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Biomedical subjects

Ming-Shiang Wu

Publications and source records attributed to Ming-Shiang Wu.

At least 73 records · Page 4Linked to original sources
PubMed2002

Color Doppler sonography for preoperative diagnosis of an aneurysm of the ileal branch of the superior mesenteric artery.

Aneurysms of the superior mesenteric artery are uncommon, and aneurysms of its branches occur even less frequently. We report the case of a 60-year-old man with an aneurysm of the ileal branch of the superior mesenteric artery whose initial symptom was abdominal pain. Gray-scale and color Doppler sonography provided noninvasive, accurate preoperative identification of the aneurysm despite its uncommon location, a small branch of the superior mesenteric artery. CT and conventional and magnetic resonance angiography confirmed the sonographic diagnosis. The aneurysm was resected successfully, and the patient's postoperative course was uneventful. Although angiography is required for a definitive diagnosis and for surgical planning, sonography is a useful tool for preoperative evaluation and diagnosis of such aneurysms.

Aneurysm↗
PubMed2002

Synchronous triple cancers at middle and lower esophagus and stomach with different histological features and genetic alterations.

Synchronous multiple primary malignancies are relatively unusual. We describe a case of synchronous triple cancers located at the middle and lower esophagus and the stomach in a 59-year-old Taiwanese man who presented with progressive dysphagia, epigastralgia, and bodyweight loss in 1 month. Endoscopic and histological features, microsatellite instability status of genomic DNA, and immunohistochemical staining of p53, MUC2, Fhit, c-erbB-2 and E-cadherin of all three cancers were demonstrated. We noted that these three cancers arose from different clones and that p53 mutation, instead of microsatellite instability, may play a major role in the development of multiple primary malignancies in this patient.

Adenocarcinoma↗
PubMed2002

Correlation between serum levels of interleukin-6 and vascular endothelial growth factor in gastric carcinoma.

BACKGROUND AND AIM: Vascular endothelial growth factor (VEGF) and interleukin-6 (IL-6) are associated with the disease status of gastric carcinoma. However, their relationship remains unclear. This study aims to determine and correlate serum levels of VEGF and IL-6 in gastric carcinoma. METHODS: A total of 107 patients receiving gastrectomy entered this study. Serum levels of VEGF and IL-6 were measured by using ELISA, and were analyzed by using the Student's t-test to compare means and by Pearson correlation analysis to calculate correlation coefficients with respect to pathological characteristics including depth of tumor invasion, Laurén's classification, tumor location, Borrmann classification, and the status of lymph node metastasis. RESULTS: Serum VEGF levels were significantly higher in patients with mixed type carcinoma (387.5 +/- 176.9 vs 255.3 +/- 154.1 pg/mL, P = 0.047) or lymph node metastasis (339.1 +/- 205.1 vs 223.2 +/- 197.4 pg/mL, P = 0.007). Serum IL-6 levels were significantly higher in patients with Borrmann type IV carcinoma, compared with Borrmann type II and III carcinoma. In general, no correlation was noted between serum VEGF levels and IL-6 levels (r = 0.142, P = 0.145), but significant correlation was found in patients with early gastric carcinoma (r = 0.627, P = 0.004) or mixed type carcinoma (r = 0.804, P = 0.016). CONCLUSIONS: This study supports the correlation between serum VEGF and IL-6 levels in distinct subsets of gastric carcinoma patients, and indicates that IL-6 may play a role for the angiogenesis of gastric carcinoma via modulation of VEGF.

Endothelial Growth Factors↗
PubMed2002

Endoscopic hemostasis of a bleeding marginal ulcer: hemoclipping or dual therapy with epinephrine injection and heater probe thermocoagulation.

