Abstract：
:Barrett's esophagus, currently defined as endoscopically apparent columnar metaplasia of the esophagus with histologic documentation of goblet cells, is the precursor to esophageal adenocarcinoma. However, not all patients with this disorder require intensive surveillance. Pathologic diagnosis and grading of dysplasia in mucosal biopsies remains the best and most widely used method of determining which patients are at highest risk for neoplastic progression. The task of diagnosing dysplasia suffers from considerable interobserver variability. Therefore, consultation with expert gastrointestinal pathologists to confirm the diagnosis of dysplasia before definitive management is highly advisable. Adjunctive methods to improve reproducibility, such as immunostaining for alpha-methylacyl-CoA racemase, show promise but require confirmation in larger studies. This article focuses on dysplasia in Barrett's esophagus in terms of its classification, pathologic diagnostic criteria, limitations, natural history, and treatment.
journal_name
Gastroenterol Clin North Amjournal_title
Gastroenterology clinics of North Americaauthors
Hornick JL,Odze RDdoi
10.1016/j.gtc.2007.08.004subject
Has Abstractpub_date
2007-12-01 00:00:00pages
775-96, vissue
4eissn
0889-8553issn
1558-1942pii
S0889-8553(07)00079-9journal_volume
36pub_type
杂志文章,评审abstract：:In most patients presenting with acute pancreatitis, the cause can be established on the basis of initial history, physical examination, laboratory studies, and abdominal sonography. Patients with unexplained pancreatitis at that point are often considered to have idiopathic disease. However, a cause and, often, effec...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1990-12-01 00:00:00
abstract：:Biotherapeutic agents offer unique advantages over traditional treatments for infectious diarrhea, and several have been shown to be effective (Table 4). These therapeutic microbial agents are most effective in types of infectious diseases that are associated with a disruption of the normal intestinal microecology (e....
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8553(05)70213-2
更新日期：2001-09-01 00:00:00
abstract：:Gastric cancers are a histologically heterogenous group of neoplasms arising from unique epidemiologic and molecular backgrounds. There is accumulating evidence that the intestinal type of gastric adenocarcinoma develops through a multistep process beginning with chronic gastritis triggered primarily by Helicobacter p...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2013.01.004
更新日期：2013-06-01 00:00:00
abstract：:Since the initial discovery of H. pylori by Marshall and Warren 17 years ago, much progress has been made in treating this infection. However, as we enter the millennium, H. pylori infection continues to be one of the most common infections of mankind. In addition, eradication of H. pylori still requires multiple anti...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8553(05)70137-0
更新日期：2000-09-01 00:00:00
abstract：:Corticosteroids are a nonspecific immune modulator used in the treatment of ulcerative colitis. Topical and systemic forms of corticosteroids have been shown to be effective in induction of clinical remission and remain first-line therapy for acute severe ulcerative colitis. A large proportion of patients experience a...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2020.08.001
更新日期：2020-12-01 00:00:00
abstract：:Radiation therapy (RT) has been used to treat cancers for more than a century. Recent randomized trials have helped clarify the treatment recommendations in the use of RT for colorectal cancers. This article reviews these trials to illustrate key concepts, places these trials in perspective, and provides direction for...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2007.12.010
更新日期：2008-03-01 00:00:00
abstract：:Esophageal adenocarcinoma (EAC) has increased dramatically in the past 3 decades, making its precursor lesion Barrett's esophagus (BE) an important clinical problem. Effective interventions are available, but overall outcomes remain unchanged. Most of the BE population remains undiagnosed; most EACs are diagnosed late...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2015.02.008
更新日期：2015-06-01 00:00:00
abstract：:Gastroparesis is a heterogeneous disorder defined by delay in gastric emptying. Symptoms of gastroparesis are nonspecific, including nausea, vomiting, early satiety, bloating, and/or abdominal pain. Normal gastric motor function and sensory function depend on a complex coordination between the enteric and central nerv...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2014.11.003
更新日期：2015-03-01 00:00:00
abstract：:Diverticulitis represents a spectrum of clinical entities ranging from minimal pericolitis in the adjacent mesentery to uncontrolled intra-abdominal sepsis and septic shock. The presentation most often described is left lower quadrant abdominal pain, fever, chills, and left lower quadrant tenderness associated with a ...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1988-06-01 00:00:00
abstract：:Several hepatobiliary diseases appear to be mediated by the host immune response. They can be subdivided into those in which the immune reaction is against an infectious agent such as hepatitis viruses, those in which the immune reaction appears to be against an autoantigen expressed on hepatobiliary cells, and those ...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1992-06-01 00:00:00
abstract：:Living donor intestinal transplantation (LDIT) has been improved leading to results comparable to those obtained with deceased donors. LDIT should be limited to specific indications and patient selection. The best indication is combined living donor intestinal/liver transplantation in pediatric recipients with intesti...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2018.01.008
更新日期：2018-06-01 00:00:00
abstract：:Treatment with a combination of radiation therapy and chemotherapy currently allows about 80 per cent of patients with epidermoid carcinomas of the anal canal to retain anorectal function, with about a 70 per cent likelihood of cure at 5 years. In these programs, radical surgery is reserved for the management of resid...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1987-03-01 00:00:00
abstract：:Hepatic injury due to chemicals or natural toxins may occur from occupational, household, or environmental exposure. The liver may dominate the syndrome of toxicity from such agents as carbon tetrachloride, poison mushrooms, and toxic alkaloids, or may be only one facet of more generalized toxicity. The entire histolo...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1995-12-01 00:00:00
