Abstract:
OBJECTIVE:Endoscopic mucosal ablation is a promising technique that is used to treat dysplastic Barrett's oesophagus. The purpose of this study was to investigate the efficacy and cost-effectiveness of two promising techniques, argon plasma coagulation (APC) and photodynamic therapy (PDT), in the ablation of dysplastic Barrett's oesophagus. MATERIALS AND METHODS:Twenty-six patients with dysplastic Barrett's oesophagus (21 M, median age 60 years, median length 4 cm, 23 low-grade dysplasia (LGD), 3 high-grade dysplasia (HGD)) were randomized to APC: 13 patients, PDT: 13 patients. APC was performed at a power setting of 65 W and argon gas flow at 1.8 l/min in 1-6 sessions (mean 5). PDT was performed 48 h after intravenous injection of Photofrin 2 mg/kg with a 630 nm red laser light, 200 J/cm through a PDT balloon in one session. All patients received treatment with high-dose proton pump inhibitors. Cost analysis was undertaken and the results were assessed by endoscopy and biopsies at 4 months and 12 months after therapy. RESULTS:All patients in both groups showed a reduction in the length of Barrett's oesophagus. The median length of Barrett's oesophagus eradicated at the 4-month follow-up: APC 65%, PDT 57% and at the 12-month follow-up: APC 56%, PDT 60%. Dysplasia eradication at 4 months: APC 62%, PDT 77%, p = 0.03 (95% CI 0.66-0.96) and at 12 months APC 67%, PDT 77%. Buried columnar glands with intestinal metaplasia were seen in both groups, with one patient in the PDT arm developing adenocarcioma under the neo-squamous epithelium. Severe adverse events included APC 2/13 (15%) stricture, 1/13 (8%) odynophagia, chest pain and fever; PDT 2/13 (15%) photosensitivity, 2/13 (15%) stricture. PDT would cost an additional 266 pounds sterling for every percentage reduction in Barrett's length and 146 pounds sterling per percentage reduction in dysplasia compared with APC treatment. CONCLUSIONS:APC and PDT are equally effective in eradicating Barrett's mucosa, with PDT being the more expensive treatment. However, PDT is more effective in eradicating dysplasia and the extra benefits of PDT are generated at an extra cost. The occurrence of buried columnar glands and carcinoma warrants caution. Long-term follow-up is needed to assess cancer prevention and the durability of the neo-squamous epithelium to justify these interventions.
journal_name
Scand J Gastroenteroljournal_title
Scandinavian journal of gastroenterologyauthors
Ragunath K,Krasner N,Raman VS,Haqqani MT,Phillips CJ,Cheung Idoi
10.1080/00365520510015737subject
Has Abstractpub_date
2005-07-01 00:00:00pages
750-8issue
7eissn
0036-5521issn
1502-7708journal_volume
40pub_type
临床试验,杂志文章,随机对照试验abstract::A systematic approach is outlined for the preparation of a whole series of immunoreactive 125I-labeled gastrointestinal regulatory peptides with high specific radioactivities. In our hands, the theoretically superior Iodo-gen method has no more to offer than the harsher chloramine-T method in the iodination of secreti...
journal_title:Scandinavian journal of gastroenterology
pub_type: 杂志文章
doi:10.3109/00365528509089682
更新日期:1985-05-01 00:00:00
abstract:BACKGROUND:Colon gas volume analysis using abdominal radiographs is an objective and reproducible method for evaluating functional bowel disorders. The aim of this study was to clarify the relevance of colon gas distribution and transit time in rectosigmoid cancer patients after surgery. METHODS:Segmental colon gas vo...
journal_title:Scandinavian journal of gastroenterology
pub_type: 杂志文章
doi:10.1080/00365520310000898
更新日期:2003-04-01 00:00:00
abstract::190 patients with elevated serum amylase levels were tested for macroamylasemia and the amylase to creatinine clearance ratio. Macroamylasemia was found in 3 patients. In these patients macroamylasemia persisted after the total activity of serum amylase had fallen to nearly normal levels. The Cam/Ccr-ratios were deter...
