Recurrent Esophageal Strictures  

Microsoft Academic Search

Esophageal strictures are a common problem in gastroenterological practice. In general, the management of malignant or benign esophageal strictures is different and requires a different treatment approach. In daily clinical practice, stent placement is a commonly used modality for the palliation of incurable malignant strictures causing dysphagia, whereas, if available, intraluminal brachytherapy can be considered in patients with a good

Laetitia R H de Wijkerslooth; Frank P Vleggaar; Peter D Siersema

2011-01-01

378

Prevention of esophageal strictures after endoscopic submucosal dissection  

PubMed Central

Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) have recently been accepted as less invasive methods for treating patients with early esophageal cancers such as squamous cell carcinoma and dysplasia of Barrett’s esophagus. However, the large defects in the esophageal mucosa often cause severe esophageal strictures, which dramatically reduce the patient’s quality of life. Although preventive endoscopic balloon dilatation can reduce dysphagia and the frequency of dilatation, other approaches are necessary to prevent esophageal strictures after ESD. This review describes several strategies for preventing esophageal strictures after ESD, with a particular focus on anti-inflammatory and tissue engineering approaches. The local injection of triamcinolone acetonide and other systemic steroid therapies are frequently used to prevent esophageal strictures after ESD. Tissue engineering approaches for preventing esophageal strictures have recently been applied in basic research studies. Scaffolds with temporary stents have been applied in five cases, and this technique has been shown to be safe and is anticipated to prevent esophageal strictures. Fabricated autologous oral mucosal epithelial cell sheets to cover the defective mucosa similarly to how commercially available skin products fabricated from epidermal cells are used for skin defects or in cases of intractable ulcers. Fabricated autologous oral-mucosal-epithelial cell sheets have already been shown to be safe. PMID:25386058

Kobayashi, Shinichiro; Kanai, Nobuo; Ohki, Takeshi; Takagi, Ryo; Yamaguchi, Naoyuki; Isomoto, Hajime; Kasai, Yoshiyuki; Hosoi, Takahiro; Nakao, Kazuhiko; Eguchi, Susumu; Yamamoto, Masakazu; Yamato, Masayuki; Okano, Teruo

2014-01-01

379

Incision of recurrent distal esophageal (Schatzki) ring after dilation  

Microsoft Academic Search

Background: Distal esophageal (Schatzki) ring is a frequent cause of dysphagia. Bougienage is generally effective but relapse is common. Outcomes for patients treated by endoscopic incision of distal esophageal rings after symptomatic relapses after bougienage are described. Methods: Eleven patients (2 women, 9 men; median age 61 years; range 24 to 81 years) with recurrent dysphagia after bougienage with large

James A. DiSario; Peder J. Pedersen; Cristina Bichi?-Canoutas; Stephen C. Alder; John C. Fang

2002-01-01

380

Osmotic water permeability of Necturus gallbladder epithelium  

PubMed Central

An electrophysiological technique that is sensitive to small changes in cell water content and has good temporal resolution was used to determine the hydraulic permeability (Lp) of Necturus gallbladder epithelium. The epithelial cells were loaded with the impermeant cation tetramethylammonium (TMA+) by transient exposure to the pore-forming ionophore nystatin in the presence of bathing solution TMA+. Upon removal of the nystatin a small amount of TMA+ is trapped within the cell. Changes in cell water content result in changes in intracellular TMA+ activity which are measured with intracellular ion-sensitive microelectrodes. We describe a method that allows us to determine the time course for the increase or decrease in the concentration of osmotic solute at the membrane surface, which allows for continuous monitoring of the difference in osmolality across the apical membrane. We also describe a new method for the determination of transepithelial hydraulic permeability (Ltp). Apical and basolateral membrane Lp's were assessed from the initial rates of change in cell water volume in response to anisosmotic mucosal or serosal bathing solutions, respectively. The corresponding values for apical and basolateral membrane Lp's were 0.66 x 10(-3) and 0.38 x 10(-3) cm/s.osmol/kg, respectively. This method underestimates the true Lp values because the nominal osmotic differences (delta II) cannot be imposed instantaneously, and because it is not possible to measure the true initial rate of volume change. A model was developed that allows for the simultaneous determination of both apical and basal membrane Lp's from a unilateral exposure to an anisosmotic bathing solution (mucosal). The estimates of apical and basal Lp with this method were 1.16 x 10(-3) and 0.84 x 10(-3) cm/s.osmol/kg, respectively. The values of Lp for the apical and basal cell membranes are sufficiently large that only a small (less than 3 mosmol/kg) transepithelial difference in osmolality is required to drive the observed rate of spontaneous fluid absorption by the gallbladder. Furthermore, comparison of membrane and transepithelial Lp's suggests that a large fraction of the transepithelial water flow is across the cells rather than across the tight junctions. PMID:2732678

1989-01-01

381

Esophageal laceration and obstruction caused by a foreign body in 2 young foals  

PubMed Central

This report describes 2 foals with esophageal laceration due to ingestion of foreign bodies. Endoscopic examination of the esophagus revealed full thickness esophageal laceration in 1 colt and partial thickness laceration of the esophagus in the other. The esophageal obstruction was relieved by repetitive esophageal lavages and flush under general anesthesia in both foals. PMID:22210941

Abutarbush, Sameeh M.

