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Sample records for pharynx und oesophagus

  1. Proteomic analysis of field cancerization in pharynx and oesophagus: a prospective pilot study.

    PubMed

    Roesch-Ely, Mariana; Leipold, Alexandra; Nees, Matthias; Holzinger, Dana; Dietz, Andreas; Flechtenmacher, Christa; Wolf, Thomas; Zapatka, Marc; Bosch, Franz X

    2010-08-01

    'Field cancerization' in head and neck squamous cell carcinoma (HNSCC) is poorly understood and it may extend from the pharynx into the oesophagus. Both local recurrences and second primary carcinomas/second field tumours may originate from field cancerization. Our prospective pilot study aimed at the identification of patients suffering from field cancerization on the basis of mucosal protein profiles. Five mucosal biopsies from the oropharynx, hypopharynx and from three regions of the oesophagus were taken from 24 patients. Protein profiles were generated from the mucosal biopsies. After classifier learning, using the profiles of the patients without tumour diagnosis (n = 9), we were able to discriminate between the different mucosal sites and between healthy mucosa and HNSCC using tumour and healthy tissue samples. Mucosal biopsies of tumour patients (n = 15) revealed changes in the protein profiles similar to those in the tumours. During 42 months median follow-up, six tumour patients experienced local recurrences and second field tumours, of which three occurred in the oesophagus. In all six cases, tumour relapse was correctly predicted by altered mucosal protein profiles (p = 0.007, Fisher's exact test, two-tailed). Consequently, molecular field cancerization had a strong impact on progression-free survival (p = 0.007, log-rank test). Protein profiles of small diagnostic biopsies hold great promise to improve personalized risk assessment in HNSCC. Larger studies are needed to further substantiate these findings.

  2. Pharynx Anatomy

    MedlinePlus

    ... e.g. -historical Searches are case-insensitive Pharynx Anatomy Add to My Pictures View /Download : Small: 720x576 ... View Download Large: 3000x2400 View Download Title: Pharynx Anatomy Description: Anatomy of the pharynx; drawing shows the ...

  3. Black oesophagus.

    PubMed

    Pereira, Olga; Figueira-Coelho, João; Picado, Bárbara; Costa, José Neves

    2013-01-29

    Acute oesophageal necrosis, also known as 'Black Oesophagus', is a rare endoscopic finding since its first description by Goldenberg in 1990. In endoscopic studies, the frequency ranged from 0.01% to 0.2%. The aetiology is undefined and is probably multifactorial. A 62-year-old woman, with chronic alcoholism, was admitted to the internal medicine department for dehydration and marked malnutrition problems. Melaena was detected, and oesophagogastroduodenoscopy showed black mucosa of the lower two-thirds of the oesophagus and candidiasis. The patient gradually recovered after conservative treatments (intravenous proton pump inhibitor and total parental nutrition) and fluconazole. Oesophagus stricture was developed after 1 month, and balloon dilatation was performed successfully.

  4. [Pharynx regeneration in planarians].

    PubMed

    Kreshchenko, N D

    2009-01-01

    The obtained and published data on pharynx regeneration in planarians have been reviewed. Planarians can regenerate from a small body fragment and restore all missing organs including the pharynx. The pharynx is a relatively autonomous organ with a differentiated structure and specialized function. Pharynx regeneration has specific features, and its studies are of considerable theoretical interest. Pharynx regeneration can also be a convenient model to study the molecular mechanisms of regeneration that remain undisclosed. In addition, this model can be used to test biologically active compounds in order to elucidate their effect on morphogenesis. This subject of investigation benefits by a simpler and more adequate analysis as well as a possibility to use large numbers of animals and small quantities of analyzed substances.

  5. Columnar lined Barrett's oesophagus.

    PubMed

    Sharma, Neel; Ho, Khek Yu

    2015-12-01

    Over the past few years, the definition of Barrett's oesophagus has altered with no real agreement on histological understanding. This article highlights the increasing confusion regarding Barrett's oesophagus with a focus on the all-too-frequently ignored aspect of the columnar lined oesophagus.

  6. Tuberculosis of the oesophagus

    PubMed Central

    Fahmy, A. R.; Guindi, R.; Farid, A.

    1969-01-01

    A case of primary tuberculosis of the oesophagus is presented; the patient was successfully treated by oesophagectomy. The condition, being rare, has stimulated the authors to review the literature concerning primary and secondary oesophageal tuberculosis. The history, modes of infection, the pathology, clinical picture, diagnosis, investigations, and methods of treatment are discussed. In contradistinction to the secondary disease, which is terminal, primary tuberculosis of the oesophagus is a curable disease with a fairly good prognosis. The case report shows that the surgeon should pay careful attention to the site of the anastomosis; otherwise post-operative stricture can develop. Even this responds well to dilatations and the patient can regain normal health. PMID:5821628

  7. Spontaneous dissection of the oesophagus.

    PubMed Central

    Morritt, G N; Walbaum, P R

    1980-01-01

    Spontaneous rupture of the oesophagus is a well-known entity. Partial or intramural rupture of the oesophagus has been described but is not so well known, and the purpose of this paper is to draw attention to this condition. The clinical presentation, radiological appearances, and treatment of two such cases are described. Images PMID:7268663

  8. Barrett's oesophagus: treatment with surgery.

    PubMed

    DeMeester, Steven R

    2015-02-01

    Barrett's oesophagus develops as a consequence of gastro-oesophageal reflux disease and may progress to oesophageal adenocarcinoma. Antireflux surgery is an option for patients with reflux disease, but the efficacy and impact on the natural history of disease in patients with Barrett's oesophagus is controversial. This review addresses the existing data on these important issues. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Telocytes in human oesophagus.

    PubMed

    Chen, Xiaoke; Zheng, Yonghua; Manole, Catalin G; Wang, Xiangdong; Wang, Qun

    2013-11-01

    Telocytes (TCs), a new type of interstitial cells, were identified in many different organs and tissues of mammalians and humans. In this study, we show the presence, in human oesophagus, of cells having the typical features of TCs in lamina propria of the mucosa, as well as in muscular layers. We used transmission electron microscopy (TEM), immunohistochemistry (IHC) and primary cell culture. Human oesophageal TCs present a small cell body with 2-3 very long Telopodes (Tps). Tps consist of an alternation of thin segments (podomers) and thick segments (podoms) and have a labyrinthine spatial arrangement. Tps establish close contacts ('stromal synapses') with other neighbouring cells (e.g. lymphocytes, macrophages). The ELISA testing of the supernatant of primary culture of TCs indicated that the concentrations of VEGF and EGF increased progressively. In conclusion, our study shows the existence of typical TCs at the level of oesophagus (mucosa, submucosa and muscular layer) and suggests their possible role in tissue repair. © 2013 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.

  10. Pharyngeal wall fold influences on the collapsibility of the pharynx.

    PubMed

    Kairaitis, Kristina

    2012-09-01

    Obstructive sleep apnoea (OSA) is a disease that is characterised by recurrent pharyngeal obstruction during sleep. The pharynx is a hollow muscular tube lined with epithelium that performs the competing functions of breathing, where it is required to be open and swallowing where it is required to close. The mechanical process by which these large changes in luminal dimensions occur have not been considered, however in other biological tubes such as the oesophagus and the bronchial airways narrowing and closure occurs via folding of the mucosal surface. The transmural pressure (P) required to collapse a tube is related to the number of folds (n) formed during collapse by the equation P=n(2)-1, so that the more folds formed during narrowing and closure, the greater the transmural pressure required to collapse the tube. In biomechanical models, the bronchial airway is modelled as a 2-layer tube with an inner epithelial lining and an outer layer of muscle. These models predict that fold numbers will be reduced with thickening and stiffening of the outer layer, accompanied by an increase in collapsibility. We hypothesise that, similar to other biological tubes the pharynx narrows and closes via folding of the surface of the tube, and that the pharynx can also be modelled as a 2-layer tube. We further hypothesise that when compared to healthy subjects, subjects with OSA will have less pharyngeal wall folds during narrowing and closure, and that this reduction in fold numbers will contribute to an increase in pharyngeal collapsibility. In the absence of muscle activity, subjects with OSA have increased pharyngeal collapsibility when compared with healthy subjects, supporting an anatomical contribution to pharyngeal collapse. Histopathological studies of the pharyngeal epithelium in subjects with OSA demonstrate that, compared with age matched subjects, there is thickening of the epithelial surface with oedema of the submucosal layer, with a loss of tethering of the

  11. Impacted dentures in the oesophagus.

    PubMed

    Bandyopadhyay, S N; Das, S; Das, S K; Mandal, A

    2014-05-01

    This study presents the incidence of denture impaction in the oesophagus, and discusses the difficulties of managing such cases. A total of 262 patients with a history of foreign body ingestion (between 1999 and 2010) were reviewed; 46 of these patients had dentures impacted in the oesophagus. The cervical section of the oesophagus was the commonest site of impaction. Dysphagia and tracheal tenderness were the most consistent features when dentures became impacted in the upper oesophagus. In most cases, rigid oesophagoscopy enabled successful removal of the impacted denture. Locating an impacted denture hidden within the oesophageal mucosal folds sometimes proved difficult. In cases of impacted dentures in the oesophagus, a positive history helps in the diagnosis, but a high degree of clinical suspicion aids early detection. Conventional radiographs are important but may not always be of assistance. Early intervention reduces complications. Dentures that are poorly maintained and old are more likely to be swallowed accidentally. The inclusion of radiopaque filler within dentures would assist localisation following accidental swallowing.

  12. Huge benign mesenchymoma in pharynx-esophagus.

    PubMed

    Li, Jun; Omo, Alfred; Liu, Ligang; Liu, Lisi; Tang, Yinxiong; Pan, Tiecheng

    2006-06-01

    Benign mesenchymoma is an uncommon neoplastic disease and its occurrence in pharynx-esophagus is even more rarely reported. A successful case operation is reported. The origin of this tumor was in the pharynx-esophagus, and complete excision was achieved through a laterocervical approach.

  13. [Endoscopic treatments for Barrett oesophagus].

    PubMed

    Vienne, Ariane; Prat, Frédéric

    2011-05-01

    High grade dysplasia and superficial carcinomas (with no extension under muscularis mucosae) can be indications for endoscopic treatments of Barrett oesophagus. When an endoscopic treatment is considered, a gastroscopy with use of acetic acid and planimetry and the confirmation of high-grade dysplasia by a new examination after PPI treatment and a pathologic second confirmation is needed. For high-grade dysplasia in focalised and visible lesions, an endoscopic resection by EMR or ESD should be proposed: it allows a more accurate pathologic examination and can be an effective curative treatment. After endoscopic resection of visible high grade dysplasia lesions, a complete eradication of Barrett oesophagus may be proposed to prevent dysplasia recurrence. In case of extensive high-grade dysplasia or to eradicate Barrett oesophagus residual lesions, radiofrequency ablation is the preferred endoscopic technique. Photodynamic therapy may also be proposed for more invasive lesions or after other endoscopic techniques with mucosal scars. Surgical oesophagus resection is still recommended for diffuse high-grade dysplasia in young patients or in case of pathologic pejorative criteria in endoscopic resection specimen. In case of Low-grade dysplasia, either endoscopic surveillance should be performed every six or 12 months or radiofrequency ablation could be proposed in the yield of prospective studies.

  14. Barrett's oesophagus: epidemiology, diagnosis and clinical management.

    PubMed

    Whiteman, David C; Kendall, Bradley J

    2016-10-03

    Barrett's oesophagus is a condition characterised by partial replacement of the normal squamous epithelium of the lower oesophagus by a metaplastic columnar epithelium containing goblet cells (intestinal metaplasia). Barrett's oesophagus is important clinically because those afflicted are predisposed to oesophageal adenocarcinoma. Prevalence surveys suggest that up to 2% of the population may be affected; most will be unaware of their diagnosis. Risk factors include age, male sex, gastro-oesophageal acid reflux, central obesity and smoking. Helicobacter pylori infection confers a reduced risk of Barrett's oesophagus. Risks of cancer progression are lower than originally reported and are now estimated at 1-3 per 1000 patient-years for patients with non-dysplastic Barrett's oesophagus. Progression rates are higher for patients with long segment (≥ 3 cm) and dysplastic Barrett's oesophagus. Australian guidelines have been developed to aid practitioners in managing patients with Barrett's oesophagus and early oesophageal adenocarcinoma. While generalised population screening for Barrett's oesophagus is not recommended, endoscopic surveillance of patients with confirmed Barrett's oesophagus is recommended, with surveillance intervals dependent on segment length and presence of dysplasia. New techniques such as endoscopic mucosal resection and endoscopic radiofrequency ablation are now available to treat patients with dysplasia and early oesophageal adenocarcinoma. New screening and surveillance technologies are currently under investigation; these may prove cost-effective in identifying and managing patients in the community.

  15. [Primary pharynx synovial sarcoma: a case report].

    PubMed

    Qingying, Cui; Youmei, Zhang; Shuai, Fu; Changbin, Zhang; Ming, Li

    2017-04-01

    A case of primary pharynx synovial sarcoma was reported in this paper. A 15-year-old male patient experienced painless pharyngeal swelling that gradually proliferated for 1 month. Special examination showed an 8 cm × 4 cm × 3 cm tumor located in the left pharynx and the supratonsillar crypt. Imaging tests revealed an irregular mass on the left side of the oropharynx and an unclear boundary. Immunohistochemical examination yielded the following results: epithelial membrane antigen (+), cytokeratin (CK)19 (+), CD7(+), vimentin (+), CK10(-), E-cadherin (+), B-cell lymphoma-2 (-), CD2 (-), CD10 (-), CD138 (+), CD99 (+), leukocyte common antigen (+), and Ki-67 (20%+). This condition was pathologically diagnosed as primary pharynx synovial sarcoma.

  16. Acute oesophageal necrosis (black oesophagus).

    PubMed

    Galtés, Ignasi; Gallego, María Ángeles; Esgueva, Raquel; Martin-Fumadó, Carles

    2016-03-01

    A 54-year-old man was admitted to hospital after being found unconscious in his home. He had a history of alcoholism, multiple drug addictions, and type I diabetes mellitus. At admission, he had hyperglycaemia (550 mg/dL) with glucosuria and ketone bodies in the urine, along with septic shock refractory to bilateral alveolar infiltrates and severe respiratory failure. The patient died 24 hours post admission due to multiple organ failure, with diabetic ketoacidosis decompensated by possible respiratory infection in a patient with polytoxicomania. The autopsy confirmed the presence of acute bilateral bronchopneumonia, chronic pancreatitis, severe hepatic steatosis, and generalized congestive changes. At the oesophagus, acute oesophageal necrosis was evident.

  17. Pulse oximetry in the oesophagus.

    PubMed

    Kyriacou, P A

    2006-01-01

    Pulse oximetry has been one of the most significant technological advances in clinical monitoring in the last two decades. Pulse oximetry is a non-invasive photometric technique that provides information about the arterial blood oxygen saturation (SpO(2)) and heart rate, and has widespread clinical applications. When peripheral perfusion is poor, as in states of hypovolaemia, hypothermia and vasoconstriction, oxygenation readings become unreliable or cease. The problem arises because conventional pulse oximetry sensors must be attached to the most peripheral parts of the body, such as finger, ear or toe, where pulsatile flow is most easily compromised. Since central blood flow may be preferentially preserved, this review explores a new alternative site, the oesophagus, for monitoring blood oxygen saturation by pulse oximetry. This review article presents the basic physics, technology and applications of pulse oximetry including photoplethysmography. The limitations of this technique are also discussed leading to the proposed development of the oesophageal pulse oximeter. In the majority, the report will be focused on the description of a new oesophageal photoplethysmographic/SpO(2) probe, which was developed to investigate the suitability of the oesophagus as an alternative monitoring site for the continuous measurement of SpO(2) in cases of poor peripheral circulation. The article concludes with a review of reported clinical investigations of the oesophageal pulse oximeter.

  18. Past, present and future of Barrett's oesophagus.

    PubMed

    Tan, W K; di Pietro, M; Fitzgerald, R C

    2017-07-01

    Barrett's oesophagus is a condition which predisposes towards development of oesophageal adenocarcinoma, a highly lethal tumour which has been increasing in incidence in the Western world over the past three decades. There have been tremendous advances in the field of Barrett's oesophagus, not only in diagnostic modalities, but also in therapeutic strategies available to treat this premalignant disease. In this review, we discuss the past, present and future of Barrett's oesophagus. We describe the historical and new evolving diagnostic criteria of Barrett's oesophagus, while also comparing and contrasting the British Society of Gastroenterology guidelines, American College of Gastroenterology guidelines and International Benign Barrett's and CAncer Taskforce (BOBCAT) for Barrett's oesophagus. Advances in endoscopic modalities such as confocal and volumetric laser endomicroscopy, and a non-endoscopic sampling device, the Cytosponge, are described which could aid in identification of Barrett's oesophagus. With regards to therapy we review the evidence for the utility of endoscopic mucosal resection and radiofrequency ablation when coupled with better characterization of dysplasia. These endoscopic advances have transformed the management of Barrett's oesophagus from a primarily surgical disease into an endoscopically managed condition. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  19. Barrett's oesophagus: pH profile.

    PubMed

    Gillen, P; Keeling, P; Byrne, P J; Hennessy, T P

    1987-09-01

    Twenty-four patients with a columnar-lined (Barrett's) oesophagus underwent oesophageal manometry and 24 h ambulatory oesophageal pH monitoring. The results were compared with 25 patients with oesophagitis studied in the same fashion. No significant difference in lower oesophageal sphincter pressure was demonstrated between the two groups. The Barrett's patients demonstrated significantly greater acid exposure in the distal oesophagus than oesophagitis patients. Clearance or refluxed acid was poorer in Barrett's patients than oesophagitis patients. Twelve of the Barrett's patients presented with complications of the condition, i.e. ulceration or stricture. No significant difference in acid exposure was demonstrated between Barrett's patients with or without complications. These results suggest that patients with columnar-lined (Barrett's) oesophagus have greater acid exposure than patients with oesophagitis. The development of complications of a Barrett's oesophagus may not be dependent on acid reflux alone.

  20. Multiple Neuropeptide-Coding Genes Involved in Planarian Pharynx Extension.

    PubMed

    Shimoyama, Seira; Inoue, Takeshi; Kashima, Makoto; Agata, Kiyokazu

    2016-06-01

    Planarian feeding behavior involves three steps: moving toward food, extending the pharynx from their planarian's ventral side after arriving at the food, and ingesting the food through the pharynx. Although pharynx extension is a remarkable behavior, it remains unknown what neuronal cell types are involved in its regulation. To identify neurons involved in regulating pharynx extension, we quantitatively analyzed pharynx extension and sought to identify these neurons by RNA interference (RNAi) and in situ hybridization. This assay, when performed using planarians with amputation of various body parts, clearly showed that the head portion is indispensable for inducing pharynx extension. We thus tested the effects of knockdown of brain neurons such as serotonergic, GABAergic, and dopaminergic neurons by RNAi, but did not observe any effects on pharynx extension behavior. However, animals with RNAi of the Prohormone Convertase 2 (PC2, a neuropeptide processing enzyme) gene did not perform the pharynx extension behavior, suggesting the possible involvement of neuropeptide(s in the regulation of pharynx extension. We screened 24 neuropeptide-coding genes, analyzed their functions by RNAi using the pharynx extension assay system, and identified at least five neuropeptide genes involved in pharynx extension. These was expressed in different cells or neurons, and some of them were expressed in the brain, suggesting complex regulation of planarian feeding behavior by the nervous system.

  1. Collis-Nissen gastroplasty for short oesophagus.

    PubMed

    Mattioli, Sandro; Lugaresi, Marialuisa; Ruffato, Alberto; Daddi, Niccolò; Di Simone, Massimo Pierluigi; Perrone, Ottorino; Brusori, Stefano

    2015-01-01

    The Collis-Nissen procedure is performed for the surgical treatment of 'true short oesophagus'. When this condition is strongly suspected radiologically, the patient is placed in the 45° left lateral position on the operating table with the left chest and arm lifted to perform a thoracostomy in the V-VI space, posterior to the axillary line. The hiatus is opened and the distal oesophagus is widely mobilized. With intraoperative endoscopy, the position of the oesophago-gastric junction in relationship to the hiatus is determined and the measurement of the length of the intra-abdominal oesophagus is performed to decide either to carry out a standard anti-reflux procedure or to lengthen the oesophagus. If the oesophagus is irreversibly short ('true short oesophagus'), the short gastric vessels are divided and the gastric fundus is mobilized. An endostapler is introduced into the left chest. The left thoracoscopic approach is suitable to control effectively the otherwise blind passage of the endostapler into the mediastinum and upper abdomen (if a second optic is not used). The tip of the stapler is clearly visible while 'walking' on the left diaphragm. The Collis gastroplasty is performed over a 46 Maloney bougie. A floppy Nissen fundoplication and the hiatoplasty complete the procedure. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  2. [Rare case of haemangioma of the pharynx].

    PubMed

    Kozakiewicz, Jacek; Gierlotka, Agata; Trzepaczyński, Marcin; Motyka, Marek

    2012-01-01

    The hemangioma is a benign tumour located mostly in the region of head and neck. It can appear at any age but especially it is diagnosed among children. The disease can be successfully treated with surgery, criotherapy, propranolol or endovascular procedures. The rare case of the 59-year-old, male patient with huge heamangioma of the pharynx was shown in this paper. The patient was mildly symptomatic - he neglected difficulty with swallowing or breathing and there was no pain. The only one complaint was experiencing a worsened hearing in the left ear. The patient was referred to the laryngologist with acute pharyngitis and with the suspicion of peritonsillar abscess. In the ENT examination apart from acute tonsillitis, the tumour of pharynx was diagnosed. Diagnostic puncture of the tumour showed blood. Ambulatory treatment with antibiotics was administered. The inflammation of pharynx was cured but the tumour remained. In the ENT department the patient underwent diagnostic process including CT of the head, angioCT of carotid arteries and consultation of vascular surgeon. The diagnosis was established and patient was referred for endovascular treatment. The outcome of the embolization of hemangioma resulted in reducing the tumour size and decreasing patient's symptoms. The epidemiology, diagnostic problems and therapy were described.

  3. Food transport in the C. elegans pharynx.

    PubMed

    Avery, Leon; Shtonda, Boris B

    2003-07-01

    Pumping of the C. elegans pharynx transports food particles (bacteria) posteriorly. We examined muscle motions to determine how this posterior transport is effected. We find that the motions of the middle section of the pharynx, the anterior isthmus, are delayed relative to the anterior section, the corpus. Simulations in which particles are assumed to move at mean fluid velocity when not captured by the walls of the pharyngeal lumen show that delayed isthmus motions do indeed cause net particle transport; however, the amount is much less than in the real pharynx. We propose that the geometry of the pharyngeal lumen forces particles to the center, where they move faster than mean fluid velocity. When this acceleration is incorporated into the simulation, particles are transported efficiently. The transport mechanism we propose explains past observations that the timing of muscle relaxation is important for effective transport. Our model also makes a prediction, which we confirm, that smaller bacteria are better food sources for C. elegans than large ones.

  4. In brief: the (molecular) pathogenesis of Barrett's oesophagus.

    PubMed

    Aichler, Michaela; Walch, Axel

    2014-03-01

    Barrett's oesophagus is a metaplastic change, such that the normal squamous epithelial lining of the oesophagus is replaced by specialized columnar-lined epithelium. Barrett's oesophagus is clinically significant and has a high health economic impact as it is associated with heightened risk of progression to oesophageal adenocarcinoma. This review discusses the pathogenesis of Barrett's oesophagus with an emphasis on the underlying molecular events. Copyright © 2013 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

  5. Developmental genetics of the Caenorhabditis elegans pharynx

    PubMed Central

    Pilon, Marc

    2014-01-01

    The Caenorhabditis elegans pharynx is a rhythmically pumping organ composed initially of 80 cells that, through fusions, amount to 62 cells in the adult worm. During the first 100 min of development, most future pharyngeal cells are born and gather into a double-plate primordium surrounded by a basal lamina. All pharyngeal cells express the transcription factor PHA-4, of which the concentration increases throughout development, triggering a sequential activation of genes with promoters responding differentially to PHA-4 protein levels. The oblong-shaped pharyngeal primordium becomes polarized, many cells taking on wedge shapes with their narrow ends toward the center, hence forming an epithelial cyst. The primordium then elongates, and reorientations of the cells at the anterior and posterior ends form the mouth and pharyngeal-intestinal openings, respectively. The 20 pharyngeal neurons establish complex but reproducible trajectories using ‘fishing line’ and growth cone-driven mechanisms, and the gland cells also similarly develop their processes. The genetics behind many fate decisions and morphogenetic processes are being elucidated, and reveal the pharynx to be a fruitful model for developmental biologists. PMID:25262818

  6. Developmental genetics of the Caenorhabditis elegans pharynx.

    PubMed

    Pilon, Marc

    2014-01-01

    The Caenorhabditis elegans pharynx is a rhythmically pumping organ composed initially of 80 cells that, through fusions, amount to 62 cells in the adult worm. During the first 100 min of development, most future pharyngeal cells are born and gather into a double-plate primordium surrounded by a basal lamina. All pharyngeal cells express the transcription factor PHA-4, of which the concentration increases throughout development, triggering a sequential activation of genes with promoters responding differentially to PHA-4 protein levels. The oblong-shaped pharyngeal primordium becomes polarized, many cells taking on wedge shapes with their narrow ends toward the center, hence forming an epithelial cyst. The primordium then elongates, and reorientations of the cells at the anterior and posterior ends form the mouth and pharyngeal-intestinal openings, respectively. The 20 pharyngeal neurons establish complex but reproducible trajectories using 'fishing line' and growth cone-driven mechanisms, and the gland cells also similarly develop their processes. The genetics behind many fate decisions and morphogenetic processes are being elucidated, and reveal the pharynx to be a fruitful model for developmental biologists. © 2014 The Authors. WIREs Developmental Biology published by Wiley Periodicals, Inc.

  7. Experimental columnar metaplasia in the canine oesophagus.

    PubMed

    Gillen, P; Keeling, P; Byrne, P J; West, A B; Hennessy, T P

    1988-02-01

    Regeneration of canine oesophageal mucosa was studied under basal conditions and in the presence of gastro-oesophageal reflux. In normal circumstances mucosal defects in the oesophagus regenerate by squamous epithelium. In the presence of gastro-oesophageal reflux of either acid or a combination of acid and bile, regeneration was frequently by columnar epithelium (Barrett's oesophagus). This columnar regeneration was not seen with bile reflux alone. By the use of squamous barriers to proximal migration of columnar epithelium in the stomach, it was demonstrated that columnar re-epithelialization may occur from cells intrinsic to the oesophagus and is not dependent on proximal migration of cardiac columnar epithelium. The cell of origin of this epithelium may be located in oesophageal gland ducts and is likely to be a multipotential stem cell since the regenerated columnar epithelium may contain goblet and parietal cells not normally found in the oesophagus. This epithelium is morphologically distinct on mucin histochemistry from cardiac columnar epithelium. These findings support the concept that Barrett's epithelium is metaplastic.

  8. Barrett’s oesophagus: Current controversies

    PubMed Central

    Amadi, Chidi; Gatenby, Piers

    2017-01-01

    Oesophageal adenocarcinoma is rapidly increasing in Western countries. This tumour frequently presents late in its course with metastatic disease and has a very poor prognosis. Barrett’s oesophagus is an acquired condition whereby the native squamous mucosa of the lower oesophagus is replaced by columnar epithelium following prolonged gastro-oesophageal reflux and is the recognised precursor lesion for oesophageal adenocarcinoma. There are multiple national and society guidelines regarding screening, surveillance and management of Barrett’s oesophagus, however all are limited regarding a clear evidence base for a well-demonstrated benefit and cost-effectiveness of surveillance, and robust risk stratification for patients to best use resources. Currently the accepted risk factors upon which surveillance intervals and interventions are based are Barrett’s segment length and histological interpretation of the systematic biopsies. Further patient risk factors including other demographic features, smoking, gender, obesity, ethnicity, patient age, biomarkers and endoscopic adjuncts remain under consideration and are discussed in full. Recent evidence has been published to support earlier endoscopic intervention by means of ablation of the metaplastic Barrett’s segment when the earliest signs of dysplasia are detected. Further work should concentrate on establishing better risk stratification and primary and secondary preventative strategies to reduce the risk of adenocarcinoma of the oesophagus. PMID:28811703

  9. Cancer of the Oesophagus in Africa

    PubMed Central

    Cook, Paula

    1971-01-01

    The oesophagus is the most common site of tumour development in men in parts of eastern and southern Africa. In West Africa cancer of the oesophagus is practically unknown. In the areas where it is common, the frequency is not uniformly high but shows sharp gradients within short distances. Most of the present high frequencies seem to have developed from a negligible incidence 30 or forty years ago. In all areas the disease is more common in men than women but the sex ratio varies from less than 2: 1 to 12: 1. Alcohol has been shown to be implicated in the development of cancer of the oesophagus elsewhere in the world. Home-made beer and spirit are common in many parts of Africa but there is no geographical association between frequency of consumption and the occurrence of oesophageal cancer. Evidence exists which suggests that both the geographical and temporal distributions in Africa could reflect the use of maize as a major ingredient of alcoholic drinks. PMID:5144546

  10. Epimorphic regeneration of the distal part of the planarian pharynx.

    PubMed

    Ito, H; Saito, Y; Watanabe, K; Orii, H

    2001-01-01

    The totipotent stem cells called neoblasts seem to be concerned with the remarkable regeneration ability of planarians. However, the pharynx is able to regenerate after the amputation of its distal part, in spite of a lack of neoblasts in the pharynx. The process of regeneration has been referred to as morphallaxis, based on conventional histochemical observations. We examined it again immuno-histochemically using anti-Dugesia japonica proliferating cell nuclear antigen (DjPCNA) antibody for neoblasts and anti-D. japonica myosin heavy chain-A (DjMHC-A) antibody for pharynx muscle fibers. This immuno-histochemical study, together with observations of the regeneration process of planarians irradiated with X-rays in particular regions, revealed that after the amputation, neoblasts from outside the pharynx entered that organ, moved through the mesenchyme of the pharynx to the wounded area, and differentiated into the cells that had been lost there. We show here that the regeneration after amputation of the distal part of the pharynx is an 'epimorphic' process.

  11. L'/R parisien et autres sons du pharynx (The Parisian /R/ and Other Sounds of the Pharynx)

    ERIC Educational Resources Information Center

    Delattre, Pierre

    1969-01-01

    Studies the sounds of the Parisian French /R/ consonant by examining sound spectrograms and X-ray photographs of speakers' pharynxes. Illustrates the phonetic distinctions and compares the Parisian consonantal usage to usage in other languages, including American English. (AM)

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

    PubMed

    Horna Strand, A; Franzén, T

    2014-01-01

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

  13. Association of adiponectin multimers with Barrett’s oesophagus

    PubMed Central

    Rubenstein, J H; Kao, J Y; Madanick, R D; Zhang, M; Wang, M; Spacek, M B; Donovan, J L; Bright, S D; Shaheen, N J

    2012-01-01

    Objective Barrett’s oesophagus is associated with abdominal obesity. Adiponectin is a peptide that is secreted from adipocytes and circulates in three multimeric forms: low molecular weight (LMW), middle molecular weight (MMW), and high molecular weight (HMW). The anti-inflammatory effects of adiponectin are specific to individual multimers, with LMW being most anti-inflammatory. We postulated that circulating levels of adiponectin and its multimers would be associated with the risk of Barrett’s oesophagus. Design Cross-sectional study. Setting Outpatient clinic in North Carolina, USA. Patients Cases of Barrett’s oesophagus and controls undergoing upper endoscopy for gastro-oesophageal reflux disease (GORD). Main outcome measures Adjusted odds ratios of plasma adiponectin levels and its multimers for Barrett’s oesophagus. Results There were 112 cases of Barrett’s oesophagus and 199 GORD controls. Total adiponectin was not associated with Barrett’s oesophagus (3rd tertile vs 1st tertile adjusted odds ratio (aOR) = 0.88; 95% confidence interval (CI) = 0.44 to 1.78). High levels of LMW adiponectin were associated with a decreased risk of Barrett’s oesophagus (3rd tertile vs 1st tertile aOR = 0.33; 95% CI, 0.16 to 0.69), and a high LMW/total ratio appeared particularly inversely associated with Barrett’s oesophagus (3rd tertile vs 1st tertile aOR = 0.27; 95% CI, 0.13 to 0.58). Conclusions High levels of LMW adiponectin are associated with a decreased risk of Barrett’s oesophagus among patients with GORD. Further human studies are required to confirm these findings, and in vitro studies are needed to understand if there is a mechanism whereby adiponectin may affect Barrett’s metaplasia. PMID:19570765

  14. Embryonal Rhabdomyosarcoma of the Oesophagus in a Young Dog.

    PubMed

    Devriendt, N; Van Brantegem, L; Willems, A; Raes, E; de Rooster, H

    2017-01-01

    A 15-month-old great Dane dog, showing clinical signs related to hypertrophic osteopathy, was diagnosed radiographically with a mass in the region of the thoracic oesophagus. Exploratory thoracotomy revealed an extensive, highly vascularized and locally invasive oesophageal mass and the presence of nodules in adjacent lung lobes. The dog was humanely destroyed intra-operatively. Histological examination revealed that the mass was an embryonal rhabdomyosarcoma. This is the first report of rhabdomyosarcoma of the oesophagus of a dog. Rhabdomyosarcoma should be considered a differential diagnosis when a mass adjacent to the oesophagus is diagnosed. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Tubular duplication of the oesophagus presenting with dysphagia.

    PubMed

    Saha, A K; Kundu, A K

    2014-06-01

    Duplications of the alimentary tract are rare congenital malformations, with the ileum being the most commonly affected site, followed by the oesophagus. Among oesophageal duplications, cystic duplication is the most common and the tubular variety, the rarest. Herein, we report a rare case of tubular oesophageal duplication, complicated by adenosquamous carcinoma at the lower end of the oesophagus, in a 32-year-old man who presented with progressive dysphagia. Although proton pump inhibitors may relieve dysphagia, oesophagectomy and gastric interpositioning should be the first-line treatment for patients with tubular oesophageal duplication, in order to reduce the risk of malignant transformation at the lower end of the oesophagus.

  16. Monophasic synovial sarcoma of the pharynx: a case report

    PubMed Central

    Betal, Dibendu; Babu, Ramesh; Mehmet, Veysi

    2009-01-01

    Synovial sarcomas are a rare form of soft tissue sarcomas. We present a case of a 62 year-old male presenting with a left thyroid lump initially though to be a thyroid adenoma but subsequently diagnosed as a monophasic synovial sarcoma of the pharynx. We discuss the diagnosis and treatment of this case. PMID:19335917

  17. Monophasic synovial sarcoma of the pharynx: a case report.

    PubMed

    Betal, Dibendu; Babu, Ramesh; Mehmet, Veysi

    2009-03-31

    Synovial sarcomas are a rare form of soft tissue sarcomas. We present a case of a 62 year-old male presenting with a left thyroid lump initially though to be a thyroid adenoma but subsequently diagnosed as a monophasic synovial sarcoma of the pharynx. We discuss the diagnosis and treatment of this case.

  18. The sensory innervation of the human pharynx: searching for mechanoreceptors.

    PubMed

    de Carlos, F; Cobo, J; Macías, E; Feito, J; Cobo, T; Calavia, M G; García-Suárez, O; Vega, J A

    2013-11-01

    The coordinate neural regulation of the upper airways muscles is basic to control airway size and resistance. The superior constrictor pharyngeal muscle (SCPM) forms the main part of the lateral and posterior walls of the pharynx and typically is devoid of muscle spindles, the main type of proprioceptor. Because proprioception arising from SCPM is potentially important in the physiology of the upper airways, we have investigated if there are mechanical sensory nerve endings substitute for the muscle spindles. Samples of human pharynx were analyzed using immunohistochemistry associated to general axonic and Schwann cells markers (NSE, PGP 9.5, RT-97, and S100P), intrafusal muscle fiber markers, and putative mechanical sense proteins (TRPV4 and ASIC2). Different kinds of sensory corpuscles were observed in the pharynx walls (Pacini-like corpuscles, Ruffini-like corpuscles, spiral-wharves nerve structures, and others) which are supplied by sensory nerves and express putative mechanoproteins. No evidence of muscle spindles was observed. The present results demonstrate the occurrence of numerous and different morphotypes of sensory corpuscles/mechanoreceptors in human pharynx that presumably detect mechanical changes in the upper airways and replace muscle spindles for proprioception. Present findings are of potential interest for the knowledge of pathologies of the upper airways with supposed sensory pathogenesis. Copyright © 2013 Wiley Periodicals, Inc.

  19. Immunohistochemical analysis of metaplastic non-goblet columnar lined oesophagus shows phenotypic similarities to Barrett's oesophagus: a study in an Asian population.

    PubMed

    Srivastava, Supriya; Liew, Mei Shan; McKeon, Frank; Xian, Wa; Yeoh, Khay Guan; Ho, Khek Yu; Teh, Ming

    2014-02-01

    Barrett's oesophagus is a premalignant condition, predisposing to oesophageal adenocarcinoma. However, some adenocarcinoma may arise in columnar lined oesophagus without goblet cells. Our aim was to evaluate the biological properties of non-goblet columnar lined oesophagus only and elucidate its relationship with Barrett's oesophagus and associated neoplasia. Endoscopic biopsies from patients with Barrett's oesophagus (n=30), non-goblet columnar lined oesophagus (n=14), Barrett's oesophagus associated high grade dysplasia (n=6) and adenocarcinoma (n=4) were selected. Immunostaining for villin, claudin 3 and MUC4 was performed. Statistical analysis was performed and a p value <0.05 was considered significant. Villin and MUC4 were positive in 42%, 100% each and 50% in non-goblet columnar lined oesophagus, Barrett's oesophagus, high grade dysplasia and adenocarcinoma respectively, while claudin 3 was 100% positive in all the groups. In non-goblet columnar lined oesophagus, six cases that were villin immunopositive, showed positive expression for claudin 3 and/or MUC4 and there was no difference from the high grade dysplasia or adenocarcinoma (p>0.05). Our results indicate that a subset of non-goblet columnar lined oesophagus shows an intestinal phenotype representing an early stage of Barrett's oesophagus. This subset probably harbours the potential to change into adenocarcinoma in the long term. Copyright © 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  20. [Pharynx perforation caused by fishbone--diagnostic problems].

    PubMed

    Sokołowski, Dariusz; Sosada, Krystyn

    2002-01-01

    The authors presented a case of perforation of the left side of pharynx by fishbone, treated successfully in spite of wrong primary diagnosis and treatment. The fishbone quickly penetrated the pharynx wall and evoked inflammatory process similar to thyroid gland tumor (size 50 x 70 mm). It was the cause of the wrong first diagnosis of thyroid gland tumor. Because of the diagnosis the patient was qualified to surgical intervention--the removal of thyroid tumor. However, the patient suspected the relationship between the tumor and choking with a foreign body. The patient was diagnosed again in another hospital where the proper diagnosis was made. The removal of fishbone from the left subclavian region was performed after 41 days from the day of choking.

  1. Multiple phenotypes resulting from a mutagenesis screen for pharynx muscle mutations in Caenorhabditis elegans.

    PubMed

    Ferrier, Andrew; Charron, Alexandra; Sadozai, Yama; Switaj, Lynn; Szutenbach, Anneliese; Smith, Pliny A

    2011-01-01

    We describe a novel screen to isolate pharyngeal cell morphology mutants in Caenorhabditis elegans using myo-2::GFP to rapidly identify abnormally shaped pharynxes in EMS (Ethyl Methanesulfonate) mutagenized worms. We observed over 83 C. elegans lines with distinctive pharyngeal phenotypes in worms surviving to the L1 larval stage, with phenotypes ranging from short pharynx, unattached pharynx, missing cells, asymmetric morphology, and non-adherent pharynx cells. Thirteen of these mutations have been chromosomally mapped using Single Nucleotide Polymorphisms (SNPs) and deficiency strain complementation. Our studies have focused on genetically mapping and functionally testing two phenotypes, the short pharynx and the loss of muscle cohesion phenotypes. We have also identified new alleles of sma-1, and our screen suggests many genes directing pharynx assembly and structure may be either pharynx specific or less critical in other tissues.

  2. Multiple Phenotypes Resulting from a Mutagenesis Screen for Pharynx Muscle Mutations in Caenorhabditis elegans

    PubMed Central

    Ferrier, Andrew; Charron, Alexandra; Sadozai, Yama; Switaj, Lynn; Szutenbach, Anneliese; Smith, Pliny A.

    2011-01-01

    We describe a novel screen to isolate pharyngeal cell morphology mutants in Caenorhabditis elegans using myo-2::GFP to rapidly identify abnormally shaped pharynxes in EMS (Ethyl Methanesulfonate) mutagenized worms. We observed over 83 C. elegans lines with distinctive pharyngeal phenotypes in worms surviving to the L1 larval stage, with phenotypes ranging from short pharynx, unattached pharynx, missing cells, asymmetric morphology, and non-adherent pharynx cells. Thirteen of these mutations have been chromosomally mapped using Single Nucleotide Polymorphisms (SNPs) and deficiency strain complementation. Our studies have focused on genetically mapping and functionally testing two phenotypes, the short pharynx and the loss of muscle cohesion phenotypes. We have also identified new alleles of sma-1, and our screen suggests many genes directing pharynx assembly and structure may be either pharynx specific or less critical in other tissues. PMID:22073173

  3. Retinoic acid-induced glandular differentiation of the oesophagus.

    PubMed

    Chang, Chih-Long; Lao-Sirieix, Pierre; Save, Vicki; De La Cueva Mendez, Guillermo; Laskey, Ron; Fitzgerald, Rebecca C

    2007-07-01

    Retinoic acid (RA) is a powerful differentiation agent. Barrett's oesophagus occurs when duodeno-gastro-oesophageal reflux causes squamous epithelium (SE) tissue to become columnar epithelium tissue by an unknown mechanism. The bile acid lithocholic acid (LCA) competes for the retinoid X receptor retinoid binding site. Hence, RA pathways may be implicated in Barrett's oesophagus. RA activity in tissues and cell lines treated with all-trans retinoic acid (ATRA) with or without LCA was assessed using a reporter. Expression of p21 was determined by real-time PCR in Barrett's oesophagus cell lines with or without LCA. SE and Barrett's oesophagus biopsy specimens were exposed to 100 muM of ATRA or 20 mM of a RA inhibitor, citral, in organ culture for >72 h. Characteristics of treated specimens, compared with untreated controls, were analysed by immunohistochemical analysis (cytokeratins (CKs), vimentin) and RT-PCR (CKs). Confocal microscopy assessed temporal changes in co-localisation of CK8/18 and vimentin. Cell proliferation was assessed by bromo-deoxyuridine incorporation and immunohistochemical analysis for Ki67 and p21. RA biosynthesis was increased in Barrett's oesophagus compared with SE (p<0.001). LCA and ATRA caused a synergistic increase in RA signalling as shown by increased p21 (p<0.01). Morphological and molecular analysis of SE exposed to ATRA showed columnar differentiation independent of proliferation. Metaplasia could be induced from the stromal compartment alone and vimentin expression co-localised with CK8/18 at 24 h, which separated into CK8/18-positive glands and vimentin-positive stroma by 48 h. Citral-treated Barrett's oesophagus led to phenotypic and immunohistochemical characteristics of SE, which was independent of proliferation. RA activity is increased in Barrett's oesophagus and is induced by LCA. Under conditions of altered RA activity and an intact stroma, the oesophageal phenotype can be altered independent of proliferation.

  4. Monitoring the premalignant potential of Barrett's oesophagus'

    PubMed Central

    Graham, David; Lipman, Gideon; Sehgal, Vinay; Lovat, Laurence B

    2016-01-01

    The landscape for patients with Barrett's oesophagus (BE) has changed significantly in the last decade. Research and new guidelines have helped gastroenterologists to better identify those patients with BE who are particularly at risk of developing oesophageal adenocarcinoma. In parallel, developments in endoscopic image enhancement technology and optical biopsy techniques have improved our ability to detect high-risk lesions. Once these lesions have been identified, the improvements in minimally invasive endoscopic therapies has meant that these patients can potentially be cured of early cancer and high-risk dysplastic lesions without the need for surgery, which still has a significant morbidity and mortality. The importance of reaching an accurate diagnosis of BE remains of paramount importance. More work is needed, however. The vast majority of those undergoing surveillance for their BE do not progress towards cancer and thus undergo a regular invasive procedure, which may impact on their psychological and physical well-being while incurring significant cost to the health service. New work that explores cheaper endoscopic or non-invasive ways to identify the at-risk individual provides exciting avenues for research. In future, the diagnosis and monitoring of patients with BE could move away from hospitals and into primary care. PMID:27761232

  5. Predicting midsagittal pharynx shape from tongue position during vowel production.

    PubMed

    Whalen, D H; Kang, A M; Magen, H S; Fulbright, R K; Gore, J C

    1999-06-01

    The shape of the pharynx has a large effect on the acoustics of vowels, but direct measurement of this part of the vocal tract is difficult. The present study examines the efficacy of inferring midsagittal pharynx shape from the position of the tongue, which is much more amenable to measurement. Midsagittal magnetic resonance (MR) images were obtained for multiple repetitions of 11 static English vowels spoken by two subjects (one male and one female). From these, midsagittal widths were measured at approximately 3-mm intervals along the entire vocal tract. A regression analysis was then used to assess whether the pharyngeal widths could be predicted from the locations and width measurements for four positions on the tongue, namely, those likely to be the locations of a receiver coil for an electromagnetometer system. Predictability was quite high throughout the vocal tract (multiple r> 0.9), except for the extreme ends (i.e., larynx and lips) and small decreases for the male subject in the uvula region. The residuals from this analysis showed that the accuracy of predictions was generally quite high, with 89.2% of errors being less than 2 mm. The extremes of the vocal tract, where the resolution of the MRI was poorer, accounted for much of the error. For languages like English, which do not use advanced tongue root (ATR) distinctively, the midsagittal pharynx shape of static vowels can be predicted with high accuracy.

  6. A new concept of the anatomy of the thoracic oesophagus: the meso-oesophagus. Observational study during thoracoscopic esophagectomy.

    PubMed

    Cuesta, Miguel A; Weijs, Teus J; Bleys, Ronald L A W; van Hillegersberg, Richard; van Berge Henegouwen, Mark I; Gisbertz, Suzanne S; Ruurda, Jelle P; Straatman, Jennifer; Osugi, Harushi; van der Peet, Donald L

    2015-09-01

    During thoracoscopic oesophageal surgery, we observed not previously described fascia-like structures. Description of similar structures in rectal cancer surgery was of paramount importance in improving the quality of resection. Therefore, we aimed to describe a new comprehensive concept of the surgical anatomy of the thoracic oesophagus with definition of the meso-oesophagus. We retrospectively evaluated 35 consecutive unedited videos of thoracoscopic oesophageal resections for cancer, to determine the surgical anatomy of the oesophageal fascia's vessels and lymphatic drainage. The resulting concept was validated in a prospective study, including 20 patients at three different centres. Additional confirmation was sought by a histologic study of a cadaver's thorax. A thin layer of connective tissue around the infracarinal oesophagus, involving the lymph nodes at the level of the carina, was observed during thoracoscopic esophagectomy in 32 of the 35 patients included in the retrospective study and in 19 of the 20 patients included in the prospective study. A thick fascia-like structure from the upper thoracic aperture to the lower thoracic aperture was visualized in all patients. This fascia is encountered between the descending aorta and left aspect of the infracarinal oesophagus. Above the carina it expands on both sides of the oesophagus to lateral mediastinal structures. This fascia contains oesophageal vessels, lymph vessels and nodes and nerves. The histologic study confirmed these findings. Here we described the concept of the "meso-oesophagus". Applying the description of the meso-oesophagus will create a better understanding of the oesophageal anatomy, leading to more adequate and reproducible surgery.

  7. Barrett's oesophagus: frequency and prediction of dysplasia and cancer.

    PubMed

    Falk, Gary W

    2015-02-01

    The incidence of oesophageal adenocarcinoma is continuing to increase at an alarming rate in the Western world today. Barrett's oesophagus is a clearly recognized risk factor for the development of oesophageal adenocarcinoma, but the overwhelming majority of patients with Barrett's oesophagus will never develop oesophageal cancer. A number of endoscopic, histologic and epidemiologic risk factors identify Barrett's oesophagus patients at increased risk for progression to high-grade dysplasia and oesophageal adenocarcinoma. Endoscopic factors include segment length, mucosal abnormalities as seemingly trivial as oesophagitis and the 12 to 6 o'clock hemisphere of the oesophagus. Both intestinal metaplasia and low grade dysplasia, the latter only if confirmed by a pathologist with expertise in Barrett's oesophagus pathologic interpretation are the histologic risk factors for progression. Epidemiologic risk factors include ageing, male gender, obesity, and smoking. Factors that may protect against the development of adenocarcinoma include a diet rich in fruits and vegetables, and the use of proton pump inhibitors, aspirin/NSAIDs and statins. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Palliative intubation for malignant strictures of the oesophagus

    PubMed Central

    Leverment, J. N.; Milne, D. Mearns

    1974-01-01

    Leverment, J. N. and Mearns Milne, D. (1974).Thorax, 29, 228-231. Palliative intubation for malignant strictures of the oesophagus. Over a 16-year period the Mousseau-Barbin tube was used for palliation in 50 patients suffering from malignant stricture of the oesophagus. In only two cases was the Souttar tube used. Thirty-seven cases were intubated as a primary method of treatment—21 cases without preliminary exploration, 13 cases following exploration, and three cases as a `delayed' procedure. Twelve cases were secondarily intubated as a result of recurrence of malignancy following an earlier oesophagogastrectomy. In three cases perforation of the oesophagus was recognized at the time of intubation, following which palliative oesophagogastrectomies were attempted. Intubation remains one method of relieving the patient's most distressing symptom, but in the majority of cases prolongation of life was seldom for more than three months. The hazards of this form of treatment are discussed. PMID:4133968

  9. Ambulatory oesophageal bile reflux monitoring in Barrett's oesophagus.

    PubMed

    Caldwell, M T; Lawlor, P; Byrne, P J; Walsh, T N; Hennessy, T P

    1995-05-01

    Bile reflux has been implicated in the pathogenesis of Barrett's oesophagus but evaluation remains difficult. Bilitec 2000 is an ambulatory system that detects bilirubin based on its spectrophotometric properties. Oesophageal bile exposure was evaluated in three groups of patients. Group 1 (n = 11) were normal controls, group 2 (n = 13) were patients with uncomplicated gastro-oesophageal reflux and group 3 (n = 12) were patients with Barrett's oesophagus. Bile reflux was greater in patients with Barrett's mucosa than in controls or those with uncomplicated reflux. This difference was seen in the supine and interdigestive periods. The percentage of time at which gastric pH was greater than 4 and oesophageal pH was above 7 did not differ between the groups. Bilitec 2000 detects greater bile reflux in patients with Barrett's oesophagus. No corresponding gastric or oesophageal alkaline shift is found. This ambulatory bile reflux monitoring system may be a useful tool in clinical practice.

  10. Implication of duodenogastric reflux in the pathogenesis of Barrett's oesophagus.

    PubMed

    Gillen, P; Keeling, P; Byrne, P J; Healy, M; O'Moore, R R; Hennessy, T P

    1988-06-01

    Fasting and postprandial intragastric bile acid concentrations have been estimated and compared in patients with complications of Barrett's oesophagus, patients with Barrett's oesophagus without complications, patients with oesophagitis and a group of normal subjects who acted as controls. There was no significant difference in fasting intragastric bile acid concentrations between the groups. Postprandial bile acid concentrations were significantly greater in the patients with complications of Barrett's than in the remaining groups at 60, 90 and 120 min. Significant concentrations of bile acids were seen in gastric juice of unaltered pH and may be undetected on intra-oesophageal pH monitoring. Duodenogastric reflux may be implicated in the pathogenesis of complications of Barrett's oesophagus.

  11. Ablation of Barrett's oesophagus: towards improved outcomes for oesophageal cancer?

    PubMed

    Mayne, George C; Bright, Tim; Hussey, Damian J; Watson, David I

    2012-09-01

    Barrett's oesophagus is the major risk factor for the development of oesophageal adenocarcinoma. The management of Barrett's oesophagus entails treating reflux symptoms with acid-suppressing medication or surgery (fundoplication). However, neither form of anti-reflux therapy produces predictable regression, or prevents cancer development. Patients with Barrett's oesophagus usually undergo endoscopic surveillance, which aims to identify dysplastic changes or cancer at its earliest stage, when treatment outcomes should be better. Alternative endoscopic interventions are now available and are suggested for the treatment of early cancer and prevention of progression of Barrett's oesophagus to cancer. Such treatments could minimize the risks associated with oesophagectomy. The current status of these interventions is reviewed. Various endoscopic interventions have been described, but with long-term outcomes uncertain, they remain somewhat controversial. Radiofrequency ablation of dysplastic Barrett's oesophagus might reduce the risk of cancer progression, although cancer development has been reported after this treatment. Endoscopic mucosal resection (EMR) allows a 1.5-2 cm diameter piece of oesophageal mucosa to be removed. This provides better pathology for diagnosis and staging, and if the lesion is confined to the mucosa and fully excised, EMR can be curative. The combination of EMR and radiofrequency ablation has been used for multifocal lesions, but long-term outcomes are unknown. The new endoscopic interventions for Barrett's oesophagus and early oesophageal cancer have the potential to improve clinical outcomes, although evidence that confirms superiority over oesphagectomy is limited. Longer-term outcome data and data from larger cohorts are required to confirm the appropriateness of these procedures. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

  12. Endoscopic modalities for the diagnosis of Barrett’s oesophagus

    PubMed Central

    Srivastava, Supriya; Kern, Florian; Xian, Wa; Ming, Teh; McKeon, Frank; Ho, Khek Yu

    2015-01-01

    Barrett’s oesophagus is a pre-malignant condition associated with the development of oesophageal adenocarcinoma. Currently white light endoscopy and biopsy is the mainstay diagnostic tool. Yet this approach is troubled by issues related to cumbersome biopsy sampling, biopsy sampling errors and cost. Therefore in order to overcome such adversity, there needs to be evolutionary advancement in terms of diagnosis, which should address these concerns and ideally enhance risk stratification in order to provide timely management in real time. This review highlights the current endoscopic tools aimed to enhance the diagnosis of Barrett’s oesophagus and its subsequent progression. PMID:28408990

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

    PubMed

    Gatenby, Piers; Soon, Yuen

    2014-08-15

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

  14. Endoluminal vacuum therapy for iatrogenic perforation of the proximal oesophagus.

    PubMed

    Möschler, O; Müller, M K

    2014-03-01

    Iatrogenic perforation of the upper gastrointestinal tract is one of the most serious complications of upper gastrointestinal endoscopy, with high rates of morbidity and mortality. Treatment is challenging because stent placement or surgical repair of the perforation in this area is often impossible. We report on two cases of iatrogenic perforations of the very proximal oesophagus and distal hypopharynx which could be successfully closed by using an endoluminal vacuum sponge treatment for 5 days. Thus, the endoluminal vacuum therapy may be a useful alternative to surgery in such cases of difficultly managable perforations of the upper oesophagus. © Georg Thieme Verlag KG Stuttgart · New York.

  15. Dynamic magnetic resonance imaging of the pharynx during deglutition.

    PubMed

    Amin, Milan R; Achlatis, Stratos; Lazarus, Cathy L; Branski, Ryan C; Storey, Pippa; Praminik, Bidyut; Fang, Yixin; Sodickson, Daniel K

    2013-03-01

    We utilized dynamic magnetic resonance imaging to visualize the pharynx and upper esophageal segment in normal, healthy subjects. A 3-T scanner with a 4-channel head coil and a dual-channel neck coil was used to obtain high-speed magnetic resonance images of subjects who were swallowing liquids and pudding. Ninety sequential images were acquired with a temporal resolution of 113 ms. Imaging was performed in axial planes at the levels of the oropharynx and the pharyngoesophageal segment. The images were then analyzed for variables related to alterations in the area of the pharynx and pharyngoesophageal segment during swallowing, as well as temporal measures related to these structures. All subjects tolerated the study protocol without complaint. Changes in the area of the pharyngeal wall lumen and temporal measurements were consistent within and between subjects. The inter-rater and intra-rater reliabilities for the measurement tool were excellent. Dynamic magnetic resonance imaging of the swallow sequence is both feasible and reliable and may eventually complement currently used diagnostic methods, as it adds substantive information.

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

    PubMed

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

    2015-01-01

    Barrett's oesophagus can progress towards oesophageal adenocarcinoma through a metaplasia-dysplasia-carcinoma sequence, but the underlying mechanisms are poorly understood. The transcription factor GATA6 is known to be involved in columnar differentiation and proliferation, and GATA6 gene amplification was recently linked with poor survival in oesophageal adenocarcinoma. To study the expression of GATA6 during Barrett's oesophagus development and malignant transformation. To determine the prognostic value of GATA6 in oesophageal adenocarcinoma. Two retrospective cohorts were derived from the pathological archive of the University Medical Center Groningen. The first cohort contained 130 tissue samples of normal squamous epithelium, metaplasia, dysplasia and oesophageal adenocarcinoma. The second cohort consisted of a tissue microarray containing tissue from 92 oesophageal adenocarcinoma patients. Immunohistochemistry was used to examine GATA6 protein expression and to correlate GATA6 expression in oesophageal adenocarcinoma with overall and disease-free survival. The percentage of GATA6-positive cells was low in squamous epithelium (10%) but increased progressively in Barrett's oesophagus (30%, P < 0.001) and high-grade dysplasia (82%, P = 0.005). GATA6 expression was not associated with overall or disease-free survival in oesophageal adenocarcinoma patients (P = 0.599 and P = 0.700 respectively). GATA6 expression is progressively increased during Barrett's oesophagus development and its malignant transformation. However, no prognostic value of GATA6 expression could be found in oesophageal adenocarcinoma. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  17. Chemical injuries of the oesophagus: aetiopathological issues in Nigeria

    PubMed Central

    Thomas, Martins O; Ogunleye, Ezekiel O; Somefun, Oladapo

    2009-01-01

    Background Chemical injuries of the oesophagus occur worldwide. There is paucity of information on aetiopathological profile of chemical injuries of the oesophagus in Nigeria. Aim The aim of the study was to determine the aetiopathological pattern of chemical injuries of the oesophagus in Nigeria. Materials and methods This is a multi-centre hospital based study in Lagos metropolis spanning a period of 10 years. The patients' bio data, substances ingested, sources of corrosives, reasons for ingesting corrosives and patients' mental state were recorded. Results In all, there were 78 patients (61 Males, 17 Females). The offending agents were acids in 55.1% of cases and it was accidental ingestion in 62 patients. The highest incidence of 57.6% was found in the middle 1/3 of the oesophagus. Conclusion Accidental ingestion of acids is the commonest cause of oesophageal injuries in Nigeria. The incidence of severe strictures necessitating oesophageal substitution could be reduced if early management of corrosive oesophagitis improves in Nigeria. PMID:19835579

  18. Laparoscopic Heller's cardiomyotomy: a viable treatment option for sigmoid oesophagus

    PubMed Central

    Panchanatheeswaran, Karthik; Parshad, Rajinder; Rohila, Jitender; Saraya, Anoop; Makharia, Govind K.; Sharma, Raju

    2013-01-01

    OBJECTIVES It is generally believed that Heller's cardiomyotomy (HCM) cannot improve dysphagia in patients with marked dilatation and axis deviation or sigmoid oesophagus. Conventional management for sigmoid oesophagus has been oesophagectomy. We report our surgical experience in the management of 8 patients with sigmoid oesophagus with laparoscopic HCM. METHODS Eight patients with sigmoid oesophagus were retrospectively identified and their records were reviewed for symptomatic outcome evaluation following laparoscopic HCM with an antireflux procedure. Preoperative and postoperative, oesophageal and respiratory symptoms and quality of life scoring of achalasia were recorded. RESULTS The mean age was 35.5 (range 25–57) years. Males and females were equally distributed. All patients had dysphagia as their chief presenting complaint. The median duration of dysphagia was 55 (range 18–180) months. All the patients had a poor quality of life. Four patients also had chronic cough. All 8 patients underwent laparoscopic HCM with an antireflux procedure. The mean duration of operation was 203.7 min. There were no mortalities and no major postoperative complications. At a median follow-up of 19.5 (range 6–45) months, there was a significant improvement of dysphagia and regurgitation scores with P-values of 0.014 and 0.008, respectively. Quality of life also significantly (P = 0.005) improved post-surgery. Chronic cough resolved in all the 4 patients (100%) following cardiomyotomy. CONCLUSIONS Laparoscopic HCM with an antireflux procedure provides significant symptom relief in patients with sigmoid oesophagus and may be considered as the first-line treatment option in such patients. Oesophagectomy should be reserved for patients with a failed cardiomyotomy. PMID:23065746

  19. Changes of the retrolingual pharynx during the Muller manoeuvre and during sleep in sleep apnoea.

    PubMed

    de Mello-Filho, Francisco Veríssimo; da Silva Junior, Sávio Nogueira; Faria, Ana Célia; Garcia, Luis Vicente

    2014-12-01

    To determine whether the retrolingual pharynx shows the same morphometric modifications during the Muller manoeuvre and during drug-induced sleep endoscopy (DISE) with propofol in patients submitted for maxillomandibular advancement surgery. Eighteen patients submitted for maxillomandibular advancement surgery (MMAS) were evaluated endoscopically before and 6 month after surgery in the region of the retrolingual pharynx while seated and lying in dorsal decubitus (supine) while performing the Muller manoeuvre and during DISE with propofol, to verify and measure if the same morphometric changes occur in the retrolingual pharynx during the Muller manoeuvre and during DISE with propofol. The area, anteroposterior, and laterolateral retrolingual pharynx images were acquired using the Sony Vegas 8.0 software and recorded on a DVD. The Image J software was used to measure and compare these images. An increase in the pharyngeal aperture was observed in all measurements after surgery, specifically in area retrolingual pharynx images. When the Muller manoeuvre was performed, a greater gain (113%) in area retrolingual pharynx measurement was observed when the patient was awake and seated. With the patient was in dorsal decubitus during DISE with propofol there was a greater gain in area retrolingual pharynx measurement (201.33%) in the smaller aperture. The Muller manoeuvre after MMAS does not simulate the dimensions of the pharynx that occur during sleep. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  20. Non-achalasic motor disorders of the oesophagus.

    PubMed

    Sifrim, Daniel; Fornari, Fernando

    2007-01-01

    Motor abnormalities of the oesophagus are characterised by a chronic impairment of the neuromuscular structures that co-ordinate oesophageal function. The best-defined entity is achalasia, which is discussed in a separate chapter. Other motor disorders with clinical relevance include diffuse oesophageal spasm, oesophageal dysmotility associated with scleroderma, and ineffective oesophageal motility. These non-achalasic motor disorders have variable prevalence but they could be associated with invalidating symptoms such as dysphagia, chest pain and gastro-oesophageal reflux disease. New oesophageal diagnostic techniques, including high-resolution manometry, high-frequency intraluminal ultrasound and intraluminal impedance, allow (1) better definition of peristalsis and sphincter function, (2) assessment of changes in oesophageal wall thickness, and (3) evaluation of pressure gradients within the oesophagus and across the sphincters that can produce normal or abnormal patterns of bolus transport. This chapter discusses recent advances in physiology, pathophysiology, diagnosis and treatment of non-achalasic oesophageal motor disorders.

  1. Adenosquamous carcinoma of the oesophagus in a dog.

    PubMed

    Okanishi, H; Shibuya, H; Miyasaka, T; Asano, K; Sato, T; Watari, T

    2015-08-01

    A six-year-old mixed-breed male dog weighing 7.0 kg was presented with chronic vomiting and regurgitation. Endoscopic examination revealed prominent oesophageal dilation in the thoracic region, multiple small greyish-white nodules over the oesophageal lumen and cauliflower-like masses in the caudal oesophagus. Histopathological studies revealed a characteristic pattern of coexisting elements of infiltrating adenocarcinoma and squamous cell carcinoma. Immunohistochemical staining with anti-cytokeratin AE1 + AE3 was positive in both types of neoplastic cells. Neoplastic glandular cells stained positively for cytokeratin 8 while neoplastic squamous cells stained positively for cytokeratin 5/6. On the basis of these findings, the dog was diagnosed with oesophageal adenosquamous carcinoma. The case history and findings suggest that the malignancy might have developed from Barrett's oesophagus following irritation of the oesophageal mucosa due to chronic vomiting and regurgitation.

  2. Jackhammer oesophagus in a case of linitis plastica.

    PubMed

    Chaudhry, Naueen Akbar; Zahid, Kamran; Coman, Roxana; Zhang, Qing

    2016-05-12

    A 52-year-old Caucasian woman presented with progressive nausea and vomiting, weight loss, and burning epigastric and chest pain. Initial oesophagogastroduodenoscopy (OGD) with biopsies demonstrated gastritis in absence of Helicobacter pylori A gastric emptying study, CT scan with pancreatic protocol and a colonoscopy revealed no concerning findings. Calcium channel blockers and proton pump inhibitors offered little improvement. A high-resolution oesophageal impedance manometry was performed, which was significant for jackhammer oesophagus with maximum distal contractile index 11 052 mm Hg-s-cm. Another OGD was carried out for Botox injection to oesophagogastric junction. Repeat gastric biopsies reported gastric adenocarcinoma, further diagnosed as stage 4 linitis plastica with metastatic peritoneal carcinomatosis. To the best of our knowledge, this is the only case of linitis plastica associated with jackhammer oesophagus. 2016 BMJ Publishing Group Ltd.

  3. Trial production of the handy amplifier for oesophagus speech.

    PubMed

    Satoh, I; Yamaguchi, T

    1982-01-01

    Oesophagus speakers cannot raise their voices. This seems to be the biggest trouble in daily life for them. Therefore, a handy amplifier has been produced by way of trial experiment to alleviate their trouble. This instrument is made up of a microphone, amplifier and speaker. The amplifier and speaker is put in a compact box 10.0 x 6.7 x 2.8 cm. The microphone is put in a cigarette holder and connected to the amplifier by a thin cord 30 cm long. When the sound is uttered whilst touching the holder with the lips it is heard through the speaker via the amplifier in the chest pocket of the coat. This instrument is recommended by many oesophagus speakers.

  4. Evaluation of Helicobacter pylori in reflux oesophagitis and Barrett's oesophagus.

    PubMed Central

    Newton, M; Bryan, R; Burnham, W R; Kamm, M A

    1997-01-01

    BACKGROUND: One of the major pathophysiological abnormalities in patients with gastro-oesophageal reflux disease is thought to involve transient lower oesophageal sphincter (LOS) relaxations. One component of the neural mechanism controlling the LOS appears to be a reflex are whose afferent limb originates in the gastric fundus. As inflammation is known to be associated with neural activation an investigation was made to determine whether gastric infection with H pylori is altered in prevalence or distribution in patients with reflux disease. METHODS: Five groups of subjects referred for endoscopy-group 1: 25 controls (asymptomatic individuals with anaemia and normal endoscopy); group 2: 36 subjects with erosive oesophagitis alone (Savary-Millar grades I-III); group 3: 16 subjects with duodenal ulcer alone; group 4: 15 subjects with oesophagitis with duodenal ulcer; group 5: 16 subjects with Barrett's oesophagus. No patients were receiving acid suppressants or antibiotics. An antral biopsy specimen was taken for a rapid urease test, and two biopsy specimens were taken from the antrum, fundus, and oesophagus (inflamed and non-inflamed) for histological evidence of inflammation and presence of H pylori using a Giemsa stain. RESULTS: Nine (36%) controls had H pylori. Patients with duodenal ulcer alone had a significantly higher incidence of colonisation by H pylori than other groups (duodenal ulcer 15 (94%); oesophagitis 13 (36%); oesophagitis+duodenal ulcer 6 (40%); Barrett's oesophagus 4 (25%)). H pylori was not more common in oesophagitis. When H pylori colonised the gastric antrum it was usually found in the gastric fundus. There was no difference in anatomical distribution of H pylori in the different patient groups. In Barrett's oesophagus H pylori was found in two of 16 in the metaplastic epithelium. CONCLUSION: H pylori is not more common and its distribution does not differ in those with oesophagitis compared with control subjects, and is therefore unlikely

  5. [Respiratory insufficiency due to duplications of the oesophagus].

    PubMed

    Luoma, Reijo

    2015-01-01

    Duplications of the oesophagus are uncommon congenital malformations with possible occurrence in any part of the gastrointestinal tract. The duplications may be cysts, diverticula or tubular-shaped. Cysts may even occur further away from the gastrointestinal tract, not necessarily having contact with it. I present a patient case, in which a 13-month-old child was brought to the emergency room due to gradually increasing dyspnea. The child made a full recovery after the surgical procedure.

  6. Acid suppression and surgical therapy for Barrett's oesophagus.

    PubMed

    de Jonge, Pieter J F; Spaander, Manon C; Bruno, Marco J; Kuipers, Ernst J

    2015-02-01

    Gastro-oesophageal reflux disease is a common medical problem in developed countries, and is a risk factor for the development of Barrett's oesophagus and oesophageal adenocarcinoma. Both proton pump inhibitor therapy and antireflux surgery are effective at controlling endoscopic signs and symptoms of gastro-oesophageal reflux in patients with Barrett's oesophagus, but often fail to eliminate pathological oesophageal acid exposure. The current available studies strongly suggest that acid suppressive therapy, both pharmacological as well as surgical acid suppression, can reduce the risk the development and progression in patients with Barrett's oesophagus, but are not capable of complete prevention. No significant differences have been found between pharmacological and surgical therapy. For clinical practice, patients should be prescribed a proton pump inhibitor once daily as maintenance therapy, with the dose guided by symptoms. Antireflux surgery can be a good alternative to proton pump inhibitor therapy, but should be primarily offered to patients with symptomatic reflux, and not to asymptomatic patients with the rationale to protect against cancer. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Agricultural pesticide use and adenocarcinomas of the stomach and oesophagus

    PubMed Central

    Lee, W; Lijinsky, W; Heineman, E; Markin, R; Weisenburger, D; Ward, M

    2004-01-01

    Aims: To evaluate the risk of the stomach and oesophageal adenocarcinomas associated with farming and agricultural pesticide use. Methods: Population based case-control study in eastern Nebraska. Telephone interviews were conducted with men and women diagnosed with adenocarcinoma of the stomach (n = 170) or oesophagus (n = 137) between 1988 and 1993, and controls (n = 502) randomly selected from the same geographical area. Unconditional logistic regression was used to calculate adjusted odds ratios (ORs) for farming and for use of individual and chemical classes of insecticides and herbicides, including pesticides classified as nitrosatable (able to form N-nitroso compounds on reaction with nitrite). Non-farmers were used as the reference category for all analyses. Results: Ever living or working on a farm, duration of farming, and size of the farm were not associated with stomach or oesophageal adenocarcinomas. There was no association for either cancer with ever-use of insecticides (stomach OR 0.9, 95% CI 0.6 to 1.4; oesophagus OR 0.7, 95% CI 0.4 to 1.1) or herbicides (stomach OR 0.9, 95% CI 0.5 to 1.4; oesophagus OR 0.7, 95% CI 0.4 to 1.2). Likewise, individual pesticides, including individual nitrosatable pesticides, were not significantly associated with risk. Conclusions: No significant associations were found between specific agricultural pesticide exposures and the risk of stomach or oesophageal adenocarcinomas among Nebraska farmers. PMID:15317914

  8. Immune competence of the Ciona intestinalis pharynx: complement system-mediated activity.

    PubMed

    Giacomelli, Stefano; Melillo, Daniela; Lambris, John D; Pinto, Maria Rosaria

    2012-10-01

    In the tunicate Ciona intestinalis, the ciliated pharynx, which connects the external environment to a highly developed and compartmentalized gastrointestinal system, represents the natural portal of entry for a vast and diverse, potentially pathogenic microbial community. To address the role of the pharynx in immune surveillance in Ciona, we asked whether C3, the key component of the complement system, was expressed in this organ and whether the encoded protein was functionally active. We found by real-time PCR that C3, constitutively expressed in the pharynx, is up-regulated by LPS injection. Using two specific anti-CiC3 and anti-CiC3a polyclonal antibodies in immunohistochemical staining of pharynx sections, we found that the gene product was localized to hemocytes of the pharyngeal bars (identified as granular amoebocytes) and in stigmata ciliated cells. Use of the same antibodies in Western blot analysis indicated that CiC3 and its activation products CiC3b and CiC3a are present in pharynx homogenates. Our observation that the amount of the bioactive fragment CiC3a increased in the pharynx of LPS-treated animals provides the first molecular and functional evidence for complement-mediated immunological activity in the tunicate pharynx. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Barrett's oesophagus and oesophageal adenocarcinoma: how does acid interfere with cell proliferation and differentiation?

    PubMed

    Fitzgerald, R C

    2005-03-01

    Acid, a principal component of gastro-oesophageal refluxate, may contribute to the development and malignant progression of Barrett's oesophagus. Oesophageal pH monitoring studies have demonstrated that patients with Barrett's oesophagus have severe and chronic acid reflux. However, there is overlap between the amount of acid exposure in patients with oesophagitis compared with patients with Barrett's oesophagus. This suggests that factors other than acid may be important in the aberrant oesophageal cell differentiation process that leads to the development of the metaplastic Barrett's mucosa. The other factors important in the aetiology of Barrett's oesophagus are poorly understood but probably include both genetic and environmental factors.

  10. Parkinson disease affects peripheral sensory nerves in the pharynx.

    PubMed

    Mu, Liancai; Sobotka, Stanislaw; Chen, Jingming; Su, Hungxi; Sanders, Ira; Nyirenda, Themba; Adler, Charles H; Shill, Holly A; Caviness, John N; Samanta, Johan E; Sue, Lucia I; Beach, Thomas G

    2013-07-01

    Dysphagia is very common in patients with Parkinson disease (PD) and often leads to aspiration pneumonia, the most common cause of death in PD. Current therapies are largely ineffective for dysphagia. Because pharyngeal sensation normally triggers the swallowing reflex, we examined pharyngeal sensory nerves in PD patients for Lewy pathology.Sensory nerves supplying the pharynx were excised from autopsied pharynges obtained from patients with clinically diagnosed and neuropathologically confirmed PD (n = 10) and healthy age-matched controls (n = 4). We examined the glossopharyngeal nerve (cranial nerve IX), the pharyngeal sensory branch of the vagus nerve (PSB-X), and the internal superior laryngeal nerve (ISLN) innervating the laryngopharynx. Immunohistochemistry for phosphorylated α-synuclein was used to detect Lewy pathology. Axonal α-synuclein aggregates in the pharyngeal sensory nerves were identified in all of the PD subjects but not in the controls. The density of α-synuclein-positive lesions was greater in PD patients with dysphagia versus those without dysphagia. In addition, α-synuclein-immunoreactive nerve fibers in the ISLN were much more abundant than those in cranial nerve IX and PSB-X. These findings suggest that pharyngeal sensory nerves are directly affected by pathologic processes in PD. These abnormalities may decrease pharyngeal sensation, thereby impairing swallowing and airway protective reflexes and contributing to dysphagia and aspiration.

  11. Dynamic Magnetic Resonance Imaging of the Pharynx During Deglutition

    PubMed Central

    Amin, Milan R.; Achlatis, Stratos; Lazarus, Cathy L.; Branski, Ryan C.; Storey, E. Pippa; Praminik, Bidyut; Fang, Yixin; Sodickson, Daniel

    2014-01-01

    Objectives To utilize dynamic magnetic resonance imaging (dMRI) to visualize the pharynx and upper esophageal segment in normal, healthy controls. Methods A 3-T scanner with a 4-channel head coil and a dual-channel neck coil was employed to obtain hsMRI images of subjects swallowing liquids and pudding. Thirty sequential images were acquired over 3300ms for each swallow. Imaging was performed in the midsagittal and axial plane at the level of the oropharynx and pharyngoesophageal segment. Axial images were then analyzed for variables related to alterations in pharyngeal and UES area during swallowing as well as temporal measures related to these structures. Results All subjects tolerated the study protocol without complaint. Changes in pharyngeal wall luminal area and temporal measurements were consistent within and between subjects. Inter- and intra-rater reliability for the measurement tool was excellent. Conclusions dMRI of the swallow sequence is both feasible and reliable and may eventually compliment currently-used diagnostic modalities as it adds substantive information. PMID:23577565

  12. Parkinson Disease Affects Peripheral Sensory Nerves in the Pharynx

    PubMed Central

    Mu, Liancai; Sobotka, Stanislaw; Chen, Jingming; Su, Hungxi; Sanders, Ira; Nyirenda, Themba; Adler, Charles H.; Shill, Holly A.; Caviness, John N.; Samanta, Johan E.; Sue, Lucia I.; Beach, Thomas G.

    2013-01-01

    Dysphagia is very common in patients with Parkinson’s disease (PD) and often leads to aspiration pneumonia, the most common cause of death in PD. Unfortunately, current therapies are largely ineffective for dysphagia. As pharyngeal sensation normally triggers the swallowing reflex, we examined pharyngeal sensory nerves in PD for Lewy pathology. Sensory nerves supplying the pharynx were excised from autopsied pharynges obtained from patients with clinically diagnosed and neuropathologically confirmed PD (n = 10) and healthy age-matched controls (n = 4). We examined: the glossopharyngeal nerve (IX); the pharyngeal sensory branch of the vagus nerve (PSB-X); and the internal superior laryngeal nerve (ISLN) innervating the laryngopharynx. Immunohistochemistry for phosphorylated α-synuclein was used to detect potential Lewy pathology. Axonal α-synuclein aggregates in the pharyngeal sensory nerves were identified in all of the PD subjects but not in the controls. The density of α-synuclein-positive lesions was significantly greater in PD subjects with documented dysphagia compared to those without dysphagia. In addition, α-synuclein-immunoreactive nerve fibers in the ISLN were much more abundant than those in the IX and PSBX. These findings suggest that pharyngeal sensory nerves are directly affected by the pathologic process of PD. This anatomic pathology may decrease pharyngeal sensation impairing swallowing and airway protective reflexes, thereby contributing to dysphagia and aspiration. PMID:23771215

  13. Stapler suture of the pharynx after total laryngectomy.

    PubMed

    Dedivitis, R A; Aires, F T; Pfuetzenreiter, E G; Castro, M A F; Guimarães, A V

    2014-04-01

    The use of a stapler for pharyngeal closure during total laryngectomy was first described in 1971. It provides rapid watertight closure without surgical field contamination. The objective of our study was to compare the incidence of pharyngocutaneous fistula after total laryngectomy with manual and mechanical closures of the pharynx. This was a non-randomised, prospective clinical study conducted at two tertiary medical centres from 1996 to 2011 including consecutive patients with laryngeal tumours who underwent total laryngectomy. We compared the incidence of pharyngocutaneous fistula between two groups of patients: in 20 patients, 75 mm linear stapler closure was applied, whereas in 67 patients a manual suture was used. Clinical data were compared between groups. The groups were statistically similar in terms of gender, age, diabetes mellitus, smoking and alcohol consumption and tumour site. The group of patients who underwent stapler-assisted pharyngeal closure had a higher number of patients with previous tracheotomy (p < 0.001) and previous chemoradiation (p < 0.001). The incidence of pharyngocutaneous fistula was 30% in the mechanical closure group and 20.9% in the manual suture group (p = 0.42). In conclusion the use of the stapler does not increase the rate of fistulae.

  14. Prolonged manometric recordings of oesophagus and lower oesophageal sphincter in achalasia patients

    PubMed Central

    van Herwaarden, M A; Samsom, M; Smout, A

    2001-01-01

    BACKGROUND AND AIMS—Conventional short term manometry is a valuable tool in the diagnosis of achalasia but the technique may fail to detect intermittent motor events. The aim of this study was to investigate the pattern of lower oesophageal sphincter (LOS) and oesophageal pressures during prolonged recording in patients with achalasia.
METHODS—Eleven patients with idiopathic achalasia were studied. Prolonged combined oesophageal pH and manometric recordings of the pharynx, LOS, and stomach were performed using a pH glass electrode and a multiple lumen assembly incorporating a Dent sleeve connected to a portable water perfused manometric system.
RESULTS—LOS pressure varied during the day. Postprandial LOS pressures were lower than those recorded preprandially (1.2 v 1.8 kPa; p=0.005) and basal LOS pressures were significantly higher during phase III of the migrating motor complex than during the subsequent phase I (3.3 v 1.8 kPa; p=0.028). Complete LOS relaxations were occasionally observed in seven patients (0.48/h). Complete LOS relaxations were longer in duration than incomplete LOS relaxations (10.8 v 2.8 s; p=0.01) and 57% of complete relaxations fulfilled the criteria of a transient LOS relaxation (TLOSR). Complete LOS relaxations were associated with oesophageal pressure waves with higher amplitudes and longer durations. In addition, a higher proportion of these oesophageal pressure waves were spontaneous (55.6% v 0%; p<0.02) and multipeaked (72.7% v 0%). During prolonged manometry, high amplitude oesophageal pressure waves (>10 kPa) were recorded in six patients and retrograde oesophageal pressure waves in four, phenomena which were not observed during short term manometry.
CONCLUSION—In contrast with short term stationary manometry, prolonged manometry in achalasia patients revealed the occurrence of complete LOS relaxations, TLOSRs, variations in LOS pressure associated with a meal or phase III, and high amplitude and retrograde

  15. Evaluation of the magnitude of gastro-oesophageal reflux in Barrett's oesophagus.

    PubMed Central

    Parrilla, P; Ortiz, A; Martinez de Haro, L F; Aguayo, J L; Ramirez, P

    1990-01-01

    A manometric study to determine the role of gastro-oesophageal reflux in Barrett's oesophagus was performed on 20 patients with Barrett's oesophagus and 53 patients with reflux oesophagitis without Barrett's oesophagus (25 with mild oesophagitis and 28 with severe oesophagitis). For the same reason, the 20 patients with Barrett's oesophagus also underwent 24 hour continuous oesophageal pH monitoring, and the results obtained were compared with those of 20 oesophagitis patients without Barrett's oesophagus (10 with mild oesophagitis and 10 with severe oesophagitis). The manometric results show that the motor changes found in the Barrett's group are specific but similar to the motor dysfunction associated with reflux oesophagitis. Motor anomalies are probably related more to the inflammatory process in the oesophageal wall than to the metaplastic changes themselves. The pH monitoring results show that while reflux in the Barrett's oesophagus patients was greater overall than in the oesophagitis group without Barrett's oesophagus, the changes are similar when the results are compared with the severe oesophagitis group. In conclusion there are other factors besides gastro-oesophageal reflux involved in the pathogenesis of Barrett's oesophagus. PMID:2210462

  16. African American ethnicity is not associated with development of Barrett's oesophagus after erosive oesophagitis.

    PubMed

    Alkaddour, Ahmad; McGaw, Camille; Hritani, Rama; Palacio, Carlos; Nakshabendi, Rahman; Munoz, Juan Carlos; Vega, Kenneth J

    2015-10-01

    Barrett's oesophagus is the primary risk factor for oesophageal adenocarcinoma; erosive oesophagitis is considered an intermediate step with Barrett's oesophagus development potential upon healing. Barrett's oesophagus occurs in 9-19% following erosive oesophagitis but minimal data exists in African Americans. The study aim was to determine if ethnicity is associated with Barrett's oesophagus formation following erosive oesophagitis. Retrospective review of endoscopies from September 2007 to December 2012 was performed. Inclusion criteria were erosive oesophagitis on index endoscopy, repeat endoscopy ≥6 weeks later and non-Hispanic white or African American ethnicity. Barrett's oesophagus frequency following erosive oesophagitis by ethnicity was compared. A total of 14,303 patients underwent endoscopy during the study period; 1636 had erosive oesophagitis. Repeat endoscopy was performed on 125 non-Hispanic white or African American patients ≥6 weeks from the index procedure. Barrett's oesophagus occurred in 8% of non-Hispanic whites while no African American developed it on repeat endoscopy following erosive oesophagitis (p=0.029). No significant difference was seen between ethnic groups in any clinical parameter assessed. African American ethnicity appears to result in decreased Barrett's oesophagus formation following erosive oesophagitis. Further investigation to demonstrate factors resulting in decreased Barrett's oesophagus formation among African Americans should be performed. Copyright © 2015. Published by Elsevier Ltd.