journal_title:Scandinavian journal of gastroenterology
pub_type: 杂志文章
doi:10.3109/00365527709181707
更新日期:1977-01-01 00:00:00
abstract:BACKGROUND:Endoluminal gastroplication (EndoCinch) has emerged as an endoscopic anti-reflux therapy, but predictive factors for symptom relief have not been established. The aim of this study was to evaluate the major determinants to predict outcome in patients treated with EndoCinch. METHODS:A total of 53 consecutive...
journal_title:Scandinavian journal of gastroenterology
pub_type: 杂志文章
doi:10.1080/00365520410003579
更新日期:2004-12-01 00:00:00
abstract:OBJECTIVE:To investigate treatment practice in non-variceal upper gastrointestinal bleeding (NVUGIB) caused by gastroduodenal ulcer and how it adheres to the best evidence as documented in randomized studies and meta-analyses. MATERIAL AND METHODS:The literature was surveyed to identify appropriate practices, and a st...
journal_title:Scandinavian journal of gastroenterology
pub_type: 杂志文章
doi:10.1080/00365520600880989
更新日期:2007-03-01 00:00:00
abstract:OBJECTIVE:Acute liver failure (ALF) is haemodynamically characterized by a hyperdynamic circulation. The aims of this study were to investigate the systemic and regional haemodynamics in ALF, to measure changes in nitric oxide metabolites (NOx) and to evaluate whether these haemodynamic disturbances could be attenuated...
journal_title:Scandinavian journal of gastroenterology
pub_type: 杂志文章
doi:10.1080/00365520600714527
更新日期:2006-11-01 00:00:00
abstract::In the prospective clinical long-term study of 246 patients with chronic pancreatitis, 26 patients (24 men) developed 27 histologically proved malignant tumors (11%). Four additional patients with neoplasia were excluded (papilloma, two; Bowen's disease of the tonsils, one; and seminoma, one, occurring 8 years before ...
journal_title:Scandinavian journal of gastroenterology
pub_type: 杂志文章
doi:10.3109/00365528009181490
更新日期:1980-01-01 00:00:00
abstract::Spontaneous rupture of a normal spleen without a history of trauma is a rare clinical entity. We report on a case of atraumatic splenic rupture in a 61-year-old man who presented to the emergency department for abdominal pain and hypotension. There was no evidence of hematologic or infectious disease involving the spl...
journal_title:Scandinavian journal of gastroenterology
pub_type: 杂志文章,评审
doi:10.1080/00365520701763472
更新日期:2008-01-01 00:00:00
abstract::The effects of electrical stimulation of the vagus nerves on the function of the feline gallbladder and hepatic bile outflow were studied with a perfusion technique in vivo. After elimination of the muscarinic receptors with atropine, efferent stimulation of the cut vagus nerve in the neck relaxed the gallbladder, red...
journal_title:Scandinavian journal of gastroenterology
pub_type: 杂志文章
doi:10.3109/00365528309181572
更新日期:1983-01-01 00:00:00
abstract::Abdominal and mental symptoms were assessed in 103 outpatients with chronic peptic ulcer disease. Patients with present symptoms and a history of duodenal or prepyloric ulcer were included if they had no other disorder requiring treatment. A normal female population was used for comparison of mental symptoms. Besides ...
journal_title:Scandinavian journal of gastroenterology
pub_type: 临床试验,杂志文章
doi:10.3109/00365528509089674
更新日期:1985-05-01 00:00:00
abstract:OBJECTIVE:In celiac disease (CD), enteropathy of the small bowel results from a T-cell-mediated reaction to gluten in the diet. In addition to gluten, other environmental and genetic factors participate in the disease pathogenesis. We have recently reported the finding of a significantly different short-chain fatty aci...
journal_title:Scandinavian journal of gastroenterology
pub_type: 杂志文章
doi:10.1080/00365520701320687
更新日期:2007-10-01 00:00:00
abstract::The occurrence of autoantibodies against intrinsic factor, H,K-ATPase, and pepsinogen was analysed by means of enzyme-linked immunosorbent assay in three groups of sera. Group 1 comprised sera from 14 rheumatoid arthritis patients with normal acid secretion; group 2, sera from 18 rheumatoid arthritis patients with red...
