500 THE PATHOLOGICAL GASTROESOPHAGEAL REFLUX IN PATIENTS WITH CYSTIC FIBROSIS

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Dmitry Bordin ◽  
Elen Valitova ◽  
Gulsara Baymakanova ◽  
Stanislav Krasovskiy ◽  
Olga Berezina
Keyword(s):  
Cystic Fibrosis ◽  
Gastroesophageal Reflux ◽  
Lung Transplantation ◽  
Distal Part ◽  
Proximal Part ◽  
Distal Esophagus ◽  
Upper Endoscopy ◽  
Proximal Esophagus ◽  
Impedance Monitoring ◽  
The Mean

Abstract   The presence of gastroesophageal reflux in patients after lung transplantation rises the risk of posttransplantant complications. The aim of our study was to evaluate the severity of gastroesophageal reflux (GER) in patients with cystic fibrosis before lung transplantation. Methods 14 patients with cystic fibrosis, who refferred to our Centre, were included in this study, mean age 28,86 ± 2,5 (6 males and 8 females). The diagnosis of cystic fibrosis was established at the age of 1–5 y.o. according to clinic, sweet test and genetic tests. All patients were performed upper endoscopy, X-ray, esophageal manometry and 24 h impedance monitoring. PPI treatment was excluded for 7 days before monitoring. Pathologic GER was established when total number of refluxes in distal esophagus was more than 75, the total number of refluxes in proximal esophagus was more than 20% of those in the distal part. Results According to endoscopy, none of patients had erosions of the esophagus. Five patients had ineffective motility and one—diffuse esophageal spazm. 56% of patients had pathologic number of refluxes in distal esophagus. 80% subjects had pathologic refluxes in proximal esophagus. The mean number of total refluxes in distal part was 54,93 ± 5,7, in proximal part—27,64 ± 2,6 (it is 40% of those in distal part). The distribution of acid and non-acid refluxes in patients with pathologic refluxes was 2:1. We didn’t reveal any correlation between number of refluxes, ineffective motility and gastric emptying. Conclusion despite normal upper endoscopy, 56% of patients with cystic fibrosis have pathologic gastroesophageal reflux. Besides, the study showed high propagation of GER to proximal esophagus in 80% of subjects, which may play role in posttransplantation period.

Gastroesophageal Reflux (Symptomatic and Silent): A Potentially Significant Problem in Patients With Cystic Fibrosis Before and After Lung Transplantation

2005 ◽  
Vol 24 (10) ◽  
pp. 1522-1529 ◽  
Author(s):  
Brenda M. Button ◽  
Stuart Roberts ◽  
Tom C. Kotsimbos ◽  
Bronwyn J. Levvey ◽  
Trevor J. Williams ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Gastroesophageal Reflux ◽  
Lung Transplantation ◽  
Significant Problem ◽  
Before And After

Regional differences in potassium content of smooth muscle from opossum esophagus.

1978 ◽  
Vol 235 (6) ◽  
pp. E709
Author(s):  
K Schulze ◽  
J J Hajjar ◽  
J Christensen
Keyword(s):  
Smooth Muscle ◽  
Distal Part ◽  
Proximal Part ◽  
Distal Segment ◽  
Intracellular Concentration ◽  
Potassium Content ◽  
Intracellular Potassium ◽  
The Mean ◽  
Intracellular Potassium Concentration ◽  
Space Volume

Strips from the proximal part of the smooth muscle segment of opossum esophagus have a significantly higher potassium content (50 +/- 3 meq/kg) than those from the distal part (38 +/- 3 meq/kg). There are no significant differences between the two regions in content of sodium (65 +/- 4 meq/kg in proximal, 71 +/- 3 meq/kg in distal) or chloride (48 +/- 10 meq/kg in proximal, 42 +/- 5 meq/ kg in distal). The mean [14C]inulin uptake is 240 +/- 10 ml/kg in both proximal and distal strips. [14C]polyethylene glycol uptake is smaller and [14C]sucrose and [14C]mannitol uptake in both areas are larger than that of inulin. Intracellular potassium concentration (based on the inulin uptake as an estimate of the extracellular space volume) is significantly higher proximally (71 +/- 3 mM) than distally (52 +/- mM). Ouabain, 10(-4) M, increases the intracellular concentration of sodium and decreases the intracellular concentration of potassium in both the proximal and distal segment. The efflux of 86Rb, measured by a washout technique, is higher in the distal than in the proximal smooth muscle segment. A difference in membrane permeability to rubidium and hence, potassium between proximal and distal smooth muscle segments may account in part for the different intracellular potassium concentrations.

scholarly journals Mucosal integrity and sensitivity to acid in the proximal esophagus in patients with gastroesophageal reflux disease