  17. Lichen planus in the oesophagus: are we missing something?

    PubMed

    Shenfine, Jon; Preston, Shaun R

    2006-10-01

    Lichen planus of the oesophagus is rare with a predilection for middle-aged to elderly women. There is a potential risk of malignant transformation to squamous cell carcinoma. Squamous cell carcinoma of the oesophagus still accounts for 30-40% of oesophageal cancer cases in the west and is almost exclusively the disease still encountered in the rest of the world. An increased awareness of oesophageal lichen planus is suggested in patients with cutaneous, oral or vulval disease. Endoscopic investigation of patients with lichen planus, possibly initially limited to those with oesophageal symptoms, and consideration of surveillance in patients with proven oesophageal lichen planus, will aid understanding of natural history of lesions and may help detect early stage tumours. Squamous cell carcinoma still accounts for 30-40% of oesophageal cancer cases in the west and is almost exclusively the disease still encountered elsewhere. Lichen planus of the oesophagus is potentially a premalignant condition for squamous cell carcinoma that could be surveilled in order to detect early-stage tumours with a consequent greater chance of cure. Oesophageal lichen planus is, however, rare, frequently asymptomatic and although the majority of cases occur in conjunction with lichen planus in other sites, the oesophageal features may be subtle and easily missed by endoscopic assessment. Furthermore, the histological changes are difficult to interpret and there may be significant underreporting. As a consequence, the true prevalence of these lesions is hard to determine. The difficulties in detection may mean that we are underestimating the frequency of oesophageal lichen planus. Endoscopic detection may be aided by the use of magnification indigo carmine chromoendoscopy and this warrants further evaluation. The risk of malignant transformation is currently unknown but may parallel that of oral lesions at approximately 1-3%. An increased awareness of the condition can only help to

  18. ER stress induces epithelial differentiation in the mouse oesophagus.

    PubMed

    Rosekrans, Sanne L; Heijmans, Jarom; Büller, Nikè V J A; Westerlund, Jessica; Lee, Amy S; Muncan, Vanesa; van den Brink, Gijs R

    2015-02-01

    Stress in the endoplasmic reticulum (ER) leads to activation of the unfolded protein response (UPR). Xbp1, a key component of the UPR has recently been linked to the risk of developing oesophageal squamous cell carcinoma, suggesting an important role for the UPR in the oesophageal epithelium. Here we examined the role of ER stress and the UPR in oesophageal epithelial homoeostasis. We examined the expression of components of the UPR in the oesophageal epithelium. We used a pharmacological approach and a genetic approach to examine the effects of ER stress in vivo in the mouse oesophagus. The oesophagus of these mice was examined using immunohistochemistry and real-time reverse transcription (RT)-PCR. Components of the UPR were heterogeneously expressed in the basal layer of the epithelium. Induction of ER stress by 24-h treatment with thapsigargin resulted in depletion of proliferating cells in the basal layer of the oesophagus and induced differentiation. We next activated the UPR by inducible deletion of the major ER chaperone Grp78 in Ah1Cre-Rosa26-LacZ-Grp78(-/-) mice in which mutant cells could be traced by expression of LacZ. In these mice LacZ-positive mutant cells in the basal layer lost their proliferative capacity, migrated towards the oesophageal lumen and were replaced by LacZ-negative non-mutant cells. We observed no apoptosis in mutant cells. These results show that ER stress induces epithelial differentiation in precursor cells in the oesophageal epithelium. This UPR induced differentiation may serve as a quality control mechanism that protects against oesophageal cancer development. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  19. Oesophagus obstruction due to ingestion of multiple foreign bodies.

    PubMed

    Karadas, Sevdegul; Cegin, Muhammet Bilal; Sayir, Fuat; Gonullu, Hayriye; Olmez, Sehmuz

    2016-04-01

    The ingestion of a foreign body (FB) is a potentially serious condition. In children, the most common years for FB ingestion are from the age of 6 months to 6 years. FB ingestion also occurs in those with psychiatric disorders or mental retardation and among adult prisoners and alcoholics. Most ingested FBs spontaneously pass out of the body via the gastrointestinal system. An endoscopic or surgical approach is only needed if the object fails to progress through the gastrointestinal tract. All objects impacted in the oesophagus require urgent treatment. This study reports a case of multiple FB ingestion and provides a literature review.

  20. Multiphoton microscopic imaging of human normal and cancerous oesophagus tissue.

    PubMed

    Chen, W S; Wang, Y; Liu, N R; Zhang, J X; Chen, R

    2014-01-01

    In this paper, microstructures of human oesophageal submucosa are evaluated using multiphoton microscopy, based on two-photon excited fluorescence and second harmonic generation. The content and distribution of collagen, elastic fibers and cancer cells in normal and cancerous submucosa layer have been distinctly obtained and briefly discussed. The variation of these components is very relevant to the pathology in oesophagus, especially in early oesophageal cancer. Our results further indicate that the multiphoton microscopy technique has the potential application in vivo in clinical diagnosis and monitoring of early oesophageal cancer. © 2013 The Authors Journal of Microscopy © 2013 Royal Microscopical Society.

  1. Cysteinyl leucotriene receptor type 1 mediates contraction in human and guinea-pig oesophagus.

    PubMed

    Chang, B-S; Chang, J-C; Wang, Y-S; Huang, S-C

    2008-10-01

    Leucotriene D(4) (LTD(4)) causes contraction of the guinea-pig and cat oesophagus. Effects of cysteinyl leucotrienes in the human oesophagus were unknown. To investigate and compare the cysteinyl leucotriene effects in the human oesophagus with those in the guinea-pig oesophagus, we measured contraction of muscularis mucosae strips isolated from the human and guinea-pig oesophagus caused by cysteinyl leucotrienes, LTC(4), LTD(4) and LTE(4), as well as the dihydroxy leucotriene, LTB(4). Effects of leucotrienes in human were similar to those in guinea-pig oesophagus. LTC(4) and LTD(4) caused moderate, whereas LTE(4) caused mild, concentration-dependent contraction. LTE(4) was a partial agonist. In contrast, LTB(4) did not cause any contraction. The relative potencies for cysteinyl leucotrienes to cause contraction were LTD(4) = LTC(4) > LTE(4). The LTD(4)-induced contraction was moderately inhibited by two selective CysLT(1) receptor antagonists, montelukast and zafirlukast, in both human and guinea-pig oesophagus. In addition, the LTD(4)-induced contraction was not and only slightly inhibited by BAY u9773, the CysLT(1) and CysLT(2) receptor antagonist, in the human and guinea-pig oesophageal muscularis mucosae respectively. These indicate the existence of the CysLT(1) mediating oesophageal contraction in both human and guinea-pig oesophagus. The LTD(4)-induced contraction was not affected by tetrodotoxin, atropine or capsaicin, suggesting a direct effect. These results demonstrate that cysteinyl leucotrienes but not the dihydroxy leucotriene cause contraction in the human and guinea-pig oesophagus. CysLT(1) mediates contraction in both human and guinea-pig oesophagus.

  2. Emerging optical methods for surveillance of Barrett’s oesophagus

    PubMed Central

    Sturm, Matthew B; Wang, Thomas D

    2016-01-01

    The rapid rise in incidence of oesophageal adenocarcinoma has motivated the need for improved methods for surveillance of Barrett’s oesophagus. Early neoplasia is flat in morphology and patchy in distribution and is difficult to detect with conventional white light endoscopy (WLE). Light offers numerous advantages for rapidly visualising the oesophagus, and advanced optical methods are being developed for wide-field and cross-sectional imaging to guide tissue biopsy and stage early neoplasia, respectively. We review key features of these promising methods and address their potential to improve detection of Barrett’s neoplasia. The clinical performance of key advanced imaging technologies is reviewed, including (1) wide-field methods, such as high-definition WLE, chromoendoscopy, narrow-band imaging, autofluorescence and trimodal imaging and (2) cross-sectional techniques, such as optical coherence tomography, optical frequency domain imaging and confocal laser endomicroscopy. Some of these instruments are being adapted for molecular imaging to detect specific biological targets that are overexpressed in Barrett’s neoplasia. Gene expression profiles are being used to identify early targets that appear before morphological changes can be visualised with white light. These targets are detected in vivo using exogenous probes, such as lectins, peptides, antibodies, affibodies and activatable enzymes that are labelled with fluorescence dyes to produce high contrast images. This emerging approach has potential to provide a ‘red flag’ to identify regions of premalignant mucosa, outline disease margins and guide therapy based on the underlying molecular mechanisms of cancer progression. PMID:25975605

  3. I-SCAN targeted versus random biopsies in Barrett's oesophagus.

    PubMed

    Verna, Carlo; Feyles, Elda; Lorenzi, Luisa; Rolle, Emanuela; Grassini, Mario; Giacobbe, Ugo; Niola, Paolo; Battaglia, Edda; Bassotti, Gabrio; Villanacci, Vincenzo

    2014-02-01

    The accuracy and effectiveness of targeted oesophageal biopsies in Barrett's oesophagus to detect dysplasia using new magnification techniques are unknown. Aim of this study was to investigate whether the combined use of acetic acid, magnification and electronic filters allows the same accuracy as the four-quadrant random biopsies pattern; pathologist interobserver agreement both in low grade and high grade dysplasia was also assessed. Fifty-four consecutive patients newly diagnosed with Barrett's oesophagus were enrolled in a prospective study from a single endoscopy unit. Biopsies were evaluated by the local pathologist and by an expert pathologist from another pathology unit. Dysplasia detection rate and interobserver agreement for the histologic diagnosis of dysplasia. The use of acetic acid, magnification and electronic filters showed an unacceptably low dysplasia detection rate by the two pathologists (9.2% and 5.5% for targeted biopsies, respectively). The interobserver agreement for low grade dysplasia between pathologists was low (Cohen's K weighted=0.45). In an average setting, the standard four-quadrant method should still be preferred, along with the implementation of a routine second evaluation by an expert pathologist. Copyright © 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  4. Spontaneous intramural rupture and intramural haematoma of the oesophagus.

    PubMed Central

    Kerr, W F

    1980-01-01

    Spontaneous intramural rupture or intramural haematoma of the oesophagus is a rare cause of acute pain in the chest and upper abdomen. Much less ominous than spontaneous complete rupture from which it must be distinguished, it seldom if ever necessitates operation. Five new cases are described and reviewed together with 15 collected from published reports. The dominant symptom of every case was severe and constant retrosternal or epigastric pain; concomitant dysphagia was mentioned in 11 cases. In seven the pain was preceded by or coincided with vomiting. The condition was related to other stresses in three and appeared to be truly spontaneous in 10. In approximately one-third of cases it started suddenly but more often it began as discomfort worsening rapidly. Fourteen patients vomited blood after experiencing pain but only four were given transfusions. In contradistinction to complete rupture, none had surgical emphysema and plain chest radiographs were unremarkable. All had abnormal gastrografin or barium swallows. Intramural haematomas with or without mucosal tears were seen in the 11 cases in which oesophagoscopy was performed. Fifteen patients made rapid and complete recoveries on conservative management. Of the four who did not respond satisfactorily, one had the oesophagus repaired, two had drainage of the mediastinum after failure to find the false lumen at thoracotomy, and one had only an abdominal exploration. The only death in the whole series occurred after a disastrous emergency exploration and subsequent total oesophagectomy. Images PMID:6973833

  5. Inflammatory pseudotumours of the oesophagus--histological and immunohistochemical findings.

    PubMed

    Sy, Keiyan; Parfitt, Jeremy; Marginean, Celia; Riddell, Robert H; Streutker, Catherine J

    2015-06-01

    Inflammatory oesophageal pseudotumours are rare lesions, thought to be reactive. Due to marked atypia of the stromal cells, these can be misdiagnosed as malignancies. The objective of this study was to characterize histological and immunohistochemical features of a series of inflammatory pseudotumours of the oesophagus. We present 12 cases of inflammatory oesophageal pseudotumours, occurring in seven females and five males, with a mean age of 57.3 years. Clinical presentations were variable; dysphagia, abdominal pain and weight loss and upper gastrointestinal bleed. In a majority of the cases, nodules or masses in the distal oesophagus were identified at endoscopy. Microscopically, the lamina propria in all 12 cases contained inflammation and granulation tissue. Ten of 12 cases showed mucosal ulceration and 11 of 12 cases had acutely inflamed epithelium. Markedly atypical pleomorphic stromal cells with prominent nucleoli were identified in all 12 cases. Immunohistochemistry showed uniform positivity for vimentin in 11 of 11 cases, and two of seven cases demonstrated weak focal positivity for smooth muscle actin. The cells were negative for all other markers. Reactive oesophageal lesions can show marked nuclear atypia in stromal fibroblasts/myofibroblasts, which are easily mistaken for malignancies. Pathologists must consider the diagnosis of an inflammatory pseudotumour if stromal atypia is present in an inflammatory background. © 2014 John Wiley & Sons Ltd.

  6. Barrett's oesophagus and associated dysplasia are not equally distributed within the esophageal circumference.

    PubMed

    Bibbò, Stefano; Ianiro, Gianluca; Ricci, Riccardo; Arciuolo, Damiano; Petruzziello, Lucio; Spada, Cristiano; Larghi, Alberto; Riccioni, Maria Elena; Gasbarrini, Antonio; Costamagna, Guido; Cammarota, Giovanni

    2016-09-01

    A careful endoscopic surveillance of Barrett's oesophagus is warranted to prevent esophageal cancer. To identify the preferred location of non-circumferential Barrett's oesophagus and associated dysplasia within the esophageal circumference. We retrospectively reviewed a prospectively maintained database of patients with non-circumferential lesions. The location of metaplastic lesions and dysplastic lesions within the esophageal circumference was identified as on a clock face, and their distribution in the 4 quadrants was compared. Of overall 443 patients with Barrett's oesophagus, 192 (43%) were eligible for our study. Multiple lesions were diagnosed in 110 (57%) of them, for a total amount of 352 metaplastic areas. Barrett's oesophagus lesions were located significantly more in the posterior wall of the oesophagus (38.4%), rather than in the right wall (28.8%), the anterior wall (22.6%), or the left wall (10.2%) (P<0.0001). Among all metaplastic lesions, 28 were associated with dysplasia (7.9%), and one with adenocarcinoma (0.3%). Dysplastic lesions were significantly more common in the posterior wall (39.3%) than, respectively, in the anterior wall (35.8%), the right wall (21.4%) or the left wall (3.5%) (P=0.03). Our results show that the posterior wall of the oesophagus is the preferential location of both Barrett's oesophagus and associated dysplasia. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  7. The distribution of transient receptor potential melastatin-8 in the rat soft palate, epiglottis, and pharynx.

    PubMed

    Sato, Tadasu; Fujita, Masatoshi; Kano, Mitsuhiro; Hosokawa, Hiroshi; Kondo, Teruyoshi; Suzuki, Toshihiko; Kasahara, Eriko; Shoji, Noriaki; Sasano, Takashi; Ichikawa, Hiroyuki

    2013-03-01

    Immunohistochemistry for transient receptor potential melastatin-8 (TRPM8), the cold and menthol receptor, was performed on the rat soft palate, epiglottis and pharynx. TRPM8-immunoreactive (IR) nerve fibers were located beneath the mucous epithelium, and occasionally penetrated the epithelium. These nerve fibers were abundant in the posterior portion of the soft palate and at the border region of naso-oral and laryngeal parts of the pharynx. The epiglottis was free from such nerve fibers. The double immunofluorescence method demonstrated that TRPM8-IR nerve fibers in the pharynx and soft palate were mostly devoid of calcitonin gene-related peptide-immunoreactivity (CGRP-IR). The retrograde tracing method also demonstrated that 30.1 and 8.7 % of sensory neurons in the jugular and petrosal ganglia innervating the pharynx contained TRPM8-IR, respectively. Among these neurons, the co-expression of TRPM8 and CGRP-IR was very rare. In the nodose ganglion, however, pharyngeal neurons were devoid of TRPM8-IR. Taste bud-like structures in the soft palate and pharynx contained 4-9 TRPM8-IR cells. In the epiglottis, the mucous epithelium on the laryngeal side had numerous TRPM8-IR cells. The present study suggests that TRPM8 can respond to cold stimulation when food and drinks pass through oral and pharyngeal cavities.

  8. Pituitary adenylatecyclase-activating polypeptide-immunoreactive nerve fibers in the rat epiglottis and pharynx.

    PubMed

    Kano, Mitsuhiro; Shimizu, Yoshinaka; Suzuki, Yujiro; Furukawa, Yusuke; Ishida, Hiroko; Oikawa, Miho; Kanetaka, Hiroyasu; Ichikawa, Hiroyuki; Suzuki, Toshihiko

    2011-12-20

    The distribution of pituitary adenylatecyclase-activating polypeptide-immunoreactive (PACAP-IR) nerve fibers was studied in the rat epiglottis and pharynx. PACAP-IR nerve fibers were located beneath the mucous epithelium, and occasionally penetrated the epithelium. These nerve fibers were abundant on the laryngeal side of the epiglottis and in the dorsal and lateral border region between naso-oral and laryngeal parts of the pharynx. PACAP-IR nerve fibers were also detected in taste buds within the epiglottis and pharynx. In addition, many PACAP-IR nerve fibers were found around acinar cells and blood vessels. The double immunofluorescence method demonstrated that distribution of PACAP-IR nerve fibers was similar to that in CGRP-IR nerve fibers in the epithelium and taste bud. However, distributions of PACAP-IR and CGRP-IR nerve fibers innervating mucous glands and blood vessels were different. The retrograde tracing method also demonstrated that PACAP and CGRP were co-expressed by vagal and glossopharyngeal sensory neurons innervating the pharynx. These findings suggest that PACAP-IR nerve fibers in the epithelium and taste bud of the epiglottis and pharynx which originate from the vagal and glossopharyngeal sensory ganglia include nociceptors and chemoreceptors. The origin of PACAP-IR nerve fibers which innervate mucous glands and blood vessels may be the autonomic ganglion. Copyright © 2011 Elsevier GmbH. All rights reserved.

  9. Morphometric endoscopic study of the pharynx in patients with sleep apnea.

    PubMed

    da Silva Junior, Sávio Nogueira; Faria, Ana Célia; Garcia, Luis Vicente; de Mello-Filho, Francisco Veríssimo

    2012-01-01

    The aims of the study were to measure endoscopically the retrolingual pharynx during wakefulness and sleep before and after maxillomandibular advancement surgery and to quantify the changes observed. Eighteen patients with mild to severe grade obstructive sleep apnea hypopnea were evaluated during wakefulness while sitting and lying down and during induced sleep in dorsal decubitus while breathing naturally. Images of the retrolingual region of the pharynx were captured with a nasofibroscope and recorded on a DVD using the Sony Vegas 8.0 software (Sony Creative Software, Madison, WI). The images captured in greater and smaller aperture were measured with the Image J software (produced by Wayne Rasband, United States National Institutes of Health, Bethesda, MD) in linear anteroposterior and linear laterolateral areas. A correction factor was then applied to equalize the size of the images and thus compare them to one another. The postoperative dimensions of the pharynx always increased significantly in all measurements compared with the preoperative ones. During induced sleep in dorsal decubitus, there was a greater gain in the area of smaller aperture (201.33%). The proposed method showed that the dimensions of the pharynx always increased significantly after surgery for maxillomandibular advancement, although the gain was not homogeneous in all dimensions and also varied according to state of consciousness. The greatest gain was observed in the area of smaller aperture with the patient in induced sleep, thus reducing the collapse of the pharynx. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Oesophageal tone and sensation in the transition zone between proximal striated and distal smooth muscle oesophagus.

    PubMed

    Karamanolis, G; Stevens, W; Vos, R; Tack, J; Clave, P; Sifrim, D

    2008-04-01

    Previous studies have shown that the proximal striated muscle oesophagus is less compliant and more sensitive than the distal smooth muscle oesophagus. Conventional and high resolution manometry described a transition zone between striated and smooth muscle oesophagus. We aimed to evaluate oesophageal tone and sensitivity at the transition zone of oesophagus in healthy volunteers. In 18 subjects (seven men, mean age: 28 years) an oesophageal barostat study was performed. Tone and sensitivity were assessed using stepwise isobaric distensions with the balloon located at transition zone and at distal oesophagus in random order. To study the effect induced on transition zone by a previous distension at the distal oesophagus and vice versa, identical protocol was repeated after 7 days with inverted order. Initial distension of a region is referred to as 'naïf' distension and distension of a region following the distension of the other segment as 'primed' distension. Assessment of three oesophageal symptoms (chest pain, heartburn and 'other') was obtained at the end of every distension step. Compliance was significantly higher in the transition zone than in the distal oesophagus (1.47 +/- 0.14 vs 1.09 +/- 0.09 mL mmHg(-1), P = 0.03) after 'naif' distensions. This difference was not observed during 'primed' distensions. Higher sensitivity at transition zone level was found in 11/18 (61%) subjects compared to 6/18 (33%, P < 0.05) at smooth muscle oesophagus. Chest pain and 'other' symptom were more often induced by distention of the transition zone, whereas heartburn was equally triggered by distension of either region. The transition zone is more complaint and more sensitive than smooth muscle oesophagus.

  11. Neuropilin-1 expression in squamous cell carcinoma of the oesophagus.

    PubMed

    Alattar, Mohamed; Omo, Alfred; Elsharawy, Mamdouh; Li, Jun

    2014-03-01

    The development of new therapeutic targets is needed to change the current low survival rates of cancer of the oesophagus. In some clinical trials, angiogenic inhibitors, including those targeting the vascular endothelial growth factor (VEGF) and its receptors, have proven efficacious. In concert with this, neuropilin-1 (NRP1), a coreceptor for VEGF, is expressed by many tumours and may be related to their progression. This study aimed to assess the expression and prognostic value of fNRP1 in primary squamous cell carcinoma (SCC) of the oesophagus. The expression of NRP1 receptors was assessed in 60 samples of resected oesophageal SCC and adjacent normal mucosa by western blotting, immunostaining and real-time quantitative PCR (qPCR). Furthermore, the relationship between NRP1 and the clinicopathological parameters was investigated. NRP1 staining was limited within normal tissues of the oesophagus, while it was prominent in tumour cells and vasculature. Overexpression of NRP1 receptors (3.6 ± 0.48-folds) was apparent in 81.7% specimens (n = 60, P = 0.0001). qPCR consistently revealed parallel NRP1-mRNA overexpression (3.7 ± 3.7-folds) (n = 16, P = 0.02). A higher molecular weight-modified NRP1 (mNRP1) species was identified in a large proportion of the tumour specimens (85%), accounting for 71.51 ± 20.6% of their total NRP1. Overexpression of tumour NRP1 was positively correlated with deeper invasion into the oesophageal wall (P = 0.05) though mNRP1-positive tumour populations were significantly associated with less lymph node metastasis (P = 0.036) and better prognostic tumour-node-metastasis stage (P = 0.037) than mNRP1 negative tumours. NRP1 overexpression in oesophageal SCC may contribute to local tumour invasiveness but the presence of the mNRP1 subtype correlates with less lymph node metastasis and better prognostic stage, suggesting that the balance between modified and unmodified NRP1 might be important for determining invasion potential.

  12. Branchen und Unternehmensbereiche

    NASA Astrophysics Data System (ADS)

    Kramer, Regine

    Dieses Kapitel gibt einen Überblick über die Haupteinsatzgebiete von Mathematikern, Informatikern, Naturwissenschaftlern und Ingenieuren in den wichtigsten Wirtschaftsbranchen und Unternehmensbereichen. Dabei werden ausbildungsnahe Aufgabenbereiche ebenso beschrieben wie eher fachferne Tätigkeiten und neben den klassischen Branchen und Berufsbildern auch neue Tätigkeitsfelder für MINT-Fachkräfte beschrieben.

  13. Fische und Fischerzeugnisse

    NASA Astrophysics Data System (ADS)

    Oehlenschläger, Jörg

    Fische und Fischerzeugnisse lassen sich gemäß den "Leitsätzen für Fische, Krebs- und Weichtiere und Erzeugnisse daraus" des Deutschen Lebensmittelbuches einteilen. Tiefgefrorene Fische werden von den "Leitsätzen für tiefgefrorene Fische, Krebs- und Weichtiere und Erzeugnisse daraus" und Salate mit Fleisch von Fischen, Krebs- und/oder Weichtieren durch Abschnitt II.B. der "Leitsätze für Feinkostsalate" abgedeckt. Zu nennen sind: Frischfische, Getrocknete Fische, Räucherfische, Gesalzene Fische, Erzeugnisse aus gesalzenen Fischen, Anchosen, Marinaden, Bratfischwaren, Kochfischwaren, Fischerzeugnisse in Gelee, Pasteurisierte Fischerzeugnisse, Fischdauerkonserven, Erzeugnisse aus Surimi, Krebstiere und Krebstiererzeugnisse, Weichtiere und Weichtiererzeugnisse und tiefgekühlte Fischereierzeugnisse.

  14. Mikrodaten und statistische Auswertungsmethoden

    NASA Astrophysics Data System (ADS)

    Hujer, Reinhard

    Mit der zunehmenden Verfügbarkeit immer größerer Querschnitts- und Längschnittsdatensätze für Personen, Haushalte und Betriebe sowie deren Verknüpfungen hat sich die mikroökonometrische Forschung in den vergangenen Jahren rasant weiterentwickelt. Dies gilt sowohl aus methodischer als auch aus empirischer, anwendungsorientierter Sicht. Mikrodaten und mikroökonometrische Ansätze dienen dazu, aktuelle, politikrelevante Fragen aufzugreifen, sie zu analysieren und fundierte politische Empfehlungen zu geben, beispielsweise im Rahmen der Arbeitsmarkt- und Sozialpolitik, der Finanzanalyse und der Marketingforschung. Die Deutsche Statistische Gesellschaft (DStatG) und deren Mitglieder haben sich in den Ausschüssen und in Hauptversammlungen kontinuierlich mit den Weiterentwicklungen der mikroökonometrischen Methodik und den empirischen Anwendungen befasst. Zahlreiche Publikationen von Mitgliedern der DStatG haben entscheidend zum kritischen Diskurs und zum wissenschaftlichen Fortschritt in diesem Bereich beigetragen.

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

    PubMed Central

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

    2016-01-01

    Surveillance of Barrett's oesophagus allows us to study the evolutionary dynamics of a human neoplasm over time. Here we use multicolour fluorescence in situ hybridization on brush cytology specimens, from two time points with a median interval of 37 months in 195 non-dysplastic Barrett's patients, and a third time point in a subset of 90 patients at a median interval of 36 months, to study clonal evolution at single-cell resolution. Baseline genetic diversity predicts progression and remains in a stable dynamic equilibrium over time. Clonal expansions are rare, being detected once every 36.8 patient years, and growing at an average rate of 1.58 cm2 (95% CI: 0.09–4.06) per year, often involving the p16 locus. This suggests a lack of strong clonal selection in Barrett's and that the malignant potential of ‘benign' Barrett's lesions is predetermined, with important implications for surveillance programs. PMID:27538785

  16. Morphologic and biomechanical changes of rat oesophagus in experimental diabetes

    PubMed Central

    Zeng, Yan-Jun; Yang, Jian; Zhao, Jing-Bo; Liao, Dong-Hua; Zhang, En-Ping; Gregersen, Hans; Xu, Xiao-Hu; Xu, Hong; Xu, Chuan-Qing

    2004-01-01

    AIM: To study morphologic and biomechanical changes of oesophagus in diabetes rats. METHODS: Diabetes was induced by a single injection of streptozotocin (STZ). The type of diabetes mellitus induced by parenteral STZ administration in rats was insulin-dependent (type I). The samples were excised and studied in vitro using a self-developed biomaterial test machine. RESULTS: The body mass was decreased after 4 d with STZ treatment. The length of esophagus shortened after 4, 7, 14 d. The opening angle increased after 14 d. The shear, longitudinal and circumferential stiffness were obviously raised after 28 d of STZ treatment. CONCLUSION: The changes of passive biomechanical properties reflect intra-structural alteration of tissue to a certain extent. This alteration will lead to some dysfunction of movement. For example, tension of esophageal wall will change due to some obstructive disease. PMID:15300896

  17. Carcinomas of the base of the tongue: diagnosis using double-contrast radiography of the pharynx

    SciTech Connect

    Apter, A.J.; Levine, M.S.; Glick, S.N.

    1984-04-01

    A barium examination is frequently performed as the primary screening study on patients with carcinoma of the base of the tongue who present with dysphagia. Because of the limitations of the conventional barium study in visualizing the pharynx, double-contrast views of this region are routinely included as part of the standard barium examination on all patients with pharyngeal dysphagia. With this technique, six carcinomas of the base of the tongue were detected, including four ulcerating and two exophytic lesions. The normal and abnormal appearance of the tongue base on double-contrast radiography of the pharynx is described.

  18. [Effect of weak electromagnetic radiation on regeneration of the pharynx in Dugesia tigrina planaria].

    PubMed

    Kreshchenko, N D; Sheĭman, I M; Fesenko, E E

    2001-01-01

    We have studied the effect of weak electromagnetic field on the morphogenesis of the planarian Dugesia tigrina. Regeneration of the pharynx was examined after its amputation. We have determined the rate of the appearance of the food response of a new pharynx. Experimental conditions were varied, such as dose and duration of irradiation, season, and time of irradiation after surgery. The results of experiments conducted with 2966 planarians have shown that weak electromagnetic field has various effects, which appear either as stimulation of regeneration or as its inhibition. In some experiments, there was no effect at all. These differences depend on numerous factors and may be modulated.

  19. [Stent implantation in the treatment of pharynx anastomotic stenosis after cervical esophageal resection: a case report].

    PubMed

    Zang, Chuanshan; Sun, Jian; Sun, Yan

    2016-03-01

    We report the treatment of one patient with pharynx anastomotic stenosis after cervical esophagealresection by stent implantation. The patient suffered from serious pharynx anastomotic stenosis after gastric-pha-ryngeal anastomosis. After balloon-dilatation,a domestic self-expanding Z-stents was implanted in the stricture ofthe esophagus under the X-rays. After stent implantation, the patient has been leading a normal life for threeyears. Balloon dilatation and stent implantation is an effective and safe method in the treatment of patients withpharynx anastomotic stenosis.

  20. [Children's OSAHS caused by the huge fibrolipoma in pharynx nasalis: a case report].

    PubMed

    Xia, Siwen; Li, Xiaomiao; Ma, Qiongfan

    2015-08-01

    We reported a case of children's OSAHS caused by the huge fibrolipoma in pharynx nasalis. The patient was a 10-years-old child who went to the hospital with the chief complaint of "Snoring and mouth breathing during sleep for 10 years". Imaging tests found one huge tumor in pharynx nasalis before the operation. The tumor was resected totally. The postoperative pathological diagnosis was fibrolipoma. No recurrence was noted during the follow-up visit one year postoperatively. The clinical features, diagnosis, treatment, pathology and prognosis were reviewed herein.

  1. Torque properties of a rat oesophagus for physiological and diabetic conditions.

    PubMed

    Zeng, Y-J; Qiao, Y-H; Yang, J; Gregersen, H; Zhang, E-P; Xu, X-H; Xu, H

    2004-10-01

    In this paper the torque of an oesophagus is studied for physiological and diabetic conditions. Since the function of the oesophagus is mainly mechanical, this work is focused on providing quantitative measurement of the passive biomechanical properties of the oesophagus torque. The oesophagus was treated as a membrane when calculating the stress and strain. The torque versus twist-angle relation was approximated to be linear at a specified pressure and longitudinal stretch ratio. Thus, the shear modulus can be computed by the torque, twist angle and polar moment of inertia in this state. The shear modulus varies greatly with the changing inflation pressure and longitudinal stretch ratio. When the longitudinal stretch ratio or transmural pressure is constant, the shear modulus is increased after 28 days of diabetes.

  2. Morphological study of the oesophagus and stomach of the Gopher snake Pituophis catenifer.

    PubMed

    Khamas, W; Reeves, R

    2011-08-01

    The gastrointestinal tract of the snake has various distinctions from mammals, birds and other reptiles. Five gopher snakes (Pituophis catenifer) were studied in relation to the gross anatomical measurements of visceral organs relative to body length as well as the histology of the oesophagus and the stomach. The oesophagus closely resembles the empty stomach upon gross examination. A small palpable thickening was observed at the junction of the oesophagus with the stomach. In both the oesophagus and the stomach, there were cellular and structural differences observed in the tunica mucosa which can be linked to the feeding habits and natural biology of the snake when compared to those of mammals. Both oesophagus and stomach were lined by simple columnar to pseudostratified columnar epithelium. There were no glands in the wall of the oesophagus. Scattered ciliated triangular cells (brush cells) were present among the columnar epithelial cells in the distal portion of the oesophagus. The stomach can be divided into three portions (proximal, middle and distal). The stomach has a small non-glandular portion with low folds. After this small non-glandular portion, glands started to appear and gradually increase in quantity. The largest quantity of glands appeared in the middle portion of the stomach with more branching folds resulting in a decrease in the lumen diameter. The tunica muscularis increased in thickness at the oesophageal and the pyloric-duodenal junctions. Positive statistical correlations were established in thickness of the tunica muscularis between proximal and distal portions of the oesophagus and the stomach. © 2011 Blackwell Verlag GmbH.

  3. Effects to exposure of tobacco smoke and alcohol on the tongue and pharynx of rats.

    PubMed

    Garcia Martins, Regina Helena; Marques Madeira, Sergio Luiz; Fabro, Alexandre Todorovic; Rocha, Noemi de Souza; de Oliveira Semenzati, Graziela; Alves, Karen Fernanda

    2012-02-01

    To study in rats the effects of exposure to tobacco and alcohol on the mucosa of the tongue and pharynx. Forty adult Wistar rats were allocated into four groups of 10 animals each: GI (control), food and water "ad libitum"; GII (alcohol), 30% of ethanol diluted in drinking water and food "ad libitum"; GIII (tobacco), exposure to the smoke of 10 cigarettes/day, food and water "ad libitum"; GIV (alcohol and tobacco), simultaneous exposure to both agents. After 260 days, the animals were sacrificed. Tongue and pharynx were removed for histopathological analysis. GI had the lowest tongue and pharynx histological scores. In GII, GIII, and GIV tongue samples revealed: apical cell hyperplasia (GII: 60%, GIII: 30%, GIV: 20%), basal cell hyperplasia (GII: 60%, GIII: 40%), hyperkeratosis (GII: 70%, GIII: 30%, GIV: 30%), dysplasia (GII: 60%, GIII: 60%, GIV: 50%), and apoptosis (GII: 60%, GIII: 40%, GIV: 60%). Pharynx samples revealed: apical cell hyperplasia (GII: 40%, GIII: 30%, GIV: 70%), basal cell hyperplasia (GII: 30%, GIII: 40%, GIV: 40%), hyperkeratosis (GII: 50%, GIII: 80%, GIV: 40%), and dysplasia (GII: 50%, GIII: 80%, GIV: 50%). Carcinoma in situ was detected in both sites. Alcohol and tobacco led to significant tongue and pharyngeal lesions that ranged from benign events to severe dysplasia. These findings confirm the deleterious effects of alcohol and tobacco on the airway mucosa.

  4. The distribution of galanin-immunoreactive nerve fibers in the rat pharynx.

    PubMed

    Suzuki, Toshihiko; Sato, Tadasu; Kano, Mitsuhiro; Ichikawa, Hiroyuki

    2013-08-01

    Galanin (GAL) consists of a chain of 29/30 amino acids which is widely distributed in the central and peripheral nervous systems. In this study, the distribution of GAL-immunoreactive (-IR) nerve fibers was examined in the rat pharynx and its adjacent regions. GAL-IR nerve fibers were located beneath the epithelium and taste bud-like structure of the pharynx, epiglottis, soft palate and larynx. These nerve fibers were abundant in the laryngeal part of the pharynx, and were rare in other regions. Mucous glands were mostly devoid of GAL-IR nerve fibers. In the musculature of pharyngeal constrictor muscles, many GAL-IR nerve fibers were also located around small blood vessels. However, intrinsic laryngeal muscles contained only a few GAL-IR nerve fibers. The double immunofluorescence method demonstrated that the distribution pattern of GAL-IR nerve fibers was partly similar to that of calcitonin gene-related peptide-IR nerve fibers in the pharyngeal mucosa and muscles. The present findings suggest that the pharynx is one of main targets of GAL-containing nerves in the upper digestive and respiratory systems. These nerves may have sensory and autonomic origins. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Oral cavity and pharynx-throat cancer in the United States, 1973-2003.

    PubMed

    Rodu, Brad; Cole, Philip

    2007-11-01

    To study incidence rates (Is) of oral cavity and pharynx-throat cancer in adults age 20+ years from 1973 to 2003, and to estimate how many of these cancers occurred in the United States in 2003. We used data and software from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program to generate age-adjusted Is, reported as cases per 100,000 person-years. For oral cancer, the Is for young men were stable, and Is at ages 40+ years declined by one third after the mid 1980s. Is declined by one third in women ages 40 to 74, but increased in the youngest and oldest groups. In 2003 there were 10,432 cases of oral cavity cancer among persons age 20+ years in the United States, and there were 12,157 cases of pharynx-throat cancer. The Is of cancers of the oral cavity and pharynx-throat are stable or declining for men and women in most age groups. Of the nearly 30,000 malignant neoplasms occurring in the SEER "oral cavity-pharynx" category in 2003, almost three quarters (21,455) were detectable during a routine oral examination.

  6. [A Case of Esophageal Polyp Regurgitated into the Pharynx at the Induction of General Anesthesia].

    PubMed

    Nishikawa, Haruko; Inagawa, Gaku

    2016-02-01

    We report the case of a mass in the pharynx found at the induction of general anesthesia that vanished postoperatively. A 46-year-old man underwent abdominal surgery. After the induction of general anesthesia, there was a mass occupying his pharynx and we could see neither the vocal cords nor the epiglottis using a Macintosh laryngoscope. Airwayscope (AWS) enabled us to successfully intubate the trachea. On postoperative examination, there was no mass on his pharynx. Imaging studies of the esophagus revealed a polyp suspected as being a fibrovascular polyp (FVP) arising from the upper esophagus. Three months later, excision of the polyp was planned. Awake intubation with AWS was planned so that if the polyp was regurgitated, he could swallow it Intubation was uneventful without regurgitation of the polyp. At the beginning of surgery, the polyp was not found in the pharynx, but was easily regurgitated by air supplied by the endoscope. FVPs are rare benign esophageal tumors and most originate from the cervical esophagus. If a polyp is regurgitated, obstruction of the airway may occur, and asphyxiation and sudden death have been reported. The fatal complication of airway obstruction requires anesthesiologists to be aware of FVP.

  7. Selective amputation of the pharynx identifies a FoxA-dependent regeneration program in planaria.

    PubMed

    Adler, Carolyn E; Seidel, Chris W; McKinney, Sean A; Sánchez Alvarado, Alejandro

    2014-04-15

    Planarian flatworms regenerate every organ after amputation. Adult pluripotent stem cells drive this ability, but how injury activates and directs stem cells into the appropriate lineages is unclear. Here we describe a single-organ regeneration assay in which ejection of the planarian pharynx is selectively induced by brief exposure of animals to sodium azide. To identify genes required for pharynx regeneration, we performed an RNAi screen of 356 genes upregulated after amputation, using successful feeding as a proxy for regeneration. We found that knockdown of 20 genes caused a wide range of regeneration phenotypes and that RNAi of the forkhead transcription factor FoxA, which is expressed in a subpopulation of stem cells, specifically inhibited regrowth of the pharynx. Selective amputation of the pharynx therefore permits the identification of genes required for organ-specific regeneration and suggests an ancient function for FoxA-dependent transcriptional programs in driving regeneration. DOI: http://dx.doi.org/10.7554/eLife.02238.001.

  8. Selective amputation of the pharynx identifies a FoxA-dependent regeneration program in planaria

    PubMed Central

    Adler, Carolyn E; Seidel, Chris W; McKinney, Sean A; Sánchez Alvarado, Alejandro

    2014-01-01

    Planarian flatworms regenerate every organ after amputation. Adult pluripotent stem cells drive this ability, but how injury activates and directs stem cells into the appropriate lineages is unclear. Here we describe a single-organ regeneration assay in which ejection of the planarian pharynx is selectively induced by brief exposure of animals to sodium azide. To identify genes required for pharynx regeneration, we performed an RNAi screen of 356 genes upregulated after amputation, using successful feeding as a proxy for regeneration. We found that knockdown of 20 genes caused a wide range of regeneration phenotypes and that RNAi of the forkhead transcription factor FoxA, which is expressed in a subpopulation of stem cells, specifically inhibited regrowth of the pharynx. Selective amputation of the pharynx therefore permits the identification of genes required for organ-specific regeneration and suggests an ancient function for FoxA-dependent transcriptional programs in driving regeneration. DOI: http://dx.doi.org/10.7554/eLife.02238.001 PMID:24737865

  9. Physiology of the mouth and pharynx, Waldeyer's ring, taste and smell.

    PubMed

    Bogaerts, M; Deggoujf, N; Huart, C; Hupin, C; Laureyns, G; Lemkens, P; Rombaux, P; Ten Bosch, J van Der Werff; Gordts, F

    2012-01-01

    This paper reviews the contribution of the different parts of the oral cavity and the pharynx to the basic physiology of breathing, phonation, speech, swallowing, and of Waldeyer's ring to the functioning of the immune system. We discuss the development of taste and smell, as well as possibilities for chemosensory testing in children.

  10. Personality, smoking, and alcohol as synergistic risk factors for cancer of the mouth and pharynx.

    PubMed

    Grossarth-Maticek, R; Eysenck, H J

    1990-12-01

    34 male patients suffering from cancer of the mouth or pharynx were studied with reference to their personality type, smoking and drinking habits, and compared with a healthy sample of 1706 men. The three risk factors showed a strong tendency to be related to cancer only in combination, adding new evidence to the theory that risk factors in cancer act in a synergistic fashion.

  11. Virus-host interactions in persistently FMDV-infected cells derived from bovine pharynx

    USDA-ARS?s Scientific Manuscript database

    Foot-and-mouth disease virus (FMDV) produces a disease in cattle characterized by vesicular lesions and a persistent infection with asymptomatic low-level production of virus. Here we describe the establishment of a persistently infected primary cell culture derived from bovine pharynx tissue (PBPT)...

  12. Information und Kommunikation

    NASA Astrophysics Data System (ADS)

    Wesoly, Michael; Ohlhausen, Peter; Bucher, Michael; Hichert, Rolf; Korge, Gabriele; Schnabel, Ulrich; Gairola, Arun; Reichwald, Ralf; Habicht, Hagen; Möslein, Kathrin; Schwarz, Torsten; Schönsleben, Paul; Scherer, Eric; Schloske, Alexander; Adlbrecht, Gerald; Federhen, Jens

    Wissen ist mittlerweile unverzichtbar für den entscheidenden Vorsprung auf dem Markt. Unabhängig davon, ob sich das Wissen in Innovationen, neuen Produkten und Dienstleistungen oder in der Verbesserung interner Unternehmensprozesse manifestiert: Wissen ist Treiber von Innovation, Wissen bringt Schnelligkeit und Wissen ist die Voraussetzung für Problemlösungen [40]. Wissensmanagement ist daher der Schlüssel für Unternehmenserfolg und bezeichnet den "bewussten und systematischen Umgang mit der Ressource Wissen und den zielgerichteten Einsatz von Wissen in der Organisation“ [6]. In dieser umfassenden Sichtweise ist Wissensmanagement ein Begriff, der Konzepte, Strategien und Methoden umfasst.

  13. Ingenieurgeologie: Grundlagen und Anwendung

    NASA Astrophysics Data System (ADS)

    Genske, Dieter D.

    Geplünderter Planet? Die Ingenieurgeologie ist ein junges, interdisziplinäres Fachgebiet. Es befasst sich mit der Wechselwirkung zwischen Geosphäre und Mensch. Der Autor stellt Georisiken vor und diskutiert die Folgen menschlicher Eingriffe in die Natur. Er thematisiert aktuelle Herausforderungen und entwirft nachhaltige Lösungskonzepte für verschiedene Problembereiche: z.B. Naturgefahren wie Hangrutschungen und Bergfälle, die Ausbeute natürlicher Ressourcen, Bau- und Sanierungsvorhaben. Fallbeschreibungen und ausgearbeitete Beispiele vertiefen das Verständnis für diesen neuen, zukunftsweisenden Zweig der Wissenschaft.

  14. The fetal larynx and pharynx: structure and development on two- and three-dimensional ultrasound.

    PubMed

    Liberty, G; Boldes, R; Shen, O; Shaul, C; Cohen, S M; Yagel, S

    2013-08-01

    To present a systematic approach for evaluating the fetal pharynx and larynx based on two- and three-dimensional ultrasound (2D-US and 3D-US) modalities, describing the sonographic appearance and function of the fetal upper respiratory tract and measuring the anatomical components of the pharynx and larynx. Gravidae presenting from the late first trimester to mid-gestation for routine booked examinations with structurally normal singleton fetuses of confirmed gestational age were enrolled. Transabdominal 2D-US was performed for anatomical and functional evaluation of the pharynx and larynx. Color Doppler was used to show fluid motion in the target area. 3D-US (Voluson® E6 with RAB-4-8-D transducer) scans of the fetal neck were acquired during fetal quiescence and in the absence of movements of the pharynx and larynx. Multiplanar reconstruction (MPR) in post-processing allowed adjustment of the volume to obtain the coronal plane. After a learning period to understand the sonographic anatomy of the target area, we measured the pharynx width and height, the upper, middle and lower larynx width and the larynx height. Render mode was applied for spatial evaluation of the target area. We developed a new methodological approach for structured evaluation of the fetal pharynx and larynx based on five spatial planes: posterior and anterior coronal planes and high, mid and low axial planes. We examined 582 fetuses during the second trimester of pregnancy; target anatomy was imaged successfully in 218 patients at 11-24 gestational weeks. Acquisition added approximately 1 min to examination time. Rates of successful visualization and measurements increased significantly as pregnancy progressed, being 23% (46/194) at 11-13 weeks, 29% (69/240) at 14-16 weeks, 35% (18/51) at 17-19 weeks and 88% (85/97) at 20-24 weeks (P < 0.01). Pharynx components identified were: the sphenoid bone, pterygoid processes, constrictor muscles, piriform recesses and uvula. Larynx components

  15. Salvage reconstruction of the oesophagus: a retrospective study of 15 cases.

    PubMed

    Oki, Masanao; Asato, Hirotaka; Suzuki, Yasutoshi; Umekawa, Kohei; Takushima, Akihiko; Okazaki, Mutsumi; Harii, Kiyonori

    2010-04-01

    Salvage reconstruction of the oesophagus is still considered a challenging procedure for all head and neck surgeons. The risk of postoperative infection and delayed wound healing is high because of thick scar formation and persistent inflammation. Furthermore, recipient vessels for free tissue transfer or vascular supercharge are not always available. Alimentary tract reconstruction with skin or musculocutaneous flap may be necessary, but this method is susceptible to fistula formation.[Nakatsuka T, Harii K, Asato H, et al. Comparative evaluation in pharyngo-oesophageal reconstruction: radial forearm flap compared with jejunal flap. A 10-year experience. Scand J Plast Reconstr Surg Hand Surg 1998; 32: 307-10] In the past 10 years, we have experienced 15 cases of salvage reconstruction of the oesophagus after prior cancer treatment or aorto-oesophageal fistula; the cervical oesophagus was reconstructed in five cases and the cervico-thoracic oesophagus in 10. In four cases of cervical oesophagus and six of cervico-thoracic oesophagus we performed free jejunal transfer including two long segment transfers with double vascular pedicle. The cervico-thoracic oesophagus was also reconstructed with pedicled alimentary tract transfer (colon interposition or jejunal pull-up) with vascular supercharge in four cases. In one case, cervical oesophageal defect was reconstructed with a latissimus dorsi musculocutaneous flap. We also used a deltopectoral flap to cover the skin defect in three cases. In three cases, a second salvage operation was necessary because of flap necrosis that was caused by unreliable recipient vessels resulting from scar formation and persistent inflammation. Successful restoration of the oesophagus and oral alimentation was achieved in 11 cases. From this study, we concluded that free jejunal transfer is a useful procedure for salvage reconstruction of the oesophagus, particularly for cervical oesophagus or short oesophageal defects. Nonetheless, surgeons

  16. The distribution of TRPV1 and TRPV2 in the rat pharynx.

    PubMed

    Sasaki, Rika; Sato, Tadasu; Yajima, Takehiro; Kano, Mitsuhiro; Suzuki, Toshihiko; Ichikawa, Hiroyuki

    2013-07-01

    Immunohistochemistry for two nociceptive transducers, the transient receptor potential cation channel subfamily V members 1 (TRPV1) and 2 (TRPV2), was performed on the pharynx and its adjacent regions. TRPV1-immunoreactivity (IR) was detected in nerve fibers beneath and within the epithelium and/or taste bud-like structure. In the pharynx, these nerve fibers were abundant in the naso-oral part and at the border region of naso-oral and laryngeal parts. They were also numerous on the laryngeal side of the epiglottis and in the soft palate. TRPV2-IR was expressed by dendritic cells in the pharynx and epiglottis, as well as in the root of the tongue and soft palate. These cells were located in the epithelium and lamina propria. TRPV2-immunoreactive (IR) dendritic cells were numerous in the naso-oral part of the pharynx, epiglottis, and tongue. Abundance of TRPV2-IR dendritic processes usually obscured the presence of TRPV2-IR nerve fibers in these portions. However, some TRPV2-IR nerve fibers could be observed in the epithelium of the soft palate. Retrograde tracing method also revealed that sensory neurons which innervate the pharynx or soft palate were abundant in the jugular-petrosal ganglion complex and relatively rare in the nodose ganglion. In the jugular-petrosal ganglion complex, TRPV1- and TRPV2-IR were expressed by one-third of pharyngeal and soft palate neurons. TRPV2-IR was also detected in 11.5 % pharyngeal and 30.9 % soft palate neurons in the complex. Coexpression of TRPV1 and CGRP was frequent among pharyngeal and soft palate neurons. The present study suggests that TRPV1- and TRPV2-IR jugular-petrosal neurons may be associated with the regulation of the swallowing reflex.

  17. Central pain mechanisms following combined acid and capsaicin perfusion of the human oesophagus.

    PubMed

    Brock, Christina; Andresen, Trine; Frøkjaer, Jens Brøndum; Gale, Jeremy; Olesen, Anne Estrup; Arendt-Nielsen, Lars; Drewes, Asbjørn Mohr

    2010-03-01

    Visceral afferents originating from different gut-segments converge at the spinal level. We hypothesized that chemically-induced hyperalgesia in the oesophagus could provoke widespread visceral hypersensitivity and also influence descending modulatory pain pathways. Fifteen healthy volunteers were studied at baseline, 30, 60 and 90 min after randomized perfusion of the distal oesophagus with either saline or 180 ml 0.1M HCl+2mg capsaicin. Electro-stimulation of the oesophagus, 8 cm proximal to the perfusion site, rectosigmoid electrical stimulation and rectal mechanical and heat stimulations were used. Evoked brain potentials were recorded after electrical stimulations before and after oesophageal perfusion. After the perfusion, rectal hyperalgesia to heat (P<0.01, 37%) and mechanical (P=0.01, 11%) stimulations were demonstrated. In contrast, hypoalgesia to electro-stimulation was observed in both the oesophagus (P<0.03, 23%) and the sigmoid colon (P<0.001, 18%). Referred pain areas to electro-stimulation in oesophagus were reduced by 13% after perfusion (P=0.01). Evoked brain potentials to rectosigmoid stimulations showed decreased latencies and amplitudes of P1, N1 and P2 (P<0.05), whereas oesophagus-evoked brain potentials were unaffected after perfusion. In conclusion, modality-specific hyperalgesia was demonstrated in the lower gut following chemical sensitization of the oesophagus, reflecting widespread central hyperexcitability. Conversely, hypoalgesia to electrical stimulation, decreases in referred pain and latencies of evoked brain potentials was seen. This outcome may reflect a counterbalancing activation of descending inhibitory pathways. As these findings are also seen in the clinical setting, the model may be usable for future basic and pharmacological studies. Copyright 2009 European Federation of International Association for the Study of Pain Chapters. Published by Elsevier Ltd. All rights reserved.

  18. Vagal afferent nerves with nociceptive properties in guinea-pig oesophagus

    PubMed Central

    Yu, Shaoyong; Undem, Bradley J; Kollarik, Marian

    2005-01-01

    Some vagal afferent nerves are thought to mediate autonomic responses evoked by noxious oesophageal stimuli and participate in the perception of pain originating in the oesophagus. However, the vagal nociceptive nerve phenotypes implicated in this function have yet to be identified. In this study, nociceptive fibres were defined by the capacity to discriminate noxious mechanical stimuli (wide range of oesophageal distension with pressure up to 100 mmHg) and detect noxious chemical stimuli (the activators of capsaicin receptor TRPV1). Using immunohistochemical techniques with retrogradely labelled oesophagus-specific neurones and performing extracellular recordings from the isolated vagally innervated oesophagus, we show that in the guinea-pig, the vagus nerves supply the oesophagus with a large population of nociceptive-like afferent nerve fibres. Vagal nociceptive-like fibres in the guinea-pig oesophagus are derived from two embryonically distinct sources: neurones situated in the nodose vagal ganglia and neurones situated in the jugular vagal ganglia. Nodose (placode-derived) nociceptive-like fibres are exclusively C-fibres sensitive to a P2X receptors agonist and rarely express the neuropeptide substance P. In contrast, jugular (neural crest-derived) nociceptive-like fibres include both A-fibres and C-fibres, are insensitive to P2X receptors agonist and mostly express substance P. The non-nociceptive vagal tension mechanoreceptors are distinguished from nociceptors by their saturable response to oesophageal distension and by the lack of TRPV1. These tension mechanoreceptors are exclusively A-fibres arising from the nodose ganglion. We conclude that the vagus nerves supply the guinea-pig oesophagus with nociceptors in addition to tension mechanoreceptors. The vagal nociceptive-like fibres in the oesophagus comprise two distinct subtypes dictated by the ganglionic location of their cell bodies. PMID:15649987

  19. The geometric configuration and morphometry of the rabbit oesophagus during luminal pressure loading.

    PubMed

    Liao, Donghua; Cassin, Jeff; Zhao, Jingbo; Gregersen, Hans

    2006-08-01

    The aim of the present study was to determine the geometric configuration and morphometric dimensions in the rabbit oesophagus during luminal pressure loading. The geometric configuration is of fundamental importance because it is related to stress and strain and determines the resistance to flow. The oesophagus was excised from rabbits, transferred to an organ bath and stretched to the in vivo length. Cannulas were inserted into both ends and each oesophagus was subjected to a luminal pressure up to 0, 1, 2, 5 and 10 cm H(2)O. After equilibrium was reached, the oesophagus was snap-frozen in liquid nitrogen. Sections were cut from five locations in the oesophagus and videotaped in the frozen state. Geometric and morphometric data including perimeter, circularities, area, thickness, buckles and strains in different layers were obtained from the video images. These variables did not show axial variation in the oesophagus. All variables changed as a function of the pressure. The whole wall thickness decreased as an inverse function of the pressure. The thickness decrease was mainly due to thinning of the submucosa and muscle. The number of buckles decreased from 4.05 +/- 0.34 at 0 cm H(2)O pressure to 0.07 +/- 0.07 at 10 cm H(2)O. Circumferential Green strain-pressure curves for the various layers all showed an exponential pattern. The curve obtained at the submucosa-muscle layer interface was located to the right of the other curves, indicating that the muscle layer was softest. The data obtained in this study will be useful for further modelling of the mechanics of the oesophagus.

  20. Vagal afferent nerves with nociceptive properties in guinea-pig oesophagus.

    PubMed

    Yu, Shaoyong; Undem, Bradley J; Kollarik, Marian

    2005-03-15

    Some vagal afferent nerves are thought to mediate autonomic responses evoked by noxious oesophageal stimuli and participate in the perception of pain originating in the oesophagus. However, the vagal nociceptive nerve phenotypes implicated in this function have yet to be identified. In this study, nociceptive fibres were defined by the capacity to discriminate noxious mechanical stimuli (wide range of oesophageal distension with pressure up to 100 mmHg) and detect noxious chemical stimuli (the activators of capsaicin receptor TRPV1). Using immunohistochemical techniques with retrogradely labelled oesophagus-specific neurones and performing extracellular recordings from the isolated vagally innervated oesophagus, we show that in the guinea-pig, the vagus nerves supply the oesophagus with a large population of nociceptive-like afferent nerve fibres. Vagal nociceptive-like fibres in the guinea-pig oesophagus are derived from two embryonically distinct sources: neurones situated in the nodose vagal ganglia and neurones situated in the jugular vagal ganglia. Nodose (placode-derived) nociceptive-like fibres are exclusively C-fibres sensitive to a P2X receptors agonist and rarely express the neuropeptide substance P. In contrast, jugular (neural crest-derived) nociceptive-like fibres include both A-fibres and C-fibres, are insensitive to P2X receptors agonist and mostly express substance P. The non-nociceptive vagal tension mechanoreceptors are distinguished from nociceptors by their saturable response to oesophageal distension and by the lack of TRPV1. These tension mechanoreceptors are exclusively A-fibres arising from the nodose ganglion. We conclude that the vagus nerves supply the guinea-pig oesophagus with nociceptors in addition to tension mechanoreceptors. The vagal nociceptive-like fibres in the oesophagus comprise two distinct subtypes dictated by the ganglionic location of their cell bodies.

  1. Lymph- und Immunsystem

    NASA Astrophysics Data System (ADS)

    Perry, Steven F.

    Alle Lebewesen müssen sich gegen Eindringlinge wehren. Ihre Abwehrmechanismen wirken auf verschiedenen Ebenen, von übergeordneten Feindvermeidungsstrategien und Putzverhalten bis hin zu molekularen Erkennungs- und Tötungsmechanismen. Da Eindringlinge über Kontaktflächen mit der Außenwelt, wie z.B. Körperoberfläche, Darmwand und Atmungsoberflächen, in den Organismus gelangen, sind an diesen Stellen immer primäre Abwehrmechanismen zu finden. Dazu zählen (1) Schleimabsonderung (Schleimhäute bei allen Schädeltieren, Fischkiemen, epidermale Schleimdrüsen (Fische, Amphibien)), (2) Stoffwechselgifte und antibakteriell wirkende Substanzen in der Haut (Fische, Amphibien) und im Speichel (Amnioten), (3) Flimmerepithelien zum Abtransport von Eindringlingen und (4) starke Keratinbildung in der mehrschichtigen Epidermis und schützende Strukturen wie Schuppen, Federn und Haare (Amnioten) (S. 20). Auch die starke Säurebildung im Magen kann als Schutz gegen Eindringlinge betrachtet werden.

  2. Genetic progression of Barrett's oesophagus to oesophageal adenocarcinoma.

    PubMed

    Gregson, Eleanor M; Bornschein, Jan; Fitzgerald, Rebecca C

    2016-08-09

    Barrett's oesophagus (BE) is the premalignant condition associated with the development of oesophageal adenocarcinoma (OAC). Diagnostically, p53 immunohistochemistry remains the only biomarker recommended clinically to aid histopathological diagnosis. The emerging mutational profile of BE is one of highly heterogeneous lesions at the genomic level with many mutations already occurring in non-dysplastic tissue. As well as point mutations, larger scale copy-number changes appear to have a key role in the progression to OAC and clinically applicable assays for the reliable detection of aneuploidy will be important to incorporate into future clinical management of patients. For some patients, the transition to malignancy may occur rapidly through a genome-doubling event or chromosomal catastrophe, termed chromothripsis, and detecting these patients may prove especially difficult. Given the heterogeneous nature of this disease, sampling methods to overcome inherent bias from endoscopic biopsies coupled with the development of more objective biomarkers than the current reliance on histopathology will be required for risk stratification. The aim of this approach will be to spare low-risk patients unnecessary procedures, as well as to provide endoscopic therapy to the patients at highest risk, thereby avoiding the burden of incurable metastatic disease.

  3. Factors associated with cancer of the oesophagus: an overview.

    PubMed

    Ghadirian, P; Vobecky, J; Vobecky, J S

    1988-01-01

    The incidence pattern of oesophageal cancer varies across the world with roughly a 500-fold difference in rates (truncated) between the highest and lowest areas. The incidence rate of this disease is rising in many countries, especially in males. Although ethnicity is a strong indicator of risk of this disease, no specific genetic factor except the occurrence of this cancer among the members of families with tylosis has been identified. The frequency of oesophageal cancer varies among the native and immigrant populations in different countries. Oesophageal cancer was found to be strongly associated with the consumption of alcohol and tobacco, especially in combination. A low socioeconomic level and poor diet, particularly deficiencies of vitamins A, C, and riboflavin, are other characteristics of the regions of highest incidence. Physical damage of the oesophagus caused by ingesting hard foods and/or hot liquids could be another factor. Intensive research in high-risk regions failed to reveal the presence of nitrosocompounds except at a very low level or other known carcinogens. The mutagenicity of pickled vegetables commonly consumed in the high-risk regions of China and high frequency of oesophageal cancer among chickens in the same regions suggest the existence of "common" carcinogens. It seems probable that in Iran an initiating carcinogenic factor may be the custom of eating opium dross, which has been shown to be mutagenic, as well as consumption of contaminated bread with extraneous seeds containing a large quantity of silica fibres, which is a strong stimulant of growth.

  4. Respiratory disease and the oesophagus: reflux, reflexes and microaspiration.

    PubMed

    Houghton, Lesley A; Lee, Augustine S; Badri, Huda; DeVault, Kenneth R; Smith, Jaclyn A

    2016-08-01

    Gastro-oesophageal reflux is associated with a wide range of respiratory disorders, including asthma, isolated chronic cough, idiopathic pulmonary fibrosis, chronic obstructive pulmonary disease and cystic fibrosis. Reflux can be substantial and reach the proximal margins of the oesophagus in some individuals with specific pulmonary diseases, suggesting that this association is more than a coincidence. Proximal oesophageal reflux in particular has led to concern that microaspiration might have an important, possibly even causal, role in respiratory disease. Interestingly, reflux is not always accompanied by typical reflux symptoms, such as heartburn and/or regurgitation, leading many clinicians to empirically treat for possible gastro-oesophageal reflux. Indeed, costs associated with use of acid suppressants in pulmonary disease far outweigh those in typical GERD, despite little evidence of therapeutic benefit in clinical trials. This Review comprehensively examines the possible mechanisms that might link pulmonary disease and oesophageal reflux, highlighting the gaps in current knowledge and limitations of previous research, and helping to shed light on the frequent failure of antireflux treatments in pulmonary disease.

  5. Successful primary staple-repair of thoracic oesophagus after delayed presentation of a spontaneous perforation

    PubMed Central

    Leoncini, Giacomo; Novello, Luca; Denegri, Andrea; Morelli, Lucia; Ratto, Giovanni B.

    2015-01-01

    Introduction Spontaneous perforation of the oesophagus is diagnosed late in over 50% of cases. Misdiagnosis may be due to atypical presentations. Primary repair is technically demanding in this setting and the risk of failure is high. Presentation of case An 85 year-old lady presented with an atypical cohort of mild nonspecific symptoms in spite of a pleuro-mediastinal purulent collection secondary to an undiagnosed spontaneous perforation of the oesophagus occurred seven days before. Despite the extent of perforation (3 cm in length), the late diagnosis and the necrosis of the muscular wall, the oesophagus was successfully repaired by means of a stapler. Discussion The mechanism of the atypical presentation is discussed and possible modalities of treatment of delayed oesophageal perforations are reviewed, with particular reference to primary repair and to the possible use of staplers within this setting. Conclusion Even large spontaneous perforations of the oesophagus can result in a contained abscess, with no frank sepsis. Diagnosis can be missed for days in these cases. The attempt at primary repair of the oesophagus is still indicated. The use of a stapler is preferable in such cases as a perfect mucosal approximation is provided with minimal manipulation and with the use of inert, well tolerated material, which does not tend to become infected. PMID:26279260

  6. The postbranchial digestive tract of the ascidian, Polyandrocarpa misakiensis (Tunicata: Ascidiacea). 1. Oesophagus.

    PubMed

    Koyama, Hiromichi

    2011-02-01

    The organization of the oesophagus in the budding styelid ascidian, Polyandrocarpa misakiensis, is described. The oesophagus consists of external and internal epithelium, and there are loose connective tissue, blood sinuses, and a muscular layer between them. The internal epithelium is simple columnar, except for the bottom of three folds. The external epithelium is simple squamous. The internal epithelium contains four cell types, i.e., ciliated mucous cells, band cells, endocrine cells, and undifferentiated cells. The ciliated mucous cells have apical cilia and microvilli, and two types of mucous vesicle. The band cells also have apical cilia and electron-dense granules in the apical cytoplasm. The endocrine cells are bottle-shaped, and have electron-dense granules both above and below the nucleus. The undifferentiated cells form pseudostratified epithelium at the bottom of each fold, and they have nuclei with prominent nucleoli. One type of coelomic cell, which has retractile cytoplasm, often migrates in the internal epithelium. Near the stomach, there are many darkly stained round cells clustered around the posterior end of the oesophagus. These two types of coelomic cells may be involved in the defense mechanism against the invasion of foreign organisms. The basic organization of the oesophagus of P. misakiensis is similar to those of other ascidians. However, the presence of three folds is a characteristic of a solitary species, rather than of a colonial species. Although ascidians are chordate invertebrates, the organization of their oesophagus is not very complex, which might reflect their life style.

  7. Hedgehog signalling stimulates precursor cell accumulation and impairs epithelial maturation in the murine oesophagus.

    PubMed

    van Dop, Willemijn A; Rosekrans, Sanne L; Uhmann, Anja; Jaks, Viljar; Offerhaus, G Johan A; van den Bergh Weerman, Marius A; Kasper, Maria; Heijmans, Jarom; Hardwick, James C H; Verspaget, Hein W; Hommes, Daan W; Toftgård, Rune; Hahn, Heidi; van den Brink, Gijs R

    2013-03-01

    In the intestine Hedgehog (Hh) signalling is directed from epithelium to mesenchyme and negatively regulates epithelial precursor cell fate. The role of Hh signalling in the oesophagus has not been studied in vivo. Here the authors examined the role of Hh signalling in epithelial homeostasis of oesophagus. The authors used transgenic mice in which the Hh receptor Patched1 (Ptch1) could be conditionally inactivated in a body-wide manner and mice in which Gli1 could be induced specifically in the epithelium of the skin and oesophagus. Effects on epithelial homeostasis of the oesophagus were examined using immunohistochemistry, in situ hybridisation, transmission electron microscopy and real-time PCR. Hh signalling was examined in patients with oesophageal squamous cell carcinoma (SCC) by quantitative real-time PCR. Sonic Hh is signalled in an autocrine manner in the basal layer of the oesophagus. Activation of Hh signalling resulted in an expansion of the epithelial precursor cell compartment and failure of epithelial maturation and migration. Levels of Hh targets GLI1, HHIP and PTCH1 were increased in SCC compared with normal tissue from the same patients. Here the authors find that Hh signalling positively regulates the precursor cell compartment in the oesophageal epithelium in an autocrine manner. Since Hh signalling targets precursor cells in the oesophageal epithelium and signalling is increased in SCCs, Hh signalling may be involved in oesophageal SCC formation.

  8. Particle retention and flow in the pharynx of the enteropneust worm Harrimania planktophilus: the filter-feeding pharynx may have evolved before the chordates.

    PubMed

    Cameron, Christopher B

    2002-04-01

    An investigation of the feeding behavior of the acorn worm Harrimania planktophilus suggests a novel form of enteropneust feeding with significant phylogenetic implications. H. planktophilus is a holoinfaunal worm that feeds on deposited sediments, and filter feeds on suspended particles in interstitial pore water. To visualize the particle retention behavior involved in filter feeding, adult animals were held in chilled seawater under low light and fed food coloring and fluorescent particles. The behavior was recorded by videography. Most particles ingested were drawn into the mouth by an incurrent flow created by cilia on the pharyngeal bars and without the aid of mucus. Particles that passed freely through the gill pores averaged 3.04 microm, whereas particles retained in the gut and defecated in the feces averaged 13.9 microm. Food coloring entered the mouth and was pumped through the pharynx at a rate of 0.5-2.0 mm/s. There is no evidence of an endostyle or mucus-net capture mechanism in H. planktophilus, but instead particles are filtered and manipulated by a dense covering of cilia on the pharyngeal gill bars. This study suggests that the filter-feeding pharynx is not an innovation of the chordates, but evolved prior to the evolutionary divergence of the hemichordate-echinoderm clade from the chordates.

  9. Three-dimensional rotational angiography of the left atrium and the oesophagus: the short-term mobility of the oesophagus and the stability of the fused three-dimensional model of the left atrium and the oesophagus during catheter ablation for atrial fibrillation.

    PubMed

    Starek, Zdenek; Lehar, Frantisek; Jez, Jiri; Scurek, Martin; Wolf, Jiri; Kulik, Tomas; Zbankova, Alena; Novak, Miroslav

    2017-08-01

    The objective of this study was to evaluate the mobility of the oesophagus and the stability of the three-dimensional (3D) model of the oesophagus using 3D rotational angiography (3DRA) of the left atrium (LA) and the oesophagus, fused with live fluoroscopy during catheter ablation for atrial fibrillation. From March 2015 to September 2015, 3DRA of the LA and the oesophagus was performed in 33 patients before catheter ablation for atrial fibrillation. Control contrast oesophagography was performed every 30 min. The positions of the oesophagograms and the 3D model of the LA and the oesophagus were repeatedly measured and compared with the spine. The average shift of the oesophagus ranged from 2.7 ± 2.2 to 5.0 ± 3.5 mm. The average real-time oesophageal shift ranged from 2.7 ± 2.2 to 3.8 ± 3.4 mm. No significant shift was detected until the 90th minute of the procedure. The average shift of the 3D model of the LA and the oesophagus ranged from 1.4 ± 1.8 to 3.3 ± 3.0 mm (right-left direction) and from 0.9 ± 1.2 to 2.2 ± 1.3 mm (craniocaudal direction). During the 2 h procedure, there were no significant shifts of the model. During catheter ablation for atrial fibrillation, there is no significant change in the position of the oesophagus until the 90th minute of the procedure and no significant shift in the 3D model of the LA and the oesophagus. The 3D model of the oesophagus reliably depicts the position of the oesophagus during the entire procedure.

  10. Fish bone foreign bodies in the pharynx and upper esophagus: evaluation with 64-slice MDCT.

    PubMed

    Park, Soyeon; Choi, Dae Seob; Shin, Hwa Seon; Cho, Jae Min; Jeon, Kyung Nyeo; Bae, Kyung-Soo; Koh, Eun Ha; Park, Jung Je

    2014-02-01

    Fish bone (FB) is one of the common causes of foreign body impaction in the pharynx and esophagus. To investigate the efficacy of 64-slice multidetector computed tomography (MDCT) for the evaluation of pharynx and upper esophageal FB foreign bodies. Sixty-six patients with suspected FB foreign body ingestion were examined by plain radiography (n = 40) and unenhanced MDCT (n = 66). We analyzed the presence, location, size, shape, and lying position of the foreign bodies. On MDCT, 46 foreign bodies were detected. Among them, 45 were confirmed by endoscopy. The sensitivity of MDCT for the detection of foreign bodies was 100%, which was superior to that of the plain radiography (51.7%). The location of the foreign bodies was most common in the upper esophagus (n = 22, 47.8%), followed by pharyngoesophageal junction (n = 10, 21.7%), transjunctional (n = 7, 15.2%), hypopharynx (n = 5, 10.9%), and oropharynx (n = 2, 4.3%). Their longest length was 5.3-40.1 mm (mean, 21.3 mm). Thirty-three FBs (71.7%) were linear and 13 (28.3%) were flat in shape. They showed transverse (n = 23, 50.0%), parallel (n = 13, 28.3%), and oblique positions (n = 10, 21.7%) to the long axis of the pharynx and esophagus, respectively. MDCT is useful for the evaluation of the pharynx and upper esophageal FB foreign bodies.

  11. Sitting posture decreases collapsibility of the passive pharynx in anesthetized paralyzed patients with obstructive sleep apnea.

    PubMed

    Tagaito, Yugo; Isono, Shiroh; Tanaka, Atsuko; Ishikawa, Teruhiko; Nishino, Takashi

    2010-10-01

    Obstructive sleep apnea (OSA) is an independent risk factor for difficult and/or impossible mask ventilation during anesthesia induction. Postural change from supine to sitting improves nocturnal breathing in patients with OSA. The purpose of this study was to evaluate the effect of patient position on collapsibility of the pharyngeal airway in anesthetized and paralyzed patients with OSA. The authors tested the hypothesis that the passive pharynx is structurally less collapsible during sitting than during supine posture. Total muscle paralysis was induced with general anesthesia in nine patients with OSA, eliminating neuromuscular factors contributing to pharyngeal patency. The cross-sectional area of the pharynx was measured endoscopically at different static airway pressures. Comparison of static pressure-area plots between the supine and sitting (62° head-up) allowed assessment of the postural differences of the mechanical properties of the pharynx. : Maximum cross-sectional area was greater during sitting than during supine posture at both retropalatal (median (10th-90th percentile): 1.91 (1.52-3.40) versus 1.25 (0.65-1.97) cm) and retroglossal (2.42 (1.72-3.84) versus 1.75 (0.47-2.35) cm) airways. Closing pressure of the passive pharynx was significantly lower during sitting than supine posture. Differences of the closing pressures between the postures are 5.89 (3.73-11.6) and 6.74 (4.16-9.87) cm H2O, at retropalatal and retroglossal airways, respectively, and did not differ between the pharyngeal segments. Postural change from supine to sitting significantly improves collapsibility of pharyngeal airway in anesthetized and paralyzed patients with OSA.

  12. [Barrett's oesophagus: endoscopic diagnosis and follow-up].

    PubMed

    Ponsot, P

    2006-01-01

    Barrett's oesophagus (BO), or replacement of the squamous mucosa by a specialized intestinal metaplasia due to gastro-oesophageal reflux disease (GORD), predisposes to adenocarcinoma. It is estimated that 6 to 12% of patients undergoing GI endoscopy have short BO (< 3 cm), and 1% have a long BO. Macroscopic diagnosis of BO is sometimes difficult and, in case of doubt, endoscopy should be redone after a period of efficient anti-secretory treatment. Diagnosis of BO is histological and should be confirmed by biopsies. The incidence of adenocarcinoma is globally estimated at 0.5% patient by year of follow-up, and exists for both short and long BO. Due to this low incidence, screening for BO is only justified in patients at high risk for adenocarcinoma (male gender, age > 50 ans, old GORD in a young patient). Low-grade dysplasia (LGD) then high-grade dysplasia (HGD) precedes adenocarcinoma. Histological diagnosis of LGD is difficult: the main cause of confusion is inflammation so diagnosis of LGD must be confirmed after a 3-month high-dose anti-secretory treatment. Diagnosis of HGD is easier but multiple biopsies are needed to determine the focal or multifocal disposition of HGD. The benefit of follow-up of BO is debated. Aged patients should be followed only if dysplasia is present. When dysplasia is absent, an endoscopic control with biopsies is desirable within 3 to 5 years. In case of dysplasia, the latter must be confirmed by another examination of biopsies, particularly in case of suspicion of HGD and after antisecretory treatment. In case of LGD, endoscopy with biopsies should be redone 6 months later to screen for HGD, then every year if LGD is confirmed. In case of HGD, the 5-year risk of cancer is 60% so surgical or endoscopic treatment is usually proposed. If HGD follow-up is decided, it should be performed on a 3- to 6-month basis.

  13. Barrett’s oesophagus and oesophageal adenocarcinoma: time for a new synthesis

    PubMed Central

    Reid, Brian J.; Li, Xiaohong; Galipeau, Patricia C.; Vaughan, Thomas

    2010-01-01

    The public health importance of Barrett’s oesophagus lies in its association with oesophageal adenocarcinoma. The incidence of oesophageal adenocarcinoma has risen at an alarming rate over the past four decades in many regions of the Western world and there are indications that the incidence of this disease is on the rise in Asian populations where it has been rare. Much has been learned of host and environmental risk factors that affect the incidence of oesophageal adenocarcinoma and data indicate that patients with Barrett’s oesophagus rarely develop oesophageal adenocarcinoma. Given that 95% of oesophageal adenocarcinoma arise in individuals without a prior diagnosis of Barrett’s oesophagus, what strategies can be used to reduce late diagnosis of oesophageal adenocarcinoma? PMID:20094044

  14. Incidence of oral cavity and pharynx cancer in New Hampshire, 1990-2007.

    PubMed

    Cherala, Sai S; Kelley, Kristina

    2012-01-01

    The purpose of this study is to describe trends of the statewide cancer and treatment-related characteristics of oral cavity and pharynx (OCP) cancer and prevalence of risk factors in New Hampshire residents from 1990-2007. This is a descriptive study on oral cavity and pharynx cancer using a state cancer registry dataset for 1990- 2007. The age-adjusted rates with 95% confidence intervals for cancer incidence rates and standard proportions for stage, treatment, and risk factors were calculated. The Joinpoint regression model was used for assessing linear trends for cancer rates. The overall differences for the period under study between age, female and male rate, and stage were analyzed using the test. During 1990-2007, oral cavity and pharynx cancer incidence rates for New Hampshire residents have remained stable. The cancer incidence rates have decreased for older age groups (greater than 59) and the 50-59 age group has shown increase in incidence rate of OCP cancer since 1990. There is significant increase in the late-stage diagnoses from 1990-2007. Early detection through periodic medical and dental examinations can reduce the risk of these cancers. Public health strategies that address the gaps identified by this study can reduce OCP cancer and protect the health of the New Hampshire population.

  15. Estimation of cultivable bacterial diversity in the cloacae and pharynx in Eurasian griffon vultures (Gyps fulvus).

    PubMed

    Vela, Ana I; Casas-Díaz, Encarna; Fernández-Garayzábal, José F; Serrano, Emmanuel; Agustí, Susana; Porrero, María C; Sánchez del Rey, Verónica; Marco, Ignasi; Lavín, Santiago; Domínguez, Lucas

    2015-04-01

    In this work, we describe the biodiversity of cloacal and pharynx culture-based bacteria (commensal and pathogenic), in 75 Eurasian griffon vultures (Gyps fulvus) from two geographic areas. We address the question of whether the cultivable microbiota of vultures is organised into assemblages occurring by chance. In addition, we assess bacterial diversity in both anatomic regions and geographic areas. Bacterial diversity was represented by 26 Gram-negative and 20 Gram-positive genera. The most common genera were Escherichia, Enterococcus, Staphylococcus, Clostridium and Lactococcus. Escherichia coli and Enterococcus faecalis were the most common species in cloacal and pharyngeal samples. Staphylococcus and Erysipelothrix were isolated from the pharynx and Salmonella and Corynebacterium from the cloacae, and no Campylobacter was isolated from the cloacal swabs. Ten cloacal swabs were positive for Salmonella, of which five isolates were Salmonella enterica serotype 4,(5),12:i:-, one isolate was S. enterica serotype Derby, three isolates were S. enterica serotype 61:k:1,5,7 and one isolate was S. enterica serotype Infantis. The null modelling approach revealed that the commensal bacteria of vultures are not structured in assemblages. On the other hand, differences in bacterial genus and species richness between cloacal and pharyngeal samples or between geographic areas were clear, with the pharynx in vultures from both geographic areas being richer. The results of this study indicate also that vultures can serve as a reservoir of certain pathogenic zoonotic bacteria. The dissemination of these zoonotic pathogens in wildlife could be prevented by periodic sanitary surveys.

  16. Investigation of the flow physics in the human pharynx/larynx region

    NASA Astrophysics Data System (ADS)

    Shinneeb, A.-M.; Pollard, Andrew

    2012-10-01

    This experimental study was carried out to investigate the flow field in the human extra-thoracic airway using the particle image velocimetry technique. The purpose of this study is to understand the physics of the turbulent flow in the pharynx/larynx region. The flow rate was 9 l/min, and the corresponding Reynolds number, based on the inlet condition, was 670. Two thousand images were acquired at each location at a framing rate of 2 Hz. The mean turbulence intensity, turbulent kinetic energy and Reynolds stress fields were calculated. Moreover, the proper orthogonal decomposition method and quadrant analysis were also used for investigating the flow in the pharynx/larynx region. The results showed that the flow is strongly three dimensional and is characterised by re-circulation, jet-like and sink-like mean flows. The pharynx/larynx region is characterised by bursting events (e.g. ejection, sweep and interaction events) particularly in the epiglottal region. These events appear to be responsible for deforming and/or tearing apart the vortical structures. In addition, the major contribution to the Reynolds shear stress comes from the events that mainly burst with or against the flow direction which, in some cases, exceeded 100 % of the inlet velocity.