2011-01-01

382

Expression of COX2 and p53 in Rat Esophageal Cancer Induced by Reflux of Duodenal Contents  

PubMed Central

Aim. Reflux of duodenal contents can induce mucosal injury, stimulate cell proliferation, and promote tumorigenesis. We examined the expression of COX2 and p53 in rat esophageal lesions induced by duodenal content reflux. Methods. Thirty 8-week-old male Wistar rats were exposed to duodenal content esophageal reflux. All animals underwent an esophagoduodenal anastomosis (EDA) with total gastrectomy in order to produce chronic esophagitis. Ten rats were the sham. Control. They were sacrificed at the 40th week. Their esophagi were examined for HE, COX2, p53, and proliferating cell nuclear antigen (PCNA). Results. After 40 weeks of reflux, dysplasia, squamous cell carcinoma (SCC), and adenocarcinoma (ADC) were found. PCNA labeling index was higher in dysplastic and cancer tissue than that in normal. Overexpression of COX2 was shown in ADC and SCC. Wild-type p53 accumulation was found in ADC, and not in SCC. Conclusion. Reflux of duodenal contents into the esophagus led to ADC and SCC in rats. COX2 may play an important role in esophageal cancer by duodenal content reflux. Our present results suggest an association between wild-type p53 accumulation and COX2 expression in ADC, with no such relation seen in SCC. PMID:22272378

Hashimoto, Naoki

2012-01-01

383

Tracheoplasty using the thymus against tracheo-esophageal fistula due to necrotizing tracheobronchitis in a very low birth weight infant.  

PubMed

We report a case of a very low birth weight infant treated successfully with tracheoplasty using the thymus against tracheo-esophageal fistula due to necrotizing tracheobronchitis. A baby boy was born at 31 weeks gestation with a birth body weight of 1,230?g. Suddenly on Day 19, his respiration deteriorated, and a flexible bronchofiberscopy showed tracheostenosis, tracheomalacia, and tracheal diverticula. On Day 21, his abdomen became significantly distended, and a flexible bronchofiberscopy showed a tracheo-esophageal fistula due to a rupture of the diverticula. On Day 105, during surgery, we confirmed necrosis of the trachea. Because the lesion was widespread, we used the thymus for tracheoplasty and closure of the tracheo-esophageal fistula. His post-operative course went well, and was discharged at 1 year 9 months of age. Now, 8 years after the operation, although he still needs a T-tube airway management through tracheostomy, he has achieved speech, normal growth and development, and takes regular classes at school. Tracheoplasty using the thymus is thought to be a treatment worth considering when there are no other effective alternative treatments for tracheo-esophageal fistula due to necrotizing tracheobronchitis. PMID:24610831

Hasegawa, Hisaya; Nagase, Yuzo; Sakai, Miho; Henmi, Nobuhide; Tsuruta, Shio

2014-09-01

384

The Effect of Beta-Aminopropionitrile and Prednisolone on the Prevention of Fibrosis in Alkali Esophageal Burns: An Experimental Study  

PubMed Central

Objective. The aim of this study was to investigate the efficacy of beta-aminopropionitrile (BAPN) and prednisolone on the prevention of esophageal damage and stricture formation after caustic esophageal burn. Method. Twenty-eight rats were divided into four equal groups. In groups 1, 2, and 3, caustic esophageal burns were generated by applying NaOH to the 1.5?cm segment of the abdominal esophagus. Group 4 was for the sham. Normal saline to group 1, BAPN to group 2, and prednisolone to group 3 were administered intraperitoneally as a single daily dose. Results. Treatment with BAPN decreased the stenosis index (SI) and histopathologic damage score (HDS) seen in caustic esophageal burn rats. The SI in group 4 was significantly lower compared with groups 1, 2, and 3. Group 2 had the minimum SI value in corrosive burn groups. The differences related to SI between groups 1, 2, and 3 were not statistically significant. The HDS was significantly lower in group 4 compared with groups 1, 2, and 3. The HDS in group 2 was significantly lower compared with groups 1 and 3. Conclusion. This study demonstrated that BAPN was able to decrease the development of stenosis and tissue damage better than prednisolone. PMID:24391667

Aciksari, Kurtulus; Yanar, Hakan Teoman; Hepgul, Gulcin; Yanar, Fatih; Agcaoglu, Orhan; Eser, Mediha; Tanriverdi, Gamze; Topacoglu, Hakan; Ayvaci, Baris Murat; Dogan, Halil; Gunay, Kayihan; Ertekin, Cemalettin; Celikmen, Ferudun

2013-01-01

385

Imaging the morphological change of tissue structure during the early phase of esophageal tumor progression using multiphoton microscopy  

NASA Astrophysics Data System (ADS)

Esophageal cancer is a common malignancy with a very poor prognosis. Successful strategies for primary prevention and early detection are critically needed to control this disease. Multiphoton microscopy (MPM) is becoming a novel optical tool of choice for imaging tissue architecture and cellular morphology by two-photon excited fluorescence. In this study, we used MPM to image microstructure of human normal esophagus, carcinoma in situ (CIS), and early invasive carcinoma in order to establish the morphological features to differentiate these tissues. The diagnostic features such as the appearance of cancerous cells, the significant loss of stroma, the absence of the basement membrane were extracted to distinguish between normal and cancerous esophagus tissue. These results correlated well with the paired histological findings. With the advancement of clinically miniaturized MPM and the multi-photon probe, combining MPM with standard endoscopy will therefore allow us to make a real-time in vivo diagnosis of early esophageal cancer at the cellular level.

