In recent years, many parameters associated with GERD are studied sum as number of reflux lasting more than five minutes (NRs), number of reflux and the longest time of reflux in 24 hours continuous introesophageal pH...In recent years, many parameters associated with GERD are studied sum as number of reflux lasting more than five minutes (NRs), number of reflux and the longest time of reflux in 24 hours continuous introesophageal pH monitoring. It is considered that NR is the best one. Thus, both the effect of NR and the relationship with acid secretion level are deserved attention. 20 patients with reflux esophagitis and 10 healthy subject (HS group) have been studied for the changs of NRs and the longest time of reflux using 24 h continuous introesophageal pH monitoring.展开更多
Barrett's oesophagus is a metaplastic condition in which the squamous epithelium of the oesophagus is replaced by specialised intestinal metaplasia. Barrett's oesophagus occurs in about 10% of patients with ga...Barrett's oesophagus is a metaplastic condition in which the squamous epithelium of the oesophagus is replaced by specialised intestinal metaplasia. Barrett's oesophagus occurs in about 10% of patients with gastrooesophageal reflux disease (GORD) and predisposes to dysplasia and adenocarcinoma. It has been estimated that the risk of developing an adenocarcinoma of the oesophagus and gastric cardia is increased 30-125 fold.展开更多
Most vertebrates have spiral bacteria that have adapted to persist in the mucus layer of the gastric mucosa. Similarly, in underdeveloped societies, most humans acquire Helicobacter pylori in childhood, and this infec...Most vertebrates have spiral bacteria that have adapted to persist in the mucus layer of the gastric mucosa. Similarly, in underdeveloped societies, most humans acquire Helicobacter pylori in childhood, and this infection persists for the person's lifetime, unless the mucosa develops atrophic gastritis. In the developed world, major changes have occurred in the prevalence of H.pylori over the past 50-100 years: the elderly population mostly has the bacterium, but very few children or young adults are infected. These changes in prevalence of H. pylori mean that the developed world is moving from peptic ulcer disease towards reflux oesophagitis.展开更多
AIM: To value whether omeprazole could induce the healing of DIS and regression of symptoms in patients with DGER. METHODS: We enrolled 15 symptomatic patients with a pathological esophageal 24-h pH-metry and bilimetr...AIM: To value whether omeprazole could induce the healing of DIS and regression of symptoms in patients with DGER. METHODS: We enrolled 15 symptomatic patients with a pathological esophageal 24-h pH-metry and bilimetry. Patients underwent endoscopy and biopsies were taken from the distal esophagus. Specimens were analyzed at histology and transmission electron microscopy (TEM). Patients were treated with omeprazole 40 mg/d for 3 mo and then endoscopy with biopsies was repeated. Patients with persistent heartburn and/or with an incomplete recovery of DIS were treated for 3 more months and endoscopy with biopsies was performed. RESULTS: Nine patients had a non-erosive reflux disease at endoscopy (NERD) while 6 had erosive esophagitis (ERD). At histology, of the 6 patients with erosive esophagitis, 5 had mild esophagitis and 1 moderate esophagitis. No patients with NERD showed histological signs of esophagitis. After 3 mo of therapy, 13/15 patients (86.7%,P<0.01) showed a complete recovery of DIS and disappearance of heartburn. Of the 2 patients treated for 3 more months, complete recovery of DIS and heartburn were achieved in one. CONCLUSION: Three or 6 mo of omeprazole therapy led to a complete regression of the ultrastructural esophageal damage in 86.7% and in 93% of patients with DGER, NERD and ERD respectively. The ultrastructural recovery of the epithelium was accompanied by regression of heartburn in all cases.展开更多