BACKGROUND AND AIMS: Endoscopic hemoclipping and dual therapy with epinephrine injection and heater probe thermocoagulation have been proven effective in the hemostasis of bleeding peptic ulcers. However, the hemostatic efficacy has not been investigated in bleeding marginal ulcers. The aim of this study is to investigate the hemostatic efficacy of endoscopic hemoclipping and dual therapy with epinephrine injection and heater probe thermocoagulation in bleeding marginal ulcers. METHODS: From November 1997 to July 2000, 50 patients with active marginal ulcer bleeding underwent either hemoclipping (20 patients) or dual therapy (30 patients) for hemostasis. The demographic data, clinicopathological characteristics, endoscopic findings, initial hemostatic rates, rebleeding rates, amount of blood transfusion, the need of surgery, and mortality rates were collected and analyzed. RESULTS: Marginal ulcers were located at the anastomotic site (64%), saddle portion (22%), efferent loop (10%), or at the afferent loop (4%). The bleeding stigmata were classified into spurting artery (32%), oozing vessel (38%), visible vessel (20%), and blood clot adhesion (10%). The overall therapeutic results in 50 patients were initial hemostasis (100%), rebleeding rate (22%), need for surgery (4%), and hospital mortality rate (4%). There was no significant difference in demographic data and clinicopathological characteristics between the two modes of treatments, whereas recurrent bleeding developed in 5% in the hemoclipping group and 33% in the dual therapy group. No complication related to the procedure occurred in either mode of therapy. The hospital mortality rates were 0 and 6.7%, respectively. CONCLUSION: Endoscopy is effective in achieving initial hemostasis from bleeding marginal ulcers. However, the rebleeding rate remains high and repeated endoscopy may be needed to arrest the hemorrhage.

Adrenergic Agonists↗
PubMed2002

Endoscopic hemoclip placement and epinephrine injection for Mallory-Weiss syndrome with active bleeding.

BACKGROUND: Mallory-Weiss syndrome with active bleeding requires effective hemostasis. This is an investigation of the respective efficacy and safety of endoscopic hemoclip placement and endoscopic epinephrine injection in Mallory-Weiss syndrome. METHODS: Thirty-five patients with Mallory-Weiss syndrome with spurting vessels or oozing in a university hospital were enrolled prospectively and randomly assigned to endoscopic hemoclip placement (18 patients) or endoscopic epinephrine injection (17 patients) performed by 4 endoscopists with similar clinical experiences. Demographic characteristics, endoscopic variables, and outcome parameters as well as rates of hemostasis and recurrent bleeding were analyzed. RESULTS: The mean (SD) number of hemoclips applied was 2.5 (1.2) and the mean volume of injection was 7.9 (4.3) mL. Primary hemostasis was achieved in all 35 patients. In each group there was 1 case of recurrent bleeding. Secondary hemostasis was achieved by repeating the same procedures as at randomization in both cases. There were no significant differences in age, gender, prior ingestion of alcohol, presenting symptoms, hemoglobin level, shock, comorbid diseases, bleeding stigmata, tear location, blood transfusion, or hospitalization between the groups. There were no procedure-related complications in either group; surgery was not required in any patient. For both groups, there were no second episodes of recurrent bleeding, procedure-related complication, or need of operation. CONCLUSION: Endoscopic hemoclip placement and endoscopic epinephrine injection are equally effective and safe for the management of active bleeding in Mallory-Weiss syndrome, even in patients with shock or comorbid diseases.

Adult↗
PubMed2002

Preferential loss of Fhit expression in signet-ring cell and Krukenberg subtypes of gastric cancer.

Gastric cancer of youth is predominantly a disease of women, usually of the signet-ring cell subtype, with a predilection for metastasizing to the ovaries. The metastatic ovarian tumor is named a Krukenberg tumor. However, the characteristic genetic alterations between the primary gastric cancer and its metastatic ovarian tumor have not been studied. We used laser capture microdissection to procure tissues from 7 patients with gastric cancer who had ovarian metastases (Krukenberg tumor) and tissues from 14 patients with gastric cancer without ovarian metastases. Loss of heterozygosity (LOH) analysis was performed by use of 16 polymorphic markers, which are mapped to the FHIT, APC, p16, BRCA2, E-cadherin, p53, BRCA1, and DPC4 loci. Immunohistochemical staining with anti-Fhit antibody was performed in 7 Krukenberg tumors and 92 gastric cancers without ovarian metastases. LOH at the FHIT locus was observed in six (85.7%) of the seven Krukenberg tumors. In contrast, the gastric cancers without ovarian metastases showed a lower frequency (28.6%, 4/14) of LOH at the FHIT locus (p < 0.05, odds ratio = 1/15). Anti-Fhit antibody showed that expression of Fhit was lost in each of the 7 (100%) Krukenberg tumors but in only 41 (44.6%) of the 92 patients who had gastric cancer without ovarian metastases (p < 0.05; odds ratio = 1/18.614). Further analysis showed that loss of Fhit expression is highly associated with signet-ring cell type gastric cancer (p < 0.0001, odds ratio = 62.5) but is not correlated with prognosis. Alteration of the FHIT gene is a characteristic of signet-ring cell type gastric cancer and Krukenberg tumor.