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

2012-12-01

386

[Autopsy results of an elderly case of Parkinson's disease and aorto-esophageal fistula who died of a massive hematemesis during prolonged bed rest].  

PubMed

An 81-year-old female patient with an 8-year history of Parkinson's disease was hospitalized because of aspiration pneumonia. The clinical course of her pneumonia was prolonged because of dysphagia with a short period of remission, and she required a long period of bed rest. She received supportive nutrition via a nasogastric tube and many peroral medications that consisted of 3 anti-Parkinsonian drugs and 5 anti-bacterial or anti-tussive agents. Six months after admission, she vomited fresh blood through the nasogastric tube, then went into hypovolemic shock. Hemodynamic stability was temporarily achieved by blood transfusion. Gastroduodenal endoscopic examination could not reveal the exact bleeding site because of massive blood clots. Five days later, the patient died of a massive hematemesis. Autopsy revealed 2 chronic longitudinal ulcers, each 1.7 x 0.4 cm in size, in the upper portion of the esophagus. One of them had developed a fistula to the aorta. Neither esophageal carcinoma nor a foreign body was detected around the fistula. Atherosclerosis of the aorta was mild and the perforation channel was covered with the esophageal epithelium. The fistula was assumed to be a product of local esophageal injury due to drug retention. PMID:8331833

Suzuki, H; Kawai, S; Okada, R; Hayashi, Y; Kanazawa, A; Mizuno, Y; Obata, K; Shiotsu, H; Kuwabara, N

1993-05-01

387

Global expression profiling of globose basal cells and neurogenic progression within the olfactory epithelium.  

PubMed

Ongoing, lifelong neurogenesis maintains the neuronal population of the olfactory epithelium in the face of piecemeal neuronal turnover and restores it following wholesale loss. The molecular phenotypes corresponding to different stages along the progression from multipotent globose basal cell (GBC) progenitor to differentiated olfactory sensory neuron are poorly characterized. We used the transgenic expression of enhanced green fluorescent protein (eGFP) and cell surface markers to FACS-isolate ?Sox2-eGFP(+) GBCs, Neurog1-eGFP(+) GBCs and immature neurons, and ?OMP-eGFP(+) mature neurons from normal adult mice. In addition, the latter two populations were also collected 3 weeks after olfactory bulb ablation, a lesion that results in persistently elevated neurogenesis. Global profiling of mRNA from the populations indicates that all stages of neurogenesis share a cohort of >2,100 genes that are upregulated compared to sustentacular cells. A further cohort of >1,200 genes are specifically upregulated in GBCs as compared to sustentacular cells and differentiated neurons. The increased rate of neurogenesis caused by olfactory bulbectomy had little effect on the transcriptional profile of the Neurog1-eGFP(+) population. In contrast, the abbreviated lifespan of ?OMP-eGFP(+) neurons born in the absence of the bulb correlated with substantial differences in gene expression as compared to the mature neurons of the normal epithelium. Detailed examination of the specific genes upregulated in the different progenitor populations revealed that the chromatin modifying complex proteins LSD1 and coREST were expressed sequentially in upstream ?Sox2-eGFP(+) GBCs and Neurog1-eGFP(+) GBCs/immature neurons. The expression patterns of these proteins are dynamically regulated after activation of the epithelium by methyl bromide lesion. PMID:22847514

Krolewski, Richard C; Packard, Adam; Schwob, James E

2013-03-01

388

Bevacizumab and Combination Chemotherapy Before Surgery in Treating Patients With Locally Advanced Esophageal or Stomach Cancer  

ClinicalTrials.gov

Adenocarcinoma of the Esophagus; Adenocarcinoma of the Gastroesophageal Junction; Diffuse Adenocarcinoma of the Stomach; Intestinal Adenocarcinoma of the Stomach; Mixed Adenocarcinoma of the Stomach; Squamous Cell Carcinoma of the Esophagus; Stage IA Esophageal Cancer; Stage IA Gastric Cancer; Stage IB Esophageal Cancer; Stage IB Gastric Cancer; Stage IIA Esophageal Cancer; Stage IIA Gastric Cancer; Stage IIB Esophageal Cancer; Stage IIB Gastric Cancer; Stage IIIA Esophageal Cancer; Stage IIIA Gastric Cancer; Stage IIIB Esophageal Cancer; Stage IIIB Gastric Cancer; Stage IIIC Esophageal Cancer; Stage IIIC Gastric Cancer

2014-03-17

389

Grafts of porcine intestinal submucosa for repair of cervical and abdominal esophageal defects in the rat.  

