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Endoscopic ultrasound in the diagnosis and treatment of pancreatic disease

world Journal of Gastroenterology 2014年第29期20卷 9976-9989页

作者： christopher w teshima Gurpal S Sandha Division of Gastroenterology University of AlbertaEdmontonAlberta T6G 2X8Canada

Endoscopic ultrasound(EUS)is an important part of modern gastrointestinal endoscopy and now has an integral role in the diagnostic evaluation of pancreatic ***,as EUS technology has advanced,it has increasingly become a therapeutic procedure,and the prospect of multiple applications of interventional EUS for the pancreas is truly on the near ***,this review focuses on the established diagnostic and therapeutic roles of EUS that are used in current clinical *** particular,the diagnostic evaluation of acute pancreatitis,chronic pancreatitis,cystic pancreatic lesions and solid masses of the pancreas are *** newer enhanced imaging modalities of elastography and contrast enhancement are evaluated in this *** main therapeutic aspects of pancreatic EUS are then considered,namely celiac plexus block and celiac plexus neurolysis for pain control in chronic pancreatitis and pancreas cancer,and EUS-guided drainage of pancreatic fluid collections.

关键词： Endoscopic ultrasonography Fine needle aspiration Pancreatic cyst Pancreatic neoplasms Pancreatitis

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Magnetic imaging-assisted colonoscopy vs conventional colonoscopy: A randomized controlled trial

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world Journal of Gastroenterology 2014年第36期20卷 13178-13184页

作者： christopher w teshima Sergio Zepeda-Gómez Suliman H AlShankiti Gurpal S Sandha Division of Gastroenterology University of Alberta Edmonton Alberta T6G 2X8 Canada

AIM: To compare magnetic imaging-assisted colonoscopy (MIC) with conventional colonoscopy (CC).

关键词： Colonoscopy Conscious sedation Magnetic endoscope imaging Pain measurement Randomized controlled trial

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Crohn's disease genotypes of patients in remission vs relapses after infliximab discontinuation

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world Journal of Gastroenterology 2012年第36期18卷 5058-5064页

作者： Cathy Lu Alistair waugh Robert J Bailey Raeleen Cherry Levinus A Dieleman Leah Gramlich Kata Matic Mario Millan Karen I Kroeker Daniel Sadowski christopher w teshima Dennis Todoruk Clarence wong Karen wong Richard N Fedorak Division of Gastroenterology Zeidler Ledcor CenterUniversity of AlbertaEdmontonAB T6G 2X8Canada Division of Gastroenterology Royal Alexandra HospitalEdmontonAB T5H 3V9Canada Division of Gastroenterology Grey Nuns HospitalEdmontonAB T6L 5X8Canada Division of Gastroenterology Misericordia HospitalEdmontonAB T5R 4H5Canada

AIM： To investigate genetic differences between Crohn＇s disease （CD） patients with a sustained remission vs relapsers after discontinuing infliximab while in cortico- steroid-free remission. METHODS： Forty-eight CD patients received infliximab and were in full corticosteroid-free clinical remission but then discontinued infliximab for reasons other than a loss of response, were identified by review of an electronic database and charts. Infliximab-associated remis- sion was defined as corticosteroid-free plus normaliza- tion of clinical disease activity [CD activity index （CDAI）〈 150] during follow-up visits based on physician global assessments. A CD relapse （loss of infliximab-induced remission） was clinically defined as a physician visit for symptoms of disease activity （CDAI 〉 220） and a thera- peutic intervention with CD medication（s）, or a hospital- ization with complications related to active CD. Genetic analyses were performed on samples from 14 patients （n = 6 who had a sustained long term remission after stopping infliximab, n -- 8 who rapidly relapsed after stopping infliximab）. Nucleotide-binding oligomerization domain 2 （NOD2）/caspase activation recruitment do- main 15 （CARD15） polymorphisms （R702w, G908R and L1007fs） and the inflammatory bowel disease 5 （IBDS） polymorphisms （IGR2060a1 and IGR3081a1） were ana- lyzed in each group. RESULTS： Five single nucleotide polymorphisms of IBD5 and NOD2/CARD15 genes were successfully analyzed for all 14 subjects. There was no signifcant increase in frequency of the NOD2/CARD15 polymor- phisms （R702w, G908R and L1007fs） and the IBD5 polymorphisms （IGR2060al and IGR3081a1） in either group of patients; those whose disease relapsed rap- idly or those who remained in sustained long term remission following the discontinuation of infliximab. Nearly a third of patients in full clinical remission who stopped infliximab for reasons other than loss of re- sponse remained in sustained clinical remission, while two-thirds rel

关键词： Infliximab Anti-tumor necrosis factor alpha Crohn's disease Inflammatory bowel disease Genotype

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Clinical characteristics of young patients with early Barrett’s neoplasia

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world Journal of Gastroenterology 2019年第24期25卷 3069-3078页

作者： Yugo Iwaya Yuto Shimamura Kenichi Goda Enrique Rodríguez de Santiago John Gerard Coneys Jeffrey D Mosko Gabor Kandel Paul Kortan Gary May Norman Marcon christopher teshima Advanced Therapeutic Endoscopy Centre St Michael’s HospitalUniversity of TorontoToronto M5B 1W8OntarioCanada Department of Gastroenterology Dokkyo Medical UniversityTochigi 321-0293Japan Department of Gastroenterology Ramón y Cajal university hospitalMadrid 28034Spain

BACKGROUND Esophageal adenocarcinoma(EAC)and high-grade dysplasia(HGD)may appear in young patients with Barrett's esophagus(BE).However,characteristics of Barrett's-related neoplasia in this younger population remain *** To identify clinical characteristics that differ between young and old patients with early-stage Barrett's-related *** we conducted a retrospective analysis of a prospectively maintained database comprised of consecutive patients with early-stage EAC(pT1)and HGD at a tertiary-referral center between 2001 and *** characteristics,drug and risk factor exposures,clinicopathological staging of EAC/HGD and treatment outcomes[complete eradication of neoplasia(CE-N),complete eradication of intestinal metaplasia(CE-IM),recurrence of neoplasia and recurrence of intestinal metaplasia]were *** analyses were performed to identify factors that differed significantly between older and younger(≤50 years)*** we identified 450 patients with T1 EAC and HGD(74%and 26%,respectively);45(10%)were≤50 *** to the older group,young patients were more likely to present with ongoing gastroesophageal reflux disease(GERD)symptoms(55%vs 38%,P=0.04)and to be obese(body mass index>30,48%vs 32%,P=0.04).Multivariate logistic regression analysis showed that young patients were significantly more likely to have ongoing GERD symptoms[odds ratio(OR)2.00,95%confidence interval(CI)1.04-3.85,P=0.04]and to be obese(OR 2.06,95%CI 1.07-3.98,P=0.03)whereas the young group was less likely to have a smoking history(OR 0.39,95%CI 0.20-0.75,Pwere no significant differences regarding tumor histology,CE-N,CE-IM,recurrence of neoplasia and recurrence of intestinal metaplasia(mean follow-up,44.3 mo).CONCLUSION while guidelines recommend BE screening in patients>50 years of age,younger patients should be considered for screening endoscopy if they suffer from obesity and GERD symptoms.

关键词： Barrett's Esophagus Gastroesophageal reflux disease Obesity Esophageal adenocarcinoma High-grade dysplasia Guideline Young patient

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