1.Characteristics of acid reflux in Barrett's esophagus.
Junying, XU ; Jie, CHEN ; Xiaohua, HOU
Journal of Huazhong University of Science and Technology (Medical Sciences) 2002;22(3):235-6, 264
To determine the relationship between Barrett's esophagus (BE) and features of gastroesophageal acid reflux, 24 h esophageal pH monitoring was performed in 90 patients. The patients were divided into 3 groups: 31 subjects with BE, 21 with mild esophagitis and 38 with severe esophagitis. The following parameters were evaluated: the percentage time of pH < 4; the number of reflux episodes over 5 min; the duration of longest episodes and DeMeester score over total period and the auterior three parameters in erect and supine position. All these parameters in BE were significantly different from those with mild esophagitis (P < 0.01) and not significantly different from those with severe esophagitis (P > 0.05). During supine position all the above parameters in BE were significantly different from those with reflux esophagitis (P < 0.05). It is concluded that the quantity of acid reflux is not an important factor in development of BE in gastroesophageal reflux (GER), and the acid reflux in supine position might be important in development of BE in GER.
Barrett Esophagus/etiology
;
Barrett Esophagus/*physiopathology
;
Esophagitis, Peptic/etiology
;
Gastroesophageal Reflux/*complications
;
Hydrogen-Ion Concentration
;
Supine Position
2.An Evaluation of Web-based Information about Barrett's Esophagus in Korea.
Sung Hyun PARK ; Jun Haeng LEE ; Kap Hyun KIM ; Ki Joo KANG ; Sang Jung KIM ; Seung Chul LEE ; Jin Yong KIM ; Poong Lyul RHEE ; Jae J KIM ; Jong Chul RHEE
The Korean Journal of Gastroenterology 2009;53(5):292-296
BACKGROUND/AIMS: Internet has become an important source of medical information not only for doctors but also patients. However, information available in the Internet may provide wrong or even harmful knowledge to the public. The aim of this study was to evaluate the quality of Internet-based medical information about Barrett's esophagus in Korea. METHODS: The first 50 Internet links were retrieved from the Google using the key word 'Barrett's esophagus'. The quality of information from a total of 49 websites was evaluated using a checklist. RESULTS: Among total 49 sites related to 'Barrett's esophagus', only 4 sites (8.2%) were made by hospitals or clinics, and 11 sites (22.4%) were for patients. Of the 49 sites, only one web site (2.0%) had all HON CODE principles (authority, complementarity, confidentiality, attribution, justifiability, transparency of authorship, transparency of sponsorship, honesty in advertising and editorial policy). Sixteen Internet links (32.0%) had fair contents for the definition, and 24 links (48.0%) for the diagnosis, and 15 links (30.0%) for the treatment. CONCLUSIONS: Information about Barrett's esophagus was incomplete in the majority of medical web sites. It will bring about confusion in patients who want to get information about Barrett's esophagus from the Internet. There is a need for better evidence-based information about Barrett's esophagus on the web.
*Barrett Esophagus/diagnosis/etiology/therapy
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Health Education
;
Humans
;
Information Services
;
*Internet
;
Korea
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Medical Informatics
;
Quality of Health Care
;
User-Computer Interface
3.Obesity and Functional Gastrointestinal Disorders.
The Korean Journal of Gastroenterology 2012;59(1):1-7
Obesity is prevalent in Korea. An increase in food intake and a decrease in energy expenditure are responsible for obesity. Gut hormones play a role in controlling food intake. Obesity is suggested to be linked to common gastrointestinal functional disorders. Obesity is associated with an increased risk of gastroesophageal reflux disease, Barrett esophagus and esophageal adenocarcinoma. Epidemiologic studies indicate that obesity is associated with chronic gastrointestinal symptoms. This association suggests the possibility that obesity and functional gastrointestinal disorders may be pathophysiologically linked. However, data on the relationship between obesity and functional gastrointestinal disorders are inconsistent. In this paper, we review the role of gastrointestinal hormones in food intake and the relationship between obesity and functional gastrointestinal disorders.
Barrett Esophagus/*etiology
;
Energy Intake
;
Energy Metabolism
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Esophageal Neoplasms/*etiology
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Gastroesophageal Reflux/*etiology
;
Humans
;
Obesity/*complications/pathology
;
Peptide Hormones/metabolism/physiology
4.Characteristics of acid reflux in Barrett's esophagus.