PubMed

Porcine small intestinal submucosa (SIS) is a cell-free collagen matrix that has demonstrated its ability as scaffold material for constructive remodeling of damaged or missing tissue. The purpose of this study was to evaluate the morphology and function of esophagoplasty in rat using a porcine SIS scaffold for the repair of a semi-circumferential defect in the cervical or in the abdominal esophagus. Sixty-seven rats underwent surgical excision of the anterior wall either of the cervical or of the abdominal esophagus and subsequent repair of the defect with an SIS patch graft. Outcomes of weight gain, signs of dysphagia, hematological and serum chemistry parameters, and barium swallow studies were used to assess the progress of healing and function over a 150-day time period. The grafts were studied for gross changes and histology at predetermined time points. Ninety-four percent of the SIS-treated rats survived, showing no significant differences in survival rate between groups. The grafted animals did well, without signs of dysphagia, and gaining weight. Barium swallow studies showed no evidence of fistula, significant stenosis, or diverticula. No hematological or serum biochemistry abnormalities were found. By 150 days, the SIS graft was replaced with esophageal-derived tissues. Specimens were completely lined by keratinized stratified squamous epithelium and showed complete regeneration of muscle fibers and scarce immunoreactivity for nerve. In the rat model, a patch graft technique using porcine SIS appears to induce esophageal regrowth either in cervical and abdominal esophagus. The repair mechanism occurred through a regenerative healing process. PMID:16531368

Lopes, Maria Francelina; Cabrita, António; Ilharco, José; Pessa, Pedro; Patrício, João

2006-01-01

390

Overexpression of interleukin-8 receptor 2 (IL-8R2) indicates better prognosis in esophageal adenocarcinoma and squamous cell carcinoma procession.  

PubMed

Researches have showed that interleukin family or receptors play a role in many human tumor progressions including esophageal carcinoma. In this study, we examined the expression of interleukin-8 receptor 2 (IL-8R2) and analyze the relationship between it and esophageal carcinoma clinical characteristics. IL-8R2 protein expression was confirmed by immunohistochemistry and immunofluorescence arrays and was analyzed further via Western blot and qRT-PCR analysis in frozen tissues. The correlation between their expression levels and clinical characteristics were evaluated by Mann-Whitney and Kruskal-Wallis test. Via Kaplan-Meier plots and Cox proportional hazard models, overall survival (OS) was analyzed. Compared with normal esophageal tissue, IL-8R2 protein was overexpressed significantly in esophageal cancer (p < 0.05) and was observed both in cytoplasm and nuclear. The lower expression of IL-8R2 protein was observed with higher p staging of esophageal cancer, and the significant association between them was confirmed (p = 0.000), and in advanced p T stage, the similar result was obtained (p = 0.015); however, compared with lymph node metastasis-negative group, it is no significant difference in positive group (p = 0.152). In a Kaplan-Meier analysis, compared with IL-8R2 low expression, IL-8R2 high expression identified a group of patients with the longest OS. Cox proportional hazard models revealed that IL-8R2 predicted long time to OS. The higher expression of IL-8R2 was found in early esophageal carcinoma, which may indicate that IL-8R2 plays an important role and is better prognostic factor in esophageal cancer development. PMID:24972913

Liang, Bing; Zhao, Hui; Che, Jian-Bo; Wang, Hao-Jie; Shi, Gong-Ning

2014-08-01

391

High Resolution Manometry Correlates of Ineffective Esophageal Motility  

PubMed Central

Background There are currently no criteria for ineffective esophageal motility (IEM) and ineffective swallow (IES) in High Resolution Manometry (HRM) and Esophageal Pressure Topography (EPT). Our aims were to utilize HRM metrics to define IEM within the Chicago Classification and to determine the distal contractile integral (DCI) threshold for IES. Methods The EPT of 150 patients with either dysphagia or reflux symptoms were reviewed for the breaks >2 cm in the proximal, middle and distal esophagus in the 20 mmHg isobaric contour (IBC). Peristaltic function in EPT was defined by the Chicago Classification, the corresponding conventional line tracing (CLT) were reviewed separately for IEM and IES. Generalized linear mixed models were used to find thresholds for DCI corresponding to traditionally determined IES and failed swallows. An external validation sample was used to confirm these thresholds. Results In terms of swallow subtypes, IES in CLT were a mixture of normal, weak and failed peristalsis in EPT. A DCI of 450mmHg-s-cm was determined to be optimal in predicting IES. In the validation sample, the threshold of 450 mmHg-s-cm showed strong agreement with CLT determination of IES (positive percent agreement 83%, negative percent agreement 90%) Thirty-three among 42 IEM patients in CLT had large peristaltic breaks, small peristaltic breaks or ‘frequent failed peristalsis’ in EPT; 87.2% (34/39) of patients classified as normal in CLT had proximal IBC-breaks in EPT. the patient level diagnostic agreement between CLT and EPT was good (78.6% positive percent agreement, 63.9% negative percent agreement), with negative agreement increasing to 92.0% if proximal breaks were excluded. Conclusions The manometric correlate of IEM in EPT is a mixture of failed swallows and IBC break in the middle/ distal troughs. A DCI value<450 mmHg-s-cm can be utilized to predict IES previously defined in CLT. IEM can be defined by >5 swallows with weak /failed peristalsis or with a DCI <450 mmHg-s-cm. PMID:22929758

Xiao, Yinglian; Kahrilas, Peter J.; Kwasny, Mary J.; Roman, Sabine; Lin, Zhiyue; Nicodeme, Frederic; Lu, Chang; Pandolfino, John E.