  17. CD44 as a receptor for colonization of the pharynx by group A Streptococcus

    PubMed Central

    Cywes, Colette; Stamenkovic, Ivan; Wessels, Michael R.

    2000-01-01

    The pharynx is the primary reservoir for strains of group A Streptococcus (GAS) associated both with pharyngitis (streptococcal sore throat) and with invasive or “flesh-eating” soft tissue infections. We now report that CD44, a hyaluronic acid-binding protein that mediates human cell-cell– and cell-extracellular matrix–binding interactions, functions as a receptor for GAS colonization of the pharynx in vivo. We found that attachment of GAS to murine epithelial keratinocytes was mediated by binding of the GAS hyaluronic acid capsular polysaccharide to CD44. In studies of transgenic mice with a selective defect in epithelial expression of CD44, GAS adherence to CD44-deficient keratinocytes in vitro was reduced compared with adherence to keratinocytes expressing normal levels of CD44. After intranasal inoculation, GAS colonized the oropharynx of wild-type mice but failed to colonize transgenic mice deficient in CD44 expression. GAS colonization of wild-type mice could be blocked by coadministration of mAb to CD44 or by pretreatment of the animals with exogenous hyaluronic acid. These results provide evidence that CD44 serves as a receptor for GAS colonization of the pharynx and support the potential efficacy of disrupting the interaction between the GAS hyaluronic acid capsule and CD44 as a novel approach to preventing pharyngeal infection. PMID:11032859

  18. [Comparative study of lymphoid follicles in mucosa of pharynx and mucosal associated lymphoid tissues in paranasal sinuses].

    PubMed

    Zhai, Weigang; Yao, Min; Chen, Jue

    2013-08-01

    To study the relationship between the lymphoid follicles in mucous membrane of pharynx and mucosal associated lymphoid tissues (MALT). Ten folliculi obtained from 10 patients of follicular pharyngitis and mucosa taken form 10 patients of paranasal sinusitis were fixed in neutral formalin and embedded in paraffin. Sections were prepared, stained by H. E and by immunohistochemical method staining with S-100,and observe by light microscopy. We observed the morphology of lymphoid follicles in mucous membrane of pharynx with MALT in mucosa of paranasal sinusitis as the contrast. Lymphoid follicles in mucosa of pharynx compared with MALT in the mucosa of paranasal sinuses, there was no mantle zone, no typical germinal center and no mucosal epithelium, immunological staining with S-100 was week. The lymphoid follicles in mucosa of pharynx does not belong to the MALT.

  19. The frequency of true short oesophagus in type II-IV hiatal hernia.

    PubMed

    Lugaresi, Marialuisa; Mattioli, Sandro; Aramini, Beatrice; D'Ovidio, Frank; Di Simone, Massimo Pierluigi; Perrone, Ottorino

    2013-02-01

    The misdiagnosis of short oesophagus may occur on recurrence of the hernia after surgery for type II-IV hiatal hernia (HH). The frequency of short oesophagus in type II-IV hernia is undefined. The aim of this study was to assess the frequency of true short oesophagus in patients undergoing surgery for type II-IV hernia. Thirty-four patients with type II-IV hernia underwent minimally invasive surgery. After full isolation of the oesophago-gastric junction, the position of the gastric folds was localized endoscopically and two clips were applied in correspondence. The distance between the clips and the diaphragm (intra-abdominal oesophageal length) was measured. When the intra-abdominal oesophagus was <1.5 cm after oesophageal mobilization, the Collis procedure was performed. After surgery, patients underwent a follow-up, comprehensive of barium swallow and endoscopy. After mediastinal mobilization (median 10 cm), the intra-abdominal oesophageal length was >1.5 cm in 17 patients (4 type II, 11 type III and 2 type IV) and ≤ 1.5 cm in 17 patients (13 type III and 4 type IV hernia). No statistically significant differences were found between patients with intra-abdominal oesophageal length > or ≤ 1.5 cm with respect to symptoms duration and severity. Global results (median follow-up 48 months) were excellent in 44% of patients, good in 50%, fair in 3% and poor in 3%. HH relapse occurred in 3%. True short oesophagus is present in 57% of type III-IV and in none of type II HHs. The intraoperative measurement of the submerged intra-abdominal oesophagus is an objective method for recognizing these patients.

  20. Assessment of a sheep animal model to optimise photodynamic therapy in the oesophagus.

    PubMed

    Glanzmann, Thomas M; Zellweger, Matthieu P E; Borle, François; Conde, Ramiro; Radu, Alexandre; Ballini, Jean-Pierre; Jaquet, Yves; Pilloud, Raphaëlle; van den Bergh, Hubert; Monnier, Philippe; Andrejevic-Blant, Snezana; Wagnières, Georges A

    2009-11-01

    Precursor lesions of oesophagus adenocarcinoma constitute a clinical dilemma. Photodynamic therapy (PDT) is an effective treatment for this indication, but it is difficult to optimise without an appropriate animal model. For this reason, we assessed the sheep model for PDT in the oesophagus with the photosensitiser meta-(tetra-hydroxyphenyl) chlorin (mTHPC). Twelve sheep underwent intravenous mTHPC injection, blood sampling and fluorescence measurements. mTHPC's pharmacokinetics was measured in vivo and in plasma by fluorescence spectroscopy. Biopsies of sheep oesophagus were compared to corresponding human tissue, and the mTHPC's biodistribution was studied under fluorescence microscopy. Finally, the sheep oesophageal mucosa was irradiated, 4 days after mTHPC's injection. Histologically, the sheep and human oesophagus were closely comparable, with the exception of additional fatty tissue in the sheep oesophagus. mTHPC's pharmacokinetics in sheep and human plasmas were similar, with a maximum of concentration in the sheep 10 hours after i.v. injection. mTHPC's pharmacokinetics in vivo reached its maximum after 30-50 hours, then decreased to background levels, as in humans under similar conditions. Two days after injection, mTHPC was mainly distributed in the lamina propria, followed by a penetration into the epithelium. The sheep and human tissue sensitivity to mTHPC PDT was similar. In conclusion, this model showed many similarities with humans as to mTHPC's plasma and tissue pharmacokinetics, and for tissue PDT response, making it suitable to optimise oesophagus PDT. Copyright 2009 Wiley-Liss, Inc.

  1. Chronic Chagas disease: presence of parasite DNA in the oesophagus of patients without megaoesophagus.

    PubMed

    Vago, Annamaria Ravara; Silva, Denise Marins; Adad, Sheila Jorge; Correa-Oliveira, Rodrigo; d'Avila Reis, Débora

    2003-01-01

    We have previously amplified Trypanosoma cruzi DNA by polymerase chain reaction (PCR) from the oesophagus of chagasic patients with megaoesophagus, whilst immunohistochemical analysis failed to detect T. cruzi antigen in the oesophagus of chagasic patients without megaoesophagus. During 2000-01, we tested for the presence of T. cruzi DNA in oesophageal tissue from 9 chronic chagasic patients without megaoesophagus and 5 were positive by PCR, which suggests that other factors, besides simply the presence of the parasite, should be considered in the understanding of the pathogenesis of megaoesophagus.

  2. Barrett’s oesophagus: Evidence from the current meta-analyses

    PubMed Central

    Gatenby, Piers; Soon, Yuen

    2014-01-01

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

  3. Zwergsatelliten und Sternriesen

    NASA Astrophysics Data System (ADS)

    Baade, Dietrich; Kuschnig, Rainer

    2017-03-01

    Leuchtkräftige Sterne sind schwierig: Fär Fotometrie mit großen Teleskopen sind sie zu hell, und ihre geringe Zahl macht konventionelle Lösungen unwirtschaftlich, besonders im Weltraum, wo die äußerste Präzision gegeben wäre. Mit einer Mini-Armada von Nanosatelliten haben Ingenieure und Astronomen aus Kanada, Österreich und Polen nun die Lösung gefunden - auch schon für viele wissenschaftliche Fragen.

  4. Button cell in oesophagus: An unusual destructive foreign body a case report.

    PubMed

    Kakkar, Sanjiv; Makker, Jugesh

    2006-04-01

    A case of button cell lodged in oesophagus is reported. The button cells are potentially destructive foreign bodies due to damage caused by leakage of harmful chemicals and their capability to generate electric current. The mucosal damage starts early and may lead to life threatening complications in long standing cases. Removal of these should be accorded highest priority to prevent complications.

  5. Evolution of oesophageal adenocarcinoma from metaplastic columnar epithelium without goblet cells in Barrett's oesophagus

    PubMed Central

    Lavery, Danielle L; Martinez, Pierre; Gay, Laura J; Cereser, Biancastella; Novelli, Marco R; Rodriguez-Justo, Manuel; Meijer, Sybren L; Graham, Trevor A; McDonald, Stuart A C; Wright, Nicholas A; Jansen, Marnix

    2016-01-01

    Objective Barrett's oesophagus commonly presents as a patchwork of columnar metaplasia with and without goblet cells in the distal oesophagus. The presence of metaplastic columnar epithelium with goblet cells on oesophageal biopsy is a marker of cancer progression risk, but it is unclear whether clonal expansion and progression in Barrett's oesophagus is exclusive to columnar epithelium with goblet cells. Design We developed a novel method to trace the clonal ancestry of an oesophageal adenocarcinoma across an entire Barrett's segment. Clonal expansions in Barrett's mucosa were identified using cytochrome c oxidase enzyme histochemistry. Somatic mutations were identified through mitochondrial DNA sequencing and single gland whole exome sequencing. Results By tracing the clonal origin of an oesophageal adenocarcinoma across an entire Barrett's segment through a combination of histopathological spatial mapping and clonal ordering, we find that this cancer developed from a premalignant clonal expansion in non-dysplastic (‘cardia-type’) columnar metaplasia without goblet cells. Conclusion Our data demonstrate the premalignant potential of metaplastic columnar epithelium without goblet cells in the context of Barrett's oesophagus. PMID:26701877

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

    PubMed Central

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

    2007-01-01

    AIM: To investigate risk factors associated with Barrett’s oesophagus and oesophageal adenocarcinoma. METHODS: This all-Ireland population-based case-control study recruited 224 Barrett’s oesophagus patients, 227 oesophageal adenocarcinoma patients and 260 controls. All participants underwent a structured interview with information obtained about potential lifestyle and environmental risk factors. RESULTS: Gastro-oesophageal reflux was associated with Barrett’s [OR 12.0 (95% CI 7.64-18.7)] and oesophageal adenocarcinoma [OR 3.48 (95% CI 2.25-5.41)]. Oesophageal adenocarcinoma patients were more likely than controls to be ex- or current smokers [OR 1.72 (95% CI 1.06-2.81) and OR 4.84 (95% CI 2.72-8.61) respectively] and to have a high body mass index [OR 2.69 (95% CI 1.62-4.46)]. No significant associations were observed between these risk factors and Barrett's oesophagus. Fruit but not vegetables were negatively associated with oesophageal adenocarcinoma [OR 0.50 (95% CI 0.30-0.86)]. CONCLUSION: A high body mass index, a diet low in fruit and cigarette smoking may be involved in the progression from Barrett’s oesophagus to oesophageal adenocarcinoma. PMID:17461453

  7. Stimulus and site specific induction of hiccups in the oesophagus of normal subjects

    PubMed Central

    Fass, R; Higa, L; Kodner, A; Mayer, E

    1997-01-01

    Background—Hiccups that are induced by a large meal have been suggested to result from gastric overdistension. The role of the oesophagus in precipitating hiccups has never been defined. 
Aims—To determine the involvement of oesophageal mechanoreceptors in the hiccup reflex. 
Methods—Ten normal healthy subjects were prospectively evaluated at a university affiliated hospital. Controlled inflation of a polyethylene bag in the proximal and distal oesophagus was carried out using slow ramp and rapid phasic distensions, by an electronic distension device. 
Results—Hiccups were induced in four subjects only during rapid phasic distensions and only in the proximal oesophagus. The mean (SEM) minimal volume threshold for the hiccup reflex was 32.5 (4.8) ml, which was above the perception threshold. Hiccups appeared during inflation and resolved after deflation. 
Conclusions—Sudden rapid stretch of the mechanoreceptors in the proximal oesophagus can trigger the hiccup reflex in normal subjects. Only rapid distensions above a determined volume threshold will predictably induce hiccups in a given subject. This mechanism may play a role in the physiological induction of hiccups. 

 Keywords: hiccups; oesophageal mechanoreceptors; electronic distension device; phasic distension; ramp distension; perception thresholds PMID:9414962

  8. Use of a metal detector in the location of a swallowed razor blade in the oesophagus.

    PubMed

    Kessler, A; Yellin, A; Kessler, A; Kronenberg, J

    1990-05-01

    A case describing the use of a metal detector to locate a metallic foreign body swallowed by a prisoner. Initial work up included plain thoracic X-rays and a gastrografin swallow which were negative. A metal detector was used to confirm the presence of a metal body in the oesophagus which was verified by a barium swallow.

  9. Endoscopic risk factors for neoplastic progression in patients with Barrett’s oesophagus

    PubMed Central

    Bureo Gonzalez, Angela; Bergman, Jacques JGHM

    2016-01-01

    Barrett’s oesophagus is a precursor lesion for oesophageal adenocarcinoma, which generally has a poor prognosis. Patients diagnosed with Barrett’s oesophagus therefore undergo regular endoscopic surveillance to detect neoplastic lesions at a curable stage. The efficacy of endoscopic surveillance of Barrett’s oesophagus patients is, however, hampered by difficulties to detect early neoplasia endoscopically, biopsy sampling error, inter-observer variability in histological assessment and the relatively low overall progression rate. Efficacy and cost-effectiveness of Barrett’s surveillance may be improved by using endoscopic and clinical characteristics to risk-stratify Barrett’s patients to high- and low-risk categories. Recent national and international surveillance guidelines have incorporated Barrett’s length and presence of low-grade dysplasia in the advised surveillance intervals. In this review we will discuss endoscopic characteristics that may be associated with neoplastic progression in Barrett’s oesophagus and that may be used to tailor surveillance in Barrett’s patients. PMID:27733907

  10. Risk of perforation using rigid oesophagoscopy in the distal part of oesophagus.

    PubMed

    Wennervaldt, Kasper; Melchiors, Jacob

    2012-11-01

    Endoscopic examination and treatment of disorders in the oesophagus have been a part of the otolaryngological specialty since the introduction of the rigid endoscope. Today, both flexible and rigid oesophagoscopy (RO) is used to that end. The aim of this study was to evaluate the safety of the RO. We conducted a retrospective cohort study of all ROs performed at a head & neck department in a Danish hospital in the 2003-2011-period. Perforation of the oesophageal wall was the primary endpoint. Secondary endpoints included: dental injury, mortality and, in case of a foreign body: location and successful removal. A total of 483 ROs were performed. Four patients (0.8%) suffered perforation; three during removal of a foreign body in the lower part of the oesophagus and one as part of investigation for cancer. 46.2% of the procedures were performed to remove a foreign body and 32.7% as investigation for cancer. The majority of the foreign bodies were located in the superior part of the oesophagus and the objects were successfully removed in all but one case. Our results are well within the range of previously published material. We recommend that the risk of serious complications is taken into consideration when choosing this modality. Furthermore, we believe that this risk increases in the distal part of the oesophagus and recommend that the use of the RO in this area is reserved as a last resort option. not relevant. not relevant.

  11. Ectopic sebaceous glands in the oesophagus: a case report and review of literature.

    PubMed

    Lee, Seung-Hwa; Lee, Duck-Joo; Kim, Kwang-Min; Kim, Kyu-Nam; Kang, Joon-Koo

    2014-08-01

    Most ectopic sebaceous glands have been reported in the tissues of ectodermal origin. However, there are relatively a few reports of ectopic sebaceous glands in the oesophagus, an organ of endodermal origin. We report the case of an asymptomatic 54-year-old man with ectopic oesophageal sebaceous glands. These lesions were incidentally observed in the distal oesophagus during screening endoscopy of gastric neoplasm and confirmed by histologic analysis. Surveillance or resection with regard to ectopic sebaceous glands in the oesophagus is generally not required since there is no known malignant potential. However, anti-reflux treatment may be sometimes needed, if such symptoms are present in patients. Also, these lesions should be differentiated from other pathologic lesions of oesophagus that need to be treated. Thus, greater attention of endoscopists is required for detection and differential diagnosis of these lesions. The narrow-band imaging mode and/or endoscopic biopsy may be helpful. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  12. The effect of sildenafil on oesophageal motor function in healthy subjects and patients with nutcracker oesophagus.

    PubMed

    Lee, J I; Park, H; Kim, J H; Lee, S I; Conklin, J L

    2003-12-01

    Type 5 phosphodiesterase terminates the action of nitric oxide (NO) induced 3',5'-cyclic monophosphate (cGMP). Sildenafil inhibits this phosphodiesterase, increases cellular cGMP concentrations and enhances NO-induced smooth muscle relaxation. We investigated the effect of sildenafil on the oesophageal motor function of healthy subjects and patients with nutcracker oesophagus. Eight healthy volunteers and nine patients with nutcracker oesophagus participated in this study. The participants underwent oesophageal manometries on two separate days after either 20 mL of distilled water or 0.8 mg kg-1 sildenafil dissolved in 20 mL of water was infused into the stomach. Lower oesophageal sphincter (LOS) resting pressure, the duration of LOS relaxation and the amplitudes of oesophageal pressure waves were examined before, and 7.5, 15, 30 and 60 min after either placebo or sildenafil. In both healthy subjects and patients with nutcracker oesophagus, sildenafil decreased resting LOS pressure and the amplitude of peristaltic pressure waves at 3, 8 and 13 cm above LOS. Sildenafil also prolonged the duration of LOS relaxation. It had no effect on the velocity of peristalsis or the amplitude of peristaltic pressure waves 18 cm above LOS. Sildenafil may be considered as an alternative treatment in nutcracker oesophagus although there are several limitations to be overcome.

  13. Bile reflux gastritis and Barrett's oesophagus: further evidence of a role for duodenogastro-oesophageal reflux?

    PubMed

    Dixon, M F; Neville, P M; Mapstone, N P; Moayyedi, P; Axon, A T

    2001-09-01

    There is increasing evidence that reflux of bile plays a part in the pathogenesis of Barrett's oesophagus. Bile injury to the gastric mucosa results in a "chemical" gastritis in which oedema and intestinal metaplasia are prominent. To determine if patients with Barrett's oesophagus have more bile related changes in antral mucosa than patients with uncomplicated gastro-oesophageal reflux disease (GORD) or non-ulcer dyspepsia (NUD). Patients were identified by a retrospective search of pathology records and those with a clinically confirmed diagnosis of either Barrett's oesophagus or reflux oesophagitis who had oesophageal and gastric biopsies taken at the same endoscopy and had no evidence of Helicobacter pylori infection entered the study. Control biopsies were taken from H pylori negative NUD patients. Antral biopsies were examined "blind" to clinical group and graded for a series of histological features from which the "reflux gastritis score" (RGS) and "bile reflux index" (BRI) could be calculated. The reproducibility of these histological scores was tested by a second pathologist. There were 100 patients with Barrett's, 61 with GORD, and 50 with NUD. The RGSs did not differ between groups. BRI values in the Barrett's group were significantly higher than those in GORD subjects (p=0.014) which in turn were higher than those in NUD patients (p=0.037). Similarly, the frequency of high BRI values (>14) was significantly greater in the Barrett's group (29/100; 29%) than in the GORD (9/61; 14.8%) or NUD (4/50; 8%) group. However, agreement on BRI values was "poor", indicating limited applicability of this approach. Patients with Barrett's oesophagus have more evidence of bile related gastritis than subjects with uncomplicated GORD or NUD. The presence of bile in the refluxate could be a factor in both the development of "specialised" intestinal metaplasia and malignancy in the oesophagus.

  14. Cancer of the oesophagus and gastroesophageal junction – a difficult clinical problem

    PubMed Central

    Kot, Marta; Kotucha, Bartłomiej; Stępień, Renata; Kozieł, Dorota

    2014-01-01

    Introduction Cancer located in the oesophagus and gastroesophageal junction is a complex clinical problem and the results of its treatment still remain unsatisfactory. The objective of the study was the clinical analysis of a group of patients with cancer of the oesophagus or gastroesophageal junction, who received combined medical and surgical treatment. Material and methods The analysis was performed on a group of 128 patients with the diagnosis of oesophageal cancer or cancer of the gastroesophageal junction. Analysis of medical records and follow-up examinations were used in the research procedure. Results From among 128 patients with a diagnosis of oesophageal or gastroesophageal junction cancer, 50 (38.5%) received surgical resections. The surgery most frequently performed (n = 15) was sub-total oesophageal resection according to Akiyama procedure by right-sided thoracotomy (oesophageal anastomosis in the neck). The largest group were patients (n = 26) with stage T3N1M0 of advancement of the disease. In all cases of cancer located in the lower third of the oesophagus, an adenocarcinoma pattern was diagnosed in the histopathological examination, whereas in the case of cancers located in the middle third and upper third of the thoracic oesophagus a carcinoma planoepitheliale pattern was seen. Anastomotic leaks occurred in seven patients (14%). Six patients died during the post-operative period (12%). The mean survival time in the group of analysed patients was two years. Conclusions Cancer of the oesophagus or gastroesophageal junction is associated with low resectability, high risk of complications after surgery, and poor oncologic outcome. It is necessary to seek new methods of treatment. PMID:25477759

  15. Treatment of dysplastic Barrett’s Oesophagus in lower volume centres after structured training

    PubMed Central

    Chadwick, Georgina; Faulkner, Jack; Ley-Greaves, Robert; Vlavianos, Panagiotis; Goldin, Rob; Hoare, Jonathan

    2015-01-01

    AIM: To investigate whether dysplastic Barrett’s Oesophagus can be safely and effectively treated endoscopically in low volume centres after structured training. METHODS: After attending a structured training program in Amsterdam on the endoscopic treatment of dysplastic Barrett’s Oesophagus, treatment of these patients was initiated at St Marys Hospital. This is a retrospective case series conducted at a United Kingdom teaching Hospital, of patients referred for endoscopic treatment of Barrett’s oesophagus with high grade dysplasia or early cancer, who were diagnosed between January 2008 and February 2012. Data was collected on treatment provided (radiofrequency ablation and endoscopic resection), and success of treatment both at the end of treatment and at follow up. Rates of immediate and long term complications were assessed. RESULTS: Thirty-two patients were referred to St Marys with high grade dysplasia or intramucosal cancer within a segment of Barrett’s Oesophagus. Twenty-seven met the study inclusion criteria, 16 of these had a visible nodule at initial endoscopy. Treatment was given over a median of 5 mo, and patients received a median of 3 treatment sessions over this time. At the end of treatment dysplasia was successfully eradicated in 96% and intestinal metaplasia in 88%, on per protocol analysis. Patients were followed up for a median of 18 mo. At which time complete eradication of dysplasia was maintained in 86%. Complications were rare: 2 patients suffered from post-procedural bleeding, 4 cases were complicated by oesophageal stenosis. Recurrence of cancer was seen in 1 case. CONCLUSION: With structured training good outcomes can be achieved in low volume centres treating dysplastic Barrett’s Oesophagus. PMID:25610536

  16. Adenocarcinoma of the oesophagus and gastric cardia: male preponderance in association with obesity.

    PubMed

    Ryan, Aoife M; Rowley, Suzanne P; Fitzgerald, Anthony P; Ravi, Narayanasamy; Reynolds, John V

    2006-05-01

    Recent evidence links obesity with the rising incidence of oesophageal adenocarcinoma. In Ireland between 1995 and 2004 the incidence of oesophageal adenocarcinoma increased by 38%, and this coincided with a 67% increase in the prevalence of obesity. In this study, a prospective case-control study was undertaken in 760 patients presenting to a tertiary centre between 1994 and 2004 diagnosed with cancer of the oesophagus, gastric cardia or stomach. Data were compared with 893 healthy controls. Multivariate logistic regression models were used to calculate the odds ratio (OR) of developing either cancer type according to quartiles of body mass index (BMI). Based on pre-illness BMI, 82% of patients who developed adenocarcinoma of the oesophagus were either overweight or obese compared with 59% of the healthy control population (P<0.001). A dose-dependent relationship existed between BMI and oesophageal adenocarcinoma in males. The adjusted odds ratio was 4.3 (95% CI: 2.3-7.9) among males in the highest BMI quartile compared with males in the lowest quartile (P<0.001 for trend). Using common cut-off points for BMI, the OR of adenocarcinoma of the lower oesophagus was 11.3 times higher (95% CI: 3.5-36.4) for individuals with a BMI >30 kg/m2 versus individuals with a BMI <22 kg/m2 (P<0.001 for trend). For adenocarcinoma of the gastric cardia, males in the top quartile of BMI had an OR of 3.5 (95% CI: 1.3-9.4) compared with the lowest quartile (P=0.03 for trend). A significant (P<0.001) inverse relationship between BMI and oesophageal SCC was observed. The odds ratio for adenocarcinoma of the oesophagus, the oesophago-gastric junction and gastric cardia rose significantly with increasing BMI. For tumours of the lower oesophagus, obesity increased the risk 10.9-fold. The increased risk is significant in males only.

  17. An unusual technique for removal of occult f. b. ( glass marble ) lying in mid oesophagus for one year.

    PubMed

    Pathak, R D; Gupta, V; Dubey, S S

    2000-10-01

    Foreign bodies in oesophagus are not uncommon. Due to natural anatomical constrictions foreign bodies get lodged invariably. Coins, bones, open safety pins, tumps of meat are commonly encountered in food pipe. Inhaled, swallowed or aspirated foreign body is a serious problem and on occasions can be fatal ( Schloss et al 1983). Many a time these accidental inhalations or aspirations of foreign bodies in children is neither observed nor suspected (Cohen et al 1980), Cases of long term impacted foreign bodies in oesophagus are uncommon and particularly round glass marble for a year is rarely reported. A rare case of impacted marble lying in mid oesophagus for one year is reported herewith.

  18. Enlargement of the Pharynx Resulting From Surgically Assisted Rapid Maxillary Expansion.

    PubMed

    Vinha, Pedro Pileggi; Faria, Ana Célia; Xavier, Samuel Porfirio; Christino, Mariana; de Mello-Filho, Francisco Veríssimo

    2016-02-01

    Given that transverse maxillary deficiency is an etiologic factor of obstructive sleep apnea and is intimately connected to pharyngeal size, the objective of this study was to determine whether surgically assisted rapid maxillary expansion (SARME) would promote pharyngeal enlargement in adults. This prospective study was conducted in patients with uni- or bilateral posterior crossbite who underwent SARME. Participants were recruited from the Integrated Center for the Study of Face Defects, School of Medicine of Ribeirão Preto, University of São Paulo (São Paulo, Brazil). All patients underwent computed tomography of the pharynx before and after surgery (171.5 days on average), and the sagittal and transverse planes and the total area across 3 levels of the pharynx, including the upper (posterior nasal spine), middle (first cervical vertebra), and lower (second cervical vertebra) levels, were measured on the images. A paired-samples t test was used to evaluate changes in the pharynx before and after surgery. The studied sample consisted of 18 adult patients (10 women and 8 men) with an average age of 37.11 years (standard deviation, 11.73 yr); all patients resided in the region of Ribeirão Preto, São Paulo, Brazil. No statistical changes were observed in the upper level. An enlargement of 17.82% (P = .0107) was observed in the sagittal plane of the middle level. The cross-sectional and area values of this same portion were enlarged (16.96 and 37.38%, respectively), with a trend toward statistical significance (P = .067 and .051, respectively). The airway enlargements in the lower level were 26.41, 24.87, and 53.87% in the sagittal and transverse planes and total area, respectively; these differences were statistically significant (P = .0003, .0033, and .0016, respectively) for all 3 measurements. SARME promotes pharyngeal enlargement, especially in the lower levels of the pharynx. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons

  19. Lymphogranuloma venereum detected from the pharynx in four London men who have sex with men.

    PubMed

    Dosekun, O; Edmonds, S; Stockwell, S; French, P; White, J A

    2013-06-01

    Lymphogranuloma venereum (LGV) is an established cause of proctitis in men who have sex with men (MSM). Currently in the UK, testing for pharyngeal Chlamydia trachomatis (CT) is not routine, and LGV typing is usually only performed in patients with anorectal symptoms. We report four cases where LGV-associated CT DNA was detected from the pharynx in MSM, demonstrating that nucleic acid amplification testing (NAAT) can be used for detecting and typing pharyngeal CT infection. These cases also highlight other possible routes of infection for LGV, and add to the broad spectrum of clinical presentations associated with this infection.

  20. Cephalometric analysis of modifications of the pharynx due to maxillo-mandibular advancement surgery in patients with obstructive sleep apnea.

    PubMed

    Faria, A C; Xavier, S P; Silva, S N; Trawitzki, L V Voi; de Mello-Filho, F V

    2013-05-01

    Cephalometry has been used to measure hard and soft facial tissues, as well as the pharyngeal air space for the diagnosis of obstructive sleep apnea (OSA). The changes occurring in the pharynx due to maxillo-mandibular advancement (MMA) have not been established or quantified. The objective of this study was to identify the anatomical changes of the pharynx and of hard tissues that occur in patients with OSA after MMA. 19 patients with a polysomnographic diagnosis of OSA were submitted to cephalometric analysis before and 6 months after surgery in order to evaluate the changes produced by MMA in the pharynx and soft tissues. Cephalometry was standardized in order to obtain descriptive measurements of the dimensions of the airways, the position of the hyoid bone, and maxilla-mandibular relations. The modifications of the pharynx due to MMA showed a significant relation obtained by cephalometry. For each millimeter of maxillary and mandibular bone advancement there was a 0.76mm increase in the retropalatal region and a 1.2mm increase in the pharynx in the retrolingual region. In addition, MMA promoted a significant repositioning of the hyoid bone in the cranial direction. Copyright © 2012 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  1. Milch, Milchprodukte, Analoge und Speiseeis

    NASA Astrophysics Data System (ADS)

    Coors, Ursula

    Die Produktpalette Milch und Erzeugnisse aus Milch beinhaltet Konsummilch, die aus Milch oder Bestandteilen der Milch hergestellten Milcherzeugnisse wie Sauermilch-, Joghurt-, Kefir-, Buttermilch-, Sahne-, Kondensmilch-, Trockenmilch- und Molkenerzeugnisse, Milchmisch- und Molkenmischprodukte (Produkte mit beigegebenen Lebensmitteln), Milchzucker, Milcheiweißerzeugnisse, Milchfette und Käse.

  2. Neuausrichtung und Konsolidierung

    NASA Astrophysics Data System (ADS)

    Grohmann, Heinz

    Mit der Wahl von Wolfgang Wetzel zum Vorsitzenden der Deutschen Statistischen Gesellschaft im Jahre 1972 begann eine 32jährige Ära, in der die praktische und die theoretische Statistik in einem ausgewogenen Verhältnis gepflegt wurden. Ein regelmäßiger vierjähriger Wechsel im Vorsitz stärkte die Gemeinschaft und die praktische wie die wissenschaftliche Arbeit gleichermaßen. Die jährlichen Hauptversammlungen behandelten gesellschaftlich aktuelle wie zukunftsorientierte Themen, und die Ausschüsse sowie weitere Veranstaltungen gaben Gelegenheit zur Förderung und Pflege einer Vielzahl von Arbeitsgebieten der Statistik. Darüber wird nicht nur in diesem Kapitel, sondern auch in den Teilen II und III des Bandes berichtet.

  3. Tensoren und Felder

    NASA Astrophysics Data System (ADS)

    Dirschmid, Hans J.

    Das Lehrbuch soll Studierende mit Grundkenntnissen der Differential- und Integralrechnung in die klassische Feldtheorie mit modernen mathematischen Methoden einführen. Dementsprechend ist die Tensoranalysis das mathematische Thema, das Prinzip der Relativität das physikalische. Aus didaktischen Erwägungen gliedert sich der Text in zwei Teile. Um den Leser mit den Objekten vertraut zu machen, wird zunächst der affine und euklidische Raum zugrundegelegt, um verallgemeinernd zur Geometrie auf Mannigfaltigkeiten und Riemannschen Räumen überleiten zu können. Im Anschluß an die mathematische Theorie wird in die spezielle und allgemeine Relativitätstheorie eingeführt, wobei die Geometrie der Raum-Zeit, die Grundgesetze der Elektrodynamik und der Gravitation sowie Folgerungen zur Sprache kommen.

  4. Gross Anatomy of Pampas Deer (Ozotoceros bezoarticus, Linnaeus 1758) Mouth and Pharynx.

    PubMed

    Pérez, W; Vazquez, N; Ungerfeld, R

    2017-04-01

    The aims of this study were to describe the anatomy of the mouth and pharynx of the pampas deer, and to consider its evolutionary feeding niche according to those characteristics. Gross dissections of the mouth and pharynx were performed in 15 animals, 10 adult females and five young animals under 1 year (three males and two females), all dead by causes unrelated to this anatomical region. The upper lip entered in the constitution of a pigmented nasolabial plane. The masseter muscles weighed 43.8 ± 3.5 g and represented 0.23% of body weight, which corresponds to ruminants of feeders intermediate to grazers and browsers. Parotid glands represented 0.08% of the body weight, characteristic that also categorize the pampas deer as belonging to the intermediate feeding group. The dental formula was the same of the domestic ruminants. The upper incisors and canines were absent, and instead of them, there was a dental pad (Pulvinus dentalis). The upper canine teeth were present only in the deciduous dentition. The existence of a brachydont dentition turns Ozotoceros very vulnerable to continuous use as there is no compensatory teeth growth. The particular anatomy of the mouth and lips of this animal was adapted to a very selective feeding, taking highly nutritious sprouts beyond plant category. In conclusion and in addition to previous studies of anatomy of the digestive organs in this species, pampas deer may be categorized as belonging to the intermediate type of feeding.

  5. Food groups, oils and butter, and cancer of the oral cavity and pharynx

    PubMed Central

    Franceschi, S; Favero, A; Conti, E; Talamini, R; Volpe, R; Negri, E; Barzan, L; Vecchia, C La

    1999-01-01

    To elucidate the role of dietary habits, a study was carried out in 1992–1997 in the province of Pordenone in Northeastern Italy, and those of Rome and Latina in central Italy. Cases were 512 men and 86 women with cancer of the oral cavity and pharynx (lip, salivary glands and nasopharynx excluded) and controls were 1008 men and 483 women who had been admitted to local hospitals for a broad range of acute non-neoplastic conditions. The validated dietary section of the questionnaire included 78 foods or recipes and ten questions on fat intake patterns. After allowance for education, smoking, alcohol and total energy intake, significant trends of increasing risk with increasing intake emerged for soups, eggs, processed meats, cakes and desserts, and butter. Risk was approximately halved in the highest compared to the lowest intake quintile for coffee and tea, white bread, poultry, fish, raw and cooked vegetables, citrus fruit, and olive oil. The inverse association with oils, especially olive oil, was only slightly attenuated by allowance for vegetable intake. Thus, frequent consumption of vegetables, citrus fruit, fish and vegetable oils were the major features of a low-risk diet for cancer of the oral cavity and pharynx. © 1999 Cancer Research Campaign PMID:10408875

  6. Easier to swallow: pictorial review of structural findings of the pharynx at barium pharyngography.

    PubMed

    Tao, Ting Y; Menias, Christine O; Herman, Thomas E; McAlister, William H; Balfe, Dennis M

    2013-01-01

    Barium pharyngography remains an important diagnostic tool in the evaluation of patients with dysphagia. Pharyngography can not only help detect functional abnormalities but also help identify a wide spectrum of structural abnormalities in children and adults. These structural abnormalities may reflect malignant or nonmalignant oropharyngeal, hypopharyngeal, or laryngeal processes that deform or alter normal coated mucosal surfaces. Therefore, an understanding of the normal appearance of the pharynx at contrast material-enhanced imaging is necessary for accurate detection and interpretation of abnormal findings. Congenital malformations are more typically identified in the younger population; inflammatory and infiltrative diseases, trauma, foreign bodies, and laryngeal cysts can be seen in all age groups; and Zenker and Killian-Jamieson diverticula tend to occur in the older population. Squamous cell carcinoma is by far the most common malignant process, with contrast-enhanced imaging findings that depend on tumor location and morphology. Treatments of head and neck cancers include total laryngectomy and radiation therapy, both of which alter normal anatomy. Patients are usually evaluated immediately after laryngectomy to detect complications such as fistulas; later, pharyngography is useful for identifying and characterizing strictures. Deviation from the expected posttreatment appearance, such as irregular narrowing or mucosal nodularity, should prompt direct visualization to evaluate for recurrence. Contrast-enhanced imaging of the pharynx is commonly used in patients who present with dysphagia, and radiologists should be familiar with the barium pharyngographic appearance of the normal pharyngeal anatomy and of some of the processes that alter normal anatomy.

  7. Scanning electron microscopy of the tongue, pharynx, and larynx of rats exposed to cigarette smoke.

    PubMed

    Martins, Regina Helena Garcia; Goncalves, Tatiana Maria; Madeira, Sergio Luis; Dias, Norimar Hernandes; de Oliveira Semenzati, Graziela

    2014-05-01

    To examine, by using scanning electron microscopy, the surface of the tongue, pharynx, and larynx of animals exposed to tobacco. Experimental study. Twenty rats were allocated to two groups: group I, control group: 10 rats not exposed to any inhaling pollutant and group II, tobacco group: 10 rats exposed to smoke from 10 cigarettes twice a day for 260 days. Animals of both groups had no restriction of food or water. After those 260 days, their aerodigestive segment was removed, and fragments of their tongue, hypopharynx, and right vocal fold were immersed in 2.5% glutaraldehyde and prepared for scanning electron microscopy. The filiform tongue papillae of the tobacco group were irregularly displayed, flattened, and adhered to each other. The hypopharynx mucosa was highly irregular, thickened, rough and had increased superficial peeling. The mucosa of the vocal folds had deep furrows surrounding the cells. These alterations were not identified for the control group. Several changes were recorded for the tongue, pharynx, and larynx of tobacco group animals, confirming the harmful effects of smoking to the respiratory and digestive epithelium. Copyright © 2014 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  8. [Multivariate analysis of pharyngo cutaneou fistulas after larynx cancer and lower pharynx cancer surgery].

    PubMed

    Su, Jiakun; Zhao, Feng; Wei, Xiaolin; Su, Jiping

    2015-04-01

    To investigate the relative factors of pharyngo cutaneou fistulas after larynx cancer and lower pharynx cancer surgery. The clinical datas of 87 larynx cancer patients and lower pharynx cancer patients admitted were retrospectively analyzed. According to the type of postoperative complications all cases could be divided into pharyngo cutaneou fistulas group and no pharyngo cutaneou fistulas group. Thirty-eight kinds of factors,including age, clinical stage, plasma electrolytes level and type of procedure are in the multivariate analysis, and the variability indicators are in binary-regression analysis. Eleven patients had pharyngo cutaneou fistulas (12.64%). Univariate analysis indicated that BMI, pre-operative serum potassium, operation time, cervical lymph dissection, post-operative prealbumin, post-operative hemoglobin, infection and delayed union of incision were the risk factors of pharyngo cutaneou fistulas (P < 0.05). Logistic stepwise regression analysis indicated that post-operative prealbumin and operation time were the independent risk factors. To avoid pharyngo cutaneou fistulam, it is very necessary to correct electrolyte disorder and negative nitrogen balance. To shorten the operation time, to avoid incision infection and delayed union were helpfulness, too.

  9. Hox-mediated endodermal identity patterns pharyngeal muscle formation in the chordate pharynx.

    PubMed

    Yoshida, Keita; Nakahata, Azusa; Treen, Nicholas; Sakuma, Tetsushi; Yamamoto, Takashi; Sasakura, Yasunori

    2017-05-01

    The chordate pharynx, possessing gill slits and the endostyle, is a complex of multiple tissues that are highly organized along the anterior-posterior (AP) axis. Although Hox genes show AP coordinated expression in the pharyngeal endoderm, tissue-specific roles of these factors for establishing the regional identities within this tissue have not been demonstrated. Here, we show that Hox1 is essential for the establishment of AP axial identity of the endostyle, a major structure of the pharyngeal endoderm, in the ascidian Ciona intestinalis We found that knockout of Hox1 causes posterior-to-anterior transformation of the endostyle identity, and that Hox1 represses Otx expression and anterior identity, and vice versa. Furthermore, alteration of the regional identity of the endostyle disrupts the formation of body wall muscles, suggesting that the endodermal axial identity is essential for coordinated pharyngeal development. Our results demonstrate an essential role of Hox genes in establishment of the AP regional identity in the pharyngeal endoderm and reveal crosstalk between endoderm and mesoderm during development of chordate pharynx. © 2017. Published by The Company of Biologists Ltd.

  10. Reduced innervation in the human pharynx in patients with obstructive sleep apnea.

    PubMed

    de Carlos, Félix; Cobo, Juan; Macías, Emilio; Feito, Jorge; González, Mónica; Cobo, Teresa; Fernández-Mondragón, María P; García-Suárez, Olivia; Vega, José A

    2015-07-01

    Obstructive sleep apnea is a disease characterized by repetitive breathing during sleep that lead to reduced oxygen saturation and sleep disturbance among other symptoms. Obstructive sleep apnea is caused by blockade of the upper respiratory airway, although the pathogenic mechanism underlying this occlusion remains unknown. In these studies we explored the hypothesis that alterations in the innervation, especially mechanosensory innervation, of the pharynx may contribute to obstructive sleep apnea. We tested this hypothesis by analyzing the innervation of the human pharynx in normal individuals and in subjects clinically diagnosed with obstructive sleep apnea. Using immunohistochemistry for axon and Schwann cells, as well as for two putative mechanoproteins (ASIC2 and TRPV4), we observed a significant reduction in the density of nerve fibers in the submucosa of patients with obstructive sleep apnea as well as morphological abnormalities in mechanosensory corpuscles. Importantly, while ASIC2 and TRPV4 expression was regularly found in the axons of mechanosensory corpuscles distributed throughout the muscular layer in the control subjects, it was absent in patients with obstructive sleep apnea. These findings support that neurological alterations are important contributors to the pathogenesis of obstructive sleep apnea.

  11. Simulation of muscle and adipose tissue deformation in the passive human pharynx.

    PubMed

    Carrigy, Nicholas B; Carey, Jason P; Martin, Andrew R; Remmers, John E; Zareian, Ali; Topor, Zbigniew; Grosse, Joshua; Noga, Michelle; Finlay, Warren H

    2016-01-01

    Quantifying the contribution of passive mechanical deformation in the human pharynx to upper airway collapse is fundamental to understanding the competing biomechanical processes that maintain airway patency. This study uses finite element analysis to examine deformation in the passive human pharynx using an intricate 3D anatomical model based on computed tomography scan images. Linear elastic properties are assigned to bone, cartilage, ligament, tendon, and membrane structures based on a survey of values reported in the literature. Velopharyngeal and oropharyngeal cross-sectional area versus airway pressure slopes are determined as functions of Young's moduli of muscle and adipose tissue. In vivo pharyngeal mechanics for small deformations near atmospheric pressure are matched by altering Young's moduli of muscle and adipose tissue. The results indicate that Young's moduli ranging from 0.33 to 14 kPa for muscle and adipose tissue matched the in vivo range of area versus pressure slopes. The developed anatomical model and determined Young's moduli range are expected to be useful as a starting point for more complex simulations of human upper airway collapse and obstructive sleep apnea therapy.

  12. Efficacy of a technique for exposing the mouse lung to particles aspirated from the pharynx.

    PubMed

    Rao, G V S; Tinkle, Sally; Weissman, David N; Antonini, James M; Kashon, Michael L; Salmen, Rebecca; Battelli, Lori A; Willard, Patsy A; Hoover, Mark D; Hubbs, Ann F

    2003-08-08

    Recent studies have demonstrated that the mouse lung can be exposed to soluble antigens by aspiration of these antigens from the pharynx. This simple technique avoids the trauma associated with intratracheal instillation. In this study, the pharyngeal aspiration technique was validated for exposing the mouse lung to respirable particles. Using respirable fluorescent amine-modified polystyrene latex beads and beryllium oxide particles, we investigated the localization of aspirated particles within the lung and the relationship between the amount of material placed in the pharynx and the amount deposited in the lung. For exposure, mice were anesthetized with isoflurane in a bell jar, placed on a slant board, and the tongue was gently held in full extension while a 50-microl suspension of particles was pipetted onto the base of the tongue. Tongue restraint was maintained until at least two breaths were completed. Less than a minute after exposure, all mice awoke from anesthesia without visible sequela. There were no significant differences in particle distribution between the left and right side of the lung (p=.16). Particles were widely disseminated in a peribronchiolar pattern within the alveolar region. There was a linear and significant correlation (r2=.99) between the amount administered and the amount deposited in the lung. In beryllium-exposed mice, measurable lung beryllium was 77.5 to 88.2% of the administered beryllium. These findings demonstrate that following aspiration of pharyngeal deposited particles, exposures to the deep lung are repeatable, technically simple, and highly correlated to the administered dose.

  13. Computed tomography of the pharynx in a closed vs. open mouth position.

    PubMed

    Laurenson, Michele P; Zwingenberger, Allison L; Cissell, Derek D; Johnson, Lynelle R; McPeters, Matie J; Spriet, Mathieu P; Taylor, Sandra L; Pollard, Rachel E

    2011-01-01

    The pharynx is anatomically complex and evaluation can be difficult even with cross-sectional imaging. Eight animals had computed tomography (CT) studies of the head performed with the mouth open and closed. The studies were anonymized and evaluated by four radiologists for visibility of six anatomic regions (dorsal wall of nasopharynx, lumen of nasopharynx, dorsal margin of the soft palate, ventral margin of the soft palate, oropharynx, and laryngopharynx) and for certainty of a normal or abnormal diagnosis of four different anatomic regions (nasopharynx, soft palate, oropharynx, and laryngopharynx). Mean visual scores differed significantly between mouth positions and were improved when the mouth was open. The ability of radiologists to classify anatomic regions as normal or abnormal vs. unsure also varied between mouth positions, and there was greater uncertainty when the mouth was closed. In addition, estimated volume of the air-filled nasopharynx differed significantly as a function of mouth position and was greater when the mouth was open (mean=1.187 cm(3) , SE=0.177) vs. closed (mean=0.584 cm(3) , SE=0.116). Computed tomographic evaluation of the pharynx can be improved with the mouth open. © 2011 Veterinary Radiology & Ultrasound.

  14. Developmentally Delayed Male with Mincer Blade Obstructing the Oesophagus for a Period of Time Suspected to Be 6 Months

    PubMed Central

    Grønhøj Larsen, Christian; Charabi, Birgitte

    2015-01-01

    Introduction. Sharp, retained foreign bodies in the oesophagus are associated with severe complications. Developmentally delayed patients are especially subject to foreign objects. We describe a 37-year-old, developmentally delayed male with a mincer blade obstructing the oesophagus. Six months prior to surgical intervention, the patient was hospitalized in a condition of sepsis and pneumonia where the thoracic X-ray reveals a foreign body in the proximal oesophagus. When rehospitalized 6 months later, a mincer blade of the type used in immersion blenders was surgically removed. During these 6 months the patient's main symptoms were dysphagia, weight loss, and diarrhoea. When developmentally delayed patients present with dysphagia, we strongly encourage the awareness of the possible presence of foreign bodies. To our knowledge this is the first reported case of a mincer blade in the oesophagus. PMID:26236532

  15. A case of acute oesophageal necrosis (AEN) in a hypothermic patient. The grave prognosis of the black oesophagus.

    PubMed

    Salem, George A; Ahluwalia, Sumit; Guild, Ralph T

    2015-01-01

    Acute oesophageal necrosis, also known as black oesophagus, is a rare, and potentially lethal syndrome which is often diagnosed incidentally during upper endoscopy for evaluation of upper gastrointestinal bleed. It is characterised by diffuse circumferential black mucosal discolouration in the distal oesophagus secondary to necrosis that may extend proximally to involve variable length of the oesophagus. One theory of pathogenesis is that the relatively low perfusion state in the distal areas of the oesophagus makes it susceptible to mucosal injury. We present a case of acute oesophageal necrosis in a 62year-old lady with history of alcoholic cirrhosis who presented with haematemesis and severe hypothermia, and was eventually found to have acute oesophageal necrosis.

  16. Substitution of thoracic oesophagus by interposition of a pedicled gastric tube, preserving LES function: clinical and histological follow-up.

    PubMed

    Dessanti, Antonio; Di Benedetto, Vincenzo; Iannuccelli, Marco; Sanna-Passino, Eraldo; Mura, Liliana; Dessanti, Giuseppina; Careddu, Gian Mario; Manunta, Maria Lucia; Cossu-Rocca, Paolo; Sanna, Ennio

    2005-09-01

    Assessment of clinical evolution and histological findings in a group of animals experimentally operated on to substitute the thoracic oesophagus with a gastric tube. Six piglets underwent oesophageal replacement with a gastric tube, constructed from the greater curvature of stomach and pedicled on the gastroepiploic vessels, which was interposed between the oesophageal stumps. At follow-up, all animals were found to be growing and eating normally, apart from case no 1 (stenosis of the lower oesophageal anastomosis). Ph-metry showed a neutral pH on the gastric tube. Postmortem histological analysis of the gastric tube and native oesophagus samples did not show any significant lesions, except in case no 1 (inflammation of the gastric tube and upper oesophagus due to food stasis). The technique of substitution of the oesophagus with an interposed pedicled gastric tube can be a breakthrough in existing surgical methods of oesophageal replacement.

  17. Mutation analysis of the p53, APC, and p16 genes in the Barrett's oesophagus, dysplasia, and adenocarcinoma.

    PubMed Central

    González, M V; Artímez, M L; Rodrigo, L; López-Larrea, C; Menéndez, M J; Alvarez, V; Pérez, R; Fresno, M F; Pérez, M J; Sampedro, A; Coto, E

    1997-01-01

    AIMS: To study the loss of heterozygosity and the presence of mutations at the p53, p16/CDKN2, and APC genes in Barrett's oesophagus, low grade dysplastic oesophageal epithelium, and adenocarcinoma of the oesophagus; to relate the presence of alterations at these genes with the progression from Barrett's oesophagus to adenocarcinoma. METHODS: DNA was extracted from paraffin blocks containing tissue from Barrett's oesophagus (12 samples), low grade dysplasia (15 cases), and adenocarcinoma (14 cases). Loss of heterozygosity (LOH) at the p53, p16, and APC genes was determined by comparing the autoradiographic patterns of several microsatellite markers between the normal tissue and the malignant tissue counterpart. SSCP was used to determine the presence of mutations at p53 (exons 5 to 8), p16 (exon 2), and APC. Homozygous deletion of the p16 gene was defined through polymerase chain reaction followed by Southern blot. RESULTS: LOH at the p53, p16, and APC genes was not observed in Barrett's oesophagus without dysplasia, and increased to 90% (p53), 89% (p16), and 60% (APC) in the adenocarcinomas. The p53 gene was mutated in only two adenocarcinomas (codons 175 and 245). In one case a mutation at the APC gene (codon 1297) was found. No patient had mutation at the second exon of p16. However, this gene was homozygously deleted in three of the 12 adenocarcinomas. CONCLUSIONS: The tumour suppressor genes p53, p16, and APC are often deleted in adenocarcinomas derived from Barrett's oesophagus. Mutations at these genes are also found in the adenocarcinomas, including the homozygous deletion of the p16 gene. However, the absence of genetic alterations in the Barrett's oesophagus and the low grade dysplastic epithelia suggest that mutations at these genes develop later in the progression from Barrett's oesophagus to adenocarcinoma. Images PMID:9155671

  18. Mortality and cardiovascular diseases risk in patients with Barrett's oesophagus: a population-based nationwide cohort study.

    PubMed

    Erichsen, R; Horvath-Puho, E; Lund, J L; Dellon, E S; Shaheen, N J; Pedersen, L; Davey Smith, G; Sørensen, H T

    2017-04-01

    Patients with Barrett's oesophagus may be at increased risk of mortality overall, and cardiovascular disease has been suggested as the main underlying cause of death. To examine cause-specific mortality and risk of cardiovascular events among patients with Barrett's oesophagus. Utilising existing Danish data sources (1997-2011), we identified all patients with histologically verified Barrett's oesophagus (n = 13 435) and 123 526 members of the general population matched by age, sex and individual comorbidities. We calculated cause-specific mortality rates and incidence rates of cardiovascular diseases. We then compared rates between patients with Barrett's oesophagus and the general population comparison cohort, using stratified Cox proportional hazard regression. Patients with Barrett's oesophagus had a 71% increased risk of overall mortality. The cause-specific mortality rate per 1000 person-years for patients with Barrett's oesophagus was 8.5 for cardiovascular diseases, 14.7 for non-oesophageal cancers, and 5.4 for oesophageal cancer. Compared to the general population cohort, corresponding hazard ratios were 1.26 (95% confidence interval (CI): 1.15-1.38), 1.77 (95% CI: 1.65-1.90), and 19.4 (95% CI: 16.1-23.4), respectively. The incidence rates of cardiovascular diseases per 1000 person-years for Barrett's oesophagus patients and for persons from the general population cohort, respectively, varied from 0.4 and 0.2 for subarachnoid bleeding (hazard ratio 1.10, 95% CI: 0.87-1.39) to 8.1 and 5.9 for congestive heart failure (hazard ratio 1.33, 95% CI: 1.21-1.46). Prophylactic measures targeted at cardiovascular diseases and non-oesophageal cancers potentially could be more important than measures against oesophageal cancer, for improving prognosis among patients with Barrett's oesophagus. © 2017 John Wiley & Sons Ltd.

  19. 5-Hydroxytryptamine selectively activates the vagal nodose C-fibre subtype in the guinea-pig oesophagus.

    PubMed

    Yu, S; Ru, F; Ouyang, A; Kollarik, M

    2008-09-01

    The afferent neurons innervating the oesophagus originate from two embryonic sources: neurons located in vagal nodose ganglia originate from embryonic placodes and neurons located in vagal jugular and spinal dorsal root ganglia (DRG) originate from the neural crest. Here, we address the hypothesis that 5-hydroxytryptamine (5-HT) differentially stimulates afferent nerve subtypes in the oesophagus. Extracellular recordings of single unit activity originating from nerve terminals were made in the isolated innervated guinea-pig oesophagus. Whole cell patch clamp recordings (35 degrees C) were made from the primary afferent neurons retrogradely labelled from the oesophagus. 5-Hydroxytryptamine (10 micromol L(-1)) activated vagal nodose C-fibres (70%) in the oesophagus but failed to activate overtly vagal jugular nerve fibres and oesophagus-specific spinal DRG neurons. The response to 5-HT in nodose C-fibre nerve terminals was mimicked by the selective 5-HT(3) receptor agonist 2-methyl-5-HT (10 micromol L(-1)) and nearly abolished by the 5-HT(3) receptor antagonists ondansetron (10 micromol L(-1)) and Y-25130 (10 micromol L(-1)). In patch clamp studies, 2-methyl-5-HT (10 micromol L(-1)) activated a proportion of isolated oesophagus-specific nodose capsaicin-sensitive neurons (putative cell bodies of nodose C-fibres). We conclude that the responsiveness to 5-HT discriminates placode-derived (vagal nodose) C-fibres from the neural crest-derived (vagal jugular and spinal DRG) afferent nerves in the oesophagus. The response to 5-HT in nodose C-fibres is mediated by the 5-HT(3) receptor in their neuronal membrane.

  20. Length of Barrett's oesophagus and cancer risk: implications from a large sample of patients with early oesophageal adenocarcinoma.

    PubMed

    Pohl, Heiko; Pech, Oliver; Arash, Haris; Stolte, Manfred; Manner, Hendrik; May, Andrea; Kraywinkel, Klaus; Sonnenberg, Amnon; Ell, Christian

    2016-02-01

    Although it is well understood that the risk of oesophageal adenocarcinoma increases with Barrett length, transition risks for cancer associated with different Barrett lengths are unknown. We aimed to estimate annual cancer transition rates for patients with long-segment (≥3 cm), short-segment (≥1 to <3 cm) and ultra-short-segment (<1 cm) Barrett's oesophagus. We used three data sources to estimate the annual cancer transition rates for each Barrett length category: (1) the distribution of long, short and ultra-short Barrett's oesophagus among a large German cohort with newly diagnosed T1 oesophageal adenocarcinoma; (2) population-based German incidence of oesophageal adenocarcinoma; and (3) published estimates of the population prevalence of Barrett's oesophagus for each Barrett length category. Among 1017 patients with newly diagnosed T1 oesophageal adenocarcinoma, 573 (56%) had long-segment, 240 (24%) short-segment and 204 (20%) ultra-short-segment Barrett's oesophagus. The base-case estimates for the prevalence of Barrett's oesophagus among the general population were 1.5%, 5% and 14%, respectively. The annual cancer transition rates for patients with long, short and ultra-short Barrett's oesophagus were 0.22%, 0.03% and 0.01%, respectively. To detect one cancer, 450 patients with long-segment Barrett's oesophagus would need to undergo annual surveillance endoscopy; in short segment and ultra-short segment, the corresponding numbers of patients would be 3440 and 12,364. Similar results were obtained when applying US incidence data. The large number of patients, who need to undergo endoscopic surveillance to detect one cancer, raises questions about the value of surveillance endoscopy in patients with short segment or ultra-short segment of Barrett's oesophagus. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  1. Effect of proton pump inhibitors on markers of risk for high-grade dysplasia and oesophageal cancer in Barrett's oesophagus.

    PubMed

    Hillman, L C; Chiragakis, L; Shadbolt, B; Kaye, G L; Clarke, A C

    2008-02-15

    It has been shown that the presence on diagnosis of endoscopic macroscopic markers indicates a high-risk group for Barrett's oesophagus. To determine whether proton pump inhibitor therapy prior to diagnosis of Barrett's oesophagus influences markers for risk development of subsequent high-grade dysplasia/adenocarcinoma. A review of all patients with Barrett's oesophagus entering a surveillance programme was undertaken. Five hundred and two patients diagnosed with Barrett's oesophagus were assessed on diagnosis for endoscopic macroscopic markers or low-grade dysplasia. Subsequent development of high-grade dysplasia/adenocarcinoma was documented. The relationship between the initiation of proton pump inhibitor therapy prior to the diagnosis of BE and the presence of macroscopic markers or low-grade dysplasia at entry was determined. Fourteen patients developed high-grade dysplasia/adenocarcinoma during surveillance. Patients who entered without prior proton pump inhibitor therapy were 3.4 times (95% CI: 1.98-5.85) more likely to have a macroscopic marker or low-grade dysplasia than those patients already on a proton pump inhibitor. Use of proton pump inhibitor therapy prior to diagnosis of Barrett's oesophagus significantly reduced the presence of markers used to stratify patient risk. Widespread use of proton pump inhibitors will confound surveillance strategies for patients with Barrett's oesophagus based on entry characteristics but is justified because of the lower risk of neoplastic progression.

  2. Falten und fliegen: Papierflieger und ihre Physik

    NASA Astrophysics Data System (ADS)

    Gruber, Werner

    2004-09-01

    Mit Papierfliegern können wichtige Eigenschaften der Aerodynamik anschaulich vermittelt werden: ein Blatt Papier, ein paar Faltungen und schon kann man experimentieren. Allerdings sind beim Trimmen des Fliegers einige Punkte zu beachten. Besonders wichtig ist die Y-Stellung der Flügel, die ihm Flugstabilität verleiht. Ist der Flieger fertig, dann gilt es, die dem Modell am besten angepasste Wurftechnik herauszufinden. Dazu variiert man Wurfgeschwindigkeit und Abwurfwinkel. Den Boden kann ein Papierflieger auf vier prinzipiell verschiedenen Flugkurven erreichen: Optimal ist die Gerade, dann fliegt er am weitesten.

  3. Oesophagus side effects related to the treatment of oesophageal cancer or radiotherapy of other thoracic malignancies.

    PubMed

    Adebahr, Sonja; Schimek-Jasch, Tanja; Nestle, Ursula; Brunner, Thomas B

    2016-08-01

    The oesophagus as a serial organ located in the central chest is frequent subject to "incidental" dose application in radiotherapy for several thoracic malignancies including oesophageal cancer itself. Especially due to the radiosensitive mucosa severe radiotherapy induced sequelae can occur, acute oesophagitis and strictures as late toxicity being the most frequent side-effects. In this review we focus on oesophageal side effects derived from treatment of gastrointestinal cancer and secondly provide an overview on oesophageal toxicity from conventional and stereotactic fractionated radiotherapy to the thoracic area in general. Available data on pathogenesis, frequency, onset, and severity of oesophageal side effects are summarized. Whereas for conventional radiotherapy the associations of applied doses to certain volumes of the oesophagus are well described, the tolerance dose to the mediastinal structures for hypofractionated therapy is unknown. The review provides available attempts to predict the risk of oesophageal side effects from dosimetric parameters of SBRT.

  4. Endoscopic examination of the upper respiratory tract and oesophagus in small ruminants: technique and normal appearance.

    PubMed

    Stierschneider, Martina; Franz, Sonja; Baumgartner, Walter

    2007-01-01

    The aim of this study was to describe the technique of rhinolaryngotracheobronchoscopy and oesophagoscopy in small ruminants and to report the normal endoscopic appearance of the structures of the upper respiratory tract and oesophagus. Thirty sheep and 30 goats, all clinically normal, underwent rhinolaryngotracheobronchoscopy and oesophagoscopy using a flexible endoscope (length 100 cm; diameter 4 mm). The anatomical features of the structures and the appearance of the mucosa were investigated. The degree of mucosal pigmentation varied between breeds. The appearance of the pharyngeal tonsil and the shape of the trachea in cross-section showed most individual variation. The technique was easily performed and sedation was necessary in only a few cases. No major complications were encountered. It was concluded that the procedure facilitated more accurate diagnosis and prognosis of conditions of the upper respiratory tract and oesophagus.

  5. Prey ingestion revealed by oesophagus and stomach temperature recordings in cormorants.

    PubMed

    Ancel, A; Horning, M; Kooyman, G L

    1997-01-01

    We examined the accuracy of both stomach and oesophagus temperature sensors-deployed on captive Brandt's cormorants-for determination of the mass of food ingested and the number of prey items swallowed. The oesophageal temperature sensor was a better detector of all feeding events, including that of small prey which were missed by the stomach sensor. Adapted to free-ranging animals (and coupled to data loggers for recording seawater temperature), oesophagus temperature recorders, in conjunction with both recordings of energy expenditure (e.g. doubly labelled water, heart rate) and determination of position (e.g. Argos transmitter, time/depth recorder), should provide further important insights into the foraging success of marine endotherms.

  6. Experimental orthotopic transplantation of a tissue-engineered oesophagus in rats.

    PubMed

    Sjöqvist, Sebastian; Jungebluth, Philipp; Lim, Mei Ling; Haag, Johannes C; Gustafsson, Ylva; Lemon, Greg; Baiguera, Silvia; Burguillos, Miguel Angel; Del Gaudio, Costantino; Rodríguez, Antonio Beltrán; Sotnichenko, Alexander; Kublickiene, Karolina; Ullman, Henrik; Kielstein, Heike; Damberg, Peter; Bianco, Alessandra; Heuchel, Rainer; Zhao, Ying; Ribatti, Domenico; Ibarra, Cristián; Joseph, Bertrand; Taylor, Doris A; Macchiarini, Paolo

    2014-04-15

    A tissue-engineered oesophageal scaffold could be very useful for the treatment of pediatric and adult patients with benign or malignant diseases such as carcinomas, trauma or congenital malformations. Here we decellularize rat oesophagi inside a perfusion bioreactor to create biocompatible biological rat scaffolds that mimic native architecture, resist mechanical stress and induce angiogenesis. Seeded allogeneic mesenchymal stromal cells spontaneously differentiate (proven by gene-, protein and functional evaluations) into epithelial- and muscle-like cells. The reseeded scaffolds are used to orthotopically replace the entire cervical oesophagus in immunocompetent rats. All animals survive the 14-day study period, with patent and functional grafts, and gain significantly more weight than sham-operated animals. Explanted grafts show regeneration of all the major cell and tissue components of the oesophagus including functional epithelium, muscle fibres, nerves and vasculature. We consider the presented tissue-engineered oesophageal scaffolds a significant step towards the clinical application of bioengineered oesophagi.

  7. Synchronous perforations of the oesophagus and stomach by air insufflation: an uncommon complication of endoscopic dilation.

    PubMed

    Fung, Arthur M; Chan, Fion S; Wong, Ian Y; Law, Simon

    2016-10-31

    A 72-year-old woman had a history of carcinoma of the hypopharynx treated by total laryngectomy, circumferential pharyngectomy and free jejunal graft. Endoscopic dilation of the pharyngojejunal anastomotic stricture resulted in synchronous perforations of the oesophagus and stomach. We postulate that the perforations were caused by high intraoesophageal and intragastric pressure resulted from air insufflation during the procedure; in a situation simulating closed-loop obstruction, because of proximal obstruction by the endoscope at the stricture site and distal obstruction by pylorospasm. The sites of perforations were inherent points of weakness at the left side of the distal oesophagus and at the high lesser curve of stomach. Satisfactory outcome of our patient was attributed to prompt diagnosis and surgical repair. Endoscopists should be aware of this possibility during oesophagogastroduodenoscopy and dilation. Rapid and over insufflation of air should be avoided. 2016 BMJ Publishing Group Ltd.

  8. Experimental orthotopic transplantation of a tissue-engineered oesophagus in rats

    PubMed Central

    Sjöqvist, Sebastian; Jungebluth, Philipp; Ling Lim, Mei; Haag, Johannes C.; Gustafsson, Ylva; Lemon, Greg; Baiguera, Silvia; Angel Burguillos, Miguel; Del Gaudio, Costantino; Rodríguez, Antonio Beltrán; Sotnichenko, Alexander; Kublickiene, Karolina; Ullman, Henrik; Kielstein, Heike; Damberg, Peter; Bianco, Alessandra; Heuchel, Rainer; Zhao, Ying; Ribatti, Domenico; Ibarra, Cristián; Joseph, Bertrand; Taylor, Doris A.; Macchiarini, Paolo

    2014-01-01

    A tissue-engineered oesophageal scaffold could be very useful for the treatment of pediatric and adult patients with benign or malignant diseases such as carcinomas, trauma or congenital malformations. Here we decellularize rat oesophagi inside a perfusion bioreactor to create biocompatible biological rat scaffolds that mimic native architecture, resist mechanical stress and induce angiogenesis. Seeded allogeneic mesenchymal stromal cells spontaneously differentiate (proven by gene-, protein and functional evaluations) into epithelial- and muscle-like cells. The reseeded scaffolds are used to orthotopically replace the entire cervical oesophagus in immunocompetent rats. All animals survive the 14-day study period, with patent and functional grafts, and gain significantly more weight than sham-operated animals. Explanted grafts show regeneration of all the major cell and tissue components of the oesophagus including functional epithelium, muscle fibres, nerves and vasculature. We consider the presented tissue-engineered oesophageal scaffolds a significant step towards the clinical application of bioengineered oesophagi. PMID:24736316

  9. Messung und Analyse

    NASA Astrophysics Data System (ADS)

    Bathelt, Hartmut; Scheinhardt, Michael; Sell, Hendrik; Sottek, Roland; Guidati, Sandro; Helfer, Martin

    Für die Beurteilung von Akustik und Fahrkomfort eines Fahrzeugs gilt in der Fahrzeugentwicklung immer noch der alte Grundsatz: "Der Kunde fährt nicht am Prüfstand, sondern auf der Straße“. Daher werden Gesamtbeurteilungen des Entwicklungsstandes und Konkurrenzvergleiche (Benchmarking) nach wie vor auf der Straße durchgeführt, meist auf ausgewählten Fahrbahnen am Prüfgelände oder im Rahmen der regelmäßigen Winter- und Sommererprobungen unter extremen Witterungsverhältnissen.

  10. An endoscopic method for thermal and chemical stimulation of the human oesophagus.

    PubMed

    Olesen, S S; Olesen, A E; Gravesen, F; Poulsen, J L; Funch-Jensen, P; Gregersen, H; Drewes, A M

    2009-12-01

    Previous methods for visceral thermal stimulation have lacked control of the temperature rate and visual inspection of the organ. The aims of this study was to develop a method for linear control of heat stimulation in the human oesophagus combined with endoscopy, to assess the reproducibility of this method and to investigate sensitivity to thermal stimulation of the distal oesophagus before and after acid perfusion. A probe with a 2.8 mm endoscope inside was constructed permitting heat and chemical stimulation. Three different temperature ramps were applied in the distal oesophagus in 12 healthy subjects by recirculation of heated water in a bag. Endoscopy of the oesophageal mucosa was performed prior to experimental stimulation. The temperature, the time of stimulation and the area under the temperature curve (AUC) were measured at the pain detection threshold. Thermal stimulation was repeated after perfusion of the oesophagus with acid. The method was tested on two subsequent days to assess reproducibility. All subjects had a normal endoscopic examination. Day-to-day reproducibility was good for the three temperature ramps (intra-class correlations >0.6). The subjects tolerated less heat stimulation, a decrease in AUC (P = 0.0003), a decrease in time to pain detection threshold (P = 0.005) and decreased temperature at pain detection threshold (P = 0.0001) after acid perfusion. The slow ramp was the most sensitive, showing a decrease in AUC of 29%. The present method was easily implemented and showed good reproducibility. It can potentially be used in basic experiments, drug and clinical studies as it provides a controllable thermal stimulus.

  11. Activation of Wnt signalling promotes development of dysplasia in Barrett's oesophagus.

    PubMed

    Moyes, Lisa H; McEwan, Hamish; Radulescu, Sorina; Pawlikowski, Jeff; Lamm, Catherine G; Nixon, Colin; Sansom, Owen J; Going, James J; Fullarton, Grant M; Adams, Peter D

    2012-09-01

    Barrett's oesophagus is a precursor of oesophageal adenocarcinoma, via intestinal metaplasia and dysplasia. Risk of cancer increases substantially with dysplasia, particularly high-grade dysplasia. Thus, there is a clinical need to identify and treat patients with early-stage disease (metaplasia and low-grade dysplasia) that are at high risk of cancer. Activated Wnt signalling is critical for normal intestinal development and homeostasis, but less so for oesophageal development. Therefore, we asked whether abnormally increased Wnt signalling contributes to the development of Barrett's oesophagus (intestinal metaplasia) and/or dysplasia. Forty patients with Barrett's metaplasia, dysplasia or adenocarcinoma underwent endoscopy and biopsy. Mice with tamoxifen- and β-naphthoflavone-induced expression of activated β-catenin were used to up-regulate Wnt signalling in mouse oesophagus. Immunohistochemistry of β-catenin, Ki67, a panel of Wnt target genes, and markers of intestinal metaplasia was performed on human and mouse tissues. In human tissues, expression of nuclear activated β-catenin was found in dysplasia, particularly high grade. Barrett's metaplasia did not show high levels of activated β-catenin. Up-regulation of Ki67 and Wnt target genes was also mostly associated with high-grade dysplasia. Aberrant activation of Wnt signalling in mouse oesophagus caused marked tissue disorganization with features of dysplasia, but only selected molecular indicators of metaplasia. Based on these results in human tissues and a mouse model, we conclude that abnormal activation of Wnt signalling likely plays only a minor role in initiation of Barrett's metaplasia but a more critical role in progression to dysplasia. Copyright © 2012 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

  12. Pedunculated, well differentiated liposarcoma of the oesophagus mimicking giant fibrovascular polyp.

    PubMed

    Mehdorn, A S; Schmidt, F; Steinestel, K; Wardelmann, E; Greulich, B; Palmes, D; Senninger, N

    2017-09-01

    We present a rare case of a big oesophageal liposarcoma causing dysphagia and weight loss in a 75-year-old patient. Endoscopically, a pedunculated lesion with subtotal obstruction of the oesophageal lumen had been detected and thoracoabdominal oesophageal resection with gastric sleeve reconstruction was performed. Surprisingly, a liposarcoma of the oesophagus was revealed on histopathological analysis, showing MDM2 overexpression. Oncological follow-up has been uneventful and the patient remains in good clinical shape at 15 months after surgery.

  13. Unusual clotted haemothorax caused by spontaneous intramural haematoma of the oesophagus: a case report

    PubMed Central

    Guo, Chenglin; Mei, Jiandong; Guan, Pujun; Lin, Feng; Pu, Qiang

    2016-01-01

    Spontaneous intramural haematoma of the oesophagus (SIHO) is a relatively rare event with benign courses. Most of the patients with SIHO may experience spontaneous healing without complications. We report a case of SIHO with clotted haemothorax. Uniportal video-assisted thoracic surgery (VATS) was successfully applied as a diagnostic and therapeutic method. Although conservative treatment is adequate for the majority of patients with SIHO, uniportal VATS may be a suitable option if there was clotted haemothorax. PMID:28149589

  14. An investigation into the spatial relationship between complexity and motility within the oesophagus.

    PubMed

    Haylett, K R; Vales, P; McCloy, R F

    1998-11-01

    Nonlinear analysis techniques have recently been used in the characterization of complex physiological signals seen in pathological disorders such as epilepsy and cardiac fibrillation. In this study a series of controlled swallows from an asymptomatic demonstration group was investigated using oesophageal manometry. The nonlinear measure of complexity, largest Lyapunov exponents and phase portraits were then used to explore the complexity of motility patterns at different points within the oesophagus. Results indicate greater complexity within the region of the striated muscle in the upper oesophagus than that observed within the region of smooth muscle in the lower oesophagus. Phase portraits showed that manometry patterns within the asymptomatic demonstration group could be quite different, highlighting the problems in clinical diagnosis. The characterization of motility disorders associated with complex manometry patterns such as diffuse oesophageal spasm (DOS) and nonspecific motility disorder (NOMD) still represents a diagnostic challenge. The use of nonlinear techniques enabling the quantitative and qualitative measurement of oesophageal complexity is considered in the classification of such disorders.

  15. A first report on the microbial colonisation of the equine oesophagus.

    PubMed

    Meyer, Wilfried; Kacza, Johannes; Schnapper, Anke; Verspohl, Jutta; Hornickel, Isabelle; Seeger, Johannes

    2010-02-20

    Based on cryo-SEM, standard and high resolution TEM, glycoconjugate histochemistry, and microbiological differentiation, the present study demonstrates the colonisation of the epithelium of the equine oesophagus with microorganisms. As particularly apparent using cryo-SEM to illustrate natural conditions, the present microbiota were clearly dominated by bacteria, forming a one-layer system, as attached to and embedded in concentrated mannose/mannan substances covering the outer stratum corneal cells. Bacterial numbers ranged from 5600 to 7200 per mm(2) in the central part of the oesophagus, the number of fungi was less than 1% of the amount of bacteria. The compact stratum corneal cells showed numerous short protrusions sometimes as part of desmosomal contacts, but mainly projecting into distinct intercellular spaces, containing a mixture of acid and neutral glycoconjugates. The outermost corneal cells exhibited intact mitochondria and cytoplasmic vesicles, and a number of short cell processes toward the oesophageal lumen; i.e. into the glycoconjugate layers on the surface of the oesophagus. The diverse spectrum of bacteria found indicated a permanent mucosal flora, predominated by facultative and obligate anaerobic species. The genera isolated most frequently and in highest numbers included streptococci, Prevotella spp., Fusobacterium spp. and Actinobacillus equuli. Only two groups of Enterobacteriaceae (Escherichia coli, Pantoea spp.) were regularly found and their abundance was lower than that of the other bacterial groups mentioned above. Yeasts were very rarely identified as the typically present fungi. Copyright (c) 2009 Elsevier GmbH. All rights reserved.

  16. Histogenesis of the Oesophagus of Guinea Fowl (Numida meleagris) at Prehatch and Posthatch

    PubMed Central

    Salami, Sulaiman Olawoye; Nzalak, James Oliver; Kawu, Muhammed Umar; Tizhe, Emmanuel Vandi; Gurumyen, Yilzem George; Dung, Edward Christopher

    2016-01-01

    The histogenesis of the primordial oesophagus was studied to determine the period in which the tunics of the oesophagus developed and became functional in the helmeted guinea fowl (Numida meleagris). Eighteen embryos and nine keets were studied at prehatch and posthatch, respectively. Simple columnar epithelium surrounded by mesenchymal cells was obvious at the 8th day of embryonic development. By the 19th day of embryonic development, the four tunics, tunica mucosa, submucosa, tunica muscularis, and tunica adventitia/serosa, were beginning to differentiate from the mesenchymal cells and also the primordial oesophageal glands appeared as clusters of cells that invaginate from the epithelium. By the 27th day, the tunics were clearly differentiated and the primordial glands were fully developed as evident with positive reaction to Periodic Acid Schiff (PAS). The tunics of the muscularis were not well developed till at posthatch. This study therefore concludes that the primordial oesophagus is active at the late incubation due to mucin secretion by mucous glands but fully functional at posthatch since the tunica muscularis is completely developed at posthatch. PMID:28053804

  17. Sensation and distribution of stress and deformation in the human oesophagus.

    PubMed

    Frøkjaer, J B; Andersen, S D; Lundbye-Christensen, S; Funch-Jensen, P; Drewes, A M; Gregersen, H

    2006-02-01

    Evaluation of the distribution of stresses and strains in relation to distension-induced sensation in the human oesophagus is valuable for understanding oesophageal biomechanics and mechano-sensation. In 12 healthy volunteers a specially designed oesophageal bag containing an endoscopic ultrasound probe was inflated to the moderate pain level. Ultrasound images, bag pressure and perceived sensation were recorded before and after pharmacological relaxation of the smooth muscle with butylscopolamine. The oesophagus was assumed to be circular and thick-walled. Distension induced a tensile circumferential stretch, radial compression and longitudinal shortening. Both circumferential strain and stress were highest at the mucosal surface and decreased throughout the wall. The stiffness increased throughout the wall and was highest at the outer surface (P < 0.001). The decrease in stiffness in response to butylscopolamine was non-significant. The infused volume (P = 0.012) and circumferential stress (P < 0.001) were most closely associated with the distension-induced sensation (adjusted R2 = 0.88). The perceived sensation was highly individual but was unaffected by butylscopolamine (P > 0.08). The present study provides a method for computation of the stress-strain distribution throughout the wall and the mechano-sensory interaction in the human oesophagus. In the future, this may be useful for understanding of mechanoreceptor responses and generation of symptoms in visceral organs in health and in disease.

  18. Cost considerations in implementing a screening and surveillance strategy for Barrett's oesophagus.

    PubMed

    Inadomi, John M

    2015-02-01

    There is increasing concern over the rising costs of healthcare leading to debate regarding the use of resources to implement preventive strategies. Oesophageal adenocarcinoma and its precursor, Barrett's oesophagus provides an excellent opportunity to highlight this issue since cancer is uncommon even among individuals with documented Barrett's oesophagus. This review provides a brief introduction to economic analysis in healthcare and summarizes published studies of the cost-effectiveness of strategies to reduce mortality from cancer. Current best estimates highlight the cost-effectiveness of endoscopic ablation among patients with Barrett's oesophagus and high-grade dysplasia and the low cost-effectiveness of ablation among patients without dysplasia. The cost-effectiveness of ablation among patients with Barrett's and low-grade dysplasia is poorly defined due to the ambiguity of diagnosing dysplasia, the unknown risk of cancer among patients with low-grade dysplasia, and the uncertain durability of ablation to maintain remission from metaplasia and dysplasia and prevent cancer. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Gastric microbiota is altered in oesophagitis and Barrett's oesophagus and further modified by proton pump inhibitors.

    PubMed

    Amir, Itay; Konikoff, Fred M; Oppenheim, Michal; Gophna, Uri; Half, Elizabeth E

    2014-09-01

    Gastro-oesophageal reflux can cause inflammation, metaplasia, dysplasia and cancer of the oesophagus. Despite the increased use of proton pump inhibitors (PPIs) to treat reflux, the incidence of oesophageal adenocarcinoma has increased rapidly in Europe and in the United States in the last 25 years. The reasons for this increase remain unclear. In this study, we aimed to determine whether the microbiota of the gastric refluxate and oesophageal biopsies differs between patients with heartburn and normal-appearing oesophageal mucosa versus patients with abnormal oesophageal mucosa [oesophagitis or Barrett's oesophagus (BE)] and to elucidate the effect of PPIs on the bacterial communities using 16S rRNA gene pyrosequencing. Significant differences in the composition of gastric fluid bacteria were found between patients with heartburn and normal oesophageal tissue versus patients with oesophagitis or BE, but in the oesophagus-associated microbiota differences were relatively modest. Notably, increased levels of Enterobacteriaceae were observed in the gastric fluid of oesophagitis and BE patients. In addition, treatment with PPIs had dramatic effects on microbial communities both in the gastric fluids and the oesophageal tissue. In conclusion, gastric fluid microbiota is modified in patients with oesophagitis and BE compared with heartburn patients with normal biopsies. Furthermore, PPI treatment markedly alters gastric and oesophageal microbial populations. Determining whether the changes in bacterial composition caused by PPIs are beneficial or harmful will require further investigation. © 2013 Society for Applied Microbiology and John Wiley & Sons Ltd.