journal_title:Scandinavian journal of gastroenterology
pub_type: 杂志文章
doi:10.3109/00365529109003961
更新日期:1991-10-01 00:00:00
abstract:OBJECTIVE:Familial adenomatous polyposis (FAP) is an interesting model for the study of colorectal tumour. Two genes contribute to the FAP phenotype - APC and MUTYH - but their relative role is still undefined. The objective of this study was to evaluate the contribution of the two genes to the pathogenesis of FAP by m...
journal_title:Scandinavian journal of gastroenterology
pub_type: 杂志文章
doi:10.1080/00365520903100481
更新日期:2009-01-01 00:00:00
abstract::The effect of sham feeding on pancreatic-polypeptide (PP) secretion was studied in 26 duodenal ulcer (DU) patients and in 8 healthy subjects. Modified sham feeding (MSF) by the 'chew and spit' technique induced a rapid increase in plasma concentrations of PP both in DU patients, 56 (2-138) pmol/l, and in the healthy s...
journal_title:Scandinavian journal of gastroenterology
pub_type: 杂志文章
doi:10.3109/00365527909179889
更新日期:1979-01-01 00:00:00
abstract::Parietal cell regeneration in cauterized gastric wounds was studied in rats after antrectomy (Billroth I), pyloroplasty, and truncal vagotomy with pyloroplasty. Six to eight animals in each group were killed 90 or 130 days after operation, and in each rat stereological data were obtained from electron micrographs of 1...
journal_title:Scandinavian journal of gastroenterology
pub_type: 杂志文章
doi:10.3109/00365528309182106
更新日期:1983-10-01 00:00:00
abstract:OBJECTIVE:Radioresistance is considered the main reason for therapeutic failure in radiotherapy of esophageal carcinoma. However, the underlying mechanisms of radioresistance remain elusive. The purpose of this study was to investigate the relationship between p27(kip1) expression and the change of radiosensitivity of ...
journal_title:Scandinavian journal of gastroenterology
pub_type: 杂志文章
doi:10.3109/00365521.2010.522721
更新日期:2011-02-01 00:00:00
abstract::The effect of insulin on epidermal growth factor (EGF)- and transforming growth factor-alpha (TGF alpha)-induced cell proliferation was examined in primary cultures of gastric surface mucous epithelial cells by using changes in cell counts and DNA as indices of cell growth. With 1.0% fetal bovine serum and Dulbecco's ...
journal_title:Scandinavian journal of gastroenterology
pub_type: 杂志文章
doi:10.3109/00365529108996250
更新日期:1991-09-01 00:00:00
abstract:OBJECTIVE:Information on mortality after cholecystectomy in defined populations is limited. In this study we examined the case fatality rates and mortality ratios, based on register data. MATERIAL AND METHODS:Hospital discharge and death certificate data were linked for all patients undergoing cholecystectomy in Swede...
journal_title:Scandinavian journal of gastroenterology
pub_type: 杂志文章
doi:10.1080/00365520510023972
更新日期:2005-12-01 00:00:00
abstract::The contribution of the different gastrin components to the gastrin response to a protein-rich meal was studied. Pooled or individual samples of venous blood drawn at intervals in 12 normal subjects and 16 patients with duodenal ulcers were fractionated on Sephadex G 50 superfine columns of various lengths. Total gast...
journal_title:Scandinavian journal of gastroenterology
pub_type: 杂志文章
doi:
更新日期:1975-01-01 00:00:00
abstract::The separations and measurements of adenine-adenosine, adenosine monophosphate (AMP), adenosine diphosphate (ADP), adenosine triphosphate (ATP), lipid phosphates (lipid-P), ribonucleic acid (RNA) and deoxyribonucleic acid (DNA) were carried out in the mucosa of the corpus, antrum, and duodenum of patients with decreas...
journal_title:Scandinavian journal of gastroenterology
pub_type: 杂志文章
doi:10.3109/00365527709181689
更新日期:1977-01-01 00:00:00
abstract::Background & aims: Non-variceal upper gastrointestinal bleeding (NVUGIB) occurs frequently and is associated with a significant morbidity and mortality, especially in patients receiving antiplatelet or anticoagulant therapy (APT and ACT, respectively). We aimed to evaluate adherence to guideline recommendations publis...
