Journal Detail Information

1

Cite

Share

The Pathogenesis and Management of Achalasia: Current Status and Future Directions.

Gut and Liver.2015;9(4):449-463. doi:10.5009/gnl14446

Achalasia is an esophageal motility disorder that is commonly misdiagnosed initially as gastroesophageal reflux disease. Patients with achalasia often complain of dysphagia with solids and liquids but may focus on regurgitation as the primary symptom, leading to initial misdiagnosis. Diagnostic tests for achalasia include esophageal motility testing, esophagogastroduodenoscopy and barium swallow. These tests play a complimentary role in establishing the diagnosis of suspected achalasia. High-resolution manometry has now identified three subtypes of achalasia, with therapeutic implications. Pneumatic dilation and surgical myotomy are the only definitive treatment options for patients with achalasia who can undergo surgery. Botulinum toxin injection into the lower esophageal sphincter should be reserved for those who cannot undergo definitive therapy. Close follow-up is paramount because many patients will have a recurrence of symptoms and require repeat treatment.
Botulinum Toxins/administration & dosage ; Deglutition Disorders/etiology ; Diagnostic Errors ; Endoscopy, Digestive System ; Esophageal Achalasia/*diagnosis/etiology/physiopathology/therapy ; Esophageal Sphincter, Lower ; Esophagus/physiopathology/surgery ; Gastroesophageal Reflux/diagnosis ; Humans ; Injections, Subcutaneous ; Manometry ; Neurotransmitter Agents/administration & dosage ; Recurrence

2

Cite

Share

Management of Hepatocellular Carcinoma: Current Status and Future Directions.

Jennifer S AU ; Catherine T FRENETTE

Gut and Liver.2015;9(4):437-448. doi:10.5009/gnl15022

Hepatocellular carcinoma (HCC) is the second most common cause of cancer death worldwide. This cancer commonly arises against a background of chronic liver disease. As a result, a patient with HCC requires multidisciplinary care. Treatment options vary widely based on tumor burden and metastases. The most widely utilized staging system is the Barcelona Clinic Liver Cancer staging system, which recommends treatments based on tumor size and the underlying liver disease and functional status of the patient. Treatment options range from surgical resection or transplantation to locoregional therapies with modalities such as radiofrequency ablation and transarterial chemoembolization to systemic chemotherapies. Future care involves the development of combination therapies that afford the best tumor response, further clarification of the patients best suited for therapies and the development of new oral chemotherapeutic agents.
Antineoplastic Agents/therapeutic use ; Carcinoma, Hepatocellular/pathology/*therapy ; Catheter Ablation/trends ; Chemoembolization, Therapeutic/trends ; Combined Modality Therapy/trends ; Forecasting ; Humans ; Liver Neoplasms/pathology/*therapy ; Liver Transplantation ; Neoplasm Staging/methods

3

Cite

Share

Confrontational Strategy Is Essential for Being Effective Precut Papillotomy.

Sang Heum PARK ; Tae Hoon LEE

Gut and Liver.2015;9(4):435-436. doi:10.5009/gnl15203

No abstract available.
Biliary Tract Diseases/*surgery ; Catheterization/*methods ; Cholangiopancreatography, Endoscopic Retrograde/*methods ; Female ; Humans ; Male ; Sphincterotomy, Endoscopic/*methods

4

Cite

Share

Is Lipase Supplementation before a High Fat Meal Helpful to Patients with Functional Dyspepsia?.

Seon Young PARK ; Jong Sun REW

Gut and Liver.2015;9(4):433-434. doi:10.5009/gnl15206

No abstract available.
Diet, High-Fat/*adverse effects ; *Dietary Supplements ; Dyspepsia/*prevention & control ; Female ; Humans ; Lipase/*administration & dosage ; Male ; Stomach/*drug effects

5

Cite

Share

Endoscopic Treatment for Obesity: New Emerging Technology Trends.

Seung Han KIM ; Hoon Jai CHUN

Gut and Liver.2015;9(4):431-432. doi:10.5009/gnl15125

No abstract available.
*Bariatric Surgery ; Endoscopy, Gastrointestinal/*trends ; Humans ; Obesity/*surgery

6

Cite

Share

A Low Serum gamma-Glutamyltransferase Level Predicts a Sustained Virological Response in Patients with Chronic Hepatitis C Genotype 1.