Acid Anhydride Hydrolases↗
PubMed2002

Association of HLA-DQB1*0301 and HLA-DQB1*0602 with different subtypes of gastric cancer in Taiwan.

Gastric cancer (GC) is a heterogeneous disorder with multifactorial etiologies. Genetic predisposition, environmental factors, and Helicobacter pylori infection are thought to interact in the manifestation of GC. Particular human leukocyte antigen (HLA) alleles play a pivotal role in cellular immunity and may be an important genetically determined host trait. To elucidate the association between the genotype of HLA class II genes and the clinical phenotype of GC, polymorphisms of HLA-DRB1 and HLA-DQB1 were determined by polymerase chain reaction with sequence-specific primers in 106 Taiwanese patients with GC and in 208 healthy controls. Comparison of allele frequencies between GC patients and healthy controls showed no significant difference at the HLA-DRB1 locus. Patients with GC had a higher frequency of DQB1(*)0602 (9.4% vs. 3.6%, P < 0.05, odds ratio 2.79, 95% confidence interval 1.41 - 5.47) and a lower frequency of DQB1(*)0301 (14.6% vs. 23.8%, P < 0.05, odds ratio 0.55, 95% confidence interval 0.35 - 0.85) compared to healthy controls. Correlation of HLA-DQB1 status with clinicopathologic features revealed predominance of male gender (16/3 vs. 50/37, P < 0.05) and proximal location (12/7 vs. 28/59, P < 0.05) in patients with positive HLA-DBQ1(*)0602 compared to those with negative HLA-DBQ1(*)0602. In contrast, a higher ratio of diffuse/intestinal subtype (20/10 vs. 30/46, P < 0.05) and a lower seropositivity of Helicobacter pylori (14/30 vs. 58/76, P < 0.005) were noted in patients with positive HLA-DQB1(*)0301 compared to those with negative HLA-DQB1(*)0301. In conclusion, HLA-DQB1(*)0602 confers susceptibility to gastric cancer, especially for male Taiwanese and proximal tumor location, while HLA-DQB1(*)0301 may have a protective effect on GC, probably through resistance to Helicobacter pylori infection. HLA-DQB1 alleles are associated with susceptibility or resistance to GC and also influence its clinical features.

Aged↗
PubMed2002

Risk factors for intestinal metaplasia in adult residents of Matzu: a cross-sectional study.

BACKGROUND AND PURPOSE: People living on Matzu, a group of small islets, have the highest mortality rate from gastric cancer (GC) in Taiwan. Intestinal metaplasia (IM) is a precursor lesion of GC. We therefore conducted a gastroscopic screening program in this district to evaluate the risk factors associated with IM. METHODS: A total of 274 residents of Matzu, aged 30 years or older, underwent testing for anti-Helicobacter pylori IgG antibody and serum pepsinogen (PG) I/PG II levels, and gastroscopic examination. Univariate and multivariate logistic regression models were used to identify risk factors associated with IM in terms of odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: Among the 274 subjects, 118 (43%) were confirmed to have IM by histologic examination. Individuals aged 60 years or older had a 2.66 times higher risk (95% CI 1.38-5.13) of having IM, as compared with those less than 60 years of age. Subjects with duodenal ulcer had a 60% lower risk of coexisting IM (OR, 0.40; 95% CI, 0.19-0.83). Meanwhile, subjects with gastric ulcer were not at increased risk of IM (OR, 0.84; 95% CI, 0.34-2.08). Low serum PG I level, low PG I/PG II ratio, and positive anti-H. pylori IgG antibody, were associated with IM in the univariate analysis. While age and duodenal ulcer maintained their independent effects in the multivariate analysis, only a low PG I/PG II ratio and H. pylori positivity were significantly associated with IM. CONCLUSIONS: This study of residents of Matzu found that age and H. pylori infection are risk factors for IM, while subjects with duodenal ulcer have a lower incidence of coexisting IM. Low PG I/PG II ratio is a potential noninvasive biomarker of IM.

Adult↗
PubMed2001

Tumor necrosis factor-alpha and interleukin-10 promoter polymorphisms in Epstein-Barr virus-associated gastric carcinoma.