journal_title:Scandinavian journal of gastroenterology
pub_type: 杂志文章
doi:10.1080/00365521.2019.1688384
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVE:To investigate the combination therapy, consisting of hyperimmune bovine colostrum, N-acetyl cysteine, zinc and amoxicillin on the eradication of Helicobacter pylori in a mouse model. MATERIAL AND METHODS:C57BL/6 female mice (6 weeks of age) were inoculated with 0.1 ml of 1×10(9) H. pylori via a single oro-g...
journal_title:Scandinavian journal of gastroenterology
pub_type: 杂志文章
doi:10.3109/00365521.2010.506245
更新日期:2010-12-01 00:00:00
abstract::Autonomic nerve function was evaluated in 40 patients with total ulcerative colitis and in 25 patients with irritable bowel syndrome by three established non-invasive tests based on the heart reactions to deep breathing (E/I ratio) and tilt (acceleration and brake index). None of the patients were diabetic. Most of th...
journal_title:Scandinavian journal of gastroenterology
pub_type: 杂志文章
doi:10.3109/00365529309096103
更新日期:1993-07-01 00:00:00
abstract:OBJECTIVE:CD137, a member of the tumor necrosis factor receptor family, generates co-stimulatory signals leading to T-cell activation and proliferation for viral eradication. We examined the expression kinetics of CD137 to validate whether it can affect treatment outcomes of chronic hepatitis C (CHC) patients. METHODS...
journal_title:Scandinavian journal of gastroenterology
pub_type: 杂志文章
doi:10.3109/00365521.2012.668929
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:Fragments of collagen arising during synthesis and breakdown have been suggested as markers of fibrous tissue remodelling in Crohn disease. We compared serum concentrations of the C-terminal propeptide of collagen I (PICP), the N-terminal propeptide of collagen III (PIIINP) and the C-terminal telopeptide of ...
journal_title:Scandinavian journal of gastroenterology
pub_type: 杂志文章
doi:10.1080/00365520152584833
更新日期:2001-11-01 00:00:00
abstract:OBJECTIVE:Postprandial dyspepsia is common and may be associated with abnormal intragastric distribution of food. We aimed to determine the effect of body position on gastric emptying, meal distribution, and postprandial perceptions in healthy subjects. MATERIAL AND METHODS:Eight adolescents (4 females and 4 males age...
journal_title:Scandinavian journal of gastroenterology
pub_type: 杂志文章
doi:10.3109/00365521.2014.990506
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:The relationship between the expression of epidermal growth factor (EGF) and transforming growth factor-alpha (TGF-alpha) and that of their receptor (EGF-R) in the Helicobacter pylori-infected gastric mucosa has not been completely elucidated. The aim of this study was to examine the interplay between H. pyl...
journal_title:Scandinavian journal of gastroenterology
pub_type: 杂志文章
doi:10.1080/00365529850170856
更新日期:1998-03-01 00:00:00
abstract::In experimental cholecystitis a net secretion of fluid to the gallbladder lumen is seen in animals with morphological signs of acute inflammation. This fluid secretion, which increases the intraluminal pressure in the obstructed gallbladder, is suggested to be influenced by non-cholinergic intramural gallbladder nerve...
journal_title:Scandinavian journal of gastroenterology
pub_type: 杂志文章
doi:10.3109/00365528608996453
更新日期:1986-12-01 00:00:00
abstract:BACKGROUND:Drinking capacity is often reduced in functional dyspepsia. Drink tests may therefore have diagnostic potential. A simple drink test in combination with ultrasonography was applied in this study, the aim being to find the best drink for this test. METHODS:On separate days, 10 patients with functional dyspep...
journal_title:Scandinavian journal of gastroenterology
pub_type: 杂志文章
doi:10.1080/00365520410003344
更新日期:2004-10-01 00:00:00
abstract:BACKGROUND:The correlation of clinical and laboratory findings with various imaging techniques in obese patients is difficult. Colour duplex Doppler is of particularly limited value in fat individuals. The Doppler Perfusion Index (DPI) measures the ratio of hepatic arterial to total liver blood flow and seems to be mor...
journal_title:Scandinavian journal of gastroenterology
pub_type: 杂志文章
doi:10.1080/003655200750023066
更新日期:2000-09-01 00:00:00