Umit Bilge DOGAN ; Mustafa Salih AKIN ; Serkan YALAKI

Gut and Liver.2014;8(1):113-115.

No abstract available.

7

Cite

Share

Gemcitabine-Induced Hemolytic Uremic Syndrome in Pancreatic Cancer: A Case Report and Review of the Literature.

Hye Won LEE ; Moon Jae CHUNG ; Huapyong KANG ; Heun CHOI ; Youn Jeong CHOI ; Kyung Joo LEE ; Seung Woo LEE ; Seung Hyuk HAN ; Jin Seok KIM ; Si Young SONG

Gut and Liver.2014;8(1):109-112.

Hemolytic uremic syndrome (HUS) is a rare thrombotic complication characterized by a triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. HUS may be caused by several different conditions, including infection, malignancy, and chemotherapeutic agents, such as mitomycin, cisplatin, and most recently, gemcitabine. The outcome of gemcitabine-induced HUS is poor, and the disease has a high mortality rate. This study reports a case of gemcitabine-induced HUS in a patient with pancreatic cancer in Korea.
Antimetabolites, Antineoplastic/*adverse effects ; Deoxycytidine/adverse effects/*analogs & derivatives ; Hemolytic-Uremic Syndrome/*chemically induced ; Humans ; Male ; Middle Aged ; Pancreatic Neoplasms/*drug therapy ; Treatment Outcome

8

Cite

Share

Is a Preoperative Assessment of the Early Recurrence of Pancreatic Cancer Possible after Complete Surgical Resection?.

Marco LA TORRE ; Giuseppe NIGRI ; Annalisa LO CONTE ; Federica MAZZUCA ; Simone Maria TIERNO ; Adelona SALAJ ; Paolo MARCHETTI ; Vincenzo ZIPARO ; Giovanni RAMACCIATO

Gut and Liver.2014;8(1):102-108.

BACKGROUND/AIMS: The prognosis of pancreatic adenocarcinoma (PAC) is poor. The serum carbohydrate antigen 19-9 (CA 19-9) level has been identified as a prognostic indicator of recurrence and reduced overall survival. The aim of this study was to identify preoperative prognostic factors and to create a prognostic model able to assess the early recurrence risk for patients with resectable PAC. METHODS: A series of 177 patients with PAC treated surgically at the St. Andrea Hospital of Rome between January 2003 and December 2011 were reviewed retrospectively. Univariate and multivariate analyses were utilized to identify preoperative prognostic indicators. RESULTS: A preoperative CA 19-9 level >228 U/mL, tumor size >3.1 cm, and the presence of pathological preoperative lymph nodes statistically correlated with early recurrence. Together, these three factors predicted the possibility of an early recurrence with 90.4% accuracy. The combination of these three preoperative conditions was identified as an independent parameter for early recurrence based on multivariate analysis (p=0.0314; hazard ratio, 3.9811; 95% confidence interval, 1.1745 to 15.3245). CONCLUSIONS: PAC patient candidates for surgical resection should undergo an assessment of early recurrence risk to avoid unnecessary and ineffective resection and to identify patients for whom palliative or alternative treatment may be the treatment of choice.
Adenocarcinoma/*diagnosis/surgery ; Aged ; CA-19-9 Antigen/blood ; Feasibility Studies ; Female ; Humans ; Male ; *Models, Biological ; Neoplasm Recurrence, Local/*diagnosis ; Pancreatic Neoplasms/*diagnosis/surgery ; Prognosis ; Retrospective Studies ; Tumor Markers, Biological/*blood

9

Cite

Share

Differential Expression of E-Cadherin, beta-Catenin, and S100A4 in Intestinal Type and Nonintestinal Type Ampulla of Vater Cancers.

Rohyun SUNG ; Li KANG ; Joung Ho HAN ; Jae Woon CHOI ; Sang Hwa LEE ; Tae Hoon LEE ; Sang Heum PARK ; Hong Ja KIM ; Eaum Seok LEE ; Young Suk KIM ; Young Woo CHOI ; Seon Mee PARK

Gut and Liver.2014;8(1):94-101.