  20. Effect of perfusion of bile salts solutions into the oesophagus of hiatal hernia patients and controls.

    PubMed Central

    Bachir, G S; Collis, J L

    1976-01-01

    Tests of the response to perfusion of the oesophagus were made in 54 patients divided into three groups. Group I consisted of patients with symptomatic hiatal hernia, group II hiatal hernia patients with peptic stricture, and group III normal individuals. Each individual oesophagus was perfused at a rate of 45-65 drops per minute over 25 minutes with six solutions: normal saline, N/10 HCl, taurine conjugates of bile salts in normal saline, taurine conjugates of bile salts in N/10 HCl, glycine conjugates of bile salts in normal saline, and taurine and glycine conjugates in a ratio of 1 to 2 in normal saline. It was found that acidified taurine solutions were more irritating than acid alone. With a 2mM/l solution of taurine in acid, symptoms are produced even in controls. With a 1 mM/l solution of the same conjugates, the majority of normal people feel slight heartburn or nothing, and therefore perfusion into the oesophagus of such a solution could be used as a test for oesophagitis. PMID:941112

  1. British Society of Gastroenterology guidelines on the diagnosis and management of Barrett's oesophagus.

    PubMed

    Fitzgerald, Rebecca C; di Pietro, Massimiliano; Ragunath, Krish; Ang, Yeng; Kang, Jin-Yong; Watson, Peter; Trudgill, Nigel; Patel, Praful; Kaye, Philip V; Sanders, Scott; O'Donovan, Maria; Bird-Lieberman, Elizabeth; Bhandari, Pradeep; Jankowski, Janusz A; Attwood, Stephen; Parsons, Simon L; Loft, Duncan; Lagergren, Jesper; Moayyedi, Paul; Lyratzopoulos, Georgios; de Caestecker, John

    2014-01-01

    These guidelines provide a practical and evidence-based resource for the management of patients with Barrett's oesophagus and related early neoplasia. The Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument was followed to provide a methodological strategy for the guideline development. A systematic review of the literature was performed for English language articles published up until December 2012 in order to address controversial issues in Barrett's oesophagus including definition, screening and diagnosis, surveillance, pathological grading for dysplasia, management of dysplasia, and early cancer including training requirements. The rigour and quality of the studies was evaluated using the SIGN checklist system. Recommendations on each topic were scored by each author using a five-tier system (A+, strong agreement, to D+, strongly disagree). Statements that failed to reach substantial agreement among authors, defined as >80% agreement (A or A+), were revisited and modified until substantial agreement (>80%) was reached. In formulating these guidelines, we took into consideration benefits and risks for the population and national health system, as well as patient perspectives. For the first time, we have suggested stratification of patients according to their estimated cancer risk based on clinical and histopathological criteria. In order to improve communication between clinicians, we recommend the use of minimum datasets for reporting endoscopic and pathological findings. We advocate endoscopic therapy for high-grade dysplasia and early cancer, which should be performed in high-volume centres. We hope that these guidelines will standardise and improve management for patients with Barrett's oesophagus and related neoplasia.

  2. Lithium battery lodged in the oesophagus: A report of three paediatric cases.

    PubMed

    Barabino, Arrigo Vittorio; Gandullia, Paolo; Vignola, Silvia; Arrigo, Serena; Zannini, Lucio; Di Pietro, Pasquale

    2015-11-01

    Over the last years the ingestion of disk batteries has become frequent in children with serious consequences. The severity of injuries is related to the growing use of new lithium batteries that may cause catastrophic damages when lodged in the oesophagus. The notes of three consecutive children with lithium batteries lodged in the oesophagus, admitted to our Institute from 2010 to 2014, were reviewed. Clinical presentation, management, and outcome were considered. The first child, a 22-month-old girl, died of a sudden exsanguination due to an aorto-oesophageal fistula. The second case, a 5-year-old boy, had an exploratory thoracotomy to exclude aortic lesion before battery removal, and a spontaneous oesophageal perforation. The third child, a 18-month-old boy, fully recovered after suffering ulcerative oesophageal burns. Lithium battery lodged in the oesophagus is a paediatric emergency requiring a multidisciplinary approach that can be implemented in a tertiary children's hospital. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  3. The submucosal glands and the orientation of the musculature in the oesophagus of the camel.

    PubMed Central

    Jamdar, M N; Ema, A N

    1982-01-01

    The histological structure of the oesophagus of the camel in different parts of its course was investigated with tissues from seven camels, and with haematoxylin and eosin and Masson's trichrome stain. Gross dissections confirmed the orientation of the muscle fibres in the tunica muscularis. The epithelium showed heavy cornification. Many submucosal mucous glands were found throughout the length and all round the wall of the oesophagus. This was contrary to what has been reported generally for ruminants. The lamina muscularis mucosae was in the form of small scattered strands of smooth muscle (more readily identifiable with trichrome stain) and only in the caudal oesophagus. It did not form a continuous layer here. The tunica muscularis was of striated type throughout which agreed with what has been found in the other ruminants. Its fibres, however, were differently oriented. The outer tunica was mainly circular (especially in the mid-thoracic part) and the inner one was mainly longitudinal in direction. Mixed orientation of the muscle fibres in parts of the same section was also noticed. These findings have not been reported previously in the camel. Images Fig. 1 Fig. 2 Fig. 3 PMID:7130050

  4. Using tracheal segments for replacement of cervical oesophagus: an experimental study.

    PubMed

    Abbasidezfouli, Azizollah; Sharifi, Davood; Sasani, Farhang; Ansari, Damoon; Abarkar, Mohammad; Rahmanijoo, Nasrin; Abbasidezfouli, Golbahar; Sheikhy, Kambiz

    2012-03-01

    Segmental resection and anastomosis of oesophageal lesions are not performed as a routine clinical practice because of complications and associated problems, whereas tracheal resection and anastomosis are a routine clinical practice. In this experimental study, we resected a segment of cervical oesophagus and replaced it with a tracheal segment. In eight dogs (mixed races), weighing 20-30 kg, ageing 1-2 years, under general anaesthesia, through a cervical incision, 5 cm of cervical trachea was separated while preserving its attachments to surrounding fibroareolar tissues. Afterwards, 5 cm of the oesophagus was resected and replaced with a prepared segment of the trachea. Oral liquids were started at the first post-operative day; the animals were kept for 2 months and then euthanized. Quality of swallowing and voice were evaluated. After an autopsy, anastomoses were examined grossly and histopathologically. No complications occurred during surgery. Swallowing function and voice were normal in all eight dogs after the operation. No sign of aspiration was seen in clinical and radiographic examinations after starting oral diet. In autopsy examination, anastomoses were patent without narrowing or abnormal mucosal changes. Remarkable histopathological findings in replaced tracheal segments were squamous metaplasia, atrophy and degeneration of mucosal glands and degeneration of cartilages. Replacement of a segment of the oesophagus with an autogenous tracheal segment is a practical procedure with low complications and can probably be used for the treatment of cervical oesophageal lesions in human beings.

  5. New analysis for the study of the muscle function in the human oesophagus.

    PubMed

    Pedersen, J; Drewes, A M; Gregersen, H

    2005-10-01

    The aim was to further develop a method for studying the active and passive tissue properties in the human oesophagus. An impedance planimetric probe with a bag for distension was placed in the distal oesophagus in 14 healthy volunteers. Distension was done at an infusion rate of 25 mL min(-1) with and without the administration of the antimuscarinic drug butylscopolamine. The flow was reversed when moderate pain was experienced by the subject. The total and the passive tension showed an exponential behaviour as function of the change in radius. The active tensions increased until they reached a maximum point. The active tension decreased after the maximum until the distension was stopped shortly after due to the pain. The change in tension during distension-induced contractions (the afterload) was plotted as function of the precontraction radius (the preload). The human oesophagus behaves in a manner known from in vitro studies on muscle strips and exhibits a muscle diagram similar to that in the heart, i.e. the larger the initial muscle length during distension (within limits), the greater the contraction force.

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

    PubMed

    Calvet, Xavier

    2016-09-01

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

  7. Getreide, Brot und Feine Backwaren

    NASA Astrophysics Data System (ADS)

    von Grabowski, Hans-Uwe; Rolfe, Birgit

    Getreide und Getreideerzeugnisse sind ebenso wie Brot und Feine Backwaren nach dem Lebensmittel- und Futtermittel-Gesetzbuch (LFGB) [1] Lebensmittel im Sinne des Artikels 2 der VO (EG) Nr. 178/2002 (BasisVO) (s. auch Kap. 1.6/2.4.1/3.2). Gesetzlich festgelegte Begriffsbestimmungen gibt es für diese Lebensmittel nicht. Man muss sich daher allgemeiner Verkehrsauffassungen bedienen, wie sie von der Deutschen Lebensmittelbuch-Kommission in Form von Leitsätzen erarbeitet und veröffentlicht wurden [2]. Der Gesundheitsschutz und der Schutz des Verbrauchers vor Täuschung sind in der Basis-VO und dem LFGB geregelt.

  8. Virus-host interactions in persistently FMDV-infected cells derived from bovine pharynx.

    PubMed

    O'Donnell, V; Pacheco, J M; Larocco, Michael; Gladue, D P; Pauszek, S J; Smoliga, G; Krug, P W; Baxt, B; Borca, M V; Rodriguez, L

    2014-11-01

    Foot-and-mouth disease virus (FMDV) produces a disease in cattle characterized by vesicular lesions and a persistent infection with asymptomatic low-level production of virus in pharyngeal tissues. Here we describe the establishment of a persistently infected primary cell culture derived from bovine pharynx tissue (PBPT) infected with FMDV serotype O1 Manisa, where surviving cells were serially passed until a persistently infected culture was generated. Characterization of the persistent virus demonstrated changes in its plaque size, ability to grow in different cell lines, and change in the use of integrins as receptors, when compared with the parental virus. These results demonstrate the establishment of persistently infected PBPT cell cultures where co-adaptation has taken place between the virus and host cells. This in vitro model for FMDV persistence may help further understanding of the molecular mechanisms of the cattle carrier state.

  9. Mechanims of aerosol particle deposition in the Oro-pharynx under non-steady airflow.

    PubMed

    Sosnowski, Tomasz R; Moskal, Arkadiusz; Gradon, Leon

    2007-01-01

    Comparison of experimental and computational results of aerosol deposition in the oro-pharyngeal cast of human published recently (Sosnowski TR, Moskal A, Gradoń L. (2006) Inhal Toxicol; 18: 773-780) demonstrated the applicability and relevance of considering realistic breathing patterns in analysis of aerosol flow and deposition within the human head airways. This issue is extended in the current paper, focused on a detailed analysis of spatial and temporal distribution of particle deposition in the oro-pharynx during inspiration. CFD modeling was used to determine both the 3D airflow structure and the local particle deposition fluxes at two different inspiratory patterns. Behavior of aerosol (particle size: 0.3-10 micro m, material density: 2200 kg m(-3)) was analyzed applying Lagrangian approach and considering Brownian effects for submicron particles. Results indicate that particles of different sizes are deposited in different parts of the oro-pharynx, depending on the point in the inspiration cycle. Larger particles (3-10 micro m) are separated efficiently in the naso-pharyngeal bend due to inertia, which predominate in the middle phase of inspiration. Submicron particles are deposited more uniformly in the oro-pharyngeal space, and their separation from the air is enhanced in a short transition period between inspiration and expiration. It suggests the importance of mixing of inspired and expired air streams for particle deposition pattern. Comparison of our computational results of deposition to the approximation derived from the in vivo data (Stahlhofen W, Rudolf G, James AC. (1989) J Aerosol Med; 2: 285-308) shows a good agreement for particles, for which the inertia is a predominant mechanism of deposition. The results of this work lead to a more detailed description of the dynamics of oro-pharyngeal aerosol deposition during inspiratory part of the breathing cycle. The recognition of that problem is essential for prediction of toxic or pharmacological

  10. Laterality of bolus passage through the pharynx in patients with unilateral medullary infarction.

    PubMed

    Mikushi, Shinya; Kagaya, Hitoshi; Baba, Mikoto; Tohara, Haruka; Saitoh, Eiichi

    2014-02-01

    Laterality of bolus passage in the pharynx is often seen in patients with medullary infarction. We evaluated the dominant side of bolus passage in the pharynx and investigated the factors that cause the passage to dominantly occur on the affected side. Forty-one patients (35 men and 6 women, 64 ± 9 years) with unilateral medullary infarction participated in this study. Bolus passage of 4 mL of thick liquid was evaluated in 3 regions (oropharyngeal, thyropharyngeal, and cricopharyngeal) and classified into 4 patterns (dominantly on the unaffected side [UAS], on both sides without clear laterality [BS], dominantly on the affected side [AS], and nonpassage of the bolus [NP]) by videofluoroscopic examination of swallowing. The bolus passages were as follows: UAS, BS, and AS occurred in 2, 32, and 7 patients in the oropharyngeal region; UAS, BS, and AS occurred in 5, 20, and 16 patients in the thyropharyngeal region; and UAS, BS, AS, and NP occurred in 11, 9, 10, and 11 patients in the cricopharyngeal region, respectively. In the thyropharyngeal region, the proportion of patients in whom the swallowing reflex occurred when the bolus was in the oropharynx and the proportion of patients with unilateral pharyngeal constrictor paralysis were greater in patients whose bolus passage was AS than in patients whose passage was BS. This suggests that the bolus predominantly passed through the affected side of the thyropharyngeal portion because of the asymmetry of pharyngeal contraction during swallowing in the early period after onset. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  11. Aspiration pneumonia in a mentally handicapped patient due to a foreign body impacted in the pharynx: a near fatal outcome.

    PubMed Central

    Asgarali, S; Nandapalan, V; Phillips, D; Osunuga, O

    1996-01-01

    A case is reported of a mentally handicapped women with dysphagia caused by a foreign body impacted in the pharynx. The case illustrates a potential pitfall in the management of patients who are unable to communicate either verbally or in writing and who present with acute dysphagia. PMID:8832357

  12. Distinct Neural Circuits Control Rhythm Inhibition and Spitting by the Myogenic Pharynx of C. elegans.

    PubMed

    Bhatla, Nikhil; Droste, Rita; Sando, Steven R; Huang, Anne; Horvitz, H Robert

    2015-08-17

    Neural circuits have long been known to modulate myogenic muscles such as the heart, yet a mechanistic understanding at the cellular and molecular levels remains limited. We studied how light inhibits pumping of the Caenorhabditis elegans pharynx, a myogenic muscular pump for feeding, and found three neural circuits that alter pumping. First, light inhibits pumping via the I2 neuron monosynaptic circuit. Our electron microscopic reconstruction of the anterior pharynx revealed evidence for synapses from I2 onto muscle that were missing from the published connectome, and we show that these "missed synapses" are likely functional. Second, light inhibits pumping through the RIP-I1-MC neuron polysynaptic circuit, in which an inhibitory signal is likely transmitted from outside the pharynx into the pharynx in a manner analogous to how the mammalian autonomic nervous system controls the heart. Third, light causes a novel pharyngeal behavior, reversal of flow or "spitting," which is induced by the M1 neuron. These three neural circuits show that neurons can control a myogenic muscle organ not only by changing the contraction rate but also by altering the functional consequences of the contraction itself, transforming swallowing into spitting. Our observations also illustrate why connectome builders and users should be cognizant that functional synaptic connections might exist despite the absence of a declared synapse in the connectome. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Volumetric analysis of the pharynx in patients with obstructive sleep apnea (OSA) treated with maxillomandibular advancement (MMA).

    PubMed

    Faria, Ana Célia; da Silva-Junior, Savio Nogueira; Garcia, Luis Vicente; dos Santos, Antonio Carlos; Fernandes, Maria Regina França; de Mello-Filho, Francisco Veríssimo

    2013-03-01

    Maxillomandibular advancement (MMA) has been reported to be the most effective surgical treatment of obstructive sleep apnea (OSA). Most reports about MMA aim to confirm the efficiency of this treatment modality, but few describe the anatomical changes produced in the pharynx by the surgery. Thus, the objective of the present investigation was to quantify the anatomical changes of the pharynx that occur in patients with OSA after MMA surgery using magnetic resonance (MR). Twenty patients with a polysomnographic diagnosis of OSA participated in the study. All patients were submitted to image acquisition by MR performed during wakefulness. Polysomnography and MR were performed preoperatively and 6 months after MMA. Volume analysis (in cubic millimeters) was performed as the sum of the areas multiplied by their thickness, with no intervals between sections. The pharyngeal air space of the region between the hard palate and the base of the epiglottis was divided into a retropalatal (RP) region and a retrolingual (RL) region. Postoperative MR showed a mean volumetric increase of 26.72 % in the RP region and of 27.2 % in the RL region. MMA increases the air space of the pharynx by expanding the facial skeletal structure to which the soft tissues of the pharynx and tongue are fixed, with a consequent reduction of collapsibility in the presence of negative pressure during inspiration. This reduced possibility of pharyngeal collapse may contribute to the reduction of obstructive events.

  14. Datenintegration und Deduplizierung

    NASA Astrophysics Data System (ADS)

    Bleiholder, Jens; Schmid, Joachim

    In Unternehmen liegen viele Daten heutzutage immer seltener vollständig an einem einzigen physikalischen Ort vor, sondern sind weltweit verteilt. Dies liegt zum einen an der immer besser gewordenen Infrastruktur, die eine solche Verteilung auf einfache Art und Weise ermöglicht, und zum anderen an der Tatsache, dass viele Unternehmen weltweit tätig sind. So fallen Daten weltweit an, werden aber jeweils lokal - vor Ort - gespeichert. Daher müssen oft mehrere Datenquellen genutzt werden, um einen aktuellen, vollständigen und genauen Überblick über die vorhandenen Daten zu gewinnen. Datenintegration hilft, indem sie Daten aus mehreren Quellen zusammenführt und einheitlich darstellt. Diese integrierten Daten können genutzt werden, um sich einen Überblick über das Unternehmen zu verschaffen, z.B. wenn Unternehmen fusionieren und nur noch eine Kundendatenbank bestehen bleiben soll, oder wenn zu einem Kunden die Daten aus den verschiedenen Fachabteilungen zusammengeführt werden sollen. Anhand eines solchen Beispiels, der Integration von Kundendaten zu Kfz- und Lebensversicherungen erläutern wir im Folgenden einzelne Techniken.

  15. Instandhaltung und Normung

    NASA Astrophysics Data System (ADS)

    Rosenkranz-Wuttig, Angela

    Das DIN Deutsches Institut für Normung e.V. ist ein eingetragener Verein mit Sitz in Berlin. Das DIN erarbeitet gemeinsam mit den Experten der interessierten Kreise Normen und Standards als Dienstleistung für Wirtschaft, Staat und Gesellschaft. Die Kenntnis entsprechender Normen, Standards oder Regeln, sowie deren richtiger Einsatz, ist unter den heutigen Marktbedingungen für jedes Unternehmen ein nicht zu unterschätzender wirtschaftlicher Faktor. Normen schaffen Effizienz bei Produktionsabläufen und sorgen durch eine gleichbleibende sowie vergleichbare Produktqualität für Vertrauen bei den Endverbrauchern. Darüber hinaus stehen Normen unter rechtlichen Aspekten für mehr Sicherheit - Hersteller erreichen bei Anwendung und Einhaltung von Normen ein hohes Maß an rechtlicher Absicherung. Das DIN vertritt die deutschen Interessen in den europäischen und weltweiten Normungsorganisationen, siehe Abb. 1. Zuständig für die elektrotechnische Normung in Deutschland sowie als deutscher Repräsentant in den übernationalen Gremien ist die DKE Deutsche Kommission Elektrotechnik Elektronik Informationstechnik im DIN und VDE.

  16. Alcohol consumption pattern and risk of Barrett's oesophagus and erosive oesophagitis: an Italian case-control study.

    PubMed

    Filiberti, Rosa A; Fontana, Vincenzo; De Ceglie, Antonella; Blanchi, Sabrina; Grossi, Enzo; Della Casa, Domenico; Lacchin, Teresa; De Matthaeis, Marina; Ignomirelli, Orazio; Cappiello, Roberta; Rosa, Alessandra; Foti, Monica; Laterza, Francesco; D'Onofrio, Vittorio; Iaquinto, Gaetano; Conio, Massimo

    2017-04-01

    Knowledge about the association between alcohol and Barrett's oesophagus and reflux oesophagitis is conflicting. In this case-control study we evaluated the role of specific alcoholic beverages (red and white wine, beer and liquors) in 339 Barrett's oesophagus and 462 oesophagitis patients compared with 619 endoscopic controls with other disorders, recruited in twelve Italian endoscopic units. Data on alcohol and other individual characteristics were obtained from structured questionnaires. No clear, monotonic significant dose-response relationship was pointed out for red wine. However, a generalised U-shaped trend of Barrett's oesophagus/oesophagitis risk due to red wine consumption particularly among current drinkers was found. Similar results were also found for white wine. Liquor/spirit consumption seemed to bring about a 1·14-2·30 risk excess, although statistically non-significant, for current Barrett's oesophagus/oesophagitis drinkers. Statistically significant decreasing dose-response relationships were found in Barrett's oesophagus for frequency and duration of beer consumption. Similar, but less clear downward tendencies were also found for oesophagitis patients. In conclusion, although often not statistically significant, our data suggested a reduced risk of Barrett's oesophagus and oesophagitis with a low/moderate intake of wine and beer consumption. A non-significant increased risk of Barrett's oesophagus/oesophagitis was observed with a higher intake of any type of heavy alcohol consumption, but no conclusion can be drawn owing to the high number of non-spirit drinkers and to the small number of drinkers at higher alcohol intake levels.

  17. Anatomy of the larynx and pharynx: effects of age, gender and height revealed by multidetector computed tomography.

    PubMed

    Inamoto, Y; Saitoh, E; Okada, S; Kagaya, H; Shibata, S; Baba, M; Onogi, K; Hashimoto, S; Katada, K; Wattanapan, P; Palmer, J B

    2015-09-01

    Although oropharyngeal and laryngeal structures are essential for swallowing, the three-dimensional (3D) anatomy is not well understood, due in part to limitations of available measuring techniques. This study uses 3D images acquired by 320-row area detector computed tomography ('320-ADCT'), to measure the pharynx and larynx and to investigate the effects of age, gender and height. Fifty-four healthy volunteers (30 male, 24 female, 23-77 years) underwent one single-phase volume scan (0.35 s) with 320-ADCT during resting tidal breathing. Six measurements of the pharynx and two of larynx were performed. Bivariate statistical methods were used to analyse the effects of gender, age and height on these measurements. Length and volume were significantly larger for men than for women for every measurement (P < 0.05) and increased with height (P < 0.05). Multiple regression analysis was performed to understand the interactions of gender, height and age. Gender, height and age each had significant effects on certain values. The volume of the larynx and hypopharynx was significantly affected by height and age. The length of pharynx was associated with gender and age. Length of the vocal folds and distance from the valleculae to the vocal folds were significantly affected by gender (P < 0.05). These results suggest that age, gender and height have independent and interacting effects on the morphology of the pharynx and larynx. Three-dimensional imaging and morphometrics using 320-ADCT are powerful tools for efficiently and reliably observing and measuring the pharynx and larynx.

  18. Statistik in Naturwissenschaft und Technik

    NASA Astrophysics Data System (ADS)

    Wilrich, Peter-Theodor

    Mit dem Aufschwung von Naturwissenschaft und Technik zu Beginn des 19. Jahrhunderts entstand die mathematische Statistik, angeregt aus der Geodäsie (wie die Methode der kleinsten Quadrate) und der Anthropologie (wie die statistische Analyse mehrdimensionaler Beobachtungen und ihrer stochastischen Abhängigkeiten). Im Gegensatz zu den Wirtschafts- und Sozialwissenschaften, in denen Daten vorwiegend aus Beobachtungsstudien gewonnen werden, stehen in den Naturwissenschaften Experimente im Vordergrund. Daher gehört die statistische Versuchsplanung zu den insbesondere in Naturwissenschaft und Technik angewendeten statistischen Methoden, aber auch die Extremwertstatistik und Lebensdaueranalysen sowie die Methoden der räumlichen Statistik (insbesondere in der Umweltforschung). Im 20. Jahrhundert wurden Stichprobenpläne und Regelkarten (Kontrollkarten) zur Prozessregelung als Hilfsmittel der statistischen Qualitätssicherung entwickelt. Diese Methodenbündel, mit denen sich der Ausschuss Statistik in Naturwissenschaft und Technik immer wieder befasst, werden im Folgenden vorgestellt.

  19. Steuerungs- und Automatisierungstechnik an Werkzeugmaschinen

    NASA Astrophysics Data System (ADS)

    Bahmann, Werner

    Eine leistungsfähige und funktionssichere Steuerungstechnik ist die Voraussetzung für die Automatisierung der Werkzeugmaschinen und der Produktionsprozesse (Definition nach DIN IEC 60050-351 siehe Teil Steuerungstechnik).

  20. Korrespondenzfragen zwischen Energiesystem und Telekommunikation

    NASA Astrophysics Data System (ADS)

    Lehmann, Heiko

    Telekommunikationsnetze und Stromnetze weisen viele Gemeinsamkeiten auf - sowohl hinsichtlich allgemeiner topologischer und hierarchischer Eigenschaften, als auch betreffs der konkreten Technoökonomie unter Regulierungsbedingungen. Das folgende Kapitel analysiert diese Eigenschaften und gibt Antworten auf die Frage, wie die wechselseitige Verkopplung beider, jeweils systemabdeckender Infrastrukturen zu einem Treiber der Energiewende in entwickelten Volkswirtschaften werden kann.

  1. Modulation of salivation and heartburn in response to the site of acid infusion in the human oesophagus.

    PubMed

    Dutta, S K; Agrawal, K; Mahmoud, M A

    2010-09-01

    The pathogenesis of gastro-oesophageal reflux disease includes increased acid reflux, reduced salivation and impaired peristalsis. This may depend upon the height of acid wave and magnitude of oesophageal mucosal exposure. Interestingly, the effect of site of acid infusion upon salivary secretion and heartburn has not been examined in any detail. To examine whether acid infusion in the upper oesophagus may cause increased salivation and heartburn as compared with acid infusion in the lower oesophagus. Twelve healthy male subjects (mean age 30) received infusions of HCl, citric acid and acetic acid at 10 and 20 cm above the lower oesophageal sphincter (LES) for fixed time periods. Parotid saliva collected periodically and heartburn severity scored using standardized scale. Standard statistical methods (paired t-tests, analysis of variance) were used to determine the significance of results. Acid infusion in the upper oesophagus increased parotid flow rate as compared with that in the lower oesophagus (P < 0.05). Likewise, there was a significantly increased heartburn score at 20 cm as well as 10 cm above LES (P < 0.05) as compared with that in the stomach. These data suggest a significant increase in salivation and heartburn in response to acid infusion in the upper vs. lower part of the oesophagus. 2010 Blackwell Publishing Ltd.

  2. Patentierung und Patentlage

    NASA Astrophysics Data System (ADS)

    Herrmann, Uwe

    Gewerbliche Schutzrechte nehmen in der nationalen Rechts- und Wirtschaftsordnung sowie auch auf internationaler Ebene stetig an Bedeutung zu. Sie dienen dem Schutz geistigen Eigentums und sind für jeden Gewerbetreibenden nicht nur im Hinblick darauf von Bedeutung, eigene Rechte zu sichern, sondern auch insofern von Relevanz, dass ein Verstoß gegen Rechte Dritter zu vermeiden ist. Zu den gewerblichen Schutzrechten gehören unter anderem Kennzeichenrechte, Geschmacksmusterrechte sowie die sogenannten technischen Schutzrechte in Form des Patents sowie des Gebrauchsmusters. Die folgenden Ausführungen befassen sich ausschließlich mit den technischen Schutzrechten und geben eine kurze Einführung in die Voraussetzungen, das Entstehen und den Wegfall sowie in die Wirkungen technischer Schutzrechte. Beleuchtet wird die Situation im Wesentlichen im Hinblick auf nationale technische Schutzrechte, d. h. auf Deutsche Patente und Gebrauchsmuster sowie auf Europäische Patente, die Schutz in Deutschland entfalten. Die Möglichkeit der Erlangung von Schutzrechten im außereuropäischen Ausland wird nur am Rande gestreift.

  3. Technikwissenschaft - Erfinden und Entdecken

    NASA Astrophysics Data System (ADS)

    Linnemann, Gerhard

    Umrissen wird das allgemeine Ziel der Technikwissenschaft, konstruktiv zu verwerten und nicht-natürlich Entdeckbares zu erfinden. Wir befinden uns in einer Umwälzung der Technik im Verlauf der wissenschaftlich-technischen Revolution, auf dem Wege zu einem neuen Techniktyp. Dieser schafft und nutzt die künstliche Intelligenz. Dazu benötigt der in der Technik tätige Mensch spezielle Kenntnisse und Erfahrungen in kreativ-konstruktiver, -gestalterischer und erfinderischer Sicht mit dem Einsatz spezieller Strukturen und Sprachen. Vorschläge zur Arbeitsweise in der Technik werden gegeben.Translated AbstractTechnological Science-Invent and DiscoverThe general aim of engineering science is outlined to utilize results constructively and to invent something that cannot be discovered in nature. We are now in a period of transformation of technology in the course of scientific-technological revolution, on the way to a new type of technology. This new type creates and utilizes artificial intelligence. For this, man acitive in this field requires special knowledge and experiences in a creative, constructive, design-oriented and ultimately inventive way by deploying special structures and languages. There are also made some proposals concerning the method of working in the field of technology.

  4. Risk factors for cancer of the oral cavity and oro-pharynx in Cuba

    PubMed Central

    Garrote, L Fernandez; Herrero, R; Reyes, R M Ortiz; Vaccarella, S; Anta, J Lence; Ferbeye, L; Muñoz, N; Franceschi, S

    2001-01-01

    In terms of worldwide levels, Cuba has an intermediate incidence of cancer of the oral cavity and oro-pharynx. We studied 200 cases of cancer of the oral cavity and pharynx, of whom 57 women (median age = 64) and 200 hospital controls, frequency matched with cases by age and sex, in relation to smoking and drinking history, intake of 25 foods or food groups, indicators of oral hygiene and sexual activity, and history of sexually transmitted diseases. Odds ratios (OR) and 95% confidence intervals (CI) were obtained from unconditional multiple logistic regressions and adjusted for age, sex, area of residence, education, and smoking and drinking habits. In the multivariate model, high educational level and white-collar occupation, but not white race, were associated with halving of oral cancer risk. Smoking ≥30 cigarettes per day showed an OR of 20.8 (95% CI: 8.9–48.3), similar to smoking ≥4 cigars daily (OR = 20.5). Drinking ≥ 70 alcoholic drinks per week showed an OR of 5.7 (95% CI: 1.8–18.5). Hard liquors were by far the largest source of alcohol. Increased risk was associated with the highest tertile of intake for maize (OR = 1.9), meat (OR = 2.2) and ham and salami (OR = 2.0), whereas high fruit intake was associated with significantly decreased risk (OR = 0.4). Among indicators of dental care, number of missing teeth and poor general oral condition at oral inspection showed ORs of 2.7 and 2.6, respectively. Number of sexual partners, marriages or contacts with prostitutes, practice of oral sex and history of various sexually transmitted diseases, including genital warts, were not associated with oral cancer risk. 82% of oral cancer cases in Cuba were attributable to tobacco smoking, 19% to smoking cigars or pipe only. The fractions attributable to alcohol drinking (7%) and low fruit intake (11%) were more modest. Thus, decreases in cigarette and cigar smoking are at present the key to oral cancer prevention in Cuba. © 2001 Cancer Research Campaign

  5. Improved transoral surgical tool design by CT measurements of the oral cavity and pharynx.

    PubMed

    Cox, Emily; Ghasemloonia, Ahmad; Nakoneshny, Steven C; Zareinia, Kourosh; Hudon, Mark; Lysack, John T; Sutherland, Garnette R; Dort, Joseph C

    2016-09-23

    The majority of head and neck cancers arise from the oral cavity and oropharynx. Many of these lesions will be amenable to surgical resection using transoral approaches including transoral robotic surgery (TORS). To develop and control TORS tools, precise dimensions of the oral cavity and pharynx are desirable. CT angiograms of 76 patients were analyzed. For the oral cavity, only the maximum length and width were measured, while for the pharynx, the width, length, and areas of the airway were all measured and the volume calculated. A prototype TORS tool was developed and tested based on the findings and dimensions. The design modification of the tool is in progress. The mean male oral cavity width and length were 93.3 ± 4.3 and 77.0 ± 7.2 mm, respectively, and the mean male pharyngeal width, length, area, and volume were 26.5 ± 7.2 mm, 16.2 ± 8.8 mm, 325 ± 149 mm(2), and 28,440 ± 14,100 mm(3), respectively, while the mean female oral cavity width and length were 84.5 ± 12.9 and 71.0 ± 6.3 mm, respectively, and the mean female pharyngeal width, length, area, and volume were 24.8 ± 5.6 mm, 13.7 ± 3.2 mm, 258 ± 98 mm(2), and 17,660 ± 7700 mm(3), respectively. The developed TORS tool was tested inside the oral cavity of an intubation mannequin. These data will also be used to develop an electronic no-go cone-shape tunnel to improve the safety of the surgical field. Reporting the oral cavity and pharyngeal dimensions is important for design of TORS tools and creating control zones for the workspace of the tool inside the oral cavity.

  6. Accuracy of end-tidal CO2 measurement through the nose and pharynx in nonintubated patients during digital subtraction cerebral angiography.

    PubMed

    Zhang, Chunyan; Wang, Maohua; Wang, Rurong; Wang, Wenjian

    2013-04-01

    To determine the accuracy of end-tidal CO2 (PETCO2) obtained in the nose through the Smart CapnoLine and in the pharynx through the modified Filterline H Set with supplemental oxygen at 5 L/min in nonintubated patients undergoing digital subtraction cerebral angiography (DSA). Prospective, observational. Twenty patients with disturbance of consciousness because of brain disease, who will receive DSA. PETCO2 was measured in the nose through the Smart CapnoLine and in the pharynx using the modified Filterline H Set that was inserted through the nasopharyngeal airway. Oxygen was administered through the Smart CapnoLine at a rate of 5 L/min. Five minutes after a constant and normally shaped capnography waveform, arterial blood was drawn from an indwelling femoral catheter for analyzing arterial CO2 partial pressure (PaCO2), and PETCO2 that was measured through the nose and the pharynx were simultaneously recorded. After the DSA procedure, PaCO2 was analyzed again. Data were analyzed with Pearson correlation and Bland-Altman analysis. PETCO2 sampled from both the nose and the pharynx was significantly correlated with PaCO2, and the correlation coefficients had approximate values, 0.832 (P<0.0001) for PaCO2 with PETCO2 through the nose and 0.836 (P<0.0001) for PaCO2 with PETCO2 through the pharynx. The mean bias±SD for PETCO2 and PaCO2 was 4.53±2.76 mm Hg (nose) and 3.22±2.86 mm Hg (pharynx). The 95% level of agreement for PETCO2 and PaCO2 ranged from -0.90 to 9.95 mm Hg (nose) and from -2.39 to 8.82 mm Hg (pharynx). End-tidal CO2 measurements through the nose and the pharynx had comparable performance. The correlation of PETCO2 measured through the nose and the pharynx was 0.971 (P<0.001). The difference between PETCO2 measured through the nose and the pharynx was 1.31±1.25 mm Hg, and t test results showed that arterial to end-tidal CO2 pressure difference (Pa-ETCO2) in sampling through the nose was significantly greater than Pa-ETCO2 sampling through the pharynx (P

  7. Mechanisms of Barrett's oesophagus (clinical): LOS dysfunction, hiatal hernia, peristaltic defects.

    PubMed

    Roman, Sabine; Kahrilas, Peter J

    2015-02-01

    Barrett's oesophagus, with the potential to develop into oesophageal adenocarcinoma (OAC), is a major complication of gastrooesophageal reflux disease (GORD). However, about 50% of patients developing OAC had no known GORD beforehand. Hence, while GORD symptoms, oesophagitis, and Barrett's have a number of common determinants (oesophagogastric junction (OGJ) incompetence, impaired oesophageal clearance mechanisms, hiatus hernia) they also have some independent determinants. Further, although excess oesophageal acid exposure plays a major role in the genesis of long-segment Barrett's oesophagus there is minimal evidence supporting this for short-segment Barrett's. Hence, these may have unique pathophysiological features as well. Long-segment Barrett's seems to share most, if not all, of the risk factors for oesophagitis, particularly high-grade oesophagitis. However, it is uncertain if OGJ function and acid clearance are more severely impaired in patients with long-segment Barrett's compared to patients with high-grade oesophagitis. With respect to short-segment Barrett's, the acid pocket may play an important pathogenic role. Conceptually, extension of the acid pocket into the distal oesophagus, also known as intra-sphincteric reflux, provides a mechanism or acid exposure of the distal osophageal mucosa without the occurrence of discrete reflux events, which are more likely to prompt reflux symptoms and lead to the development of oesophagitis. Hence, intra-sphincteric reflux related to extension of the acid/no acid interface at the proximal margin of the acid pocket may be key in the development of short segment Barrett's. However, currently this is still somewhat speculative and further studies are required to confirm this. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Optimized endoscopic autofluorescence spectroscopy for the identification of premalignant lesions in Barrett's oesophagus.

    PubMed

    Holz, Jasmin A; Boerwinkel, David F; Meijer, Sybren L; Visser, Mike; van Leeuwen, Ton G; Aalders, Maurice C G; Bergman, Jacques J G H M

    2013-12-01

    Fluorescence spectroscopy has the potential to detect early cellular changes in Barrett's oesophagus before these become visible. As the technique is based on varying concentrations of intrinsic fluorophores, each with its own optimal excitation wavelength, it is important to assess the optimal excitation wavelength(s) for identification of premalignant lesions in patients with Barrett's oesophagus. The endoscopic spectroscopy system used contained five (ultra)violet light sources (λexc=369-416 nm) to generate autofluorescence during routine endoscopic surveillance. Autofluorescence spectroscopy was followed by a biopsy for histological assessment and spectra correlation. Three intensity ratios (r1, r2, r3) were calculated by dividing the area, A, under the spectral curve of selected emission wavelength ranges for each spectrum generated by each excitation wavelength λexc as follows (Equation is included in full-text article.). Double intensity ratios were calculated using two excitation wavelengths. Fifty-eight tissue areas from 22 patients were used for autofluorescence spectra analysis. Excitation with 395, 405 or 410 nm showed a significant (P≤0.0006) differentiation between intestinal metaplasia and grouped high-grade dysplasia/early carcinoma for intensity ratios r2 and r3. A sensitivity of 80.0% and specificity of 89.5% with an area under the ROC curve of 0.85 was achieved using 395 nm excitation and intensity ratio r3. Double excitation showed no additional value over single excitation. The combination of 395 nm excitation and intensity ratio r3 showed optimal conditions to discriminate nondysplastic from early neoplasia in Barrett's oesophagus.

  9. Acromegaly can be associated with impairment of LES relaxation in the oesophagus.

    PubMed

    Ilhan, Muzaffer; Danalioglu, Ahmet; Turgut, Seda; Karaman, Ozcan; Arabaci, Elif; Tasan, Ertugrul

    2015-01-01

    Although prolonged small intestine and colonic transit time has been demonstrated in acromegaly patients, the influence of acromegaly on oesophagus motility and the pathological mechanisms involved are still not clarified. We aimed to investigate manometric measurements to ascertain whether oesophagus motility is affected in active acromegaly patients. The study was performed in an institutional referral centre at a tertiary care hospital. Twenty-three acromegaly patients (mean age 43.2 ± 13.2 years) and 25 sex- and age-matched healthy control subjects (mean age 48.6 ± 7.9 years) were recruited to a case-control study. Oesophageal manometry was performed using MMS (Medical Measurement Systems, Netherlands) Solar GI - Air Charged Intelligent Gastrointestinal Conventional Manometry. In manometric measurements the lower oesophageal sphincter pressure was 18 ± 7 mmHg in acromegaly patients and 15.6 ± 4.4 mm Hg in controls, and there was no significant difference (p = 0.17). The percentage of relaxation was 64.8% and 81.8%, respectively, and it was significantly lower in acromegaly patients than in controls (p < 0.001). Additionally, the duration of relaxation was found to be 4 ± 1.9 seconds and 5 ± 1.7 seconds in patients and controls, respectively (p = 0.049). Our study has demonstrated a significant reduction in the percentage and duration of lower oesophageal sphincter relaxation in oesophagus motility even in acromegaly patients without any gastrointestinal symptoms. Further clinical and pathophysiological studies are required to clarify the underlying mechanisms of gastrointestinal motility disorders in acromegaly.

  10. The impact of goitre and its treatment on the trachea, airflow, oesophagus and swallowing function. A systematic review.

    PubMed

    Sørensen, Jesper Roed; Hegedüs, Laszlo; Kruse-Andersen, Søren; Godballe, Christian; Bonnema, Steen Joop

    2014-08-01

    In this systematic review, we investigated the effects of goitre and its treatment on the trachea and the oesophagus. A total of 6355 papers were screened in scientific databases, which disclosed 40 original studies (nine descriptive and 31 interventional). Although most studies are hampered by a number of methodological shortcomings, it is uncontested that goitre affects the trachea as well as the oesophagus in a large proportion of people. This leads to upper airway obstruction, swallowing dysfunction, or both, which may remain undisclosed unless specifically investigated for. Assessment of the tracheal dimensions should be done by magnetic resonance imaging or computed tomography, and detection of upper airway obstruction by flow volume loops, with focus on the inspiratory component. A clinical evaluation of the oesophageal function is difficult to implement and could be replaced by available and validated questionnaires on swallowing. Although radioiodine therapy and thyroidectomy relieve the negative effect of goitre on the trachea and the oesophagus, many issues remain unexplored.

  11. Venture Kapital und Life Science

    NASA Astrophysics Data System (ADS)

    Moss, Sebastian; Beermann, Christian

    Um sich weiter im internationalen Wettbewerb behaupten zu können, müssen deutsche Unternehmen heute in Schlüsseltechnologien wie die Medizintechnik und die Biotechnologie, zusammenfassend unter dem Begriff der Life Sciences bekannt, investieren. Eine führende Wettbewerbsposition erfordert immer die konsequente Weiterentwicklung von Produkten und Lösungen, um Innovationspotenziale in medizinische Verfahren umzusetzen. Die damit unmittelbar verbundenen hohen Ausgaben für Forschung und Entwicklung stellen ein bedeutendes Problem junger Life Science Unternehmen dar. Vor allem die, verglichen mit nicht-medizinischen Branchen, längeren Forschungs- und Entwicklungszyklen in der Frühphase eines Life Science Unternehmens und die längere Dauer bis zur Profitabilität erhöhen das Risiko der Finanzinvestoren. Die Zeitdauer, um ein medizinisches Produkt bis zur Marktreife zu entwickeln und letztlich auf dem Markt anzubieten, kann aufgrund der notwendigen intensiven Forschung nur unscharf geplant werden und erhöht die Unsicherheit über den Zeitpunkt der ersten Einnahmen. Damit verschärfen sich gerade im Life Science Bereich allgemeine Problematiken von Gründungs- und Wachstumsfinanzierungen wie starke Informationsasymmetrien zwischen Gründer und potentiellen Kapitalgebern. Oftmals ist die Entwicklung einer innovativen Technologie abhängig von einzelnen Personen, von deren Wissen und Engagement die Umsetzung und der Erfolg eines gesamten Produktkonzeptes abhängen.

  12. Leptomeningeal metastasis from squamous cell carcinoma of oesophagus with unusual presentation

    PubMed Central

    Akhavan, Ali; Navabii, Hossein

    2012-01-01

    Oesophageal cancer rarely metastasis to the brain but advances in brain imaging and increasing survival of these patients has led to more detection of this condition. Although oesophageal cancer is common in the north of Iran it is less frequent in the central parts such as Yazd. Leptomeningeal metastasis is very uncommon in oesophageal cancer. This paper presents a 73-year-old man with leptomeningeal carcinomatosis from squamous cell carcinoma of oesophagus presented by hoarseness due to true vocal cord plegia. PMID:23174999

  13. Morphometric analysis of muscularis proper and myenteric plexus of the normal human oesophagus. Age related changes.

    PubMed

    Milosavljevic, Z; Zelen, I; Tanaskovic, I; Sazdanovic, M

    2013-08-01

    Oesophagus is a muscular tube that transports food and liquids by coordinated contraction of its muscular lining led by stimuli from the nerve plexus. Its muscularis proper layer consists of muscle cells, connective tissue and myenteric plexus. The aim of our histomorphometric study was to reveal detailed characteristics of this layer, cell number, volume, orientation, properties of myenteric plexus as well as changes related to aging. Oesophagus tissue samples from 17 male cadavers were taken from the cranial and thoracic parts. Samples were divided in 2 groups: younger(ages 21-45) and older (ages 66-78). The tissue was routinely processed,embedded and serially sectioned. Sections were stained with Masson-Goldner and Cresyl-violet dyes. Digital images were analysed with the image analysis software.Statistics were performed with SPSS software. The average thickness of the cranial part of the oesophageal wall and muscularis proper was 2590 μm and 1197 μm, respectively in the younger and 2453 μm and 1144 μm in the older group. Overall volume of the muscle tissue was slightly larger in the thoracic part, and in the younger group compared to the cranial part and the older group. The average number of the striated muscle cells per 100 μm in the cranial part was 771.5 and 749.7 in the younger and the older group, respectively. Striated cells were significantly less present only in the lower thoracic part of the oesophagus. In the older group,smaller striated muscle cells dominated over the larger ones. In the younger group, majority of the striated muscle cells were mid-sized. The thickness of the circular layer of muscularis proper was more affected by aging than the longitudinal one. Ganglion cells number was lower in the older group, but plexus area was unchanged. Aging affects muscularis proper and myenteric plexus of the oesophagus.Major differences can be observed in the striated muscle cells size, volume of the circular layer and number of the ganglionic

  14. Different tissue reaction of oesophagus and diaphragm after mesh hiatoplasty. Results of an animal study

    PubMed Central

    Otto, Jens; Kämmer, Daniel; Jansen, Petra Lynen; Anurov, Michael; Titkova, Svetlana; Öttinger, Alexander; Rosch, Raphael; Schumpelick, Volker; Jansen, Marc

    2008-01-01

    Background Laparoscopic mesh-reinforcement of the hiatal region in the treatment of gastroesophageal reflux disease (GERD) and paraesophageal hernia (PEH) reduces the risk of recurrence. However, there are still controversies about the technique of mesh placement, shape, structure and material. We therefore compared tissue integration and scar formation after implantation of two different polypropylene-meshes in a rabbit model. Methods A total of 20 female chinchilla rabbits were included in this study. Two different meshes (Polypropylene PP, Polyglecaprone 25 Composite PP-PG) were implanted on the abdominal diaphragm around the oesophagus. After 3 months the implanted meshes were excised en-bloc. Histological and morphological analyses were carried out accordingly proliferation rate, apoptosis and collagen type I/III ratio. Results Regarding proliferation rate of oesophagus PP (9.31 ± 3.4%) and PP-PG (13.26 ± 2.54%) differ in a significant (p = 0.0097) way. In the diaphragm we found a significant (p = 0.00066) difference between PP (9.43 ± 1.45%) and PP-PG (18.73 ± 5.92%) respectively. Comparing oesophagus and diaphragm we could prove a significant difference within PP-PG-group (p = 0.0195). Within PP-group the difference reached no statistical significance (p = 0.88). We found analogous results regarding apoptosis. Furthermore, there is a significant (p = 0.00013) difference of collagen type I/III ratio in PP-PG (12.28 ± 0.8) compared to PP (8.44 ± 1,63) in case of oesophageal tissue. Concerning diaphragm we found a significant difference (p = 0.000099) between PP-PG (8.85 ± 0.81) and PP (6.32 ± 1.07) as well. Conclusion The histologic and morphologic characteristics after prosthetic enforcement of the hiatus in this animal model show a more distinct tissue integration using PP-PG compared to PP. Additionally, different wound healing and remodelling capability influence tissue integration of the mesh in diaphragm and oesophagus. PMID:18405386

  15. Organization of the innervation of the oesophagus and stomach in chinchilla (Chinchilla laniger, Molina).

    PubMed

    Nowak, Elżbieta

    2013-01-01

    Using the histochemical and histological techniques the morphology and topography of the autonomic plexuses of the oesophagus and stomach in chinchilla (Chinchilla laniger) was investigated. AChE-positive and adrenergic structures in the myenteric and submucosal plexus were observed. According to the results the cholinergic structures were formed by the different in shape network meshes, various size of the neurons agglomerations and nerve fibres. Adrenergic fibres were found. Density of these structures varied in different parts of the investigated organs. This study is the first attempt to localize the intramural autonomic plexuses in this species.

  16. Wärme und Arbeit

    NASA Astrophysics Data System (ADS)

    Dehli, Martin; Wittig, Heinz

    Kapitel 27 Wärme und Arbeit befasst sich zunächst mit dem Systembegriff. Darauf werden die innere Energie U, die Wärme Q und mit der Volumenänderungsarbeit W v , der technischen Arbeit (Druckänderungsarbeit) W t und der irreversiblen Dissipationsarbeit W d verschiedene Formen der Arbeit W behandelt; auch wird die Enthalpie H eingeführt. Weiter wird das Prinzip von der Erhaltung der Energie - der erste Hauptsatz der Thermodynamik - vorgestellt. Auf Kreisprozesse und den thermischen Wirkungsgrad η th wird eingegangen. Weiter werden der zweite Hauptsatz der Thermodynamik und - damit zusammenhängend - reversible und irreversible Abläufe erörtert; hiernach wird - als Zustandsgröße zur Erfassung des Ausmaßes der Irreversibilität eines Prozesses - die Entropie S behandelt. Schließlich wird kurz auf die Exergie und die Anergie - als zwei Bestandteilen der Energie - eingegangen.

  17. Multiple cag genotypes of Helicobacter pylori isolates colonize the oesophagus in individual hosts in a Venezuelan population.

    PubMed

    Peña, Jessy; Rojas, Héctor; Reyes, Nelson; Fernández-Delgado, Milagro; García-Amado, María-Alexandra; Michelangeli, Fabián; Contreras, Monica

    2017-03-01

    Multiple Helicobacter pylori strains colonize and coexist in the stomach of one single patient, carrying heterogeneous distributions of cag genotypes. The oesophagus provides a niche for H. pylori colonization; however, little is known about its adaptive role. Using PCR for cagA, cagE and virB11 genes from cag-pathogenicity island (PAI) and Etest for antimicrobial susceptibility test, we determined cag-PAI genotypes associated with H. pylori virulence, when positive cultures were matching in both the stomach and the oesophagus (96 isolates; 8 out of 80 dyspeptic patients). The stomach showed complete cag-PAI islands in 77 % of the isolates, whereas the oesophagus showed complete cag-PAI islands only in 44 % of the isolates. Expression of CagA and interleukin 8 correlated with inflammatory processes and histopathological changes in the stomach, but not in the oesophagus. Different cag-PAI profiles were found in both mucosae of an individual host, and at least one oesophagus profile corresponded to one profile identified in stomach. The antibiotic resistance profiles showed variability in the colonization by single or mixed H. pylori isolates in the gastric and oesophageal mucosa both intra- and inter-individuals. These results demonstrate colonization with multiple H. pylori isolates in the oesophageal mucosa, like those found in the stomach of individual hosts. H. pylori was characterized by a dominant partial island, low interleukin 8 induction with lower histopathological damage and lower antibiotic resistance, suggesting that the microenvironmental changes in individual hosts select less virulent isolates in the oesophagus than in the stomach. New approaches to ensure effective eradication therapy in multi-resistant H. pylori strains must be developed.

  18. Genetics of Extracellular Matrix Remodeling During Organ Growth Using the Caenorhabditis elegans Pharynx Model

    PubMed Central

    Jafari, Gholamali; Burghoorn, Jan; Kawano, Takehiro; Mathew, Manoj; Mörck, Catarina; Axäng, Claes; Ailion, Michael; Thomas, James H.; Culotti, Joseph G.; Swoboda, Peter; Pilon, Marc

    2010-01-01

    The organs of animal embryos are typically covered with an extracellular matrix (ECM) that must be carefully remodeled as these organs enlarge during post-embryonic growth; otherwise, their shape and functions may be compromised. We previously described the twisting of the Caenorhabditis elegans pharynx (here called the Twp phenotype) as a quantitative mutant phenotype that worsens as that organ enlarges during growth. Mutations previously known to cause pharyngeal twist affect membrane proteins with large extracellular domains (DIG-1 and SAX-7), as well as a C. elegans septin (UNC-61). Here we show that two novel alleles of the C. elegans papilin gene, mig-6(et4) and mig-6(sa580), can also cause the Twp phenotype. We also show that overexpression of the ADAMTS protease gene mig-17 can suppress the pharyngeal twist in mig-6 mutants and identify several alleles of other ECM-related genes that can cause or influence the Twp phenotype, including alleles of fibulin (fbl-1), perlecan (unc-52), collagens (cle-1, dpy-7), laminins (lam-1, lam-3), one ADAM protease (sup-17), and one ADAMTS protease (adt-1). The Twp phenotype in C. elegans is easily monitored using light microscopy, is quantitative via measurements of the torsion angle, and reveals that ECM components, metalloproteinases, and ECM attachment molecules are important for this organ to retain its correct shape during post-embryonic growth. The Twp phenotype is therefore a promising experimental system to study ECM remodeling and diseases. PMID:20805556

  19. [Outcome after surgery preserving pharynx and larynx for cervical esophageal cancer].

    PubMed

    Ma, Shao-hua; Qin, Bin; Shen, Lu-yan; Liang, Zhen; Kang, Xiao-zhen; Dai, Liang; Chen, Ke-neng

    2012-01-01

    To evaluate the long-term survival of multidisciplinary treatment based on thoracic surgery for cervical esophageal squamous cell carcinoma. The clinical characters and follow-up data of forty-one cervical esophageal cancer patients who accepted multidisciplinary treatment based on surgery with preservation of pharynx and larynx were retrospectively reviewed, and the long-term survival was compared with 480 non-cervical esophageal cancers who accepted surgery in the same period done by the same surgical team. There were 28 males and 13 females with a mean age of 62 years old. In the cervical esophageal cancer group, 30 patients accepted neoadjuvant chemotherapy, 25 patients accepted adjuvant chemotherapy, and 21 patients accepted both. Six patients received postoperative radiation. Four patients underwent exploratory surgery alone, and 37 cases underwent radical surgery and cervical anastomosis. One case died during the perioperative period. The 1-, 3-, 5- and 8-year survival rates were 96.8%, 52.6%, 35.1%, and 35.1% in the 36 patients with cervical esophageal cancer who underwent radical surgery, and were 85.0%, 54.3%, 45.0%, and 36.7% respectively in the 457 non-cervical esophageal cancer patients. There was no significant difference between the cervical group and non-cervical group(P=0.91). Cervical esophageal cancer should be treated in a multidisciplinary approach to obtain satisfactory long-term outcomes.

  20. Increase of Phosphatase and Tensin Homolog by Silymarin to Inhibit Human Pharynx Squamous Cancer

    PubMed Central

    Su, Chin-Hui; Chen, Li-Jen; Liao, Jyh Fei

    2013-01-01

    Abstract Silymarin is an active principle from the seeds of the milk thistle plant and is widely used as a hepatoprotective gent due to its antioxidant-like activity. In the present study, we evaluated the potential efficacy of silymarin against oral cancer and investigated its possible mechanism of action. Cell viability assay and western blotting analyses were used to identify silymarin-induced apoptotic cell death in human pharynx squamous cell carcinoma (FaDu) cells. The short interfering RNA (siRNA) is used to confirm the role of phosphatase and tensin homolog (PTEN) in silymarin-induced apoptosis. Treatment of FaDu cells with silymarin resulted in a significant decrease in cell viability (up to 70%). Silymarin inhibited the phosphorylation of Akt (over 10-fold) with an increase in expression of PTEN (five to sixfold). Consequently, the level of Bcl-2 expression was decreased five to sixfold and caspase 3 activated to induce apoptosis. Treatment with siRNA specific to PTEN gene diminished the action of silymarin. The results suggest that silymarin inhibits the Akt signaling pathway by increasing PTEN expression in FaDu cells and directly affects Bcl-2 family members. Also, we demonstrated the inhibitory activity of silymarin for oral cancer is related to cell survival. These mechanisms may in part explain the actions of silymarin and provide a rationale for the development of silymarin as an anticancer agent. PMID:23909904

  1. Alcohol Consumption and Cancer of the Oral Cavity and Pharynx from 1988 to 2009: An Update

    PubMed Central

    Goldstein, Binh Y.; Chang, Shen-Chih; Hashibe, Mia; Vecchia, Carlo La; Zhang, Zuo-Feng

    2010-01-01

    The evidence for the human carcinogenic effects of alcohol drinking on the risk of cancers of the oral cavity and pharynx has been considered sufficient in the IARC Monograph 44 on alcohol and cancer in 1988. We evaluated human carcinogenic evidence related to oral and pharyngeal cancer risk based on cohort and case-control studies published from 1988 to 2009. A large body of evidence from epidemiological studies of different designs and conducted in different populations has consistently supported that alcohol consumption is strongly associated with an increase in risk of oral and pharyngeal cancer. The relative risks are 3.2–9.2 for more than 60 grams/day (or more than 4 drinks/day) when adjusted for tobacco smoking and other potential confounders. A strong dose-response relationship on intensity of alcohol use is reported in most of the studies. However, no apparent association is observed for the duration of alcohol use. Compared with current drinkers, a decreased risk is associated with alcohol cessation for about 10–15 years. Similar associations have been observed among non-smokers in over 20 studies. Generally, the dominant type of alcohol consumption in each population is associated with the greatest increases in risk. A large number of studies on joint exposure of alcohol and tobacco consumption demonstrate a more than multiplicative synergistic effect. PMID:20679896

  2. Safety of flexible endoscopic biopsy of the pharynx and larynx under topical anesthesia.

    PubMed

    Wellenstein, David J; de Witt, Joey K; Schutte, Henrieke W; Honings, Jimmie; van den Hoogen, Frank J A; Marres, Henri A M; Takes, Robert P; van den Broek, Guido B

    2017-06-21

    Recent advancements in transnasal endoscopy enable a shift in diagnostic workup of lesions in the pharynx and larynx, from an examination with biopsy under general anesthesia to an office-based examination with flexible endoscopic biopsy under topical anesthesia. Procedural complications were evaluated to assess the safety of office-based flexible endoscopic biopsy in patients with benign and malignant laryngopharyngeal lesions. Patients who underwent flexible endoscopic biopsy from 2012 to 2016 were evaluated retrospectively. Complications were classified using the Clavien-Dindo classification of surgical complications. A total of 201 flexible endoscopic biopsies were performed in 187 patients. Two Clavien-Dindo grade I (laryngospasm and anterior epistaxis), one grade II (laryngeal bleeding), and one grade IIIb (laryngeal edema) complication were observed. The first complication was self-limiting and the other three required an intervention. All patients fully recovered without sequelae. Flexible endoscopic biopsy appears to be a safe office-based procedure for the diagnosis of benign and malignant laryngopharyngeal lesions.

  3. Cell Architecture: Surrounding Muscle Cells Shape Gland Cell Morphology in the Caenorhabditis elegans Pharynx

    PubMed Central

    Raharjo, Wahyu Hendrati; Ghai, Vikas; Dineen, Aidan; Bastiani, Michael; Gaudet, Jeb

    2011-01-01

    The acquisition and maintenance of shape is critical for the normal function of most cells. Here we investigate the morphology of the pharyngeal glands of Caenorhabditis elegans. These unicellular glands have long cellular processes that extend discrete lengths through the pharyngeal musculature and terminate at ducts connected to the pharyngeal lumen. From a genetic screen we identified several mutants that affect pharyngeal gland morphology. The most severe such mutant is an allele of sma-1, which encodes a β-spectrin required for embryonic elongation, including elongation of the pharynx. In sma-1 mutants, gland projections form normally but become increasingly abnormal over time, acquiring additional branches, outgrowths, and swelling, suggestive of hypertrophy. Rather than acting in pharyngeal glands, sma-1 functions in the surrounding musculature, suggesting that pharyngeal muscles play a critical role in maintenance of gland morphology by restricting their growth, and analysis of other mutants known to affect pharyngeal muscles supports this hypothesis. We suggest that gland morphology is maintained by a balance of forces from the muscles and the glands. PMID:21868609

  4. Upregulated transcription of phenoloxidase genes in the pharynx and endostyle of Ciona intestinalis in response to LPS.

    PubMed

    Vizzini, Aiti; Parrinello, Daniela; Sanfratello, Maria Antonietta; Trapani, Maria Rosa; Mangano, Valentina; Parrinello, Nicolò; Cammarata, Matteo

    2015-03-01

    We investigated the role of phenoloxidases (POs) in ascidians inflammatory reaction, a components of a copper-containing protein family involved in invertebrate immune system. In Ciona intestinalis two phenoloxidases (CinPO-1, CinPO-2) have been sequenced. In the present study, real time PCR analysis showed that both CinPO-1 and CinPO-2 genes were modulated by LPS inoculation suggesting that they are inducible and highly expressed in the inflamed pharynx. In situ hybridization disclosed CinPO-1 and CinPO-2 transcripts in pharynx hemocytes (granulocytes) and, mainly, in unilocular refractile granulocytes (URG) which mainly populated the inflamed tunic matrix. Interestingly, the genes are also upregulated by LPS in the endostyle (zones 7, 8 and 9) that is considered homolog to the vertebrate thyroid.

  5. Hairy polyp of the pharynx obscured on physical examination by endotracheal tube, but diagnosed on brain imaging.

    PubMed

    Budenz, Cameron L; Lesperance, Marci M; Gebarski, Stephen

    2005-11-01

    We report a case of hairy polyp of the pharynx diagnosed on brain MRI in order to stress the need to examine carefully all tissues included on an imaging study, even those outside the clinically stated region of interest, and to remind practitioners to consider unusual as well as common etiologies for neonatal respiratory distress. Our case is unique in that thorough examination of a brain MRI, ordered in the evaluation of presumed central apnea, led to the correct diagnosis.

  6. Identification of vortical structures inside the human pharynx/larynx region from POD-reconstructed velocity fields

    NASA Astrophysics Data System (ADS)

    Shinneeb, A.-M.; Pollard, Andrew

    2012-08-01

    This paper reports an experimental investigation of the vortical structures in the pharynx/larynx region of an idealised human extra-thoracic airway obtained using particle image velocimetry (PIV). The inlet velocity was 0.13 m/s yielding a Reynolds number, based on the inlet condition, of 670. Two thousand images were acquired at each location at a framing rate of 2 Hz. The proper orthogonal decomposition method was applied to the PIV data. Only a few modes were used for POD reconstruction which recovered about 60 % of the turbulent kinetic energy. A vortex identification algorithm was employed to identify and measure properties of the structures. This step was followed by a statistical analysis of the distribution of number, size, and strength of these vortices. The results reveal the formation of a large number of structures identified along two planes in the pharynx/larynx region. This study also revealed an increased strength in the counter-clockwise structures as compared to clockwise structures in the pharynx region. As well, there is some evidence to suggest that the vortical structures, whose axes are perpendicular to the sagittal plane, change their orientation as they proceed further into the laryngeal region.

  7. Simulations of two-phase flow through the pharynx with moving boundaries using the lattice Boltzmann method

    NASA Astrophysics Data System (ADS)

    Pal, Anupam; Brasseur, James G.; Shaker, Reza

    2000-11-01

    Transport of food through the human pharynx involves rapidly moving boundaries and liquid-vapor flow within highly complex geometries. Conventional continuum models are limited in their ability to handle two-phase flows with complex moving boundaries. We used the lattice Boltzmann (LB) method to simulate liquid flow in the air-filled pharynx with boundary motions which approximate those of anatomical structures from the mouth to the esophagus. The two phases in the LB simulation were separated using an interparticle interaction force based on a non-ideal gas equation of state. A moving boundary condition was applied by augmenting the `bounce-back' rule with added/subtracted mass and momentum for the displaced fluid due to boundary movement. Simulations predicted liquid movement in the pharynx which resembled closely actual movement of food boluses observed radiographically. Pressures along a simulated manometric catheter show similar transient and quasi-steady periods as measured pressures. Pressure gradient within the liquid is sensitive to the geometric constriction suggesting its potential application as a clinical parameter in diagnosing restrictive pharyngo-esophageal disorders.

  8. Long-term monitoring of Ca2+ dynamics in C. elegans pharynx: an in vivo energy balance sensor

    PubMed Central

    Alvarez-Illera, Pilar; Sanchez-Blanco, Adolfo; Lopez-Burillo, Silvia; Fonteriz, Rosalba I.; Alvarez, Javier; Montero, Mayte

    2016-01-01

    Ca2+ is a key signal transducer for muscle contraction. Continuous in vivo monitoring of intracellular Ca2+-dynamics in C. elegans pharynx muscle revealed surprisingly complex Ca2+ patterns. Despite the age-dependent decline of pharynx pumping, we observed unaltered fast Ca2+ oscillations both in young and old worms. In addition, sporadic prolonged Ca2+ increases lasting many seconds or minutes were often observed in between periods of fast Ca2+ oscillations. We attribute them to the inhibition of ATP-dependent Ca2+-pumps upon energy depletion. Accordingly, food deprivation largely augmented the frequency of prolonged [Ca2+] increases. However, paradoxically, prolonged [Ca2+] increases were more frequently observed in young worms than in older ones, and less frequently observed in energy-deficient mitochondrial respiratory chain nuo-6 mutants than in wild-type controls. We hypothesize that young animals are more susceptible to energy depletion due to their faster energy consumption rate, while nuo-6 mutants may keep better the energy balance by slowing energy consumption. Our data therefore suggest that the metabolic state of the pharynx during feeding stimulation depends mainly on the delicate balance between the instant rates of energy production and consumption. Thus, in vivo monitoring of muscle Ca2+ dynamics can be used as a novel tool to study cellular energy availability. PMID:27661127

  9. Denture impaction in the oesophagus experience of a young ENT practice in Nigeria

    PubMed Central

    Adedeji, Taiwo Olugbemiga; Olaosun, Adedayo Olugbenga; Sogebi, Olusola Ayodele; Tobih, James E

    2014-01-01

    Introduction The effect of dental loss and associated desire to restore its function and aesthesis has led to an increase in the number of people wearing dentures. This study therefore reviews the cases of impacted acrylic dentures in the oesophagus. Methods A retrospective review of patients that were managed for oesophageal denture impaction at Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Osun State, Nigeria, over an eight year period from 2005 to 2012. Results A total of 14 patients (M: F 2.5: 1). The age ranged from 32 - 75 years. Majority 64.3%) were 51 years and above. Over 70% presented early. Major presenting symptoms were throat pain (100%), odynophageal (92.9%) and dysphageal (78.6%). The radiographic findings were air entrapment (64.3%) and increase in prevertebral soft tissue shadow (78.6%). Majority (87.5%) were impacted at the upper (cervical) oesophagus. Over 78% had successful extraction with rigid oesophagoscopy. Two (14.3%) had spontaneous expulsion of the denture and 1 (7.1%) discharged himself against medical advice. Complications were mucosa tear (28.6%), laryngeal spasm/ airway obstruction (14.3%), mucosa oedema/ erythema (57.1%), neck abscess (7.1%). Conclusion Impaction of esophageal dentures is relatively common in our locality; most patients present early for medical attention and associated with successful rigid oesophagoscopies and denture extraction under GA, and generally good outcome. Education of the wearers of dentures was emphasized as a way of preventing dentures impaction. PMID:25478051

  10. A review of the management of 100 cases of benign stricture of the oesophagus

    PubMed Central

    Raptis, S.; Milne, D. Mearns

    1972-01-01

    One hundred cases of benign stricture of the oesophagus treated over a period of 11 years from 1960 to 1971 under the care of the senior author (D.M.M.) at Frenchay Hospital Thoracic Unit are reviewed. The results indicate that the commonest site of the lesion is in the lower third of the oesophagus and that the commonest cause is peptic oesophagitis due to gastric reflux and associated hiatus hernia. As the disease is commoner in the elderly a conservative medical regimen of dilatation, antacids, and posturing is recommended as the first line of treatment. When this fails surgery is necessary. Collis (1965) managed 69 patients by gastroplasty. Belsey (1965) reported his experience with colon transplants, while Brain (1967) and Allison (1970) advised jejunal transplantation. Our experience has shown that in view of the old age and often poor physical condition of these patients resection of the stricture and oesophagogastric anastomosis is a relatively safe and simple procedure. The results obtained indicate that 25% of patients operated on will require future dilatations. PMID:4538878

  11. Ultrastructure of intramural ganglia in the striated muscle portions of the guinea pig oesophagus

    PubMed Central

    MORIKAWA, SHUNICHI; KOMURO, TERUMASA

    1999-01-01

    The ultrastructure of the myenteric plexus located in the striated muscle portion of the guinea pig oesophagus was examined and compared with that of the plexus associated with the smooth muscle portion of the rest of the digestive tract. The oesophageal ganglia had essentially the same architecture as those of the smooth muscle portion, such as a compact neuropil without the intervention of connective tissue and blood vessels. Some features, however, were particular to the striated muscle part of the oesophagus. It was clearly demonstrated that myelinated fibres, probably sensory terminals of vagal origin, join the myenteric ganglia. Synapses and terminal varicosities are sparsely distributed within the ganglia and fewer morphological types of axon varicosities could be distinguished compared with other regions. Glial cells are well developed in the oesophageal myenteric ganglia. These cells outnumber the ganglion cells, having a higher ratio than in the lower digestive tract, and form numerous cytoplasmic lamellar processes. The lamellar processes, located at the surface of the ganglia, considerably reduce the area of neuronal membrane which directly contacts the basal lamina. The role of these lamellar processes in the oesophageal ganglia is discussed. PMID:10473298

  12. Acid reflux into the oesophagus does not influence exercise-induced airway narrowing in bronchial asthma.

    PubMed

    Ferrari, M; Bonella, F; Benini, L; Ferrari, P; De Iorio, F; Testi, R; Lo Cascio, V

    2008-10-01

    A few studies on small patient series have investigated the relationship between gastroesophageal reflux and bronchial responsiveness as expressed by exercise-induced bronchoconstriction (EIB), with non-conclusive results. The aim of this study was to evaluate whether the presence of acid in the oesophagus may influence EIB. 45 patients with bronchial asthma underwent spirometry, exercise challenge on bicycle ergometer and 24 h oesophageal pH monitoring. Subjects with EIB (Forced expiratory volume in the first second (FEV1)) percentage decrease after exercise (DeltaFEV1) > or =15%, n = 28) were retested after a 2 week treatment course with omeprazole 40 mg/daily. Exercise at baseline was performed at the same time as oesophageal pH monitoring. In basal condition, there was no difference in FEV1, acid exposure time or number of refluxes measured during 24 h pH monitoring between patients with and without EIB. There was no relationship between spirometry results and DeltaFEV1 on one hand, and parameters of gastroesophageal reflux on the other. Nine patients with EIB (31.0%) and six patients without EIB (37.5%) had one or more episodes of GER during exercise challenge, without significant differences between the two groups. After gastric acid inhibition by omeprazole, DeltaFEV1 did not change significantly. The results indicate that acid in the oesophagus, or its short-term inhibition by proton pump inhibitors, has no influence on exercise-induced bronchoconstriction.

  13. Denture impaction in the oesophagus experience of a young ENT practice in Nigeria.

    PubMed

    Adedeji, Taiwo Olugbemiga; Olaosun, Adedayo Olugbenga; Sogebi, Olusola Ayodele; Tobih, James E

    2014-01-01

    The effect of dental loss and associated desire to restore its function and aesthesis has led to an increase in the number of people wearing dentures. This study therefore reviews the cases of impacted acrylic dentures in the oesophagus. A retrospective review of patients that were managed for oesophageal denture impaction at Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Osun State, Nigeria, over an eight year period from 2005 to 2012. A total of 14 patients (M:F 2.5:1). The age ranged from 32-75 years. Majority 64.3%) were 51 years and above. Over 70% presented early. Major presenting symptoms were throat pain (100%), odynophageal (92.9%) and dysphageal (78.6%). The radiographic findings were air entrapment (64.3%) and increase in prevertebral soft tissue shadow (78.6%). Majority (87.5%) were impacted at the upper (cervical) oesophagus. Over 78% had successful extraction with rigid oesophagoscopy. Two (14.3%) had spontaneous expulsion of the denture and 1 (7.1%) discharged himself against medical advice. Complications were mucosa tear (28.6%), laryngeal spasm/ airway obstruction (14.3%), mucosa oedema/ erythema (57.1%), neck abscess (7.1%). Impaction of esophageal dentures is relatively common in our locality; most patients present early for medical attention and associated with successful rigid oesophagoscopies and denture extraction under GA, and generally good outcome. Education of the wearers of dentures was emphasized as a way of preventing dentures impaction.

  14. One year treatment of Barrett's oesophagus with proton pump inhibitors (a multi-center study).

    PubMed

    Babic, Z; Bogdanovic, Z; Dorosulic, Z; Petrovic, Z; Kujundzic, M; Banic, M; Marusic, M; Heinzl, R; Bilić, B; Andabak, M

    2015-12-01

    Aim of the study was to investigate the effects of 1-year therapy by different proton pump inhibitors (PPIs) on epithelial tissue and surrounding inflammatory changes in Barrett's oesophagus, in patients who have abandoned invasive therapy. A group of 120 patients (sampled in 60-month period, from 61201 upper gastrointestinal endoscopies) who were diagnosed both, endoscopically and pathohistologically with Barrett's oesophagus, and who have abandoned invasive therapeutic approach were enrolled in study. Treatment with different PPIs was initiated and continued for a year. At the end of treatment, patients were reassessed by endoscopy with tissue biopsy and pathohistological analysis. No difference in regenerating squamous epithelium or degree of dysplasia was seen between different treatment groups. Interestingly, most patients receiving pantoprazole (94%) ended up with thinner squamous epithel (P<0.0001). The squamous epithel was consider thinner only if its total thickness, measured on histological specimen, was smaller for more than 50% of the thickness before therapy. Significantly less of difference (P<0.0014) was seen with patients receiving lansoprazole (65%) and (P<0.003) omeprazole (50%). Regeneration of the squamous epithel was the same for all PPIs but not good enough to stop the progression of the disease.

  15. Immunohistochemical/histochemical double staining method in the study of the columnar metaplasia of the oesophagus.

    PubMed

    Cabibi, D; Giannone, A G; Mascarella, C; Guarnotta, C; Castiglia, M; Pantuso, G; Fiorentino, E

    2014-03-05

    Intestinal metaplasia in Barrett's oesophagus (BO) represents an important risk factor for oesophageal adenocarcinoma. Instead, few and controversial data are reported about the progression risk of columnar-lined oesophagus without intestinal metaplasia (CLO), posing an issue about its clinical management. The aim was to evaluate if some immunophenotypic changes were present in CLO independently of the presence of the goblet cells. We studied a series of oesophageal biopsies from patients with endoscopic finding of columnar metaplasia, by performing some immunohistochemical stainings (CK7, p53, AuroraA) combined with histochemistry (Alcian-blue and Alcian/PAS), with the aim of simultaneously assess the histochemical features in cells that shows an aberrant expression of such antigens. We evidenced a cytoplasmic expression of CK7 and a nuclear expression of Aurora A and p53,  both in goblet cells of BO and in non-goblet cells of CLO, some of which showing mild dysplasia. These findings suggest that some immunophenotypic changes are present in CLO and they can precede the appearance of the goblet cells or can be present independently of them, confirming the conception of BO as the condition characterized by any extention of columnar epithelium. This is the first study in which a combined immunohistochemical/histochemical method has been applied to Barrett pathology.

  16. Mechanisms of Barrett's oesophagus: intestinal differentiation, stem cells, and tissue models.

    PubMed

    Nakagawa, Hiroshi; Whelan, Kelly; Lynch, John P

    2015-02-01

    Barrett's oesophagus (BE) is defined as any metaplastic columnar epithelium in the distal oesophagus which replaces normal squamous epithelium and which predisposes to cancer development. It is this second requirement, the predisposition to cancer, which makes this condition both clinically highly relevant and an important area for ongoing research. While BE has been defined pathologically since the 1950's (Allison and Johnstone, Thorax 1955), and identified as a risk factor for esophageal adenocarcinoma since the 1970's (Naef A.P., et al J Thorac Cardiovasc Surg. 1975), our understanding of the molecular events giving rise to this condition remains limited. Herein we will examine what is known about the intestinal features of BE and how well it recapitulates the intestinal epithelium, including stem identity and function. Finally, we will explore laboratory models of this condition presently in use and under development, to identify new insights they may provide into this important clinical condition. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Arbeitsgestaltung und Mitarbeiterqualifizierung

    NASA Astrophysics Data System (ADS)

    Weiss-Oberdorfer, Werner; Hörner, Barbara; Holm, Ruth; Pirner, Evelin

    Die Wertkette gliedert ein Unternehmen in strategisch relevante Tätigkeiten, um dadurch Kostenverhalten sowie vorhandene und potenzielle Differenzierungsquellen zu verstehen. Wenn ein Unternehmen diese strategisch wichtigen Aktivitäten billiger oder besser als seine Konkurrenten erledigt, verschafft es sich einen Wettbewerbsvorteil." Michael Porter, 1985

  18. Tipps und Tricks

    NASA Astrophysics Data System (ADS)

    Häger, Wolfgang; Bauermeister, Dirk

    Hier wollen wir einige uns nützlich erscheinende Hinweise zur Arbeit mit dem Inventor geben. Dabei geht es vor allem darum, das Arbeiten mit dem Inventor zu vereinfachen. Die Beispiele stellen eine unvollständige Aufzählung dar und sollen dazu anregen, nach alternativen Vorgehensweisen zu suchen (hier sei noch einmal ausdrücklich auf das Internet verwiesen).

  19. [Oral cavity and pharynx cancer in the region of Siberia and Far East].

    PubMed

    Choinzonov, E L; Pisareva, L F; Odintsova, I N; Zhuikova, L D

    2015-01-01

    The objective of the present work was to study the prevalence of malignant oral cavity and pharynx neoplasms among the population of the region of Siberia and Far East. These neoplasms are the ninth most frequent conditions in the structure of malignant tumours among the male population and rank the eighteenth among the women. On the whole, the morbidity rate of oral cavity and pharyngeal cancer (3.8‱ and 2.0‱ respectively) was consistent with the mean morbidity levels in Russia. The risk of the development of these conditions among the men is significantly higher than among the women. The highest morbidity is recorded among the subjects at the age of 65-69 years. It increases in the subjects of either sex at a rate that is 3.4 times higher in the women than in the men. The study revealed the territories characterized ether by the enhanced or by the reduced risk of oral cavity and pharyngeal cancer development. The prevalence of this pathology was estimated at 28.4 per 100,000 population, with the overall active detectability being 11.8%, that of stage 1 an 2 disease 7.8% and 19.3% respectively. One-year lethality was 35.6%. The radical treatment was completed in 41.1% of the patients; 45.8% of them were followed up during 5 years. It is concluded that the increasing oral cavity and pharyngeal cancer morbidity and the insufficient volume of preventive measures taken together suggest the necessity of closer cooperation of general practitioners and dental surgeons with oncologists.

  20. Sentinel node detection in N0 cancer of the pharynx and larynx

    PubMed Central

    Werner, J A; Dünne, A-A; Ramaswamy, A; Folz, B J; Lippert, B M; Moll, R; Behr, Th

    2002-01-01

    Neck lymph node status is the most important factor for prognosis in head and neck squamous cell carcinoma. Sentinel node detection reliably predicts the lymph node status in melanoma and breast cancer patients. This study evaluates the predictive value of sentinel node detection in 50 patients suffering from pharyngeal and laryngeal carcinomas with a N0 neck as assessed by ultrasound imaging. Following 99m-Technetium nanocolloid injection in the perimeter of the tumour intraoperative sentinel node detection was performed during lymph node dissection. Postoperatively the histological results of the sentinel nodes were compared with the excised neck dissection specimen. Identification of sentinel nodes was successful in all 50 patients with a sensitivity of 89%. In eight cases the sentinel node showed nodal disease (pN1). In 41 patients the sentinel node was tumour negative reflecting the correct neck lymph node status (pN0). We observed one false-negative result. In this case the sentinel node was free of tumour, whereas a neighbouring lymph node contained a lymph node metastasis (pN1). Although we have shown, that skipping of nodal basins can occur, this technique still reliably identifies the sentinel nodes of patients with squamous cell carcinoma of the pharynx and larynx. Future studies must show, if sentinel node detection is suitable to limit the extent of lymph node dissection in clinically N0 necks of patients suffering from pharyngeal and laryngeal squamous cell carcinoma. British Journal of Cancer (2002) 87, 711–715. doi:10.1038/sj.bjc.6600445 www.bjcancer.com © 2002 Cancer Research UK PMID:12232751

  1. Inducible galectins are expressed in the inflamed pharynx of the ascidian Ciona intestinalis.

    PubMed

    Vizzini, Aiti; Parrinello, Daniela; Sanfratello, Maria Antonietta; Salerno, Giuseppina; Cammarata, Matteo; Parrinello, Nicolò

    2012-01-01

    Although ascidians belong to a key group in chordate phylogenesis, amino acid sequences of Ciona intestinalis galectin-CRDs (CiLgals-a and -b) have been retained too divergent from vertebrate galectins. In the present paper, to contribute in disclosing Bi-CRD galectin evolution a novel attempt was carried out on CiLgals-a and -b CRDs phylogenetic analysis, and their involvement in ascidian inflammatory responses was shown. CiLgals resulted aligned with Bi-CRD galectins from vertebrates (Xenopus tropicalis, Gallus gallus, Mus musculus, Homo sapiens), cephalochordates (Branchiostoma floridae), echinoderms (Strongylocentrotus purpuratus) and a mono-CRD galectin from the ascidian Clavelina picta. The CiLgals-a N-terminal and C-terminal CRDs contain the signature sequence involved in carbohydrate binding, whereas the CiLgals-b C-CRD presents only three out of seven key aminoacids and it could not be suitable as sugar binding motif. Sequence similarity between clusters suggests an evolutionary model based on CRD domain gene duplication and sequence diversification. In particular CiLgals-b N-CRD and C-CRD were similar to each other and both grouped with the ascidian C. picta mono-CRD. Homology modeling process shows a CiLgals molecular structure superimposed to chicken and mouse galectins. The CiLgals-a and CiLgals-b genes were upregulated by LPS inoculation suggesting that they are inducible and expressed in the inflamed pharynx as revealed by real-time PCR analysis. Finally, in situ hybridization and immunohistochemical assays showed their localization in the inflamed tissues, while immunoblotting analysis indicated that CiLgals can form oligomers.