To investigate whether genetic differences in cytokine promoter polymorphisms effect various outcomes after exposure to Epstein-Barr virus (EBV) infection, 30 patients with EBV-positive gastric carcinoma (GC), 120 patients with EBV-negative GC, and 220 control subjects were enrolled. Promoter polymorphisms of tumor necrosis factor (TNF)-alpha at positions -238 and -308 and of interleukin (IL)-10 at position -1082 were determined. The frequency of the high-producer allele (-308A) in the TNF-alpha gene was significantly higher among EBV-positive GC patients compared with control subjects (23.3% vs. 12.0%, P<.05), whereas the frequency of the high-producer allele (-1082G) in the IL-10 gene was significantly higher among EBV-negative GC patients compared with control subjects (6.3% vs. 3.0%, P<.05). These data support the notion that genetic factors may modify the outcomes of infectious diseases through different TNF-alpha- or IL-10-producing capabilities.

Adenocarcinoma↗
PubMedDate not supplied

Interleukin-6 increases vascular endothelial growth factor and angiogenesis in gastric carcinoma.

Interleukin-6 (IL-6) is a proinflammatory cytokine associated with the disease status of gastric carcinoma (GC). Vascular endothelial growth factor (VEGF) is a potent tumor angiogenic factor in GC. In this study, we attempted to clarify whether IL-6 can regulate VEGF and angiogenesis in GC. GC samples from 54 surgical specimens were subjected to immunohistochemical examination of IL-6, VEGF, and tumor microvessels, and results showed that IL-6 was positively correlated with VEGF expression and tumor vasculature. We determined VEGF expression in four GC cell lines by ELISA, revealing that GC cells can produce significant amount of VEGF with increasing dose and duration of IL-6 stimulation. Next, a luciferase reporter gene assay was employed to determine the signaling pathway driving the VEGF promoter by IL-6, which showed that the JAK/STAT pathway is involved in the stimulation of VEGF gene expression. The effects of IL-6 on angiogenesis in vitro and in vivo were evaluated by HUVEC studies and the Matrigel plug assay, respectively. Results showed that IL-6 effectively promoted HUVEC proliferation and tube formation in vitro and Matrigel plug vascularization in vivo, primarily by inducing VEGF in GC. This study provides evidence that the multifunctional cytokine, IL-6, may induce VEGF expression which increases angiogenesis in gastric carcinogenesis.

Cell Proliferation↗
PubMedDate not supplied

Alterations of BAT-26 identify a subset of gastric cancer with distinct clinicopathologic features and better postoperative prognosis.

BACKGROUND/AIMS: Gastrointestinal tumors with microsatellite instability represent a replication error-positive phenotype. BAT-26, a repeat of 26 deoxyadenosine localized in intron 5 of hMSH2 gene, has been reported as a reliable indicator of replication error phenotype in colorectal cancers. This study investigated whether BAT-26 is a useful marker for a mutator phenotype with distinct clinicopathologic features in gastric cancer. METHODOLOGY: One hundred and nineteen gastric cancer tissues and matched non-tumor tissue were examined by polymerase chain reactions with electrophoresis for 9 dinucleotide microsatellites and BAT-26, and frameshift mutations of transforming growth factor-beta type II receptor. The relation between BAT-26 alterations and relevant clinicopathological or genetic parameters were analyzed. RESULTS: Gastric cancer with BAT-26 alterations was highly correlated with multiple microsatellite alterations (> or = 3 loci) and frameshift mutations of transforming growth factor-beta type II receptor, and predominantly showed antral location, intestinal histologic subtype, advanced stage, a higher rate of Helicobacter pylori infection, a better postoperative survival and less lymph node metastasis. CONCLUSIONS: These results show testing of BAT-26 alterations is a convenient and rapid screening method for identifying a subset of gastric cancer with a mutator phenotype and better prognosis.

Adenocarcinoma↗
PubMedDate not supplied

Clinical application of argon plasma coagulation in endoscopic hemostasis for non-ulcer non-variceal gastrointestinal bleeding--a pilot study in Taiwan.

BACKGROUND/AIMS: Argon plasma coagulation is an innovative non-touch electrocoagulation technique. A broad spectrum of indications has been proposed for argon plasma coagulation since its introduction into endoscopy in 1991. The aim of this study is to evaluate the efficacy of utilizing argon plasma coagulation in the endoscopic hemostasis of non-ulcer, non-variceal gastrointestinal bleeding in Taiwan. METHODOLOGY: A total of 26 consecutive patients (15 men, 11 women; mean age: 67.6 years) underwent argon plasma coagulation treatment between May 1999 and August 2000. Causes of bleeding included angiodysplasia in 3, tumor bleeding in 8, radiation colitis in 11, watermelon stomach in 1, Osler-Weber-Rendu syndrome in 1, and post-intervention in 2. Argon plasma coagulation was performed in 2 patients with bleeders in the esophagus, 10 in the stomach, 1 in the stomach and duodenum, and 13 in the colon. RESULTS: A total of 38 sessions of application in 26 patients were performed. Successful endoscopic argon plasma coagulation treatment was achieved in 21 (80.8%) patients. Neither complication nor mortality related to argon plasma coagulation was observed in these 26 patients. CONCLUSIONS: Argon plasma coagulation is a safe, efficacious, and low-cost hemostatic modality for non-ulcer, non-variceal gastrointestinal bleeding. It is mandatory to establish a comparative trial with other treatment modalities with a longer follow-up in the future.