AIM: To investigate the difference of gene expression profiles between Barrett's esophagus and reflux esophagitis induced by gastroduodenoesophageal reflux in rats.METHODS: Eight-week-old Sprague-Dawley rats were ...AIM: To investigate the difference of gene expression profiles between Barrett's esophagus and reflux esophagitis induced by gastroduodenoesophageal reflux in rats.METHODS: Eight-week-old Sprague-Dawley rats were treated esophagoduodenostomy to produce gastroduodenoesophageal reflux, and another group received sham operation as control. Esophageal epithelial tissues were dissected and frozen in liquid nitrogen immediately for pathology 40 wk after surgery. The expression profiles of 4 096 genes in reflux esophagitis and Barrett's esophagus tissues were compared with normal esophageal epithelium by cDNA microarray.RESULTS: Four hundred and forty-eight genes in Barrett'sesophagus were more than three times different from those in normal esophageal epithelium, including 312 up regulated and 136 down-regulated genes. Two hundred and thirty-twogenes in RE were more than three times different from those in normal esophageal epithelium, 90up-regulated and 142 down-regulated genes. Compared to reflux esophagitis, there were 214 up-regulated and 142 down-regulated genes in Barrett's esophagus. CONCLUSION: Esophageal epithelium exposed excessively to harmful ingredients of duodenal and gastric reflux can develop esophagitis and Barrett's esophagus gradually.The gene expression level is different between reflux esophagitis and Barrett's esophagus and the differentially expressed genes might be related to the occurrence and development of Barrett's esophagus and the promotion or progression in adenocarcinoma.展开更多
AIM: Experimental studies suggest that free radicals are involved in acid and pepsin-induced damage of esophageal mucosa. The profile and balance between free radicals and antioxidant systems in human esophagitis are ...AIM: Experimental studies suggest that free radicals are involved in acid and pepsin-induced damage of esophageal mucosa. The profile and balance between free radicals and antioxidant systems in human esophagitis are unknown. METHODS: Superoxide anion and its powerful oxidant reaction with nitric oxide (peroxynitrite) generation were determined in esophageal mucosal biopsies from 101 patients with different gastro-esophageal reflux diseases and 28 controls. Activity of both superoxide dismutase (SOD) and catalase, and reduced glutathione (GSH) levels, were also assessed. Expression of Cu,ZnSOD, MnSOD and tyrosine-nitrated MnSOD were analyzed by Western blot and/or immunohistochemistry. RESULTS: The highest levels of superoxide anion generation were found in patients with severe lesions of esophagitis. Peroxynitrite generation was intense in Barrett's biopsies, weaker in esophagitis and absent/weak in normal mucosa. Expression of Cu,ZnSOD and MnSOD isoforms were present in normal mucosa and increased according to the severity of the lesion, reaching the highest level in Barrett's esophagus. However, SOD mucosal activity significantly decreased in patients with esophagitis and Barrett's esophagus, which was, at least in part, due to nitration of its tyrosine residues. Catalase activity and GSH levels were significantly increased in mucosal specimens from patients with esophagitis and/or Barrett's esophagus. CONCLUSION: A decrease in SOD antioxidant activity leading to increased mucosal levels of superoxide anion and peroxynitrite radicals may contribute to the development of esophageal damage and Barrett's esophagus in patients with gastroesophageal reflux. Administration of SOD may be a therapeutic target in the treatment of patients with esophagitis and Barrett's esophagus.展开更多
Reflux esophagitis falls into the category of reflux gastroesophagopathy. It is characterized by inflammation, erosion, ulcer formation and fibrosis of the esophageal mucous membrane due to reflux of the content of th...Reflux esophagitis falls into the category of reflux gastroesophagopathy. It is characterized by inflammation, erosion, ulcer formation and fibrosis of the esophageal mucous membrane due to reflux of the content of the stomach and duodenum into the esophagus.展开更多