  2. Relationship of craniofacial morphology in 3-dimensional analysis of the pharynx.

    PubMed

    Brasil, Danieli Moura; Kurita, Lúcio Mitsuo; Groppo, Francisco Carlos; Haiter-Neto, Francisco

    2016-05-01

    Pharynx dimensions may vary according to the position and morphology of the mandible. The aim of this study was to test the hypothesis that craniofacial morphology affects pharyngeal volume and its cross-sectional areas. Seventy-four subjects (38 men, 36 women) aged 18 to 56 years (mean ± SD 32.8 ± 1.8 years) were scanned with a cone-beam computed tomography unit and had facial profile photographs taken. All participants were classified according to skeletal anteroposterior (Class II and Class III) and vertical facial patterns (brachyfacial, mesofacial, and dolichofacial). Facial profile analyses and pharyngeal volume and cross-sectional area determinations were performed. The soft palate cross-sectional area of the oropharynx was significantly greater in the Class III patients. The upper facial third (trichion to soft tissue glabella/facial height) correlated negatively with pharyngeal volume and with soft palate cross-sectional area in the oropharynx. Alternatively, the midfacial third (soft tissue glabella to subnasale/facial height) correlated positively with soft palate cross-sectional area of the oropharynx. No significant differences across sexes and facial patterns regarding pharyngeal volume were found (P >0.05). The soft palate cross-sectional area is larger in skeletal Class III subjects. It seems that analysis of the facial profile focusing on the proportions of the facial thirds allows for inferences on pharyngeal dimensions. However, anteroposterior skeletal facial type and vertical facial pattern do not seem to affect pharyngeal volume. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  3. Dietary patterns and risk of cancer of the oral cavity and pharynx in Uruguay.

    PubMed

    De Stefani, Eduardo; Boffetta, Paolo; Ronco, Alvaro L; Correa, Pelayo; Oreggia, Fernando; Deneo-Pellegrini, Hugo; Mendilaharsu, Maria; Leiva, Juan

    2005-01-01

    From 1995 to 2002, a case-control study on food groups and risk of cancer of the oral cavity and pharynx was conducted in Montevideo, Uruguay. Two hundred thirty cases were frequency-matched to 460 controls on age, residence, and urban/rural status. The study was restricted to men. The relationship between foods and risk of oral and pharyngeal squamous cell carcinoma was examined through: 1) individual food group analysis, 2) factor analysis, and 3) determination of empirical scores. The results were similar. Factor analysis generated 2 patterns, which were labeled as "stew" and "vegetables and fruits." The stew pattern loaded positively on boiled meat, cooked vegetables, potato, and sweet potato. This pattern was directly associated with risk of oral and pharyngeal cancer [odds ratio (OR), 3.75; 95% confidence interval (CI), 1.99-7.06; P value for trend=0.0002]. The vegetables and fruits factor loaded positively on raw vegetables, citrus fruits, other fruits, liver, fish, and desserts. This pattern was inversely associated with risk of oropharyngeal carcinoma (OR, 0.34; 95% CI, 0.18-0.64; P value for trend=0.0008). Joint effects of high intake of risk foods and low intake of protective foods were associated with a risk of 12.0 (95% CI, 4.1-34.6). Our study confirms the important role of dietary factors in oral and pharyngeal cancer risk and suggests that the analysis of dietary patterns is a powerful tool to investigate the links between nutrition and cancer.

  4. Heterochromia of the irides and a motility disorder of the oesophagus: a coincidence or a defect during embryogenesis?

    PubMed

    Goethals, S; Hoffman, I; Devriendt, K; Casteels, I

    2003-01-01

    We present an infant with heterochromia of the irides and a motility disorder of the oesophagus. The association between Hirschsprung's disease and heterochromia of the irides has been reported in the past and has been explained by the common origin during embryogenesis of the parasympathetic ganglion cells and the stroma of the iris.

  5. Confocal laser endomicroscopy for in vivo diagnosis of Barrett's oesophagus and associated neoplasia: a pilot study conducted in a single Italian centre.

    PubMed

    Trovato, Cristina; Sonzogni, Angelica; Ravizza, Davide; Fiori, Giancarla; Tamayo, Darina; De Roberto, Giuseppe; de Leone, Annalisa; De Lisi, Stefania; Crosta, Cristiano

    2013-05-01

    Diagnosis and management of Barrett's oesophagus are controversial. Technical improvements in real-time recognition of intestinal metaplasia and neoplastic foci provide the chance for more effective target biopsies. Confocal laser endomicroscopy allows to analyze living cells during endoscopy. To assess the diagnostic accuracy, inter- and intra-observer variability of endomicroscopy for detecting in vivo neoplasia (dysplasia and/or early neoplasia) in Barrett's oesophagus. Prospective pilot study. Patients referred for known Barrett's oesophagus were screened. Endomicroscopy was carried out in a circular fashion, every 1-2 cm, on the whole columnar-lined distal oesophagus. Visible lesions, when present, were analyzed first. Targeted biopsies were taken. Confocal images were classified according to confocal Barrett classification. Endomicroscopic and histological findings were compared. Forty-eight out of 50 screened patients underwent endomicroscopy. Visible lesions were observed in 3 patients. In a per-biopsy analysis, Barrett's-oesophagus-associated neoplasia could be predicted with an accuracy of 98.1%. The agreement between endomicroscopic and histological results was substantial (κ=0.76). This study suggests that endomicroscopy can provide in vivo diagnosis of Barrett's oesophagus-associated neoplasia. Because it allows for the study of larger surface areas of the mucosa, endomicroscopy may lead to significant improvements in the in vivo screening and surveillance of Barrett's oesophagus. Copyright © 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  6. Wirkstoffe, Medikamente und Mathematische Bildverarbeitung

    NASA Astrophysics Data System (ADS)

    Bauer, Günter J.; Lorenz, Dirk A.; Maaß, Peter; Preckel, Hartwig; Trede, Dennis

    Die Entwicklung neuer Medikamente ist langwierig und teuer. Der erste Schritt ist hierbei die Suche nach neuen Wirkstoffkandidaten, die für die Behandlung bislang schwer therapierbarer Krankheiten geeignet sind. Hierfür stehen der Pharma- und Biotechnologieindustrie riesige Substanzbibliotheken zur Verfügung. In diesen Bibliotheken werden die unterschiedlichsten Substanzen gesammelt, die entweder synthetisch hergestellt oder aus Pilzen, Bakterienkulturen und anderen Lebewesen gewonnen werden können.

  7. Gastro-oesophageal reflux symptoms, oesophagitis and Barrett's oesophagus in the general population: the Loiano-Monghidoro study.

    PubMed

    Zagari, R M; Fuccio, L; Wallander, M-A; Johansson, S; Fiocca, R; Casanova, S; Farahmand, B Y; Winchester, C C; Roda, E; Bazzoli, F

    2008-10-01

    Existing endoscopy-based data on gastro-oesophageal reflux disease (GORD) in the general population are scarce. This study aimed to evaluate typical symptoms and complications of GORD, and their associated risk factors, in a representative sample of the Italian population. 1533 adults from two Italian villages were approached to undergo symptom assessment using a validated questionnaire and upper gastrointestinal endoscopy. Data were obtained from 1033 individuals (67.4% response rate). The prevalence of reflux symptoms was 44.3%; 23.7% of the population experienced such symptoms on at least 2 days per week (frequent symptoms). The prevalence rates of oesophagitis and Barrett's oesophagus in the population were 11.8% and 1.3%, respectively. Both frequent (relative risk (RR) 2.6; 95% confidence interval (CI) 1.7 to 3.9) and infrequent (RR 1.9; 95% CI 1.2 to 3.0) reflux symptoms were associated with the presence of oesophagitis. No reflux symptoms were reported by 32.8% of individuals with oesophagitis and 46.2% of those with Barrett's oesophagus. Hiatus hernia was associated with frequent reflux symptoms and oesophagitis, and was present in 76.9% of those with Barrett's oesophagus. We found no association between body mass index and reflux symptoms or oesophagitis. GORD is common in Italy, but the prevalence of Barrett's oesophagus in the community is lower than has been reported in selected populations. Both frequent and infrequent reflux symptoms are associated with an increased risk of oesophagitis. Individuals with oesophagitis and Barrett's oesophagus often have no reflux symptoms.

  8. Pharmacological characterization of the opioid receptor in the submucous plexus of the guinea-pig oesophagus.

    PubMed Central

    Kamikawa, Y.; Shimo, Y.

    1983-01-01

    1 The cholinergically mediated electrically-induced contractions of the submucous plexus-longitudinal muscularis mucosae preparation of the guinea-pig oesophagus were used to study the actions of opioid peptides and morphine. 2 The twitch contractions of the tissue (0.1 Hz, 0.5 ms, supramaximal voltage) were inhibited by all the opioid peptides and morphine in a concentration-dependent manner. The order of potency was dynorphin-(1-13) greater than alpha-neo-endorphin greater than beta-endorphin greater than [D-Ala2]-methionine-enkephalin much greater than alpha-endorphin, methionine-enkephalin, leucine-enkephalin and morphine. 3 The inhibitory actions of dynorphin-(1-13) (20 nM), alpha-neo-endorphin (100 nM) and beta-endorphin (3 microM) were completely reversed either by naloxone (1 microM) or by morphine (100 microM). The Ke values of naloxone against dynorphin-(1-13) and alpha-neo-endorphin were 30 and 25 nM, respectively. 4 Increasing the concentration of calcium from 1.8 to 3.6 mM in Tyrode solution decreased the sensitivity of the tissue to dynorphin-(1-13) 7.4 times and to alpha-neo-endorphin 462 times. 5 The inhibitory actions of dynorphin-(1-13) (100 nM) and alpha-neo-endorphin (300 nM) were inversely related to stimulus frequency, being most active at low frequencies (0.1-1 Hz), and least active at high (30 Hz). 6 Exogenously applied acetylcholine produced concentration-dependent contractions of the isolated muscularis mucosae, with an EC50 of 72.6 +/- 4.5 nM. The contractile response of the oesophagus to acetylcholine was not affected by the pretreatment of the tissue with dynorphin-(1-13) (100 nM), alpha-neo-endorphin (300 nM) or beta-endorphin (3 microM). 7 It is concluded that the submucous plexus-longitudinal muscularis mucosae of the guinea-pig oesophagus is inhibited by opioid peptides acting at prejunctional opioid receptors, probably of the kappa-subtype. PMID:6303485

  9. Derivation of genetic biomarkers for cancer risk stratification in Barrett's oesophagus: a prospective cohort study.

    PubMed

    Timmer, Margriet R; Martinez, Pierre; Lau, Chiu T; Westra, Wytske M; Calpe, Silvia; Rygiel, Agnieszka M; Rosmolen, Wilda D; Meijer, Sybren L; Ten Kate, Fiebo J W; Dijkgraaf, Marcel G W; Mallant-Hent, Rosalie C; Naber, Anton H J; van Oijen, Arnoud H A M; Baak, Lubbertus C; Scholten, Pieter; Böhmer, Clarisse J M; Fockens, Paul; Maley, Carlo C; Graham, Trevor A; Bergman, Jacques J G H M; Krishnadath, Kausilia K

    2016-10-01

    The risk of developing adenocarcinoma in non-dysplastic Barrett's oesophagus is low and difficult to predict. Accurate tools for risk stratification are needed to increase the efficiency of surveillance. We aimed to develop a prediction model for progression using clinical variables and genetic markers. In a prospective cohort of patients with non-dysplastic Barrett's oesophagus, we evaluated six molecular markers: p16, p53, Her-2/neu, 20q, MYC and aneusomy by DNA fluorescence in situ hybridisation on brush cytology specimens. Primary study outcomes were the development of high-grade dysplasia or oesophageal adenocarcinoma. The most predictive clinical variables and markers were determined using Cox proportional-hazards models, receiver operating characteristic curves and a leave-one-out analysis. A total of 428 patients participated (345 men; median age 60 years) with a cumulative follow-up of 2019 patient-years (median 45 months per patient). Of these patients, 22 progressed; nine developed high-grade dysplasia and 13 oesophageal adenocarcinoma. The clinical variables, age and circumferential Barrett's length, and the markers, p16 loss, MYC gain and aneusomy, were significantly associated with progression on univariate analysis. We defined an 'Abnormal Marker Count' that counted abnormalities in p16, MYC and aneusomy, which significantly improved risk prediction beyond using just age and Barrett's length. In multivariate analysis, these three factors identified a high-risk group with an 8.7-fold (95% CI 2.6 to 29.8) increased HR when compared with the low-risk group, with an area under the curve of 0.76 (95% CI 0.66 to 0.86). A prediction model based on age, Barrett's length and the markers p16, MYC and aneusomy determines progression risk in non-dysplastic Barrett's oesophagus. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  10. Zusammenfassung und Ausblick

    NASA Astrophysics Data System (ADS)

    Knopp, Lothar; Wiegleb, Gerhard

    Mit dem vorliegenden Buch wird als Ergebnis eines durch die Deutsche BundesstiftungUmwelt (DBU) geförderten Forschungsprojektes an der Brandenburgischen Technischen Universität Cottbus eine erste Standardisierung der Vorgehensweise zur Erfassung, Risikoabschätzung und Bewertung eines Biodiversitätsschadens nach dem Umweltschadensgesetz (USchadG) vorgelegt. Damit kann eine erste Bewertung potentieller Schadenssituationen vorgenommen werden. Die Nutzung der hier erarbeiteten Vorgehensweise bietet sich daher für all diejenigen an, die mit der Frage einer möglichen Haftung für Biodiversitätsschäden nach dem USchadG konfrontiert sind, seien es die Unteren und Oberen Naturschutzbehörden der Länder, die Schadensversicherer, die potentiell Haftenden oder die Naturschutzverbände.

  11. Spontaneous perforation in the upper oesophagus resulting from ulcer in heterotopic gastric mucosa.

    PubMed

    Righini, C A; Faure, Cl; Karkas, A; Schmerber, S; Reyt, E

    2007-01-01

    Heterotopic gastric mucosa (HGM) can be found throughout the entire gastrointestinal tract, more frequently in the cervical oesophagus. Macroscopic HGM is named inlet patch (IP). The great majority of IPs are asymptomatic and discovered incidently during oesophageal endoscopy performed for another pathology. However, complications can occur. Among these, perforation is extremely rare. We report a case of a 27-year old man who presented with a perforation of an upper oesophageal ulcer arising from an IP. The diagnosis was made during endoscopy and confirmed with biopsy of the tissue surrounding the perforation, showing histologic modifications consistent with heterotopic gastric mucosa. Medical treatment using a proton pump inhibitor and antibiotics delivered with a gastric tube was advocated. The perforation was closed at day 7 and plasma Argon coagulation of the inlet patch was performed two months later. Annual endoscopy has been normal for three years.

  12. Effect of long-term treatment with cimetidine and antacids in Barrett's oesophagus.

    PubMed Central

    Wesdorp, I C; Bartelsman, J; Schipper, M E; Tytgat, G N

    1981-01-01

    The effect of a long-term treatment (one to two years) with cimetidine (1.6 g per day) and an antacid (Regla pH) was evaluated in nine patients with a Barrett's oesophagus. The results showed that such long-term treatment had a beneficial effect on the symptoms and endoscopic signs of oesophagitis and on the healing of a Barrett's ulcer, but did not result in a regression of the squamocolumnar junction back towards the cardia. No significant changes were observed in the histological epithelial types in the biopsies taken below the squamocolumnar junction. No clinical or biochemical side-effects or changes in biochemical parameters were noted during this study. PMID:7297920

  13. Opsoclonus myoclonus syndrome due to squamous cell carcinoma of the oesophagus.

    PubMed

    Rossor, Alexander M; Perry, Fiona; Botha, Abrie; Norwood, Fiona

    2014-03-03

    We present the case of a 47-year-old woman with encephalopathy, ataxia and oscillopsia diagnosed with opsoclonus myoclonus syndrome (OMS). In adults, OMS in the context of encephalopathy is commonly paraneoplastic. A CT of the chest, abdomen and pelvis and a gastroscopy were performed and were normal. A fluorodeoxyglucose positron emission tomography CT scan demonstrated increased uptake in the mid-oesophagus and an endoscopic ultrasound examination demonstrated intramural thickening of 5 mm with no epithelial lesion. The patient was treated with three courses of intravenous immunoglobulin (IvIg) with improvement in her symptoms. A year following the initial presentation a repeat endoscopic examination demonstrated an ulcerated oesophageal carcinoma with regional lymph node involvement. The patient was treated with neo adjuvant chemotherapy prior to oesophagectomy. The patient's symptoms resolved within 6 months of tumour resection without the need for further IvIg. Unfortunately, after a further 6 months the patient developed liver metastases and died.

  14. Autonomic regulation of mucociliary transport rate in the oesophagus of the frog, Rana temporaria.

    PubMed Central

    Morley, J; Sanjar, S

    1984-01-01

    Transport of lead particles along the mucosal surface of the frog oesophagus has been measured by direct observation with the aid of video recording. Electrical stimulation of the vagus nerve increased the rate of particle transport. This acceleration was suppressed by atropine or by hexamethonium. Acetylcholine and other parasympathomimetic agents accelerated particle transport rate. Such acceleration was abolished by atropine. Nicotine increased the rate of particle transport and this effect was suppressed by hexamethonium or by atropine. Atropine did not significantly alter basal particle transport rate. Neither basal particle transport rate nor the response to vagal nerve stimulation were affected by eserine. Adrenaline, noradrenaline or isoprenaline did not affect basal particle transport rate. Adrenaline or noradrenaline were without effect on the increased particle transport rate due to electrical stimulation of the vagus. PMID:6332901

  15. An unusual sharp magnetic foreign body in the oesophagus and its removal: A case report.

    PubMed

    Agrawal, Swati; Arora, Sandeep; Sharma, Nishi

    2016-08-01

    Ingestion of foreign bodies is a common pediatric problem. The majority of ingested foreign bodies pass spontaneously. Oesophageal foreign bodies should be urgently removed because of their potential to cause complications. Ingested batteries that lodge in the oesophagus, sharp or pointed foreign bodies in the oesophageal or gastric tract, and ingestion of multiple magnets all require urgent endoscopic removal. A 4-year-old boy ingested a sharp magnetic foreign body, which was removed via rigid oesophagoscopy without complication. To the best of our knowledge, this is the only sharp magnetic foreign body ingested by a young child ever reported in the English-language literature. We describe the presentation and therapeutic procedure adopted in this case. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. Dieulafoy's lesion of the oesophagus: a case series and literature review.

    PubMed

    Inayat, Faisal; Ullah, Waqas; Hussain, Qulsoom; Hurairah, Abu

    2017-01-06

    Dieulafoy's lesion is a vascular abnormality consisting of a tortuous, dilated aberrant submucosal vessel that erodes the overlying mucosal layer without ulceration. The oesophagus is a very rare location for the lesion. Herein, we report a case series of 3 patients who presented with upper gastrointestinal bleeding. Endoscopy was performed, which showed a large calibre-persistent tortuous submucosal artery protruding into the oesophageal lumen. All the patients were successfully managed with endoscopic intervention using epinephrine injection around the lesion followed by hemoclip application. The present paper highlights the remarkably rare occurrence of oesophageal Dieulafoy's lesion and reviews the pathophysiology, epidemiology and management with a focus on diagnostic challenge encountered in such patients. 2017 BMJ Publishing Group Ltd.

  17. Morphometric evaluation of oesophageal wall in patients with nutcracker oesophagus and ineffective oesophageal motility.

    PubMed

    Kim, H S; Park, H; Lim, J H; Choi, S H; Park, C; Lee, S I; Conklin, J L

    2008-08-01

    The pathogenesis of nutcracker oesophagus (NE) and ineffective oesophageal motility (IEM) is unclear. Damage to the enteric nervous system or smooth muscle can cause oesophageal dysmotility. We tested the hypothesis that NE and IEM are associated with abnormal muscular or neural constituents of the oesophageal wall. Oesophageal manometry was performed in patients prior to total gastrectomy for gastric cancer. The oesophageal manometries were categorized as normal (n = 7), NE (n = 13), or IEM (n = 5). Histologic examination of oesophageal tissue obtained during surgery was performed after haematoxylin and eosin (H&E) and trichrome staining. Oesophageal innervation was examined after immunostaining for protein gene product-9.5 (PGP-9.5), choline acetyltransferase (ChAT) and neuronal nitric oxide synthase (nNOS). There were no significant differences in inner circular smooth muscle thickness or degree of fibrosis among the three groups. Severe muscle fibre loss was found in four of five patients with IEM. The density of PGP-9.5-reactive neural structures was not different among the three groups. The density of ChAT immunostaining in the myenteric plexus (MP) was significantly greater in patients with NE (P < 0.05) and the density of nNOS immunostaining in the circular muscle (CM) was significantly greater in IEM patients (P < 0.05). The ChAT/nNOS ratio in both MP and CM was significantly greater in NE patients. NE may result from an imbalance between the excitatory and inhibitory innervation of the oesophagus, because more than normal numbers of ChAT-positive myenteric neurones are seen in NE. Myopathy and/or increased number of nNOS neurones may contribute to the hypocontractile motor activity of IEM.

  18. Crypt dysplasia in Barrett's oesophagus shows clonal identity between crypt and surface cells.

    PubMed

    Khan, Shabuddin; McDonald, Stuart A C; Wright, Nicholas A; Graham, Trevor A; Odze, Robert D; Rodriguez-Justo, Manuel; Zeki, Sebastian

    2013-09-01

    Epithelial dysplasia is an important histological diagnosis signifying the presence of pre-invasive disease, usually needing intervention. However, the specific genetic changes responsible for the induction of this phenotypic change are unknown. Moreover, recent reports indicate that the dysplastic phenotype may not be immutable: in basal crypt dysplasia (CD), unequivocal dysplastic changes are seen in the crypts in Barrett's oesophagus and other pre-invasive lesions in the gastrointestinal tract, but the upper crypts and surface epithelium associated with these dysplastic crypts show the definitive morphology of a differentiated epithelium. The genotypic relationship between CD and the differentiated surface epithelium is presently unclear. We obtained 17 examples of CD: the lower and upper crypts and surface epithelium were differentially laser-microdissected from formalin-fixed, paraffin-embedded sections and mutations were sought in tumour suppressor genes frequently associated with progression in Barrett's oesophagus. We found two patients who both showed a c. C238T mutation in the CDKN2A (CDKN2AInk4A) gene and where the precise microanatomical relationships could be discerned: this mutation was present in both the CD at the crypt base and in the upper crypt and surface epithelium. We conclude that, in CD, the dysplastic basal crypt epithelium and the upper crypt and surface epithelium show clonal CDKN2A mutations, thus showing definitively that the surface epithelium is derived from the dysplastic crypt epithelium: the dysplastic phenotype is therefore not fixed and can be reversed. The mechanism of this change is unclear but may be related to the possibility that dysplastic cells can, probably early in their progression, respond to differentiation signals. However, it is also clear that a heavy mutational burden can be borne by crypts in the gastrointestinal tract without the development of phenotypic dysplasia. We are evidently some way from understanding

  19. The relationship between smoking and severe dysplastic disease in patients with Barrett's columnar-lined oesophagus.

    PubMed

    Ramus, James R; Gatenby, Piers A C; Caygill, Christine P J; Watson, Anthony; Winslet, Marc C

    2012-11-01

    The aim of this study was to examine the relationship between smoking and oesophageal high-grade dysplasia (HGD) or adenocarcinoma (AC) in a large cohort of patients with Barrett's columnar-lined oesophagus (CLO). A total of 1280 patients diagnosed with CLO and registered with the UK National Barrett's Oesophagus Registry were included. Data, including smoking habits, were collected from the patient's notes and development of HGD or AC noted. Analysis was performed with SPSS using logistic regression for calculation of odds ratios (ORs) for development of HGD/AC. Data on smoking habits were available in 956 (74.6%) patients. There was no significant difference between smokers and nonsmokers in mean age (P=0.877) or length of follow-up (P=0.359). There was a significant risk of HGD/AC in patients with any history of smoking compared with those who had never smoked (P<0.001, OR 2.81). Ex-smokers of 10 years or more remained at a significantly higher risk of HGD/AC compared with those who had never smoked (P=0.001, OR 3.37). Current smokers were not at a significantly higher risk of HGD/AC compared with ex-smokers (P=0.857) nor were those who smoked at least 20 a day compared with those who smoked fewer than 20 a day (P=0.632). In patients with CLO, smoking appears to be a significant risk factor for the development of severe dysplastic disease; however, we did not observe a dose-dependent effect of smoking on progression of disease.

  20. Pyropheophorbide und a as a catabolite of ethylene-induced chlorophyll und a degradation

    SciTech Connect

    Shimokawa, Keishi; Hashizume, Akihito ); Shioi, Yuzo )

    1990-05-01

    An enzyme extract prepared from ethylene-induced degreening Citrus fruits contains chlorophyll (Chl) degrading enzymes. The fate of Chl carbons during an enzymatic degradation was investigated using Chl {und a}-{sup 14}C. Accompanying the disappearance of labelled Chl {und a}, pheophorbide {und a} and pyropheophorbide {und a} appeared and accumulation of pyropheophorbide {und a} was observed. HydroxyChl {und a} was also detected, but this is thought to be an artifact during chromatography. Unlike ethylene-induced Citrus fruits (in vivo), further degradation of pyropheophorbide {und a} did not occur in vitro enzyme system. This suggests that there is a lack of enzyme(s) and/or cofactor(s) for further degradation. It is concluded that Chl {und a} degraded enzymatically by the following order: Chl {und a}, chlorophyllide {und a}, pheophorbide {und a} and pyropheophorbide {und a}.

  1. Bildanalyse in Medizin und Biologie

    NASA Astrophysics Data System (ADS)

    Athelogou, Maria; Schönmeyer, Ralf; Schmidt, Günther; Schäpe, Arno; Baatz, Martin; Binnig, Gerd

    Heutzutage sind bildgebende Verfahren aus medizinischen Untersuchungen nicht mehr wegzudenken. Diverse Methoden - basierend auf dem Einsatz von Ultraschallwellen, Röntgenstrahlung, Magnetfeldern oder Lichtstrahlen - werden dabei spezifisch eingesetzt und liefern umfangreiches Datenmaterial über den Körper und sein Inneres. Anhand von Mikroskopieaufnahmen aus Biopsien können darüber hinaus Daten über die morphologische Eigenschaften von Körpergeweben gewonnen werden. Aus der Analyse all dieser unterschiedlichen Arten von Informationen und unter Konsultation weiterer klinischer Untersuchungen aus diversen medizinischen Disziplinen kann unter Berücksichtigung von Anamnesedaten ein "Gesamtbild“ des Gesundheitszustands eines Patienten erstellt werden. Durch die Flut der erzeugten Bilddaten kommt der Bildverarbeitung im Allgemeinen und der Bildanalyse im Besonderen eine immer wichtigere Rolle zu. Gerade im Bereich der Diagnoseunterstützung, der Therapieplanung und der bildgeführten Chirurgie bilden sie Schlüsseltechnologien, die den Forschritt nicht nur auf diesen Gebieten maßgeblich vorantreiben.

  2. [Detection of early neoplasia in Barrett's oesophagus: focus attention on index endoscopy in short-segment-Barrett's oesophagus with random biopsies].

    PubMed

    Behrens, A; Pech, O; Wuthnow, E; Manner, H; Pohl, J; May, A; Ell, C

    2015-06-01

    Detecting early neoplasias in Barrett's oesophagus (BE) is challenging. Recent publications have been focusing on improving the detection of such lesions during Barrett's surveillance. However in a recently published Danish register study calculating the risk for cancer-development in BE two-thirds of the diagnosed tumors were identified during the first examination or in the first year. This means that index endoscopy might be more effective than surveillance in detecting early neoplasia in BE.  In the period from January 2010 to April 2011, all patients who consecutively presented with a diagnosis of early neoplastic changes in BE were recorded prospectively. The analysis included data for 121 patients. In patients with short-segment BE (SSBE), neoplasia was only diagnosed in 6 % of cases in the surveillance examination, compared with 44 % of cases in long-segment BE (LSBE). The neoplastic lesion was identified visually in 43 patients (36 %) during the external EGD. Type II tumours were detected in 40 % (39/98) and were correctly assessed as neoplastic in 25 % of cases (24/98). 1. in patients with SSBE almost all early tumours are diagnosed by index endoscopy and not by Barrett's surveillance; 2. around 40 % of all early neoplasias are endoscopically invisible and are only diagnosed using four-quadrant biopsies; 3. the macroscopic tumour type has a substantial influence on the detection rate for neoplasia. If efforts to increase the detection rate for early neoplasia in BE are focused solely on the Barrett's surveillance method, then only a minority of patients - 20 % in the present group - will benefit from the measure. German clinical trials register, DRKS00 004 168. © Georg Thieme Verlag KG Stuttgart · New York.

  3. Endoscopic removal of a battery that was lodged in the oesophagus of a two-year-old boy for an extremely long time

    PubMed Central

    Popławski, Cezary; Romańczuk, Bartosz; Parzęcka, Monika

    2015-01-01

    In the present work we describe a 2-year-old boy whose battery ingestion was overlooked, and who had the battery endoscopically removed from the upper part of his oesophagus after several months. This is the only described case of such a long impaction of a lithium battery in the oesophagus, without development of severe complications. We stress the necessity to take into account ingestion of a dangerous foreign body by children demonstrating unspecific clinical signs. PMID:26557945

  4. Sex-specific associations between body mass index, waist circumference and the risk of Barrett's oesophagus: a pooled analysis from the international BEACON consortium.

    PubMed

    Kubo, Ai; Cook, Michael Blaise; Shaheen, Nicholas J; Vaughan, Thomas L; Whiteman, David C; Murray, Liam; Corley, Douglas A

    2013-12-01

    Barrett's oesophagus is a precursor lesion of oesophageal adenocarcinoma, a cancer that, in the USA, has increased in incidence over 600% during the past 40 years. Barrett's oesophagus and oesophageal adenocarcinoma are much more common among men than among women; this finding is unexplained and most earlier studies lacked sufficient numbers of women to evaluate sex-specific risk factors. We leveraged the power of an international consortium to assess sex-specific relationships between body mass index (BMI), abdominal circumference and Barrett's oesophagus. Four case-control studies provided a total of 1102 cases (316 women, 786 men) and 1400 population controls (436 women, 964 men) for analysis. Study-specific estimates, generated using individual participant data, were combined using random effects meta-analysis. Waist circumference was significantly associated with Barrett's oesophagus, even after adjustment for BMI; persons in the highest versus the lowest quartiles of waist circumference had approximately 125% and 275% increases in the odds of Barrett's oesophagus among men and women, respectively (OR 2.24, 95% CI 1.08 to 4.65, I(2)=57; OR 3.75, 95% CI 1.47 to 9.56, I(2)=0). In contrast, there was no evidence of a significant association between BMI and the risk of Barrett's oesophagus, with or without adjustment for waist circumference. Waist circumference, independent of BMI, was found to be a risk factor for Barrett's oesophagus among both men and women. Future studies examining the biological mechanisms of this association will extend our knowledge regarding the pathogenesis of Barrett's oesophagus.

  5. Endoscopic removal of a battery that was lodged in the oesophagus of a two-year-old boy for an extremely long time.

    PubMed

    Szaflarska-Popławska, Anna; Popławski, Cezary; Romańczuk, Bartosz; Parzęcka, Monika

    2015-01-01

    In the present work we describe a 2-year-old boy whose battery ingestion was overlooked, and who had the battery endoscopically removed from the upper part of his oesophagus after several months. This is the only described case of such a long impaction of a lithium battery in the oesophagus, without development of severe complications. We stress the necessity to take into account ingestion of a dangerous foreign body by children demonstrating unspecific clinical signs.

  6. Cas9-mediated excision of Nematostella brachyury disrupts endoderm development, pharynx formation and oral-aboral patterning

    PubMed Central

    Steinworth, Bailey; Simmons, David

    2017-01-01

    ABSTRACT The mesoderm is a key novelty in animal evolution, although we understand little of how the mesoderm arose. brachyury, the founding member of the T-box gene family, is a key gene in chordate mesoderm development. However, the brachyury gene was present in the common ancestor of fungi and animals long before mesoderm appeared. To explore ancestral roles of brachyury prior to the evolution of definitive mesoderm, we excised the gene using CRISPR/Cas9 in the diploblastic cnidarian Nematostella vectensis. Nvbrachyury is normally expressed in precursors of the pharynx, which separates endoderm from ectoderm. In knockout embryos, the pharynx does not form, embryos fail to elongate, and endoderm organization, ectodermal cell polarity and patterning along the oral-aboral axis are disrupted. Expression of many genes both inside and outside the Nvbrachyury expression domain is affected, including downregulation of Wnt genes at the oral pole. Our results point to an ancient role for brachyury in morphogenesis, cell polarity and the patterning of both ectodermal and endodermal derivatives along the primary body axis. PMID:28705897

  7. High-Resolution Manometry Evaluation of the Pharynx and Upper Esophageal Sphincter Motility in Patients with Achalasia.

    PubMed

    Menezes, Mariano A; Herbella, Fernando A M; Patti, Marco G

    2015-10-01

    The motility of the pharynx and upper esophageal sphincter (UES) is still poorly understood. It is also unclear if the motility of this area may be compromised in patients with achalasia. This study aims to evaluate the motility of the pharynx, UES, and proximal esophagus in patients with esophageal achalasia. Sixty patients with achalasia underwent high-resolution manometry (HRM) (52 % females, mean age 54 years). Esophageal dilatation was classified according to the radiologic diameter in Type I (<4 cm): 6 %; Type II (4-7 cm): 36 %; Type III (7-10 cm): 34 %; and Type IV (>10 cm): 24 %. HRM classified 43 % of the patients as Chicago Type I and 57 % as Type II. Manometric parameters were compared to normal values obtained from a previous study in volunteers. The motility of the velopharynx showed short, premature, and hypertonic contraction. The epiglottis also showed hypertonic contraction. The UES had increased residual pressure. Chicago classification Type II patients had higher UES residual pressure (p = 0.03). The degree of esophageal dilatation did not correlate with manometric parameters. Achalasia may affect the motility of the pharyngo-upper esophageal area. The changes observed may represent functional alterations to prevent aspiration, especially in patients with Chicago classification Type II achalasia.

  8. Cas9-mediated excision of Nematostella brachyury disrupts endoderm development, pharynx formation and oral-aboral patterning.

    PubMed

    Servetnick, Marc D; Steinworth, Bailey; Babonis, Leslie S; Simmons, David; Salinas-Saavedra, Miguel; Martindale, Mark Q

    2017-08-15

    The mesoderm is a key novelty in animal evolution, although we understand little of how the mesoderm arose. brachyury, the founding member of the T-box gene family, is a key gene in chordate mesoderm development. However, the brachyury gene was present in the common ancestor of fungi and animals long before mesoderm appeared. To explore ancestral roles of brachyury prior to the evolution of definitive mesoderm, we excised the gene using CRISPR/Cas9 in the diploblastic cnidarian Nematostella vectensisNvbrachyury is normally expressed in precursors of the pharynx, which separates endoderm from ectoderm. In knockout embryos, the pharynx does not form, embryos fail to elongate, and endoderm organization, ectodermal cell polarity and patterning along the oral-aboral axis are disrupted. Expression of many genes both inside and outside the Nvbrachyury expression domain is affected, including downregulation of Wnt genes at the oral pole. Our results point to an ancient role for brachyury in morphogenesis, cell polarity and the patterning of both ectodermal and endodermal derivatives along the primary body axis. © 2017. Published by The Company of Biologists Ltd.

  9. Utility and stability of transnasal endoscopy for examination of the pharynx - a prospective study and comparison with transoral endoscopy.

    PubMed

    Tsuboi, Masaru; Arai, Makoto; Maruoka, Daisuke; Matsumura, Tomoaki; Nakagawa, Tomoo; Katsuno, Tatsuro; Yokosuka, Osamu

    2013-01-01

    Transnasal endoscopy may be used to observe the head and neck part readily without excessive reflexes. We aimed to evaluate the utility and stability of transnasal esophagogastroduodenoscopy (TN-EGD) in comparison with transoral EGD (TO-EGD) for observation of the pharynx. Prospective study A total of 497 patients received unsedated TN-EGD with a 5.5 mm diameter endoscope or unsedated TO-EGD with endoscopes of 6.5 mm, 7.9 mm and 9.2 mm diameter. The rate of completion of pharyngeal observation and numbers of gag reflexes and cough reflexes were recorded. TN-EGD was performed in 175 patients and TO-EGD was performed in 322 patients. Pharyngeal observation was completed in 173 patients (98.9%) in the TN-EGD group and 235 patients (73.2%) in the TO-EGD group, a significant difference (p<0.001). The TN-EGD group had a low rate of occurrence of gag reflex (0.57%), in contrast, 28.3% of the TO-EGD group had a gag reflex, a significant difference (p<0.01). Multivariable analyses revealed that the use of TN-EGD was the only predictive factor for completion of pharyngeal observation (p<0.0001). TN-EGD is ideally suited to observation of the pharynx by unsedated EGD.

  10. Gross morphology of the intra-oral rhamphotheca, oropharynx and proximal oesophagus of the emu (Dromaius novaehollandiae).

    PubMed

    Crole, M R; Soley, J T

    2010-06-01

    Information on the gross morphology of the upper digestive tract of ratites is sparse. This is an important region considering that it is the first area for food selection and intake which is vital to the nutrition and growth of the animal and therefore its commercial viability. Twenty-three heads from sub-adult (12-14 months) emus were used to provide a definitive description of the oropharynx and proximal oesophagus. Besides supplying baseline morphological data of veterinary importance, this study also underlines the functional importance of this region. The mandibular and maxillary nails, and serrations on the rostral mandibular tomia, provide the emu with a formidable combination of gripping, tearing and pecking power. The folded oropharyngeal floor allows distention of the dorso-ventrally flattened cavity during eating and drinking. The laryngeal mound performs both respiratory and digestive functions, whereas the distensible proximal oesophagus supports the particular feeding method employed by ratites.

  11. Organe der Osmoregulation und Exkretion

    NASA Astrophysics Data System (ADS)

    Møbjerg, Nadja

    Die meisten Schädeltiere sind in der Lage, die Wasser- und Ionenkonzentration ihres Innenmilieus zu regulieren, sind also im Hinblick auf ihren Ionenhaushalt weitgehend unabhängig von der Umgebung. Sie halten die Konzentration von Wasser und anorganischen Ionen in ihren Körperflüssigkeiten (interstitielle Flüssigkeit und Blut) innerhalb enger Grenzen konstant (Osmoregulierer). Schleim aale (Myxinoida) können zwar die Konzentration einzelner anorganischer Ionen regulieren, sind aber insgesamt der hohen Osmolarität des Meerwassers angepasst, also isoosmostisch zu diesem. Isoosmotisch oder leic ht hyperosmostisch zur Umgebung sind auch marine Neoselachier und Latimeria chalumnae (Actinistia), die dazu organische Osmolyte (Harnstoff und Trimethylaminoxid) im Blut akkumulieren (Osmokonformer). Bei anderen aquatischen Schädeltieren sind die Körperflüssigkeiten zur Umgebung hypoosmotisch (im Meerwasser) — sie halten Wasser zurück und scheiden anorganiche Ionen aus — oder hyperosmotisch (im Süßwasser), indem sie Wasser abgeben und anorganische Ionen aufnehmen.

  12. Beschallungstechnik, Beschallungsplanung und Simulation

    NASA Astrophysics Data System (ADS)

    Ahnert, Wolfgang; Goertz, Anselm

    Die primäre Aufgabe einer Lautsprecheranlage ist es, Musik, Sprache oder auch Signaltöne und Geräusche wiederzugeben. Diese können von einem Tonträger kommen (CD, Sprachspeicher), von einem anderen Ort übertragen (Zuspielung über Radio, TV, Telefon) oder vor Ort erzeugt werden. Letzteres umfasst Konzerte, Ansprachen, Durchsagen oder künstlerische Darbietungen, bei denen es meist darum geht, eine bereits vorhandene Quelle einer größeren oder weiter verteilten Anzahl von Personen zugänglich zu machen.

  13. Gross anatomical features of the gastrointestinal tract (GIT) of blue-and-yellow macaws (Ara ararauna) - oesophagus to cloaca.

    PubMed

    Aizawa, J; Tivane, C; Rodrigues, M N; Wagner, P G; Campos, D B; Guerra, R R; Miglino, M A

    2013-12-01

    Morphological studies of the gastrointestinal tract of blue-and-yellow macaws (Ara ararauna) are scarce. In view of the paucity of information regarding the digestive tract of macaws, this study aims to describe the gross anatomical features (oesophagus to cloaca) as part of a broad study of the gastrointestinal tract (GIT) of these birds. Three animals (two males and one female) adult macaws were anatomically dissected from the oropharynx to the cloaca to expose the GIT. The oesophagus was identified as a muscle-membranous tube continuous with the crop, which was intimately attached to the skin. The internal longitudinal folds of the cervical oesophagus were sparser cranial to the crop and less evident compared to the portion caudal to the crop. The duodenum began in the pylorus and was grey-coloured exhibiting a large lumen. The jejunum was formed by loops in a spiral-fashion model supported by mesojejunum. The ileum was also composed by small loops and was continuous with the colo-rectum forming the large intestine, because the caeca were absent. The large intestine was short, median in position, suspended in the dorsal wall of the abdominal cavity by mesentery and ended in the cloaca. The GIT was similar to the basic patterns in birds, in general, and also presented new unreported morphological data that might be important when studying nutrition and health of the macaws.

  14. The immunophenotypic relationship between the submucosal gland unit, columnar metaplasia and squamous islands in the columnar-lined oesophagus.

    PubMed

    Lörinc, Ester; Mellblom, Lennart; Öberg, Stefan

    2015-12-01

    To characterize the immunophenotypic relationship between the squamous and the glandular compartments in the oesophagus of patients with columnar-lined oesophagus (CLO). Eight tissue blocks from three oesophageal resection specimens from patients who underwent oesophagectomy for adenocarcinoma of the oesophagus were selected for immunohistochemical analysis. The markers of intestinal differentiation [CK20, CDX2 and MUC2] were all expressed in the expected pattern, solely in the glandular compartment of the resection specimens. CK4, CK17 and lysozyme were expressed in both the glandular and the squamous compartments. In addition, CK17 expression was found on both the squamous and glandular margins of the squamocolumnar transformation zones and in the submucosal gland (SMG) intraglandular and excretory ducts. There is an immunophenotypic relationship between the squamous and the glandular compartments of the CLO, with expression of lysozyme, CK4 and CK17 in both squamous and columnar cells. These overlapping immunophenotypes indicate similar differentiation paths, and link the SMG unit with the columnar metaplasia and the neosquamous islands in CLO. Our findings support the theory of a cellular origin of CLO and neosquamous islands from the SMG unit. © 2015 John Wiley & Sons Ltd.

  15. Isolation and sequencing of the cDNA of a novel cytochrome P450 from rat oesophagus.

    PubMed

    Brookman-Amissah, N; Mackay, A G; Swann, P F

    2001-01-01

    RT-PCR was used to find whether cytochromes P450 of the 2A, 2B and 2E sub-families are expressed in the rat oesophagus. This showed that this tissue expresses a previously unknown member of the CYP2B sub-family, now designated CYP2B21. Using a combination of 5'- and 3'-RACE (rapid amplification of cDNA ends) and library screening, the cDNA was amplified and sequenced. The cDNA sequence (GenBank accession no. AF159245) covers the whole of the coding region and the whole of the 3'-untranslated region (UTR), but only 17 nt of the 5'-UTR. The DNA sequence has strong similarity to those of CYP2B1 and CYP2B2, with the derived amino acid sequence being 84 and 83% identical, respectively. The ease with which this cDNA was found in the cDNA library suggests that CYP2B21 is a major P450 of the oesophagus. The catalytic activity of this new CYP2B is not yet known, but as previous authors have reported that other members of this sub-family (CYP2B1 or 2B2) metabolize the selective oesophageal carcinogen N:-nitrosomethylbutylamine with the chemical selectivity necessary for carcinogenesis, i.e. they preferentially hydroxylate the alpha-carbon of the butyl chain, this new CYP2B may be the nitrosamine-activating enzyme of the oesophagus.

  16. Long-term proton pump induced hypergastrinaemia does induce lineage-specific restitution but not clonal expansion in benign Barrett's oesophagus in vivo.

    PubMed

    Obszynska, Jolanta A; Atherfold, Paul A; Nanji, Manoj; Glancy, Deborah; Santander, Sonia; Graham, Trevor A; Otto, William R; West, Kevin; Harrison, Rebecca F; Jankowski, Janusz A Z

    2010-02-01

    Barrett's oesophagus is a common premalignant lesion caused partly by acid reflux. Although the requisite therapy, proton pump inhibitors (PPIs), have been implicated in the progression of Barrett's oesophagus in animal models, harmful effects of prolonged PPI therapy in Barrett's oesophagus is both inconclusive and controversial. We therefore aimed to test the role of PPI-induced hypergastrinaemia in vitro and see whether any biological parameters were useful surrogates of long-term therapy in man. We undertook detailed serological and tissue assessment of gastrin and CCK(2) receptors in 90 patients randomised to different doses of PPI therapy during a detailed 2-year follow-up. We also undertook a comprehensive study of cell models to study the consequential biological effects of gastrin on the mucosa. Gastrin and its cognate receptor CCK(2)R were expressed highest in the stomach, then less in Barrett's oesophagus and least in squamous oesophagus (SqE) (n=20 paired t-test, p<0.01). Analysis of the change in Barrett's oesophagus segment length change in 70 patients who were randomised to high or low PPI dose showed no difference over 2 years (n=70 t-test, p=0.8). Prolonged PPI use did, however, increase the serum gastrin, (36 pg/ml+/-57 pg/ml to 103 pg/ml+/-94 pg/ml (paired t test, p<0.05)). In vitro gastrin also induced changes in OE33(E)(cckr) Barrett's oesophagus cells, but not OE21(E)(cckr) squamous cells, transfected with CCK(2)R; migration was induced by 1 ng/ml of gastrin but proliferation only increased with 100 ng/ml (paired t-test, p<0.01) and both were abolished by antagonists. While the short-term effects of gastrin enhance epithelial restitution in Barrett's oesophagus (but not squamous mucosa) there is no clinical evidence that Barrett's oesophagus length expands over time. This study, which is the largest and longest term randomised controlled trial of gastrin biology in Barrett's oesophagus, is further proof of the clinical safety of PPI therapy.

  17. Der Forschungsflughafen und das Institut fuer Luft- und Raumfahrtsysteme

    DTIC Science & Technology

    2007-11-02

    Forschungsflughafen Aerodata Deutsches Zentrum für Luft- und Raumfahrt DLR VW Air Services TU Braunschweig Luftfahrt-Bundesamt LBA Deutscher Aeroclub... Aerodata - Weltmarktführer für Flight Inspection Systeme Flight Inspection - Flugvermessung

  18. The effects of lung resection on physiological motor activity of the oesophagus.

    PubMed

    Fiorelli, Alfonso; Vicidomini, Giovanni; Milione, Roberta; Grassi, Roberto; Rotondo, Antonio; Santini, Mario

    2013-08-01

    To assess the modifications of oesophageal function after major lung resection and whether these modifications are correlated with the extent of resection (pneumonectomy vs others). In the last 5 years, 40 consecutive surgical patients with lung cancer were prospectively enrolled and divided in two groups: Group A (n = 20) patients scheduled for elective pneumonectomy and Group B (n = 20) for more limited resections (lobectomy or bilobectomy). In addition to routine evaluations, all patients underwent preoperative (within 5 days) and postoperative (6 months) oesophageal manometry to assess the lower oesophageal sphincter (LES), the oesophageal body and the upper oesophageal sphincter functions. Symptoms scoring questionnaires were recorded for each patient and the oesophageal dislocation assessed by radiological examinations. Thirty-three (15 of Group A and 18 of Group B) patients completed the study. After operation, we found that LES resting pressure was significantly lower in Group A compared with Group B (P = 0.01); conversely, the relaxing pressure resulted as being higher in Group A than in Group B (P = 0.01). In Group A compared with Group B, a significant reduction of amplitude and that of wave duration of oesophageal contractions were seen at the upper (0.0001 and 0.02, respectively), middle (0.0003 and 0.002, respectively) and lower (0.0001 and 0.0004, respectively) oesophageal body. In addition, 12 of 15 (80%) patients of Group A and 3 of 18 (17%) of Group B presented a lack of regular peristaltic movement (P = 0.001). Despite chest CT scan showing a shift of the oesophagus in 11 of 15 (73%) and 2 of 18 (11.1%) patients of Groups A and B (P = 0.001), the oesophagus dislocation resulted 'severe' on barium swallow study in only two patients of Group A. The manometric alterations were subclinical; heartburn was recorded in three patients (two of Group A and one of Group B) and epigastric pain in four (two for each group). No other symptoms were observed

  19. Entwicklung und Formulierung der Unternehmensstrategie

    NASA Astrophysics Data System (ADS)

    Crespo, Isabel; Bergmann, Lars; Lacker, Thomas

    Ursprünglich stammt der Begriff "Strategie“ aus dem Altgriechischen: "strategos“ bedeutete "Heer“, "Heeresmacht“ und damit auch "konzentrierte Kraft“; das Wort "agein“ bedeutete "tun, machen, treiben“. Ein Stratege war also eine Person, die ein Heer führte und damit Kraft, Macht und Stärke konzentrierte und einsetzen konnte. Strategie bezeichnete dementsprechend die Maßnahmen, die in dieser Funktion entwickelt wurden. Daher ist es leicht verständlich, dass der Begriff Strategie bis in die Mitte des letzten Jahrhunderts in erster Linie militärisch verstanden wurde. Anschließend wurde der Begriff in weiteren Bereichen, wie beispielsweise der Unternehmensführung, verwendet. Im betriebswirtschaftlichen Sinne bedeutet der Begriff Strategie die langfristig geplante Verhaltensweise eines Unternehmens zur Erreichung seiner Ziele.

  20. Grundlagen und Grundbegriffe der Messtechnik

    NASA Astrophysics Data System (ADS)

    Plaßmann, Wilfried

    Es ist eine wesentliche Aufgabe der Messtechnik, technische Vorgänge quantitativ zu erfassen und anhand der gemessenen Größen Funktionsabläufe zu steuern. Als Beispiel sei ein Kraftwerk zur Energieerzeugung genannt, bei dem nur über die Messung von Temperaturen, Leistungen, Drücken und anderen Größen Aussagen über den momentanen Zustand möglich sind und bei Abweichungen vom Sollwert geeignete Eingriffe in das System erfolgen können. Damit eine eindeutige Kommunikation möglich wird, sind die in der Messtechnik verwendeten Begriffe, Messverfahren und Maßeinheiten in entsprechenden Normen oder Vorschriften festgelegt.

  1. Loss of human leucocyte antigen class I and gain of class II expression are early events in carcinogenesis: clues from a study of Barrett's oesophagus.

    PubMed

    Rajendra, S; Ackroyd, R; Karim, N; Mohan, C; Ho, J J; Kutty, M K

    2006-09-01

    Human leucocyte antigen (HLA) expression is altered in oesophageal carcinomas compared with normal tissue. It is unclear, however, whether this phenotype precedes malignant transformation or results as a consequence of it. To investigate HLA class I and II expression in Barrett's oesophagus and normal squamous oesophageal tissue. Asian patients with Barrett's oesophagus (n = 64) and a control group (n = 60) with a normal oesophagus but without reflux symptoms were recruited using endoscopic and histopathological criteria. Tissue samples were stained with monoclonal antibodies specific for HLA-ABC, HLA-DR alpha chain or HLA-DP/DQ/DR, and scored semiquantitatively. The results of immunohistochemical staining were correlated with clinical and histopathological characteristics of patients. Marked expression of HLA-ABC was observed in 50% of Barrett's oesophagus sections as compared with 68.3% of controls (p = 0.038). HLA-DR staining was seen in 51.6% of Barrett's oesophagus samples versus 11.7% of controls (p<0.001). Expression of HLA-DP/DQ/DR was evident in 73.4% of oesophageal intestinal metaplasia tissue as opposed to 18.3% of controls (p<0.001). Importantly, a total loss of HLA-ABC and a concomitant gain of HLA-DP/DQ/DR expression were seen in 37.5% of patients with Barrett's oesophagus but in none of the controls (p<0.001). Interestingly, this phenotype was associated positively with dysplasia (adjusted p, p* = 0.031) but negatively with non-steroidal anti-inflammatory drug use (p* = 0.004). HLA class I expression is down regulated and class II expression is up regulated in Barrett's oesophagus. As these changes predate malignant transformation, altered major histocompatibility complex expression may be a key event in disease progression, possibly in facilitating evasion from immune surveillance.

  2. Bile acids in combination with low pH induce oxidative stress and oxidative DNA damage: relevance to the pathogenesis of Barrett's oesophagus.

    PubMed

    Dvorak, Katerina; Payne, Claire M; Chavarria, Melissa; Ramsey, Lois; Dvorakova, Barbora; Bernstein, Harris; Holubec, Hana; Sampliner, Richard E; Guy, Naihsuan; Condon, Amanda; Bernstein, Carol; Green, Sylvan B; Prasad, Anil; Garewal, Harinder S

    2007-06-01

    Barrett's oesophagus is a premalignant condition associated with an increased risk for the development of oesophageal adenocarcinoma (ADCA). Previous studies indicated that oxidative damage contributes to the development of ADCA. To test the hypothesis that bile acids and gastric acid, two components of refluxate, can induce oxidative stress and oxidative DNA damage. Oxidative stress was evaluated by staining Barrett's oesophagus tissues with different degrees of dysplasia with 8-hydroxy-deoxyguanosine (8-OH-dG) antibody. The levels of 8-OH-dG were also evaluated ex vivo in Barrett's oesophagus tissues incubated for 10 min with control medium and medium acidified to pH 4 and supplemented with 0.5 mM bile acid cocktail. Furthermore, three oesophageal cell lines (Seg-1 cells, Barrett's oesophagus cells and HET-1A cells) were exposed to control media, media containing 0.1 mM bile acid cocktail, media acidified to pH 4, and media at pH 4 supplemented with 0.1 mM bile acid cocktail, and evaluated for induction of reactive oxygen species (ROS). Immunohistochemical analysis showed that 8-OH-dG is formed mainly in the epithelial cells in dysplastic Barrett's oesophagus. Importantly, incubation of Barrett's oesophagus tissues with the combination of bile acid cocktail and acid leads to increased formation of 8-OH-dG. An increase in ROS in oesophageal cells was detected after exposure to pH 4 and bile acid cocktail. Oxidative stress and oxidative DNA damage can be induced in oesophageal tissues and cells by short exposures to bile acids and low pH. These alterations may underlie the development of Barrett's oesophagus and tumour progression.

  3. Genome-wide association studies in oesophageal adenocarcinoma and Barrett's oesophagus: a large-scale meta-analysis.

    PubMed

    Gharahkhani, Puya; Fitzgerald, Rebecca C; Vaughan, Thomas L; Palles, Claire; Gockel, Ines; Tomlinson, Ian; Buas, Matthew F; May, Andrea; Gerges, Christian; Anders, Mario; Becker, Jessica; Kreuser, Nicole; Noder, Tania; Venerito, Marino; Veits, Lothar; Schmidt, Thomas; Manner, Hendrik; Schmidt, Claudia; Hess, Timo; Böhmer, Anne C; Izbicki, Jakob R; Hölscher, Arnulf H; Lang, Hauke; Lorenz, Dietmar; Schumacher, Brigitte; Hackelsberger, Andreas; Mayershofer, Rupert; Pech, Oliver; Vashist, Yogesh; Ott, Katja; Vieth, Michael; Weismüller, Josef; Nöthen, Markus M; Attwood, Stephen; Barr, Hugh; Chegwidden, Laura; de Caestecker, John; Harrison, Rebecca; Love, Sharon B; MacDonald, David; Moayyedi, Paul; Prenen, Hans; Watson, R G Peter; Iyer, Prasad G; Anderson, Lesley A; Bernstein, Leslie; Chow, Wong-Ho; Hardie, Laura J; Lagergren, Jesper; Liu, Geoffrey; Risch, Harvey A; Wu, Anna H; Ye, Weimin; Bird, Nigel C; Shaheen, Nicholas J; Gammon, Marilie D; Corley, Douglas A; Caldas, Carlos; Moebus, Susanne; Knapp, Michael; Peters, Wilbert H M; Neuhaus, Horst; Rösch, Thomas; Ell, Christian; MacGregor, Stuart; Pharoah, Paul; Whiteman, David C; Jankowski, Janusz; Schumacher, Johannes

    2016-10-01

    Oesophageal adenocarcinoma represents one of the fastest rising cancers in high-income countries. Barrett's oesophagus is the premalignant precursor of oesophageal adenocarcinoma. However, only a few patients with Barrett's oesophagus develop adenocarcinoma, which complicates clinical management in the absence of valid predictors. Within an international consortium investigating the genetics of Barrett's oesophagus and oesophageal adenocarcinoma, we aimed to identify novel genetic risk variants for the development of Barrett's oesophagus and oesophageal adenocarcinoma. We did a meta-analysis of all genome-wide association studies of Barrett's oesophagus and oesophageal adenocarcinoma available in PubMed up to Feb 29, 2016; all patients were of European ancestry and disease was confirmed histopathologically. All participants were from four separate studies within Europe, North America, and Australia and were genotyped on high-density single nucleotide polymorphism (SNP) arrays. Meta-analysis was done with a fixed-effects inverse variance-weighting approach and with a standard genome-wide significance threshold (p<5 × 10(-8)). We also did an association analysis after reweighting of loci with an approach that investigates annotation enrichment among genome-wide significant loci. Furthermore, the entire dataset was analysed with bioinformatics approaches-including functional annotation databases and gene-based and pathway-based methods-to identify pathophysiologically relevant cellular mechanisms. Our sample comprised 6167 patients with Barrett's oesophagus and 4112 individuals with oesophageal adenocarcinoma, in addition to 17 159 representative controls from four genome-wide association studies in Europe, North America, and Australia. We identified eight new risk loci associated with either Barrett's oesophagus or oesophageal adenocarcinoma, within or near the genes CFTR (rs17451754; p=4·8 × 10(-10)), MSRA (rs17749155; p=5·2 × 10(-10)), LINC00208

  4. Barrett's oesophagus: effect of antireflux surgery on symptom control and development of complications.

    PubMed

    Attwood, S E; Barlow, A P; Norris, T L; Watson, A

    1992-10-01

    Forty-five patients with histologically proven Barrett's columnar-lined oesophagus (CLO) were treated in one unit over a 9-year period. Patients were studied prospectively as part of a surveillance programme; all initially received standard conservative treatment including high-dose H2-receptor antagonists. A satisfactory initial response was seen in 21 patients, but in 24 the symptoms were unchanged or progressed; 19 patients in the latter group were considered suitable for antireflux surgery and underwent fundoplication. Symptoms of heartburn or dysphagia persisted or recurred in 88 per cent of patients receiving medical treatment alone and complications developed in 38 per cent, including nine strictures and one adenocarcinoma. In patients undergoing antireflux surgery, symptoms persisted or recurred in 21 per cent and complications developed in 16 per cent (P < 0.01). Complete regression of Barrett's CLO occurred in two patients (11 per cent) after antireflux surgery. The results of this study suggest the superiority of antireflux surgery over pharmacological acid suppression in the control of symptoms and prevention of complications in patients with Barrett's CLO.

  5. Barrett's Oesophagus in an Achalasia Patient: Immunological Analysis and Comparison with a Group of Achalasia Patients

    PubMed Central

    Torres-Landa, Samuel; Coss-Adame, Enrique; Valdovinos, Miguel A.; Alejandro-Medrano, Edgar; Ramos-Ávalos, Bárbara; Martínez-Benítez, Braulio

    2016-01-01

    The aim of the study was to characterize the presence of diverse CD4 and CD8 T cell subsets and regulatory cells in peripheral blood and lower oesophageal sphincter (LES) from a young patient with BE/achalasia without treatment versus achalasia group. In order to characterize the circulating cells in this patient, a cytometric analysis was performed. LES tissue was evaluated by double-immunostaining procedure. Five healthy blood donors, 5 type achalasia patients, and 5 oesophagus tissue samples (gastrooesophageal junction) from transplant donors were included as control groups. A conspicuous systemic inflammation was determined in BE/achalasia patient and achalasia versus healthy volunteer group. Nonetheless, a predominance of Th22, Th2, IFN-α-producing T cells, Tregs, Bregs, and pDCregs was observed in BE/achalasia patient versus achalasia group. A low percentage of Th1 subset in BE/achalasia versus achalasia group was determined. A noticeable increase in tissue of Th22, Th17, Th2, Tregs, Bregs, and pDCregs was observed in BE/achalasia versus achalasia group. Th1 subset was lower in the BE/achalasia patient versus achalasia group. This study suggests that inflammation is a possible factor in the pathogenesis of BE/achalasia. Further research needs to be performed to understand the specific cause of the correlation between BE and achalasia. PMID:27752370

  6. Hyperplasia of the submucosal glands of the columnar-lined oesophagus.

    PubMed

    Lörinc, Ester; Öberg, Stefan

    2015-04-01

    To evaluate the presence of multi-layered epithelium (ME) and to compare the distribution, size and morphology of the oesophageal submucosal glands (SMG) beneath reflux exposed metaplastic columnar mucosa with those of normal squamous epithelium in patients with columnar-lined oesophagus (CLO). In eight oesophageal resection specimens, the SMG of the metaplastic segments were significantly larger than those in the squamous segments of patients with CLO (0.81 versus 0.56 mm(2) , P = <0.001). There was an accumulation of SMG close to the neosquamocolumnar junction (NSCJ), as indicated by a higher median frequency of SMG (0.080 SMG/mm) compared with that of the squamous (0.013 SMG/mm) and metaplastic segments (0.031 SMG/mm) (P = 0.022). The frequency of ME was significantly higher in the metaplastic compared with the normal squamous segments (1/158 mm and 1/341 mm, respectively, P = 0.028) and ME was found almost exclusively (96%) in direct connection with the excretory ducts of SMG. Hyperplasia of SMG in the metaplastic segment, accumulation of SMG near the NSCJ, the presence of ME in connection with the excretory ducts of SMG and metaplasia are all reflux-induced morphological changes, possibly induced by stimulation of progenitors in the excretory ducts of the SMG. © 2014 John Wiley & Sons Ltd.

  7. The changing role of the pathologist in the management of Barrett's oesophagus.

    PubMed

    Hopcroft, Suzanne A; Shepherd, Neil A

    2014-10-01

    Pathological specimens from columnar-lined oesophagus (CLO) comprise a considerable proportion of the workload of gastrointestinal pathologists in Western countries. There remain controversies concerning the diagnostic role of pathology. More recently, in the UK at least, the diagnosis has been regarded as primarily an endoscopic endeavour, with pathology being corroborative and only diagnostic when endoscopic features are equivocal or when there are additional features that make the endoscopic diagnosis unclear. There is also recognition that demonstration of intestinalisation or 'goblet cells' is not paramount, and should not be required for the diagnosis. There have been notable changes in the management of CLO neoplasia: pathologists are centrally involved in its management. Pathological assessment of endoscopic mucosal resection (EMR) specimens provides the most useful means of determining the management of early neoplasia and of determining indications for surgery. This represents an extraordinarily rapid change in management, in that, <10 years ago, laborious Seattle-type biopsy protocols were recommended, and high grade dysplasia was an indication for resectional surgery. Now, individual patient management is paramount: multi-professional meetings determine management after biopsy and EMR assessment. One significant change is that major resections are undertaken less often, in Western countries, for CLO neoplasia. © 2014 John Wiley & Sons Ltd.

  8. Absence of cardiovascular autonomic dysfunction and vagal pancreatic impairment in idiopathic achalasia of the oesophagus.

    PubMed

    Herreros, B; Ascaso, J F; Mora, F; Costa, A J; Sanchiz, V; Minguez, M; Benages, A

    2007-08-01

    Extra-oesophageal autonomic dysfunction in idiopathic achalasia is not well documented, due to contradictory results reported. We aimed to study the cardiovascular and pancreatic autonomic function in patients with idiopathic achalasia. Thirty patients with idiopathic achalasia (16M/14F; 34.5 +/- 10.8 years) and 30 healthy volunteers (13M/17F; 34.8 +/- 10.7 years) were prospectively studied. Age >60 years and conditions affecting results of autonomic evaluation were excluded. Both groups underwent the sham feeding test and plasmatic levels of pancreatic polypeptide (PP) were determined by radioimmunoassay (basal, at 5, 10, 20 and 30 min). Cardiovascular parasympathetic (deep breathing, standing, Valsalva) and sympathetic function (postural decrease of systolic blood pressure, Handgrip test) were assessed. Statistical comparison of basal and increase levels of PP and parasympathetic/sympathetic cardiovascular parameters was performed between groups. Basal levels of PP were similar in controls and patients and maximum increase of PP during sham feeding test. A similar rate of abnormal cardiovascular tests was found between groups (P > 0.05). E/I ratio was the mostly impaired parameter (patients: 36.7% vs controls: 20%, P = 0.15, chi-squared test). Autonomic cardiovascular tests and pancreatic response to vagal stimulus are not impaired in patients with primary achalasia of the oesophagus.

  9. Rapid infrared mapping for highly accurate automated histology in Barrett's oesophagus.

    PubMed

    Old, O J; Lloyd, G R; Nallala, J; Isabelle, M; Almond, L M; Shepherd, N A; Kendall, C A; Shore, A C; Barr, H; Stone, N

    2016-10-07

    Barrett's oesophagus (BE) is a premalignant condition that can progress to oesophageal adenocarcinoma. Endoscopic surveillance aims to identify potential progression at an early, treatable stage, but generates large numbers of tissue biopsies. Fourier transform infrared (FTIR) mapping was used to develop an automated histology tool for detection of BE and Barrett's neoplasia in tissue biopsies. 22 oesophageal tissue samples were collected from 19 patients. Contiguous frozen tissue sections were taken for pathology review and FTIR imaging. 45 mid-IR images were measured on an Agilent 620 FTIR microscope with an Agilent 670 spectrometer. Each image covering a 140 μm × 140 μm region was measured in 5 minutes, using a 1.1 μm(2) pixel size and 64 scans per pixel. Principal component fed linear discriminant analysis was used to build classification models based on spectral differences, which were then tested using leave-one-sample-out cross validation. Key biochemical differences were identified by their spectral signatures: high glycogen content was seen in normal squamous (NSQ) tissue, high glycoprotein content was observed in glandular BE tissue, and high DNA content in dysplasia/adenocarcinoma samples. Classification of normal squamous samples versus 'abnormal' samples (any stage of Barrett's) was performed with 100% sensitivity and specificity. Neoplastic Barrett's (dysplasia or adenocarcinoma) was identified with 95.6% sensitivity and 86.4% specificity. Highly accurate pathology classification can be achieved with FTIR measurement of frozen tissue sections in a clinically applicable timeframe.

  10. An anthropomorphic tissue-mimicking phantom of the oesophagus for endoscopic ultrasound.

    PubMed

    Inglis, Scott; Ramnarine, Kumar V; Plevris, John N; McDicken, W Norman

    2006-02-01

    This study details the design and construct of an anthropomorphic phantom of the oesophagus suitable for use with endoscopic ultrasound (EUS) and 3-D volume measurements. The phantom was constructed using agar-based tissue-mimicking material (TMM) of different acoustical properties to simulate various anatomical and pathologic features. The acoustical properties were measured with a scanning acoustical macroscope. An Olympus GF-UM200 echo-endoscope and digital position measurement arm were used to scan the phantom at 7.5 and 12 MHz. Comparative dimensional measurements were performed on the phantom via 2-D and 3-D EUS. TMM attenuation varied between 0.1 and 0.5 dB/cm.MHz. Backscatter power, relative to normal TMM, was from 0 to -12.2 dB, with an average speed of sound of 1537 +/- 1.9 m/s. Measurements of objects within the phantom by 2-D and 3-D EUS had mean errors of 8% and 2.2%, respectively. The construction of the anthropomorphic EUS phantom facilitated EUS training and research and development studies.

  11. A new species of chondracanthid copepod parasitic in the pharynx of hagfishes (Myxiniformes: Myxinidae) from off Taiwan.

    PubMed

    Cheng, Yu-Rong; Luo, Hao-Yuan; Dai, Chang-Feng; Shih, Hsiu-Hui

    2014-07-01

    A new species of Acanthochondria Oakley, 1927 (Copepoda, Poecilostomatoida, Chondracanthidae), parasitic in the pharynx of hagfishes Eptatretus burgeri (Girard), E. sheni (Kuo, Huang & Mok) and E. yangi (Teng), from off Taiwan is described and illustrated. The new species can be distinguished from its congeners by having the neck region longer than wide (about 2-3 times as long as wide), the moderately long protopod of leg 2 (Type E), the endopod of leg 2 as large as exopod, the cephalosome wider than long, the armature formula of antennule (1, 1, 2, 2, 9), the relatively long trunk (6.7 mm) and egg-sacs (14.4 mm). This is the first record of a parasitic chondracanthid from hagfishes. The findings may provide insights into the phylogenetic relationships and interactions among chondracanthids, hagfishes and demersal fishes, but call for further molecular studies.

  12. Polarization dependant in vivo second harmonic generation imaging of Caenorhabditis elegans vulval, pharynx, and body wall muscles

    NASA Astrophysics Data System (ADS)

    Psilodimitrakopoulos, Sotiris; Santos, Susana; Amat-Roldan, Ivan; Mathew, Manoj; Thayil K. N., Anisha; Artigas, David; Loza-Alvarez, Pablo

    2008-02-01

    Second harmonic generation (SHG) imaging has emerged in recent years as an important laboratory imaging technique since it can provide unique structural information with submicron resolution. It enjoys the benefits of non-invasive interaction establishing this imaging modality as ideal for in vivo investigation of tissue architectures. In this study we present, polarization dependant high resolution SHG images of Caenorhabditis elegans muscles in vivo. We imaged a variety of muscular structures such as body walls, pharynx and vulva. By fitting the experimental data into a cylindrical symmetry spatial model we mapped the corresponding signal distribution of the χ (2) tensor and identified its main axis orientation for different sarcomeres of the earth worm. The cylindrical symmetry was considered to arise from the thick filaments architecture of the inside active volume. Moreover, our theoretical analysis allowed calculating the mean orientation of harmonophores (myosin helical pitch). Ultimately, we recorded and analysed vulvae muscle dynamics, where SHG signal decreased during in vivo contraction.

  13. The Caenorhabditis elegans ems class homeobox gene ceh-2 is required for M3 pharynx motoneuron function.

    PubMed

    Aspöck, Gudrun; Ruvkun, Gary; Bürglin, Thomas R

    2003-08-01

    Several homeobox genes, for example those of the ems class, play important roles in animal head development. We report on the expression pattern and function of ceh-2, the Caenorhabditis elegans ems/Emx ortholog. CEH-2 protein is restricted to the nuclei of one type of small muscle cell, one type of epithelial cell, and three types of neurons in the anterior pharynx in the head. We have generated a deletion allele of ceh-2 that removes the homeobox. Animals homozygous for this deletion are viable and fertile, but grow slightly slower and lay fewer eggs than wild type. We assayed the function of two types of pharynx neurons that express ceh-2, the pairs M3 and NSM. M3 activity is substantially reduced in electropharyngeograms of ceh-2 deletion mutants; this defect can account for the observed retardation in larval development, as M3 activity is known to be necessary for effective feeding. NSM function and metabolism are normal based on the assays used. All cells that express ceh-2 in wild type are present in the ceh-2 mutant and have normal morphologies. Therefore, unlike other ems/Emx genes, ceh-2 seems to be important for a late differentiation step and not for neuron specification or regional patterning. Because the CEH-2 homeodomain is well conserved, we tested whether ceh-2 can rescue ems(-) brain defects in Drosophila, despite the apparent differences in biological roles. We found that the C. elegans ems ortholog is able to substitute for fly ems in brain development, indicating that sequence conservation rather than conservation of biological function is important.

  14. Endoscopic findings using narrow-band imaging to distinguish between basal cell hyperplasia and carcinoma of the pharynx.

    PubMed

    Yagishita, Atsushi; Fujii, Satoshi; Yano, Tomonori; Kaneko, Kazuhiro

    2014-07-01

    Narrow-band imaging (NBI) has been reported to be useful for detecting superficial-type esophageal or head and neck squamous cell carcinoma (SCC), and in the present study we have used NBI to detect non-carcinomatous lesions, such as basal cell hyperplasia (BCH) accompanied by microvascular irregularities; these non-carcinomatous lesions were pathologically discriminated from squamous cell carcinoma of the pharynx. The aim of the present study was to clarify the endoscopic characteristics of BCH that contribute to the discrimination of superficial-type head and neck SCC (HNSCC). We examined the key endoscopic findings capable of distinguishing BCH from SCC using 26 BCH and 37 superficial-type SCC of the pharynx that had been pathologically diagnosed at our institution between January 2008 and July 2012. The clinicopathological factors were also compared. The size of the BCH lesions was significantly smaller (P < 0.001), and their intervascular transparency was more clearly observed (P < 0.001). Intra-epithelial papillary capillary loop (IPCL) shapes were less variable and monotonous (P < 0.001), and the distribution of the IPCL was more regular with an interval comparable to that of SCC (P < 0.001), although no significant differences in the sharpness of the lesion border, dilatation of IPCL and tortuosity of the IPCL were seen between the BCH and SCC lesions. This study revealed that BCH was an independent entity in terms of not only pathological findings, but also endoscopic findings observed using NBI, such as the regular distribution of IPCL and the preserved intervascular transparency. © 2014 The Authors. Cancer Science published by Wiley Publishing Asia Pty Ltd on behalf of Japanese Cancer Association.

  15. [Acupuncture in ear, nose and throat medicine: part 1: Diseases and functional disturbances in the area of the trachea, larynx, pharynx and mouth].

    PubMed

    Collins, E N

    2007-03-01

    The two parts of this article describe acupuncture-therapy in several important ear, nose and throat disorders. The first part deals with diseases and functional disorders of the trachea, larynx, pharynx and mouth. The possibilities and limitations of treatment by ear and body acupuncture are discussed. Connections between traditional Chinese medicine and orthodox medicine are pointed out for some diseases.

  16. Comparison of streamlined liner of the pharynx airway (SLIPA ™) and laryngeal mask airway: a systematic review and meta-analysis.

    PubMed

    Choi, G J; Kang, H; Baek, C W; Jung, Y H; Woo, Y C; Kim, S H; Kim, J G

    2015-05-01

    We performed a systematic review to compare the efficacy and safety of the streamlined liner of the pharynx airway and laryngeal mask airway used in adults during general anaesthesia. We included 14 studies with studies with 1273 patients in total. There was no evidence of a difference between the two devices in insertion success rate on the first attempt (13 studies, 1143 patients), insertion time (seven studies, 576 patients), ease of insertion (five studies, 466 patients), oropharyngeal leak pressure (eight studies, 771 patients) and the quality of the fibreoptic view of the larynx through the device (three studies, 281 patients). The relative risk (95% CI) of bloodstaining of the device (nine studies, 859 patients) was 2.09 (1.46-3.00) for the streamlined liner of the pharynx airway compared with the laryngeal mask airway. Other adverse events were comparable. Subgroup analysis suggested that the insertion by novice users might be faster and more successful with the streamlined liner of the pharynx airway than the laryngeal mask airway; however, this was from only two studies and 186 patients. The method of size selection of the streamlined liner of the pharynx airway device might also affect the speed of insertion: choosing according to the width of the patient's thyroid cartilage, rather than height, may produce better results. © 2015 The Association of Anaesthetists of Great Britain and Ireland.

  17. Welt und Wirkungsprinzip (2nd Aufl.)

    NASA Astrophysics Data System (ADS)

    Landgraf, Werner

    2010-03-01

    Modell einer kausalen Bewirkung der Welt, und logische, geometrische, physikalische Interprätation dieser Kausalmenge und Fortwirkung der frühsten ihrer sukzessiv als echt Neues bewirkten und durch Vorhandenes oder Späteres nicht darstellbaren oder widerrufbaren Ereignisse als Dimensionen und sie verkörpernde primäre Naturkräfte, mit Korrespondenz zur beobachteten Welt und ihrer grundlegendsten Eigenschaften. Wirklich ist nur was wirkt, wo und wie. Entsprechend ist im Bogenelement statt der Eigenzeit die variante Anzahl Wirkungen relevant, 0 ≈ 1/h2 dS2 - 1/tpl2 (dt2 - 1/c2 {dq12 + G02/G2 [dq2,32 - ...]}) mit G0 = c4lpl/Epl ≈ G. Die heutigen Dimensionen und Naturkräfte entstanden in dieser Reihenfolge, haben 'komplementäre' aber gleichwertige statische und dynamische Aspekte, entsprechend ihren Termen in Bogenelement bzw. Vierervektor, aus derem Vergleich sowie mit denen ihrer Nachbarn folgen Grundgleichungen bzw. Erhaltungssätze. Jeweils individuelle Eigenschaften wie ihre Naturkonstante konkretisieren sie und tragen zu gattungsmäßigen wie globale Affinität und Äquivalenzen bei. Ältestes Gebiet oder räumlicher Rand jeder Dimension sind die ersten vom Vorgänger bewirkten Ereignisse, selbst raumzeitlicher Ursprung des Nachfolgers, dort einmalig und ewig maximal rotverschoben fortwirkend und nicht lokalisierbar, um neue Elementareinheiten verschieden und lichtartig mit deren Verhältnis oder dem ihrer globalen Zustandsgrößen als konstanten Anfangsimpuls, Expansion, Längen- oder Ereignisdichte zueinander. Der Übergang vom diskreten Modell weniger Informationen zum Kontinuum und die Korrespondenz zur Physik ist problemlos, Details wie ein kontinuierlicher, abrupter oder ganz fehlender Abfall der Metrik beim ältesten Gebiet sind aber nur durch Beobachtungen entscheidbar. Erörtert werden allgemeine und individuelle Eigenschaften und ihre Konsequenzen der Dimensionen mit ihren Kräften, selbst und im Verhältnis zueinander, etwa ihrer begrenzten

  18. Unfallaufnahme und Datenerhebung

    NASA Astrophysics Data System (ADS)

    Brösdorf, Klaus-Dieter; Moser, Andreas; Burg, Jürgen

    Unfälle ereignen sich in unterschiedlichen Schweregraden. Man unterscheidet zwischen Unfälle mit nur Sachschaden und in Unfälle mit Personenschaden. Gemäß Statistik [1] machten in Deutschland im Jahr 2005 Unfälle mit Personenschaden (336.619) etwa 15 % der Gesamtanzahl der polizeilich erfassten Unfälle (2.253.992) aus. In den amtlichen Statistiken sind nur polizeilich erfasste Unfälle enthalten. Eine größere Zahl von Unfällen, insbesondere leichtere Unfälle, wird offensichtlich polizeilich nicht gemeldet. Mit den Daten der Versicherungswirtschaft wird die Anzahl der Kfz-Schäden pro Jahr in Deutschland mit 8.673.000 angegeben [2].

  19. Kernspaltung und Westintegration Beispiel österreich

    NASA Astrophysics Data System (ADS)

    Forstner, Christian

    Während des Kalten Krieges erreichte in Europa sowohl die Verflechtung physikalischer Forschung mit Staat, Politik und Industrie als auch deren öffentliche Verhandlung und Bewertung eine qualitativ neuartige Dimension. Dieser Aspekt tritt am schärfsten in der Geschichte der Kernphysik und Kerntechnik hervor.

  20. Risk stratification of Barrett's oesophagus using a non-endoscopic sampling method coupled with a biomarker panel: a cohort study.