Adult↗
PubMedDate not supplied

A multiple logistic regression analysis of risk factors in different subtypes of gastric ulcer.

BACKGROUND/AIMS: To elucidate the relationship among disparate ulcer risk factors in 3 subtypes of gastric ulcer. METHODOLOGY: One hundred and fifty-nine age-matched controls, 30 patients with ulcer craters in the gastric body (GU-I), 55 with coexistent gastroduodenal ulcer (GU-II), and 69 with ulcer craters in the prepyloric region (GU-III) were examined for potential risk factors. These included cigarette smoking, nonsteroidal anti-inflammatory drug use, Helicobacter pylori infection, gender and ABO blood group. Using multiple logistic regression analysis, Odds ratios of relevant risk factors associated with different subtypes of gastric ulcer were reported. RESULTS: Among all gastric ulcer subsets, cigarette smoking, nonsteroidal anti-inflammatory drugs use and H. pylori infection were independent ulcer risk factors. For GU-I, smoking (OR: 3.98; 95% CI: 1.44-11.0) and nonsteroidal anti-inflammatory drugs use (OR: 4.33; 95% CI: 1.10-17.1) raised the likelihood of ulceration. For GU-II and GU-III, smoking, nonsteroidal anti-inflammatory drug use and H. pylori infection were identified as risk factors. H. pylori infection carried the strongest association with gastroduodenal ulcer (OR: 9.29; 95% CI: 3.11-27.7) in GU-II, and nonsteroidal anti-inflammatory drug use generated the highest possibility of GU-III (OR: 11.3; 95% CI: 3.49-36.5). Nonsteroidal anti-inflammatory drug use also markedly raised the likelihood of multiple gastric ulcers (OR: 17.0; 95% CI: 4.21-68.9). CONCLUSIONS: Stratification analysis showed differential influences of risk factors on separate subtypes of gastric ulcer. These data support the hypothesis that peptic ulcer disease is heterogeneous in etiology and pathogenesis.

Aged↗
PubMedDate not supplied

Tumor angiogenesis increases with nuclear p53 accumulation in gastric carcinoma.

BACKGROUND/AIMS: Tumor angiogenesis is associated with disease stage in gastric carcinoma. The tumor suppressor p53 was recently reported to regulate angiogenesis. We investigated the relationship between nuclear p53 accumulation and tumor vascularity in gastric carcinoma. METHODOLOGY: Patients with gastric carcinoma undergoing surgery were randomly enrolled. Nuclear p53 expression assessed by immunohistochemistry on tumor sections was categorized as higher and lower groups. Tumor vascularity was assessed by counting microvessel density on anti-CD34 stained sections. Tumor vascularity between different p53 expressions was compared based on the different clinicopathologic characteristics. RESULTS: Twenty-three patients had gastric carcinoma with higher nuclear p53 expression and 42 with lower nuclear p53 expression. Vascularity in higher p53 group (54.3 +/- 35.3) was significantly higher than that in lower p53 group (32.1 +/- 29.9) (p = 0.009). Further analysis showed that higher nuclear p53 immunoreactivity was associated with significantly higher vascularity in the advanced gastric carcinoma group (p = 0.023), the intestinal type group (p = 0.003), the non-cardiac group (p = 0.019), and the H. pylori-negative group (p = 0.014). CONCLUSIONS: The present study demonstrated that nuclear p53 protein expression positively associates vascularity in gastric carcinoma although their relationship varies in the different clinicopathologic subsets.

Aged↗
PubMedDate not supplied

Association of polymorphisms of interleukin-1 beta gene and Helicobacter pylori infection with the risk of gastric ulcer.