The incidence of GERD in Asian countries is relatively different compare to Western world. In Japan, heartburn affects approximately 2% of the population, and in another population based study, about 20% of the age gr...The incidence of GERD in Asian countries is relatively different compare to Western world. In Japan, heartburn affects approximately 2% of the population, and in another population based study, about 20% of the age group over the age of 40 years are reported to have heartburn on the daily bases eventhogh only in mild form. Recent data from USA showed the prevalence of weekly heartburn being 18% and prevalence of any heartburn within the last year being 42%. It seems that the prevalence increase with age and a wide geographic variation with the highest orevalence in Western countries.展开更多
9804895 SUL 的逆流性食道炎的临床第Ⅲ相试验[日]/杉町圭藏//临床と研究.-1996,73(10).-197～206 友谊医9804896 内镜下结扎和硬化注射疗法联合治疗食管静脉曲张/Urita Y//Gastroin-test Endosc.-1996,43(2 part 1).-140～143 湘医图98...9804895 SUL 的逆流性食道炎的临床第Ⅲ相试验[日]/杉町圭藏//临床と研究.-1996,73(10).-197～206 友谊医9804896 内镜下结扎和硬化注射疗法联合治疗食管静脉曲张/Urita Y//Gastroin-test Endosc.-1996,43(2 part 1).-140～143 湘医图9804897 钡餐 X 线检查与食管 PH 监测诊断胃食管返流病的比较/Johnston B T//Am J Gastroenterol.-1996,91(6),-1181～1185展开更多
文摘In recent years, many parameters associated with GERD are studied sum as number of reflux lasting more than five minutes (NRs), number of reflux and the longest time of reflux in 24 hours continuous introesophageal pH monitoring. It is considered that NR is the best one. Thus, both the effect of NR and the relationship with acid secretion level are deserved attention. 20 patients with reflux esophagitis and 10 healthy subject (HS group) have been studied for the changs of NRs and the longest time of reflux using 24 h continuous introesophageal pH monitoring.
文摘Barrett's oesophagus is a metaplastic condition in which the squamous epithelium of the oesophagus is replaced by specialised intestinal metaplasia. Barrett's oesophagus occurs in about 10% of patients with gastrooesophageal reflux disease (GORD) and predisposes to dysplasia and adenocarcinoma. It has been estimated that the risk of developing an adenocarcinoma of the oesophagus and gastric cardia is increased 30-125 fold.
文摘Most vertebrates have spiral bacteria that have adapted to persist in the mucus layer of the gastric mucosa. Similarly, in underdeveloped societies, most humans acquire Helicobacter pylori in childhood, and this infection persists for the person's lifetime, unless the mucosa develops atrophic gastritis. In the developed world, major changes have occurred in the prevalence of H.pylori over the past 50-100 years: the elderly population mostly has the bacterium, but very few children or young adults are infected. These changes in prevalence of H. pylori mean that the developed world is moving from peptic ulcer disease towards reflux oesophagitis.
文摘AIM: To value whether omeprazole could induce the healing of DIS and regression of symptoms in patients with DGER. METHODS: We enrolled 15 symptomatic patients with a pathological esophageal 24-h pH-metry and bilimetry. Patients underwent endoscopy and biopsies were taken from the distal esophagus. Specimens were analyzed at histology and transmission electron microscopy (TEM). Patients were treated with omeprazole 40 mg/d for 3 mo and then endoscopy with biopsies was repeated. Patients with persistent heartburn and/or with an incomplete recovery of DIS were treated for 3 more months and endoscopy with biopsies was performed. RESULTS: Nine patients had a non-erosive reflux disease at endoscopy (NERD) while 6 had erosive esophagitis (ERD). At histology, of the 6 patients with erosive esophagitis, 5 had mild esophagitis and 1 moderate esophagitis. No patients with NERD showed histological signs of esophagitis. After 3 mo of therapy, 13/15 patients (86.7%,P<0.01) showed a complete recovery of DIS and disappearance of heartburn. Of the 2 patients treated for 3 more months, complete recovery of DIS and heartburn were achieved in one. CONCLUSION: Three or 6 mo of omeprazole therapy led to a complete regression of the ultrastructural esophageal damage in 86.7% and in 93% of patients with DGER, NERD and ERD respectively. The ultrastructural recovery of the epithelium was accompanied by regression of heartburn in all cases.
