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Flap Valve (flap + valve)
Selected AbstractsEndoscopic grading of gastroesophageal flap valve and atrophic gastritis is helpful to predict gastroesophageal refluxJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 2 2008Gwang Ha Kim Abstract Background and Aim:, The endoscopic grading of the gastroesophageal flap valve (GEFV) has been suggested to be a good predictor of reflux status. Atrophic gastritis is inversely associated with reflux esophagitis. The aim of the present study was to investigate the association between GEFV, atrophic gastritis and gastroesophageal reflux. Methods:, A total of 608 patients (252 men and 356 women; mean age 51.1 years) who underwent endoscopy, esophageal manometry and ambulatory 24-h pH monitoring were included. GEFV was graded I through IV using Hill's classification: the GEFV was largely classified into two groups: the normal GEFV group (grades I and II) and the abnormal GEFV group (grades III and IV). Atrophic gastritis was classified into two groups by endoscopic atrophic border: closed-type (C-type) and open-type (O-type). Findings of endoscopy, esophageal manometry and ambulatory pH monitoring were compared among the groups. Results:, The incidence of reflux esophagitis and gastroesophageal reflux disease was associated with an abnormal GEFV grade and was inversely associated with open-type atrophic gastritis. The patients with a coexisting abnormal GEFV and closed-type atrophic gastritis showed a significantly higher incidence of reflux esophagitis and gastroesophageal reflux disease than the patients with a coexisting normal GEFV and open-type atrophic gastritis (OR, 20.6 [95% CI, 6.2,68.4], 11.4 [95% CI, 6.3,20.7], respectively). Conclusions:, Endoscopic grading of GEFV and atrophic gastritis is simple and provides useful information on the status of gastroesophageal reflux. [source] Evaluation of gastro-oesophageal flap valve is useful for diagnosing gastro-oesophageal reflux diseaseALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 2006M. IWAMOTO Summary Background Gastro-oesophageal flap valve (GEFV) grade correlated with endoscopic reflux oesophagitis (RE) prevalence. Aim To investigate relationships among gastro-oesophageal reflux disease (GERD) symptoms, RE and/or non-erosive reflux disease (NERD) and GEFV grades in subjects undergoing endoscopy. Methods We enrolled 1305 subjects from whom endoscopic results and the results of a self-administered questionnaire (QUEST) were available. Subjects were evaluated for GERD symptoms (QUEST score), GEFV grade, RE and gastric mucosal atrophy. Results Total GERD prevalence, including symptomatic GERD (QUEST score , 4) and/or RE, was 27%. RE grade and prevalence increased with GEFV grade. QUEST scores and GEFV grades showed a positive correlation. NERD prevalence was 14% and increased with GEFV grade, but the relationship was weaker than that between RE and GEFV. Comparing RE-negative subjects by GEFV grade, GERD symptoms were noted in 10%, 19%, 36% and 52% with GEFV grades I, II, III and IV, respectively. Neither type of gastric mucosal atrophy correlated with GEFV grade. Conclusions Total GERD, NERD and RE prevalences increased with GEFV grade. Subjects with high GEFV grades often complain of GERD symptoms, even without RE. Our findings suggest that endoscopic GEFV evaluation provides a useful clinical index for diagnosing GERD. [source] Histochemical analysis of lymphatic endothelial cells in lymphostasisMICROSCOPY RESEARCH AND TECHNIQUE, Issue 2 2001Rui-Cheng Ji Abstract The ultrastructure of endothelial cells of intestinal lymphatics and the thoracic duct (TD) and the relation to lymphostasis were examined in rats and monkeys. Localization of 5,-nucleotidase (5,-Nase) and endothelial nitric oxide synthase (eNOS) was studied. In normal lymphatic endothelial cells, 5,-Nase reaction product was evenly deposited on the cell surface in vivo and on cultured TD endothelial cells (TDECs), whereas eNOS was evenly distributed throughout the nucleus and cytoplasm. TDECs had a long filamentous process extending towards the subendothelial extracellular matrix but became flat and regular within 30,40 minutes after gastric perfusion with olive oil. According to their electron-density, two types of cells were found in the TD endothelial layer. The cells with low electron-density exhibited stronger 5,-Nase activity. Valves were bicuspid formations and the valvular endothelial surface of the convex side showed weaker 5,-Nase activity than the concave side. During TD blockage-induced lymphostasis in rats, the 5,-Nase product was almost not discernible in the TDECs within 2 weeks. Larger vesicles were found in the endothelial cytoplasm of the ligated TD. Their number decreased after 6,12 weeks. The small intestinal lymphatics in the mucosa and submucosa were dilated, with numerous open intercellular junctions. The endothelial lining appeared to have reduced activities for 5,-Nase and eNOS in 9 of 11 experimental animals. The results indicated that the inability of the open intercellular junctions, normally working as one-way endothelial flap valves, may be a key morphological feature after TD blockage. Reduced eNOS and 5,-Nase may functionally influence contractile activity and transport capability of the lymphatic vessels in the lymphostasis. Microsc. Res. Tech. 55:70,80, 2001. © 2001 Wiley-Liss, Inc. [source] | ||||||||||