Diagnosis, Differential ; Gastric Mucosa ; pathology ; Gastritis, Hypertrophic ; pathology ; surgery ; Humans ; Male ; Middle Aged

After an episode of acute bleeding from esophageal varices, patients are at a high risk for recurrent bleeding and death. However, there are few reports regarding the long-term results of secondary prophylaxis using endoscopic variceal ligation (EVL) against variceal rebleeding in pediatrics. Thirty-seven, who were followed for over 3 yr post-eradication, were included in the study. The mean duration of follow up after esophageal variceal eradication was 6.4+/-1.9 yr. The mean time required to achieve the eradication of varices was 3.25 months. The mean number of sessions and O-bands needed to eradicate varices was 1.9+/-1.2 and 3.8+/-1.5, respectively. During the period before the first EVL treatment, 145 episodes of bleedings developed in 37 children. Over the 3 yr of follow-up after variceal eradication, only 4 episodes of rebleeding developed in 4 of 37 patients. The four rebleeding episodes consisted of an esophageal variceal bleed, a gastric variceal bleed, a duodenal ulcer bleed, and a bleed caused by hemorrhagic gastritis. There was no mortality during long-term follow up after variceal eradication. During long-term follow up after esophageal variceal eradication using solely EVL in children with esophageal variceal bleeds, rebleeding episodes and recurrence of esophageal varices were rare. EVL is a safe and highly effective method for the long-term prophylaxis of variceal rebleeding in children with portal hypertension.
Child ; Duodenum/surgery ; Endoscopy/*methods ; Esophageal and Gastric Varices/*surgery ; Esophagus/surgery ; Female ; Gastritis/surgery ; Gastrointestinal Hemorrhage/*surgery ; Humans ; Ligation ; Male ; Recurrence/prevention & control ; Retrospective Studies ; Treatment Outcome

No abstract available.
Endosonography ; Gastric Mucosa/pathology ; Gastritis, Hypertrophic/*diagnosis/pathology/surgery ; Gastroscopy ; Humans ; Male ; Middle Aged ; Tomography, X-Ray Computed

Gastritis cystica profunda (GCP) is an uncommon hyperplastic benign lesion, and histologically characterized by hyperplasia and cystic dilatation of the gastric glands extending into the submucosal layer. GCP usually occurs at a gastroenterostomy site, although it can occasionally be found in an unoperated stomach. GCP is thought to be a possible precancerous lesion, since a few early gastric cancers associated with it were reported. Herein, we report a case of gastric adenoma associated with GCP in an unoperated patient. The sizes of both the GCP and adenoma overlying it have increased during a 10 year follow-up period. Adenoma on the latest biopsy showed low grade dysplasia, and it was successfully treated by endoscopic submucosal dissection.
Adenoma/complications/*diagnosis/surgery ; Aged, 80 and over ; Female ; Follow-Up Studies ; Gastritis/complications/*diagnosis/ultrasonography ; Gastroenterostomy ; Humans ; Precancerous Conditions ; Stomach Neoplasms/complications/*diagnosis/surgery ; Tomography, X-Ray Computed

Acute phlegmonous infection of the gastrointestinal tract is characterized by purulent inflammation of the submucosa and muscular layer with sparing of the mucosa. The authors report a rare case of acute diffuse phlegmonous esophagogastritis, which was well diagnosed based on the typical chest computed tomographic (CT) findings and was successfully treated. A 48-yr-old man presented with left chest pain and dyspnea for three days. Chest radiograph on admission showed mediastinal widening and bilateral pleural effusion. The patient became febrile and the amount of left pleural effusion is increased on follow-up chest radiograph. Left closed thoracostomy was performed with pus drainage. A CT diagnosis of acute phlegmonous esophagogastritis was suggested and a surgery was decided due to worsening of clinical condition of the patient and radiologic findings. Esophageal myotomies were performed and the submucosal layer was filled with thick, cheesy materials. The patient was successfully discharged with no postoperative complication.
Acute Disease ; Cellulitis/complications/*diagnosis/radiography ; Drainage ; Esophagitis/complications/*diagnosis/surgery ; Gastritis/complications/*diagnosis/surgery ; Humans ; Klebsiella Infections/diagnosis ; Klebsiella pneumoniae/isolation & purification ; Male ; Middle Aged ; Pleural Effusion/etiology/radiography ; Thoracostomy ; Tomography, X-Ray Computed

