Abstract:
BACKGROUND AND AIMS:Current methods to diagnose malignant biliary strictures are of low sensitivity. Confocal endomicroscopy is a new approach that may improve the diagnosis of indeterminate biliary strictures. The purpose of this study was to evaluate indeterminate biliary strictures using probe-based confocal laser endomicroscopy and to understand the histologic basis for the confocal images. METHODS:Fourteen patients with indeterminate biliary strictures underwent endoscopic retrograde cholangiopancreatography with examination of their common bile duct with fluorescein-aided probe-based confocal laser endomicroscopy. Standard brushings and biopsies were performed. In parallel, rat bile ducts were examined either with conventional staining and light microscopy or with multiphoton microscopy. RESULTS:Earlier published criteria were used to evaluate possible malignancy in the confocal images obtained in the 14 patients. None of the individual criteria were found to be specific enough for malignancy, but a normal-appearing reticular pattern without other putative markers of malignancy was observed in all normal patients. Multiphoton reconstructions of intact rat bile ducts revealed that the reticular pattern seen in normal tissue was in the same focal plane but was smaller than blood vessels. Special stains identified the smaller structures in this network as lymphatics. CONCLUSIONS:Our limited series suggests that a negative confocal imaging study of the biliary tree can be used to rule out carcinoma, but there are frequent false positives using individual earlier published criteria. An abnormal reticular network, which may reflect changes in lymphatics, was never seen in benign strictures. Better correlation with known histologic structures may lead to improved accuracy of diagnoses.
journal_name
J Clin Gastroenteroljournal_title
Journal of clinical gastroenterologyauthors
Loeser CS,Robert ME,Mennone A,Nathanson MH,Jamidar Pdoi
10.1097/MCG.0b013e3181fbdc38subject
Has Abstractpub_date
2011-03-01 00:00:00pages
246-52issue
3eissn
0192-0790issn
1539-2031journal_volume
45pub_type
杂志文章abstract:GOALS:Our aim was to study the prevalence of dysplasia and progression to high-grade dysplasia (HGD) and esophageal adenocarcinoma (EAC) in African Americans (AA) with Barrett's esophagus (BE) and compare it with that of non-Hispanic white (NHW) controls. BACKGROUND:BE, a precursor of EAC, is a disease of predominantl...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000000559
更新日期:2017-05-01 00:00:00
abstract::Many lines of research have established a relationship between the gut microbiome and patients with liver disease. For example, patients with cirrhosis have increased bacteremia, increased blood levels of lipopolysaccharide, and increased intestinal permeability. Patients with cirrhosis have bacterial overgrowth in th...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000000391
更新日期:2015-11-01 00:00:00
abstract:GOALS:To compare the healthcare resource consumption of patients who have irritable bowel syndrome (IBS) with an age-, gender-, and comorbidity-matched cohort of patients without IBS from a managed care perspective. STUDY:Retrospective cohort analysis. Data were obtained electronically through the Henry Ford Health Sy...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200207000-00005
更新日期:2002-07-01 00:00:00
abstract::We describe, to our knowledge, the first reported case of nortriptyline-induced fulminant hepatic failure. This tricyclic antidepressant drug was taken by a postmenopausal woman for 64 days before her presentation. The absence of fever, rash, or marked eosinophilia, the predominant zone 3 necrosis with bridging, and t...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199501000-00014
更新日期:1995-01-01 00:00:00
abstract::Duodenal neoplasms are a rare and not often considered cause of massive upper gastrointestinal bleeding. During a 4-year period, 859 endoscopies in patients with upper gastrointestinal bleeding revealed a duodenal tumor to be the cause of bleeding in eight patients. Three patients had a primary duodenal neoplasm, two ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198202000-00006
更新日期:1982-02-01 00:00:00
abstract::Pneumocystis carinii infection of the liver is being reported with increasing frequency in patients with acquired immune deficiency syndrome (AIDS). The clinical picture typically resembles hepatitis. We report such an occurrence in a patient with persistent elevation of alkaline phosphatase and gamma-glutamyl transpe...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-199207000-00013
更新日期:1992-07-01 00:00:00
abstract::We have seen three patients with acute ulcerative colitis after hydrogen peroxide enemas. The colitis is probably the result of the explosive entrance of gas into the loose connective tissues of the mucosa and submucosa of the rectum and sigmoid. Fortunately, it is transitory in nature, but it should be distinguished ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198103000-00008
更新日期:1981-03-01 00:00:00
abstract::The aim of this paper (presented in Rome, Italy, at the 2nd Congress of Probiotics, Prebiotics, and New Food, September 7-9, 2003) was to provide an objective view of the regulatory trends at the European level specifically referring to probiotics, because until now they have never been directly mentioned nor official...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/01.mcg.0000128733.79515.c4
更新日期:2004-07-01 00:00:00
abstract::We describe a patient who presented with mechanical obstruction of the small bowel secondary to impaction of the ileocecal valve from a gallstone. The stone impaction of the ileocecal valve was confirmed by colonoscopy. Although the stone was disimpacted, it could not be trapped and extracted during colonoscopy. There...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200004000-00027
更新日期:2000-04-01 00:00:00
abstract:BACKGROUND:The aims of this study were to analyze the overall survival of patients with cirrhosis and small hepatocellular carcinoma (HCC) and identify independent pretreatment predictors of survival in Brazil. METHODS:Between 1998 and 2003, 74 patients with cirrhosis and small HCC were evaluated. Predictors of surviv...