    PubMed

    Ross-Innes, Caryn S; Chettouh, Hamza; Achilleos, Achilleas; Galeano-Dalmau, Nuria; Debiram-Beecham, Irene; MacRae, Shona; Fessas, Petros; Walker, Elaine; Varghese, Sibu; Evan, Theodore; Lao-Sirieix, Pierre S; O'Donovan, Maria; Malhotra, Shalini; Novelli, Marco; Disep, Babett; Kaye, Phillip V; Lovat, Laurence B; Haidry, Rehan; Griffin, Michael; Ragunath, Krish; Bhandari, Pradeep; Haycock, Adam; Morris, Danielle; Attwood, Stephen; Dhar, Anjan; Rees, Colin; Rutter, Matt D; Ostler, Richard; Aigret, Benoit; Sasieni, Peter D; Fitzgerald, Rebecca C

    2017-01-01

    Barrett's oesophagus predisposes to adenocarcinoma. However, most patients with Barrett's oesophagus will not progress and endoscopic surveillance is invasive, expensive, and fraught by issues of sampling bias and the subjective assessment of dysplasia. We investigated whether a non-endoscopic device, the Cytosponge, could be coupled with clinical and molecular biomarkers to identify a group of patients with low risk of progression suitable for non-endoscopic follow-up. In this multicentre cohort study (BEST2), patients with Barrett's oesophagus underwent the Cytosponge test before their surveillance endoscopy. We collected clinical and demographic data and tested Cytosponge samples for a molecular biomarker panel including three protein biomarkers (P53, c-Myc, and Aurora kinase A), two methylation markers (MYOD1 and RUNX3), glandular atypia, and TP53 mutation status. We used a multivariable logistic regression model to compute the conditional probability of dysplasia status. We selected a simple model with high classification accuracy and applied it to an independent validation cohort. The BEST2 study is registered with ISRCTN, number 12730505. The discovery cohort consisted of 468 patients with Barrett's oesophagus and intestinal metaplasia. Of these, 376 had no dysplasia and 22 had high-grade dysplasia or intramucosal adenocarcinoma. In the discovery cohort, a model with high classification accuracy consisted of glandular atypia, P53 abnormality, and Aurora kinase A positivity, and the interaction of age, waist-to-hip ratio, and length of the Barrett's oesophagus segment. 162 (35%) of 468 of patients fell into the low-risk category and the probability of being a true non-dysplastic patient was 100% (99% CI 96-100) and the probability of having high-grade dysplasia or intramucosal adenocarcinoma was 0% (0-4). 238 (51%) of participants were classified as of moderate risk; the probability of having high-grade dysplasia was 14% (9-21). 58 (12%) of participants were

  1. Acceptability of the Cytosponge procedure for detecting Barrett's oesophagus: a qualitative study

    PubMed Central

    Freeman, Madeleine; Sasieni, Peter; Smith, Samuel G

    2017-01-01

    Objective To investigate the acceptability of the Cytosponge, a novel sampling device to detect Barrett's oesophagus (BE), a precursor to oesophageal adenocarcinoma (EAC), among people with risk factors for this condition. Design A qualitative study using semistructured interviews and focus group discussions. Data were explored by three researchers using thematic analysis. Setting Community setting in London, UK. Participants A recruitment company identified 33 adults (17 men, 16 women) aged 50–69 years with gastro-oesophageal reflux disease (GERD), a risk factor for BE. The majority of participants were white British (73%). The focus groups were stratified by gender and education. 10 individuals were interviewed and 23 participated in four focus groups. Results 3 key themes emerged from the data: the anticipated physical experience, preferences for the content of information materials and comparisons with the current gold-standard test. Overall acceptability was high, but there was initial concern about the physical experience of taking the test, including swallowing and extracting the Cytosponge. These worries were reduced after handling the device and a video demonstration of the procedure. Knowledge of the relationship between GERD, BE and EAC was poor, and some suggested they would prefer not to know about the link when being offered the Cytosponge. Participants perceived the Cytosponge to be more comfortable, practical and economical than endoscopy. Conclusions These qualitative data suggest the Cytosponge was acceptable to the majority of participants with risk factors for BE, and could be used as a first-line test to investigate GERD symptoms. Concerns about the physical experience of the test were alleviated through multimedia resources. The development of patient information materials is an important next step to ensuring patients are adequately informed and reassured about the procedure. Patient stakeholders should be involved in this process to

  2. Psychosocial factors and their association with reflux oesophagitis, Barrett’s oesophagus and oesophageal adenocarcinoma

    PubMed Central

    Denver, Paul; Donnelly, Michael; Murray, Liam J; Anderson, Lesley A

    2013-01-01

    AIM: To investigate the role of psychological characteristics as risk factors for oesophageal adenocarcinoma (OAC), as well as the reflux-mediated precursor pathway. METHODS: An all-Ireland population-based case-control study recruited 230 reflux oesophagitis (RO), 224 Barrett’s oesophagus (BO) and 227 OAC patients and 260 controls. Each case/control group completed measures of stress, depression, self-efficacy, self-esteem, repression and social support. A comparative analysis was undertaken using polytomous logistic regression adjusted for potential confounders. RESULTS: Compared to controls, OAC patients were almost half as likely to report high stress levels over their lifetime (P = 0.010, OR 0.51; 95%CI: 0.29-0.90) and 36% less likely to report having experienced depression (OR 0.64; 95%CI: 0.42-0.98). RO patients reported significantly higher stress than controls particularly during middle- and senior-years (P for trends < 0.001). RO patients were 37% less likely to report having been highly emotionally repressed (OR 0.63; 95%CI: 0.41-0.95). All case groups (OAC, RO and BO) were more likely than controls to report having had substantial amounts of social support (OR 2.84; 95%CI: 1.63-4.97; OR 1.97; 95%CI: 1.13-3.44 and OR 1.83; 95%CI: 1.03-3.24, respectively). CONCLUSION: The improved psychological profile of OAC patients may be explained by response shift. The role of psychological factors in the development of OAC requires further investigation. PMID:23555165

  3. Total body fat and the risk of Barrett's oesophagus - a bioelectrical impedance study.

    PubMed

    Kendall, Bradley J; Macdonald, Graeme A; Prins, Johannes B; O'Brien, Suzanne; Whiteman, David C

    2014-06-01

    Body mass index is associated with the risk of Barrett's oesophagus (BO). It is uncertain whether this is related to total body fat or other factors that correlate with body mass index. We aimed to quantify the association between total body fat (measured by bioelectrical impedance) and risk of BO and examine if this association was modified by gastro-oesophageal reflux (GOR) and abdominal obesity. In 2007-2009, we surveyed 235 cases (69% Males, Mean age 62.1 years) and 244 age and sex matched population controls from a population based case-control study of BO. We conducted structured interviews, standard anthropometry and bioimpedance analysis of total body fat. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using multivariable logistic regression analysis. There was a significantly increased risk of BO among those in the highest tertile of total body fat weight (OR 2.01; 95%CI 1.26-3.21) and total body fat percentage (OR 1.86; 95%CI 1.10-3.15). These risks were largely attenuated after adjustment for GOR and waist circumference. There was a significantly increased risk of BO among those in the highest tertile of waist circumference (OR 2.21; 95%CI 1.39-3.51) and this was minimally attenuated after adjustment for total body fat and moderately attenuated after adjustment for GOR. Total body fat is associated with an increased risk of BO but this appears to be mediated via both abdominal obesity and GOR. These findings provide evidence that abdominal obesity is more important than total body fat in the development of BO. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Partial oesophagectomy for giant leiomyoma of the oesophagus: report of 7 cases.

    PubMed

    De Giacomo, Tiziano; Bruschini, Pietro; Arcieri, Stefano; Ruberto, Franco; Venuta, Federico; Diso, Daniele; Francioni, Federico

    2015-01-01

    Oesophageal leiomyoma is the most common benign tumour of the oesophagus. The incidence of leiomyomas larger than 10 cm, defined as giant oesophageal leiomyomas (GELs), has been reported in 17% of all cases. Although computed tomographic scan and endoscopy are usually useful for diagnosis, big and symptomatic masses located in the lower mediastinum remain both a diagnostic and therapeutic challenge. We describe our experience in the management of 7 patients (4 males and 3 females, with a mean age of 41 years) with GEL treated in our department. Radical resection was performed in all cases with partial oesophagectomy in order to relieve symptoms and to obtain a definitive diagnosis. There was no perioperative mortality. The minimum diameter of the tumours was 15 cm and the maximum was 30 cm. Definitive histological examination confirmed the diagnosis of leiomyoma in all cases without any sign of malignancy. No major postoperative complications developed. Minor complications included partial abdominal wound dehiscence in 1 case, and retention of secretions requiring bronchoscopy in 2. The mean length of hospital stay was 12 days (ranging between 9 and 14 days). After a mean follow-up of 5.4 years (ranging between 12 and 2 years), no sign of recurrence was observed. Whereas removal of small oesophageal leiomyomas can be performed by simple enucleation by conventional thoracotomy or video-assisted thoracoscopy, partial oesophagectomy is often necessary for giant lesions. Since it is not possible preoperatively to distinguish GEL from leiomyosarcoma when metastases are absent, partial oesophageal resection is not to be considered an overtreatment and radical resection should always be planned. A gastric tube, in our experience employed as an oesophageal substitute, is effective and could reduce the risk of significant postoperative gastro-oesophageal reflux. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio

  5. Protective role of gluteofemoral obesity in erosive oesophagitis and Barrett's oesophagus.

    PubMed

    Rubenstein, Joel H; Morgenstern, Hal; Chey, William D; Murray, Joseph; Scheiman, James M; Schoenfeld, Philip; Appelman, Henry D; McMahon, Laurence; Metko, Val; Kellenberg, Joan; Kalish, Tal; Baker, Jason; Inadomi, John M

    2014-02-01

    Abdominal obesity has been associated with erosive oesophagitis (EO) and Barrett's oesophagus (BO). As gluteofemoral obesity protects against diabetes mellitus and cardiovascular disease, we hypothesised that gluteofemoral obesity would be inversely associated with EO and BO. We conducted a cross-sectional study on 822 male colorectal cancer screenees who were recruited to also undergo upper endoscopy. An additional 80 patients with BO clinically detected by upper endoscopy referred for clinical indications were recruited shortly after their diagnoses of BO. Logistic regression was used to estimate the effects of abdominal obesity (waist circumference), gluteofemoral obesity (hip circumference) and waist-to-hip ratio (WHR) on EO and BO (vs neither condition). There were 225 cases of either BO or EO and 675 controls. After adjustment for potential confounders, a positive association was observed between waist circumference and BO and/or EO, which became stronger with further adjustment for hip circumference. In contrast, hip circumference was inversely associated with BO and/or EO. Compared with the lowest quartile of WHR, the adjusted ORs were 1.32 (95% CI 0.747 to 2.33) for the 2nd quartile, 1.54 (95% CI 0.898 to 2.63) for the 3rd quartile, and 2.68 (95% CI 1.57 to 4.55) for the highest quartile. Similar results were obtained for BO and EO treated as separate outcomes. In a population of older, mostly overweight men, the distribution of obesity is associated with the presence of EO and BO. Abdominal obesity appears to increase the risk of these outcomes, whereas gluteofemoral obesity may be protective.

  6. Betel nut and tobacco chewing; potential risk factors of cancer of oesophagus in Assam, India.

    PubMed

    Phukan, R K; Ali, M S; Chetia, C K; Mahanta, J

    2001-09-01

    Cancer of the oesophagus is the most commonly diagnosed cancer in males in Assam, in north-eastern India, and ranks second for females. The chewing of betel nut, with or without tobacco and prepared in various ways, is a common practice in the region and a case-control study has been designed to study the pattern of risk associated with different ways of preparing and chewing the nuts. 358 newly diagnosed male patients and 144 female have been interviewed together with 2 control subjects for each case chosen at random from among the attendants who accompanied patients to hospital. There were significant trends in risk ratios associated with the frequency of chewing each day, with the duration of chewing in years and with the age at which the habit was started that were apparent for both males and females and which remained significant after allowance was made for other known risk factors, notably tobacco smoking and alcohol consumption. The adjusted ratios, in comparison with non-chewers, were 13.3 M and 5.7 F for chewing more than 20 times a day, 10.6 M and 7.2 F for persons who had chewed for more than 20 years and 10.3 M and 5.3 F for those who had started before the age of 20. Among the different combinations of ingredients that were chewed the adjusted odds ratios were highest for those who had been using fermented betel nut with any form of tobacco (7.1 M and 3.6 F). The risk associated with tobacco smoking and alcohol consumption, which are high in some parts of the world, were less in Assam than those associated with the chewing of betel nut.

  7. Germline variation in inflammation-related pathways and risk of Barrett's oesophagus and oesophageal adenocarcinoma.

    PubMed

    Buas, Matthew F; He, Qianchuan; Johnson, Lisa G; Onstad, Lynn; Levine, David M; Thrift, Aaron P; Gharahkhani, Puya; Palles, Claire; Lagergren, Jesper; Fitzgerald, Rebecca C; Ye, Weimin; Caldas, Carlos; Bird, Nigel C; Shaheen, Nicholas J; Bernstein, Leslie; Gammon, Marilie D; Wu, Anna H; Hardie, Laura J; Pharoah, Paul D; Liu, Geoffrey; Iyer, Prassad; Corley, Douglas A; Risch, Harvey A; Chow, Wong-Ho; Prenen, Hans; Chegwidden, Laura; Love, Sharon; Attwood, Stephen; Moayyedi, Paul; MacDonald, David; Harrison, Rebecca; Watson, Peter; Barr, Hugh; deCaestecker, John; Tomlinson, Ian; Jankowski, Janusz; Whiteman, David C; MacGregor, Stuart; Vaughan, Thomas L; Madeleine, Margaret M

    2017-10-01

    Oesophageal adenocarcinoma (OA) incidence has risen sharply in Western countries over recent decades. Local and systemic inflammation is considered an important contributor to OA pathogenesis. Established risk factors for OA and its precursor, Barrett's oesophagus (BE), include symptomatic reflux, obesity and smoking. The role of inherited genetic susceptibility remains an area of active investigation. Here, we explore whether germline variation related to inflammatory processes influences susceptibility to BE/OA. We used data from a genomewide association study of 2515 OA cases, 3295 BE cases and 3207 controls. Our analysis included 7863 single-nucleotide polymorphisms (SNPs) in 449 genes assigned to five pathways: cyclooxygenase (COX), cytokine signalling, oxidative stress, human leucocyte antigen and nuclear factor-κB. A principal components-based analytic framework was employed to evaluate pathway-level and gene-level associations with disease risk. We identified a significant signal for the COX pathway in relation to BE risk (p=0.0059, false discovery rate q=0.03), and in gene-level analyses found an association with microsomal glutathione-S-transferase 1 (MGST1); (p=0.0005, q=0.005). Assessment of 36 MGST1 SNPs identified 14 variants associated with elevated BE risk (q<0.05). Four of these were subsequently confirmed (p<5.5×10(-5)) in a meta-analysis encompassing an independent set of 1851 BE cases and 3496 controls, and are known strong expression quantitative trait loci for MGST1. Three such variants were associated with similar elevations in OA risk. This study provides the most comprehensive evaluation of inflammation-related germline variation in relation to risk of BE/OA and suggests that variants in MGST1 influence disease susceptibility. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  8. ALA PDT for high grade dysplasia in Barrett's oesophagus: review of a decade's experience

    NASA Astrophysics Data System (ADS)

    Bown, Stephen G.; Mackenzie, Gary D.; Dunn, Jason M.; Thorpe, Sally M.; Lovat, Laurence B.

    2009-06-01

    We have been investigating PDT with 5 aminolaevulinic acid (ALA) for the treatment of high grade dysplasia (HGD) in Barrett's oesophagus (BO) for over a decade. This drug has inherent advantages over porfimer sodium (Photofrin), the current approved photosensitiser in the UK and USA, which causes strictures in 18-50% and light sensitivity for up to three months. ALA has a lower rate of oesophageal strictures due to its preferential activity in the mucosa, sparing the underlying muscle, and patients are only light sensitive for 1-2 days. Within a randomised controlled trial, we demonstrated that an ALA dose of 60mg/kg activated by 1000J/cm red laser light is the most effective. Using these values we achieved complete reversal of HGD at 1 year in 89% of 27 patients. A randomised controlled trial of ALA vs porfimer sodium PDT for HGD is currently under way with end points of efficacy and safety. 50 of 66 patients have been recruited. Preliminary data suggest ALA PDT is safer with a trend to higher efficacy. Late relapse can occur in 20% of patients. New prognostic markers, in particular aneuploidy, are helping us to identify and target patients at risk of late relapse. Furthermore optical biopsy techniques such as elastic scattering spectroscopy (ESS) may allow detection of nuclear abnormalities in vivo and enable us to target areas of interest whilst reducing sampling error. PDT faces new challenges for the treatment of HGD in BO, with the recent introduction of balloon based radiofrequency ablation. This technique appears simpler and as effective as PDT, but follow up is currently short and long term safety data is lacking. In our experience ALA PDT is currently the most effective minimally invasive treatment for HGD in BO. This work was undertaken at UCLH/UCL who received a proportion of funding from the Department of Health's NIHR Biomedical Research Centres funding scheme.

  9. Electrophysiological characterization of vagal afferents relevant to mucosal nociception in the rat upper oesophagus

    PubMed Central

    Lennerz, J K M; Dentsch, C; Bernardini, N; Hummel, T; Neuhuber, W L; Reeh, P W

    2007-01-01

    Emerging evidence indicates a nociceptive role of vagal afferents. A distinct oesophageal innervation in the rat, with muscular and mucosal afferents travelling predominantly in the recurrent (RLN) and superior laryngeal nerve (SLN), respectively, enabled characterization of mucosal afferents with nociceptive properties, using novel isolated oesophagus–nerve preparations. SLN and RLN single-fibre recordings identified 55 and 14 units, respectively, with none conducting faster than 8.7 m s−1. Mucosal response characteristics in the SLN distinguished mechanosensors (n= 13), mechanosensors with heat sensitivity (18) from those with cold sensitivity (19) and a mechanoinsensitive group (5). The mechanosensitive fibres, all slowly adapting, showed a unimodal distribution of mechanical thresholds (1.4–128 mN, peak ∼5.7 mN). No difference in response characteristics of C and Aδ fibres was encountered. Mucosal proton stimulation (pH 5.4 for 3 min), mimicking gastro-oesophageal reflux disease (GORD), revealed in 31% of units a desensitizing response that peaked around 20 s and faded within 60 s. Cold stimulation (15°C) was proportionally encoded but the response showed slow adaptation. In contrast, the noxious heat (48°C) response showed no obvious adaptation with discharge rates reflecting the temperature's time course. Polymodal (69%) mucosal units, > 30% proton sensitive, were found in each fibre category and were considered nociceptors; they are tentatively attributed to vagal nerve endings type I, IV and V, previously morphologically described. All receptive fields were mapped and the distribution indicates that the posterior upper oesophagus may serve as a ‘cutbank’, detecting noxious matters, ingested or regurgitated, and triggering nocifensive reflexes such as bronchoconstriction in GORD. PMID:17478536

  10. The morphological tissue response of the piglet oesophagus to experimental irradiation by 1320 nm Nd:YAG laser.

    PubMed Central

    Stratmann, U; Schaarschmidt, K; Lehmann, R R; Schürenberg, M; Willital, G H; Berens, A

    1995-01-01

    The oesophagus of 18 minipiglets was exposed to endoscopic intraluminal irradiation with a 1320 nm Nd:YAG laser (10 W, 20 s) via a radial applicator with strictly radially symmetric light distribution. Immediately and at 2, 3, 4 and 8 wk after irradiation, the oesophagus was perfusion-fixed and filled with contrast solution. Radiographs were taken for evaluation by microradiometry. The specimens were subsequently prepared for light and transmission electron microscopy. The immediate reaction to irradiation was a morphological gradient of damage extending from the centre of the laser exposure where there was cellular thermonecrosis in all layers of the wall and condensation of the extracellular matrix, to a peripheral zone (at a distance of up to 8 mm from the region where the laser was centred) which showed only minor tissue damage manifested by intracellular vacuolation. In this zone dilatation of most vascular lumina was prominent. In the period between 2 and 8 wk after irradiation all phases of wound healing were observed and resulted in occlusion of the lumen of the oesophagus by early scar tissue after an interval of more than 3 wk at the former centre of laser exposure. Peripherally, epithelial regeneration resulted in a new luminal lining. Both the process of epithelial regeneration and that of fibrous repair indicated a good reparative capacity of laser-irradiated oesophageal wall tissues resembling the phases of normal wound healing. The immediate laser interaction with tissue indicated that the noncellular matrix components of tissues are more resistant to the photothermal effect than the cellular components. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 Fig. 7 Fig. 8 Fig. 9 Fig. 10 PMID:8586565

  11. HER-2 overexpression/amplification in Barrett's oesophagus predicts early transition from dysplasia to adenocarcinoma: a clinico-pathologic study.

    PubMed

    Rossi, Elisa; Grisanti, Salvatore; Villanacci, Vincenzo; Della Casa, Domenico; Cengia, Paolo; Missale, Guido; Minelli, Luigi; Buglione, Michela; Cestari, Renzo; Bassotti, Gabrio

    2009-09-01

    Barrett's oesophagus (BO) is the primary precursor lesion for oesophageal adenocarcinoma (ADC). The natural history of metaplasia-dysplasia-carcinoma sequence remains largely unknown. HER2/neu oncogene results overexpressed/amplified in preneoplastic lesions and in ADC of the oesophagus and it has been associated with poor prognosis. Our aim was to evaluate the role of HER2 overexpression/amplification in predicting the conversion from precursor lesions to ADC. We retrospectively evaluated by univariate analysis of single variables clinical records and histological specimens of 21 patients with a confirmed diagnosis of BO and/or oesophageal dysplasia. Clinical variables included age, gender, alcohol and smoking intake, presence of symptoms (pyrosis, disphagia) and endoscopic features (length). HER2 status was studied by immunohistochemistry and fluorescence in situ hybridization (FISH) on paraffin-embedded tissue. The end-points were the occurrence of progression and the time-to-progression (TTP) from the initial histologic lesion to the worst pathological pattern. Median age at diagnosis was 63 years (range 37-84). BO median length was 4.5 cm. Progression occurred in 11 of 21 patients and median TTP was 24 months. HER2 was overexpressed/amplified in 8 of 21 (38%) patients. HER2 overexpression/ amplification and the presence of dysplasia were statistically associated with progression (P= 0.038). This study provides evidence for a possible role of HER2 in the transition from dysplasia to ADC of the oesophagus. This fact could help in identifying patients at high risk of malignant transformation.

  12. A novel mechanism of acid and bile acid-induced DNA damage involving Na+/H+ exchanger: implication for Barrett's oesophagus.

    PubMed

    Goldman, Aaron; Shahidullah, Mohammad; Goldman, David; Khailova, Ludmila; Watts, George; Delamere, Nicholas; Dvorak, Katerina

    2010-12-01

    Barrett's oesophagus is a premalignant disease associated with oesophageal adenocarcinoma. The major goal of this study was to determine the mechanism responsible for bile acid-induced alteration in intracellular pH (pH(i)) and its effect on DNA damage in cells derived from normal oesophagus (HET1A) or Barrett's oesophagus (CP-A). Cells were exposed to bile acid cocktail (BA) and/or acid in the presence/absence of inhibitors of nitric oxide synthase (NOS) or sodium-hydrogen exchanger (NHE). Nitric oxide (NO), pH(i) and DNA damage were measured by fluorescent imaging and comet assay. Expression of NHE1 and NOS in cultured cells and biopsies from Barrett's oesophagus or normal squamous epithelium was determined by RT-PCR, immunoblotting or immunohistochemistry. A dose dependent decrease in pH(i) was observed in CP-A cells exposed to BA. This effect of BA is the consequence of NOS activation and increased NO production, which leads to NHE inhibition. Exposure of oesophageal cells to acid in combination with BA synergistically decreased pH(i). The decrease was more pronounced in CP-A cells and resulted in >2-fold increase in DNA damage compared to acid treatment alone. Examination of biopsies and cell lines revealed robust expression of NHE1 in Barrett's oesophagus but an absence of NHE1 in normal epithelium. The results of this study identify a new mechanism of bile acid-induced DNA damage. We found that bile acids present in the refluxate activate immediately all three isoforms of NOS, which leads to an increased NO production and NHE inhibition. This consequently results in increased intracellular acidification and DNA damage, which may lead to mutations and cancer progression. Therefore, we propose that in addition to gastric reflux, bile reflux should be controlled in patients with Barrett's oesophagus.

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

    PubMed

    Winzer, Brooke M; Paratz, Jennifer D; Reeves, Marina M; Whiteman, David C

    2010-06-16

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

  14. A novel mechanism of acid and bile acid-induced DNA damage involving Na+/H+ exchanger: implication for Barrett’s oesophagus

    PubMed Central

    Goldman, Aaron; Shahidullah, Mohammad; Goldman, David; Khailova, Ludmila; Watts, George; Delamere, Nicholas; Dvorak, Katerina

    2011-01-01

    Objective Barrett’s oesophagus is a premalignant disease associated with oesophageal adenocarcinoma. The major goal of this study was to determine the mechanism responsible for bile acid-induced alteration in intracellular pH (pHi) and its effect on DNA damage in cells derived from normal oesophagus (HET1A) or Barrett’s oesophagus (CP-A). Design Cells were exposed to bile acid cocktail (BA) and/or acid in the presence/absence of inhibitors of nitric oxide synthase (NOS) or sodium–hydrogen exchanger (NHE). Nitric oxide (NO), pHi and DNA damage were measured by fluorescent imaging and comet assay. Expression of NHE1 and NOS in cultured cells and biopsies from Barrett’s oesophagus or normal squamous epithelium was determined by RT-PCR, immunoblotting or immunohistochemistry. Results A dose dependent decrease in pHi was observed in CP-A cells exposed to BA. This effect of BA is the consequence of NOS activation and increased NO production, which leads to NHE inhibition. Exposure of oesophageal cells to acid in combination with BA synergistically decreased pHi. The decrease was more pronounced in CP-A cells and resulted in >2-fold increase in DNA damage compared to acid treatment alone. Examination of biopsies and cell lines revealed robust expression of NHE1 in Barrett’s oesophagus but an absence of NHE1 in normal epithelium. Conclusions The results of this study identify a new mechanism of bile acid-induced DNA damage. We found that bile acids present in the refluxate activate immediately all three isoforms of NOS, which leads to an increased NO production and NHE inhibition. This consequently results in increased intracellular acidification and DNA damage, which may lead to mutations and cancer progression. Therefore, we propose that in addition to gastric reflux, bile reflux should be controlled in patients with Barrett’s oesophagus. PMID:20876775

  15. Restaurierung von Seen und Renaturierung von Seeufern

    NASA Astrophysics Data System (ADS)

    Grüneberg, Björn; Ostendorp, Wolfgang; Leßmann, Dieter; Wauer, Gerlinde; Nixdorf, Brigitte

    Süßwasserseen haben als ökosysteme und Lebensraum für Pflanzen und Tiere eine herausragende Bedeutung für die Artenvielfalt auf der Erde und prägen als Landschaftselemente unsere natürliche Umwelt. Seen fungieren als natürliche Stoffsenken, vor allem für Kohlenstoff und Nährstoffe, aber auch als Senken für in ihren Einzugsgebieten emittierte gelöste und feste Schadstoffe. Darüber hinaus ist Wasser eine wichtige Naturressource. Süßwasserseen stellen in den meisten Regionen der Erde lebenswichtige Quellen für die Versorgung mit Trinkwasser und tierischem Eiweiß (Fischfang) dar. Sie dienen als Wasserspeicher für die landwirtschaftliche und industrielle Nutzung. Auch für Erholungsaktivitäten des Menschen kommt ihnen eine große Bedeutung zu.

  16. Konfigurations- und Sicherheitsmanagement in heterogenen Verzeichnisdienstumgebungen

    NASA Astrophysics Data System (ADS)

    Hommel, Wolfgang; Pluta, Daniel

    In komplexen Umgebungen wie IntegraTUM reicht der Einsatz eines Verzeichnisdienstprodukts mit nur einer hochverfügbaren Instanz nicht aus. Vielmehr müssen, um ein möglichst breites Spektrum an Diensten integrieren zu können, beispielsweise Microsoft Active Directory, Novell eDirectory und OpenLDAP parallel und jeweils in verschiedenen Ausprägungen bereitgestellt und betrieben werden. Um dennoch Skalierbarkeit und ein effizientes operatives Management sicherstellen zu können, müssen Betriebs- und auch Sicherheitskonzepte systemübergreifend nachweislich konsistent umgesetzt werden. Dieser Artikel gibt einen Überblick über die im Rahmen von IntegraTUM erarbeiteten und mit sehr gutem Erfolg praktisch eingesetzten Konzepte für das Konfigurations- und Sicherheitsmanagement der heterogenen Verzeichnisdienstlandschaft.

  17. Stenting as a palliative method in the management of advanced squamous cell carcinoma of the oesophagus and gastro-oesophageal junction

    PubMed Central

    Kużdżał, Jarosław

    2016-01-01

    Advanced squamous cell carcinoma of the oesophagus and gastroesophageal junction usually requires palliative treatment, and the method of choice is stenting. There are several types of stents currently available, including: self-expandable metallic stents (fully or partially covered); self-expandable plastic stents; biodegradable stents. Each of the mentioned stents has its advantages and limitations, and requires a proper, patient-tailored selection. Due to the close anatomical relationship between the oesophagus and bronchial tree, some patients may require bilateral stenting. Oesophageal stenting may not only be considered as a palliative procedure, but can also be implemented to alleviate dysphagia during preoperative chemotherapy and/or radiotherapy. PMID:28133493

  18. Bewegungsapparat: Postcraniales Skelett und Muskulatur

    NASA Astrophysics Data System (ADS)

    Fischer, Martin S.

    Der Bewegungsapparat bestimmt die Form des Wirbeltierkörpers. So lässt sich z. B. aus der Gestalt eines Fisches auf seine bevorzugt e Schwimmweise schließen (S. 61). Bei den aquatisch en Schädeltieren dominiert die Fortbewegung mit axialem Antrieb; bei den meisten Tetrapoda findet sich eine Kombination aus axialem Antrieb und Bewegung durch Gliedmaßen. Selbst beim höchst spezialisierten Gang, der bipeden Bewegung des Menschen, sind Torsionsbewegungen des Rumpfes noch maßgeblich und bestimmen auch die Grundform des menschlichen Körpers (z. B. die Taille). Obwohl die verschiedenen Antriebsmechanismen eine funktionelle Einheit bilden, werden im Folgenden das Axialskelett sowie der Schulter- und Beckengürtel mit den zugehörigen Extremitäten getrennt besprochen.

  19. Association of Insurance and Community-Level Socioeconomic Status With Treatment and Outcome of Squamous Cell Carcinoma of the Pharynx.

    PubMed

    Shin, Jacob Y; Yoon, Ja Kyoung; Shin, Aaron K; Blumenfeld, Philip; Mai, Miranda; Diaz, Aidnag Z

    2017-09-01

    Community-level socioeconomic status, particularly insurance status, is increasingly becoming important as a possible determinant in patient outcomes. To determine the association of insurance and community-level socioeconomic status with outcome for patients with pharyngeal squamous cell carcinoma (SCC). This study extracted data from more than 1500 Commission on Cancer-accredited facilities collected in the National Cancer Database. A total of 35 559 patients diagnosed with SCC of the pharynx from 2004 through 2013 were identified. The χ2 test, Kaplan-Meier method, and Cox regression models were used to analyze data from April 1, 2016, through April 16, 2017. Overall survival was defined as time to death from the date of diagnosis. Among the 35 559 patients identified (75.6% men and 24.4% women; median age, 61 years [range, 18-90 years]), 15 146 (42.6%) had Medicare coverage; 13 061 (36.7%), private insurance; 4881 (13.7%), Medicaid coverage; and 2471 (6.9%), no insurance. Uninsured patients and Medicaid recipients were more likely to be younger, black, or Hispanic; to have lower median household income and lower educational attainment; to present with higher TNM stages of disease; and to start primary treatment at a later time from diagnosis. Those with private insurance (reference group) had significantly better overall survival than uninsured patients (hazard ratio [HR], 1.72; 95% CI, 1.59-1.87), Medicaid recipients (HR, 1.99; 95% CI, 1.88-2.12), or Medicare recipients (HR, 2.07; 95% CI, 1.99-2.16), as did those with median household income of at least $63 000 (reference) vs $48 000 to $62 999 (HR, 1.19; 95% CI, 1.13-1.26), $38 000 to $47 999 (HR, 1.31; 95% CI, 1.24-1.38), and less than $38 000 (HR, 1.51; 95% CI, 1.43-1.59). On multivariable analysis, insurance status and median household income remained independent prognostic factors for overall survival even after accounting for educational attainment, race, Charlson/Deyo comorbidity

  20. Kosmologie und Teilchenphysik.

    NASA Astrophysics Data System (ADS)

    Appenzeller, I.

    This book is a selection of 17 articles published in the journal "Spektrum der Wissenschaft". The original English versions of the papers were first published in "Scientific American". Contents: 1. Einführung (I. Appenzeller). 2. Sehr große Strukturen im Universum (J. O. Burns). 3. Die großräumigen Eigenbewegungen der Galaxien (A. Dressler). 4. Dunkle Materie im Universum (L. M. Krauss). 5. Der doppelte Beta-Zerfall (M. K. Moe, S. P. Rosen). 6. Quark-Lepton Familien (D. B. Cline). 7. Beschleunigerexperimente testen kosmologische Theorien (D. N. Schramm, G. Steigman). 8. Das Rätsel der kosmologischen Konstanten (L. Abbott). 9. Das Higgs-Boson (M. J. G. Veltman). 10. Die Suche nach dem Protonenzerfall (J. M. LoSecco, F. Reines, D. Sinclair). 11. Das inflationäre Universum (A. H. Guth, P. J. Steinhardt). 12. Die fünfte Dimension (E. Schmutzer). 13. Die verborgenen Dimensionen der Raumzeit (D. Z. Freedman, P. van Nieuwenhuizen). 14. Ist die Natur supersymmetrisch? (H. E. Haber, G. L. Kane). 15. Schwerkraft und Antimaterie (T. Goldman, R. J. Hughes, M. M. Nieto). 16. Superstrings (M. B. Green). 17. Kosmische Strings (A. Vilenkin).

  1. A systematic review of photodynamic therapy in the treatment of pre-cancerous skin conditions, Barrett's oesophagus and cancers of the biliary tract, brain, head and neck, lung, oesophagus and skin.

    PubMed

    Fayter, D; Corbett, M; Heirs, M; Fox, D; Eastwood, A

    2010-07-01

    Photodynamic therapy (PDT) is the use of a light-sensitive drug, in combination with light of a visible wavelength, to destroy target cells. PDT is used either as a primary treatment or as an adjunctive treatment. It is fairly well accepted in clinical practice for some types of skin cancer but has yet to be fully explored as a treatment for other forms of cancer. To systematically review the clinical effectiveness and safety of PDT in the treatment of Barrett's oesophagus, pre-cancerous skin conditions and the following cancers: biliary tract, brain, head and neck, lung, oesophageal and skin. The search strategy included searching electronic databases (between August and October 2008), followed by update searches in May 2009, along with relevant bibliographies, existing reviews, conference abstracts and contact with experts in the field. Randomised controlled trials (RCTs) in skin conditions and Barrett's oesophagus, non-randomised trials for all other sites. People with Barrett's oesophagus, pre-cancerous skin conditions or primary cancer in the following sites: biliary tract, brain, head and neck, lung, oesophageal and skin. Any type of PDT for either curative or palliative treatment. Any comparator including differing applications of PDT treatments (relevant comparators varied according to the condition). The outcomes measured were mortality, morbidity, quality of life, adverse events and resource use. A standardised data extraction form was used. The quality of RCTs and non-randomised controlled studies was assessed using standard checklists. Data extracted from the studies were tabulated and discussed in a narrative synthesis, and the influence of study quality on results was discussed. Meta-analysis was used to estimate a summary measure of effect on relevant outcomes, with assessment of both clinical and statistical heterogeneity. Two reviewers independently screened all titles and abstracts, and data extracted and quality assessed the trials, with

  2. Food groups and risk of squamous cell carcinoma of the oesophagus: a case-control study in Uruguay.

    PubMed

    De Stefani, E; Deneo-Pellegrini, H; Ronco, A L; Boffetta, P; Brennan, P; Muñoz, N; Castellsagué, X; Correa, P; Mendilaharsu, M

    2003-10-06

    In the time period January 1998-December 2000, a case-control study on squamous cell cancer of the oesophagus was conducted in Montevideo, Uruguay. The main objective of the study was to estimate the odds ratios (ORs) associated with main food groups. For this purpose, 166 patients afflicted with squamous cell oesophageal cancer and 664 hospitalised controls were frequency matched on age and sex. Both series of patients were administered with a structured questionnaire. Aside from queries related with tobacco smoking, alcohol drinking and maté drinking, patients were interviewed with a food-frequency questionnaire (FFQ) on 64 items, representative of the usual Uruguayan diet. Red meat, salted meat and boiled meat displayed strong direct associations (OR for red meat 2.4, 95% CI 1.4-4.2). On the other hand, fish and total white meat showed moderate protective effect (OR for total white meat 0.5, 95% CI 0.3-0.9). Total fruit intake displayed a strong inverse association (OR 0.2, 95% CI 0.1-0.4), whereas total vegetable consumption presented a weak inverse association (OR for total vegetable intake 0.7, 95% CI 0.4-1.2). These results suggest that vegetables, mainly cooked vegetables, are rich in thermolabile protective substances. On the other hand, boiled (stewed) meat, which is ingested at high temperature could be, like maté, a risk factor for squamous cell cancer of the oesophagus.

  3. Submucosal glands in the columnar-lined oesophagus: evidence of an association with metaplasia and neosquamous epithelium.

    PubMed

    Lörinc, Ester; Öberg, Stefan

    2012-07-01

    A multipotential stem cell, possibly located in the submucosal gland ducts, has been suggested as the origin of metaplastic mucosa in the oesophagus. The topographic distribution of these glands and their excretory ducts (SMG) within the columnar lined oesophagus (CLO) is largely unknown. The aim of this study was to examine the distribution of SMG in relation to the type of overlying epithelium in patients with CLO. Seven oesophageal resection specimens were examined histologically in toto. The median frequency of SMG was similar in the metaplastic segments (0.12 SMG/mm) and the normal squamous segments (0.10 SMG/mm). Within the metaplastic segments, the median frequency of SMG beneath the squamous islands was significantly higher than that observed under the columnar lined parts (0.22 versus 0.08 SMG/mm, P = 0.046), There was a strong accumulation of SMG at the squamo-columnar transition zones (0.53 SMG/mm), which was significantly greater than that found in the columnar and squamous parts (P = 0.001 and 0.002, respectively). The relative accumulation of SMG beneath squamous islands and the squamo-columnar junctions within the metaplastic segment supports the hypothesis that both metaplastic columnar mucosa and neosquamous epithelium originate from a progenitor in the SMG. © 2012 Blackwell Publishing Ltd.

  4. Differential expression of mitochondrial energy metabolism profiles across the metaplasia-dysplasia-adenocarcinoma disease sequence in Barrett's oesophagus.

    PubMed

    Phelan, J J; MacCarthy, F; Feighery, R; O'Farrell, N J; Lynam-Lennon, N; Doyle, B; O'Toole, D; Ravi, N; Reynolds, J V; O'Sullivan, J

    2014-11-01

    Contemporary clinical management of Barrett's oesophagus has highlighted the lack of accurate predictive markers of disease progression to oesophageal cancer. This study aims to examine alterations in mitochondrial energy metabolism profiles across the entire disease progression sequence in Barrett's oesophagus. An in-vitro model was used to screen 84 genes associated with mitochondrial energy metabolism. Three energy metabolism genes (ATP12A, COX4I2, COX8C) were significantly altered across the in-vitro Barrett's disease sequence. In-vivo validations across the Barrett's sequence demonstrated differential expression of these genes. Tissue microarrays demonstrated significant alterations in both epithelial and stromal oxidative phosphorylation (ATP5B and Hsp60) and glycolytic (PKM2 and GAPDH) protein markers across the in-vivo Barrett's sequence. Levels of ATP5B in sequential follow up surveillance biopsy material segregated Barrett's non progressors and progressors to HGD and cancer. Utilising the Seahorse XF24 flux analyser, in-vitro Barrett's and adenocarcinoma cells exhibited altered levels of various oxidative parameters. We show for the first time that mitochondrial energy metabolism is differentially altered across the metaplasia-dysplasia-adenocarcinoma sequence and that oxidative phosphorylation profiles have predictive value in segregating Barrett's non progressors and progressors to adenocarcinoma. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  5. Subjective neck pain or foreign body sensation and the true location of foreign bodies in the pharynx.

    PubMed

    Yang, Chih Yung; Yang, Cheng-Chien

    2015-02-01

    The location of the foreign body did not correspond well to the location of pain reported by patients. When patients present with foreign bodies in the pharynx, in addition to recording the location of pain and foreign body sensation, clinicians should perform a comprehensive and thorough oropharyngeal examination to avoid misdiagnosis. Physicians are often guided by patient-indicated locations of pharyngeal foreign bodies. In this study, we aimed to determine the correlation between the location of the subjective neck pain or foreign body sensation and the true location of the foreign body. We prospectively studied 90 patients who had pharyngeal foreign bodies removed at MacKay Memorial Hospital. We divided the head and neck into 10 zones according to the superficial anatomy. Subjective location, examination findings, and actual foreign body location were recorded and compared. The overall subjective and true locations of the foreign body were poorly correlated (kappa 0.27, p = 0.003). The positive predictive value (PPV) for the midline neck was 68%, which was higher than that on either lateral side of the neck. PPV above cricoid cartilage level was 66%.

  6. Ancient homeobox gene loss and the evolution of chordate brain and pharynx development: deductions from amphioxus gene expression.

    PubMed

    Butts, Thomas; Holland, Peter W H; Ferrier, David E K

    2010-11-22

    Homeobox genes encode a large superclass of transcription factors with widespread roles in animal development. Within chordates there are over 100 homeobox genes in the invertebrate cephalochordate amphioxus and over 200 in humans. Set against this general trend of increasing gene number in vertebrate evolution, some ancient homeobox genes that were present in the last common ancestor of chordates have been lost from vertebrates. Here, we describe the embryonic expression of four amphioxus descendants of these genes--AmphiNedxa, AmphiNedxb, AmphiMsxlx and AmphiNKx7. All four genes are expressed with a striking asymmetry about the left-right axis in the pharyngeal region of neurula embryos, mirroring the pronounced asymmetry of amphioxus embryogenesis. AmphiMsxlx and AmphiNKx7 are also transiently expressed in an anterior neural tube region destined to become the cerebral vesicle. These findings suggest significant rewiring of developmental gene regulatory networks occurred during chordate evolution, coincident with homeobox gene loss. We propose that loss of otherwise widely conserved genes is possible when these genes function in a confined role in development that is subsequently lost or significantly modified during evolution. In the case of these homeobox genes, we propose that this has occurred in relation to the evolution of the chordate pharynx and brain.

  7. In vitro inhibition of growth of Neisseria gonorrhoeae by Neisseria meningitidis isolated from the pharynx of homosexual men.

    PubMed

    Bisaillon, J G; Turgeon, P; Dubreuil, D; Beaudet, R; Sylvestre, M; Ashton, F E

    1984-01-01

    Despite the high prevalence of pharyngeal gonorrhea and of meningococcal carriage among homosexual men, Neisseria gonorrhoeae and Neisseria meningitidis are rarely co-isolated from the throat. Forty-seven meningococcal isolates from the pharynx of homosexual men were examined, by a lawn-spotting method, for their ability to inhibit N. gonorrhoeae in vitro. Eight (17%) of the meningococcal isolates were inhibitory when tested against gonococci from the same patient, while 31 (66%) were inhibitory when tested against N. gonorrhoeae strain 650 (T1). The colonial type T1 of a given strain was, in all cases tested, more sensitive to the inhibitory activities than the corresponding T4 type. Since the meningococci co-isolated from the throat with gonococci were at least as inhibitory in vitro as those isolated without gonococci, the natural resistance to gonococcal pharyngitis cannot be explained on the basis of the inhibitory activities produced by the meningococci in vitro. The inhibitory strains of N. meningitidis were identified in decreasing importance as: nonserogroupable, W135, C, B, 29E, and X. The addition of trypsin to the solid medium removed the inhibition produced by the meningococci, an observation suggesting the involvement of protein inhibitors.

  8. Social inequality and incidence of and survival from cancers of the mouth, pharynx and larynx in a population-based study in Denmark, 1994-2003.

    PubMed

    Andersen, Zorana Jovanovic; Lassen, Christina Funch; Clemmensen, Inge Haunstrup

    2008-09-01

    We investigated the effects of socioeconomic, demographic and health-related indicators on the incidence of and survival from mouth, pharynx and larynx cancers diagnosed in 1994-2003 with follow-up through 2006 in Denmark using information from nationwide registers. The analyses were based on data on 3058 patients with mouth and pharynx cancer and 1799 with larynx cancer in a cohort of 3.22 million persons born between 1925 and 1973 and aged >or=30 years. The incidences of all the three cancers increased with decreasing socioeconomic position, measured as disposable income, work market affiliation, social class, housing tenure, cohabiting status and type of district. Similar differences in survival persisted for all 5 years observed. Immigrants had better survival from larynx cancer than native Danes. We could not determine the effects of differences in tobacco and alcohol consumption or their multiplicative interactions.

  9. The risk of oesophageal adenocarcinoma in a prospectively recruited Barrett’s oesophagus cohort

    PubMed Central

    Theron, BT; Padmanabhan, H; Aladin, H; Smith, P; Campbell, E; Nightingale, P; Cooper, BT

    2016-01-01

    Background Varying rates of oesophageal adenocarcinoma (OAC) complicating Barrett’s oesophagus (BO) have been reported. Recent studies and meta-analyses suggest a lower incidence, questioning the value of endoscopic surveillance. Aim We aimed to retrospectively examine the rate of OAC, risk factors and causes of death in a prospectively recruited BO cohort. Methods Data from patients with BO from a cohort from 1982–2007 were studied. Patients were subdivided into surveyed, failed to attend surveillance and unfit for surveillance. Standardised mortality ratios (SMR) were calculated for common causes of death. Cox proportional hazards models were used to determine which factors were associated with progression to OAC. Results In total, 671 BO patients (61% male) were studied; 37 (76% male) were diagnosed with OAC. OAC incidence was 0.47% per annum and stable across three decades (1982–1991 0.56%, 1992–2001 0.46%, 2002–2012 0.41% (p = 0.8)). All-cause mortality was increased for the whole cohort (SMR 163(95% CI 145–183)). Mortality from OAC appeared higher in patients who failed to attend surveillance (SMR 3216(95% CI 1543–5916)) compared with surveyed (SMR 1753(95% CI 933–2998)) and those unfit for surveillance due to co-morbidity (SMR 440(95% CI 143–1025)). Multivariable analysis identified low-grade dysplasia (HR 4.4(95% CI 1.56–12.43), p = 0.005) and length of BO (HR 1.2(95% (1.1–1.3)), p < 0.001)) as associated with OAC. Conclusions Progression to OAC appeared stable over three decades at 0.47% per annum. Patients with BO had a modest increase in all-cause mortality and a large increase in OAC mortality, particularly if fit for surveillance. Low-grade dysplasia and the length of the BO segment were associated with developing OAC. PMID:28408992

  10. Association of insulin and insulin-like growth factors with Barrett’s oesophagus

    PubMed Central

    Greer, Katarina B; Thompson, Cheryl L; Brenner, Lacie; Bednarchik, Beth; Dawson, Dawn; Willis, Joseph; Grady, William M; Falk, Gary W; Cooper, Gregory S; Li, Li; Chak, Amitabh

    2013-01-01

    Background It is postulated that high serum levels of insulin and insulin growth factor 1 (IGF-1) mediate obesity-associated carcinogenesis. The relationship of insulin, IGF-1 and IGF binding proteins (IGFBP) with Barrett’s oesophagus (BO) has not been well examined. Methods Serum levels of insulin and IGFBPs in patients with BO were compared with two separate control groups: subjects with gastro-oesophageal reflux disease (GORD) and screening colonoscopy controls. Fasting insulin, IGF-1 and IGFBPs were assayed in the serum of BO cases (n = 135), GORD (n = 135) and screening colonoscopy (n = 932) controls recruited prospectively at two academic hospitals. Logistic regression was used to estimate the risk of BO. Results Patients in the highest tertile of serum insulin levels had an increased risk of BO compared with colonoscopy controls (adjusted OR 2.02, 95% CI 1.15 to 3.54) but not compared with GORD controls (adjusted OR 1.55, 95% CI 0.76 to 3.15). Serum IGF-1 levels in the highest tertile were associated with an increased risk of BO (adjusted OR 4.05, 95% CI 2.01 to 8.17) compared with the screening colonoscopy control group but were not significantly different from the GORD control group (adjusted OR 0.57, 95% CI 0.27 to 1.17). IGFBP-1 levels in the highest tertile were inversely associated with a risk of BO in comparison with the screening colonoscopy controls (adjusted OR 0.11, 95% CI 0.05 to 0.24) but were not significantly different from the GORD control group (adjusted OR 1.04, 95% CI 0.49 to 2.16). IGFBP-3 levels in the highest tertile were inversely associated with the risk of BO compared with the GORD controls (OR 0.36, 95% CI 0.16 to 0.81) and also when compared with the colonoscopy controls (OR 0.40, 95% CI 0.20 to 0.79). Conclusions These results provide support for the hypothesis that the insulin/IGF signalling pathways have a role in the development of BO. PMID:21930730

  11. Acceptability of the Cytosponge procedure for detecting Barrett's oesophagus: a qualitative study.

    PubMed

    Freeman, Madeleine; Offman, Judith; Walter, Fiona M; Sasieni, Peter; Smith, Samuel G

    2017-03-01

    To investigate the acceptability of the Cytosponge, a novel sampling device to detect Barrett's oesophagus (BE), a precursor to oesophageal adenocarcinoma (EAC), among people with risk factors for this condition. A qualitative study using semistructured interviews and focus group discussions. Data were explored by three researchers using thematic analysis. Community setting in London, UK. A recruitment company identified 33 adults (17 men, 16 women) aged 50-69 years with gastro-oesophageal reflux disease (GERD), a risk factor for BE. The majority of participants were white British (73%). The focus groups were stratified by gender and education. 10 individuals were interviewed and 23 participated in four focus groups. 3 key themes emerged from the data: the anticipated physical experience, preferences for the content of information materials and comparisons with the current gold-standard test. Overall acceptability was high, but there was initial concern about the physical experience of taking the test, including swallowing and extracting the Cytosponge. These worries were reduced after handling the device and a video demonstration of the procedure. Knowledge of the relationship between GERD, BE and EAC was poor, and some suggested they would prefer not to know about the link when being offered the Cytosponge. Participants perceived the Cytosponge to be more comfortable, practical and economical than endoscopy. These qualitative data suggest the Cytosponge was acceptable to the majority of participants with risk factors for BE, and could be used as a first-line test to investigate GERD symptoms. Concerns about the physical experience of the test were alleviated through multimedia resources. The development of patient information materials is an important next step to ensuring patients are adequately informed and reassured about the procedure. Patient stakeholders should be involved in this process to ensure their concerns and preferences are considered. ISRCTN

  12. Surveillance endoscopy is associated with improved outcomes of oesophageal adenocarcinoma detected in patients with Barrett's oesophagus.

    PubMed

    El-Serag, Hashem B; Naik, Aanand D; Duan, Zhigang; Shakhatreh, Mohammad; Helm, Ashley; Pathak, Amita; Hinojosa-Lindsey, Marilyn; Hou, Jason; Nguyen, Theresa; Chen, John; Kramer, Jennifer R

    2016-08-01

    The effectiveness of surveillance endoscopy in patients with Barrett's oesophagus (BE) for reducing oesophageal adenocarcinoma (EAC)-related mortality in patients with BE is unclear. This is a cohort study of patients with BE diagnosed in the National Veterans Affairs hospitals during 2004-2009 excluding those with conditions that affect overall survival. We identified those diagnosed with EAC after BE diagnosis through 2011 and conducted chart reviews to identify BE surveillance programme, and indication for EAC diagnosis, verify diagnosis, stage, therapy and cause of death. We examined the association between surveillance indication for EAC diagnosis with or without surveillance programme and EAC stage and treatment receipt in logistic regression models, and with time to death or cancer-related death using a Cox proportional hazards regression model. Among 29 536 patients with BE, 424 patients developed EAC during a mean follow-up of 5.0 years. A total of 209 (49.3%) patients with EAC were in BE surveillance programme and were diagnosed as a result of surveillance endoscopy. These patients were more likely to be diagnosed at an early stage (stage 0 or 1: 74.7% vs 56.2, p<0.001), survived longer (median 3.2 vs 2.3 years; p<0.001) and have lower cancer-related mortality (34.0% vs 54.0%, p<0.0001) and had a trend to receive oesophagectomy (51.2% vs 42.3%; p=0.07) than 215 patients diagnosed by non-BE surveillance endoscopy (17.2% of whom were BE surveillance failure). BE surveillance endoscopy was associated with a decreased risk of cancer-related death (HR 0.47, 0.35 to 0.64), which was largely explained by the early stage of EAC at the time of diagnosis. Similarly, the adjusted mortality for patients with cancer in a prior surveillance programme for overall death was 0.63 (0.47 to 0.84) compared with patients with cancer not in a surveillance programme. Surveillance endoscopy among patients with BE is associated with significantly better EAC outcomes

  13. Lineare und verzweigte Blockcopolymere aus Polypeptiden und synthetischen Polymeren

    NASA Astrophysics Data System (ADS)

    Kukula, Hildegard

    2001-07-01

    Die vorliegende Arbeit beschäftigt sich mit der Synthese und den Eigenschaften von linearen und verzweigten amphiphilen Polypeptid-Blockcopolymeren. Die Frage nach dem Einfluss der Topologie und Konformation der Blockcopolymere auf die supramolekularen und kolloidalen Eigenschaften bildete einen wichtigen Aspekt bei den Untersuchungen. Die Blockcopolymere wurden nach einem mehrstufigen Reaktionsschema durch Kombination von anionischer und ringöffnender Polymerisation von Aminosäuren-N-Carboxyanhydriden (NCA) synthetisiert. Die Untersuchung der Polypeptid-Blockcopolymere hinsichtlich ihres Aggregationsverhaltens in fester Phase sowie in verdünnter wässriger Lösung erfolgte mittels Streumethoden (SAXS, WAXS, DLS) sowie abbildender Methoden (TEM). Durch Einsatz der Blockcopolymere als polymere Stabilisatoren in der Emulsionspolymerisation wurden Oberflächen funktionalisierte Latizes erhalten. Als Beispiel für eine pharmazeutische Anwendung wurden bioverträgliche Polypeptid-Blockcopolymere als Wirkstoff-Trägersysteme in der Krebstherapie eingesetzt. This work describes the synthesis and characterization of linear and branched polypeptide block copolymers having amphiphilic character. The studies focused on the impact of the block copolymers' conformation and architecture on the supramolecular and colloidal properties. The polypeptide block copolymers were prepared in a multi-step process involving the anionic synthesis of (poly)amino-functional polymers (polystyrene and polybutadiene) which where used as macroinitiators for the ring-opening polymerization of N-carboxyanhydrides (NCA) of protected a-aminoacids. Supramolecular structures of the block copolymers in the solid state as well as in diluted aqueous solution were investigated using scattering (SAXS, WAXS, DLS) and microscopic (TEM) methods. Both linear and branched polypeptide block copolymers were used as polymeric stabilizers in the emulsion polymerization of styrene to yield polypeptide

  14. Dual-focus versus conventional magnification endoscopy for the diagnosis of superficial squamous neoplasms in the pharynx and esophagus: a randomized trial.

    PubMed

    Goda, Kenichi; Dobashi, Akira; Yoshimura, Noboru; Aihara, Hiroyuki; Kato, Masayuki; Sumiyama, Kazuki; Toyoizumi, Hirobumi; Kato, Tomohiro; Saijo, Hiroki; Ikegami, Masahiro; Tajiri, Hisao

    2016-04-01

    Conventional magnification narrow-band imaging (CM-NBI) endoscopy has demonstrated high diagnostic accuracy for superficial squamous neoplasms in the pharynx and esophagus. This study aimed to evaluate the diagnostic utility of the newly developed dual-focus NBI (DF-NBI) compared with that of CM-NBI. We recruited patients with squamous cell carcinoma (SCC) in the head and neck, or esophagus, or with a history of SCC. The primary endpoint of this prospective controlled non-inferiority trial was the sensitivity of DF-NBI and CM-NBI for detecting superficial carcinoma in the pharynx and esophagus. Secondary endpoints included other diagnostic values and the resolving power of each endoscope. Superficial carcinoma was defined as high grade dysplasia and SCC invading up to the submucosal layer. The study included 93 patients. A total of 28 superficial carcinomas were detected in the pharynx and esophagus. The sensitivities of DF-NBI and CM-NBI for superficial carcinoma were 82 % and 71 %, respectively. The lower limit of the 90 % confidence interval for the difference between the sensitivities exceeded the non-inferiority threshold. The specificity and overall accuracy of DF-NBI vs. CM-NBI were 93 % vs. 90 % and 91 % vs. 86 %, respectively (both non-significant differences). The maximum resolving power of a conventional magnification endoscope was significantly higher than a dual-focus endoscope (7.2 µm vs. 11.6 µm: P < 0.001). The findings indicate the non-inferiority of DF-NBI versus CM-NBI in detecting superficial carcinoma in the pharynx and esophagus. DF-NBI appears to have a resolving power that, although significantly lower, is sufficient to achieve high diagnostic accuracy, comparable to that of CM-NBI.University Hospital Medical Information Network (UMIN, No. 000007585). © Georg Thieme Verlag KG Stuttgart · New York.

  15. Calcitonin gene-related peptide immunoreactive neurons innervating the soft palate, the root of tongue, and the pharynx in the superior glossopharyngeal ganglion of the rat.

    PubMed

    Hayakawa, Tetsu; Kuwahara, Sachi; Maeda, Seishi; Tanaka, Koichi; Seki, Makoto

    2010-07-01

    We have examined whether calcitonin gene-related peptide immunoreactive (CGRP-ir) neurons in the glossopharyngeal ganglia innervate the soft palate, the root of tongue, and the pharynx of the rat. Immunohistochemical observations revealed that numerous CGRP-ir neurons are located in the superior glossopharyngeal ganglion located ventrolateral to the medulla oblongata in the cranial cavity, and that CGRP-ir neurons are also located in the inferior glossopharyngeal ganglion at the jugular foramen. When Fluorogold was injected into the soft palate, the root of tongue, or the pharyngeal constrictor muscles, many retrogradely Fluorogold-labeled neurons were found in the superior glossopharyngeal ganglion and the nodose ganglion, and several Fluorogold-labeled neurons were found in the inferior glossopharyngeal ganglion. Double labeling with immunohistochemistry for CGRP and Fluorogold showed that in every case of injections of Fluorogold into the soft palate, the root of tongue, or the pharynx, about 30% of the Fluorogold-labeled neurons in the superior glossopharyngeal ganglion expressed CGRP-like immunoreactivity, while no double-labeled neurons were found in the inferior glossopharyngeal ganglion or the nodose ganglion. These results indicate that nociceptive sensory information from the soft palate, the root of tongue, and the pharynx might be conveyed by the neurons in the superior glossopharyngeal ganglion to the nucleus tractus solitarii.

  16. Biochemical basis of 5-aminolaevulinic acid-induced protoporphyrin IX accumulation: a study in patients with (pre)malignant lesions of the oesophagus.

    PubMed Central

    Hinnen, P.; de Rooij, F. W.; van Velthuysen, M. L.; Edixhoven, A.; van Hillegersberg, R.; Tilanus, H. W.; Wilson, J. H.; Siersema, P. D.

    1998-01-01

    Administration of 5-aminolaevulinic acid (ALA) leads to porphyrin accumulation in malignant and premalignant tissues, and ALA is used as a prodrug in photodynamic therapy (PDT). To understand the mechanism of porphyrin accumulation after the administration of ALA and to investigate whether ALA-induced protoporphyrin IX might be a suitable photosensitizer in Barrett's oesophagus and adenocarcinoma, we determined the activities of porphobilinogen deaminase (PBG-D) and ferrochelatase (FC) in various malignant and premalignant as well as in normal tissues of the human oesophagus. A PDT power index for ALA-induced porphyrin accumulation, the ratio of PBG-D to FC normalized for the normal squamous epithelium of the oesophagus, was calculated to evaluate intertissue variation in the ability to accumulate porphyrins. In malignant and premalignant tissue a twofold increased PBG-D activity and a marginally increased FC activity was seen compared with normal squamous epithelium. A significantly increased PDT power index in Barrett's epithelium and adenocarcinoma was found. Our results suggest that, after the administration of ALA, porphyrins will accumulate in a greater amount in Barrett's epithelium and adenocarcinoma of the oesophagus because of an imbalance between PBG-D and FC activities. The PDT power index here defined might be a useful indicative parameter for predicting the susceptibility of these tissues to ALA-PDT. PMID:9744510

  17. Übergreifende Risiken und Unsicherheiten

    NASA Astrophysics Data System (ADS)

    Renn, Ortwin

    Inzwischen kann die Wissenschaft mit Klimamodellen künftige Entwicklungen und Gefährdungen durch den Klimawandel relativ gut projizieren. Doch das ist immer mit Unsicherheiten und Mehrdeutigkeiten verbunden, die Anlass für gesellschaftliche Debatten geben. Im Mittelpunkt dieses Kapitels steht daher die Frage, wie Individuen, Gesellschaften und die Weltgemeinschaft mit globalen Risiken umgehen sollen und wie sie die mit Risiko verknüpften Probleme von Komplexität, Unsicherheit und Mehrdeutigkeit angehen wollen. Zudem gilt es auszuhandeln, wie viel Aufmerksamkeit und wie viele Ressourcen eine Gesellschaft aufwenden soll, um das Risiko "Klimawandel" zu mindern, während noch viele andere, ebenso gravierende Risiken die Menschheit bedrohen.

  18. Abdichtungen im Verbund mit Fliesen und Platten

    NASA Astrophysics Data System (ADS)

    Platts, Thomas

    Abdichtungen im Verbund mit Fliesen und Platten, im Folgenden auch als Verbundabdichtungen oder mit Kurzzeichen als AIV bezeichnet, haben sich in der Baupraxis insbesondere in Innenräumen wegen des vereinfachten konstruktiven Aufbaus gegenüber Bahnenabdichtungen nach DIN 18195-5 [14.1] in der Mehrzahl der Ausführungen durchgesetzt und bewährt. Sie können im Innen- und Außenbereich angeordnet werden und sind dadurch gekennzeichnet, dass die Nutzschicht in Boden- und Wandbereichen im Dünnbettverfahren unmittelbar auf die Abdichtung aufgebracht wird. Aufwändige Zwischenschichten oder Einbauteile wie armierter Putz, Telleranker etc. entfallen (Bild 14.1) und es lassen sich geringere Aufbauhöhen realisieren.

  19. Die Wirkung als Naturkraft und die Herkunft von Zeit, Raum, Dimensionen, Naturkräften, und Gesetzen von Logik, Geometrie und Physik bei der Entstehung der Welt

    NASA Astrophysics Data System (ADS)

    Landgraf, Werner

    2011-02-01

    Das Wirkungs-Welt-Modell enthält eine einfache Beschreibung des Anfanges der Welt, wonach, ausgehend vom einfachsten Zustand der logisch notwendigen Bejahung ihrer Existenz innerhalb ihr selbst, alles sukzessiv bewirkt wird, und ihre logischen, geometrischen und physikalischen Eigenschaften Aspekte der Verkörperung und Fortwirkung primordialer Fakten darstellen, ohne externe Schöpfung auszuschließen. Die ersten Dimensionen und sie formal und subjektiv charakterisierenden Größen sind: Informationsmenge und Wirkung, mit abzählbarem Ereignis und Wirkungsquantum; Zeit und Energie, mit deren Planck-Einheiten; Geschwindigkeit oder Strecke und Impuls, mit Lichtgeschwindigkeit oder Planck-Länge; Krümmung oder zwei räumliche Richtungen, mit Gravitationskonstanten, und aus den ihnen entsprechenden primären Naturkräften setzen sich die uns geläufigen zusammen.

  20. FAUST: Entwicklung von Fahrerassistenz- und autonomen Systemen

    NASA Astrophysics Data System (ADS)

    Pareigis, Stephan; Schwarz, Bernd; Korf, Franz

    Der Beitrag beschreibt ein Ausbildungs- und Entwicklungsprojekt am Department Informatik der Hochschule für Angewandte Wissenschaften (HAW) Hamburg. Auf verschiedenen Fahrzeugplattformen werden Fahrerassistenz- und autonome Systeme entwickelt. Die zu erarbeitenden Inhalte umfassen die Themen verteilte Echtzeitsysteme, Sensordatenverarbeitung und Bildverarbeitung. Aus didaktischer Sicht wird durch die geforderte Teamarbeit ein hohes Motivationspotential der Studierenden erreicht, durch das neben den technologischen Kenntnissen auch Softskills vermittelt werden.

  1. Use of oral gadobenate dimeglumine to visualise the oesophagus during magnetic resonance angiography in patients with atrial fibrillation prior to catheter ablation.

    PubMed

    Faletti, Riccardo; Rapellino, Alessandro; Barisone, Francesca; Anselmino, Matteo; Ferraris, Federico; Fonio, Paolo; Gaita, Fiorenzo; Gandini, Giovanni

    2014-06-13

    Atrio-oesophageal fistula was first reported as a fatal complication of surgical endocardial and percutaneous endocardial radiofrequency ablation for atrial fibrillation, with an incidence after catheter ablation between 0.03% and 0.5%. Magnetic resonance angiography (MRA) was usually performed to obtain pre-procedural 3D images, used to merging into an electro-anatomical map, guiding step-by-step ablation strategy of AF. Our aim was to find an easy, safe and cost-effective way to enhance the oesophagus during MRA. In 105 consecutive patients, a right-left phase encoding, free breathing, 3D T1 MRA sequence was performed in the axial plane, >24 hours before catheter ablation, using an intravenous injection of gadobenate dimeglumine contrast medium. The oesophagus was enhanced using an oral gel solution of 0.7 mL gadobenate dimeglumine contrast medium mixed with approximately 40 mg thickened water gel, which was swallowed by the patients on the scanning table, immediately before the MRA sequence acquisition. The visualisation of the oesophagus was obtained in 104/105 patients and images were successfully merged, as left atrium and pulmonary veins, into an electro-anatomical map, during percutaneous endocardial radiofrequency ablation. All patients tolerated the study protocol and no immediate or late complication was observed with the oral contrast agent administration. The free-breathing MRA sequence used in our protocol took 7 seconds longer than MRA breath-hold conventional sequence. Oesophagus visualization with oral gadobenate dimeglumine is feasible for integration of oesophagus anatomy images into the electro-anatomical map during AF ablation, without undesirable side effects and without significantly increasing cost or examination time.

  2. Use of oral gadobenate dimeglumine to visualise the oesophagus during magnetic resonance angiography in patients with atrial fibrillation prior to catheter ablation

    PubMed Central

    2014-01-01

    Background Atrio-oesophageal fistula was first reported as a fatal complication of surgical endocardial and percutaneous endocardial radiofrequency ablation for atrial fibrillation, with an incidence after catheter ablation between 0.03% and 0.5%. Magnetic resonance angiography (MRA) was usually performed to obtain pre-procedural 3D images, used to merging into an electro-anatomical map, guiding step-by-step ablation strategy of AF. Our aim was to find an easy, safe and cost-effective way to enhance the oesophagus during MRA. Methods In 105 consecutive patients, a right-left phase encoding, free breathing, 3D T1 MRA sequence was performed in the axial plane, >24 hours before catheter ablation, using an intravenous injection of gadobenate dimeglumine contrast medium. The oesophagus was enhanced using an oral gel solution of 0.7 mL gadobenate dimeglumine contrast medium mixed with approximately 40 mg thickened water gel, which was swallowed by the patients on the scanning table, immediately before the MRA sequence acquisition. Results The visualisation of the oesophagus was obtained in 104/105 patients and images were successfully merged, as left atrium and pulmonary veins, into an electro-anatomical map, during percutaneous endocardial radiofrequency ablation. All patients tolerated the study protocol and no immediate or late complication was observed with the oral contrast agent administration. The free-breathing MRA sequence used in our protocol took 7 seconds longer than MRA breath-hold conventional sequence. Conclusion Oesophagus visualization with oral gadobenate dimeglumine is feasible for integration of oesophagus anatomy images into the electro-anatomical map during AF ablation, without undesirable side effects and without significantly increasing cost or examination time. PMID:24927953

  3. Final Results Following Platin-based Exclusive Chemotherapy for Selected Patients with Squamous Cell Carcinoma of the Larynx and Pharynx

    PubMed Central

    Holsinger, F. Christopher; Lin, Heather Y.; Bassot, Vincent; Laccourreye, Ollivier

    2009-01-01

    Purpose To determine the long-term outcomes for patients with squamous cell carcinoma of the larynx and pharynx treated with platin-based exclusive chemotherapy (EC) after complete clinical response (CCR) to induction chemotherapy. Materials and Methods 142 patients who achieved a CCR after platin-based induction chemotherapy were treated exclusively with additional chemotherapy. 98.6% were followed for a minimum of 3 years or until death; 35 patients had >10yrs of follow-up. Results Survival at 1- and 5-year was 95.8% and 61.2%, respectively. The main causes of death were metachronous second primaries (27) and intercurrent disease (21). Death related to EC was not encountered and only two patients (1.4%) had grade 4 toxicity. In multivariate analysis, primary tumor arising outside the glottic larynx (p=.0001), and Charlson comorbidity index>1 (p=.0001) were associated with a statistically significant reduction in survival. The 1-and 5-year Kaplan-Meier local control estimates were 76.1% and 50.7%, respectively. Salvage treatment resulted in an observed final 93.0% local control rate and varied from 97.2% in patients with glottic cancer to 88.7% in patients with tumor originating from other sites (p = .097). PF chemotherapy allowed for successful modulation of local therapy in 54.9% of patients. Conclusions For selected patients, EC may provide long-term durable disease control. For patients with relapse after EC, this approach does not diminish survival and maintains function in a majority of patients. Future work should be directed to select markers of response to PF chemotherapy and thereby to identify which patients are optimally suited for this approach. PMID:19551883

  4. Mittelwert- und Arbeitstaktsynchrone Simulation von Dieselmotoren

    NASA Astrophysics Data System (ADS)

    Zahn, Sebastian

    Getrieben durch die immer restriktiveren Anforderungen an das Emissions- und Verbrauchsverhalten moderner Verbrennungsmotoren steigt die Komplexität von Motormanagementsystemen mit jeder Modellgeneration an. Damit geht nicht nur eine Zunahme des Softwareumfangs von Steuergeräten sondern zugleich ein deutlicher Anstieg des Applikations-, Vermessungs- und Testaufwandes einher. Zur Effizienzsteigerung des Software- und Funktionsentwicklungsprozesses haben sich daher in der Automobilindustrie sowie in Forschungsinstituten verschiedene modell- und simulationsbasierte Methoden wie die Model-in-the-Loop (MiL) Simulation, die Software-in-the-Loop (SiL) Simulation, das Rapid Control Prototyping (RCP) sowie die Hardware-in-the-Loop (HiL) Simulation etabliert.

  5. An in vitro model for the evaluation of the adhesion of solid oral dosage forms to the oesophagus.

    PubMed

    Smart, John D; Dunkley, Sian; Tsibouklis, John; Young, Simon

    2013-04-15

    Adhesion of solid oral dosage forms to the oesophagus can be a disadvantage when delivering drugs that may cause oesophageal damage, or can be an advantage when developing localised therapies for this region. In this study, apparatus to investigate coatings that may influence oesophageal retention was developed and evaluated. The apparatus incorporated a section of porcine oesophageal mucosa held flat by the application of a gentle vacuum and kept moist by the application of a simulated saliva solution. The resistance to the application of more physiologically relevant shear stresses was evaluated. Using a range of materials it was found that differences in oesophageal adhesion could be identified. Materials like sodium alginate were highly adhesive and had a tendency to re-adhere while paraffin waxes showed no adhesion. The rapid loss of the polymer coat from the surface for water swellable materials was identified as an issue. Copyright © 2013 Elsevier B.V. All rights reserved.

  6. C-erb-B2 and Bcl-xl protein expression in Barrett's oesophagus in correlation with morphological parameters.

    PubMed

    Barwijuk-Machała, M; Reszeć, J; Kemona, A; Sobaniec-Lotowska, M

    2004-01-01

    The aim of the study was to evaluate the correlation of c-erb-b2 and Bcl-xl expression in biopsy specimens of Barrett's oesophagus from 44 patients with morphological features. The examined group was subdivided into: negative for dysplasia, indefinite for dysplasia, positive for dysplasia-low grade, and adenocarcinoma with high grade dysplasia. Positive c-erb-B2 staining was found in 34.1% and Bcl-xl protein expression was observed in 96.9% of BE. The results showed increased c-erb-B2 and Bcl-xl protein expressions with progressive grades of dysplasia to adenocarcinoma. In conclusion, an evaluation of c-erb-B2 and Bcl-xl expression can be useful for the histopatologic diagnosis of BE and correct interpretation of dysplasia.

  7. Unusual case of respiratory embarrassment secondary to tracheal compression by a dilated oesophagus in a patient with recurrent achalasia.

    PubMed

    Brodie, Andrew; Okeahialam, Nicola; Farinella, Eriberto

    2016-05-04

    We present the case of a 79-year-old woman with recurrent achalasia following a laparoscopic Heller's cardiomyotomy. The patient presented to the emergency department, with epigastric pain, severe dyspnoea and profound respiratory acidosis. She required intubation and ventilation followed by gastric decompression with nasogastric tube and the administration of intravenous antibiotics for a lower respiratory tract infection. Once stable, she underwent a CT scan revealing a massively dilated oesophagus causing marked tracheal compression. She received a period of continuous positive airway pressure ventilation while on the intensive care unit, for persistent low saturations, however, this was promptly ceased due to exacerbation of gastric dilation and fears over perforation. The patient responded well to conservative measures and was discharged home 18 days later awaiting follow-up with operating consultant surgeon. 2016 BMJ Publishing Group Ltd.

  8. Delayed reconstruction of the upper digestive tract in a patient following total pharyngolaryngectomy with resection of the cervical oesophagus

    PubMed Central

    Szewczyk, Mateusz; Pazdrowski, Jakub; Golusiński, Paweł; Golusiński, Wojciech

    2015-01-01

    Carcinoma of the hypopharynx is an uncommon disease, with an annual incidence of approximately 1 in 100,000. Post-cricoid carcinoma is more common in women and is not usually associated with tobacco and alcohol abuse. Reconstruction of large pharyngeal defects following surgery for squamous cell carcinoma is complex and often requires microvascular free tissue transfer to achieve the best oncological and functional outcomes. The most common complications of such procedures include fistulas and strictures of the neopharynx. Here, we describe a case of a female patient admitted to the Head and Neck Department at our hospital to undergo delayed reconstruction following pharyngolaryngectomy and removal of the cervical oesophagus. Several complications occurred during post-operative care, including stricture and skin dehiscence. At present, the patient is able to swallow saliva and is currently being prepared to return to a normal diet. PMID:25949230

  9. Multiphoton microscopic imaging of histological sections without hematoxylin and eosin staining differentiates carcinoma in situ lesion from normal oesophagus

    NASA Astrophysics Data System (ADS)

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

    2013-10-01

    Multiphoton microscopy (MPM) has become a powerful, important tool for tissues imaging at the molecular level. In this paper, this technique was extended to histological investigations, differentiating carcinoma in situ (CIS) lesion from normal oesophagus by imaging histological sections without hematoxylin and eosin (H&E) staining. The results show that the histology procedures of dehydration, paraffin embedding, and de-paraffinizing highlighted two photon excited fluorescence of cytoplasm and nucleolus of epithelial cell and collagen in stroma. MPM has the ability to identify the characteristics of CIS lesion including changes of squamous cells and full epithelium, identification of basement membrane, especially prominent nucleolus. The studies described here show that MPM has the potential for future retrospective studies of tumor staging by employing on histological section specimens without H&E staining.

  10. Transplantation of tissue-engineered cell sheets for stricture prevention after endoscopic submucosal dissection of the oesophagus

    PubMed Central

    Sjöqvist, Sebastian; Elbe, Peter; Kanai, Nobuo; Enger, Jenny; Haas, Stephan L; Mohkles-Barakat, Ammar; Okano, Teruo; Takagi, Ryo; Ohki, Takeshi; Yamamoto, Masakazu; Kondo, Makoto; Markland, Katrin; Lim, Mei Ling; Yamato, Masayuki; Nilsson, Magnus; Permert, Johan; Blomberg, Pontus; Löhr, J-Matthias

    2016-01-01

    Background and objective Endoscopic mucosal dissection (ESD) is a treatment option for oesophagus tumours localized to the mucosa enabling en bloc removal of large lesions. The resulting larger mucosal defects have resulted in an increase in the occurrence of post-treatment strictures. Transplantation of autologous cell sheets, cultured from oral mucosa, has been shown to prevent post-ESD strictures. The aim of the study was to assess the efficacy and safety of cell sheet transplantation after oesophageal ESD in a Western patient population where reflux-associated pre-malignant and malignant conditions predominate. Methods Patients with Barrett’s oesophagus associated high-grade dysplasia or early adenocarcinoma where ESD entailed a resection >3 cm in length and ≥75% of the circumference were eligible for treatment under hospital exemption. Cell sheets were cultured from buccal mucosa according to Good Manufacturing Practice and were endoscopically applied to the post-ESD defect directly after resection. Patients were followed with weekly endoscopy examinations, including confocal laser microscopy, for a total of four weeks. Results Five patients were treated. ESD was extensive with resections being circumferential in three patients and 9–10 cm in length in two. The number of transplanted cell sheets ranged from two to six. Three patients developed strictures requiring two to five dilatation sessions. Conclusions Cell sheet transplantation shows to be safe and feasible in a Western population. Results suggest that transplantation has a protective effect on the mucosal defect after ESD, decreasing both the risk for and extent of stricture formation. PMID:28408991

  11. Coding of Barrett's oesophagus with high-grade dysplasia in national administrative databases: a population-based cohort study.

    PubMed

    Chadwick, Georgina; Varagunam, Mira; Brand, Christian; Riley, Stuart A; Maynard, Nick; Crosby, Tom; Michalowski, Julie; Cromwell, David A

    2017-06-09

    The International Classification of Diseases 10th Revision (ICD-10) system used in the English hospital administrative database (Hospital Episode Statistics (HES)) does not contain a specific code for oesophageal high-grade dysplasia (HGD). The aim of this paper was to examine how patients with HGD were coded in HES and whether it was done consistently. National population-based cohort study of patients with newly diagnosed with HGD in England. The study used data collected prospectively as part of the National Oesophago-Gastric Cancer Audit (NOGCA). These records were linked to HES to investigate the pattern of ICD-10 codes recorded for these patients at the time of diagnosis. All patients with a new diagnosis of HGD between 1 April 2013 and 31 March 2014 in England, who had data submitted to the NOGCA. The main outcome assessed was the pattern of primary and secondary ICD-10 diagnostic codes recorded in the HES records at endoscopy at the time of diagnosis of HGD. Among 452 patients with a new diagnosis of HGD between 1 April 2013 and 31 March 2014, Barrett's oesophagus was the only condition coded in 200 (44.2%) HES records. Records for 59 patients (13.1%) contained no oesophageal conditions. The remaining 193 patients had various diagnostic codes recorded, 93 included a diagnosis of Barrett's oesophagus and 57 included a diagnosis of oesophageal/gastric cardia cancer. HES is not suitable to support national studies looking at the management of HGD. This is one reason for the UK to adopt an extended ICD system (akin to ICD-10-CM). © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. Epigenetic biomarkers in progression from non-dysplastic Barrett's oesophagus to oesophageal adenocarcinoma: a systematic review protocol

    PubMed Central

    Tomlinson, C L; Dretzke, J; Bayliss, S; Dilworth, M; Beggs, A D; Tucker, O

    2016-01-01

    Introduction Barrett's oesophagus (BO), a metaplastic condition affecting the lower oesophagus due to long-standing gastro-oesophageal reflux and chronic inflammation, is a precursor lesion for oesophageal adenocarcinoma (OADC). There is no clinical test to predict which patients with BO will progress to OADC. The British Society of Gastroenterology recommends endoscopic surveillance of patients with BO. Epigenetic changes have been well characterised in the neoplastic progression of ulcerative colitis to colonic carcinoma, another gastrointestinal cancer associated with chronic inflammation. This systematic review protocol aims to identify and evaluate studies which examine epigenetic biomarkers in BO and their association with progression to OADC. Methods and analysis All prospective and retrospective primary studies, and existing systematic reviews investigating epigenetic markers including DNA methylation, histone modification, chromatin remodelling, micro and non-coding RNAs of all types will be eligible for inclusion. Eligible patients are those over the age of 18 with BO, BO with dysplasia, OADC or unspecified oesophageal cancer. A comprehensive search of bibliographic databases using combinations of text and index words relating to the population, prognostic markers and outcome will be undertaken with no language restrictions. Results will be screened by 2 independent reviewers and data extracted using a standardised proforma. The quality and risk of bias of individual studies will be assessed using the Quality in Prognostic Studies (QUIPS) tool. A narrative synthesis of all evidence will be performed with key findings tabulated. Meta-analysis will be considered where studies and reported outcomes are considered sufficiently homogeneous, both clinically and methodologically. Findings will be interpreted in the context of the quality of included studies. The systematic review will be reported according to PRISMA guidelines. Ethics and dissemination This is a

  13. Quantitative immunohistochemical co-localization of TRPV1 and CGRP in varicose axons of the murine oesophagus, stomach and colorectum.

    PubMed

    Sharrad, D F; Hibberd, T J; Kyloh, M A; Brookes, S J H; Spencer, N J

    2015-07-10

    In the gastrointestinal (GI) tract of mammals, endings of spinal afferent neurons with cell bodies in dorsal root ganglia (DRG) detect many stimuli, including those that give rise to pain. Many of these sensory neurons express calcitonin gene-related peptide (CGRP) and TRPV1 in their cell bodies and axons. Indeed, CGRP and TRPV1 have been widely used as immunohistochemical markers of nociceptive spinal afferent axons. Although CGRP and TRPV1 often coexist in the same axons in the GI tract, their degree of coexistence along its length has yet to be quantified. In this study, we used double-labeling immunohistochemistry to quantify the coexistence of CGRP and TRPV1 in varicose axons of the murine oesophagus, stomach and colorectum. The great majority of CGRP-immunoreactive (IR) varicosities in myenteric ganglia of the lower esophagus (97±1%) and stomach (95±1%) were also TRPV1-immunoreactive. Similarly, the majority of TRPV1-IR varicosities in myenteric ganglia of the lower esophagus (95±1%) and stomach (91±1%) were also CGRP-IR. In the colorectum similar observations were made for an intensely immunoreactive population of CGRP-IR axons, of which most (91±1%) were also TRPV1-IR. Of the TRPV1-IR axons in the colorectum, most (96±1%) contained intense CGRP-IR. Another population of axons in myenteric ganglia of the colorectum had low intensity CGRP immunoreactivity; these showed negligible co-existence with TRPV1. Our observations reveal that in the myenteric plexus of murine oesophagus, stomach and colorectum, CGRP and TRPV1 are largely expressed together.

  14. The human squamous oesophagus has widespread capacity for clonal expansion from cells at diverse stages of differentiation.

    PubMed

    Barbera, Mariagnese; di Pietro, Massimiliano; Walker, Elaine; Brierley, Charlotte; MacRae, Shona; Simons, Benjamin D; Jones, Phil H; Stingl, John; Fitzgerald, Rebecca C

    2015-01-01

    Knowledge of the cellular mechanisms involved in homeostasis of human squamous oesophagus in the steady state and following chronic injury is limited. We aimed to better understand these mechanisms by using a functional 3D approach. Proliferation, mitosis and the expression of progenitor lineage markers were assessed in normal squamous oesophagus from 10 patients by immunofluorescence on 3D epithelial whole mounts. Cells expressing differential levels of epithelial and progenitor markers were isolated using flow cytometry sorting and characterised by qPCR and IF. Their self-renewing potential was investigated by colony forming cells assays and in vitro organotypic culture models. Proliferation and mitotic activity was highest in the interpapillary basal layer and decreased linearly towards the tip of the papilla (p<0.0001). The orientation of mitosis was random throughout the basal layer, and asymmetric divisions were not restricted to specific cell compartments. Cells sorted into distinct populations based on the expression of epithelial and progenitor cell markers (CD34 and EpCAM) showed no difference in self-renewal in 2D culture, either as whole populations or as single cells. In 3D organotypic cultures, all cell subtypes were able to recapitulate the architecture of the tissue of origin and the main factor determining the success of the 3D culture was the number of cells plated, rather than the cell type. Oesophageal epithelial cells demonstrate remarkable plasticity for self-renewal. This situation could be viewed as an ex vivo wounding response and is compatible with recent findings in murine models. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  15. Ruhende Flüssigkeiten und Gase

    NASA Astrophysics Data System (ADS)

    Heintze, Joachim

    Das mechanische Verhalten von Flüssigkeiten und Gasen ist dadurch gekennzeichnet, dass sie keine statische Schubfestigkeit besitzen, andernfalls würden sie nicht beginnen, zu fließen. In ruhenden Flüssigkeiten und Gasen können daher keine Schubspannungen bestehen:

  16. Ton- und Bildübertragung

    NASA Astrophysics Data System (ADS)

    Plaßmann, Wilfried

    Stichworte zum Kapitel: Analoge Rundfunk-Stereoübertragung; Digitale Farbfernsehtechnik: Zielsetzung, Vorgaben, DVB-Projekt, MPEG-2 Standard, Redundanz- und Irrelevanzreduktion, Differenz-Pulsmodulation, Diskrete Kosinus-Transformation, Fehler-Erkennung und -Korrektur, Energieverwischung, 16-QAPSK-Modulation, Gleichwellennetz, Statistischer Multiplex, Daten zum DVB-T.