2013-01-01

392

Removable esophageal stents have poor efficacy for the treatment of refractory benign esophageal strictures (RBES).  

PubMed

With the recent availability of removable esophageal stents, endoscopic stenting has been utilized to treat refractory benign esophageal strictures (RBES). The objective of this study was to review the feasibility and effectiveness of removable esophageal stents to treat RBES. Patients who received removable esophageal stents for the treatment of RBES at the institution between 2004-2010 using its stent implantation logs and endoscopic database were retrospectively identified. Patient demographics, stricture etiology and location, stent and procedure characteristics, and clinical outcomes were obtained. Twenty-five patients with a mean age of 70 (72% male) underwent initial stent placement; 24 were successful. Overall clinical success was achieved in five of the 19 patients (26%) ultimately undergoing stent removal. RBES etiologies included anastomotic (13), radiation (5), peptic (3), chemotherapy (1), scleroderma (1), and unknown (2). Alimaxx-E (Merit-Endotek, South Jordan, UT, USA) stents were placed in 20 patients and Polyflex (Boston Scientific, Natick, MA, USA) stents were used in five patients. Immediate complications included failed deployment (1) and chest pain (7). Five patients died prior to stent removal. Stent migration was found in 53% (10/19) of patients who underwent stent removal: nine required additional therapy and one had symptom resolution. Out of the nine patients without stent migration, five required additional therapy and four had symptom resolution. Although placement of removable esophageal stents for RBES is technically feasible, it is frequently complicated by stent migration and chest pain. In addition, few patients achieved long-term stricture resolution after initial stenting. In this study, most patients ultimately required repeated stenting and/or dilations to maintain relief of dysphagia. PMID:23121426

Dan, D T; Gannavarapu, B; Lee, J G; Chang, K; Muthusamy, V R

2014-08-01

393

FOXJ1 Prevents Cilia Growth Inhibition by Cigarette Smoke in Human Airway Epithelium In Vitro.  

PubMed

Airway epithelium ciliated cells play a central role in clearing the lung of inhaled pathogens and xenobiotics, and cilia length and coordinated beating are important for airway clearance. Based on in vivo studies showing that the airway epithelium of healthy smokers has shorter cilia than that of healthy nonsmokers, we investigated the mechanisms involved in cigarette smoke-mediated inhibition of ciliogenesis by assessing normal human airway basal cell differentiation in air-liquid interface (ALI) cultures in the presence of nontoxic concentrations of cigarette smoke extract (CSE). Measurements of cilia length from Day 28 ALI cultures demonstrated that CSE exposure was associated with shorter cilia (P < 0.05), reproducing the effect of cigarette smoking on cilia length observed in vivo. This phenotype correlated with a broad CSE-mediated suppression of genes involved in cilia-related transcriptional regulation, intraflagellar transport, cilia motility, structural integrity, and basal body development but not of control genes or epithelial barrier integrity. The CSE-mediated inhibition of cilia growth could be prevented by lentivirus-mediated overexpression of FOXJ1, the major cilia-related transcription factor, which led to partial reversal of expression of cilia-related genes suppressed by CSE. Together, the data suggest that components of cigarette smoke are responsible for a broad suppression of genes involved in cilia growth, but, by stimulating ciliogenesis with the transcription factor FOXJ1, it may be possible to maintain close to normal cilia length despite the stress of cigarette smoking. PMID:24828273

Brekman, Angelika; Walters, Matthew S; Tilley, Ann E; Crystal, Ronald G

2014-11-01

394

Effect of taurine on the isolated retinal pigment epithelium of the frog: Electrophysiologic evidence for stimulation of an apical, electrogenic Na + ?K + pump  

Microsoft Academic Search

Summary The apical surface of the retinal pigment epithelium (RPE) faces the neural retina whereas its basal surface faces the choroid. Taurine, which is necessary for normal vision, is released from the retina following light exposure and is actively transported from retina to choroid by the RPE. In these experiments, we have studied the effects of taurine on the electrical

Bruce F. Scharschmidt; Edwin R. Griff; Roy H. Steinberg

1988-01-01

395

Pathophysiological mechanisms linking obesity and esophageal adenocarcinoma.  

PubMed

In recent decades there has been a dramatic rise in the incidence of esophageal adenocarcinoma (EAC) in the developed world. Over approximately the same period there has also been an increase in the prevalence of obesity. Obesity, especially visceral obesity, is an important independent risk factor for the development of gastro-esophageal reflux disease, Barrett's esophagus and EAC. Although the simplest explanation is that this mediated by the mechanical effects of abdominal obesity promoting gastro-esophageal reflux, the epidemiological data suggest that the EAC-promoting effects are independent of reflux. Several, not mutually exclusive, mechanisms have been implicated, which may have different effects at various points along the reflux-Barrett's-cancer pathway. These mechanisms include a reduction in the prevalence of Helicobacter pylori infection enhancing gastric acidity and possibly appetite by increasing gastric ghrelin secretion, induction of both low-grade systemic inflammation by factors secreted by adipose tissue and the metabolic syndrome with insulin-resistance. Obesity is associated with enhanced secretion of leptin and decreased secretion of adiponectin from adipose tissue and both increased leptin and decreased adiponectin have been shown to be independent risk factors for progression to EAC. Leptin and adiponectin have a set of mutually antagonistic actions on Barrett's cells which appear to influence the progression of malignant behaviour. At present no drugs are of proven benefit to prevent obesity associated EAC. Roux-en-Y reconstruction is the preferred bariatric surgical option for weight loss in patients with reflux. Statins and aspirin may have chemopreventative effects and are indicated for their circulatory benefits. PMID:25400997

