• Title/Summary/Keyword: Barrett

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Evidence for Enhanced Telomerase Activity in Barrett's Esophagus with Dysplasia and Adenocarcinoma

  • Merchant, Nipun B.;Dutta, Sudhir K.;Girotra, Mohit;Arora, Manish;Meltzer, Stephen J.
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.2
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    • pp.679-683
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    • 2013
  • Background: Dysplasia and adenocarcinoma developing in Barrett's esophagus (BE) are not always endoscopically identifiable. Molecular markers are needed for early recognition of these focal lesions and to identify patients at increased risk of developing adenocarcinoma. The aim of the current study was to correlate increased telomerase activity (TA) with dysplasia and adenocarcinoma occurring in the setting of BE. Materials and Methods: Esophageal mucosal biopsies were obtained from patients (N=62) who had pathologically verified BE at esophagogastroduodenoscopy (EGD). Mucosal biopsies were also obtained from the gastric fundus as controls. Based on histopathology, patients were divided into three groups: 1) BE without dysplasia (n=24); 2) BE with dysplasia (both high grade and low grade, n=13); and 3) BE with adenocarcinoma (n=25). TA was measured by a PCR-based assay (TRAPeze$^{(R)}$ ELISA Telomerase Detection Kit). Statistical analyses were performed using one-way ANOVA and post-hoc Bonferroni testing. Results: TA was significantly higher in biopsies of BE with dyplasia and BE with adenocarcinoma than in BE without dysplasia. Subgroup analyses did not reveal any significant correlations between TA and patient age, length of BE, or presence of gastritis. Conclusions: Telomerase activity in esophageal mucosal biopsies of BE may constitute a useful biomarker for the early detection of esophageal dysplasia and adenocarcinoma.

Bile acid sequestrants in poor healing after endoscopic therapy of Barrett's esophagus

  • Lukas Welsch;Andrea May;Tobias Blasberg;Jens Wetzka;Elisa Muller;Myriam Heilani;Mireen Friedrich-Rust;Mate Knabe
    • Clinical Endoscopy
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    • v.56 no.2
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    • pp.194-202
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    • 2023
  • Background/Aims: Endoscopic therapy for neoplastic Barrett's esophagus (BE) has become the standard of care over the past two decades. In clinical practice, we regularly encounter patients who fail to achieve complete squamous epithelialization of the esophagus. Although the therapeutic strategies in the individual stages of BE, dysplasia, and esophageal adenocarcinoma are well studied and largely standardized, the problem of inadequate healing after endoscopic therapy is only marginally considered. This study aimed to shed light on the variables influencing inadequate wound healing after endoscopic therapy and the effect of bile acid sequestrants (BAS) on healing. Methods: Retrospective analysis of endoscopically treated neoplastic BE in a single referral center. Results: In 12.1% out of 627 patients, insufficient healing was present 8 to 12 weeks after previous endoscopic therapy. The average follow-up duration was 38.8±18.4 months. Complete healing was achieved in 13 patients already after intensifying proton pump inhibitor therapy. Out of 48 patients under BAS, 29 patients (60.4%) showed complete healing. An additional eight patients (16.7%) improved, but only partial healing was achieved. Eleven (22.9%) patients showed no response to BAS augmented therapy. Conclusions: In cases of insufficient healing even under exhaustion of proton pump inhibitors, treatment with BAS can be an option as an ultimate healing attempt.

(De)Colonizing Literary Digital Annotating: A Student's Experience in the Classroom

  • Koo, Yeonwoo
    • International Journal of Advanced Culture Technology
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    • v.7 no.4
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    • pp.194-207
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    • 2019
  • This paper is the author's personal experience and interpretation as a student whilst participating in Professor Kyung-Sook Shin's English Literature graduate course, "Literature and Technology II: Feminisms and Digital Humanities," during the 2019 spring semester at Yonsei University, South Korea. Exploring the intersections of literary feminist theory and digital humanities, this paper examines not only the content, but also the methodology and political effects of collaboratively digitally annotating Elizabeth Barrett Browning's epic novel/poem, Aurora Leigh (1856) through the medium, Google Docs. In particular, this paper observes the students' interaction with the digital tools and literature-related pedagogy in two main parts. First, the democratic political nature of classroom culture when creating a new language/code during annotation. Second, the coexistence of cyberspace and the physical classroom space and its effect on time, specifically in the archival of the past, influencing of the future, and the splitting into the present multiverse. From a student's perspective in digital literary annotation, this paper shows that technology could become a way to decolonize and reprogram education to be more inclusive and collaborative.