journal_title:Journal of clinical gastroenterology
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doi:10.1097/MCG.0b013e31817ff199
更新日期:2009-02-01 00:00:00
abstract::The intestinal barrier serves 2 critical functions for the survival of the individual: first, it allows nutrient absorption and second, it defends the body from dangerous macromolecule penetration. It is a complex multilayer system, consisting of an external "anatomic" barrier and an inner "functional" immunological b...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MCG.0b013e31826ae849
更新日期:2012-10-01 00:00:00
abstract::Helicobacter pylori has been implicated in the pathogenesis of a number of digestive tract disorders, such as chronic active gastritis, peptic ulceration, gastric cancer, and mucosa-associated lymphoid tissue lymphoma. Disease outcome is dependent on many factors, including bacterial genotype, host physiology and gene...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MCG.0b013e318030e3c3
更新日期:2007-07-01 00:00:00
abstract::Associations between diverticular disease of the colon and the colorectal cancer has been studied for >60 years. Observational, cross-sectional, and case-control studies as well as large population-based studies gave conflicting results and association was not fully proven. Obtaining the proof was difficult because bo...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000000643
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND AND GOAL:Peribiliary cysts, which are known to be associated with various hepatobiliary diseases including alcoholic liver disease, have been reported to originate in the peribiliary glands along the biliary tree. The causal relationship between the peribiliary cysts and alcohol-related hepatic and pancreati...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e318299c8c1
更新日期:2014-02-01 00:00:00
abstract::Over the past 10 years, Kiron Das and his associates have developed an animal model for the study of a putative Crohn's disease (CD)-specific antigen. Athymic T-cell deficient nu/nu mice inoculated with intestinal and lymph node tissue filtrates from patients with CD sometimes develop lymphomas and/or lymph node plasm...
journal_title:Journal of clinical gastroenterology
pub_type: 评论,杂志文章
doi:
更新日期:1989-12-01 00:00:00
abstract::Severe sepsis with associated multisystem organ dysfunction is a leading cause of death in patients hospitalized in intensive care units. The gastrointestinal system plays a key role in the pathogenesis of multisystem organ dysfunction owing to a breakdown of intestinal barrier function and increased translocation of ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MCG.0b013e31817283cb
更新日期:2008-09-01 00:00:00
abstract::The esophagogastric junction (EGJ) is a complex barrier between the thoracic and abdominal luminal gut compartments, comprised primarily of the lower esophageal sphincter (LES) and crural diaphragm. Although closed at rest, the EGJ relaxes to allow antegrade bolus transit and retrograde venting of air. Abnormal relaxa...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000001474
更新日期:2021-02-01 00:00:00
abstract::Jejunal varices were a cause of recurrent gastrointestinal hemorrhage in an 18-year-old man with common variable immunodeficiency and nodular lymphoid hyperplasia of the small intestine. Despite numerous procedures, including upper gastrointestinal endoscopy, colonoscopy, arteriography, and exploratory laparotomy no a...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198510000-00010
更新日期:1985-10-01 00:00:00
abstract:BACKGROUND AND AIM:Voice-related complaints are the most common extraesophageal manifestation of gastroesophageal reflux disease (GERD). The aim of this study was to compare objectively measured voice parameters in normal subjects and patients with GERD and to assess the impact of antireflux surgery on these parameters...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e31822f386e
更新日期:2012-02-01 00:00:00
abstract::We reviewed the initial lipid and fat-soluble vitamin levels in 56 patients with primary sclerosing cholangitis (PSC) enrolled in a randomized, placebo-controlled trial evaluating ursodeoxycholic acid. We also evaluated lipid and vitamin levels in a group of 87 patients with advanced PSC being evaluated for liver tran...
