Comparison of COX-2, Ki-67, and BCL-2 expression in normal esophageal mucosa, Barrett's esophagus, dysplasia, and adenocarcinoma with postablation mucosa and implications for ablative therapies.

Background: The neosquamous mucosa that replaces ablated esophageal endothelium after endoscopic mucosal ablation for Barrett's metaplasia or high-grade dysplasia (HGD) may retain buried glandular tissue. This study aimed to assess the neoplastic potential, cellular proliferation, and resistance to apoptosis of this buried glandular tissue by measuring COX-2, Ki-67, and BCL-2 expression in these tissues.

Methods: A prospectively collected database was sourced for esophageal biopsy specimens with normal histologic appearance, Barrett's metaplasia, HGD, adenocarcinoma, and postablation mucosa comprising ablated Barrett's and ablated HGD.

Risk factors in laparoscopic cholecystectomy: a multivariate analysis.

Background: Laparoscopic cholecystectomy (LC) is the operation of choice in the treatment of symptomatic gallstone disease. The aim of this study is to identify risk factors for LC, outcomes include operating time, length of stay, conversion rate, morbidity and mortality.

Methods: All patients undergoing LC between 1998 and 2007 in a single district general hospital.

Eosinophilic oesophagitis and other non-reflux inflammatory conditions of the oesophagus: diagnostic imaging and management.

Non-reflux inflammatory conditions of the oesophagus are at present rarely encountered in routine clinical practice. However there has been a recent increase in their diagnosis notably due to heightened awareness of their existence and because of the emergence of a number of immunological diseases and deficiencies. Of all the non-reflux conditions, most interest and literature is emerging on the natural history, pathophysiology, endoscopic pattern and management of eosinophilic oesophagitis.

Standardization of surgical technique in antireflux surgery: the LOTUS Trial experience.

Background: To date, it has been difficult to compare medical therapy for gastroesophageal reflux disease with that of surgical management from a scientific viewpoint, mainly because of the lack of standardization of the operative technique. This study was designed to identify a methodology for standardization of surgical technique and to measure the effectiveness of this standardization.

Methods: Surgeons contributing to a major international multicenter trial comparing optimum medical therapy with surgical therapy for treatment of gastroesophageal reflux attempted to optimize their surgical techniques so that a realistic comparison could be made that may aid clinical decision-making.

Argon beam plasma coagulation as therapy for high-grade dysplasia in Barrett's esophagus.

Background & Aims: Patients with high-grade dysplasia in Barrett's esophagus have a high chance of developing adenocarcinoma. Previously these patients have undergone resection, however, the management of patients unsuitable for surgical resection is unclear. We have studied the long-term outcome of patients who have undergone endoscopic Argon ablation for high-grade dysplasia in Barrett's.

Gastrin induces proliferation in Barrett's metaplasia through activation of the CCK2 receptor.

Background And Aims: Factors associated with the development and malignant progression of Barrett's esophagus are poorly understood. Gastrin is a mitogen capable of inducing growth in normal and malignant gastrointestinal mucosa. It is unknown whether gastrin can influence cellular events in the esophagus in Barrett's.