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Long-term results of graded pneumatic dilatation under endoscopic guidance in patients with primary esophageal achalasia

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World Journal of Gastroenterology 2004年第22期10卷 3322-3327页

作者： AhmetDobrucali YusufErzin MuratTuncer AhmetDirican DepartmentofGastroenterology CerrahpasaMedicalFacultyIstanbulUniversityIstanbulTurkey DepartmentofBioistatistics CerrahpasaMedicalFacultyIstanbulUniversityIstanbulTurkey

AIM:Achalasia is the best known primary motor disorder of the esophagus in which the lower esophageal sphincter (LES)has abnormally high resting pressure and incomplete relaxation with *** dilatation remains the first choice of *** aims of this study were to determine the long term clinical outcome of treating achatasia initially with pneumatic dilatation and usefulness of pneumatic dilatation technique under endoscopic observation without fluoroscopy. METHODS:A total of 65 dilatations were performed in 43 patients with achalasia[23 males and 20 females,the mean age was 43 years(range,19-73)].All patients underwent an initial dilatation by inflating a 30 mm balloon to 15 psi under endoscopic *** need for subsequent dilatation was based on symptom assessment.A 3.5 cm balloon was used for repeat procedures. RESULTS:The 30 mm balloon achieved a satisfactory result in 24 patients(54%)and the 35 mm ballon in 78% of the remainder(14/18).Esophageal perforation as a short-term complication was observed in one patient(2.3%).The only late complication encountered was gastroesophageal reflux in 2(4%)patients with a good response to *** mean follow-up period was 2.4 years(6 mo-5 years).Of the patients studied,38(88%)were relieved of their symptoms after only one or two *** patients were referred for surgery(one for esophageal perforation and four for persistent or recurrent symptoms).Among the patients whose follow up information was available,the percentage of patients in remission was 79%(19/24)at 1 year and 54%(7/13)at 5 years. CONCLUSION:Performing balloon dilatation under endoscopic observation as an outpatient procedure is simple,safe and efficacious for treating patients with achalasia and referral of surgical myotomy should be considered for patients who do not respond to medical therapy or individuals that do not desire pneumatic dilatations.

关键词： Adult Aged Balloon Dilatation endoscopy, gastrointestinal Esophageal Achalasia Female Follow-Up Studies Humans Male Manometry Middle Aged Outpatients Treatment Outcome

Impact of Helicobacter pylori infection on histological changes in non-erosive reflux disease

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World Journal of Gastroenterology 2004年第8期10卷 1180-1182页

作者： AnthieGatopoulou KonstantinosMimidis GeorgeMinopoulos Konstantinos Mimidis EfthimiosSivridis AlexandraGiatromanolaki Alexandros Polichronidis NikolaosLirantzopoulos endoscopy Unit Democritus University of ThraceAlexandroupolisGreece First Department of Surgery Democritus University of ThraceAlexandroupolisGreece First Department of Internal Medicine Democritus University of Thrace AlexandroupolisGreece Department of Pathology Democritus University of ThraceAlexandroupolisGreece Second Department of Surgery Democritus University of ThraceAlexandroupolisGreece