2016 ◽  
Vol 311 (1) ◽  
pp. G117-G122 ◽  
Author(s):  
Froukje B. van Hoeij ◽  
Pim W. Weijenborg ◽  
Marius A. van den Bergh Weerman ◽  
René M. J. G. J. van den Wijngaard ◽  
J. Verheij ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Distal Esophagus ◽  
Mucosal Permeability ◽  
Tissue Impedance ◽  
Mucosal Integrity ◽  
Proximal Esophagus ◽  
Acid Perfusion

Acid reflux episodes that extend to the proximal esophagus are more likely to be perceived. This suggests that the proximal esophagus is more sensitive to acid than the distal esophagus, which could be caused by impaired mucosal integrity in the proximal esophagus. Our aim was to explore sensitivity to acid and mucosal integrity in different segments of the esophagus. We used a prospective observational study, including 12 patients with gastroesophageal reflux disease (GERD). After stopping acid secretion-inhibiting medication, two procedures were performed: an acid perfusion test and an upper endoscopy with electrical tissue impedance spectroscopy and esophageal biopsies. Proximal and distal sensitivity to acid and tissue impedance were measured in vivo, and mucosal permeability and epithelial intercellular spaces at different esophageal levels were measured in vitro. Mean lag time to heartburn perception was much shorter after proximal acid perfusion (0.8 min) than after distal acid perfusion (3.9 min) ( P = 0.02). Median in vivo tissue impedance was significantly lower in the distal esophagus (4,563 Ω·m) compared with the proximal esophagus (8,170 Ω·m) ( P = 0.002). Transepithelial permeability, as measured by the median fluorescein flux was significantly higher in the distal (2,051 nmol·cm−2·h−1) than in the proximal segment (368 nmol·cm−2·h−1) ( P = 0.033). Intercellular space ratio and maximum heartburn intensity were not significantly different between the proximal and distal esophagus. In GERD patients off acid secretion-inhibiting medication, acid exposure in the proximal segment of the esophagus provokes symptoms earlier than acid exposure in the distal esophagus, whereas mucosal integrity is impaired more in the distal esophagus. These findings indicate that the enhanced sensitivity to proximal reflux episodes is not explained by increased mucosal permeability.

scholarly journals Non-invasive ultrasound diagnosis of gastroesophageal reflux disease

2017 ◽  
Vol 38 (4) ◽  
pp. 64-67
Author(s):  
Z. Z. Saatov ◽  
M. M. Karimov ◽  
G. N. Sobirova ◽  
A. M. Akhmatkhodzhaev ◽  
M. M. Yakubov
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Clinical Efficacy ◽  
Reflux Disease ◽  
Distal Part ◽  
Distal Esophagus ◽  
Ultrasound Diagnosis ◽  
Transabdominal Ultrasonography ◽  
Non Invasive ◽  
Gastric Contents

The clinical efficacy of transabdominal ultrasonography in the diagnosis of gastroesophageal reflux disease was presented in the article. 250 patients with clinical and endoscopic signs of gastroesophageal reflux disease were examined. The authors examined the distal esophagus, where they determined the length of the abdominal esophagus, the esophageal diameter, lumen width, the thickness and structure of walls. It was revealed that the most common signs of gastroesophageal reflux disease were the expansion of the diameter of the distal part of the esophagus after ingestion of liquids, regurgitation of gastric contents into the esophagus in the form of a symmetrical thickening of the walls of the esophagus.

scholarly journals Bleb-Independent Glaucoma Surgery to Activate the Uveolymphatic Route of Non-Trabecular Aqueous Humor Outflow: Short-Term Clinical and OCT Results

Vision ◽  
2022 ◽  
Vol 6 (1) ◽  
pp. 4
Author(s):  
Vinod Kumar ◽  
Kamal Abdulmuhsen Abu Zaalan ◽  
Andrey Igorevich Bezzabotnov ◽  
Galina Nikolaevna Dushina ◽  
Ahmad Saleh Soliman Shradqa ◽  
...  
Keyword(s):  
Aqueous Humor ◽  
Distal Part ◽  
Lymphatic Vessels ◽  
Glaucoma Surgery ◽  
Proximal Part ◽  
Deep Sclerectomy ◽  
Aqueous Humor Outflow ◽  
Collagen Implant ◽  
The Mean ◽  
Partial Success

The deep sclerectomy technique was modified to enhance aqueous humor (AH) outflow via the non-trabecular pathway. A pilot study was carried out to assess its safety and effectiveness. Thirty-eight patients were under observation. After superficial scleral flap (4 × 4 mm), deep scleral layers were divided into three parts by three parallel-to-limbus incisions. Deep sclerectomy without creating a window in the Descemetes’ membrane was carried out in the distal part. A collagen implant was placed under the sclera of the remaining two parts with one end in the intrascleral pool. The third proximal part was excised to expose the uvea and implant. A Nd:YAG laser trabeculotomy at the surgery site was made on postoperative days 7–10. Outcome measures were IOP change, use of hypotensive medication(s), complications, and the need for a second surgery. At six months, the mean IOP decreased from 29.1 ± 9.2 mm Hg to 14.0 ± 4.3 mm Hg (p = 1.4 × 10−9); hypotensive medication use reduced from 2.9 ± 0.9 to 0.6 ± 1.0 (p = 1.3 × 10−10); complete success was achieved in 68.4% of cases and partial success was achieved in 31.6% of cases. Intraoperative and postoperative complications were rare and manageable. The OCT of the surgery site revealed the absence of bleb in all cases. Lymphatic vessels with characteristic bicuspid valves in their lumen were detected in conjunctiva near the operation site and over it in 32 patients. IOP decrease in the proposed technique was achieved by activation of the uveolymphatic route of AH outflow.