Junying XU ; Jie CHEN ; Xiaohua HOU
Journal of Huazhong University of Science and Technology (Medical Sciences) 2002;22(3):235-264
To determine the relationship between Barrett's esophagus (BE) and features of gastroesophageal acid reflux, 24 h esophageal pH monitoring was performed in 90 patients. The patients were divided into 3 groups: 31 subjects with BE, 21 with mild esophagitis and 38 with severe esophagitis. The following parameters were evaluated: the percentage time of pH < 4; the number of reflux episodes over 5 min; the duration of longest episodes and DeMeester score over total period and the auterior three parameters in erect and supine position. All these parameters in BE were significantly different from those with mild esophagitis (P < 0.01) and not significantly different from those with severe esophagitis (P > 0.05). During supine position all the above parameters in BE were significantly different from those with reflux esophagitis (P < 0.05). It is concluded that the quantity of acid reflux is not an important factor in development of BE in gastroesophageal reflux (GER), and the acid reflux in supine position might be important in development of BE in GER.
Adult
;
Barrett Esophagus
;
etiology
;
physiopathology
;
Esophagitis, Peptic
;
etiology
;
Female
;
Gastroesophageal Reflux
;
complications
;
Humans
;
Hydrogen-Ion Concentration
;
Male
;
Middle Aged
;
Supine Position
5.Immunohistochemical Expression of the p53 and Ki-67 Proteins in Barrett's Esophagus in Korea.
Chang Whan KIM ; Bo In LEE ; Beung Wook KIM ; Jin Il KIM ; Soo Heon PARK ; Jae Kwang KIM ; Sok Won HAN ; In Sik JUNG ; Hee Sik SUN ; A Won LEE ; Kyo Young LEE
The Korean Journal of Gastroenterology 2005;46(3):189-195
BACKGROUND/AIMS: Barrett's esophagus is a premalignant lesion of the esophagus in which normal squamous epithelium is replaced by intestinalized columnar epithelium. In Korea, adenocarcinoma associated with Barrett's esophagus is rare compared with that of Western country. The purpose of this study was to investigate the immunohistochemical expression of p53 and Ki-67 in Barrett's esophagus which had predictive value for cancer risk in Korea. METHODS: Ninety five patients (43 male and 52 female, median age 44, range 21-75) who have been suspected to have Barrett's esophagus by endoscopic assessment were enrolled in this study. Alcian blue (pH 2.5) and high ion diamine stain for the evaluation of specialized intestinal metaplasia (SIM) and immunohistochemical stain for p53 and Ki-67 were done. RESULTS: 57.9% (55/95) of biopsies from the columnar lined esophagus showed SIM, but no dyspalsia. 56.4% (31/55) of Barrett's esophagus showed sulfomucin positive colonic metaplasia. The p53 expression was observed in 10.9% (6/55) of the patients of Barrett's esophagus and all of them showed colonic metaplasia. Ki-67 labeling index showed no difference significantly. CONCLUSIONS: In Korea, 10.9% of Barrett's esophagus had p53 mutation and moreover all of them had colonic metaplasia. Consequently, we expect that these patients have high risk of developing dysplasia and adenocarcinoma and need careful follow-up.
Adenocarcinoma/etiology/genetics
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Adult
;
Aged
;
Barrett Esophagus/complications/*metabolism
;
Esophageal Neoplasms/etiology/genetics
;
Female
;
Humans
;
Immunohistochemistry
;
Ki-67 Antigen/*metabolism
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Male
;
Middle Aged
;
Risk Factors
;
Tumor Suppressor Protein p53/*metabolism
6.Barrett's Esophagus and Cancer Risk: How Research Advances Can Impact Clinical Practice.