AIM:The evidence for an association between Helicobacter pylori (H pylori) and gastroesophageal reflux disease,either in non-erosive (NERD) or erosive esophagitis (ERD) remains *** available data on the histological changes in NERD and the effect on Hpyloriinfection on them are elusive. The aim of this study therefore was to prospectively evaluate the histological findings and the impact of Hpyloriinfection on a group of symptomatic patients with NERD. METHODS:Fifty consecutive patients were prospectively evaluated for symptoms compatible with *** all cases, routine endoscopy and lugol directed biopsies were performed and assessed histologically in a blinded manner. RESULTS:The overall prevalence of Hpyloriinfection was 70%.Twenty-nine patients out of 50 (58%) were NERD *** statistical significance was observed between the H pyloristatus and *** remaining 21 (42%) were diagnosed as follows:13 (26%),6 (12%),2(4%) with esophagitis grade A,B and C respectively.A statistically significant correlation was observed between the Hpylori+ and esophagitis grade A,as well as between Hpylori-and grade *** from 2 patients were not included because of insufficient ***,a basal zone hyperplasia was found in 47 (97.91%) patients,alterations of glycogen content in 47 (97.91%),papillae elongation in 33 (68.75%), blood vessels dilatation in 35(72.91%),chronic inflammation in 21 (43.75%),infiltration with eosinophils,neutophils and T-lymphocytes in 4 (8.33%),6 (12.5%) and 39 (81.25%) *** correlation was observed between the Hpyloristatus and the histological parameters studied either in NERD or GERD. CONCLUSION:Histological assessment can not differentiate symptomatic patients with erosive versus non-erosive reflux ***,Hpyloriinfection may not act as an important factor in patients with NERD.

关键词： Helicobacter pylori Biopsy endoscopy, gastrointestinal Esophagitis, Peptic Female Gastroesophageal Reflux Helicobacter Infections Humans Hyperplasia Male Middle Aged Prospective Studies

Lasers in gastroenterology

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World Journal of Gastroenterology 2001年第3期7卷 317-323页

作者： LaurenceB.Lovat StephenG.Bown Lovat BSc PhD MRCP Senior Lecturer in Gastroenterology. National Medical Laser CentreUCL67-73 Riding House StreetLondon

INTRODUCTIONendoscopy has revolutionised our management of many gastrointestinal disorders over the past 30 years .We are increasingly able to diagnose gastrointestinal (GI) tumors at an early stage,and endoscopic therapy has made a difference to the outcome of GI haemorrhage. We still rely on surgery for cure of cancer of cancer but as diagnostic techniques improve the goal of minimally invasive diagnosis and therapy appears ever more attainable diagnosis and therapy appears vevr more attainable . As populations get older ,it is also increasingly desirable .Laser light can be used for both diagnosis and therapy in the gut .This article reviews the value of lasers in these areas .

关键词： endoscopy, gastrointestinal gastrointestinal Diseases Humans Lasers

Detection of anti-Helicobacter pyloriantibodies in serum and duodenal fluid in peptic gastroduodenal disease

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World Journal of Gastroenterology 2004年第20期10卷 2997-3000页

作者： Angelo Locateili Wilson Roberto Catapani Claudio Rufino Gomes Junior Claudilene Battistin Paula Silva Jaques Waisberg Department of Surgery ABC Faculty of MedicineAvenida Principe de Gales 821Santo AndreSao Paulo09060-650Brazil

AIM:To study the diagnosis of Helicobacter pylori(H pylori) infection through the determination of serum levels of anti- H pylori IgG and IgA antibodies,and the levels of anti-H pylori IgA antibodies in duodenal fluid. METHODS:Data were collected from 93 patients submitted to upper digestive endoscopy due to dyspeptic symptoms. The patients were either negative(group A)or positive (group B)to H pylori by means of both histological detection and urease *** endoscopy,peripheral blood was collected for the investigation of anti-H pylori IgG and IgA *** perform the urease test,biopsies were obtained from the gastric *** the histological evaluation,biopsies were collected from the gastric antrum (greater and lesser curvatures)and the gastric body. Following this,duodenal fluid was collected from the first and second portions of the *** the serological assaying of anti-Hpylori IgG and IgA,and anti-Hpylori IgA in duodenal fluids,the ELISA method was utilized. RESULTS:The concentration of serum IgG showed sensitivity of 64.0%,specificity of 83.7%,positive predictive value of 82.0%,negative predictive value of 66.6% and accuracy of 73.1% for the diagnosis of H pylori *** the same purpose,serum IgA showed sensitivity of 72.0%, specificity of 65.9%,positive predictive value of 72.0%, negative predictive value of 67.4% and accuracy of 69.8%. If the serological tests were considered together,*** both were positive or negative,the accuracy was 80.0%, sensitivity was 86.6%,specificity was 74.2%,positive predictive value was 74.2% and negative predictive value was 86.6%.When values obtained in the test for detecting IgA in the duodenal fluid were analyzed,no significant difference(P=0.43)was observed between the values obtained from patients with or without H pylori infection. CONCLUSION:The results of serum IgG and IgA tests for H pylori detection when used simultaneously,are more efficient in accuracy,sensitivity and negative pred