BACKGROUND/AIMS: Interleukin-1 beta (IL-1 beta) plays an important role in gastric inflammation and physiology. Functional polymorphisms of IL-1 beta gene have been related to different risks of gastric cancer and duodenal ulcer but their role in gastric ulcer remains unknown. In this study, we investigate a plausible association between gastric ulcer and the polymorphisms in the IL-1 beta and IL-1 receptor antagonist (IL-1RN) genes. The relationships among the cytokine genotyping, other environmental risks such as Helicobacter pylori infection and smoking, and clinical characteristics of gastric ulcer were also determined. METHODOLOGY: Peripheral blood DNAs from 120 unrelated Taiwan Chinese patients with gastric ulcer and 238 ethnically matched healthy controls were genotyped for the promoter (position -31 and -511) and Taq I polymorphism (position +3954) in the IL-1 beta gene and the variable number of tandem repeats polymorphisms in intron 2 of the IL-1RN gene. The status of Helicobacter pylori infection was determined by serology. RESULTS: The seropositive rate of Helicobacter pylori (95/120 vs. 134/238, OR: 2.95, 95%CI 1.77-4.91), habitual smoking (67/120 vs. 82/238, OR: 2.40, 95%CI 1.54-3.77) and blood group O (63/120 vs. 98/238, OR: 1.55, 95%CI 1.0-2.41) were significantly higher in patients with gastric ulcer than controls. The distributions of allele frequencies of IL-1 beta (-31 C/T or -511 C/T or +3954) and IL-1RN were similar between patients with gastric ulcer and controls. No significant differences were observed, including those analyzed after stratification of the infected population and by the ulcer subgroup. CONCLUSIONS: Our data suggested that Helicobacter pylori infection, cigarette smoking, and blood group O are risk factors of gastric ulcer and IL-1 beta or IL-1RN polymorphisms do not influence susceptibility to gastric ulcer in a Taiwanese population.

Aged↗
PubMedDate not supplied

Cyclooxygenase-2 expression correlates with nuclear p53 accumulation in gastric carcinoma.

BACKGROUND/AIMS: COX-2 (Cyclooxygenase-2) is the inducible isoform of cyclooxygenase in response to cytokines, mitogens, and growth factors and may induce carcinogenesis through the mechanisms of inhibiting apoptosis, increasing cell proliferation, and enhancing angiogenesis. This study aimed to clarify the relationship of COX-2 and p53, a well-known tumor suppressor gene, in gastric carcinoma. METHODOLOGY: Immunohistochemical staining of nuclear p53 protein and cytoplasmic COX-2 protein were utilized on tumor tissue sections from 65 surgical specimens. Their correlation was further analyzed according to pathologic characteristics. RESULTS: There were 47% (16/34) of high COX-2 expression in the high p53 immunoreactivity group but only 19% (6/31) of high COX-2 expression in the low p53 immunoreactivity group. COX-2 overexpression significantly correlated with the accumulation of nuclear p53 protein in general (p = 0.035). Analysis based on different pathologic characteristics revealed that COX-2 correlates with p53 in subsets of advanced, cardiac, and H. pylori (-) gastric carcinomas (p = 0.027, 0.048, 0.036, respectively). But the relationship does not differ between Lauren's intestinal- and diffuse-type gastric carcinomas. CONCLUSIONS: Our work provides evidence linking COX-2 and p53 in gastric carcinogenesis, but the mechanism how they interact to promote tumorigenesis remains to be elucidated.

Aged↗
PubMedDate not supplied

Ambulatory esophageal pH monitoring by using a wireless system: a pilot study in Taiwan.

BACKGROUND/AIMS: A new wireless esophageal pH monitoring device, the Bravo system, had been tested in the US with favorable results over conventional systems. However, its clinical application in eastern countries remains limited. The aim of the study was to assess the efficacy of the Bravo system in an Asian population, and compare it with the western results. METHODOLOGY: Thirty consecutive patients with clinically evident gastroesophageal reflux disease underwent esophageal pH monitoring by using the Bravo system. The Bravo capsule capable of measuring and transmitting pH data was introduced into the squamocolumnar junction and fixed on the esophageal mucosa through a locking pin. All patients were instructed to carry the receiver for a 48-hour study. RESULTS: Twenty-nine (97%) of the 30 patients were successfully tested. In most cases (26/30, 87%) the capsules were placed without conscious sedation. All patients had successful capsule placement; however, two of them had failed the initial capsule attachment and required a second capsule. All patients had successful 24-hour recordings (30/30, 100%), while the successful 48-hour recording rate was 97% (29/30). A minor mucosal injury caused by inadvertent capsule extraction was the only complication (1/30, 3.3%). CONCLUSIONS: Compared to the western experience, the new wireless pH monitoring system achieved a comparable attaching rate and recording efficacy. Potential complication was rare and self-limited.

Adult↗