Advances in the endoscopic management of malignant biliary obstruction.

Biliary obstruction is common in pancreatobiliary malignancies and has a negative impact on the patient's quality of life, postoperative complications, and survival rates. Particularly in the last decade, there has been enormous progress regarding the diagnostic and therapeutic options in patients with malignant biliary obstruction. Endoscopy has given a new insight in this direction and novel techniques have been developed for the better characterization and treatment of malignant strictures.

hMSH2 is the most commonly mutated MMR gene in a cohort of Greek HNPCC patients.

Germline mutations in genes encoding proteins involved in DNA mismatch repair are responsible for the autosomal dominantly inherited cancer predisposition syndrome hereditary nonpolyposis colorectal cancer (HNPCC). We describe here analysis of hMLH1 and hMSH2 in nine Greek families referred to our centre for HNPCC. A unique disease-causing mutation has been identified in seven out of nine (78%) families.

Staging of ampullary and pancreatic carcinoma: comparison between endosonography and surgery.

Background: The aim of the study was to update our previously published data on the clinical TNM staging of ampullary and pancreatic carcinoma by endosonography.

Methods: Endosonography was performed in 70 patients with pancreatic cancer and in 32 patients with ampullary carcinoma. TNM staging was carried out before surgery and compared with findings of histology and/or surgery.

Prognosis of esophageal cancers preoperatively staged to be locally invasive (T4) by endoscopic ultrasound (EUS): a multicenter retrospective cohort study.

Background: Endosonography is a significant advance in the preoperative staging (TNM classification) of esophageal cancer. Its accuracy for evaluating depth of tumor invasion is over 80%.

Methods: A multicenter retrospective cohort study of patients with esophageal carcinomas defined to be invasive (T4) by endosonography was performed to compare the survival of surgically and nonsurgically treated patients.

Functional evidence for the presence of nitric oxide synthase in the dorsal motor nucleus of the vagus.

Background & Aims: Histochemical studies indicate that reduced nicotinamide adenine dinucleotide phosphate diaphorase, the nitric oxide synthase-related enzyme, is present in the dorsal motor nucleus of the vagus of the cat. We have previously shown in vitro that NO synthase is present in this nucleus in the rat and that the excitatory effect of N-methyl-D-aspartate on these neurons is in part caused by NO formation. The aim of this study was to obtain functional evidence for the presence of NO synthase in the cat dorsal motor nucleus of the vagus.

Endoscopic ultrasound for staging esophageal cancer, with or without dilation, is clinically important and safe.

Background: To fully evaluate patients with esophageal cancer by endoscopic ultrasonography (EUS), the transducer must pass through the entire tumor to the cardia to scan the celiac axis. Dilation may be necessary. Published information suggests that dilation with EUS carries a sizeable risk.

Endoscopic ultrasonography of perianorectal fistulas and abscesses.

In this article we describe the history, instrument, indications, and results of endoscopic ultrasonography (EUS) in the evaluation of perianorectal fistulas and abscesses. EUS has been reported to be helpful in the management of patients with Crohn's disease or colitis associated with fistulas and abscesses, due to its clear imaging of the leasion and valuable topographic anatomical information. Recent studies point out the relationship between EUS and electromyography.

Endoscopic ultrasonography of perigastrointestinal lymph nodes.

The introduction of endoscopic ultrasonography (EUS) has opened a window in the diagnosis of the perigastrointestinal lymph nodes. Initial euphoria has been sobered by the fact that false-positive and false-negative diagnoses may occur. We review here the use of EUS to stage gastrointestinal cancer, and particularly to predict the presence or absence of lymph-node metastases.

The role of endoscopic ultrasonography in diagnosis of benign lesions of the upper GI tract.

The contribution of endoscopic ultrasonography (EUS) in the diagnosis of benign lesions of the upper gastrointestinal (UGI) tract was studied in 46 patients with polypoid lesions which were not thought to have invaded adjacent tissues or organs. Precise visualization of the five layers of the UGI tract was possible with EUS. The site of origin of the tumour was also determined.

Eradication of Campylobacter pylori and recurrence of duodenal ulcer. A six-month follow-up study.

Fifty-four patients were studied, 41 men and 13 woman, aged 26-76 years, suffering from duodenal ulcer that healed 4-8 weeks after colloidal bismuth subcitrate therapy (360 mgr twice a day). All patients underwent endoscopy before treatment, 4-8 weeks and 6 months later. Biopsy was taken for campylobacter pylori (C.