基金Supported by Ministry of Health Clinical Subject Key Project, No. 20012130
文摘AIM: To investigate the difference of gene expression profiles between Barrett's esophagus and reflux esophagitis induced by gastroduodenoesophageal reflux in rats.METHODS: Eight-week-old Sprague-Dawley rats were treated esophagoduodenostomy to produce gastroduodenoesophageal reflux, and another group received sham operation as control. Esophageal epithelial tissues were dissected and frozen in liquid nitrogen immediately for pathology 40 wk after surgery. The expression profiles of 4 096 genes in reflux esophagitis and Barrett's esophagus tissues were compared with normal esophageal epithelium by cDNA microarray.RESULTS: Four hundred and forty-eight genes in Barrett'sesophagus were more than three times different from those in normal esophageal epithelium, including 312 up regulated and 136 down-regulated genes. Two hundred and thirty-twogenes in RE were more than three times different from those in normal esophageal epithelium, 90up-regulated and 142 down-regulated genes. Compared to reflux esophagitis, there were 214 up-regulated and 142 down-regulated genes in Barrett's esophagus. CONCLUSION: Esophageal epithelium exposed excessively to harmful ingredients of duodenal and gastric reflux can develop esophagitis and Barrett's esophagus gradually.The gene expression level is different between reflux esophagitis and Barrett's esophagus and the differentially expressed genes might be related to the occurrence and development of Barrett's esophagus and the promotion or progression in adenocarcinoma.
基金Supported by the grant FIS 99/0569 from the Fondo de Investigaciones Sanitarias and Instituto de Salud Carlos Ⅲ (C03/02)
文摘AIM: Experimental studies suggest that free radicals are involved in acid and pepsin-induced damage of esophageal mucosa. The profile and balance between free radicals and antioxidant systems in human esophagitis are unknown. METHODS: Superoxide anion and its powerful oxidant reaction with nitric oxide (peroxynitrite) generation were determined in esophageal mucosal biopsies from 101 patients with different gastro-esophageal reflux diseases and 28 controls. Activity of both superoxide dismutase (SOD) and catalase, and reduced glutathione (GSH) levels, were also assessed. Expression of Cu,ZnSOD, MnSOD and tyrosine-nitrated MnSOD were analyzed by Western blot and/or immunohistochemistry. RESULTS: The highest levels of superoxide anion generation were found in patients with severe lesions of esophagitis. Peroxynitrite generation was intense in Barrett's biopsies, weaker in esophagitis and absent/weak in normal mucosa. Expression of Cu,ZnSOD and MnSOD isoforms were present in normal mucosa and increased according to the severity of the lesion, reaching the highest level in Barrett's esophagus. However, SOD mucosal activity significantly decreased in patients with esophagitis and Barrett's esophagus, which was, at least in part, due to nitration of its tyrosine residues. Catalase activity and GSH levels were significantly increased in mucosal specimens from patients with esophagitis and/or Barrett's esophagus. CONCLUSION: A decrease in SOD antioxidant activity leading to increased mucosal levels of superoxide anion and peroxynitrite radicals may contribute to the development of esophageal damage and Barrett's esophagus in patients with gastroesophageal reflux. Administration of SOD may be a therapeutic target in the treatment of patients with esophagitis and Barrett's esophagus.
文摘Reflux esophagitis falls into the category of reflux gastroesophagopathy. It is characterized by inflammation, erosion, ulcer formation and fibrosis of the esophageal mucous membrane due to reflux of the content of the stomach and duodenum into the esophagus.
文摘The incidence of GERD in Asian countries is relatively different compare to Western world. In Japan, heartburn affects approximately 2% of the population, and in another population based study, about 20% of the age group over the age of 40 years are reported to have heartburn on the daily bases eventhogh only in mild form. Recent data from USA showed the prevalence of weekly heartburn being 18% and prevalence of any heartburn within the last year being 42%. It seems that the prevalence increase with age and a wide geographic variation with the highest orevalence in Western countries.
文摘9804895 SUL 的逆流性食道炎的临床第Ⅲ相试验[日]/杉町圭藏//临床と研究.-1996,73(10).-197～206 友谊医9804896 内镜下结扎和硬化注射疗法联合治疗食管静脉曲张/Urita Y//Gastroin-test Endosc.-1996,43(2 part 1).-140～143 湘医图9804897 钡餐 X 线检查与食管 PH 监测诊断胃食管返流病的比较/Johnston B T//Am J Gastroenterol.-1996,91(6),-1181～1185