BACKGROUND/AIMS: Epithelial-mesenchymal transition (EMT)-related proteins may exhibit differential expression in intestinal type or pancreatobiliary type ampulla of Vater carcinomas (AVCs). We evaluated the expression of E-cadherin, beta-catenin, and S100A4 in intestinal and nonintestinal type AVCs and analyzed their relationships with clinicopathological variables and survival. METHODS: A clinicopathological review of 105 patients with AVCs and immunohistochemical staining for E-cadherin, beta-catenin, and S100A4 were performed. The association between clinicopathological parameters, histological type, and expression of EMT proteins and their effects on survival were analyzed. RESULTS: Sixty-five intestinal type, 35 pancreatobiliary type, and five other types of AVCs were identified. The severity of EMT changes differed between the AVC types; membranous loss of E-cadherin and beta-catenin was observed in nonintestinal type tumors, whereas aberrant nonmembranous beta-catenin expression was observed in intestinal type tumors. EMT-related changes were more pronounced in the invasive tumor margin than in the tumor center, and these EMT-related changes were related to tumor aggressiveness. Among the clinicopathological parameters, a desmoplastic reaction was related to overall survival, and the reaction was more severe in nonintestinal type than in intestinal type AVCs. CONCLUSIONS: Dysregulation of E-cadherin, beta-cadherin, and S100A4 expression may play a role in the carcinogenesis and tumor progression of AVCs.
Aged ; Aged, 80 and over ; Ampulla of Vater/*metabolism ; Cadherins/metabolism ; Common Bile Duct Neoplasms/classification/*metabolism ; Disease-Free Survival ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; S100 Proteins/metabolism ; Tumor Markers, Biological/*metabolism ; beta Catenin/metabolism

10

Cite

Share

Fiducial Placement for Stereotactic Body Radiation Therapy under Only Endoscopic Ultrasonography Guidance in Pancreatic and Hepatic Malignancy: Practical Feasibility and Safety.

Jun Ho CHOI ; Dong Wan SEO ; Do Hyun PARK ; Sung Koo LEE ; Myung Hwan KIM

Gut and Liver.2014;8(1):88-93.

BACKGROUND/AIMS: Stereotactic body radiation therapy (SBRT) for gastrointestinal malignancies requires the placement of fiducials to guide treatment delivery. This study aimed to determine the safety and technical feasibility of endoscopic ultrasonography (EUS)-guided fiducial placement for SBRT. METHODS: From November 2010 to August 2012, 32 consecutive patients who were scheduled to receive SBRT for pancreatic and hepatic malignancies were referred for EUS-guided fiducial placement. Primary outcome measurements included technical success, the fiducial migration rate, and procedural complications. RESULTS: All 32 patients had successful fiducial placement under EUS guidance. The mean number of fiducials placed per patient was 2.94+/-0.24 (range, 2 to 3 seeds). Spontaneous fiducial migration was noted in one patient (3.1%). Of the 32 patients with fiducials placed, 29 patients (90.6%) successfully underwent SBRT. One patient (3.1%) developed mild pancreatitis, requiring a 2-day prolonged hospitalization after fiducial placement. Five patients (15.6%) underwent same-session, EUS-guided fine needle aspiration for histologic confirmation at the time of fiducial placement, without any procedure-related complication. CONCLUSIONS: EUS-guided fiducial placement is a safe and technically feasible technique for preparing patients with both pancreatic and hepatic malignancies for SBRT. The fiducial markers facilitate safe and accurate targeting of the tumor during SBRT.
Aged ; Aged, 80 and over ; Endosonography/*methods ; Equipment Design ; Feasibility Studies ; Female ; *Fiducial Markers ; Humans ; Liver Neoplasms/*radiotherapy/ultrasonography ; Male ; Middle Aged ; Needles ; Pancreatic Neoplasms/*radiotherapy/ultrasonography ; Radiosurgery/*methods ; Treatment Outcome

DISPLAY OPTIONS

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share