Barrett's esophagus: prevalence-incidence and etiology-origins.

Although the prevalence of Barrett's esophagus (BE) is rising no data exist for racial minorities on prevalence in the general population. Minorities have a lower prevalence than Caucasians, and yet age, smoking, abdominal obesity, and Helicobacter pylori are all risk factors. Metabolic changes induced by adipocytokines and the apparently strong association between obesity, central adiposity, and BE may lead to reconsideration of some aspects of the natural history of BE.

Unilateral ischemic preconditioning and heterologous preconditioning in living donor liver transplantation.

Ischemic preconditioning (IP) exerts a protective effect on tissues undergoing prolonged ischemia. No studies have been performed to assess the clinical impact of IP on normal human liver used for living donor transplantation (LDLT). Heterologous preconditioning (HP) protects liver tissue as demonstrated in a rat model.

Does nonalcoholic fatty liver disease predispose patients to hepatocellular carcinoma in the absence of cirrhosis?

Context: Hepatocellular carcinoma (HCC) is recognized as a complication of cirrhosis related to nonalcoholic fatty liver disease (NAFLD). Diabetes and the metabolic syndrome are also associated with HCC. However, it is not clear whether NAFLD predisposes patients to HCC in the absence of cirrhosis.

Endovascular treatment of intimomedial mucoid degeneration.

Intimomedial degeneration is a rare and poorly understood vascular disorder involving the circumferential deposition of large amounts of mucoid material within the intima and media of the arterial wall, causing weakening that results in aneurysm formation of the involved segment. The cause of the disease is unknown at this time. The authors describe the endovascular treatment of a large symptomatic superior gluteal artery aneurysm in a patient with multiple arterial aneurysms and the histologic diagnosis of intimomedial mucoid degeneration.

Pulmonary sequestration with CCAM type II appearing as adrenal tumor protruding through a Bochdalek hernia.

A case of a pulmonary sequestration, which almost exclusively consisted of a congenital cystic adenomatoid malformation type II located subdiaphragmatically in the left retroperitoneal area, is reported. This case, in a 24-year-old male patient, is unique in that it appeared as an adrenal incidentaloma and extended through a Bochdalek hernia into the pleural space. It was discovered upon routine ultrasound screening for hepatocellular carcinoma in a patient with a carrier state for hepatitis B.

Alveolar rhabdomyosarcoma with neuroendocrine/neuronal differentiation: report of 3 cases.

The aim of this study is to report the clinicopathologic characteristics of 3 cases of alveolar rhabdomyosarcoma with neuroendocrine/neuronal differentiation. Specimens of 3 cases of alveolar rhabdomyosarcoma were studied using histologic, immunohistochemical, ultrastructural, and molecular genetic techniques. The patients were a 19-year-old man with metastatic alveolar rhabdomyosarcoma in a groin lymph node, a 16-year-old girl with alveolar rhabdomyosarcoma of the perineum, and a 20-year-old man with recurrent orbital alveolar rhabdomyosarcoma.

Adult living-donor liver transplantation with ABO-incompatible grafts.

Background: Liver transplantation using ABO-incompatible grafts is rarely performed because the reported outcome is poorer than with compatible grafts. We report our positive experience with adult-to-adult living-donor liver transplant (LDLT) using ABO-incompatible grafts.

Methods: The immunosuppressive protocol consisted of plasmapheresis/intravenous immunoglobulin infusion before LDLT followed by thymoglobulin induction and splenectomy, maintenance with tacrolimus/cyclosporine (FK/CSA), mycophenolate mofetil, and a rapid steroid taper.

Five-year colon surveillance after screening colonoscopy.

Background & Aims: Outcomes of colon surveillance after colorectal cancer screening with colonoscopy are uncertain. We conducted a prospective study to measure incidence of advanced neoplasia in patients within 5.5 years of screening colonoscopy.

Primary biliary B-cell lymphoma of the cystic duct causing obstructive jaundice.