Alexandre, Leo; Long, Elizabeth; Beales, Ian Lp

2014-11-15

396

Pathophysiological mechanisms linking obesity and esophageal adenocarcinoma  

PubMed Central

In recent decades there has been a dramatic rise in the incidence of esophageal adenocarcinoma (EAC) in the developed world. Over approximately the same period there has also been an increase in the prevalence of obesity. Obesity, especially visceral obesity, is an important independent risk factor for the development of gastro-esophageal reflux disease, Barrett’s esophagus and EAC. Although the simplest explanation is that this mediated by the mechanical effects of abdominal obesity promoting gastro-esophageal reflux, the epidemiological data suggest that the EAC-promoting effects are independent of reflux. Several, not mutually exclusive, mechanisms have been implicated, which may have different effects at various points along the reflux-Barrett’s-cancer pathway. These mechanisms include a reduction in the prevalence of Helicobacter pylori infection enhancing gastric acidity and possibly appetite by increasing gastric ghrelin secretion, induction of both low-grade systemic inflammation by factors secreted by adipose tissue and the metabolic syndrome with insulin-resistance. Obesity is associated with enhanced secretion of leptin and decreased secretion of adiponectin from adipose tissue and both increased leptin and decreased adiponectin have been shown to be independent risk factors for progression to EAC. Leptin and adiponectin have a set of mutually antagonistic actions on Barrett’s cells which appear to influence the progression of malignant behaviour. At present no drugs are of proven benefit to prevent obesity associated EAC. Roux-en-Y reconstruction is the preferred bariatric surgical option for weight loss in patients with reflux. Statins and aspirin may have chemopreventative effects and are indicated for their circulatory benefits.

Alexandre, Leo; Long, Elizabeth; Beales, Ian LP

2014-01-01

397

[Physiology of the upper esophageal sphincter].  

PubMed

The upper esophageal sphincter (UES) forms a barrier between the pharynx and the esophagus. When opened, the UES allows the food bolus to pass into the esophagus, as well as permitting emesis and eructation. The basal sphincter tone constitutes a barrier function which serves to prevent reflux and passive aerophagia in the case of deep breathing. Basal sphincter tone is dependent on several influencing factors; during swallowing, sphincter opening and closure follow a complex multiphase pattern. This article presents an overview of the current understanding of UES physiology. PMID:24916353

Jungheim, M; Miller, S; Kühn, D; Schwemmle, C; Schneider, J P; Ochs, M; Ptok, M

2014-06-01

398

Esophageal stricture in a cougar (Puma concolor).  

PubMed

A 7-mo-old female cougar (Puma concolor) was presented with a 2-wk history of anorexia and a 1-wk history of regurgitation. Barium contrast esophagogram and gastroesophagoscopy revealed the presence of a segmental intraluminal esophageal stricture in the middle third of the esophagus. The stricture was potentially secondary to a previous anesthetic episode. Three endoscopic balloon dilations allowed increasing the luminal diameter to a size that enabled the cougar to eat food softened with water without any signs of discomfort or regurgitation. Two months after being discharged, the cougar was doing well, had gained weight and was eating horsemeat softened with water. PMID:19569481

Desmarchelier, Marion; Lair, Stéphane; Defarges, Alice; Lécuyer, Manon; Langlois, Isabelle

2009-06-01

399

Cell sheets engineering for esophageal regenerative medicine  

PubMed Central

Recently, cell-based therapies, regenerative medicine, and tissue engineering have been progressing rapidly. We have developed a novel strategy for regenerative medicine to recover tissue functions using temperature-responsive cell culture surfaces. To overcome of conventional methods such as the usage of single-cell suspension injection, we have applied transplantable cell sheets fabricated with temperature-responsive culture surfaces for cell delivery. In the field of gastroenterology, transplantable cell sheets from autologous oral mucosal epithelial cells can prevent esophageal stricture following extensive endoscopic mucosal resection.

Kanai, Nobuo; Yamato, Masayuki

2014-01-01

400

Emerging Therapeutic Options for Eosinophilic Esophagitis  

PubMed Central

Eosinophilic esophagitis (EoE) is a chronic inflammatory condition of the esophagus that often occurs in atopic persons. Management strategies include pharmacotherapy, dietary modification, and endoscopic therapy, although patients will often have a relapsing and remitting course. Currently, the primary pharmacotherapy for EoE consists of corticosteroids. Immuno-modulators, leukotriene antagonists, biologies, and monoclonal antibodies are currently under study for treatment of EoE. The role of immunoglobulin E-mediated allergic reactions has been well documented and may provide insight into the etiology and effective therapy of EoE. PMID:24803874

Dougherty, Timothy; Stephen, Sindu; Borum, Marie L.

