1.Minimal Change Esophagitis.
Han Seung RYU ; Suck Chei CHOI
The Korean Journal of Gastroenterology 2016;67(1):4-7
Gastroesophageal reflux disease (GERD) is defined as a condition which develops when the reflux of gastric contents causes troublesome symptoms and long-term complications. GERD can be divided into erosive reflux disease and non-erosive reflux disease based on endoscopic findings defined by the presence of mucosal break. The Los Angeles classification excludes minimal changes as an evidence of reflux esophagitis because of poor interobserver agreement. In the Asian literature, minimal changes are considered as one of the endoscopic findings of reflux esophagitis, but the clinical significance is still controversial. Minimal change esophagitis is recognized quite frequently among patients with GERD and many endoscopists recognize such findings in their clinical practice. This review is intended to clarify the definition of minimal change esophagitis and their histology, interobserver agreement, and symptom association with GERD.
Esophagitis/pathology
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Esophagoscopy
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Gastroesophageal Reflux/classification/*diagnosis
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Humans
;
Mucous Membrane/pathology
2.Endoscopic Experience Improves Interobserver Agreement in the Grading of Esophagitis by Los Angeles Classification: Conventional Endoscopy and Optimal Band Image System.
Si Hyung LEE ; Byung Ik JANG ; Kyeong Ok KIM ; Seong Woo JEON ; Joong Goo KWON ; Eun Young KIM ; Jin Tae JUNG ; Kyung Sik PARK ; Kwnag Bum CHO ; Eun Soo KIM ; Chang Geun PARK ; Chang Heon YANG
Gut and Liver 2014;8(2):154-159
BACKGROUND/AIMS: Interobserver variation by experience was documented for the diagnosis of esophagitis using the Los Angeles classification. The aim of this study was to evaluate whether interobserver agreement can be improved by higher levels of endoscopic experience in the diagnosis of erosive esophagitis. METHODS: Endoscopic images of 51 patients with gastroesophageal reflux disease (GERD) symptoms were obtained with conventional endoscopy and optimal band imaging (OBI). Endoscopists were divided into an expert group (16 gastroenterologic endoscopic specialists guaranteed by the Korean Society of Gastrointestinal Endoscopy) and a trainee group (individuals with fellowships, first year of specialty training in gastroenterology). All endoscopists had no or minimal experience with OBI. GERD was diagnosed using the Los Angeles classification with or without OBI. RESULTS: The mean weighted paired kappa statistics for interobserver agreement in grading erosive esophagitis by conventional endoscopy in the expert group was better than that in the trainee group (0.51 vs 0.42, p<0.05). The mean weighted paired k statistics in the expert group and in the trainee group based on conventional endoscopy with OBI did not differ (0.42, 0.42). CONCLUSIONS: Interobserver agreement in the expert group using conventional endoscopy was better than that in the trainee group. Endoscopic experience can improve the interobserver agreement in the grading of esophagitis using the Los Angeles classification.
Clinical Competence/*standards
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Esophagitis/classification/*pathology
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Esophagoscopy/*standards
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Gastroenterology/*standards
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Gastroesophageal Reflux/classification/pathology
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Humans
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Observer Variation
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Retrospective Studies
3.Update on classification of precancerous lesions of larynx.
Hong-kai ZHANG ; Hong-gang LIU
Chinese Journal of Pathology 2010;39(8):570-573
Alcohol Drinking
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Carcinoma in Situ
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pathology
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Epithelium
;
pathology
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Gastroesophageal Reflux
;
complications
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Humans
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Hyperplasia
;
Laryngeal Neoplasms
;
classification
;
etiology
;
pathology
;
therapy
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Larynx
;
pathology
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Papillomavirus Infections
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Precancerous Conditions
;
classification
;
etiology
;
pathology
;
therapy
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Prognosis
;
Smoking
4.Endoscopic Grading of Atrophic Gastritis is Inversely Associated with Gastroesophageal Reflux and Gastropharyngeal Reflux.
Do Hoon KIM ; Gwang Ha KIM ; Ji Young KIM ; Hwal Suk CHO ; Chan Won PARK ; Sun Mi LEE ; Tae Oh KIM ; Dae Hwan KANG ; Geun Am SONG
The Korean Journal of Internal Medicine 2007;22(4):231-236
BACKGROUND: Reflux esophagitis is inversely associated with the presence of atrophic gastritis, and endoscopic grading of atrophic gastritis correlates with histological evaluation. The aim of this study was to investigate the association of the endoscopic grade of atrophic gastritis with gastroesophageal and gastropharyngeal reflux. METHDOS: A total of 627 patients, who underwent endoscopy and ambulatory 24-hour dual-probe pH monitoring, were included in this study. The grade of atrophic gastritis was endoscopically classified into 2 types with the atrophic pattern system: the closed-type (C-type) and the open-type (O-type). We compared the findings from endoscopy and ambulatory pH monitoring for these 2 types. RESULTS: The O-type was significantly associated with a lower prevalence of reflux esophagitis (p=0.001). All variables showing gastroesophageal reflux in the distal probe were significantly lower in the O-type than in the C-type (p<0.05). Similarly for the proximal probe, all variables, except the supine time of pH<4, were significantly lower in the O-type than in the C-type (p<0.05). The frequency of gastroesophageal reflux disease and gastropharyngeal reflux disease was in significantly lower in the O-type than in the C-type (p<0.001, p=0.012, respectively). CONCLUSIONS: Endoscopic grading of atrophic gastritis is easy and is inversely associated with gastroesophageal and gastropharyngeal reflux.
*Endoscopy, Gastrointestinal
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Esophageal pH Monitoring
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Female
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Gastritis, Atrophic/classification/*physiopathology
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Gastroesophageal Reflux/epidemiology/*physiopathology
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Health Status Indicators
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Humans
;
Korea/epidemiology
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Male
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Middle Aged
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Pharynx/*pathology
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Prevalence
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Retrospective Studies
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Risk Factors