Autoimmune Diseases ; metabolism ; pathology ; surgery ; Chromogranin A ; metabolism ; Female ; Gastrectomy ; Gastric Mucosa ; pathology ; Gastrin-Secreting Cells ; metabolism ; pathology ; Gastrins ; metabolism ; Gastritis, Atrophic ; metabolism ; pathology ; surgery ; Humans ; Hyperplasia ; Middle Aged ; Mucin-6 ; metabolism ; Neuroendocrine Tumors ; metabolism ; pathology ; surgery ; Stomach ; pathology ; surgery ; Stomach Neoplasms ; metabolism ; pathology ; surgery ; Synaptophysin ; metabolism

OBJECTIVETo investigate the feasibility of gastric cancer screening for the susceptible population in the high-risk areas of China and to optimize the screening programme.

METHODSBy using the two-round screening method i.e. serum pepsinogen test combined with gastric mucosa biopsy, large-scale population screening programs were carried out in Zhuanghe, Liaoning province. All adults or residents above 35 years old with a positive family history of gastric cancer or gastrointestinal symptoms were targeted.

RESULTSThree large-scale population screenings were developed over the past 15 years. All together, 13078 participants accepted the two-round screening, and 108 gastric cancer cases were detected. Among them, the detection rate of early gastric cancer was 56.82%, 51.22% and 82.61%, respectively. The pathologically confirmed gastric cancer cases were immediately arranged to have early surgical treatment, and meanwhile, the follow-up files for the patients were established. With a consecutive and regular 10-year postoperative follow-up, the 5-year survival rate for these early gastric cancer patients reached 90.48%. Effectiveness and health economic evaluation confirmed that there are good specificity and sensitivity for the two round screening programs. It is cost-effective. As the primary screening method serum PG test can improve the screening examination rate and concentrate the gastric cancer risk populations.

CONCLUSIONSIt is feasible to develop the gastric cancer screening program among the susceptible population in high-risk areas in our country, and the two-round screening method is of practical value. Research for early detection of gastric cancer should be further enhanced, and multidisciplinary and multicenter cooperation should be organized. It is necessary to extend the implementation the gastric cancer screening and to further improve the early detection programme, in order to make a breakthrough based on the present practice.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biopsy ; Child ; China ; Cost-Benefit Analysis ; Early Detection of Cancer ; methods ; Feasibility Studies ; Female ; Follow-Up Studies ; Gastric Mucosa ; pathology ; Gastritis ; diagnosis ; Gastritis, Atrophic ; diagnosis ; Gastroscopy ; Humans ; Male ; Mass Screening ; methods ; Middle Aged ; Pepsinogen A ; blood ; Sensitivity and Specificity ; Stomach Neoplasms ; blood ; diagnosis ; pathology ; surgery ; Young Adult

Lung transplantation is a viable option for patients with chronic obstructive pulmonary disease (COPD), and emphysema is the most common indication to undergo lung transplantation. A total of seven lung and one heart-lung transplantations were performed between July 1996 and June 2004 at the Yongdong Severance Hospital, and herein, three emphysema patients who underwent single lung transplantations are reviewed. There were 2 males and 1 female, with a mean age of 50 years (35, 57 and 58 years). They all underwent an operation, without cardiopulmonary bypass, and there was no operative mortality. The mean survival was 12 months (4 months, 15 months and 17 months) and all succumbed to death due to activation of pulmonary tuberculosis, post-transplantation lymphoproliferative disease and cytomegalovirus (CMV) gastritis associated with asphyxia. Infection was the most common postoperative complication, resulting in longer hospital stays, higher medical expenses and shorter survival rates, necessitating aggressive prophylactic management. The accumulation of experience, modifications to operative procedures and perioperative care may lead to improved early and long- term survival in patients with emphysema undergoing single or bilateral lung transplantations.
Adult ; Aged ; Asphyxia/mortality ; Cytomegalovirus Infections ; Fatal Outcome ; Female ; Gastritis/mortality/virology ; Humans ; *Lung Transplantation ; Lymphoproliferative Disorders/mortality ; Male ; Middle Aged ; Pulmonary Emphysema/*surgery ; Survival Analysis ; Tuberculosis, Pulmonary/mortality