Massimiliano DI PIETRO ; Durayd ALZOUBAIDI ; Rebecca C FITZGERALD
Gut and Liver 2014;8(4):356-370
Barrett's esophagus (BE) is the only known precursor to esophageal adenocarcinoma (EAC), whose incidence has increased sharply in the last 4 decades. The annual conversion rate of BE to cancer is significant, but small. The identification of patients at a higher risk of cancer therefore poses a clinical conundrum. Currently, endoscopic surveillance is recommended in BE patients, with the aim of diagnosing either dysplasia or cancer at early stages, both of which are curable with minimally invasive endoscopic techniques. There is a large variation in clinical practice for endoscopic surveillance, and dysplasia as a marker of increased risk is affected by sampling error and high interobserver variability. Screening programs have not yet been formally accepted, mainly due to the economic burden that would be generated by upper gastrointestinal endoscopy. Screening programs have not yet been formally accepted, mainly due to the economic burden that would be generated by widespread indication to upper gastrointestinal endoscopy. In fact, it is currently difficult to formulate an accurate algorithm to confidently target the population at risk, based on the known clinical risk factors for BE and EAC. This review will focus on the clinical and molecular factors that are involved in the development of BE and its conversion to cancer and on how increased knowledge in these areas can improve the clinical management of the disease.
Adenocarcinoma/*etiology
;
Animals
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Barrett Esophagus/*complications/diagnosis
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Diagnostic Imaging/methods
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Disease Models, Animal
;
Epigenesis, Genetic/physiology
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Esophageal Neoplasms/diagnosis/*etiology
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Esophagoscopy/methods
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Forecasting
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Genetic Markers/physiology
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Humans
;
Mice
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Practice Guidelines as Topic
;
Risk Factors
7.Mucosal biopsy diagnosis of Barrett's esophageal: an update.
Chinese Journal of Pathology 2010;39(7):497-500
Adenocarcinoma
;
etiology
;
metabolism
;
pathology
;
Barrett Esophagus
;
complications
;
epidemiology
;
etiology
;
metabolism
;
pathology
;
Biomarkers, Tumor
;
metabolism
;
Biopsy
;
CDX2 Transcription Factor
;
Esophagogastric Junction
;
pathology
;
Esophagus
;
pathology
;
Homeodomain Proteins
;
metabolism
;
Humans
;
Intercellular Signaling Peptides and Proteins
;
metabolism
;
Keratin-20
;
metabolism
;
Keratin-7
;
metabolism
;
Mucous Membrane
;
pathology
;
Precancerous Conditions
;
metabolism
;
pathology
8.Sulindac Prevents Esophageal Adenocarcinomas Induced by Gastroduodenal Reflux in Rats.
Sung Wook KIM ; Tae Jung JANG ; Ki Hoon JUNG ; Jung Il SUH
Yonsei Medical Journal 2007;48(6):1020-1027
PURPOSE: It is known that cyclooxygenase (COX)-2 expression is increased in Barrett's esophagus and esophageal adenocarcinomas. We studied COX-2 expression and the effect sulindac has on the genesis of Barrett's esophagus and adenocarcinoma in rats undergoing esophagogastroduodenal anastomosis (EGDA). MATERIALS AND METHODS: Fifty-one rats were divided into a control group (n=27), a 500ppm sulindac-treated group (n=15) and 1000 ppm sulindac-treated group (n=9). Randomly selected rats were killed by diethyl ether inhalation at 20 and 40 weeks after surgery. RESULTS: At 40 weeks, rats treated with 1000 ppm sulindac showed narrower esophageal diameter and milder inflammation than the control rats. At 40 weeks, the incidence of Barrett's esophagus was similar between control and sulindac-treated groups, but the incidence of adenocarcinoma was significantly lower in the 1000ppm sulindac-treated group than either the control or 500 ppm sulindac-treated groups. COX-2 was significantly increased in the lower esophagus of control rats killed at 40 weeks. Cyclin D1 expression was negligible in the sulindac- treated group compared with the control group. CONCLUSION: We suggest that the chemopreventive effect of sulindac is related to decreased COX-2 and cyclin D1 expression, which may be influenced by reduced inflammation.
Adenocarcinoma/etiology/metabolism/*prevention & control
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Animals
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Antineoplastic Agents/therapeutic use
;
Barrett Esophagus/etiology/metabolism/prevention & control
;
Blotting, Western
;
Cyclin D1/metabolism
;
Cyclooxygenase 2/metabolism
;
Duodenogastric Reflux/*complications
;
Esophageal Neoplasms/etiology/metabolism/*prevention & control
;
Immunohistochemistry
;
Male
;
Proliferating Cell Nuclear Antigen/metabolism
;
Rats
;
Rats, Sprague-Dawley
;
Sulindac/*therapeutic use