A distinctive case of primary biliary lymphoma occurring in the cystic duct causing extrinsic compression of the porta hepatis in a 48-year-old woman is presented. Imaging studies revealed stricture of the common hepatic duct with a 2.5-cm nonhomogeneous mass at the porta hepatis, mimicking a Klatskin tumor.

Peliosis hepatis in a living related liver transplantation donor candidate.

Peliosis hepatis is a rare benign condition histologically characterized by multiple cystic blood-filled spaces distributed throughout the liver parenchyma. Peliosis hepatis has been associated with malignancies, immunosuppression, infections and medications. We report a case of peliosis hepatis in a candidate for living liver donation, which regressed with restitutio ad integrum, after the noxious stimulus was stopped.

Thymoglobulin induction protects liver allografts from ischemia/reperfusion injury.

Background: Interventions that minimize hepatic ischemia/reperfusion injury (IRI) can expand the donor organ pool. Thymoglobulin (TG) induction therapy has been shown to ameliorate delayed graft function and possibly decrease IRI in cadaver renal transplants recipients. This controlled randomized trial was designated to assess the ability of TG to protect against IRI in liver transplant recipients.

Early experience employing a linear hepatic parenchyma coagulation device.

Background: In recent years, hepatic resection for primary and metastatic disease has been facilitated by improved anesthetic and surgical techniques, as well as by the application of new technologies. Historically, the major complications associated with hepatic resection have been postoperative bleeding, bile leak, and liver failure. Resection techniques and devices that minimize hemorrhage and bile leak, and enable the preservation of functional hepatic parenchyma, have been useful in the surgical management of liver tumors.

Asthmatics with gastroesophageal reflux: long term results of a randomized trial of medical and surgical antireflux therapies.

Objective: In short term studies, asthma symptoms and pulmonary function have been reported to improve during and after medical treatment or surgical correction of gastroesophageal reflux (GER). In this study, we aimed to determine whether prolonged treatment of GER altered the long term natural history of asthma in asthmatics with GER.

Methods: A total of 62 patients with both GER and asthma entered a randomized study of antireflux treatments for at least 2 yr: 24 controls (antacids as needed); 22 medical (ranitidine 150 mg t.

Gastrointestinal stromal tumors: a spectrum of disease.

The majority of gastrointestinal stromal tumors (GIST) express c-kit, a growth factor receptor with tyrosine kinase activity. Mutations in the c-kit proto-oncogene may lead to constitutive ligand-independent activation of c-kit and subsequent neoplastic transformation. Selective tyrosine kinase inhibitors target this property of GIST and have become the standard chemotherapy for metastatic or unresectable tumors.

Hemostatic modulation with the liver dialysis device in humans with advanced liver disease.

Background/aims: To determine the alterations in coagulation and fibrinolysis occurring in patients treated with the liver dialysis device.

Methodology: Patients with advanced liver disease treated with the liver dialysis device were studied immediately before and after the liver dialysis device treatment.

Setting: A university hospital intensive care unit.

Hiatal hernia size, Barrett's length, and severity of acid reflux are all risk factors for esophageal adenocarcinoma.

Objective: The reasons for the development of dysplasia and adenocarcinoma in Barrett's mucosa are not well understood. The aims of this study were to characterize risk factors for the transition from Barrett's esophagus without dysplasia to Barrett's esophagus with high-grade dysplasia or esophageal adenocarcinoma.

Methods: A group of 131 patients with high-grade dysplasia or esophageal adenocarcinoma were selected as case subjects.

Malakoplakia of liver diagnosed by a needle core biopsy: a case report and review of the literature.

Although malakoplakia of the genitourinary tract and colon is reported frequently in the literature, malakoplakia that occurs primarily in the liver is rare, and only 4 cases have been described thus far. To our knowledge, this is the first case of malakoplakia of the liver diagnosed by a needle core biopsy. This case occurred in a 19-year-old man with small bowel ileus following Klebsiella pneumonia.