2014-01-01

401

Fluorescence detection of esophageal neoplasia  

NASA Astrophysics Data System (ADS)

White-light endoscopy is well-established and wide used modality. However, despite the many technological advances that have been occurred, conventional endoscopy is suboptimal and usually detects advanced stage lesions. The limitations of standard endoscopy initiate development of spectroscopic techniques, additional to standard endoscopic equipment. One of the most sensitive approaches is fluorescence spectroscopy of gastrointestinal mucosa for neoplasia detection. In the recent study delta-aminolevulinic acid/Protoporphyrin IX (5-ALA/PpIX) is used as fluorescent marker for dysplasia and tumor detection in esophagus. The 5-ALA is administered per os six hours before measurements at dose 20 mg/kg weight. Excitation source has max of emission at 405 nm and light is delivered by the standard light guide of the endoscopic equipment. Through endoscopic instrumental channel a fiber is applied to return information about fluorescence to microspectrometer. Spectral features observed during endoscopic investigations could be distinct as the next regions: 450-630 nm region, where tissue autofluorescence is observed; 630-710 nm region, where fluorescence of PpIX is clearly pronounced; 530-580 nm region, where minima in the autofluorescence signal are observed, related to reabsorption of blood. The lack of fluorescence peaks in the red spectral area for normal mucosa is an indication for selective accumulation of 5-ALA/PpIX only in abnormal sites Very good correlation between fluorescence signals and histology examination of the lesions investigated is achieved.

Borisova, E.; Vladimirov, B.; Avramov, L.

2008-06-01

402

Fine structure of the olfactory epithelium in some primates.  

PubMed

Electron microscopy of the olfactory epithelium of two prosimian primates, the trees shrew and slow loris, and two simian primates, the macaque and gibbon, has shown that this epithelium consists of three cell types, receptor cells, supporting cells and basal cells, as in other mammals. Receptor cells were ciliated in all the animals investigated except the tree shrew, where, in addition to ciliated receptors, nonciliated receptors bearing only microvilli were occasionally present. Developing receptor cells containing numerous centrioles between nucleus and cell surface were occasionally observed and these cells had poorly developed olfactory knobs and few mitochondria. The olfactory epithelium was similar in morphology in all four species, except that supporting cells showed progressively more numerous, more slender and longer microvilli on their distal surface from tree shrew to slow loris to macaque to gibbon. This may imply a more discriminatory surface in the higher primates in view of the close relationship of these microvilli to the receptor cell surface. PMID:838619

Loo, S K

1977-02-01

403

Endoscopic assessment and management of early esophageal adenocarcinoma.  

PubMed

Esophageal carcinoma affects more than 450000 people worldwide and the incidence is rapidly increasing. In the United States and Europe, esophageal adenocarcinoma has superseded esophageal squamous cell carcinoma in its incidence. Esophageal cancer has a high mortality rates secondary to the late presentation of most patients at advanced stages. Endoscopic screening is recommended for patients with multiple risk factors for cancer in Barrett's esophagus. These risk factors include chronic gastroesophageal reflux disease, hiatal hernia, advanced age, male sex, white race, cigarette smoking, and obesity. The annual risk of esophageal cancer is approximately 0.25% for patients without dysplasia and 6% for patients with high-grade dysplasia. Twenty percent of all esophageal adenocarcinoma in the United States is early stage with disease confined to the mucosa or submucosa. The significant morbidity and mortality of esophagectomy make endoscopic treatment an attractive option. The American Gastroenterological Association recommends endoscopic eradication therapy for patients with high-grade dysplasia. Endoscopic modalities for treatment of early esophageal adenocarcinoma include endoscopic resection techniques and endoscopic ablative techniques such as radiofrequency ablation, photodynamic therapy and cryoablation. Endoscopic therapy should be precluded to patients with no evidence of lymphovascular invasion. Local tumor recurrence is low after endoscopic therapy and is predicted by poor differentiation of tumor, positive lymph node and submucosal invasion. Surgical resection should be offered to patients with deep submucosal invasion. PMID:25132925

Hammoud, Ghassan M; Hammad, Hazem; Ibdah, Jamal A

2014-08-15

404

Esophageal hypomotility and spastic motor disorders: current diagnosis and treatment.  

PubMed

Esophageal hypomotility (EH) is characterized by abnormal esophageal peristalsis, either from a reduction or absence of contractions, whereas spastic motor disorders (SMD) are characterized by an increase in the vigor and/or propagation velocity of esophageal body contractions. Their pathophysiology is not clearly known. The reduced excitation of the smooth muscle contraction mediated by cholinergic neurons and the impairment of inhibitory ganglion neuronal function mediated by nitric oxide are likely mechanisms of the peristaltic abnormalities seen in EH and SMD, respectively. Dysphagia and chest pain are the most frequent clinical manifestations for both of these dysfunctions, and gastroesophageal reflux disease (GERD) is commonly associated with these motor disorders. The introduction of high-resolution manometry (HRM) and esophageal pressure topography (EPT) has significantly enhanced the ability to diagnose EH and SMD. Novel EPT metrics in particular the development of the Chicago Classification of esophageal motor disorders has enabled improved characterization of these abnormalities. The first step in the management of EH and SMD is to treat GERD, especially when esophageal testing shows pathologic reflux. Smooth muscle relaxants (nitrates, calcium channel blockers, 5-phosphodiesterase inhibitors) and pain modulators may be useful in the management of dysphagia or pain in SMD. Endoscopic Botox injection and pneumatic dilation are the second-line therapies. Extended myotomy of the esophageal body or peroral endoscopic myotomy (POEM) may be considered in highly selected cases but lack evidence. PMID:25376746

