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Endoscopy Findings (endoscopy + finding)
Selected AbstractsLaparoscopic fundoplication in mentally normal children with gastroesophageal reflux diseaseDISEASES OF THE ESOPHAGUS, Issue 2 2002K. V. Menon SUMMARY., Laparoscopic antireflux surgery has been performed in neurologically impaired and scoliotic children. We aimed to assess the effectiveness of laparoscopic fundoplication in mentally normal children with gastroesophageal reflux disease that failed to respond to medical therapy. Data were prospectively collected (symptoms, medical therapy, endoscopies' findings) on 12 children (nine boys, three girls) aged 9,15 years with gastroesophageal reflux disease. Pre- and postoperative ambulatory 24-h pH and DeMeester and Johnson scores were also recorded. Effectiveness of surgery was assessed by comparison of pre- and postoperative total acid exposure time, Visick grade, need for antireflux medication and symptom scores. In total, 11 children underwent a laparoscopic Nissen fundoplication and one underwent a Toupet procedure. Median length of stay was 2 (2,3) nights. The median preoperative pH acid exposure time (AET) was 4.7 (0.8,16.4) percent compared with postoperative AET of 0.4 (0,3) percent. Early postoperative dysphagia occurred in four out of 12 patients, requiring a total of six dilatations. Postoperative Visick scores were: grade I=7 and grade II=5. Laparoscopic fundoplication can be safely performed and is effective in children with GERD who have failed to respond to medical therapy. [source] Clara cell 10-kDa protein expression in chronic rhinosinusitis and its cytokine-driven regulation in sinonasal mucosaALLERGY, Issue 1 2009Z. Liu Background:, Clara cell 10-kDa protein (CC10) is a multifunction protein with anti-inflammatory and immunomodulatory effects; hence we compared the CC10 expression between chronic rhinosinusitis (CRS) patients with and without nasal polyps (NPs), analyzed its association with disease severity and response to surgery, and explored its regulation via cytokines. Methods:, The plasma and tissue CC10 levels were compared between controls and CRS patients with and without NPs by means of quantitative RT-PCR, ELISA, and immunohistochemistry. Computed tomography (CT) scan and endoscopy findings and symptoms were scored. Nasal explant culture was used to explore the effect of TNF-,, IL-1,, IL-4, INF-,, and IL-10 on CC10 gene regulation. Results:, Compared with controls, the CC10 expression in sinonasal mucosa was significantly inhibited in both CRS patients with and without NPs. There was a significant further decrease of CC10 expression in patients with NPs and asthma. No difference in CC10 plasma levels was found between controls and patients. CC10 levels inversely correlated with preoperative CT scores, and postoperative endoscopy and symptom scores. TNF-,, IL-1, and IL-4 inhibited, whereas INF-, and IL-10 promoted CC10 production in nasal mucosa. A significantly faster decay of CC10 transcripts was seen after IL-1, treatment. IL-1, and IL-10 induced thyroid transcription factor-1 expression. INF-, increased, whereas IL-4 inhibited hepatocyte nuclear factor-3, expression. Conclusion:, CC10 may take part in the pathogenesis of CRS and correlates with disease severity and response to surgery. Different cytokines can regulate CC10 expression in nasal mucosa differentially through modulating mRNA stability and certain transcriptional factors expression. [source] Neurologic Diagnosis and Treatment in Patients with Computed Tomography and Nasal Endoscopy Negative Facial PainTHE LARYNGOSCOPE, Issue 11 2004Eric P. Paulson MD Abstract Objective: To determine the helpfulness of specialist neurology referral for patients with facial pain, a normal sinus computed tomography (CT) scan, and normal nasal endoscopy findings. Study Design: Prospective identification of patients and analysis of data approved by the Institutional Review Board. Methods: The data of 104 consecutive patients presenting with facial pain, a normal sinus CT scan, and normal nasal endoscopy findings were reviewed. The patients presented to a single rhinologist in a tertiary care institution. All patients were referred for specialist neurologic evaluation and potential treatment. Further information was obtained from a patient survey. Results: Of the 104 patients, 81 were women and 23 were men. The average age was 46 years (range, 22,85). Fifty-six had clear CT scans, 48 had minimal change, and all had negative endoscopies. Twenty-nine had previous unsuccessful sinus surgery. The average follow-up period was 10.5 months. Forty of 75 patients seeing a neurologist were seen on multiple occasions. Four percent of patients seen by a neurologist had an unsuspected serious intracranial diagnosis. The most common diagnoses were migraine (37%), rebound headache (17%), chronic daily headache (17%), and obstructive sleep apnea (16%). Overall, 58% improved on medical therapy; 60% of those with a clear CT scan improved, and 53% of those with minimal change on CT scan improved (P = .749). Conclusions: Facial pain remains a difficult symptom to diagnose and treat in rhinologic practice. Patients often undergo surgery without help. Most patients with facial pain, a normal sinus CT scan, and normal endoscopy findings benefit from neurologic consultation. Serious intracranial pathologic conditions can be excluded and diagnosis-specific pharmacogenetic therapy instituted with improvement in more than 50%. [source] Gastric fundic gland polyps: a clinico-pathological study from North West TasmaniaANZ JOURNAL OF SURGERY, Issue 6 2009Inian Samarasam Abstract Background:, Fundic gland polyps (FGPs) of the stomach were originally described in association with familial polyposis syndromes. It is now known that the majority of these polyps occur in the sporadic setting and are incidentally seen in up to 1.9% of routine upper gastrointestinal endoscopes. The aim of this study was to look at the clinico-pathological features of the FGPs and to analyse their relationship to Helicobacter pylori infection, proton pump inhibitor treatment, colonic polyps and malignancy. Methods:, A search of the histopathology records for a period of 10 years from 1997 to 2006 identified 120 patients with a histologically confirmed diagnosis of FGPs. The clinical history, upper gastrointestinal endoscopy findings, histopathology and colonoscopy findings were recorded from the medical records and analysed. Results:, FGPs were seen in 3.2% of patients undergoing routine upper gastrointestinal endoscopes. There was a definite association with long-term proton pump inhibitor treatment. There was a strikingly low incidence of H. pylori infection in the study population. Although there was no dysplasia or malignancy in any of these polyps, one patient had concomitant adenocarcinoma of the stomach. In the subgroup of patients who also had colonoscopy during the study period, 19% had associated colonic polyps and 6% had associated colonic malignancies. Conclusions:, Every new patient diagnosed with FGPs should have a thorough clinico-pathological study to see if the polyps are part of a sporadic or syndromic setting. A long-term follow-up study of patients with FGPs and its association with colonic polyps may be warranted. [source] | ||||||||||