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International benchmarking in oesophageal and gastric cancer surgery

Background: Benchmarking on an international level might lead to improved outcomes at a national level. The aim of this study was to compare treatment and surgical outcome data from the Swedish National Register for Oesophageal and Gastric Cancer (NREV) and the Dutch Upper Gastrointestinal Cancer Audit (DUCA).Methods: All patients with primary oesophageal or gastric cancer who underwent a resectio

A new vessel segmentation algorithm for robust blood flow quantification from two-dimensional phase-contrast magnetic resonance images

Blood flow measurements in the ascending aorta and pulmonary artery from phase-contrast magnetic resonance images require accurate time-resolved vessel segmentation over the cardiac cycle. Current semi-automatic segmentation methods often involve time consuming manual correction, relying on user experience for accurate results. The purpose of this study was to develop a semi-automatic vessel segme

Telomerase reverse transcriptase expression is increased early in the Barrett's metaplasia, dysplasia, adenocarcinoma sequence

Barrett's esophagus is a multistage polyclonal disease that is associated with the development of adenocarcinoma of the esophagus and esophagogastric junction. Telomerase activation is associated with cellular immortality and carcinogenesis, and increased expression of the telomerase reverse transcriptase catalytic subunit (hTERT) has been used for the early detection of malignant diseases. To ide

Suppression of gastric acid secretion in patients with gastroesophageal reflux disease results in gastric bacterial overgrowth and deconjugation of bile acids

The aim of this study was to test the hypothesis that gastric bacterial overgrowth is a side effect of acid suppression therapy in patients with gastroesophageal reflux disease (GERD) and that the bacteria-contaminated gastric milieu is responsible for an increased amount of deconjugated bile acids. Thirty patients with GERD who were treated with 40 mg of omeprazole for at least 3 months and 10 pa

Cardiac mucosa in the remnant esophagus after esophagectomy is an acquired epithelium with Barrett's-like features

BACKGROUND: The cervical esophagus is normally lined by squamous epithelium and is usually not exposed to gastroesophageal reflux. The aims of this study were, first, to investigate whether cardiac mucosa can be acquired in the remnant cervical esophagus after esophagectomy and cervical esophagogastrostomy and, second, to characterize this mucosa if present.METHODS: The medical records of 100 pati

Risk factors and the prevalence of trocar site herniation after laparoscopic fundoplication

BACKGROUND: Although there have been case reports describing trocar site herniation after laparoscopic fundoplication, its overall prevalence and the risk factors for its development are unclear.METHODS: The records of 320 patients undergoing primary laparoscopic fundoplication as treatment for gastroesophageal reflex disease (GERD) or hiatal hernia between 1991 and 1999 were reviewed retrospectiv

Outcome 5 years after 360 degree fundoplication for gastro-oesophageal reflux disease

Forty patients with a mean age of 45 (range 22-65) years were operated on between 1982 and 1985 for gastro-oesophageal reflux disease with a short floppy 360 degree fundoplication. The results of the operation were determined by endoscopy, oesophageal manometry, ambulatory 24-h pH recording and symptom evaluation 6 months and 5 years after operation. These results were compared with findings in he

Adenocarcinoma in the distal esophagus with and without Barrett esophagus. Differences in symptoms and survival rates

OBJECTIVE: To evaluate differences in clinical appearance and survival rates in patients operated on for adenocarcinoma in the distal esophagus with and without Barrett epithelium.DESIGN: Prospective clinical study.SETTING: University hospital, Sweden.PATIENTS: Fifty-four patients with adenocarcinoma in the distal esophagus with (n = 17) or without (n = 37) Barrett epithelium.INTERVENTION: Esophag

Radioisotope evaluation of the esophageal remnant and the gastric conduit after gastric pull-up esophagectomy

BACKGROUND: The act of swallowing after gastric pull-up esophagectomy has not been thoroughly investigated. The aim of this study was to evaluate deglutition in the esophageal remnant and in the gastric conduit in patients who have undergone this operation.METHODS: The residual radionuclide activity was measured 15 seconds after a swallow in the esophageal remnant and at intervals up to a maximum

Pharyngeal reflux after gastric pull-up esophagectomy with neck and chest anastomoses

OBJECTIVE: Pharyngeal reflux after a gastric pull-up esophagectomy may cause aspiration. This study evaluates acid exposure to the esophageal remnant and to the pharynx after gastric pull-up esophagectomy and evaluates the impact of additional dissection of the esophagus that is necessary for neck anastomoses versus no neck exploration and proximal chest anastomoses.METHODS: Forty-seven patients h

Screening for oesophageal adenocarcinoma : an evaluation of a surveillance program for columnar metaplasia of the oesophagus

BACKGROUND: Screening patients with columnar metaplasia of the oesophagus for adenocarcinoma is controversial owing to the low cancer incidence and diverging opinions as to whether screening improves the prognosis of these patients. Our aim was to evaluate a screening program for adenocarcinoma in patients with columnar metaplasia in the oesophagus, with focus on cancer incidence and costs.METHODS

Clinical outcome and long-term survival rates after esophagectomy are not determined by age over 70 years

Esophagectomy is considered a high-risk procedure in patients aged 70 years or older. This study evaluates the impact of two age groups (younger than 70 and 70 years or older) on clinical outcome and long-term survival rates following this procedure. This prospective study included survival analysis and clinical evaluations at 3, 6, and 12 months after esophagectomy. All esophagectomy patients und

Anastomotic diameters and strictures following esophagectomy and total gastrectomy in 256 patients

The prevalence of anastomotic strictures in esophageal anastomoses provides us with limited information about the anastomotic healing process. This prospective study evaluates the exact esophageal anastomotic diameters in 256 patients who underwent esophagectomy and esophagogastrostomy without pyloroplasty (n = 107) or total gastrectomy and Roux reconstruction (n = 149). No perioperative chemoradi

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This article examines the legal scope and pressing issues of applying the privileges and immunities of the representations of states to international organizations. The content of the privileges and immunities of state’s representations is analyzed. The pressing issues of the application of privileges and immunities of representations of states to international organizations are deliberated, and a

Oral administration of magnesium hydroxide to subjects with insulin dependent diabetes mellitus. Effects on magbesium and potassium levels and on insulin requirements

Intra- and extracellular levels of magnesium and potassium were determined in 16 subjects with insulin-dependent type I diabetes mellitus (IDDM) and 30 healthy controls. Subjects with IDDM had lower levels of magnesium in muscle biopsies (p less than 0.001), plasma (p less than 0.001), and mononuclear cells (p less than 0.05), and higher urinary excretions of magnesium (p less than 0.01), and lowe