abstract：:In conclusion, the availability of liver transplantation has dramatically advanced the management of fulminant hepatic failure. A major responsibility of the gastroenterologist/hepatologist involved in the care of patients with liver failure is early decision making regarding likelihood of spontaneous recovery and con...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1993-06-01 00:00:00
abstract：:Autoimmune pancreatitis (AIP) is steroid-responsive fibroinflammatory disorder of the pancreas. There are 2 distinct subtypes of AIP, types 1 and 2. Type 1 is associated with systemic immunoglobulin (Ig)G4 disease and may affect multiple organs in the body. Type 2 is confined to the pancreas and shows an association w...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2018.04.007
更新日期：2018-09-01 00:00:00
abstract：:Although significant strides have been made in the surgical technique of orthotopic liver transplantation, numerous problems and nuisances are still encountered. Further surgical refinements will certainly evolve. The development of better preservation techniques, the use of intraoperative flowmeters, and the availabi...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章
doi：
更新日期：1988-03-01 00:00:00
abstract：:Upper gastrointestinal bleeding (UGIB) is the most common emergency condition in gastroenterology. Although peptic ulcer and esophagogastric varices are the predominant causes, other conditions account for up to 50% of UGIBs. These conditions, among others, include angiodysplasia, Dieulafoy and Mallory-Weiss lesions, ...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2014.08.004
更新日期：2014-12-01 00:00:00
abstract：:Hepatocellular carcinomas can be further divided into distinct subtypes that provide important clinical information and biological insights. These subtypes are distinct from growth patterns and are on based on morphologic and molecular findings. There are 12 reasonably well-defined subtypes as well as 6 provisional su...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2017.01.009
更新日期：2017-06-01 00:00:00
abstract：:Many disorders of the gastrointestinal tract have cutaneous manifestations. Thus, a careful examination of the skin may uncover clues to underlying diseases of the liver, gastrointestinal tract, and pancreas. This article explores the alimentary-cutaneous relationship. ...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8553(05)70023-6
更新日期：1998-09-01 00:00:00
abstract：:Biologics are a primary focus for research and development of new treatments for IBD and other immune disorders. CDER, which is a branch of the FDA, oversees most of the biologics that are being used or tested for IBD, and it regulates nonbiologic medications for IBD. The approval process for most biologics for IBD is...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2006.09.010
更新日期：2006-12-01 00:00:00
abstract：:Chronic pelvic pain is pain lasting longer than 6 months and is estimated to occur in 15% of women. Causes of pelvic pain include disorders of gynecologic, urologic, gastroenterologic, and musculoskeletal systems. The multidisciplinary nature of chronic pelvic pain may complicate diagnosis and treatment. Treatments va...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2013.08.005
更新日期：2013-12-01 00:00:00
abstract：:The cellular and molecular understanding of human gastroparesis has markedly improved due to studies on full-thickness gastric biopsies. A decrease in the number of interstitial cells of Cajal (ICC) and functional changes in ICC constitutes the hallmark cellular feature of gastroparesis. More recently, in animal model...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2020.04.009
更新日期：2020-09-01 00:00:00
abstract：:Fecal incontinence affects up to 20% of community-dwelling adults and more than 50% of nursing home residents, and is one of the major risk factors for elderly persons in the nursing home. Institutionalization itself is a risk factor (eg, immobility due to physical restraints). Management should focus on identifying a...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2009.06.007
更新日期：2009-09-01 00:00:00
abstract：:The heterogeneous group of proteinases known as pepsinogens are synthesized, stored, and upon appropriate stimulation released from gastric mucosal chief cells. Under the acidic conditions of the lumen of the stomach, the proenzymes, pepsinogens, are converted to "pepsin", which plays an important physiologic role as ...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1990-03-01 00:00:00
abstract：:Inborn errors of metabolism (IEMs) are usually recognized by characteristic neurologic and metabolic manifestations and sometimes by dysmorphism. However, IEMs can present with a wide variety of gastrointestinal manifestations, whether as the primary or a minor clinical symptom. Regardless, gastrointestinal and hepati...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2019.02.001
更新日期：2019-06-01 00:00:00
abstract：:This article reviews the role of therapeutic endoscopy in the diagnosis and treatment of nonvariceal upper and lower gastrointestinal (GI) hemorrhage. The initial approach to patients with GI bleeding is reviewed. Endoscopic treatment of various stigmata of recent peptic ulcer hemorrhage is discussed in detail. Manage...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0889-8553(05)70123-0
更新日期：2000-06-01 00:00:00
abstract：:Pediatric pancreatitis is an emerging field with an increasing incidence of disease. Management of pediatric pancreatitis is understudied and, therefore, extrapolated from adult studies (although the etiologies are different). There is evidence that feeding is safe in mild acute pancreatitis in children without increa...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2018.07.003
更新日期：2018-12-01 00:00:00
abstract：:Colorectal cancer (CRC) develops from a dysplastic precursor lesion, regardless of whether it arises sporadically, in the setting of high-risk hereditary conditions, or in the context of chronic inflammation like inflammatory bowel disease (IBD). This review focuses on the molecular alterations associated with CRC pat...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2006.07.002
更新日期：2006-09-01 00:00:00
abstract：:Foreign body ingestion is a common occurrence in children and in specific high-risk groups of adults such as those with underlying esophageal disease, prisoners, the mentally retarded, and those with psychiatric illnesses. Although most foreign bodies pass through the gastrointestinal tract without difficulty, sharp, ...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1991-12-01 00:00:00
abstract：:Choosing NSAID therapy remains confusing and controversial-the challenge for the clinician is to sum all the risks as well as analgesic and anti-inflammatory efficacy. COX-2 inhibitors are an important scientific advance in pain therapy, and using them in a safe and cost-effective manner is possible when all the compe...
journal_title：Gastroenterology clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.gtc.2009.03.006
更新日期：2009-06-01 00:00:00