关键词： Adolescent Adult Aged Antibodies, Bacterial Duodenum endoscopy, gastrointestinal Enzyme-Linked Immunosorbent Assay Female Gastric Mucosa Helicobacter Infections Helicobacter pylori purification Humans Immunoglobulin A Immunoglobulin G Male Middle Aged Peptic Ulcer Sensitivity and Specificity Serologic Tests

Effect of biopsies on sensitivity and specificity of ultra-rapid urease test for detection of Helicobacter pylori infection:A prospective evaluation

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World Journal of Gastroenterology 2004年第13期10卷 1907-1910页

作者： LiLinLim KhekYuHo Bow Ho Manuel Salto-Tellez Department of Medicine National University HospitalSingapore Department of Microbiology National University HospitalSingapore Department of Pathology National University HospitalSingapore

AIM:To prospectively assess the sensitivity,specificity and time to positivity of theUltra-rapid urease test (URUT) for Helicobacter pylori(H pylori),and compare the results of one with those of two biopsies. METHODS:Five antral biopsies were taken in consecutive patients undergoing upper endoscopy:one and two biopsies for URUT,and one each for H pylori culture and histology. URUT was read at 1,5,10,20 and 30 min,1,2,3 and 24 h after biopsy insertion into the reagent.A positive histology and/or culture was used as positive reference“gold standards”. RESULTS:URUT was more sensitive for detecting Hpylori with two biopsies rather than one,at all time points up to 120 *** sensitivity improved from 3.6% to 82.1% for one biopsy and 10.7% to 85.7% for two biopsies from 1 to 120 *** sensitivity reached 96.4% at 24 h for both, but the specificity reduced from 100% to 96% and 92% for one and two biopsies,respectively. CONCLUSION:Development of a positive URUT result is hastened by doubling the number of gastric *** recommend taking two instead of one biopsy to achieve an earlier positive URUT result so that H pylori eradication therapy can be initiated before patient is discharged from the endoscopy suite.

关键词： Helicobacter pylori Adult Aged Aged, 80 and over Biopsy endoscopy, gastrointestinal Female Gastric Mucosa Helicobacter Infections Humans Male Middle Aged Prospective Studies Sensitivity and Specificity Urease

Typical endoscopic appearance accurately predicts sporadic fundic gland polyps： a retrospective study of 47 771 endoscopies

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Chinese Medical Journal 2013年第15期126卷 2984-2986页

作者： CAO Hai-long SONG Shu-li YANG Bo-li ZHANG Zhi-hua ZHANG Hui QU Rui WANG Bang-mao Tianjin Med Univ Dept Gastroenterol & Hepatol Gen Hosp Tianjin 300052 Peoples R China Cangzhou Peoples Hosp Dept Gastroenterol & Hepatol Cangzhou 061000 Heibei Peoples R China Anhui Med Univ Dept Epidemiol Hefei 230032 Anhui Peoples R China

Sporadic fundic gland polyps （FGPs） account for 0.8%- 1.9% of all gastric polyps and are observed in patients undergoing esophagogastroduodenoscopy （EGD） in whom they account for more than 50% of all gastric polyps. The prevalence is increasing in recent years possibly due to decreased Helicobacter pylori （1t. pylori） infection rate and long-term proton pump inhibitor use. Generally, sporadic FGPs are assumed to be benign polyps with no risk of malignant transformation. We evaluated the feasibility of predicting sporadic FGPs based on typical endoscopic appearance in a large database of 47 771 endoscopies.