  17. Physik gestern und heute Das Eiskalorimeter

    NASA Astrophysics Data System (ADS)

    Heering, P.

    2003-07-01

    Kalorimetrische Messungen gehören heute zum experimentellen Standardrepertoire im Bereich der Thermodynamik und der physikalischen Chemie. Das erste Gerät für derartige Messungen entwickelten Ende des 18. Jahrhunderts die französischen Wissenschaftler Antoine Laurent Lavoisier und Pierre Simon de Laplace.

  18. Quantitative Analyse und Visualisierung der Herzfunktionen

    NASA Astrophysics Data System (ADS)

    Sauer, Anne; Schwarz, Tobias; Engel, Nicole; Seitel, Mathias; Kenngott, Hannes; Mohrhardt, Carsten; Loßnitzer, Dirk; Giannitsis, Evangelos; Katus, Hugo A.; Meinzer, Hans-Peter

    Die computergestützte bildbasierte Analyse der Herzfunktionen ist mittlerweile Standard in der Kardiologie. Die verfügbaren Produkte erfordern meist ein hohes Maß an Benutzerinteraktion und somit einen erhöhten Zeitaufwand. In dieser Arbeit wird ein Ansatz vorgestellt, der dem Kardiologen eine größtenteils automatische Analyse der Herzfunktionen mittels MRT-Bilddaten ermöglicht und damit Zeitersparnis schafft. Hierbei werden alle relevanten herzphysiologsichen Parameter berechnet und mithilfe von Diagrammen und Graphen visualisiert. Diese Berechnungen werden evaluiert, indem die ermittelten Werte mit manuell vermessenen verglichen werden. Der hierbei berechnete mittlere Fehler liegt mit 2,85 mm für die Wanddicke und 1,61 mm für die Wanddickenzunahme immer noch im Bereich einer Pixelgrösse der verwendeten Bilder.

  19. A protocol describing pharynx counts and a review of other assays of apoptotic cell death in the nematode worm Caenorhabditis elegans.

    PubMed

    Schwartz, Hillel T

    2007-01-01

    Studies of the nematode worm Caenorhabditis elegans have provided important insights into the genetics of programmed cell death (PCD), and revealed molecular mechanisms conserved from nematodes to humans. The organism continues to offer opportunities to investigate the processes of apoptosis under very well-defined conditions and at single-cell resolution in living animals. Here, a survey of the common methods used to study the process of PCD in C. elegans is described. Detailed instructions are provided for one standard method--the counting of extra cells of the anterior pharynx--a quantitative technique that can be used to detect even very subtle alterations in the progression of apoptotic cell death.

  20. Intraluminal pressure, transmucosal potential difference, and pH studies in the oesophagus of patients before and after Collis repair of a hiatal hernia

    PubMed Central

    Habibulla, K. S.; Collis, J. Leigh

    1973-01-01

    Intraluminal pressure, transmucosal potential difference, and endo-oesophageal pH measurements were studied in patients with hiatal hernia—before and after a hiatal repair. The operation employed is the Collis (1968) repair for uncomplicated hiatal hernia and does not refer to gastroplasty as recommended for peptic stricture (Collis, 1961). Postoperative studies show that the repair approximates the inferior oesophageal sphincter to the hiatus with the production of a single band of raised pressure at the lower end of the oesophagus. This band is similar to that seen in normal subjects and its appearance was associated with cure of the symptoms, abolition of the gastro-oesophageal reflux, and improvement in the function of the inferior oesophageal sphincter and the musculature of the body of the oesophagus. Certain physiological implications of this study are discussed. Images PMID:4724501

  1. Retinoic Acid-Activated Ndrg1a Represses Wnt/β-catenin Signaling to Allow Xenopus Pancreas, Oesophagus, Stomach, and Duodenum Specification

    PubMed Central

    Zhang, Tiejun; Guo, Xiaogang; Chen, Yonglong

    2013-01-01

    How cells integrate multiple patterning signals to achieve early endoderm regionalization remains largely unknown. Between gastrulation and neurulation, retinoic acid (RA) signaling is required, while Wnt/β-catenin signaling has to be repressed for the specification of the pancreas, oesophagus, stomach, and duodenum primordia in Xenopus embryos. In attempt to screen for RA regulated genes in Xenopus endoderm, we identified a direct RA target gene, N-myc downstream regulated gene 1a (ndrg1a) that showed expression early in the archenteron roof endoderm and late in the developing pancreas, oesophagus, stomach, and duodenum. Both antisense morpholino oligonucleotide mediated knockdown of ndrg1a in Xenopus laevis and the transcription activator-like effector nucleases (TALEN) mediated disruption of ndrg1 in Xenopus tropicalis demonstrate that like RA signaling, Ndrg1a is specifically required for the specification of Xenopus pancreas, oesophagus, stomach, and duodenum primordia. Immunofluorescence data suggest that RA-activated Ndrg1a suppresses Wnt/β-catenin signaling in Xenopus archenteron roof endoderm cells. Blocking Wnt/β-catenin signaling rescued Ndrg1a knockdown phenotype. Furthermore, overexpression of the putative Wnt/β-catenin target gene Atf3 phenocopied knockdown of Ndrg1a or inhibition of RA signaling, while Atf3 knockdown can rescue Ndrg1a knockdown phenotype. Lastly, the pancreas/stomach/duodenum transcription factor Pdx1 was able to rescue Atf3 overexpression or Ndrg1a knockdown phenotype. Together, we conclude that RA activated Ndrg1a represses Wnt/β-catenin signaling to allow the specification of pancreas, oesophagus, stomach, and duodenum progenitor cells in Xenopus embryos. PMID:23741453

  2. Retinoic acid-activated Ndrg1a represses Wnt/β-catenin signaling to allow Xenopus pancreas, oesophagus, stomach, and duodenum specification.

    PubMed

    Zhang, Tiejun; Guo, Xiaogang; Chen, Yonglong

    2013-01-01

    How cells integrate multiple patterning signals to achieve early endoderm regionalization remains largely unknown. Between gastrulation and neurulation, retinoic acid (RA) signaling is required, while Wnt/β-catenin signaling has to be repressed for the specification of the pancreas, oesophagus, stomach, and duodenum primordia in Xenopus embryos. In attempt to screen for RA regulated genes in Xenopus endoderm, we identified a direct RA target gene, N-myc downstream regulated gene 1a (ndrg1a) that showed expression early in the archenteron roof endoderm and late in the developing pancreas, oesophagus, stomach, and duodenum. Both antisense morpholino oligonucleotide mediated knockdown of ndrg1a in Xenopus laevis and the transcription activator-like effector nucleases (TALEN) mediated disruption of ndrg1 in Xenopus tropicalis demonstrate that like RA signaling, Ndrg1a is specifically required for the specification of Xenopus pancreas, oesophagus, stomach, and duodenum primordia. Immunofluorescence data suggest that RA-activated Ndrg1a suppresses Wnt/β-catenin signaling in Xenopus archenteron roof endoderm cells. Blocking Wnt/β-catenin signaling rescued Ndrg1a knockdown phenotype. Furthermore, overexpression of the putative Wnt/β-catenin target gene Atf3 phenocopied knockdown of Ndrg1a or inhibition of RA signaling, while Atf3 knockdown can rescue Ndrg1a knockdown phenotype. Lastly, the pancreas/stomach/duodenum transcription factor Pdx1 was able to rescue Atf3 overexpression or Ndrg1a knockdown phenotype. Together, we conclude that RA activated Ndrg1a represses Wnt/β-catenin signaling to allow the specification of pancreas, oesophagus, stomach, and duodenum progenitor cells in Xenopus embryos.

  3. COX‐2 induction by unconjugated bile acids involves reactive oxygen species‐mediated signalling pathways in Barrett's oesophagus and oesophageal adenocarcinoma

    PubMed Central

    Song, Shumei; Guha, Sushovan; Liu, Kaifeng; Buttar, Navtej S; Bresalier, Robert S

    2007-01-01

    Objectives Bile reflux contributes to oesophageal injury and neoplasia. COX‐2 is involved in both inflammation and carcinogenesis; however, the precise mechanisms by which bile acids promote COX‐2 expression in the oesophagus are largely unknown. We analysed the molecular mechanisms that govern bile acid‐mediated expression of COX‐2 in Barrett's oesophagus and oesophageal adenocarcinoma (OA). Design The effects of bile acids on COX‐2 expression were analysed in immortalised Barrett's oesophagus and OA cells using immunoblotting and transient transfections. Pharmacological inhibitors, phospho‐specific antibodies, dominant‐negative mutants and siRNA techniques were used to identify relevant signalling pathways. Flow cytometry and reactive oxygen species (ROS) scavengers were used to examine ROS involvement. Immunohistochemistry was performed on oesophageal mucosa obtained from an established rat model of bile reflux. Results Unconjugated bile acids potently stimulated COX‐2 expression and induced AKT and ERK1/2 phosphorylation in concert with COX‐2 induction. These findings were mimicked in the in vivo rat model. Dominant‐negative (DN) AKT and LY294002 (PI3K inhibitor) or U0126 (MEK‐1/2 inhibitor) blocked chenodeoxycholic acid (CD) and deoxycholic acid (DC) mediated COX‐2 induction. CD and DC also induced CREB phosphorylation and AP‐1 activity. CREB‐specific siRNA and DN AP‐1 blocked CD and DC‐induced COX‐2 induction. Finally, CD and DC increased intracellular ROS, while ROS scavengers blocked COX‐2 induction and the signalling pathways involved. Conclusions Unconjugated bile acids induce CREB and AP‐1‐dependent COX‐2 expression in Barrett's oesophagus and OA through ROS‐mediated activation of PI3K/AKT and ERK1/2. This study enhances our understanding of the molecular mechanisms by which bile acids promote the development of oesophageal adenocarcinoma. PMID:17604323

  4. Dietary magnesium, calcium:magnesium ratio and risk of reflux oesophagitis, Barrett's oesophagus and oesophageal adenocarcinoma: a population-based case-control study.

    PubMed

    Dai, Qi; Cantwell, Marie M; Murray, Liam J; Zheng, Wei; Anderson, Lesley A; Coleman, Helen G

    2016-01-28

    Evidence suggests a role of Mg and the ratio of Ca:Mg intakes in the prevention of colonic carcinogenesis. The association between these nutrients and oesophageal adenocarcinoma - a tumour with increasing incidence in developed countries and poor survival rates - has yet to be explored. The aim of this investigation was to explore the association between Mg intake and related nutrients and risk of oesophageal adenocarcinoma and its precursor conditions, Barrett's oesophagus and reflux oesophagitis. This analysis included cases of oesophageal adenocarcinoma (n 218), Barrett's oesophagus (n 212), reflux oesophagitis (n 208) and population-based controls (n 252) recruited between 2002 and 2005 throughout the island of Ireland. All the subjects completed a 101-item FFQ. Unconditional logistic regression analysis was applied to determine odds of disease according to dietary intakes of Mg, Ca and Ca:Mg ratio. After adjustment for potential confounders, individuals consuming the highest amounts of Mg from foods had significant reductions in the odds of reflux oesophagitis (OR 0·31; 95 % CI 0·11, 0·87) and Barrett's oesophagus (OR 0·29; 95 % CI 0·12, 0·71) compared with individuals consuming the lowest amounts of Mg. The protective effect of Mg was more apparent in the context of a low Ca:Mg intake ratio. No significant associations were observed for Mg intake and oesophageal adenocarcinoma risk (OR 0·77; 95 % CI 0·30, 1·99 comparing the highest and the lowest tertiles of consumption). In conclusion, dietary Mg intakes were inversely associated with reflux oesophagitis and Barrett's oesophagus risk in this Irish population.

  5. Asia-Pacific consensus on the management of gastro-oesophageal reflux disease: an update focusing on refractory reflux disease and Barrett's oesophagus.

    PubMed

    Fock, Kwong Ming; Talley, Nicholas; Goh, Khean Lee; Sugano, Kentaro; Katelaris, Peter; Holtmann, Gerald; Pandolfino, John E; Sharma, Prateek; Ang, Tiing Leong; Hongo, Michio; Wu, Justin; Chen, Minhu; Choi, Myung-Gyu; Law, Ngai Moh; Sheu, Bor-Shyang; Zhang, Jun; Ho, Khek Yu; Sollano, Jose; Rani, Abdul Aziz; Kositchaiwat, Chomsri; Bhatia, Shobna

    2016-09-01

    Since the publication of the Asia-Pacific consensus on gastro-oesophageal reflux disease in 2008, there has been further scientific advancement in this field. This updated consensus focuses on proton pump inhibitor-refractory reflux disease and Barrett's oesophagus. A steering committee identified three areas to address: (1) burden of disease and diagnosis of reflux disease; (2) proton pump inhibitor-refractory reflux disease; (3) Barrett's oesophagus. Three working groups formulated draft statements with supporting evidence. Discussions were done via email before a final face-to-face discussion. We used a Delphi consensus process, with a 70% agreement threshold, using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria to categorise the quality of evidence and strength of recommendations. A total of 32 statements were proposed and 31 were accepted by consensus. A rise in the prevalence rates of gastro-oesophageal reflux disease in Asia was noted, with the majority being non-erosive reflux disease. Overweight and obesity contributed to the rise. Proton pump inhibitor-refractory reflux disease was recognised to be common. A distinction was made between refractory symptoms and refractory reflux disease, with clarification of the roles of endoscopy and functional testing summarised in two algorithms. The definition of Barrett's oesophagus was revised such that a minimum length of 1 cm was required and the presence of intestinal metaplasia no longer necessary. We recommended the use of standardised endoscopic reporting and advocated endoscopic therapy for confirmed dysplasia and early cancer. These guidelines standardise the management of patients with refractory gastro-oesophageal reflux disease and Barrett's oesophagus in the Asia-Pacific region. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  6. Dentalwerkstoffe und Dentalimplantate - Teil 2

    NASA Astrophysics Data System (ADS)

    Faltermeier, Andreas

    Wie in allen Bereichen der Medizin findet auch in der Zahnmedizin eine kontinuierliche Weiterentwicklung der verwendeten Werkstoffe statt. Gerade für Zahnersatz werden Werkstoffe gesucht, die zum einen ästhetisch, zum anderen haltbar und darüber hinaus auch körperverträglich sind. Auch steigt immer mehr der Wunsch der Patienten nach ästhetischen und zugleich biokompatiblen Materialien. Wurde früher fast ausschließlich als Füllungsmaterial im Seitenzahngebiet quecksilberhaltiges Amalgam verwendet, hat der Zahnarzt heutzutage eine große Auswahl an verschiedenen zahnfarbenen Materialien: zum einen werden sog. Komposite verwendet, das aus einer Polymermatrix mit eingebetteten Füllstoffen besteht, zum anderen können diverse Dentalkeramiken verwendet werden. Besonders die Verwendung von Hochleistungskeramiken, wie beispielsweise Zirkonoxid, das sich bereits als Bremsscheiben für Sportwägen, Hitzeschilde im Space Shuttle und als Kugelköpfe künstlicher Hüftgelenke bewährt hat, spielt heutzutage eine große Rolle bei der Verdrängung des Metalls aus der Mundhöhle. War es früher nur möglich, einen verloren gegangen Zahn mittels einer Brücke, die ein Beschleifen der Nachbarzähne zur Folge hat, oder durch herausnehmbaren Zahnersatz zu ersetzen, ist es heutzutage mit der modernen Implantologie möglich, Zahnersatz zahnschonend einzugliedern. Auch kann mittels Dentalimplantaten dem Wunsch vieler Patienten nach festem Zahnersatz anstelle eines herausnehmbaren Zahnersatzes entsprochen werden. So kann mit Hilfe neuer biokompatiblen Werkstoffe sowohl der ästhetische Anspruch befriedigt als auch das Selbstwertgefühl vieler Patienten angehoben werden.

  7. Circulating vitamin D in relation to cancer incidence and survival of the head and neck and oesophagus in the EPIC cohort

    PubMed Central

    Fanidi, Anouar; Muller, David C.; Midttun, Øivind; Ueland, Per Magne; Vollset, Stein Emil; Relton, Caroline; Vineis, Paolo; Weiderpass, Elisabete; Skeie, Guri; Brustad, Magritt; Palli, Domenico; Tumino, Rosario; Grioni, Sara; Sacerdote, Carlotta; Bueno-de-Mesquita, H. B(as).; Peeters, Petra H.; Boutron-Ruault, Marie-Christine; Kvaskoff, Marina; Cadeau, Claire; Huerta, José María; Sánchez, Maria-José; Agudo, Antonio; Lasheras, Cristina; Quirós, J. Ramón; Chamosa, Saioa; Riboli, Elio; Travis, Ruth C.; Ward, Heather; Murphy, Neil; Khaw, Kay-Tee; Trichopoulou, Antonia; Lagiou, Pagona; Papatesta, Eleni-Maria; Boeing, Heiner; Kuehn, Tilman; Katzke, Verena; Steffen, Annika; Johansson, Anders; Brennan, Paul; Johansson, Mattias

    2016-01-01

    Experimental and epidemiological data suggest that vitamin D play a role in pathogenesis and progression of cancer, but prospective data on head and neck cancer (HNC) and oesophagus cancer are limited. The European Prospective Investigation into Cancer and Nutrition (EPIC) study recruited 385,747 participants with blood samples between 1992 and 2000. This analysis includes 497 case-control pairs of the head and neck and oesophagus, as well as 443 additional controls. Circulating 25(OH)D3 were measured in pre-diagnostic samples and evaluated in relation to HNC and oesophagus cancer risk and post-diagnosis all-cause mortality. After controlling for risk factors, a doubling of 25(OH)D3 was associated with 30% lower odds of HNC (OR 0.70, 95% confidence interval [95% CI] 0.56–0.88, Ptrend = 0.001). Subsequent analyses by anatomical sub-site indicated clear inverse associations with risk of larynx and hypopharynx cancer combined (OR 0.55, 95CI% 0.39–0.78) and oral cavity cancer (OR 0.60, 95CI% 0.42–0.87). Low 25(OH)D3 concentrations were also associated with higher risk of death from any cause among HNC cases. No clear association was seen with risk or survival for oesophageal cancer. Study participants with elevated circulating concentrations of 25(OH)D3 had decreased risk of HNC, as well as improved survival following diagnosis. PMID:27812016

  8. Circulating vitamin D in relation to cancer incidence and survival of the head and neck and oesophagus in the EPIC cohort.

    PubMed

    Fanidi, Anouar; Muller, David C; Midttun, Øivind; Ueland, Per Magne; Vollset, Stein Emil; Relton, Caroline; Vineis, Paolo; Weiderpass, Elisabete; Skeie, Guri; Brustad, Magritt; Palli, Domenico; Tumino, Rosario; Grioni, Sara; Sacerdote, Carlotta; Bueno-de-Mesquita, H B As; Peeters, Petra H; Boutron-Ruault, Marie-Christine; Kvaskoff, Marina; Cadeau, Claire; Huerta, José María; Sánchez, Maria-José; Agudo, Antonio; Lasheras, Cristina; Quirós, J Ramón; Chamosa, Saioa; Riboli, Elio; Travis, Ruth C; Ward, Heather; Murphy, Neil; Khaw, Kay-Tee; Trichopoulou, Antonia; Lagiou, Pagona; Papatesta, Eleni-Maria; Boeing, Heiner; Kuehn, Tilman; Katzke, Verena; Steffen, Annika; Johansson, Anders; Brennan, Paul; Johansson, Mattias

    2016-11-04

    Experimental and epidemiological data suggest that vitamin D play a role in pathogenesis and progression of cancer, but prospective data on head and neck cancer (HNC) and oesophagus cancer are limited. The European Prospective Investigation into Cancer and Nutrition (EPIC) study recruited 385,747 participants with blood samples between 1992 and 2000. This analysis includes 497 case-control pairs of the head and neck and oesophagus, as well as 443 additional controls. Circulating 25(OH)D3 were measured in pre-diagnostic samples and evaluated in relation to HNC and oesophagus cancer risk and post-diagnosis all-cause mortality. After controlling for risk factors, a doubling of 25(OH)D3 was associated with 30% lower odds of HNC (OR 0.70, 95% confidence interval [95% CI] 0.56-0.88, Ptrend = 0.001). Subsequent analyses by anatomical sub-site indicated clear inverse associations with risk of larynx and hypopharynx cancer combined (OR 0.55, 95CI% 0.39-0.78) and oral cavity cancer (OR 0.60, 95CI% 0.42-0.87). Low 25(OH)D3 concentrations were also associated with higher risk of death from any cause among HNC cases. No clear association was seen with risk or survival for oesophageal cancer. Study participants with elevated circulating concentrations of 25(OH)D3 had decreased risk of HNC, as well as improved survival following diagnosis.

  9. The conserved miR-51 microRNA family is redundantly required for embryonic development and pharynx attachment in Caenorhabditis elegans.

    PubMed

    Shaw, W Robert; Armisen, Javier; Lehrbach, Nicolas J; Miska, Eric A

    2010-07-01

    microRNAs (miRNAs) are approximately 22-nucleotide small RNAs that act as endogenous regulators of gene expression by base-pairing with target mRNAs. Here we analyze the function of the six members of the Caenorhabditis elegans miR-51 family of miRNAs (miR-51, miR-52, miR-53, miR-54, miR-55, miR-56). miR-51 family miRNAs are broadly expressed from mid-embryogenesis onward. The miR-51 family is redundantly required for embryonic development. mir-51 family mutants display a highly penetrant pharynx unattached (Pun) phenotype, where the pharyngeal muscle, the food pump of C. elegans, is not attached to the mouth. Unusually, the Pun phenotype in mir-51 family mutants is not due to a failure to attach, but instead a failure to maintain attachment during late embryogenesis. Expression of the miR-51 family in the mouth is sufficient to maintain attachment. The Fat cadherin ortholog CDH-3 is expressed in the mouth and is a direct target of the miR-51 family miRNAs. Genetic analysis reveals that miR-51 family miRNAs might act in part through CDH-3 to regulate pharynx attachment. This study is the first to assign a function to the miR-51/miR-100 miRNA family in any organism.

  10. Body Mass Index, Cigarette Smoking, and Alcohol Consumption and Cancers of the Oral Cavity, Pharynx, and Larynx: Modeling Odds Ratios in Pooled Case-Control Data

    PubMed Central

    Lubin, Jay H.; Gaudet, Mia M.; Olshan, Andrew F.; Kelsey, Karl; Boffetta, Paolo; Brennan, Paul; Castellsague, Xavier; Chen, Chu; Curado, Maria Paula; Maso, Luigino Dal; Daudt, Alexander W.; Fabianova, Eleonora; Fernandez, Leticia; Wünsch-Filho, Victor; Franceschi, Silvia; Herrero, Rolando; Koifman, Sergio; La Vecchia, Carlo; Lazarus, Philip; Levi, Fabio; Lissowska, Jolanta; Mates, Ioan Nicolae; Matos, Elena; McClean, Michael; Menezes, Ana; Morgenstern, Hal; Muscat, Joshua; Neto, Jose Eluf; Purdue, Mark P.; Rudnai, Peter; Schwartz, Stephen M.; Shangina, Oxana; Sturgis, Erich M.; Szeszenia-Dabrowska, Neonilia; Talamini, Renato; Wei, Qingyi; Winn, Deborah; Zhang, Zuo-Feng; Hashibe, Mia; Hayes, Richard B.

    2010-01-01

    Odds ratios for head and neck cancer increase with greater cigarette and alcohol use and lower body mass index (BMI; weight (kg)/height2 (m2)). Using data from the International Head and Neck Cancer Epidemiology Consortium, the authors conducted a formal analysis of BMI as a modifier of smoking- and alcohol-related effects. Analysis of never and current smokers included 6,333 cases, while analysis of never drinkers and consumers of ≤10 drinks/day included 8,452 cases. There were 8,000 or more controls, depending on the analysis. Odds ratios for all sites increased with lower BMI, greater smoking, and greater drinking. In polytomous regression, odds ratios for BMI (P = 0.65), smoking (P = 0.52), and drinking (P = 0.73) were homogeneous for oral cavity and pharyngeal cancers. Odds ratios for BMI and drinking were greater for oral cavity/pharyngeal cancer (P < 0.01), while smoking odds ratios were greater for laryngeal cancer (P < 0.01). Lower BMI enhanced smoking- and drinking-related odds ratios for oral cavity/pharyngeal cancer (P < 0.01), while BMI did not modify smoking and drinking odds ratios for laryngeal cancer. The increased odds ratios for all sites with low BMI may suggest related carcinogenic mechanisms; however, BMI modification of smoking and drinking odds ratios for cancer of the oral cavity/pharynx but not larynx cancer suggests additional factors specific to oral cavity/pharynx cancer. PMID:20494999

  11. Body mass index, cigarette smoking, and alcohol consumption and cancers of the oral cavity, pharynx, and larynx: modeling odds ratios in pooled case-control data.

    PubMed

    Lubin, Jay H; Gaudet, Mia M; Olshan, Andrew F; Kelsey, Karl; Boffetta, Paolo; Brennan, Paul; Castellsague, Xavier; Chen, Chu; Curado, Maria Paula; Dal Maso, Luigino; Daudt, Alexander W; Fabianova, Eleonora; Fernandez, Leticia; Wünsch-Filho, Victor; Franceschi, Silvia; Herrero, Rolando; Koifman, Sergio; La Vecchia, Carlo; Lazarus, Philip; Levi, Fabio; Lissowska, Jolanta; Mates, Ioan Nicolae; Matos, Elena; McClean, Michael; Menezes, Ana; Morgenstern, Hal; Muscat, Joshua; Eluf Neto, Jose; Purdue, Mark P; Rudnai, Peter; Schwartz, Stephen M; Shangina, Oxana; Sturgis, Erich M; Szeszenia-Dabrowska, Neonilia; Talamini, Renato; Wei, Qingyi; Winn, Deborah; Zhang, Zuo-Feng; Hashibe, Mia; Hayes, Richard B

    2010-06-15

    Odds ratios for head and neck cancer increase with greater cigarette and alcohol use and lower body mass index (BMI; weight (kg)/height(2) (m(2))). Using data from the International Head and Neck Cancer Epidemiology Consortium, the authors conducted a formal analysis of BMI as a modifier of smoking- and alcohol-related effects. Analysis of never and current smokers included 6,333 cases, while analysis of never drinkers and consumers of < or =10 drinks/day included 8,452 cases. There were 8,000 or more controls, depending on the analysis. Odds ratios for all sites increased with lower BMI, greater smoking, and greater drinking. In polytomous regression, odds ratios for BMI (P = 0.65), smoking (P = 0.52), and drinking (P = 0.73) were homogeneous for oral cavity and pharyngeal cancers. Odds ratios for BMI and drinking were greater for oral cavity/pharyngeal cancer (P < 0.01), while smoking odds ratios were greater for laryngeal cancer (P < 0.01). Lower BMI enhanced smoking- and drinking-related odds ratios for oral cavity/pharyngeal cancer (P < 0.01), while BMI did not modify smoking and drinking odds ratios for laryngeal cancer. The increased odds ratios for all sites with low BMI may suggest related carcinogenic mechanisms; however, BMI modification of smoking and drinking odds ratios for cancer of the oral cavity/pharynx but not larynx cancer suggests additional factors specific to oral cavity/pharynx cancer.

  12. Early development of the digestive tract (pharynx and gut) in the embryos and pre-larvae of the European sea bass Dicentrarchus labrax.

    PubMed

    Sucré, E; Charmantier-Daures, M; Grousset, E; Charmantier, G; Cucchi-Mouillot, P

    2009-10-01

    The European sea bass Dicentrarchus labrax is a marine teleost important in Mediterranean aquaculture. The development of the entire digestive tract of D. labrax, including the pharynx, was investigated from early embryonic development to day 5 post hatching (dph), when the mouth opens. The digestive tract is initialized at stage 12 somites independently from two distinct infoldings of the endodermal sheet. In the pharyngeal region, the anterior infolding forms the pharynx and the first gill slits at stage 25 somites. The other three gill arches and slits are formed between 1 and 5 dph. Posteriorly, in the gut tube region, a posterior infolding forms the foregut, midgut and hindgut. The anus opens before hatching, at stage 28 somites. Associated organs (liver, pancreas and gall bladder) are all discernable from 3 dph. Some aspects of the development of the two independent initial infoldings seem original compared with data in the literature. These results are discussed and compared with embryonic and post-embryonic development patterns in other teleosts.

  13. Aufbau und Anpassung der Motorsteuerungs-Software für Otto- und Dieselmotoren

    NASA Astrophysics Data System (ADS)

    Stuhler, Harald; Ricken, Volker; Diener, René

    Die Erfüllung steigender Kundenansprüche und strenger gesetzlicher Vorgaben hinsichtlich der Verringerung des Kraftstoffverbrauchs, der Reduzierung von Schadstoffemissionen, der Erhöhung von Fahrsicherheit, Fahrleistung und Fahrkomfort ist untrennbar mit dem Einzug elektronischer Systeme in moderne Kraftfahrzeuge verbunden. Die elektronischen Systeme bestimmen zunehmend den Kundennutzen und werden für die Differenzierung der Automobilhersteller untereinander immer wichtiger. Daher sind sie ein wesentlicher Erfolgsfaktor moderner Kraftfahrzeuge.

  14. Systemlieferant und OEM Hersteller für die Medizintechnik und Pharmabranche

    NASA Astrophysics Data System (ADS)

    Jakob, Thomas; Reichenberger, Robert

    Unter einem Original Equipment Manufacturer (OEM) versteht man einen Hersteller fertiger Komponenten oder Produkte, der diese in seinen eigenen Produktionsfabriken produziert, sie aber anschließend nicht selbst in den Handel bringt. Die Anforderungen an einen OEM für die Medizintechnik- und Pharmabranche sind weitaus komplexer und umfangreicher als in anderen Branchen. Diese zusätzlichen Anforderungen haben schließlich auch ihre Berechtigung, da es letztendlich immer um die Gesundheit und das Leben von Menschen geht. Ein OEM muss neben der heute immer stärker geforderten Flexibilität, Schnelligkeit und Wettbewerbsfähigkeit sämtliche für die Medizintechnik- und Pharmabranche erforderlichen Qualitäts- und Prozesssicherheitskriterien erfüllen. Entsprechende Nachweise sind durch regelmäßige Kunden- und Überwachungsaudits zu erbringen. Das Arbeitsumfeld eines OEM für die Medizintechnik- und Pharmabranche bezieht sich somit nicht nur auf die Herstellung der Produkte für seine Kunden, sondern auch auf die Einhaltung sämtlicher Normen, Sicherheitskriterien, regulatorischen Voraussetzungen und Gesetze die zur Herstellung der Produkte notwendig sind.

  15. PCR und Real-Time PCR

    NASA Astrophysics Data System (ADS)

    Konrad, Regina; Busch, Ulrich

    Die vielfältigen Anwendungsmöglichkeiten der Polymerasekettenreaktion (polymerase chain reaction, PCR) machen sie zu einer der wichtigsten und am häufigsten eingesetzten Methoden in der molekularbiologischen Forschung und Diagnostik. Für diese Technologie wurde der Erfinder der Methode, Kary Mullis, 1993 mit dem Nobelpreis ausgezeichnet. Die PCR erlaubt einen hochsensitiven und spezifischen in-vitro-Nachweis von Desoxyribonukleinsäuren (DNA), da im Zuge der Reaktion Sequenzabschnitte gezielt vermehrt werden. Innerhalb weniger Stunden können aus einem einzigen Zielmolekül 1012 identische Moleküle entstehen [1].

  16. Symmetriebrechung und Emergenz in der Kosmologie.

    NASA Astrophysics Data System (ADS)

    Mainzer, K.

    Seit der Antike wird der Aufbau des Universums mit einfachen und regulären (symmetrischen) Grundstrukturen verbunden. Diese Annahme liegt selbst noch den Standardmodellen der relativistischen Kosmologie zugrunde. Demgegenüber läßt sich die Emergenz neuer Strukturen von den Elementarteilchen über Moleküle bis zu den komplexen Systemen des Lebens als Symmetriebrechung verstehen. Symmetriebrechung und strukturelle Komplexität bestimmen die kosmische Evolution. Damit zeichnet sich ein fachübergreifendes Forschungsprogramm von Physik, Chemie und Biologie ab, in dem die Evolution des Universums untersucht werden kann.

  17. Allelic loss of 10q23, the PTEN tumour suppressor gene locus, in Barrett's oesophagus-associated adenocarcinoma

    PubMed Central

    Kulke, M H; Odze, R D; Thakore, K S; Thomas, G; Wang, H; Loda, M; Eng, C

    2001-01-01

    PTEN is a putative tumour suppressor gene located on chromosome band 10q23. Mutations in PTEN have been identified in numerous human malignancies, including cancers of the brain, endometrium, ovary, and prostate. In this study, we screened 80 Barrett's oesophagus-associated adenocarcinomas (BOAd) for loss of heterozygosity (LOH) at 10q23, using the microsatellite markers D10S541, D10S219, and D10S551. Tumours demonstrating LOH were then screened for the presence or absence of PTEN mutations. LOH at one or more loci was identified in 17/80 (21%) cases. In none of these cases did we detect mutations in PTEN. The presence of LOH did not correlate with patient age, tumour stage, degree of differentiation, presence of perineural or vascular invasion, or overall survival. We conclude that LOH at chromosome 10q23 is uncommon in BOAd, is not associated with mutations in the PTEN tumour suppressor gene, and does not correlate with the clinical or pathologic features of these tumours. It is possible that PTEN is inactivated through other mechanisms in BOAd. © 2001 Cancer Research Campaign http://www.bjcancer.com PMID:11259087

  18. Barrett's Oesophagus Surveillance versus endoscopy at need Study (BOSS): protocol and analysis plan for a multicentre randomized controlled trial.

    PubMed

    Old, Oliver; Moayyedi, Paul; Love, Sharon; Roberts, Corran; Hapeshi, Julie; Foy, Chris; Stokes, Clive; Briggs, Andrew; Jankowski, Janusz; Barr, Hugh

    2015-09-01

    The absolute annual risk of patients with Barrett's oesophagus (BO) developing oesophageal adenocarcinoma (OAC) is ≤ 0.5%. Screening BO patients for malignant progression using endoscopic surveillance is widely practised. To assess the efficacy and cost-effectiveness of this, we developed a protocol for a randomized controlled trial of surveillance versus 'at need' endoscopy. In a multicentre trial, 3400 BO patients randomized to either 2-yearly endoscopic surveillance or 'at need' endoscopy will be followed up for 10 years. Urgent endoscopy will be offered to all patients who develop symptoms of dysphagia, unexplained weight loss > 7lb (3.2 kg), iron deficiency anaemia, recurrent vomiting, or worsening upper gastrointestinal symptoms. Participants must have endoscopically and histologically confirmed BO, with circumferential BO ≥ 1 cm or maximal tongue/island length ≥ 2 cm. Candidates with existing oesophageal high-grade dysplasia or cancer, or previous upper gastrointestinal cancer will be excluded. Primary outcome will be overall survival. Secondary outcomes will be cost effectiveness (cost per life year saved and quality adjusted life years); cancer-specific survival; time to OAC diagnosis and stage at diagnosis; morbidity and mortality related to any interventions; and frequency of endoscopy. This randomized trial will provide data to evaluate the efficacy and cost-effectiveness of screening BO patients for OAC. © The Author(s) 2015.

  19. Lugol's iodine dye-enhanced endoscopy in patients with cancer of the oesophagus and head and neck.

    PubMed

    Chisholm, E M; Williams, S R; Leung, J W; Chung, S C; Van Hasselt, C A; Li, A K

    1992-12-01

    Lugol's iodine dye indicates the presence of unsuspected early oesophageal cancers during endoscopy at which such cancers fail to show the characteristic black colour change. We evaluated Lugol's iodine dye-enhanced endoscopy in 17 patients with oesophageal cancer. In a further 37 patients with head and neck cancer we examined the use of Lugol's iodine since these patients have a 29% risk of synchronous oesophageal cancer. The oesophagus was sprayed with Lugol's iodine (1.5%) during endoscopy. Any areas not turning black were biopsied. In 13 patients with oesophageal cancer discrete areas beyond the macroscopically obvious primary tumour showed no change in colour. Biopsy revealed cancer in all cases. Six synchronous cancers were found in the head and neck group, one of which was identified only by the use of Lugol's iodine. Lugol's iodine augmented the information gained about the oesophageal mucosa during endoscopy. It revealed unsuspected cancer which altered the management of patients with primary oesophageal cancer as well as those with head and neck cancer. We recommend the routine use of Lugol's iodine-enhanced endoscopy for surveillance of all 'at risk' oesophageal cases.

  20. Kosmische Katastrophen und der Ursprung der Religion.

    NASA Astrophysics Data System (ADS)

    Hoyle, F.

    This book is a German translation, by V. Delavre, from the English original "The origin of the Universe and the origin of religion", published in 1993. Contents: E. Sens: Die unterbrochene Musikstunde. Einleitung zur deutschen Ausgabe. C. Ryskamp: Einführung. R. N. Anshen: Vorwort. F. Hoyle: Kosmische Katastrophen und der Ursprung der Religion - Die Folgen der Respektabilität; Eiszeiten und Kometen; Die allgemeine Situation in den Nacheiszeiten; Kometen und der Ursprung der Religionen; Der Übergang zu Mittelalter und Neuzeit. Diskussionsbeiträge: Ruth Nanda Anshen, Freeman Dyson, Paul Oscar Kristeller, John Archibald Wheeler, James Schwartz, Roger Shinn, Milton Gatch, Philip Solomon, Norman Newell. F. Hoyle: Schlußwort. A. Tollmann: Nachwort zur deutschen Ausgabe.

  1. Uniform National Discharge Standards (UNDS): Outreach

    EPA Pesticide Factsheets

    Describes the Federalism and Tribal consultation efforts related to the Uniform National Discharge Standards (UNDS) and links to copies of each presentation, both to state and local representatives, as well as federally-recognized tribes.

  2. Hochschule fur Film und Fernsehen (Babelsberg).

    ERIC Educational Resources Information Center

    Neumann, Roland

    1992-01-01

    Describes the Hochschule fur Film und Fernsehen, an institution of higher education for the study of film and television production in Babelsberg, Germany (formerly the German Democratic Republic). Discusses the major reorientations in the school caused by Germany's reunification. (SR)

  3. Satellitenbewegung, band III: Natiirliche und gesteuerte bewegung.

    NASA Astrophysics Data System (ADS)

    Jochim, E. F.

    2014-12-01

    Im dritten Band der Satellitenbewegung werden in fortlaufender Nummerierung einige für Untersuchungen der Bewegung der künstlichen Satelliten wichtige Grundlagen der Astrodynamik mit ausführlichen mathematischen Formelsystemen behandelt. Dazu zählen die unterschiedlichen Aspekte der Bewegung der natürlichen Himmelskörper, die Steuerung und Kontrolle von künstlichen Objekten, und insbesondere die für eine Satellitenbahnanalyse wichtigen physikalischen Beeinflussungen einer Satellitenbewegung. Mathematisch entscheidend ist die Wahl geeigneter Bahnparameter, die ein bestimmtes Bewegungsproblem widerspruchsfrei und singularitätenfrei zu behandeln gestatten. Für die Behandlung routinemäßiger Aufgabenstellungen der Satellitenbewegung, in erster Linie einer präzisen Bahnbestimmung und Bahnverbesserung, kann auf eine Fülle von lehrbuchartigen Monographien verwiesen werden, so dass diese Problematik in der vorliegenden Arbeit nur angedeutet werden soll.

  4. Hobeln und Stoßen

    NASA Astrophysics Data System (ADS)

    Böge, Wolfgang

    Im Gegensatz zum Drehen ist die Schnittbewegung bei Maschinen mit hin- und hergehender Bewegung nicht gleichförmig (Hobel-, Stoß- und Räummaschinen). Die mittlere Rücklaufgeschwindigkeit v mr ist meist größer als die mittlere Geschwindigkeit beim Arbeitshub v ma , z. B. beim Antrieb durch die schwingende Kurbelschleife ({v}_{m}\\colon{v}_{ma} etwa 1,4-1,8).

  5. Kostenüberwachung und Wirtschaftlichkeitsrechnung

    NASA Astrophysics Data System (ADS)

    Bauer, Jürgen

    Die ERP-Produktkalkulation erfolgt auf der Basis des Mengen- und Wertgerüsts der Produktionsprozesse. Sie greift dabei auf die Stammdaten (Materialstamm, Arbeitsplätze, Arbeitspläne, Stücklisten) zu. Basis ist die übliche Industriekalkulation in der Form einer Zuschlagskalkulation, ergänzt durch Platzkostensätze der Maschinen und Arbeitsplätze (siehe Teil ).

  6. Positionsbestimmung des Unternehmens: Interne und externe Analyse

    NASA Astrophysics Data System (ADS)

    Bergmann, Lars; Crespo, Isabel; Portmann, Stefan

    Die Initiierung und Lenkung von Maßnahmen zur integrierten Modernisierung zielen auf die Verbesserung der Wettbewerbsfähigkeit eines Unternehmens ab. Damit diese Maßnahmen zielgerichtet die Wettbewerbsfähigkeit verbessern können, ist Wissen über die bestehende Wettbewerbsfähigkeit sowie über die bestehenden Fähigkeiten eine zentrale Voraussetzung. Eine zielgerichtete Auswahl problemadäquater Maßnahmen zur Verbesserung der Wettbewerbsfähigkeit bedarf daher im Vorfeld einer Bewertung der aktuellen Situation des Unternehmens im Sinne einer Positionsbestimmung. Erst wenn die internen Stärken und Schwächen sowie die externen Chancen und Risiken identifiziert sind, kann ein ganzheitliches Bild von der Position eines Unternehmens in seiner Umwelt gewonnen werden. Auf Basis der Kenntnisse über die Position des Unternehmens können anschließend zielgerichtet Maßnahmen ausgewählt werden, die einen Beitrag zur Verbesserung der Wettbewerbsfähigkeit des Unternehmens haben. Damit kommt der Positionsbestimmung als initialer Schritt des Prozesses der strategischen Unternehmensplanung eine zentrale Bedeutung im Rahmen der integrierten Modernisierung zu. Erfolgt die Auswahl von Maßnahmen ohne eine vorherige Positionsbestimmung, also lediglich auf Basis drängender Probleme, so besteht die Gefahr einer unbedachten und nur auf das "hier und heute“ bezogenen Schwerpunktbildung ohne Berücksichtigung der mittel- und langfristigen Ziele des Unternehmens.

  7. Aus Wirtschaft und Betrieb. Biomasse: Gewinnung und Verarbeitung mit Profilschal-maschinen

    Treesearch

    P. Koch

    1977-01-01

    1963 wurden in den Südstaaten der USA nur 30% der oberund unterirdischen Biomasse der geernteten sog. Southern pines für Schnittholz und Zellstoff verwertet bzw. als getrockneies, gehobletes und abgelängtes Schnittholz oder als Kraftpapier verkauft. Keine der zusammen mit den Kiefern vorkommenden Laubholzarten wurde bisher in nennenswertem Umfan verwertet. Auch heute...

  8. Ein mobiler und offener Kernspintomograph: Kernspintomographie für Medizin und Materialforschung

    NASA Astrophysics Data System (ADS)

    Blümich, Bernhard; Kölker, Christian; Casanova, Federico; Perlo, Juan; Felder, Jörg

    2005-09-01

    An der RWTH Aachen wurde der erste offene und mobile Kernspintomograph entwickelt. Anders als die normalerweise riesigen und unbeweglichen Geräte besitzt er keine enge Magnetröhre. So kann er auch in große Untersuchungsobjekte hinein schauen, ohne dass diese zerstört werden müssen. Wie eine Lupe erfasst er dabei ein begrenztes Volumen um den Aufsatzpunkt herum. Neben der Medizin ermöglicht der offene Tomograph viele neue Anwendungsgebiete, vor allem in der Materialprüfung und Qualitätskontrolle. Der Aachener Prototyp kann auch das Fließprofil und die Geschwindigkeitsverteilung strömender Flüssigkeiten sichtbar machen. Sein offenes Prinzip erforderte neue technische Komponenten und modifizierte bildgebende Verfahren. Die Messzeit pro Bild kann heute schon unter einer Viertelstunde liegen.

  9. Das Assessment von Vulnerabilitäten, Risiken und Unsicherheiten

    NASA Astrophysics Data System (ADS)

    Birkmann, Jörn; Greiving, Stefan; Serdeczny, Olivia Maria

    Die Risiken und möglichen Folgen des Klimawandels für Menschen, Produktions- und Ökosysteme sind eng mit sozioökonomischen Entwicklungen und Rahmenbedingungen verflochten. Die Schlüsselbegriffe "Vulnerabilität", "Risiko" und "Unsicherheit" werden näher beleuchtet, um u. a. deutlich zu machen, wie sie im neueren Risikoansatz des Fünften Sachstandsberichts (AR5) des Weltklimarats (IPCC) genutzt werden. Das Risikokonzept wird vom Vulnerabilitätskonzept unterschieden. In den Fokus rückt die Betrachtung von Gefahr und Exposition. Auch die Frage, was unter Unsicherheit und Bandbreiten möglicher Entwicklungen des Klimas und sogenannter sozioökonomischer Entwicklungspfade zu verstehen ist, spielt dabei eine wichtige Rolle. Bisherige Untersuchungsmethoden zu Risiken im Kontext des Klimawandels und darauf aufbauende Entscheidungsprozesse werden im Hinblick auf künftige Anpassungsmaßnahmen diskutiert.

  10. High-resolution computed tomography of the paranasal sinuses, pharynx and related regions: Impact of CT identification on diagnosis and patient management

    SciTech Connect

    Maatman, G.

    1986-01-01

    The purpose of this textbook is two-fold: to define the normal anatomic structure and pathologic conditions of the nose, paranasal sinuses, pharynx and soft tissues, and to discuss the diagnostic impact and ultimate-effect of computed tomography (CT) in the treatment of patients with head and neck disorders. The two chapters on normal gross and CT anatomic configuration are meticulously constructed. The subsequent sections on pathologic conditions are illustrated with examples of neoplastic disease. The CT scans are very good; a few of these were obtained in the direct sagittal plane. There is considerable discussion of the reasons that CT is equal to better than, or worse than other imaging modalities with respect to patient treatment in terms of both diagnosis and therapy.

  11. [pH values in the pharynx of the patients presenting with compromised nasal breathing of inflammatory and non-inflammatory genesis concomitant with gastroesophageal reflux disease].

    PubMed

    Subbotina, M V; Temnikova, I V; Onuchina, E V

    2015-01-01

    The objective of the present study was to estimate the influence of gastroesophageal reflux disease (GERD) on the pH values in the pharynx and nose. It included 87 patients at the age varying from 18 to 81 years admitted to the Irkutsk-based Railway Clinical Hospital and allocated to four groups. Group 1 was comprised of 25 patients presenting with gastroesophageal reflux disease and chronic rhinosinusitis (CRS), group 2 consisted of 29 patients with CRS in the absence of GERD, group 3 included 22 patients with nasal septum deformations (NSD) and GERD, group 4 included 11 patients with NSD and motor rhinitis without GERD. The control group was formed from 10 volunteers. pH was measured by the contact method with the use ofEkokhim indicator paper. Gastroesophageal reflux disease was diagnosed following the recommendations of the Montreal consensus. It was shown that pH values in the pharynx of the patients with compromised nasal breathing of any origin in combination with GERD were lower than in the absence of GERD and in the healthy volunteers. The study groups did not differ in terms of pH values in the nasal cavity. It is concluded that pH values 4 or lower may serve as the criterion for pharyngo-laryngeal reflux (PLR) concomitant with HERD while pH 5 occurs more frequently in the patients with compromised nasal breathing of any etiology, regardless of the presence or absence of GERD.Disordered nasal breathing of any genesis in the patients presenting with gastroesophageal reflux disease was associated with the feeling of the lump in the throat, congestion of the respiratory tract and the nose, pain in the ears, cardialgia, and irregular heartbeat. It isrecommended to use pH measurements as a criterion for diagnostics of pharyngo-laryngeal reflux in the patients presenting with gastroesophageal reflux disease.

  12. Histological and immunohistochemical study of the expression of p53 and ki-67 proteins in the mucosa of the tongue, pharynx and larynx of rats exposed to cigarette smoke.

    PubMed

    de Oliveira Semenzati, Graziela; de Souza Salgado, Breno; Rocha, Noeme Sousa; Michelin Matheus, Selma Maria; de Carvalho, Lídia Raquel; Garcia Martins, Regina Helena

    2012-09-01

    Head and neck cancers are linked to smoking. The most affected sites are the oral cavity, pharynx and larynx. Experimental studies show epithelial lesions caused by cigarette smoke. To investigate in rats the effects of acute cigarette smoke exposure on the mucosa of the tongue, pharynx and larynx. Wistar rats were allocated into two groups of 20 animals: CG (control) receiving food and water ad libitum and TG (Tobacco) exposed to the smoke of 40 cigarettes/day for 60 days. Biopsy of their tongues, pharynxes and larynxes were subjected to histopathological, histomorphometric and immunohistochemical studies of protein p53 and ki-67. The histological analysis of tongue from the Tobacco group revealed epithelial hyperplasia (90%), basal cell hyperplasia (95%) and mild to moderate dysplasia (85%). In pharynx showed basal cell hyperplasia (85%), dysplasia (25%) and vascular congestion (95%). In larynx showed basal cell hyperplasia (70%), epithelial hyperplasia (55%), congestion (100%) and inflammatory infiltrate (25%). Morphometric analysis revealed that keratin layer thickness was greater in the tobacco group. P53 immunoexpression was negative in both groups. Ki-67 immunoexpression was positive in basal cell nuclei but in parabasal cell nuclei it was positive only in the Tobacco group. The exposure of animals to cigarette smoke for 60 days resulted in benign lesions. The duration of exposure was not enough to cause the development cancer, as confirmed by the negative expression of p53 protein in all slides examined. Analysis of ki-67 expression showed intense epithelial proliferation in response to damage.

  13. Tycho Brahe - Instrumentenbauer und Meister der Beobachtungstechnik

    NASA Astrophysics Data System (ADS)

    Wolfschmidt, Gudrun

    Vor der Erfindung des Fernrohrs war der dänische Astronom Tycho Brahe (1546 - 1601) der bedeutendste beobachtende Astronom. Von seinem Observatorium Uraniborg auf der - damals dänischen - Insel Hven ist heute noch der Grundriß erkennbar, von Stjerneborg sind die Fundamente erhalten, die Kuppeln in den 1950er Jahren ergänzt. In der Astronomie-Ausstellung im Deutschen Museum gibt es ein Modell der Sternwarte Uraniborg und der zugehörigen Instrumente (Maßstab 1:10); das größere Modell wurde dem Technischen Museum in Malmö geschenkt. Die Instrumente, die er in den Observatorien Uraniborg und Stjerneborg benutzte, sind nicht erhalten. Aber es gibt gute Beschreibungen der Instrumente (Halbkreis, Quadranten, Sextanten, Armillarsphären, Triquetrum, Himmelsglobus) in seinem Buch Astronomiae instauratae mechanica (Wandsbek 1598). Eine Nachbildung des großen hölzernen Quadranten kann man im Runden Turm in Kopenhagen sehen. Zwei Sextanten, hergestellt für Tycho um 1600 von Jost Bürgi und Erasmus Habermel, gibt es noch im Nationalmuseum für Technik in Prag. Ähnlichkeiten von Tychos Instrumenten mit Groß-Instrumenten aus dem islamischen Kulturkreis sind auffällig. Tycho Brahes Meßgeräte markieren einen großen Fortschritt in der Entwicklung astronomischer Instrumente und Meßtechniken und bilden die Grundlage für den weiteren Fortschritt der Positionsastronomie und der damit verbundenen Tabellenwerke. Die Nachwirkungen sind bis ins 17. und 18. Jahrhundert nachweisbar.

  14. [Reconstruction of the gastrointestinal tract in the absence of the oesophagus, stomach and colon, with preservation of the larynx].

    PubMed

    Filippini, Arnaldo; Pagliaricci, Laura; Pomidori, Augusto

    2009-01-01

    The authors report a case of reconstruction of the gastrointestinal tract in a young woman of 36 years of age who, after ingesting muriatic acid, and after a series of consecutive operations found herself without an oesophagus (from the hypopharynx) stomach and colon. She was fed with a jejunostomy and had a large pharyngostomy to prevent sialorrhoea. After one year, the patient manifested the need to resume eating by mouth. The problem was serious due both to the anastomosis above the level of the larynx and the very long period of rehabilitation. The technical problem included the need to avoid the thoracic cavity due to the previous empyema, and thus to bring a viable jejunal loop up to the neck in a subject already operated on four times. The solution was a Roux loop at the level of the 4th-5th jejunal arcade brought to the neck via a subcutaneous presternal route and anastomised in a supraglottic location at the level of the right pyriform sinus. The viability of the loop was guaranteed by an arterial shunt with a branch of the mesenteric artery by means of a segment of saphenous vein and a venous shunt over the right internal jugular vein to guarantee venous flow. The pharyngo-jejunal anastomosis was done with a 21 mm circular stapler with a rotary head after a partial parietal resection of the laryngeal cartilage and under the protection of a provisional tracheostomy. After 4 months' treatment, partly in intensive care and partly in a rehabilitation centre with logopaedic assistance, the tracheal cannula could be removed and the patient is now able to eat by mouth with normal phonation.

  15. Aberrant p53 protein expression is associated with an increased risk of neoplastic progression in patients with Barrett's oesophagus.

    PubMed

    Kastelein, Florine; Biermann, Katharina; Steyerberg, Ewout W; Verheij, Joanne; Kalisvaart, Marit; Looijenga, Leendert H J; Stoop, Hans A; Walter, Laurens; Kuipers, Ernst J; Spaander, Manon C W; Bruno, Marco J

    2013-12-01

    The value of surveillance for patients with Barrett's oesophagus (BO) is under discussion given the overall low incidence of neoplastic progression and lack of discriminative tests for risk stratification. Histological diagnosis of low-grade dysplasia (LGD) is the only accepted predictor for progression to date, but has a low predictive value. The aim of this study was therefore to evaluate the value of p53 immunohistochemistry for predicting neoplastic progression in patients with BO. We conducted a case-control study within a prospective cohort of 720 patients with BO. Patients who developed high-grade dysplasia (HGD) or oesophageal adenocarcinoma (OAC) were classified as cases and patients without neoplastic progression were classified as controls. P53 protein expression was determined by immunohistochemistry in more than 12 000 biopsies from 635 patients and was scored independently by two expert pathologists who were blinded to long-term outcome. During follow-up, 49 (8%) patients developed HGD or OAC. P53 overexpression was associated with an increased risk of neoplastic progression in patients with BO after adjusting for age, gender, Barrett length and oesophagitis (adjusted relative risks (RR(a)) 5.6; 95% CI 3.1 to 10.3), but the risk was even higher with loss of p53 expression (RR(a) 14.0; 95% CI 5.3 to 37.2). The positive predictive value for neoplastic progression increased from 15% with histological diagnosis of LGD to 33% with LGD and concurrent aberrant p53 expression. Aberrant p53 protein expression is associated with an increased risk of neoplastic progression in patients with BO and appears to be a more powerful predictor of neoplastic progression than histological diagnosis of LGD.

  16. HER-2 overexpression/amplification in Barrett’s oesophagus predicts early transition from dysplasia to adenocarcinoma: a clinico-pathologic study

    PubMed Central

    Rossi, Elisa; Grisanti, Salvatore; Villanacci, Vincenzo; Casa, Domenico Della; Cengia, Paolo; Missale, Guido; Minelli, Luigi; Buglione, Michela; Cestari, Renzo; Bassotti, Gabrio

    2009-01-01

    Barrett’s oesophagus (BO) is the primary precursor lesion for oesophageal adenocarcinoma (ADC). The natural history of metaplasia-dysplasia-carcinoma sequence remains largely unknown. HER2/neu oncogene results overexpressed/amplified in preneoplastic lesions and in ADC of the oesophagus and it has been associated with poor prognosis. Our aim was to evaluate the role of HER2 overexpression/amplification in predicting the conversion from precursor lesions to ADC. We retrospectively evaluated by univariate analysis of single variables clinical records and histological specimens of 21 patients with a confirmed diagnosis of BO and/or oesophageal dysplasia. Clinical variables included age, gender, alcohol and smoking intake, presence of symptoms (pyrosis, disphagia) and endoscopic features (length). HER2 status was studied by immunohistochemistry and fluorescence in situ hybridization (FISH) on paraffin-embedded tissue. The end-points were the occurrence of progression and the time-to-progression (TTP) from the initial histologic lesion to the worst pathological pattern. Median age at diagnosis was 63 years (range 37–84). BO median length was 4.5 cm. Progression occurred in 11 of 21 patients and median TTP was 24 months. HER2 was overexpressed/amplified in 8 of 21 (38%) patients. HER2 overexpression/ amplification and the presence of dysplasia were statistically associated with progression (P= 0.038). This study provides evidence for a possible role of HER2 in the transition from dysplasia to ADC of the oesophagus. This fact could help in identifying patients at high risk of malignant transformation. PMID:19292734

  17. Dietary inflammatory index and risk of reflux oesophagitis, Barrett's oesophagus and oesophageal adenocarcinoma: a population-based case-control study.

    PubMed

    Shivappa, Nitin; Hebert, James R; Anderson, Lesley A; Shrubsole, Martha J; Murray, Liam J; Getty, Lauren B; Coleman, Helen G

    2017-05-01

    The dietary inflammatory index (DIITM) is a novel composite score based on a range of nutrients and foods known to be associated with inflammation. DII scores have been linked to the risk of a number of cancers, including oesophageal squamous cell cancer and oesophageal adenocarcinoma (OAC). Given that OAC stems from acid reflux and that the oesophageal epithelium undergoes a metaplasia-dysplasia transition from the resulting inflammation, it is plausible that a high DII score (indicating a pro-inflammatory diet) may exacerbate risk of OAC and its precursor conditions. The aim of this analytical study was to explore the association between energy-adjusted dietary inflammatory index (E-DIITM) in relation to risk of reflux oesophagitis, Barrett's oesophagus and OAC. Between 2002 and 2005, reflux oesophagitis (n 219), Barrett's oesophagus (n 220) and OAC (n 224) patients, and population-based controls (n 256), were recruited to the Factors influencing the Barrett's Adenocarcinoma Relationship study in Northern Ireland and the Republic of Ireland. E-DII scores were derived from a 101-item FFQ. Unconditional logistic regression analysis was applied to determine odds of oesophageal lesions according to E-DII intakes, adjusting for potential confounders. High E-DII scores were associated with borderline increase in odds of reflux oesophagitis (OR 1·87; 95 % CI 0·93, 3·73), and significantly increased odds of Barrett's oesophagus (OR 2·05; 95 % CI 1·22, 3·47), and OAC (OR 2·29; 95 % CI 1·32, 3·96), when comparing the highest with the lowest tertiles of E-DII scores. In conclusion, a pro-inflammatory diet may exacerbate the risk of the inflammation-metaplasia-adenocarcinoma pathway in oesophageal carcinogenesis.

  18. Structure of the oesophagus and morphometric, histochemical-immunohistochemical profiles of the oesophageal gland during the post-hatching period of Japanese quails (Coturnix coturnix japonica).

    PubMed

    Sağsöz, H; Liman, N

    2009-10-01

    In the oesophagus, mucins, which originate from oesophageal submucosal glands, play an important role in the mucosal protection as a pre-epithelial barrier. In this study, the structure of cervical and thoracic parts of oesophagus of Japanese quail during the post-hatching period was compared, and the contents of carbohydrate and gastric mucin MUC5AC of the oesophageal glands in these parts were analysed at the light microscope levels by applying conventional histochemical and immunohistochemical methods. The oesophageal glands were present at hatching, located in the laminae propria. The numbers of glands were different in the cervical and thoracic parts, but the differences were found to be insignificant. The thoracic part has the oesophageal tonsils which are associated with the glands. Oesophageal tonsil was formed from day 5 after hatching. In quail of all ages, the secretory epithelium of glands contained neutral sialomucins and weakly sulphomucins. The cells in the neck region of secretory units contained sialomucins, while the cells of excretory ducts had strongly sulphomucins. Sialomucin containing cells in the secretory units increased with the advance of age and glandular development. But, in the secretory units, the sulphomucin content of glands was more in the thoracic part. The secretory epithelium of tonsil-associated glands contained mostly sulphomucins and a little sialomucin. From the hatching, MUC5AC mucin was detected in the cells of excretory ducts. Although the lymphoepithelium of the tonsil units exhibited negative reactions to all histochemical methods, it showed positive reaction to MUC5AC mucin antibody. In conclusion, the cervical and thoracic parts may be functionally different and the thoracic part of oesophagus was transformed into an immunological organ following day 5 after hatching.

  19. Exposure to non-steroid anti-inflammatory drugs (NSAIDs) and suppressing hydrogen sulfide synthesis leads to altered structure and impaired function of the oesophagus and oesophagogastric junction.

    PubMed

    Zayachkivska, Oksana; Bula, Nazar; Khyrivska, Dzvinka; Gavrilyuk, Elena; Wallace, John L

    2015-06-01

    The non-steroid anti-inflammatory drugs (NSAIDs) are among the drugs that can commonly cause injury in the esophagus, such as non-reflux oesophagitis, with important clinical consequences. This injury may be 'silent' and therefore often overlooked. Recently, we established that hydrogen sulfide (H2S) is a critical mediator of esophageal mucosal protection and repair. The aim of the study was to determine the effect of naproxen, the most commonly used NSAIDs, on the oesophagus and oesophagogastric junction and its relation with suppression or stimulation of endogenous H2S synthesis during naproxen-induced oesophageal injury. Rats were treated with vehicle (control) or naproxen, with or without being subjected to water immersion restricted stress (Takagi et al. Chem Pharm Bul 12:465-472, 1964). Subgroups of rats were pre-treated with an inhibitor of H2S synthesis cystathionine γ-lyase (CSE) or cystathionine β-synthase (CBS), or with the Sodium sulphide (NaHS), which spontaneously generates H2S in solution. Damage of the oesophageal mucosa and oesophagogastric junction was estimated and scored using a histological damage index. Treatment with naproxen increased the thickness of the corneal and epithelial layers of the oesophagus, as well as producing disorganization of the muscle plate and irregular submucosal oedema. Both injury factors, stress and suppression of H2S synthesis resulted in the development of severe esophagitis and damage to the oesophagogastric junction. The damage was exacerbated by inhibitors of H2S biosynthesis, and attenuated by treatment with NaHS. Inhibition of endogenous H2S synthesis provides a novel experimental model that can be useful in preclinical studies NSAID-related non-reflux oesophagitis. H2S contributes significantly to mucosal defence in the oesophagus.

  20. Prevalence of intestinal metaplasia in the distal oesophagus, oesophagogastric junction and gastric cardia in symptomatic patients in north-east Italy: a prospective, descriptive survey. The Italian Ulcer Study Group "GISU".

    PubMed

    Zaninotto, G; Avellini, C; Barbazza, R; Baruchello, G; Battaglia, G; Benedetti, E; Bernardi, A; Boccù, C; Bonoldi, E; Bottona, E; Bozzola, L; Canizzaro, R; Canzonieri, V; Caroli, A; Carta, A; Colonna, A; Costa-Biedo, F; Dal Bò, N; De Bastiani, R; De Bernardin, M; De Bernardinis, F; De Pretis, G; Di Mario, F; Doglioni, C; Donisi, P M; Franceschi, M; Furlanetto, A; Germanà, B; Grassi, S A; Macor, V; Marcon, V; Marin, R; Meggiato, T; Melina, V; Menghi, A; Milan, R; Militello, C; Molena, D; Monica, F; Murer, B; Nisi, E; Olivieri, P; Orzes, N; Parenti, A; Paternello, E; Penelli, N; Pilotto, A; Piscioli, F; Pozzato, F; Ronzani, G; Rugge, M; Saggioro, A; Stracca-Pansa, V; Togni, R; Valiante, F; Vianello, F

    2001-05-01

    Incidence of adenocarcinoma of distal oesophagus and gastric cardia, probably arising from areas of intestinal metaplasia, has been increasing rapidly. To define prevalence of intestinal metaplasia of distal oesophagus, oesophagogastric junction and gastric cardia and to evaluate potential associated factors, by means of a prospective multicentre study including University and teaching hospitals, and primary and tertiary care centres. Each of 24 institutions involved in study enrolled 10 consecutive patients undergoing first-time routine endoscopy for dyspeptic symptoms. Patients answered symptom questionnaires and underwent gastroscopy Three biopsies were taken from distal oesophagus, oesophago-gastric junction and gastric cardia, and were stained with haematoxylin and eosin. Specimens were also evaluated for Helicobacter pylori infection. A total of 240 patients (124 male, 116 female; median age 56 years, range 20-90) were enrolled in study. Intestinal metaplasia affected distal oesophagus in 5, oesophago-gastric junction in 19 and gastric cardia in 10 patients. Low-grade dysplasia was found at distal oesophagus and/or oesophago-gastric junction of 3/24 patients with intestinal metaplasia vs 2/216 without intestinal metaplasia (p<0.05). A significant association was found between symptoms and presence of intestinal metaplasia, regardless of location, and between Helicobacter pylori infection and intestinal metaplasia at oesophago-gastric junction. Intestinal metaplasia of distal oesophagus, oesophagogastric-junction and gastric cardia is found in a significant proportion of symptomatic patients undergoing gastroscopy and is associated with dysplasia in many cases. Although prevalence of dysplasia seems to decrease when specialized columnar epithelium is found in short segment, or even focally in oesophago-gastric junction, these small foci of intestinal metaplastic cells may represent source of most adenocarcinomas of cardia.

  1. Hochwasser und Sturzfluten an Flüssen in Deutschland

    NASA Astrophysics Data System (ADS)

    Bronstert, Axel; Bormann, Helge; Bürger, Gerd; Haberlandt, Uwe; Hattermann, Fred; Heistermann, Maik; Huang, Shaochun; Kolokotronis, Vassilis; Kundzewicz, Zbigniew W.; Menzel, Lucas; Meon, Günter; Merz, Bruno; Meuser, Andreas; Paton, Eva Nora; Petrow, Theresia

    Flusshochwasser werden in lokale und plötzliche Sturzfluten und in Hochwasser an größeren Flüssen unterschieden. Für verschiedene Hochwasserindikatoren und Flusseinzugsgebiete ergeben sich erhebliche Unterschiede, wobei sowohl überwiegend aus Regen als auch überwiegend aus Schmelzwasser gespeiste Hochwasserereignisse betrachtet werden. Besondere Aufmerksamkeit finden Hochwasserereignisse an Rhein, Elbe, Weser und Ems sowie die Entwicklung von Sturzfluten infolge von Extremniederschlägen kurzer Dauer, wobei die Beobachtungen und Trends zu Modellierungsergebnissen in Beziehung gesetzt werden. Auch die Notwendigkeit von Anpassungsmaßnahmen aufgrund überwiegend positiver Trends wird diskutiert.

  2. Topologie und Dynamische Netzwerke: Anwendungen Der Optimierung MIT Zukunft

    NASA Astrophysics Data System (ADS)

    Leugering, Günter; Martin, Alexander; Stingl, Michael

    Die optimale Auslegung von Infrastrukturen z. B. bei der Verkehrsplanung und bei der Planung von Versorgungssystemen, die optimale Strukturierung bzw. Formgebung von Materialien und Werkstücken z. B. im Leichtbau sind aktuelle Themen angewandter Forschung. In beiden Bereichen wurde bis in die jüngste Zeit vornehmlich eine simulationsbasierte Optimierung auf der Grundlage einer Parameterjustierung vorgenommen, die oft wenig systematisch und zeit- und kostenintensiv ist. Stattdessen erweisen sich modellbasierte mathematische Optimierungsalgorithmen zusammen mit moderner numerischer Simulations-und Visualisierungstechnologie zunehmend als Katalysator neuer Technologien. Eine so verstandene Mathematische Optimierung kann bereits auf beeindruckende Erfolgsgeschichten verweisen und so den Anspruch als eine Zukunftsdisziplin behaupten. Diesem Anspruch trägt die Einrichtung des DFG-Schwerpunktprogramms 1253, Optimierung mit partiellen Differentialgleichungen’ im Jahre 2006 Rechnung, in dem über 25 Projekte im Bundesgebiet sowohl auf die theoretische Fundierung, als auch und insbesondere auf die Verzahnung zwischen Methodenentwicklung und numerischer Realisierung fokussieren. Forschung im Bereich der mathematischen Optimierung und Steuerung von Prozessen bzw. Eigenschaften, die mit Hilfe partieller Differentialgleichungen, so genannten, verteilten Systemen’, beschrieben werden, erfolgt im Kontext konkreter und exemplarischer Anwendungssituationen, die neue mathematische Herausforderungen markieren: Sicherheitsvorgaben etwa bei der Belastung von Gas- und Frischwasserleitungen oder solche für die Belastbarkeit von Verkehrsflugzeugen führen auf Druckbeschränkungen bzw.

  3. The retinoic acid signaling pathway regulates anterior/posterior patterning in the nerve cord and pharynx of amphioxus, a chordate lacking neural crest

    NASA Technical Reports Server (NTRS)

    Escriva, Hector; Holland, Nicholas D.; Gronemeyer, Hinrich; Laudet, Vincent; Holland, Linda Z.

    2002-01-01

    Amphioxus, the closest living invertebrate relative of the vertebrates, has a notochord, segmental axial musculature, pharyngeal gill slits and dorsal hollow nerve cord, but lacks neural crest. In amphioxus, as in vertebrates, exogenous retinoic acid (RA) posteriorizes the embryo. The mouth and gill slits never form, AmphiPax1, which is normally downregulated where gill slits form, remains upregulated and AmphiHox1 expression shifts anteriorly in the nerve cord. To dissect the role of RA signaling in patterning chordate embryos, we have cloned the single retinoic acid receptor (AmphiRAR), retinoid X receptor (AmphiRXR) and an orphan receptor (AmphiTR2/4) from amphioxus. AmphiTR2/4 inhibits AmphiRAR-AmphiRXR-mediated transactivation in the presence of RA by competing for DR5 or IR7 retinoic acid response elements (RAREs). The 5' untranslated region of AmphiTR2/4 contains an IR7 element, suggesting possible auto- and RA-regulation. The patterns of AmphiTR2/4 and AmphiRAR expression during embryogenesis are largely complementary: AmphiTR2/4 is strongly expressed in the cerebral vesicle (homologous to the diencephalon plus anterior midbrain), while AmphiRAR expression is high in the equivalent of the hindbrain and spinal cord. Similarly, while AmphiTR2/4 is expressed most strongly in the anterior and posterior thirds of the endoderm, the highest AmphiRAR expression is in the middle third. Expression of AmphiRAR is upregulated by exogenous RA and completely downregulated by the RA antagonist BMS009. Moreover, BMS009 expands the pharynx posteriorly; the first three gill slit primordia are elongated and shifted posteriorly, but do not penetrate, and additional, non-penetrating gill slit primordia are induced. Thus, in an organism without neural crest, initiation and penetration of gill slits appear to be separate events mediated by distinct levels of RA signaling in the pharyngeal endoderm. Although these compounds have little effect on levels of AmphiTR2/4 expression, RA

  4. The retinoic acid signaling pathway regulates anterior/posterior patterning in the nerve cord and pharynx of amphioxus, a chordate lacking neural crest

    NASA Technical Reports Server (NTRS)

    Escriva, Hector; Holland, Nicholas D.; Gronemeyer, Hinrich; Laudet, Vincent; Holland, Linda Z.

    2002-01-01

    Amphioxus, the closest living invertebrate relative of the vertebrates, has a notochord, segmental axial musculature, pharyngeal gill slits and dorsal hollow nerve cord, but lacks neural crest. In amphioxus, as in vertebrates, exogenous retinoic acid (RA) posteriorizes the embryo. The mouth and gill slits never form, AmphiPax1, which is normally downregulated where gill slits form, remains upregulated and AmphiHox1 expression shifts anteriorly in the nerve cord. To dissect the role of RA signaling in patterning chordate embryos, we have cloned the single retinoic acid receptor (AmphiRAR), retinoid X receptor (AmphiRXR) and an orphan receptor (AmphiTR2/4) from amphioxus. AmphiTR2/4 inhibits AmphiRAR-AmphiRXR-mediated transactivation in the presence of RA by competing for DR5 or IR7 retinoic acid response elements (RAREs). The 5' untranslated region of AmphiTR2/4 contains an IR7 element, suggesting possible auto- and RA-regulation. The patterns of AmphiTR2/4 and AmphiRAR expression during embryogenesis are largely complementary: AmphiTR2/4 is strongly expressed in the cerebral vesicle (homologous to the diencephalon plus anterior midbrain), while AmphiRAR expression is high in the equivalent of the hindbrain and spinal cord. Similarly, while AmphiTR2/4 is expressed most strongly in the anterior and posterior thirds of the endoderm, the highest AmphiRAR expression is in the middle third. Expression of AmphiRAR is upregulated by exogenous RA and completely downregulated by the RA antagonist BMS009. Moreover, BMS009 expands the pharynx posteriorly; the first three gill slit primordia are elongated and shifted posteriorly, but do not penetrate, and additional, non-penetrating gill slit primordia are induced. Thus, in an organism without neural crest, initiation and penetration of gill slits appear to be separate events mediated by distinct levels of RA signaling in the pharyngeal endoderm. Although these compounds have little effect on levels of AmphiTR2/4 expression, RA

  5. Unde venis? Amebiasis presenting as appendicitis.

    PubMed

    Wilson, Dennis A; Wilson, Gerald A; Bryan, Charles S

    2013-06-01

    A returning traveler presenting with fever accompanied by abdominal "pressure" and pain proved to have amebic appendicitis, amebic liver abscess, and probable recent amebic dysentery--a rare combination of findings amply illustrating the value of asking "Unde venis--from where do you come?"

  6. Hyoid apparatus and pharynx in the lion (Panthera leo), jaguar (Panthera onca), tiger (Panthera tigris), cheetah (Acinonyx jubatus) and domestic cat (Felis silvestris f. catus)

    PubMed Central

    Weissengruber, GE; Forstenpointner, G; Peters, G; Kübber-Heiss, A; Fitch, WT

    2002-01-01

    Structures of the hyoid apparatus, the pharynx and their topographical positions in the lion, tiger, jaguar, cheetah and domestic cat were described in order to determine morphological differences between species or subfamilies of the Felidae. In the lion, tiger and jaguar (species of the subfamily Pantherinae) the Epihyoideum is an elastic ligament lying between the lateral pharyngeal muscles and the Musculus (M.) thyroglossus rather than a bony element like in the cheetah or the domestic cat. The M. thyroglossus was only present in the species of the Pantherinae studied. In the lion and the jaguar the Thyrohyoideum and the thyroid cartilage are connected by an elastic ligament, whereas in the tiger there is a synovial articulation. In adult individuals of the lion, tiger and jaguar the ventral end of the tympanohyal cartilage is rotated and therefore the ventral end of the attached Stylohyoideum lies caudal to the Tympanohyoideum and the cranial base. In newborn jaguars the Apparatus hyoideus shows a similar topographical position as in adult cheetahs or domestic cats. In adult Pantherinae, the Basihyoideum and the attached larynx occupy a descended position: they are situated near the cranial thoracic aperture, the pharyngeal wall and the soft palate are caudally elongated accordingly. In the Pantherinae examined the caudal end of the soft palate lies dorsal to the glottis. Differences in these morphological features between the subfamilies of the Felidae have an influence on specific structural characters of their vocalizations. PMID:12363272

  7. Hyoid apparatus and pharynx in the lion (Panthera leo), jaguar (Panthera onca), tiger (Panthera tigris), cheetah (Acinonyxjubatus) and domestic cat (Felis silvestris f. catus).

    PubMed

    Weissengruber, G E; Forstenpointner, G; Peters, G; Kübber-Heiss, A; Fitch, W T

    2002-09-01

    Structures of the hyoid apparatus, the pharynx and their topographical positions in the lion, tiger, jaguar, cheetah and domestic cat were described in order to determine morphological differences between species or subfamilies of the Felidae. In the lion, tiger and jaguar (species of the subfamily Pantherinae) the Epihyoideum is an elastic ligament lying between the lateral pharyngeal muscles and the Musculus (M.) thyroglossus rather than a bony element like in the cheetah or the domestic cat. The M. thyroglossus was only present in the species of the Pantherinae studied. In the lion and the jaguar the Thyrohyoideum and the thyroid cartilage are connected by an elastic ligament, whereas in the tiger there is a synovial articulation. In adult individuals of the lion, tiger and jaguar the ventral end of the tympanohyal cartilage is rotated and therefore the ventral end of the attached Stylohyoideum lies caudal to the Tympanohyoideum and the cranial base. In newborn jaguars the Apparatus hyoideus shows a similar topographical position as in adult cheetahs or domestic cats. In adult Pantherinae, the Basihyoideum and the attached larynx occupy a descended position: they are situated near the cranial thoracic aperture, the pharyngeal wall and the soft palate are caudally elongated accordingly. In the Pantherinae examined the caudal end of the soft palate lies dorsal to the glottis. Differences in these morphological features between the subfamilies of the Felidae have an influence on specific structural characters of their vocalizations.

  8. Relationship between the rheological properties of thickener solutions and their velocity through the pharynx as measured by the ultrasonic pulse Doppler method.

    PubMed

    Tashiro, Akiko; Hasegawa, Atsuko; Kohyama, Kaoru; Kumagai, Hitomi; Kumagai, Hitoshi

    2010-01-01

    The dependence of the dynamic viscoelastic parameters of carboxymethylcellulose (CMC), xanthan gum, and guar gum solutions on the angular frequency (omega) was compared with that of their viscosity (mu) on the shear rate (gamma). In addition, the effect of these rheological properties on the maximum velocity through the pharynx, V(max), as measured by the ultrasonic pulse Doppler method, was investigated. The CMC and guar gum solutions examined were taken as a dilute solution and a true polymer solution, respectively. The xanthan gum solution was taken as a weak gel above 0.5% and a true polymer solution below 0.2%. The maximum velocity, V(max), of the thickener solutions correlated well with mu, the dynamic viscosity eta', and the complex viscosity eta(*), especially those measured at gamma or omega of 20-30 s(-1) (or rad/s) and above, suggesting that mu, eta', and eta(*) are suitable indexes for care foods of the liquid type for dysphagic patients.

  9. Cephalometric evaluation of pharynx, soft palate, adenoid tissue, tongue, and hyoid bone following the use of a mandibular repositioning appliance in obstructive sleep apnea patients.

    PubMed

    Athanasiou, A E; Papadopoulos, M A; Mazaheri, M; Lagoudakis, M

    1994-01-01

    The aim of this study was to evaluate the pharynx, soft palate, adenoid tissue, tongue, and hyoid bone when a mandibular repositioning appliance was used for managing patients with obstructive sleep apnea. Lateral cephalograms of 45 adult obstructive sleep apnea patients from the Lancaster Cleft Palate Clinic were taken without the appliance and some days later with the device in the mouth. This device was used during sleep for improving patients' respiration. Twenty-four cephalometric variables were evaluated. When the appliance was in the mouth, significant alterations (P < .001) were observed in the distances: (a) between anterior and posterior pharyngeal walls at the level of the second and third cervical vertebrae, respectively; (b) between the most superior point of the tongue and the maxillary plane; and (c) between the hyoid bone and the mandibular plane, ramus plane, cervical vertebrae tangent, mandibular symphysis, gonion, and third and fourth cervical vertebrae. The results of this study indicate that significant changes in pharyngeal space, hyoid bone, and tongue positions take place in obstructive sleep apnea patients when a mandibular repositioning device is used.

  10. Kommunale Energieversorger als wesentliche Akteure der Digitalisierung - Strategien und Handlungsoptionen

    NASA Astrophysics Data System (ADS)

    Reiche, Katherina

    Die Digitalisierung erfasst sämtliche Bereiche des Lebens und Wirtschaftens. Auch die Kommunalwirtschaft - insbesondere die kommunale Energiewirtschaft - sieht sich perspektivisch disruptiven Entwicklungen gegenüber. Stadtwerke haben bereits viele Herausforderungen erfolgreich gemeistert und stehen auch der Digitalisierung positiv gegenüber. Vielerorts gestalten kommunale Unternehmen den digitalen Wandel bereits aktiv mit. Dieser Artikel arbeitet die Assets kommunaler Unternehmen heraus und zeigt Strategien und Handlungsoptionen zum Umgang mit der digitalen Transformation für kommunale Energieversorgungsunternehmen auf. Dabei zeigt sich, dass das politische und regulatorische Umfeld für das positive Gelingen der Digitalisierung entscheidend sind. Kommunale Unternehmen benötigen die gleichen Marktzugangsbedingungen wie andere Akteure. Ferner profitieren kommunale Unternehmen von einigen Wettbewerbsvorteilen, etwa hohen Vertrauenswerten ihrer Kunden und umfangreiches Know-how im Datenmanagement.

  11. Surgery for Type III-IV hiatal hernia: anatomical recurrence and global results after elective treatment of short oesophagus with open and minimally invasive surgery.