Valdovinos, Miguel A; Zavala-Solares, Monica R; Coss-Adame, Enrique

2014-11-01

405

Exploring the physiologic role of human gastroesophageal reflux by analyzing time?series data from 24?h gastric and esophageal pH recordings  

PubMed Central

Abstract Our previous finding of a fractal pattern for gastric pH and esophageal pH plus the statistical association of sequential pH values for up to 2 h led to our hypothesis that the fractal pattern encodes information regarding gastric acidity and that depending on the value of gastric acidity, the esophagus can signal the stomach to alter gastric acidity by influencing gastric secretion of acid or bicarbonate. Under our hypothesis values of gastric pH should provide information regarding values of esophageal pH and vice versa. We used vector autoregression, a theory?free set of inter?related linear regressions used to measure relationships that can change over time, to analyze data from 24?h recordings of gastric pH and esophageal pH. We found that in pH records from normal subjects, as well as from subjects with gastroesophageal reflux disease alone and after treatment with a proton pump inhibitor, gastric pH values provided important information regarding subsequent values of esophageal pH and values of esophageal pH provided important information regarding subsequent values of gastric pH. The ability of gastric pH and esophageal pH to provide information regarding subsequent values of each other was reduced in subjects with gastroesophageal reflux disease compared to normal subjects. Our findings are consistent with the hypothesis that depending on the value of gastric acidity, the esophagus can signal the stomach to alter gastric acidity, and that this ability is impaired in subjects with gastroesophageal reflux disease. PMID:25347850

Lu, Luo; Mu, John C.; Sloan, Sheldon; Miner, Philip B.; Gardner, Jerry D.

2014-01-01

406

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

PubMed Central

AIM: To determine the gastroesophageal refluxate in the cervical esophagus (CE) and measure transcutaneous cervical esophageal ultrasound (TCEUS) findings [anterior wall thickness (WT) of CE, esophageal luminal diameter (ELD), esophageal diameter (ED)]; to compare TCEUS findings in the patient subgroups divided according to 24-h esophageal pH monitoring and manometry; and to investigate possible cut-off values according to the TCEUS findings as a predictor of gastroesophageal reflux (GER). METHODS: In 45/500 patients, refluxate was visualized in TCEUS. 38/45 patients underwent esophagogastroduodenoscopy (EGD), 24-h pH monitoring and manometry. RESULTS: The 38 patients were grouped according to 24-h pH monitoring as follows: Group A: GER-positive (n = 20) [Includes Group B: isolated proximal reflux (PR) (n = 6), Group C: isolated distal reflux (DR) (n = 6), and Group D: both PR/DR (n = 8)]; Group E: no reflux (n = 13); and Group F: hypersensitive esophagus (HSE) (n = 5). Groups B + D indicated total PR patients (n = 14), Groups E + F reflux-negatives with HSE (n = 18), and Groups A + F reflux-positives with HSE (n = 25). When the 38 patients were grouped according to manometry findings, 24 had normal esophageal manometry; 7 had hypotensive and 2 had hypertensive lower esophageal sphincter (LES); and 5 had ineffective esophageal motility disorder (IEM). The ELD measurement was greater in group A + F than group E (P = 0.023, 5.0 ± 1.3 vs 3.9 ± 1.4 mm). In 27/38 patients, there was at least one pathologic acid reflux and/or pathologic manometry finding. The cut-off value for ELD of 4.83 mm had 79% sensitivity and 61% specificity in predicting the PR between Groups B + D and E (AUC = 0.775, P = 0.015). CONCLUSION: Visualizing refluxate in TCEUS was useful as a pre-diagnostic tool for estimating GER or manometric pathology in 71.1% of adults in our study, but it was not diagnostic for CE WT. PMID:17876896

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

2007-01-01

407

Normal Distribution  

NSDL National Science Digital Library

Generate a graphic and numerical display of the properties of the Normal Distribution. For a unit normal distribution, with M=0 and SD=ÃÂñ1, enter 0 and 1 at the prompt. For a distribution with M=100 and SD=ÃÂñ15, enter 100 and 15. And so forth

Lowry, Richard, 1940-

2008-09-04

408

Influence of Ionizing Radiation on Stromal-Epithelial Intercellular Communication in Esophageal Carcinogenesis  

NASA Technical Reports Server (NTRS)

Esophageal cancer is the 6th leading cause of cancer death worldwide. Its development is associated with a variety of risk factors including tobacco use, heavy alcohol consumption, human papilloma virus infection, and certain dietary factors such as trace mineral and vitamin deficiencies. An association with ionizing radiation exposure is revealed by the high excess relative risk for squamous cell carcinoma of the esophagus observed in the survivors of the atomic bomb detonations in Japan. It is also seen as a secondary malignancy in patients who received radiotherapy for breast and thoracic cancers; additionally, patients with head/neck and oral squamous cell cancers are at increased risk for metachronous esophageal squamous cell cancers. This malignancy is rapidly fatal, mainly because it remains asymptomatic u