journal_title:Journal of clinical gastroenterology
pub_type: 临床试验,杂志文章
doi:10.1097/00004836-199504000-00011
更新日期:1995-04-01 00:00:00
abstract:BACKGROUND AND AIM:The role of alcohol consumption in insulin resistance remains unclear. The aim of this study was to examine the association between alcohol consumption and insulin resistance in a large asymptomatic population. METHODS:A total of 2463 asymptomatic Japanese men aged 28 years or above undergoing a com...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e318223bd53
更新日期:2011-10-01 00:00:00
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journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000001454
更新日期:2020-10-16 00:00:00
abstract::To determine whether the urease-based CLOtest or low-dose 14C urea breath test can predict severity of gastritis or the presence of peptic ulcers, we studied 84 patients presenting for upper endoscopy. Antral biopsies were obtained for histologic analysis and CLOtesting, and urea breath testing was performed. The time...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199709000-00003
更新日期:1997-09-01 00:00:00
abstract::A 41-year-old white man with a 2-year history of irritable bowel syndrome (IBS) was referred for psychological treatment. At the time of assessment he was being treated with Metamucil and Darvocet N-100s with little success. A detailed psychosocial assessment indicated several areas for cognitive-behavioral interventi...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198704000-00020
更新日期:1987-04-01 00:00:00
abstract:BACKGROUND:The presence of laryngopharyngeal reflux disease is controversial when abnormal sensation of the laryngopharynx is felt without heartburn. GOALS:The aims of this study were to investigate the relationship between abnormal sensation of the laryngopharynx and gastroesophageal reflux, and to elucidate the path...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e318167b8b5
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND/AIMS:The aim of this exploratory trial was to establish if the probiotic Bifidobacterium natren life start (NLS) strain strain may affect the clinical course and pathophysiological features of patients with untreated celiac disease (CD). Positive findings would be helpful in directing future studies. METHOD...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,随机对照试验
doi:10.1097/MCG.0b013e31827759ac
更新日期:2013-02-01 00:00:00
abstract::The 99mtechnetium pertechnetate nuclear red blood cell scan proved to be a valuable diagnostic tool in localizing the site of bleeding, from a Meckel's diverticulum, in a 41-year-old man. When peptic ulcer or colorectal disease has been excluded by panendoscopy, bleeding Meckel's diverticulum remains a diagnostic cons...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198904000-00019
更新日期:1989-04-01 00:00:00
abstract::We investigated the eradication and recurrence rate of Helicobacter pylori-infected gastric ulcer patients by combination therapies. Eighty-six H. pylori-positive gastric ulcer patients were assigned randomly to one of seven groups: I, omeprazole 20 mg (n = 9); II, lansoprazole (LPZ) 30 mg (n = 16); III, LPZ 30 mg plu...
journal_title:Journal of clinical gastroenterology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00004836-199506002-00036
更新日期:1995-01-01 00:00:00
abstract::The clinicopathologic findings in eight Mexican patients with immunoproliferative small intestinal disease (IPSID) are analyzed. Four of these cases have been previously reported and the remainder were found in a retrospective review of 42 lymphoproliferative disorders of the small bowel (9.5% of the cases at our inst...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-199401000-00016
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND AND AIMS:Probiotic supplementation seems to provide beneficial effects in the prevention and treatment of radiation-induced diarrhea. We performed a systematic review and meta-analysis to estimate the efficacy of probiotic supplementation for prevention and treatment of radiation-induced diarrhea. METHODS:T...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,meta分析,评审
doi:10.1097/MCG.0b013e3181a1f59c
更新日期:2009-07-01 00:00:00