    PubMed

    Lugaresi, Marialuisa; Mattioli, Benedetta; Daddi, Niccolò; Di Simone, Massimo Pierluigi; Perrone, Ottorino; Mattioli, Sandro

    2016-04-01

    Type III-IV hiatal hernia (HH) is associated with a true short oesophagus in more than 50% of cases; dedicated treatment of this condition might be appropriate to reduce the recurrence rate after surgery. A case series of patients receiving surgery for Type III-IV hernia was examined for short oesophagus, and the results were analysed. From 1980 to 1994, 60 patients underwent an open surgical approach, and the position of the oesophago-gastric junction was visually localized; from 1995 to 2013, 48 patients underwent a minimally invasive approach, and the oesophago-gastric junction was objectively localized using a laparoscopic-endoscopic method. The patients underwent a timed clinical-instrumental follow-up that included symptoms assessment, barium swallow and endoscopy. The results were considered to be excellent in the absence of symptoms and oesophagitis; good, if symptoms occurred two to four times a month in the absence of oesophagitis; fair, if symptoms occurred two to four times a week in the presence of hyperaemia, oedema and/or microscopic oesophagitis; and poor, if symptoms occurred on a daily basis in the presence of any grade of endoscopic oesophagitis, HH of any size or type, or the need for antireflux medical therapy. The follow-up time was calculated from the time of surgery to the last complete follow-up. Among the open surgery patients, 78% underwent abdominal fundoplication, 10% the Belsey Mark IV procedure, 8% laparotomic Collis-Nissen fundoplication and 3% the Pearson operation. Among the minimally invasive surgery patients, 44% underwent a laparoscopic floppy Nissen procedure and 56% a left thoracoscopic Collis-laparoscopic Nissen procedure. The postoperative mortality and complication rates were 1.6% (1/60) and 15% for open surgery and 4.1% (2/48) and 12.5% for minimally invasive surgery. A total of 105 patients were followed up for a median period of 96 months. Five relapses occurred after open surgery (5/59, 8%) and two after minimally

  12. The enhancing effect of ethanol on the mutagenic activation of N-nitrosomethylbenzylamine by cytochrome P450 2A in the rat oesophagus.

    PubMed

    Tatematsu, Kenjiro; Koide, Akihiro; Morimura, Keiichirou; Fukushima, Shoji; Mori, Yukio

    2013-03-01

    Alcohol consumption is frequently associated with various cancers and the enhancement of the metabolic activation of carcinogens has been proposed as a mechanism underlying this relationship. The ethanol-induced enhancement of N-nitrosodiethylamine (DEN)-mediated carcinogenesis can be attributed to an increase in hepatic activity. However, the mechanism of elevation of N-nitrosomethylbenzylamine (NMBA)-induced tumorigenesis remains unclear. To elucidate the mechanism underlying the role of ethanol in the enhancement of NMBA-induced oesophageal carcinogenesis, we evaluated the hepatic and extrahepatic levels of the cytochrome P450 (CYP) and mutagenic activation of environmental carcinogens by immunoblot analyses and Ames preincubation test, respectively, in F344 rats treated with ethanol. Five weeks of treatment with 10% ethanol added to the drinking water or two intragastric treatments with 50% ethanol, both resulted in elevated levels of CYP2E1 (1.5- to 2.3-fold) and mutagenic activities of DEN, N-nitrosodimethylamine and N-nitrosopyrrolidine in the presence of rat liver S9 (1.5- to 2.4-fold). This was not the case with CYP1A1/2, CYP2A1/2, CYP2B1/2 or CYP3A2, nor with the activities of 2-amino-3-methylimidazo[4,5-f]quinoline, 3-amino-1-methyl-5H-pyrido[4,3-b]indole, aflatoxin B(1) or other N-nitroso compounds (NOCs), including NMBA. Ethanol-induced elevations of CYP2A and CYP2E1 were observed in the oesophagus (up to 1.7- and 2.3-fold) and kidney (up to 1.5- and 1.8-fold), but not in the lung or colon. In oesophagus and kidney, the mutagenic activities of NMBA and four NOCs were markedly increased (1.3- to 2.4-fold) in treated rats. The application of several CYP inhibitors revealed that CYP2A were likely to contribute to the enhancing effect of ethanol on NMBA activation in the rat oesophagus and kidney, but that CYP2E1 failed to do so. These results showed that the enhancing effect of ethanol on NMBA-induced oesophageal carcinogenesis could be attributed to an

  13. SCOPE1: a randomised phase II/III multicentre clinical trial of definitive chemoradiation, with or without cetuximab, in carcinoma of the oesophagus

    PubMed Central

    2011-01-01

    Background Chemoradiotherapy is the standard of care for patients with oesophageal cancer unsuitable for surgery due to the presence of co-morbidity or extent of disease, and is a standard treatment option for patients with squamous cell carcinoma of the oesophagus. Modern regimens of chemoradiotherapy can lead to significant long-term survival. However the majority of patients will die of their disease, most commonly with local progression/recurrence of their tumours. Cetuximab may overcome one of the principal mechanisms of tumour radio-resistance, namely tumour repopulation, in patients treated with chemoradiotherapy. The purpose of this research is first to determine whether the addition of cetuximab to definitive chemoradiotherapy for treatment of patients with non-metastatic carcinoma of the oesophagus is active (in terms of failure-free rate), safe, and feasible within the context of a multi-centre randomised controlled trial in the UK. If the first stage is successful then the trial will continue to accrue sufficient patients to establish whether the addition of cetuximab to the standard treatment improves overall survival. Methods/Design SCOPE1 is a two arm, open, randomised multicentre Phase II/III trial. Eligible patients will have histologically confirmed carcinoma of the oesophagus and have been chosen to receive definitive chemoradiotherapy by an accredited multidisciplinary team including a specialist Upper GI surgeon. 420 patients will be randomised to receive definitive chemoradiotherapy with or without cetuximab using a 1:1 allocation ratio. During Phase II of the study, the trial will assess safety (toxicity), activity (failure-free rate) and feasibility (recruitment rate and protocol dose modifications/delays) in 90 patients in the experimental arm. If the experimental arm is found to be active, safe, and feasible by the Independent Data Monitoring Committee then recruitment will continue into Phase III. This second stage will recruit a further

  14. Autofluorescence endoscopy with "real-time" digital image processing in differential diagnostics of selected benign and malignant lesions in the oesophagus.

    PubMed

    Sieroń-Stołtny, Karolina; Kwiatek, Sebastian; Latos, Wojciech; Kawczyk-Krupka, Aleksandra; Cieślar, Grzegorz; Stanek, Agata; Ziaja, Damian; Bugaj, Andrzej M; Sieroń, Aleksander

    2012-03-01

    Oesophageal papilloma and Barrett's oesophagus are benign lesions known as risk factors of carcinoma in the oesophagus. Therefore, it is important to diagnose these early changes before neoplastic transformation. Autofluorescence endoscopy is a fast and non-invasive method of imaging of tissues based on the natural fluorescence of endogenous fluorophores. The aim of this study was to prove the diagnostic utility of autofluorescence endoscopy with digital image processing in histological diagnosis of endoscopic findings in the upper digestive tract, primarily in the imaging of oesophageal papilloma. During the retrospective analysis of about 200 endoscopic procedures in the upper digestive tract, 67 cases of benign, precancerous or cancerous changes were found. White light endoscopy (WLE) image, single-channel (red or green) autofluorescence images, as well as green and red fluorescence intensities in two modal fluorescence image and red-to-green (R/G) ratio (Numerical Colour Value, NCV) were correlated with histopathologic results. The NCV analysis in autofluorescence imaging (AFI) showed increased R/G ratio in cancerous changes in 96% vs. 85% in WLE. Simultaneous analysis with digital image processing allowed us to diagnose suspicious tissue as cancerous in all of cases. Barrett's metaplasia was confirmed in 90% vs. 79% (AFI vs. WLE), and 98% in imaging with digital image processing. In benign lesions, WLE allowed us to exclude tissue as malignant in 85%. Using autofluorescence endoscopy R/G ratio was increased in only 10% of benign changes causing the picture to be interpreted as suspicious, but when both methods were used together, 97.5% were cases excluded as malignancies. Mean R/G ratios were estimated to be 2.5 in cancers, 1.25 in Barrett's metaplasia and 0.75 in benign changes and were statistically significant (p=0.04). Autofluorescence imaging is a sensitive method to diagnose precancerous and cancerous early stages of the diseases located in oesophagus

  15. Transrapid und Rad-Schiene-Hochgeschwindigkeitsbahn: Ein gesamtheitlicher Systemvergleich

    NASA Astrophysics Data System (ADS)

    Schach, R.; Jehle, P.; Naumann, R.

    Der Transrapid bietet im Hochgeschwindigkeitsbereich eine sehr interessante Alternative. Über Vor-und Nachteile des Transrapid im Vergleich mit konventionellen Rad-Schiene-Systemen, im Hochgeschwindigkeitsbereich auf Strecken zwischen 150 und 800 Kilometernund als peer-to-peer-Verbindung im Kurzstreckenbereich, wurden viele einze lne Aspekte behandelt, darunter sachliche wie politische Statements. Ein Systemvergleich muß aber alle technischen, wirtschaftlichen und ökologischen Faktoren einschließen.

  16. Rahmen, Herausforderungen und Visionen für die Unternehmensorganisation

    NASA Astrophysics Data System (ADS)

    Westkämper, Engelbert; Seidel, Bernhard; Bruhn, Manfred; Bahke, Torsten; Klotz, Ulrich; Buck, Hartmut

    Die Produktion trägt entscheidend zur gesamten Wertschöpfung des Landes mit mehr als einem Drittel aller Beschäftigten bei. Die direkte Wertschöpfung ist dabei für ein rohstoff- und energiearmes Land allein durch Veredelung und technisches Know-how sowie durch die Herstellung von Produkten für den Binnen- und Weltmarkt möglich.

  17. Cancer of Oesophagus or Gastricus - New Assessment of Technology of Endosonography (COGNATE): report of pragmatic randomised trial.

    PubMed

    Russell, I T; Edwards, R T; Gliddon, A E; Ingledew, D K; Russell, D; Whitaker, R; Yeo, S T; Attwood, S E; Barr, H; Nanthakumaran, S; Park, K G M

    2013-09-01

    Endoscopic ultrasonography is recommended for staging gastro-oesophageal cancers, but has never been evaluated. COGNATE (Cancer of Oesophagus or Gastricus - New Assessment of Technology of Endosonography) therefore aimed to evaluate whether adding 'endoscopic ultrasound' (EUS) to the usual staging algorithm changes treatment, improves (quality-adjusted) survival, and uses resources cost-effectively. Pragmatic parallel-group trial. Patients with gastro-oesophageal cancer received standard staging algorithms. Multidisciplinary teams chose provisional management plans from endoscopic mucosal resection, immediate surgery, surgery after chemotherapy, or chemotherapy and radiotherapy. We used dynamic randomisation to allocate consenting patients remotely by telephone in equal proportions between EUS and not. Thereafter we recorded changes in management plan, use of health-care resources, and three aspects of participant-reported quality of life: generic [measured by European Quality of Life - 5 Dimensions (EQ-5D)], cancer related [Functional Assessment of Cancer Therapy - General scale (FACT-G)] and condition-specific [FACT - Additional Concerns scale (FACT-AC)]. We followed participants regularly until death or the end of the trial - for between 1 and 4.5 years. We devised a quality assurance programme to maintain standards of endosonographic reporting. Eight British hospitals, of which two - one Scottish teaching hospital and one English district general hospital - contributed 80% of participants; we combined the other six for analysis. Patients were eligible if they had a diagnosis of gastro-oesophageal cancer, had not started treatment, were free of metastatic disease, were fit for surgery (even if not planned) and had American Society of Anesthesiologists and World Health Organization grades of less than 3. Intervention group: standard staging algorithm plus EUS; control group: standard staging algorithm. Primary: quality-adjusted survival. Secondary: survival

  18. Ökologische Grundlagen und limitierende Faktoren der Renaturierung

    NASA Astrophysics Data System (ADS)

    Hölzel, N.; Rebele, F.; Rosenthal, G.; Eichberg, C.

    In den dicht besiedelten und agrarisch besonders intensiv genutzten Regionen Mittel- und Westeuropas ist seit Ende des Zweiten Weltkrieges ein fortschreitender Verlust an naturnahen ökosystemen mit hoher biologischer Vielfalt zu verzeichnen. Spätestens seit den 1970er-Jahren ist daher die Neuschaffung und Wiederherstellung gefährdeter Lebensräume und Biozönosen zunehmend in den Mittelpunkt von Naturschutzmaßnahmen gerückt (Bakker 1989, Muller et al. 1998, Bakker und Berendse 1999). Aufgrund fehlender wissenschaftlicher Grundlagen und praktischer Erfahrungen wurden Renaturierungsmaßnahmen anfangs fast durchweg nach dem trial and error-Prinzip durchgeführt. Im Vordergrund standen dabei zunächst die Wiederherstellung adäquater abiotischer Standortbedingungen sowie die Reorganisation traditioneller Nutzungsmanagements. Bei Ersterem ging es neben der Wiedervernässung entwässerter Feuchtgebiete (Pfadenhauer und Grootjans 1999) vor allem darum, Eutrophierungseffekte zu beseitigen und die Produktivität des Standortes auf das Niveau der Zielgemeinschaft zurückzuführen (Gough und Marrs 1990, Oomes et al. 1996, Snow et al. 1997, Tallowin et al. 1998).

  19. Modellgestützte Hybrid Systementwicklung - Modellierung und Optimierung

    NASA Astrophysics Data System (ADS)

    Huber, Thomas

    Im Bereich der Hybridfahrzeugentwicklung wird nach wie vor intensiv an Konzepten zur Verbrauchseinsparung und Reduzierung von Emissionen gearbeitet. Gleichzeitig sollen "Fahrspaß" und Komfort solcher Fahrzeuge verbessert werden. Für verschiedene Anwendungen sind unterschiedlichste Hybridkonzepte denkbar und sinnvoll. Trotz dieser Variantenvielfalt und den daraus resultierenden technischen Anforderungen sind die Kosten eines Hybridfahrzeugs zu minimieren, wobei ein wesentlicher Aspekt bei der Kostenreduzierung die Stückzahl ist. Bei der Entwicklung von Komponenten steht daher, neben den technischen Anforderungen, deren vielseitige Einsetzbarkeit im Vordergrund.

  20. Methodisches Vorgehen zur integralen Auslegung von Produkt und Montage

    NASA Astrophysics Data System (ADS)

    Meyer, André; Grauer, Matthias; Rittner, Martin; Zeltner, Stefan; März, Martin; Egelkraut, Sven; Birkner, Klaus; Braun, Steven

    Die Produktlebenszyklen werden durch den steigenden Wettbewerbsdruck stetig kürzer. Dies veranlasst Unternehmen, Produktinnovationen in immer geringeren Zeitabständen auf den Markt zu bringen und Produktentwicklungszeiten zu verkürzen. Zusätzlich wirken sich erhöhte Anforderungen bezüglich Produktzuverlässigkeit und -lebensdauer erschwerend aus. Um dieser Herausforderung zu begegnen ist eine enge Zusammenarbeit zwischen Entwicklung, Konstruktion, Fertigungsplanung und Prozessentwicklung unabdingbar, denn nur durch eine optimale Abstimmung von Konstruktion und Fertigungsprozess lassen sich die hohen Qualitätsanforderungen erfüllen.

  1. Transcription factors GATA/ELT-2 and forkhead/HNF-3/PHA-4 regulate the tropomyosin gene expression in the pharynx and intestine of Caenorhabditis elegans.

    PubMed

    Anokye-Danso, Frederick; Anyanful, Akwasi; Sakube, Yasuji; Kagawa, Hiroaki

    2008-05-30

    Gene regulation during development is an important biological activity that leads to synthesis of biomolecules at specific locations and specific times. The single tropomyosin gene of Caenorhabditis elegans, tmy-1/lev-11, produces four isoforms of protein: two from the external promoter and two from the internal promoter. We investigated the internal promoter of tropomyosin to identify sequences that regulate expression of tmy-1 in the pharynx and intestine. By promoter deletion of tmy-1 reporters as well as by database analyses, a 100-bp fragment that contained binding sequences for a GATA factor, for a chicken CdxA homolog, and for a forkhead factor was identified. Both the forkhead and CdxA binding sequences contributed to pharyngeal and intestinal expression. In addition, the GATA site also influenced intestinal expression of tmy-1 reporter. We showed that ELT-2 and PHA-4 proteins interact directly with the GATA and forkhead binding sequences, respectively, in gel mobility shift assays. RNA interference knockdown of elt-2 diminished tmy-1::gfp expression in the intestine. In contrast to RNA interference knockdown of pha-4, expression of tmy-1::gfp in pha-4;smg-1 mutants was slightly weaker than that of the wild type. Ectopic expression of PHA-4 and ELT-2 by heat shock was sufficient to elicit widespread expression of tmy-1::lacZ reporter in embryos. We found no indication of a synergistic relation between ELT-2 and PHA-4. Based on our data, PHA-4 and CdxA function as general transcription factors for pharyngeal and intestinal regulation of tmy-1. We present models by which ELT-2, PHA-4, and CdxA orchestrate expression from the internal promoter of tmy-1.

  2. Pre-warming the Streamlined Liner of the Pharynx Airway (SLIPA) improves fitting to the laryngeal structure: a randomized, double-blind study.

    PubMed

    Kang, Hyun; Kim, Dong Rim; Jung, Yong Hun; Baek, Chong Wha; Park, Yong Hee; In Oh, Jong; Kim, Won Joong; Choi, Geun Joo

    2015-11-20

    The Streamlined Liner of the Pharynx Airway (SLIPA), a type of supraglottic airway, has a non-inflatable cuff that softens at body temperature to fit the laryngeal structure. We investigated whether pre-warming of SLIPA to body temperature may improve insertion parameters. Ninety adult patients were assigned equally randomized to either Group W or Group R. Anesthesia was induced using propofol, fentanyl, and rocuronium. In Group W, the SLIPA was warmed to 37 ° C before insertion, whereas in Group R, it was inserted at room temperature. The insertion time, oropharyngeal leak pressure, postoperative throat pain, blood staining, regurgitation, number of attempts at insertion, and difficulty of insertion were compared between the two groups. The insertion time was shorter in Group W than in Group R (3.60 [3.15-4.06] s vs. 6.00 [4.45-7.50] s; P < 0.001). Oropharyngeal leak pressure from the time of insertion until 3 min after insertion was significantly higher in Group W than in Group R (P < 0.05). Postoperative throat pain, measured using the visual analog scale, was lower in Group W than in Group R (0.00 [0.00-2.50] vs. 2.00 [0.00-4.50]; P = 0.006). The difficulty of insertion was lower in Group W than in Group R (P < 0.004). There were no significant differences in terms of blood staining, regurgitation, and number of attempts. Pre-warming the SLIPA to body temperature has significant benefits compared to maintaining the device at room temperature. Specifically, insertion was easier, both insertion and fitting to the laryngeal structure could be performed more quickly, and the incidence of sore throat was reduced. Clinical Research Information Identifier NCT01209000.

  3. Comparison of streamlined liner of the pharynx airway (SLIPA™) with the laryngeal mask airway Proseal™ for lower abdominal laparoscopic surgeries in paralyzed, anesthetized patients

    PubMed Central

    Abdellatif, Ashraf Abualhassan; Ali, Monaz Abdulrahman

    2011-01-01

    Context: Supraglottic airway devices have been used as an alternative to tracheal intubation during laparoscopic surgery. Aims: The study was designed to compare the efficacy of Streamlined Liner of the Pharynx Airway (SLIPA) for positive pressure ventilation and postoperative complications with the Laryngeal Mask Airway ProSeal (PLMA) for patients undergoing lower abdominal laparoscopies under general anesthesia with controlled ventilation. Settings and Design: Prospective, crossover randomized controlled trial performed on patients undergoing lower abdominal laparoscopic surgeries. Methods: A total of 120 patients undergoing lower abdominal laparoscopic surgeries were randomly allocated into two equal groups; PLMA and SLIPA groups. Number of intubation attempts, insertion time, ease of insertion, and fiberoptic bronchoscopic view were recorded. Lung mechanics data were collected 5 minutes after securing the airway, then after abdominal insufflation. Blood traces and regurgitation were checked for; postoperative sore throat and other complications were recorded. Statistical Analysis: Arithmetic mean and standard deviation values were calculated and statistical analyses were performed for each group. Independent sample t-test was used to compare continuous variables exhibiting normal distribution, and Chi-squared test for noncontinuous variables. P value <0.05 was considered significant. Results: Insertion time, first insertion success rate, and ease of insertion were comparable in both groups. Fiberoptic bronchoscopic view was significantly better and epiglottic downfolding was significantly lower in SLIPA group. Sealing pressure and lung mechanics were similar. Gastric distension was not observed in both groups. Postoperative sore throat was significantly higher in PACU in PLMA group. Blood traces on the device were significantly more in SLIPA group. Conclusions: SLIPA can be used as a useful alternative to PLMA in patients undergoing lower abdominal laparoscopic

  4. Darwin, Engels und die Rolle der Arbeit in der biologischen und kulturellen Evolution des Menschen

    NASA Astrophysics Data System (ADS)

    Reichholf, Josef H.

    Im Jahre 1876, 5 Jahre nach Erscheinen von Darwins Buch über die Evolution des Menschen und die sexuelle Selektion (Darwin 1871), veröffentlichte Friedrich Engels den berühmt gewordenen Essay "Anteil der Arbeit an der Menschwerdung des Affen“ (Engels 1876). Die Kernfrage darin lautet in Kurzform: Warum hat der Mensch eigentlich ein Bedürfnis nach Arbeit? Engels Antwort wird nachfolgend näher betrachtet und vom gegenwärtigen Kenntnisstand aus beurteilt. Wie sich zeigen wird, beantworten seine Überlegungen die Frage nicht wirklich. Sie ist weiterhin offen. Es können lediglich einige zusätzliche Anhaltspunkte zur Diskussion gestellt werden. Angesichts des drängenden Problems millionenfacher Arbeitslosigkeit und der Forderungen nach einem "Grundrecht auf Arbeit“ kommt den Überlegungen zum möglichen Ursprung des Bedürfnisses nach Arbeit mehr als nur akademisches Interesse zu.

  5. Haptische Modellierung und Deformation einer Kugelzelle

    NASA Astrophysics Data System (ADS)

    Schippritt, Darius; Wiemann, Martin; Lipinski, Hans-Gerd

    Haptische Simulationsmodelle dienen in der Medizin in erster Linie dem Training operativer Eingriffe. Sie basieren zumeist auf physikalischen Gewebemodellen, welche eine sehr genaue Simulation der biomechanischen Eigenschaften des betreffenden Gewebes erlauben, aber gleichzeitig sehr rechenintensiv und damit zeitaufwändig in der Ausführung sind. Die menschliche Wahrnehmung kann allerdings auch eine ungenaue haptische Modellierung psychooptisch ausgleichen. Daher kann es sinnvoll sein, haptische Simulationen auch mit nicht vollständig physikalisch definierten Deformationsmodellen durchzuführen. Am Beispiel der haptischer Simulation einer in-vitro Fertilisation wird gezeigt, dass durch die Anwendung eines geometrischen Deformationsmodells eine künstliche Befruchtung unter realistischen experimentellen Bedingungen in Echtzeit haptisch simuliert und damit trainiert werden kann.

  6. Implantate und Verfahren in der Augenheilkunde

    NASA Astrophysics Data System (ADS)

    Neuhann, Tobias H.

    Das in der Medizin mit am häufigsten verwendete Implantat weltweit ist die Intraokulare Linse (IOL). Die Gründe hierfür sind vielschichtig: einmal haben die Operationstechniken in den letzten 30 Jahren eine wesentliche Steigerung an Gleichmäßigkeit, Erfolg und Effizienz erfahren, zum anderen verursachen die gestiegenen Anforderungen des Alltags in den Industrienationen und im Berufsleben den höheren Anspruch an das Sehvermögen. Ist die menschliche Linse Ursache für schlechtes Sehvermögen, besteht meist eine Trübung des Linsenproteins. Diese Trübung nennt wird Volksmund Grauer Star genannt, wissenschaftlich die Katarakt (cataracta). Es gibt unterschiedliche Formen wie angeborene (congenita) oder erworbene, traumatische, krankheitsoder altersbedingte Formen [45]. Wird die eingetrübte Linse nun mittels moderner Operationsverfahren entfernt, muss für Ersatz dieses lichtbrechenden Mediums gesorgt werden [2].

  7. Herstellung von Chitosan und einige Anwendungen

    NASA Astrophysics Data System (ADS)

    Struszczyk, Marcin Henryk

    2001-05-01

    1. Die Deacetylierung von crabshell - Chitosan führte gleichzeitig zu einem drastischen Abfall der mittleren viscosimetrischen Molmasse ( Mv), insbesondere wenn die Temperatur und die Konzentration an NaOH erhöht werden. Diese Parameter beeinflussten jedoch nicht den Grad der Deacetylierung (DD). Wichtig ist jedoch die Quelle des Ausgangsmaterials: Chitin aus Pandalus borealis ist ein guter Rohstoff für die Herstellung von Chitosan mit niedrigem DD und gleichzeitig hoher mittlerer Mv, während Krill-Chitin (Euphausia superba) ein gutes Ausgangsmaterial zur Herstellung von Chitosan mit hohem DD und niedrigem Mv ist. Chitosan, das aus Insekten (Calliphora erythrocephala), unter milden Bedingungen (Temperatur: 100°C, NaOH-Konzentration: 40 %, Zeit: 1-2h ) hergestellt wurde, hatte die gleichen Eigenschaften hinsichtlich DD und Mv wie das aus Krill hergestellte Chitosan. Der Bedarf an Zeit, Energie und NaOH ist für die Herstellung von Insekten-Chitosan geringer als für crabshell-Chitosan vergleichbare Resultaten für DD und Mv. 2. Chitosan wurde durch den Schimmelpilz Aspergillus fumigatus zu Chitooligomeren fermentiert. Die Ausbeute beträgt 25%. Die Chitooligomere wurden mit Hilfe von HPLC und MALDI-TOF-Massenspektrmetrie identifiziert. Die Fermentationsmischung fördert die Immunität von Pflanzen gegen Bakterien und Virusinfektion. Die Zunahme der Immunität schwankt jedoch je nach System Pflanze-Pathogen. Die Fermentation von Chitosan durch Aspergillus fumigatus könnte eine schnelle und billige Methode zur Herstellung von Chitooligomeren mit guter Reinheit und Ausbeute sein. Eine partiell aufgereinigte Fermentationsmischung dieser Art könnte in der Landwirtschaft als Pathogeninhibitor genutzt werden. Durch kontrollierte Fermentation, die Chitooligomere in definierter Zusammensetzung (d.h. definierter Verteilung des Depolymerisationsgrades) liefert, könnte man zu Mischungen kommen, die für die jeweilige Anwendung eine optimale Bioaktivität besitzen. 3

  8. Die Einzelhandelsakteure im Spannungsfeld des Wettbewerbs und öffentlicher Vorgaben

    NASA Astrophysics Data System (ADS)

    Bleyer, Burkhard

    2002-03-01

    Vielfältige, unterschiedlich starke und oft auch gegenläufig agierende Akteure und Interessenvertreter wirken auf das spezifische Standortmuster des Einzelhandels ein. Wie hat sich der Einzelhandel auf der Anbieter- und Nachfragerseite geändert? Es fehlt nicht an Regelungswerken für den großflächigen Einzelhandel und Konzepten für einen gleichrangigen Standortwettbewerb zwischen den traditionellen Einkaufslagen und denen auf der Grünen Wiese. Wer sind die Standortakteure und wie stimmen sie sich ab? Wie lösen sie die Standortkonflikte angesichts der Wettbewerbssituation? Welchen Beitrag leisten dazu staatliche und kommunale Vorgaben?

  9. Prä- und perioperative Aspekte der Versorgung dermatochirurgischer Patienten.

    PubMed

    Müller, Cornelia S L; Hubner, Wakiko; Thieme-Ruffing, Sigrid; Pföhler, Claudia; Vogt, Thomas; Volk, Thomas; Gärtner, Barbara C; Bialas, Patric

    2017-02-01

    Die Dermatochirurgie nimmt hinsichtlich vieler Punkte eine Sonderstellung unter den operativen Fächern ein. Hierzu gehört in erster Linie die Tatsache, dass bis auf wenige Ausnahmen fast alle Eingriffe traditionell in Lokal- bzw. Regionalanästhesie und oft auch in räumlich-infrastruktureller Trennung von den großen Zentral-Operationssälen stattfinden können. Die peri- und postoperative Überwachung obliegt dabei dem dermatochirurgischen Operationsteam. Das sui generis kleinere OP-Team hat somit eine ganze Reihe perioperativer Notwendigkeiten zu beachten, um die sich in den "großen" chirurgischen Fächern eine Vielzahl verschiedener beteiligter Fachgruppen gemeinsam kümmern. Hierzu gehören neben Hygieneaspekten, Kenntnissen in der Überwachung der Patienten sowie dem Aspekt der surgical site infections auch Fragen zur postoperativen Schmerztherapie sowie detailliertes pharmakologisches Wissen über die zur Anwendung kommenden Lokalanästhetika und das Handling der damit assoziierten toxischen und allergischen Reaktionen. Eine interdisziplinäre Zusammenarbeit und Verantwortung für den Patienten ist notwendig und erfordert die Erarbeitung und Umsetzung qualitätsorientierter und evidenzbasierter Handlungsanweisungen, die im dermatochirurgischen OP-Setting meist weit über das eigentliche Fach hinausgehen. Ziel dieses Weiterbildungsartikels soll die komprimierte Darstellung der genannten fachübergreifenden Standpunkte bezüglich der wichtigsten perioperativen Aspekte sein. © 2017 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  10. Smart Meter Rollout: Intelligente Messsysteme als Schnittstelle zum Kunden im Smart Grid und Smart Market

    NASA Astrophysics Data System (ADS)

    Vortanz, Karsten; Zayer, Peter

    Das Gesetz zur Digitalisierung der Energiewende ist verabschiedet. Ab 2017 sind moderne Messeinrichtungen (mME) und intelligente Messsysteme (iMSys) zu verbauen und zu betreiben. Der "deutsche Weg" für die Einführung von Smart Metern sieht einen stufenweisen Rollout sowie ein Höchstmaß an Informations- und Datensicherheit vor. Dabei spielen iMSys und mME eine wichtige Rolle bei der Neugestaltung der intelligenten Netze (Smart Grids) und des neuen Marktmodells (Smart Market). Dieser Beitrag beschäftigt sich mit den neuen Gesetzen, den Marktrollen und ihren Aufgaben, Datenschutz und Datensicherheit, dem iMSys als sichere Lösung, dem sicheren Betrieb von Smart Meter Gateways, Smart Grid - Smart Market, dem Zusammenspiel zwischen reguliertem Bereich und Markt, den Einsatzbereichen der iMSys sowie den Auswirkungen auf Prozesse und Systeme und gibt Handlungsempfehlungen.

  11. Experimentalphysik 3: Atome, Moleküle und Festkörper

    NASA Astrophysics Data System (ADS)

    Demtröder, Wolfgang

    Pressestimmen: "...Die Kapitel über Molekülphysik und die experimentellen Methoden der Atom- und Molekülphysik sind aus meiner Sicht einmalig, da sie sehr überschaubar und kompetent eine große Stoff-Fülle vermitteln... Der ansprechende äußere Aufbau, die hohe graphische Qualität und viele sinnvolle Tabellen und Zusammenfassungen lassen das Studium dieses Lehrbuches zum Vergnügen werden...

  12. B-Zell-Lymphome der Haut - Pathogenese, Diagnostik und Therapie.

    PubMed

    Nicolay, Jan P; Wobser, Marion

    2016-12-01

    Primär kutane B-Zell-Lymphome (PCBCL) beschreiben reifzellige lymphoproliferative Erkrankungen der B-Zell-Reihe, die primär die Haut betreffen. Die Biologie und der klinische Verlauf der einzelnen PCBCL-Subtypen variieren untereinander stark und unterscheiden sich grundsätzlich von primär nodalen und systemischen B-Zell-Lymphomen. Primär kutane Marginalzonenlymphome (PCMZL) und primäre kutane follikuläre Keimzentrumslymphome (PCFCL) werden auf Grund ihres unkomplizierten Verlaufs und ihrer exzellenten Prognose zu den indolenten PCBCL gezählt. Demgegenüber stellen die diffus großzelligen B-Zell-Lymphome, hauptsächlich vom Beintyp (DLBCL, LT) die aggressiveren PCBCL-Varianten mit schlechterer Prognose dar. Für die Ausbreitungsdiagnostik und die Therapieentscheidung sind eine genaue histologische und immunhistochemische Klassifizierung sowie der Ausschluss einer systemischen Beteiligung in Abgrenzung zu nodalen oder systemischen Lymphomen notwendig. Die Diagnostik sollte dabei durch molekularbiologische Untersuchungen unterstützt werden. Therapeutisch stehen für die indolenten PCBCL primär operative und radioonkologische Maßnahmen im Vordergrund sowie eine Systemtherapie mit dem CD20-Antikörper Rituximab bei disseminiertem Befall. Die aggressiveren Varianten sollten in erster Linie mit Kombinationen aus Rituximab und Polychemotherapieschemata wie z. B. dem CHOP-Schema oder Modifikationen davon behandelt werden. Auf Grund der in allen seinen Einzelheiten noch nicht vollständig verstandenen Pathogenese und Biologie sowie des begrenzten Therapiespektrums der PCBCL besteht hier, speziell beim DLBCL, LT, noch erheblicher Forschungsbedarf. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  13. Strahlen-und kinetische Waffen: Neue Waffentechniken und Rüstungskontrolle

    NASA Astrophysics Data System (ADS)

    Neuneck, Götz

    Laserstrahlen, Mikrowellen oder elektromagnetische Beschleuniger lassen sich nicht nur für zivile, sondern für militärische Zwecke einsetzen. Die Aufgabe einer vorbeugenden Rüstungskontrolle wäre es, diese wie andere künftige Waffentechnologien auf ihren destabilisierenden Charakter hin zu untersuchen und ihre Stationierung zu beschränken oder zu verhindern.

  14. Comparison of the Disposable Streamlined Liner of the Pharynx Airway and the Disposable I-gel in Anaesthetized, Paralyzed Adults: A Randomized Prospective Study

    PubMed Central

    EL-Radaideh, Khaled; Alhowary, Ala"a; Bani Hani, Diab

    2015-01-01

    Introduction. This study compared streamlined liner of the pharynx airway (SLIPA) and I-gel noninflatable, single-use, supraglottic airway device (SAD) performance in anesthetized, paralyzed adults. Methods. Eighty adults (ASA physical statuses I–III) who were undergoing elective procedures under general anesthesia with an SAD were enrolled in this prospective, randomized, single-blind study. Subjects were randomly and evenly assigned to the SLIPA or I-gel group for intraoperative airway management. Ease and number of insertions, insertion time, oropharyngeal sealing pressure, hemodynamic response, oxygen saturation (SpO2), end-tidal CO2 (EtCO2), and peri- and postoperative complications were examined. Results. The SLIPA and I-gel devices were successfully inserted in 100% and 95% of subjects, respectively. In two I-gel subjects (5%), ventilation was not possible after two attempts, but a size 55 SLIPA was successfully inserted in both cases. Forty-two and 38 patients were ultimately included in the SLIPA and I-gel groups, respectively. Insertion time was significantly shorter with the SLIPA (11.19 ± 3.03 s) than with the I-gel (15.05 ± 6.37 s, P = 0.003). Oropharyngeal sealing pressure was significantly higher in SLIPA (28.76 ± 3.11 cmH2O) than in I-gel (25.9 ± 3.65 cmH2O) subjects (P = 0.001). Blood staining occurred more frequently in SLIPA (n = 8, 19.0%) than in I-gel (n = 5, 13.2%) patients (P < 0.01). Heart rate, mean arterial blood pressure, SpO2, and EtCO2 were not significantly different between groups. Conclusion. Although blood staining incidence was higher, SLIPA insertion was easier and faster than I-gel insertion. The SLIPA provided better airway sealing pressure. Both devices had similar mechanical ventilation and oxygenation characteristics and comparable hemodynamic stability. Both noninflatable SADs are useful, but SLIPA rapid insertion and good airway sealing make it an effective alternative to the I-gel. PMID:26697064

  15. [The spa-and-health resort-based rehabilitation of the patients presenting with frequently recurring erosive and ulcerative lesions in the oesophagus, stomach, and duodenum in the phase of subsiding exacerbation].

    PubMed

    Efimenko, N V; Kaĭsinova, A S

    2014-01-01

    To develop a new medical technology for the spa-and-health resort-based treatment of the patients presenting with frequently recurring erosive and ulcerative lesions in the oesophagus, stomach, and duodenum in the phase of subsiding exacerbation. A total of 100 patients presenting with frequently recurring erosive and ulcerative lesions in the oesophagus, stomach, and duodenum in the phase of subsiding exacerbation were available for the examination that included detailed investigations of the clinical picture, characteristics of the immune status, and psychological testing before and after a course of the spa-and-health resort-based treatment. The effectiveness of two therapeutic modalities was evaluated. One of them (control) prescribed to 50 patients consisted of standard antiulcer pharmacotherapy in combination with Essentuki Novaya drinking mineral water and carbon dioxide mineral baths, the other given to 50 patients included radon baths instead of carbon dioxide mineral baths. The combined application of drinking mineral waters, radon baths, and standard antiulcer pharmacotherapy produced the most conspicuous clinical effect in the framework of spa-and-health resort-based rehabilitation of the patients presenting with frequently recurring erosive and ulcerative lesions in the oesophagus, stomach, and duodenum in the phase of subsiding exacerbation as confirmed by positive dynamics of their psychoemotional status in 97.7% of the cases, regression of pain syndrome (91.5%), and improvement of humoral and cellular immunity (94%). An important result of the spa-and-health resort-based rehabilitation is the intensification of the reparative processes in gastroduodenal mucosa responsible for the healing of ulcers and erosions in 94.7% of the patients. The spa-and-health resort-based rehabilitation is a pathogenetically sound and efficacious approach to the management of the patients presenting with frequently recurring erosive and ulcerative lesions in the

  16. Entwicklungsperspektiven von Social Software und dem Web 2.0

    NASA Astrophysics Data System (ADS)

    Raabe, Alexander

    Der Artikel beschäftigt sich zunächst mit dem derzeitigen und zukünftigen Einsatz von Social Software in Unternehmen. Nach dem großen Erfolg von Social Software im Web beginnen viele Unternehmen eigene Social Software-Initiativen zu entwickeln. Der Artikel zeigt die derzeit wahrgenommenen Einsatzmöglichkeiten von Social Software im Unternehmen auf, erörtert Erfolgsfaktoren für die Einführung und präsentiert mögliche Wege für die Zukunft. Nach der Diskussion des Spezialfalles Social Software in Unternehmen werden anschließend die globalen Trends und Zukunftsperspektiven des Web 2.0 in ihren technischen, wirtschaftlichen und sozialen Dimensionen dargestellt. Wie aus den besprochenen Haupttrends hervorgeht, wird die Masse an digital im Web verfügbaren Informationen stetig weiterwachsen. So stellt sich die Frage, wie es in Zukunft möglich sein wird, die Qualität der Informationssuche und der Wissensgenerierung zu verbessern. Mit dem Einsatz von semantischen Technologien im Web wird hier eine revolutionäre Möglichkeit geboten, Informationen zu filtern und intelligente, gewissermaßen verstehende" Anwendungen zu entwerfen. Auf dem Weg zu einem intelligenten Web werden sich das Semantic Web und Social Software annähern: Anwendungen wie Semantic Wikis, Semantic Weblogs, lightweight Semantic Web-Sprachen wie Microformats oder auch kommerzielle Angebote wie Freebase von Metaweb werden die ersten Vorzeichen einer dritten Generation des Webs sein.

  17. Darwinische Kulturtheorie - Evolutionistische und "evolutionistische`` Theorien sozialen Wandels

    NASA Astrophysics Data System (ADS)

    Antweiler, Christoph

    Evolutionistische Argumentationen außerhalb der Biologie sind weit verbreitet. Wenn sie vertreten werden, heißt das mitnichten, dass sie notwendigerweise von darwinischen Argumenten geprägt sind. Wenn man Evolution und Kultur aus explizit darwinischer Perspektive zusammen bringt, bedeutet das noch lange nicht unbedingt Soziobiologie. Und es bedeutet sicherlich nicht Sozialdarwinismus. Dieser Beitrag soll einen Überblick der so genannten evolutionären Ansätze bzw. evolutionistischen Ansätze zu menschlichen Gesellschaften bzw. Kulturen geben. Es soll gezeigt werden, was in den Ansätzen analytisch zu trennen ist und was synthetisch zusammen gehört. Mein Beitrag ist nicht wissenschaftsgeschichtlich angelegt, sondern systematisch ausgerichtet und hat zwei Schwerpunkte (Antweiler 2008; Antweiler 2009b). Zum einen geht es um kausale Zusammenhänge von organischer Evolution und gesellschaftlichem Wandel. Auf der anderen Seite werden Analogien zwischen biotischer und kultureller Evolution erläutert, die als spezifische Ähnlichkeiten dieser beiden als grundsätzlich verschieden gesehenen Prozesse aufgefasst werden. Dadurch wird die Frage aufgeworfen, ob die Evolution von Organismen einerseits und die Transformation von Gesellschaften bzw. Kulturen andererseits, spezielle Fälle eines allgemeinen Modells von Evolution darstellen.

  18. Das CARNOTsche Paradigma und seine erkenntnistheoretischen Implikationen

    NASA Astrophysics Data System (ADS)

    Schöpf, Hans-Georg

    Der vorliegende historisch-kritische Essay führt die Eigentümlichkeiten der klassischen phänomenologischen Thermodynamik auf das von CARNOT geschaffene Paradigma zurück und greift einige damit zusammenhängende Fragen auf.Translated AbstractCARNOT's Paradigm and its Epistemological ImplicationsThe present historic-critical essay traces the pecularities of classical phenomenological thermodynamics back to the paradigm, created by CARNOT, and takes up some questions to which this paradigm gives rise.

  19. Expertise bewerben und finden im Social Semantic Web

    NASA Astrophysics Data System (ADS)

    Polleres, Axel; Mochol, Malgorzata

    Im vorliegenden Beitrag diskutieren wir Rahmenbedingungen zur Kombination, Wiederverwendung und Erweiterung bestehender RDFVokabulare im Social Semantic Web. Hierbei konzentrieren wir uns auf das Anwendungsszenario des Auffindens und Bewerbens von Experten im Web oder Intranet. Wir präsentieren, wie RDF-Vokabulare einerseits und de facto Standardformate andererseits, die von täglich verwendeten Applikationen benutzt werden (z. B. vCard, iCal oder Dublin Core), kombiniert werden können, um konkrete Anwendungsfälle der Expertensuche und zum Management von Expertise zu lösen. Unser Fokus liegt darauf aufzuzeigen, dass für praktische Anwendungsszenarien nicht notwendigerweise neue Ontologien entwickelt werden müssen, sondern der Schlüssel vielmehr in der Integration von bestehenden, weit verbreiteten und sich ergänzenden Formaten zu einem kohärenten Netzwerk von Ontologien liegt. Dieser Ansatz garantiert sowohl direkte Anwendbarkeit von als auch niedrige Einstiegsbarrieren in Semantic Web-Technologien sowie einfache Integrierbarkeit in bestehende Applikationen. Die im Web verfügbaren und verwendeten RDFFormate decken zwar einen großen Bereich der Aspekte zur Beschreibung von Personen und Expertisen ab, zeigen aber auch signifikante Überlappungen. Bisher gibt es wenig systematische Ansätze, um diese Vokabulare zu verbinden, sei es in Form von allgemeingültigen Praktiken, die definieren, wann welches Format zu benutzen ist, oder in Form von Regeln, die Überlappungen zwischen einzelnen Formaten formalisieren. Der vorliegende Artikel analysiert, wie bestehende Formate zur Beschreibung von Personen, Organisationen und deren Expertise kombiniert und, wo nötig, erweitert werden können. Darüber hinaus diskutieren wir Regelsprachen zur Beschreibung von Formatüberlappungen sowie deren praktische Verwendbarkeit zur Erstellung eines Ontologie-Netzwerks zur Beschreibung von Experten.

  20. Anwendungsgebiete und Nutzen der RFID-Technologie in der Instandhaltung

    NASA Astrophysics Data System (ADS)

    Müller, Gerhard; Plate, Cathrin

    Im Vergleich zu Fertigungsbereichen, in denen eine Vielzahl von Terminals den Zugriff auf Fertigungsinformationen und Produktionsdaten ermöglichen, sind viele Instandhaltungsbereiche dadurch gekennzeichnet, dass der Zugriff auf Anlagendaten, Planungs- und operative Informationen nur an wenigen Stationen des Instandhaltungsplanungs- und Steuerungssystems (IPS-System) vollzogen werden kann. Das IPS-System-Spektrum reicht von einfachen MS-Office Produkten über Stand-Alone-Applikationen der Instandhaltung (z. B. IPS-Systeme wie ApiPro oder WartMan) bis hin zu in Warenwirtschaftssysteme integrierten Instandhaltungsmodulen (z. B. SAP-PM).

  1. Digital Transformation Canvas - Übersicht behalten und Handlungsfelder gestalten

    NASA Astrophysics Data System (ADS)

    Köster, Michael; Mache, Tobias

    Im Beitrag "Digital Transformation Canvas - Übersicht behalten und Handlungsfelder gestalten" wird zunächst grob auf die wesentlichen Herausforderungen, die mit der zunehmenden Digitalisierung einhergehen, eingegangen. Anschließend werden ausgewählte Konzepte des Business Transformation Management vorgestellt, die sich mit der grundlegenden Weiterentwicklung von Organisationen - wie es die Digitalisierung erfordert - auseinandersetzen. Eine detaillierte Einführung in die Methodik des Business Transformation Canvas, der sich mit den unterschiedlichsten Gestaltungsfeldern der Transformation auseinandersetzt und ein Framework für Transformationsprojekte darstellt, rundet den Beitrag ab. Er schließt mit einem Fazit und Ausblick.

  2. Grundlagen und Vollzug der amtlichen Lebensmittelkontrolle in der Schweiz

    NASA Astrophysics Data System (ADS)

    Hübner, Philipp; Spinner, Christoph

    In der Schweiz wird die Mehrheit der hoheitlichen Aufgaben von den 26 Kantonen, die zusammen die schweizerische Eidgenossenschaft bilden, autonom vollzogen. So liegt zum Beispiel die Kompetenz in den Bereichen Steuern, Gesundheit, Schulen oder Polizei grundsätzlich bei den Kantonen. Im Gegensatz dazu ist die Lebensmittelgesetzgebung national durch eidgenössische Erlasse harmonisiert. Die Vollzugsaufgaben liegen aber auch in diesem Bereich, abgesehen vom Vollzug an der Grenze und von einer nationalen Vollzugsaufsicht und Weisungsberechtigung, in kantonaler Kompetenz. Die Kantone können anhand kantonaler Erlasse das Bundesrecht präzisieren - insbesondere die organisatorischen Aspekte - und Regelungen im nicht harmonisierten Bereich treffen.

  3. [Leben im Eismeer - Tauchuntersuchungen zur Biologie arktischer Meerespflanzen und Meerestiere

    PubMed

    Lippert; Karsten; Wiencke

    2000-01-01

    Die Maske wird nochmals auf Dichtigkeit überprüft, der Knoten der Sicherungsleine mit zwei halben Schlägen fixiert, dann rutscht die Taucherin von der Eiskante in das kalte Wasser. Eine halbe Stunde vergeht, bevor ihr Kopf wieder aus dem Eisloch auftaucht und sie ein großes Sammelnetz nach oben reicht, gefüllt mit verschiedenen Arten von Makroalgen. Obwohl noch große Flächen des Kongsfjordes im arktischen Spitzbergen zugefroren sind und das Festland von einer dicken Schneedecke bedeckt ist, hat unter Wasser in den Algenwäldern bereits der Sommer und damit die Saison der Meeresbiologen begonnen.

  4. Quantitative Immunohistochemical Analyses of the Expression of E-Cadherin, Thrombomodulin, CD44H and CD44v6 in Primary Tumours of pharynx/larynx Squamous Cell Carcinoma and their Lymph Node Metastases

    PubMed Central

    Gaspar, Rocío Hernández; de los Toyos, Juan R.; Marcos, César Álvarez; Riera, José Ramón; Sampedro, Andrés

    1999-01-01

    The quantitative expression of E‐cadherin, thrombomodulin, CD44H and CD44v6 in 32 specimens of primary tumours of pharynx/larynx squamous cell carcinoma and their lymph node metastases was studied by immunohistochemistry. With the aim of obtaining comparative and objective data, image acquisition conditions were kept unaltered for all the measurements and the immunostaining intensity was quantified by applying an image processing system. On the one hand, correlations were only observed between CD44H and CD44v6, both in primary tumours and metastases, and between E‐cadherin and TM in metastases. On the other hand, statistical analyses of paired data did not show significant differences in the expression of these markers between the two tumour sites. In agreement with previous reports, E‐cadherin expression was rather low or negative in primary tumours and metastases of the three poorly differentiated specimens we studied, as well as that of TM, but otherwise some of these samples showed intermediate immunostaining levels of CD44H/CD44v6. It may be concluded from the present study that the quantitative expression of these adhesion molecules in well established lymph node metastases of pharynx/larynx squamous cell carcinoma is essentially unaltered in relation to their primary sites. PMID:10609562

  5. Characterization of glutamate-gated chloride channels in the pharynx of wild-type and mutant Caenorhabditis elegans delineates the role of the subunit GluCl-alpha2 in the function of the native receptor.

    PubMed

    Pemberton, D J; Franks, C J; Walker, R J; Holden-Dye, L

    2001-05-01

    Glutamate-gated chloride (GluCl) channels are the site of action of the anthelmintic ivermectin. Previously, the Xenopus laevis oocyte expression system has been used to characterize GluCl channels cloned from Caenorhabditis elegans. However, information on the native, pharmacologically relevant receptors is lacking. Here, we have used a quantitative pharmacological approach and intracellular recording techniques of C. elegans pharynx to characterize them. The glutamate response was a rapidly desensitizing, reversible, chloride-dependent depolarization (EC(50) = 166 microM), only weakly antagonized by picrotoxin. The order of potency of agonists was ibotenate > L-glutamate > kainate = quisqualate. Ivermectin potently and irreversibly depolarized the muscle (EC(50) = 2.7 nM). No further depolarization was seen with coapplication of maximal glutamate during the maximal ivermectin response, indicating that ivermectin depolarizes the muscle by the same ionic mechanism as glutamate (i.e., chloride). The potency of ivermectin on the pharynx was greater than at any of the GluCl subunits expressed in X. laevis oocytes. This effect of ivermectin was abolished in the mutant avr-15, which lacks a functional GluCl-alpha2 subunit. However, a chloride-dependent, nondesensitizing response to glutamate persisted. Therefore, the GluCl-alpha2 subunit confers ivermectin sensitivity and a high-affinity desensitizing glutamate response on the native pharyngeal GluCl receptor.

  6. Three-dimensional finite element model of the two-layered oesophagus, including the effects of residual strains and buckling of mucosa.

    PubMed

    Yang, W; Fung, T C; Chian, K S; Chong, C K

    2007-05-01

    This study was carried out to develop a two-layered finite element model of the oesophagus. The outer muscle and inner mucosal layer were constructed individually with different mechanical properties and zero-stress opening angles. With the model, two simulations were performed. First, the distention of oesophageal wall under the pressurized state was investigated, from which the effects of residual strains on the stress distribution were evaluated. Second, the buckling modes were determined using a linear eigenvalue analysis. The self-contact capability in ABAQUS was applied to simulate the folding of mucosa under the muscle contraction. The first simulation indicated that, by taking the residual strains into account, the mucosa undertook a very small portion of stress and the luminal pressure almost transmitted completely to the outer muscle layer. On the other hand, the folding of mucosa was shown to be able to reduce the contractile force of circular muscle to maintain the lumen closure. In conclusion, the preliminary study demonstrated the feasibility of simulating the oesophageal peristaltic transport using finite element analysis.

  7. The impact of the vitamins A, C and E in the prevention of gastroesophageal reflux disease, Barrett's oesophagus and oesophageal adenocarcinoma.

    PubMed

    Lukić, Marko; Segec, Ana; Segec, Igor; Pinotić, Ljerka; Pinotić, Kregimir; Atalić, Bruno; Solić, Kresiimir; Vcev, Aleksandar

    2012-09-01

    This paper aims at evaluating the impact of vitamins intake in the prevention of gastroesophageal reflux disease (GERD), Barrett's oesophagus (BE), and oesophageal adenocarcinoma (EADC). It concentrates primarily on the antioxidant vitamins A, C and E. There were 180 subjects included in the trial, 109 males and 71 females, which were divided in the four groups (70 patients with GERD, 20 patients with BE, 20 patients with EADC, and 70 healthy examinees composing a control group). Their antioxidant vitamins intake was investigated through the usage of the dietary questionnaires. Concentration of the mentioned antioxidant vitamin in serum was detected by HPLC method, and although there were no major statistical differences in their levels between four groups, there existed a correlation between the vitamin serum concentration and the rephlux disease degree. The results showed that the healthy examinees had consumed the greater quantities of the vitamins A, C and E, through both the natural (fruits and vegetables) and the supplementary (industrial vitamin additives) way, than the patients with GERD, BE and EADC. This was reflected in the higher serum levels of the mentioned vitamins in the first group in the comparison with the second group. Based on this, the intake of the vitamins A, C and E through both the natural and the supplementary ways is suggested in order to prevent the development of the GERD, BE and EADC.

  8. Impact of the inflammatory microenvironment on T-cell phenotype in the progression from reflux oesophagitis to Barrett oesophagus and oesophageal adenocarcinoma.

    PubMed

    Kavanagh, Maria E; Conroy, Melissa J; Clarke, Niamh E; Gilmartin, Niamh T; O'Sullivan, Katie E; Feighery, Ronan; MacCarthy, Finbar; O'Toole, Dermot; Ravi, Narayanasamy; Reynolds, John V; O'Sullivan, Jacintha; Lysaght, Joanne

    2016-01-01

    The incidence of oesophageal adenocarcinoma (OAC), arising from reflux-induced Barrett oesophagus (BO), is increasing dramatically. T-cells have recently been implicated in the initiation of oesophagitis; however, their role in the progression from oesophagitis to BO and OAC has not been fully elucidated. Previous studies have examined the secreted cytokines from oesophageal tissue during disease progression but this study is the first to examine the activation phenotype and the inflammatory profile of CD4(+) and CD8(+) T-cells in human oesophagitis, BO and OAC tissue. Results demonstrated significantly higher levels of IL-4 producing CD4(+) T-cells and secreted levels of IL-6, confirming a Th2 phenotype in BO. In OAC tissue, both pro- and anti-inflammatory cytokines were secreted, with significantly higher levels of IL-6, IL-1β, TNF-α, IFN-γ, IL-2 and IL-10 compared with normal oesophageal tissue. In addition, CD4(+) T-cells infiltrating OAC tissue displayed a decreased activation profile, with significantly lower CD45RO and CD69 expression compared with normal tissue. Data from this study suggest that factors in the tissue microenvironment may alter T-cell phenotype and function early during oesophageal disease progression and may represent targets for immune intervention. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. Wesentliche Geräuschquellen im Fahrzeug und deren Charakterisierung

    NASA Astrophysics Data System (ADS)

    Engel, Klaus; Snitil, Bernhard; Wolff, Klaus; Handel, Rainer; Krüger, Jan; Gauterin, Frank; Helfer, Martin; Brass, Otto

    Der Motor ist die Kraftquelle des Fahrzeugs. Leider klingt er nicht immer so. Viele Funktionsgeräusche dieses maschinenbaulichen Konstrukts gilt es zu besänftigen und das psychoakustisch wirksame Potential an die Fahrgastzelle anzubinden.

  10. Methodik und Qualität statistischer Erhebungen

    NASA Astrophysics Data System (ADS)

    Krug, Walter; Schmidt, Jürgen; Wiegert, Rolf

    Kapitel 8 wirft einen Blick hinter die Kulissen statistischer Arbeit und ihrer Methoden, insbesondere auch hinter die der amtlichen Statistik: Wie kommen die Myriaden von Zahlen zustande, die heute aus statistischen Quellenwerken aller Art und aus Datenbanken abgerufen werden können? Dabei wird deutlich, welche Schwierigkeiten bei Erhebungen, insbesondere bei Stichprobenerhebungen, zu überwinden sind, wie man Antwortverweigerer kooperativer stimmt, wie sich auch aus kleinen Stichproben auf intelligente Weise verlässliche Ergebnisse erzielen lassen und wie Großstichproben auf europäischer Ebene harmonisiert werden. Am Beispiel des Zensus 2011 wird gezeigt, wie sich eine Kombination von Stichproben und Registerauswertungen als Ersatz für eine Volkszählung nutzen lässt. Mitglieder der Deutschen Statistischen Gesellschaft waren daran kooperativ beteiligt.

  11. Konstruieren von Pkw-Karosserien: Grundlagen, Elemente und Baugruppen, Vorschriftenübersicht, Beispiele mit CATIA V4 und V5

    NASA Astrophysics Data System (ADS)

    Grabner, Jörg; Nothhaft, Richard

    Die Faszination, die vom Auto ausgeht, ist und bleibt ungebrochen. Entsprechend interessant ist es, sich vor dem Hintergrund konventioneller Konstruktionstechniken über die virtuelle Produktentwicklung von Pkw-Karosserien an modernen CAD-Arbeitsplätzen informieren zu können. Die Autoren führen in die Grundlagen ein und zeigen anhand von Beispielen und zahlreichen Abbildungen, wie mit dem System CATIA der Rohbau sowie die Ausstattung innen und au=C3=9Fen konstruiert werden. Darüber hinaus wird das so genannte "Package" an Beispielen beschrieben, also das Management und die Harmonisierung der Anforderungen an die Bauräume (z.

  12. Einstellung und Wissen von Lehramtsstudierenden zur Evolution - ein Vergleich zwischen Deutschland und der Türkei

    NASA Astrophysics Data System (ADS)

    Graf, Dittmar; Soran, Haluk

    Es wird eine Untersuchung vorgestellt, in der Wissen und Überzeugungen von Lehramtsstudierenden aller Fächer zum Thema Evolution an zwei Universitäten in Deutschland und der Türkei erhoben worden sind. Die Befragung wurde in Dortmund und in Ankara durchgeführt. Es stellte sich heraus, dass ausgeprägte Defizite im Verständnis der Evolutionsmechanismen herrschen. Viele Studierende, insbesondere aus der Türkei, sind nicht von der Faktizität der Evolution überzeugt. Dies gilt sowohl für Studierende mit Fach Biologie als auch für Studierende mit anderen Fächern. Näher untersucht worden sind die Faktoren, die die Überzeugungen zur Evolution beeinflussen können, was ja in Anbetracht der hohen Ablehnungsrate der Evolution von besonderem Interesse ist. Das Vertrauen in die Wissenschaft spielt hierbei eine besondere Rolle: Wer der Wissenschaft vertraut, ist auch eher von der Evolution überzeugt, als diejenigen, die skeptisch gegenüber der Wissenschaft sind.

  13. PMD basierte Fahrspurerkennung und -Verfolgung für Fahrerassistenzsysteme

    NASA Astrophysics Data System (ADS)

    Gumpp, T.; Schamm, T.; Bergmann, S.; Zöllner, J. M.; Dillmann, R.

    In diesem Artikel wird ein System zur Verfolgung von Fahrspuren unter Verwendung von PMD-Kameras vorgestellt. Er gibt einen überblick über die Auswertung der Intensitäts- und Tiefenbilder dieses Sensors in einem System zur fremdlichtunabhängigen Fahrspurverfolgung. Ein Kaiman-Filter wird verwendet, um neben den Fahrspurparametern auch die Position und Orientierung des Fahrzeugs relativ zur Fahrspur zu schätzten.

  14. Physik gestern und heute Von der Metallstange zum Hochenergielaser

    NASA Astrophysics Data System (ADS)

    Heering, Peter

    2002-05-01

    Im Mai 1752 wurde in Marly bei Paris auf Anregung des amerikanischen Forschers und Politikers Benjamin Franklin erstmals die elektrische Natur des Blitzes nachgewiesen. Damals beschrieb Franklin auch eine technische Vorrichtung, die als Schutz von Gebäuden vor Blitzschlägen dienen sollte: den Blitzableiter. Diese aus heutiger Sicht scheinbar triviale Vorrichtung wurde aber keineswegs unmittelbar akzeptiert. Und bis heute ist die Forschung zum Schutz von Einrichtungen vor Blitzschlägen nicht abgeschlossen.

  15. Zahlen und Rechenvorgänge auf unterschiedlichen Abstraktionsniveaus

    NASA Astrophysics Data System (ADS)

    Rödler, Klaus

    "Das Verständnis geht langsam vor sich!" Diesen wichtigen Satz hörte ich bei einem Vortrag von Martin Lowsky. Auf die hier behandelte Fragestellung übertragen heißt das: Was eine Zahl ist und wie ich sie im Rechenvorgang einsetzen und interpretieren kann, das erschließt sich erst allmählich. Die Zahl des Rechenanfängers ist nicht dieselbe wie die des kompetenten Rechners und es ist nicht die Zahl des Lehrers oder der Lehrerin. Die Zahlen sind nur auf der Oberfläche der Worte und Zeichen gleich. Im Innern, im Verständnis, sind sie völlig verschieden! Ich glaube, dass die Missachtung dieser Divergenz dazu führt, dass manche Kinder in für den Lehrer und Lehrerin nicht nachvollziehbaren Routinen stecken bleiben, einfachste Informationen nicht wirklich integrieren. Die auf beiden Seiten wachsende Verunsicherung durch die nicht erkannte und daher nicht kommunizierbare Diskrepanz im inneren Zahlkonzept stört den allmählichen Aufbau strukturierter Zahlvorstellungen.

  16. S1-Leitlinie zur UV-Phototherapie und Photochemotherapie.

    PubMed

    Herzinger, Thomas; Berneburg, Mark; Ghoreschi, Kamran; Gollnick, Harald; Hölzle, Erhard; Hönigsmann, Herbert; Lehmann, Percy; Peters, Thorsten; Röcken, Martin; Scharffetter-Kochanek, Karin; Schwarz, Thomas; Simon, Jan; Tanew, Adrian; Weichenthal, Michael

    2016-08-01

    Die heilsame Wirkung des Sonnenlichts war teilweise schon im Altertum bekannt und fand in der zweiten Hälfte des 19. Jahrhunderts wieder zunehmend Beachtung. Den Beginn der modernen Phototherapien markiert die Entwicklung einer Apparatur zur ultravioletten Bestrahlung der Hauttuberkulose durch Finnsen zu Beginn des zwanzigsten Jahrhunderts. Zur Therapie von Hauterkrankungen finden beinahe ausschließlich die spektralen Bereiche unterhalb des sichtbaren Lichtes (ultraviolett) Anwendung. Seit den 1970er Jahren stehen zunehmend leistungsfähige künstliche Strahlenquellen bereit für die Therapie mit UVB, UVA und die Kombination von UVA mit Photosensibilisatoren (Photochemotherapie). Hohe strukturelle und prozedurale Qualitätsstandards sind unabdingbare Voraussetzung für die Durchführung einer gleichermaßen wirkungsvollen wie auch sicheren Phototherapie. Die Leitlinie formuliert den aktuellen Konsens führender Experten auf dem Gebiet der Phototherapie in Bezug auf die Indikationen für die jeweiligen Therapieverfahren, deren Gegenanzeigen und Nebenwirkungen und insbesondere für die Wahl der korrekten Dosis zu Beginn und im Verlauf einer Therapie sowie das Management von Nebenwirkungen. © 2016 The Authors | Journal compilation © Blackwell Verlag GmbH, Berlin.

  17. Modifications of und rbcS in und Synechococcus sp. PCC7942 resulted in high CO sub 2 requiring mutants

    SciTech Connect

    Schwarz, R.; Liehman-Hurwitz, J.; Martinez, F.; Reinhold, L.; Kaplan, A. )

    1990-05-01

    High CO{sub 2} requiring mutants (HCR), capable of growing in the presence of kanamycin, were obtained following transformation with a construct containing {und nptII} in the coding region of rbcS (encoding for the small subunit (SS) of Rubisco). The apparent photosynthetic affinity for inorganic carbon was very low in mutant EK6 whereas in mutant JR12 it was only slightly lower than in high-CO{sub 2}-grown wild type. Southern analysis indicated double crossing over in the case of EK6. In mutant JR12 Southern analysis revealed some rearrangement and a deletion of a region downstream fro {und rbcS}. Western analysis demonstrated normal SS in JR12 but a larger (by about 3 kD) SS in EK6. Sequence analysis indicated that the latter was the result of fusion between {und rbcS} and the flanking region of {und nptII}.

  18. Regelungen im Verkehr mit Lebensmitteln und Bedarfsgegenständen in Deutschland

    NASA Astrophysics Data System (ADS)

    Thomas, Gundula; Freund, Astrid; Gründig, Friedrich

    Im Zuge der Globalisierung von Produktion und Handel ändert sich auch der Charakter der Vorschriften im Lebensmittelrecht. Zunehmend treten internationale Rechtsbestimmungen, Abkommen, Standards und andere Normen an die Stelle nationaler Regelungen.

  19. VDI-Richtlinien - mit Technischen Regeln Wirtschaftlichkeit erhöhen und Standards setzen

    NASA Astrophysics Data System (ADS)

    Mandelartz, Johannes

    Der Verein Deutscher Ingenieure e.V. (VDI) ist ein gemeinnütziger, wirtschaftlich und politisch unabhängiger, technisch-wissenschaftlicher Verein von Ingenieuren und Naturwissenschaftlern. Mit über 137 000 persönlich zugeordneten Mitgliedern ist er eine der größten Ingenieur-Vereinigungen Europas und gilt in Deutschland als führender Sprecher der Technik und der Ingenieure. 1856 gegründet, hat er viele für die Technik wesentliche Entwicklungen in Gang gesetzt, so im Bereich der technischen Überwachung, der technischen Regelsetzung und Normung, der Arbeitsstudien, im gewerblichen Rechtsschutz und im Patentwesen. Seit seiner Gründung sieht es der VDI als seine Aufgabe, "das Zusammenwirken aller geistiger Kräfte der Technik im Bewusstsein ethischer Verantwortung zu fördern“ und die Lebensmöglichkeiten aller Menschen durch Entwicklung und sinnvoller Anwendung technischer Mittel zu verbessern.

  20. Subclass distribution of IgG antibodies to the rat oesophagus stratum corneum (so-called anti-keratin antibodies) in rheumatoid arthritis.

    PubMed Central

    Vincent, C; Serre, G; Basile, J P; Lestra, H C; Girbal, E; Sebbag, M; Soleilhavoup, J P

    1990-01-01

    Serum IgG, labelling the stratum corneum of the rat oesophagus epithelium, so-called anti-keratin antibodies (AKA) constitute the most specific marker for the diagnosis of rheumatoid arthritis. In this study, we investigated 31 IgG AKA-positive rheumatoid sera and 21 control sera from patients with non-rheumatoid inflammatory rheumatic diseases. The serum level of IgG1,2,3 and 4 was determined by radial immunodiffusion and the subclass distribution of IgG AKA by a three-step semi-quantitative immunofluorescence assay using standard monoclonal antibodies specific for each of the four human IgG subclasses. In the rheumatoid sera, the serum level of IgG1 was found to be significantly increased and the level of IgG2 significantly decreased with regard to the control sera, while the levels of IgG3 and 4 as well as total IgG were in the normal range. IgG1,2,3, and 4 AKA were detected in 27 (87%), 6 (19%), 4 (13%) and 11 (35%) of the 31 rheumatoid sera, respectively, and were found to be independent of the clinical and biological indices of the disease. In spite of inter-individual heterogeneity, two predominant profiles were distinguished: IgG1 (alone) and IgG(1 + 4), which together represented 18 sera (58%). The large predominance of IgG1 AKA and the quasi-absence of IgG2 AKA suggest that the recognized antigen may be partly comprised of protein. Moreover, the high frequency of occurrence of IgG4 AKA might result from chronic exposure to the eliciting antigen, which could be a genuine autoantigen since we demonstrated that it is also present in the stratum corneum of human epidermis. Images Fig. 1 PMID:1696185

  1. Proton pump inhibitor use may not prevent high-grade dysplasia and oesophageal adenocarcinoma in Barrett's oesophagus: a nationwide study of 9883 patients.

    PubMed

    Hvid-Jensen, F; Pedersen, L; Funch-Jensen, P; Drewes, A M

    2014-05-01

    Proton pump inhibitors (PPI) may potentially modify and decrease the risk for development of oesophageal adenocarcinoma in Barrett's oesophagus (BO). To investigate if the intensity and adherence of PPI use among all patients with BO in Denmark affected the risk of oesophageal adenocarcinoma. We performed a nationwide case-control study in Denmark among 9883 patients with a new diagnosis of BO. All incident oesophageal adenocarcinomas and high-grade dysplasias were identified, and risk ratios were estimated on the basis of prior use of PPIs. Sex- and age-matched BO patients without dysplasia or malignancies in a 10:1 ratio were used for comparison. Conditional logistic regression was used for analysis, adjusting for low-grade dysplasia, gender and medication. We identified 140 cases with incident oesophageal adenocarcinomas and/or high-grade dysplasia, with a median follow-up time of 10.2 years. The relative risk of oesophageal adenocarcinoma or high-grade dysplasia was 2.2 (0.7-6.7) and 3.4 (95% CI: 1.1-10.5) in long-term low- and high-adherence PPI users respectively. No cancer-protective effects from PPI's were seen. In fact, high-adherence and long-term use of PPI were associated with a significantly increased risk of adenocarcinoma or high-grade dysplasia. This could partly be due to confounding by indication or a true negative effect from PPIs. Until the results from future studies hopefully can elucidate the association further, continuous PPI therapy should be directed at symptom control and additional modalities considered as aid or replacement. © 2014 John Wiley & Sons Ltd.

  2. Phase II trial of modified FOLFOX6 and erlotinib in patients with metastatic or advanced adenocarcinoma of the oesophagus and gastro-oesophageal junction

    PubMed Central

    Wainberg, Z A; Lin, L-S; DiCarlo, B; Dao, K M; Patel, R; Park, D J; Wang, H-J; Elashoff, R; Ryba, N; Hecht, J R

    2011-01-01

    Background: There is increased recognition that cancers of the upper GI tract comprise distinct epidemiological and molecular entities. Erlotinib has shown activity in patients with adenocarcinoma of the oesophagus/gastro-oesophageal junction (GEJ), but not in distal gastric cancer. mFOLFOX6 is one of several active regimens used to treat adenocarcinoma of the Eso/GEJ. This study evaluates the efficacy and safety of mFOLFOX6 and erlotinib in patients with metastatic or advanced Eso/GEJ cancers. Methods: Patients with previously untreated advanced or metastatic Eso/GEJ adenocarcinoma are treated with oxaliplatin 85 mg m–2, 5-FU 400 mg m–2, LV 400 mg m–2 on day 1, 5-FU 2400 mg m–2 over 48 h and erlotinib 150 mg PO daily. Treatment was repeated every 14 days. The primary objective was response rate (RR), secondary objectives include toxicity, progression-free survival (PFS), overall survival (OS) and to correlate clinical outcome with expression patterns and molecular alterations in the epidermal growth factor receptor-dependent pathways. Results: A total of 33 patients were treated and evaluable: there were two complete responses, 15 partial responses for an objective RR of 51.5% (95% CI, 34.5–68.6%). Median PFS was 5.5 months (95% CI, 3.1–7.5 months) and median OS was 11.0 months (95% CI, 8.0–17.4 months). The most common grade 3–4 toxicities were: diarrhoea (24%), nausea/vomiting (11%), skin rash (8%) and peripheral neuropathy (8%). The frequency of alterations was KRAS mutations (8%), EGFR mutations (0%) and HER2 amplification (19%). Conclusion: In patients with Eso/GEJ adenocarcinoma, mFOLFOX6 and erlotinib is active, has an acceptable toxicity profile and FOLFOX±erlotinib could be considered for further development. PMID:21811258

  3. Verbesserte Ausbildung für neue Betriebsleiter und -ingenieure - eine wichtige Investition in die Zukunft

    NASA Astrophysics Data System (ADS)

    Franta, Oliver

    Bedingt durch die Globalisierung und die damit einhergehende Verschärfung des Wettbewerbs befinden sich die Produktionsbetriebe der chemischen Industrie in stetigem Wandel. Für Betriebsleiter und Betriebsingenieure werden damit Fähigkeiten wie Kostenmanagement, Sozial- und Organisationskompetenz, Führungsqualifikationen und unternehmerisches Handeln immer wichtiger. Neben den Anforderungsprofilen bei Neueinstellungen ist dies auch bei der Fortbildung zu berücksichtigen. Das Trainingsprogramm der Evonik Degussa wurde daher durch die Konzeption neuer Seminare und die Anpassung bestehender Weiterbildungsmaßnahmen weiterentwickelt. Neben Vorträgen und Fallbeispielen sind ebenfalls die Durchführung von Planspielen sowie das Kennenlernen eines Produktionsbetriebes einer anderen Organisationseinheit enthalten. Ziel ist es vor allem die unternehmerische Orientierung neuer Betriebsleiter und -ingenieure zu fördern, die Innovationsgeschwindigkeit zu erhöhen und durch Kenntnis und Nutzung bereits anderweitig entwickelter Lösungen und Methoden die Produktivität zu steigern. Die Produktionsmeister werden aufgrund der Bedeutung dieser Funktion für die Führung der Mitarbeiter und bei der Umsetzung von Veränderungsprojekten in das Ausbildungsprogramm einbezogen. Der Erfolg des Trainingsprogramms zeigt sich an den Teilnehmerzahlen und den ausgesprochen positiven Rückmeldungen.

  4. Nicolaus Copernicus Gesamtausgabe. Band VI/1. Documenta Copernicana: Briefe (Texte und Übersetzungen).

    NASA Astrophysics Data System (ADS)

    Kühne, A.

    Im Auftrage der Kommission für die Copernicus-Gesamtausgabe, herausgegeben von H. M. Nobis und M. Folkerts. Band VI/1 wurde bearbeitet von A. Kühne unter Mitarbeit von F. Boockmann und S. Kirschner und Verwendung der Vorarbeiten von H. M. Nobis.

  5. Ökophysik: Plaudereien über das Leben auf dem Land, im Wasser und in der Luft

    NASA Astrophysics Data System (ADS)

    Nachtigall, W.

    Prof. em. Dr. rer. nat. Werner Nachtigall, geb. 1934, war als Zoophysiologe und Biophysiker Leiter des Zoologischen Instituts der Universität des Saarlandes in Saarbrücken. In Forschung und Ausbildung hat er sich insbesondere mit Aspekten der Technischen Biologie und Bionik befasst und mit seinen Forschergruppen viele Basisdaten insbesondere zur Ökologie, Physiologie und Physik des Fliegens und Schwimmens aber auch zur Stabilität beispielsweise der Gräser erarbeitet. Lebewesen überraschen immer wieder durch ihre "Biodiversität", ihre hochspezifischen Ausgestaltungen und Anpassungen.

  6. Einfluss des Internets auf das Informations-, Einkaufs- und Verkehrsverhalten

    NASA Astrophysics Data System (ADS)

    Nerlich, Mark R.; Schiffner, Felix; Vogt, Walter

    Mit Daten aus eigenen Erhebungen können das einkaufsbezogene Informations- und Einkaufsverhalten im Zusammenhang mit den verkehrlichen Aspekten (Distanzen, Verkehrsmittel, Wegekopplungen) dargestellt werden. Die Differenzierung in die drei Produktkategorien des täglichen, mittelfristigen und des langfristigen Bedarfs berücksichtigt in erster Linie die Wertigkeit eines Gutes, die seine Erwerbshäufigkeit unmittelbar bestimmt. Der Einsatz moderner IKT wie das Internet eröffnet dem Endverbraucher neue Möglichkeiten bei Information und Einkauf. Die verkehrliche Relevanz von Online-Shopping wird deutlich, wenn man berücksichtigt, dass im Mittel rund 17% aller Online-Einkäufe, die die Probanden durchgeführt haben, Einkäufe in Ladengeschäften ersetzen. Dies gilt in verstärktem Maße für Online-Informationen: etwa die Hälfte hätte alternativ im stationären Einzelhandel stattgefunden. Da der Erwerb von Gütern des täglichen Bedarfs häufig nahräumlich und in relevantem Anteil nicht-motorisiert erfolgen kann, sind in diesem Segment - im Gegensatz zum mittel- und langfristigen Bedarf - nur geringe Substitutionseffekte zu beobachten.

  7. Herschel und die Zukunft der Fern-Infrarot-Astronomie

    NASA Astrophysics Data System (ADS)

    Linz, Hendrik

    2015-06-01

    Schon lange ist die beobachtende Astronomie den engen Grenzen des optisch Sichbaren entwachsen und hat fast alle Bereiche des elektromagnetischen Spektrums für sich dienstbar gemacht. Im sogenannten nahen und mittleren Infrarot (Wellenlängen zwischen 1-30 μm) sowie im Millimeter- und Radio-Regime (Wellenlängen zwischen 1 mm und 10 m) ist die Erdatmosphäre relativ gut durchlässig für elektromagnetische Signale oder hat zumindest eine Vielzahl von spektral begrenzten Transmissionsfenstern, die astronomische Beobachtungen zumindest von höheren Bergen aus möglich machen. Allerdings ist das sogenannte Ferne Infrarot (FIR, 30-300 μm Wellenlänge) von der Erde aus fast völlig unzugänglich für astronomische Beobachtungen. Selbst für die besten Beobachtungsplätze der Erde bleibt die atmosphärische Transmission durch die immense Wasserdampf- Absorption auf ein absolutes Minimum beschränkt. Jedoch erlaubt uns das FIR Zugang zu Informationen, die sehr nützlich sind für die astrophysikalische Forschung und komplementär zu anderen Wellenlängen-Bereichen.

  8. Aufnahme, Analyse und Visualisierung von Bewegungen nativer Herzklappen in-vitro

    NASA Astrophysics Data System (ADS)

    Weiß, Oliver; Friedl, Sven; Kondruweit, Markus; Wittenberg, Thomas

    Die hohe Zahl an Transplantationen von Herzklappen und viele nötige Re-Operationen machen eine detaillierte Analyse der Strömungen und Klappenbewegungen klinisch interessant. Ein neuer Ansatz ist hierbei der Einsatz von Hochgeschwindigkeitskameras um Bewegungsabl äufe der Herzklappen beobachten und auswerten zu können. Die hohen Datenraten erfordern allerdings eine möglichst automatisierte Analyse und möglichst komprimierte Darstellung des Schwingungsverhaltens. In dieser Arbeit wird ein Ansatz vorgestellt, bei dem Bewegungen nativer Herzklappen in-vitro aufgenommen, analysiert und kompakt visualisiert werden.

  9. Modellgestützte Ladedruck- und Abgasrückführ-Regelung von Dieselmotoren

    NASA Astrophysics Data System (ADS)

    von Pfeil, Karl

    Zur Erfüllung der Abgasgesetzgebung bei gleichzeitiger hoher Fahrleistung und Beschleunigung sind moderne Pkw-Dieselmotoren mit externer Abgasrückführung (AGR) und mit Abgasturbolader mit variabler Turbinengeometrie (VTG) ausgestattet, siehe Bild 10-1. Der über ein Ventil stellbare AGR-Massenstrom wird zur Senkung der Stickoxidemissionen eingesetzt und der Turbolader wird hauptsächlich zur Steigerung des Ladedrucks und damit zur Leistungssteigerung verwendet. Mittels VTG wird der Turbolader an den Motorbetriebspunkt angepasst. Hierzu wird über einen elektrisch oder pneumatisch betätigten Aktor die Turbinenleitschaufelstellung und damit die wirksame Turbinenströmung verstellt.

  10. Wie LCC-Management die Produktionstechnik und die Instandhaltung verändert

    NASA Astrophysics Data System (ADS)

    Zick, Manfred

    Die zunehmende Komplexität von Produktionsanlagen und deren steigende Investitionssummen erfordern eine intensive Nutzung und überschaubare Folgekosten, zum Beispiel in der Instandhaltung. Um diese Ziele beim Investitionsvorgang von Anlagen effizienter als in der Vergangenheit zu gestalten sind Organisationsverfahren wie Life Cycle Cost Management (LCC-Management) bzw. Total Cost of Ownership (TCO) sinnvoll. Dieser Beitrag zeigt, wie Hersteller und Betreiber bis heute mit diesen Verfahren die Auslegung und das Betriebsverhalten von Anlagen entwickeln, deren reduzierten Instandhaltungsaufwand prognostizieren und die Leistungen zum Vorteil beider Vertragspartner steigern.

  11. Oesophageal rhabdomyoma

    PubMed Central

    Roberts, F; Kirk, A; More, I; Butler, J; Reid, R

    2000-01-01

    Extracardiac rhabdomyomas are rare benign tumours showing striated muscle differentiation. Seventy percent of these lesions occur in the head and neck region. The most common sites for these lesions are the larynx, pharynx, and the floor of the mouth. There has been only one previous report of a rhabdomyoma of the oesophagus; two further cases are described. Key Words: rhabdomyoma • oesophagus PMID:10961182

  12. IQM-Reifegradmodell für die Bewertung und Verbesserung des Information Lifecycle Management Prozesses

    NASA Astrophysics Data System (ADS)

    Baškarada, Saša; Gebauer, Marcus; Koronios, Andy; Gao, Jing

    Heutige Organisationen produzieren und speichern mehr Informationen als je zuvor. Der resultierende Informationsüberfluss, zusammen mit einem Mangel an Qualitätssicherung für das Information Lifecycle Management, führt zu einem unsicheren Status der Informationsqualität in vielen Organisationen. Weiterhin hat sich herausgestellt, dass das Bewerten, Verbessern und Steuern der Informationsqualität ein offenkundig schwieriges Unterfangen ist. Dieses Kapitel stellt ein Modell zur Bewertung und Verbesserung der Information Quality Management Capability Maturity (IQM-Reifegrad) vor. Es wird ein Satz von Kriterien vorgestellt, der aus Literaturrecherche und Fallstudien abgeleitet wurde. Die Reifegradindikatoren werden validiert