Use of a novel through-the-needle biopsy forceps in endoscopic ultrasound.

Background And Aims: Pancreatic cysts are becoming more common. Their differential diagnosis includes benign, premalignant, and malignant lesions. Distinguishing the type of cyst helps in the management decision making.

Impaired upper esophageal sphincter reflexes in patients with supraesophageal reflux disease.

Background & Aims: Normal responses of the upper esophageal sphincter (UES) and esophageal body to liquid reflux events prevent esophagopharyngeal reflux and its complications, however, abnormal responses have not been characterized. We investigated whether patients with supraesophageal reflux disease (SERD) have impaired UES and esophageal body responses to simulated reflux events.

Methods: We performed a prospective study of 25 patients with SERD (age, 19-82 y; 13 women) and complaints of regurgitation and supraesophageal manifestations of reflux.

Prevention of esophagopharyngeal reflux by augmenting the upper esophageal sphincter pressure barrier.

Objectives/hypothesis: Incompetence of the upper esophageal sphincter (UES) is fundamental to the occurrence of esophagopharyngeal reflux (EPR), and development of supraesophageal manifestations of reflux disease (SERD). However, therapeutic approaches to SERD have not been directed to strengthening of the UES barrier function. Our aims were to demonstrate that EPR events can be experimentally induced in SERD patients and not in healthy controls, and ascertain if these events can be prevented by application of a modest external cricoid pressure.

Characterization of the upper esophageal sphincter response during cough.

Background: Vagal reflex initiated by esophageal stimulation and microaspiration can cause chronic cough in patients with gastroesophageal reflux disease (GERD). By raising intraabdominal pressure,cough can, in turn, predispose to GERD. The role of the upper esophageal sphincter (UES)in preventing esophagopharyngeal reflux during coughing is not well known.

Response of the upper esophageal sphincter to esophageal distension is affected by posture, velocity, volume, and composition of the infusate.

Background & Aims: Studies of the pressure response of the upper esophageal sphincter (UES) to simulated or spontaneous gastroesophageal reflux have shown conflicting results. These discrepancies could result from uncontrolled influence of variables such as posture, volume, and velocity of distension. We characterized in humans the effects of these variables on UES pressure response to esophageal distension.