Endoscopy plays an important role in the diagnosis and treatment of postoperative complications of gastric cancer. Endoscopic intervention can avoid the second operation and has attracted wide attention. Early gastric anastomotic bleeding after gastrectomy is the most common. With the development of technology, emergency endoscopy and endoscopic hemostasis provide a new treatment approach. According to the specific circumstances, endoscopists can choose metal clamp to stop bleeding, electrocoagulation hemostasis, local injection of epinephrine or sclerotherapy agents, and spraying specific hemostatic agents. Anastomotic fistula is a serious postoperative complication. In addition to endoscopically placing the small intestine nutrition tube for early enteral nutrition support treatment, endoscopic treatment, including stent, metal clip, OTSC, and Over-stitch suture system, can be chosen to close fistula. For anastomotic obstruction or stricture, endoscopic balloon or probe expansion and stent placement can be chosen. For esophageal anastomotic intractable obstruction after gastroesophageal surgery, radial incision of obstruction by the hook knife or IT knife, a new method named ERI, is a good choice. Bile leakage caused by bile duct injury can be treated by placing the stent or nasal bile duct. In addition, endoscopic methods are widely used as follows: abdominal abscess can be treated by the direct intervention under endoscopy; adhesive ileus can be treated by placing the catheter under the guidance of endoscopy to attract pressure; alkaline reflux gastritis can be rapidly diagnosed by endoscopy; gastric outlet obstruction mainly caused by cancer recurrence can be relieved by metal stent placement and the combination of endoscopy and X-ray can increase success rate; pyloric dysfunction and spasm caused by the vagus nerve injury during proximal gastrectomy can be treated by endoscopic pyloromyotomy, a new method named G-POEM, and the short-term outcomes are significant. Endoscopic submucosal dissection (ESD) allows complete resection of residual gastric precancerous lesions, however it should be performed by the experienced endoscopists.
Anastomosis, Surgical ; adverse effects ; Bile Ducts ; injuries ; Constriction, Pathologic ; etiology ; therapy ; Digestive System Fistula ; etiology ; therapy ; Duodenogastric Reflux ; diagnostic imaging ; etiology ; Endoscopy, Gastrointestinal ; methods ; Enteral Nutrition ; instrumentation ; methods ; Female ; Gastrectomy ; adverse effects ; Gastric Outlet Obstruction ; surgery ; Gastritis ; diagnosis ; Gastrointestinal Hemorrhage ; etiology ; therapy ; Hemostasis, Endoscopic ; methods ; Hemostatics ; administration & dosage ; therapeutic use ; Humans ; Male ; Neoplasm Recurrence, Local ; surgery ; Postoperative Complications ; diagnosis ; therapy ; Precancerous Conditions ; surgery ; Pylorus ; innervation ; physiopathology ; surgery ; Stents ; Stomach Neoplasms ; complications ; surgery ; Treatment Outcome ; Vagus Nerve Injuries ; etiology ; surgery

Gastric cancer is the second most common cause of cancer death worldwide and is usually detected at a late stage, except in Korea and Japan where early screening is in effect. Results from animal and epidemiological studies suggest that Helicobacter pylori infection, and subsequent gastritis, promote development of gastric cancer in the infected mucosa. Relatively effective treatment regimens are available to treat H. pylori infection, and in general, mass eradication of the organism is not currently recommended as a gastric cancer prevention strategy. However, regional guidelines vary regarding the indications and recommendations for H. pylori treatment for gastric cancer prevention. In this review, we discuss the results from intervention studies, provide insight regarding current guideline recommendations, and discuss future study directions.
Anti-Bacterial Agents/*therapeutic use ; Drug Therapy, Combination ; Early Detection of Cancer ; Evidence-Based Medicine ; Gastrectomy ; Gastritis/diagnosis/*drug therapy/microbiology ; Helicobacter Infections/complications/diagnosis/*drug therapy/microbiology ; Humans ; Neoplasm Recurrence, Local ; Practice Guidelines as Topic ; Proton Pump Inhibitors/*therapeutic use ; Risk Factors ; Stomach Neoplasms/diagnosis/microbiology/*prevention & control/surgery ; Treatment Outcome