Chemoprevention of Barrett's Esophagus (바렛식도의 화학예방)

  • Kyung Ho Song
    • Journal of Digestive Cancer Research
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    • v.11 no.1
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    • pp.9-14
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    • 2023
  • The prevalence of Barrett's esophagus is increasing in South Korea. Several strategies have been tried to prevent its progression to esophageal adenocarcinoma. It is questionable whether the strategies being tried in the West can be applied adequately in South Korea. However, despite the incidence of esophageal adenocarcinoma in the West, which is considerably higher than that in South Korea, the incidence of high-grade dysplasia/esophageal adenocarcinoma in population-based studies is as low as 0.23%/person-year. Therefore, in Korea, where the prevalence is lower than that, it is necessary to select high-risk groups more carefully for chemoprevention. The age of onset of gastroesophageal reflux disease-like symptoms at least once a week is related to the high-risk group rather than the presence or absence of chronic gastroesophageal reflux symptoms. The risk factors for esophageal adenocarcinoma include the patient's sex, age, smoking habit, and obesity. Proton pump inhibitors have a better preventive effect against esophageal adenocarcinoma compared to H2-receptor blockers, but their application to patients in Korea is limited due to the high number of individuals in need of treatment. Therefore, while considering the risk factors for the progression of esophageal adenocarcinoma, the administration of proton pump inhibitors should be considered for gastroesophageal reflux disease.

Cryotherapy versus radiofrequency ablation in the treatment of dysplastic Barrett's esophagus with or without early esophageal neoplasia: a systematic review and meta-analysis

  • Igor Logetto Caetite Gomes;Diogo Turiani Hourneaux de Moura;Igor Braga Ribeiro;Sergio Barbosa Marques;Alexandre de Sousa Carlos;Beanie Conceicao Medeiros Nunes;Bruno Salomao Hirsch;Guilherme Henrique Peixoto de Oliveira;Roberto Paolo Trasolini;Wanderley Marques Bernardo;Eduardo Guimaraes Hourneaux de Moura
    • Clinical Endoscopy
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    • v.57 no.2
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    • pp.181-190
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    • 2024
  • Background/Aims: Radiofrequency ablation (RFA) is the first-line therapy for dysplastic Barrett's esophagus (BE). Therefore, cryotherapy has emerged as an alternative treatment option. This study aimed to compare the efficacies of these two techniques based on the rates of complete eradication of intestinal metaplasia (CE-IM) and dysplasia (CE-D). Adverse events and recurrence have also been reported. Methods: An electronic search was conducted using the Medline (PubMed), Embase, LILACS, and Google Scholar databases until December 2022. Studies were included comparing cryotherapy and RFA for treating dysplastic BE with or without early esophageal neoplasia. This study was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: Three retrospective cohort studies involving 627 patients were included. Of these, 399 patients underwent RFA, and 228 were treated with cryotherapy. There was no difference in CE-IM (risk difference [RD], -0.03; 95% confidence interval [CI], -0.25 to 0.19; p=0.78; I2=86%) as well as in CE-D (RD, -0.03; 95% CI, -0.15 to 0.09; p=0.64; I2=70%) between the groups. The absolute number of adverse events was low, and there was no difference in the recurrence rate. Conclusions: Cryotherapy and RFA were equally effective in treating dysplastic BE, with or without early esophageal neoplasia.

Role of linked color imaging for upper gastrointestinal disease: present and future

  • Sang Pyo Lee
    • Clinical Endoscopy
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    • v.56 no.5
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    • pp.546-552
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    • 2023
  • Techniques for upper gastrointestinal endoscopy are advancing to facilitate lesion detection and improve prognosis. However, most early tumors in the upper gastrointestinal tract exhibit subtle color changes or morphological features that are difficult to detect using white light imaging. Linked color imaging (LCI) has been developed to overcome these shortcomings; it expands or reduces color information to clarify color differences, thereby facilitating the detection and observation of lesions. This article summarizes the characteristics of LCI and advances in LCI-related research in the upper gastrointestinal tract field.