关键词： fundic gland polyps stomach neoplasms dysplasia endoscopy, gastrointestinal

Comparison of treatment outcomes between biliary plastic stent placements with and without endoscopic sphincterotomy for inoperable malignant common bile duct obstruction

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World Journal of Gastroenterology 2004年第8期10卷 1212-1214页

作者： PietroDiGiorgio LeonardoDeLuca Department of Gastroenterology Pellegrini HospitalNapoliItaly

AIM:Considerable controversy surrounds the adoption of endoscopic sphincterotomy(ES)to facilitate the placement of 10F plastic stents(PS)and to reduce the risk of pancreatitis The aim of the study was to assess the possible advantages of ES before PS placement. METHODS:From 3/1996 to 6/2001,172 consecutive patients, who underwent placement of a single 10F-polyethylene stent for inoperable malignant strictures of the common bile duct,were randomly assigned to 2 *** group A(96 patients),a ES was performed before PS placement In Group B,96 patients had PS *** complications(within 30 d)and late effects(from 30 d to stent replacement)were *** interval was defined as the period between PS placement and obstruction or *** success of stent replacement in the 2 groups was evaluated. RESULTS:Stent insertion was successful in 95.8%(92/96) of the pts in group A and in 93.7%(90/96)of the patients in group B(P>0.05).Early complications were more frequent in patients who underwent ES(6.5% vs4.4%)but the data were not significant(P>0.05).In group A pancreatitis developed in two patients and bleeding in three;whereas pancreatitis occurred in 2 patients in group *** were managed *** procedure related mortality *** late complications were acute cholangitis due to stent *** performed a stent replacement in 87 patients that was successful in 84 cases without differences between groups. CONCLUSION:Sphincterotomy does not seem to be necessary for placement of 10F-PS in patients with malignant common bile duct obstruction.

关键词： Stents Aged Aged, 80 and over Cholangiocarcinoma Cholestasis, Extrahepatic Comparative Study endoscopy, gastrointestinal Female Humans Lymphatic Metastasis Male Pancreatic Neoplasms Pancreatitis control Plastics Postoperative Complications Risk Reduction Behavior Sphincter of Oddi

Large pedinculated antral hyperplastic gastric polyp traversed the bulbus causing outlet obstruction and iron deficiency anemia: endoscopic removal

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World Journal of Gastroenterology 2003年第3期9卷 633-634页

作者： Murat Alper Yusuf Akcan Olcay Belenli Departments of Pathology University of Abant izzet BaysalDüzce Medical FacultyTurkey Departments of Gastroenterology University of Abant izzet BaysalDüzce Medical FacultyTurkey

We present here a large (3 cm) hyperplastic gastric polyp prolapsed into duodenum and caused outlet obstruction and iron deficiency anemia in 60 years old male *** removal was performed successfully.

关键词： endoscopy, gastrointestinal Anemia, Iron-Deficiency Gastric Outlet Obstruction Humans Male Middle Aged Polyps Stomach Neoplasms

A successful treatment of traumatic bronchobiliary fistula by endoscopic retrograde biliary drainage

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Chinese Journal of Traumatology 2012年第1期15卷 59-61页

作者： LIAOGuan—qun WANG Hao HUQiu-hui TAISheng Department of General Surgery Second Affiliated Hospital of Harbin Medical University Harbin 150086 China

Bronchobiliary fistula（BBF）is a rare condition in which there is a nonnatural communication between the biliary tract and the bronchial *** is usually aroused by the complications of hepatic hydatidosis,hepatic amebic,biliary obstruction,trauma,neoplasm and hepatic abscess *** this paper,we described a patient suffering from BBF that is secondary to trauma or ***,BBF was detected in the left ***,we managed this case successfully without an open surgery.

关键词： Bronchial fistula Biliary fistula Cholangiopancreatography, endoscopic retrograde endoscopy, gastrointestinal