18F-Deoxyglucose PET for the staging of oesophageal cancer

2003 ◽  
Vol 42 (03) ◽  
pp. 90-93 ◽  
Author(s):  
N. Döbert ◽  
O. Rieker ◽  
W. Kneist ◽  
St. Mose ◽  
A. Teising ◽  
...  
Keyword(s):  
Oesophageal Cancer ◽  
Squamous Cell ◽  
Distal Part ◽  
Standard Uptake Value ◽  
Squamous Cell Carcinomas ◽  
Tumour Grading ◽  
Positron Emission ◽  
Group A ◽  
The Mean ◽  
Drop Outs

SummaryAim: Evaluation of the influence of histopathologic sub-types and grading of primaries of oesophageal cancer, relative to their size and location, on the uptake of 18F-deoxyglucose (FDG) as measured by positron emission tomography (PET). Methods: 50 consecutive patients were evaluated. There were four drop-outs due to previous surgical and/or chemotherapeutical treatments and thus in 46 patients (28 squamous cell carcinomas and 18 adenocarcinomas) a pretherapeutic PET evalution of the primary including a standard uptake value (SUV) was obtained. In 42 cases data on tumour grading were available also. Results: Squamous cell carcinomas (SCC) were in 7/13/8 cases located in the proximal, medial and distal part of the oesophagus, respectively the grading was Gx in 3, G 2 in 12, G2-3 in 7, and G3 in 6 cases. The SUVmax showed a mean of 6.5 ± 2.8 (range 1.7-13.5). Adenocarcinomas (ACA) were located in the medial oesophagus in two cases and otherwise in its distal parts. Grading was Gx in one, G2 in 4, G2-3 in 3, G3 in 3, G3-4 in 3, and G4 in one case. The mean SUVmax was 5.2 ± 3.2 (range 1-13.6) and this was not significantly different from the SCC. Concerning the tumour grading there was a slight, statistically not relevant trend towards higher SUVmax in more dedifferentiated cancer. Discussion: SCC and ACA of the oesophagus show no relevant differences in the FDG-uptake. While there was a significant variability of tumour uptake in the overall study group, a correlation of SUV and tumour grading was not found.

scholarly journals Stratigraphic revision and reconstruction of the deep-sea fan of the Voirons Flysch (Voirons Nappe, Chablais Prealps)

2021 ◽  
Vol 114 (1) ◽  
Author(s):  
Jérémy Ragusa ◽  
Lina Maria Ospina-Ostios ◽  
Pascal Kindler ◽  
Mario Sartori
Keyword(s):  
Deep Sea ◽  
Distal Part ◽  
Accretionary Prism ◽  
Proximal Part ◽  
Late Eocene ◽  
Lithostratigraphic Units ◽  
Stratigraphic Record ◽  
Sea Fan ◽  
Stratigraphic Evolution ◽  
Depositional Setting

AbstractThe Voirons Flysch (Caron in Eclogae Geologicae Helvetiae 69:297–308, 1976), is a flysch sequence aggregated into the sedimentary accretionary prism of the Chablais and Swiss Prealps. Its palaeogeographic location is still debated (South Piemont or Valais realm). We herein present a stratigraphic revision of the westernmost unit of the former Gurnigel Nappe sensu Caron (Eclogae Geologicae Helvetiae 69:297–308, 1976): the Voirons Flysch. This flysch is subdivided into three lithostratigraphic units at the formation level (the Voirons Sandstone, the Vouan Conglomerate, the Boëge Marl), with an additional unit (Bruant Sandstone) of uncertain attribution, ranging from the early Eocene to probably the late Eocene. We further propose a new model of the depositional setting of the deep-sea of the Voirons Flysch based on palaeocurrent directions, the overall geometry and sedimentary features. This model depicts an eastward deflected deep-sea fan. The stratigraphic record of the proximal part of this fan is fairly complete in the Voirons area, whereas its most distal part is only represented by one small exposure of thinly bedded sandstones in the Fenalet quarry. The stratigraphic evolution of the Voirons Flysch shows two major disruptions of the detrital sedimentation at the transition between Voirons Sandstone—Vouan Conglomerate and Vouan Conglomerate—Boëge Marl. The cause of these disturbances has to be constrained in the framework of the palaeogeographic location of the Voirons Flysch.

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