Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Helicobacter pylori (H. pylori) is the most common cause of peptic ulcers, and is considered as carcinogenic with respect to gastric cancer and MALT lymphoma. The role of H. pylori in other gastroduodenal diseases like atrophic gastritis and functional dyspepsia has been investigated in hundreds of works, but little is done about what role H. pylori may play in non gastric diseases. Gastro-esophageal reflux disease does not seem to be related to H. pylori but Barrett's esophagus might be. Inflammatory bowel diseases tend to be reverse correlated with H. pylori. In coronary heart disease some studies have shown a connection, others not. Diabetes is not likely to be H. pylori-associated and nor do liver diseases with exception for cirrhosis, where a correlation is possible. Respiratory diseases are little examined but bronchiectasis might have a correlation with H. pylori. A small series of children, who had died in sudden infant death, showed a high rate of H. pylori infection.
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PMID:Non-gastric effects of H. pylori infection: a literature review with respect to non gastric diseases which might be associated with H. pylori infection. 1002 62

A variety of carcinogens, in particular smoking, alcohol abuse and infections, are associated with an increased risk for the development of cancer of the upper gastrointestinal tract. Cancer prevention should start here, in particular since cessation of nicotine abuse, only moderate consumption of alcohol, and weight loss also have other positive effects on health. Where the indication is appropriate, H. pylori eradication, vaccination against hepatitis B and avoidance of exposure to hepatitis are well-founded prophylactic measures. Further screening measures make good sense only in high-risk groups, and are based on recommendations. It has, however, not yet been demonstrated that the screening of patients with Barrett's esophagus, liver cirrhosis, chronic hepatitis or gastric risk diseases actually can lower cancer-related deaths.
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PMID:[Esophagus, stomach, liver, pancreas carcinoma. What recommendations for prevention?]. 1460 99

Esophageal cancer can be divided in squamous-cell cancer (SCC) and adenocarcinoma (Barrett cancer: AEG I) by histopathology. However, most studies do not differentiate between these two tumor entities. SCC is associated with a lower socioeconomic level with nicotine and alcohol abuse resulting in comorbidities like liver cirrhosis and reduced pulmonary function; in contrast, AEG I is associated with a high socioeconomic level and cardiovascular risk factors. The median age of patients with SCC is 10 years younger than with AEG I. The localization of AEG I is in 94% below the tracheal bifurcation, whereas SCC has contact to the tracheal bronchial tree in 75%. Furthermore, SCC shows an earlier lymphatic spread and a worse prognosis compared to AEG I. The different localization and different comorbidities require different therapeutic strategies. The preoperative induction therapy consists of combined chemoradiotherapy for locally advanced SCC and of chemotherapy for AEG I in our department. Due to the favorable position of AEG I a classic Ivor-Lewis procedure ending with an intrathoracic anastomosis is possible, in contrast, SCC frequently requires a subtotal esophagectomy with cervical anastomosis (in a two step strategy). Therefore, at the moment there is no doubt that SCC and AEG I are two different diseases with different pathogenesis, epidemiology, tumor biology and prognosis requiring different therapeutic strategies. We suggest that the two different tumor entities should be analyzed and reported separately to provide comparable results in the future.
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PMID:Are squamous and adenocarcinomas of the esophagus the same disease? 1718 96

Capsule endoscopy is a new technology that was recently introduced into clinical practice for the diagnosis of gastrointestinal diseases. As of today, three different capsule types have been produced, designed for the exploration of the small bowel (PillCam SB), the esophagus (PillCam ESO) and the colon (PillCam Colon). The PillCam SB has gained widespread acceptance as a powerful tool for the diagnosis of bleeding from the small bowel as well as for other indications. The PillCam ESO has been used to study patients with gastroesophageal reflux disease, for the screening of Barrett's esophagus, and for the screening and surveillance of esophageal varices in patients with cirrhosis. The results of the pilot studies carried out with this capsule have been encouraging. Large-scale studies are ongoing. The evaluation of the potential of the PillCam Colon capsule is still in its infancy: the two pilot studies published showed that this capsule can produce high-quality images of the colon. The potential of this capsule for clinical purposes, such as colon cancer screening, needs to be evaluated.
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PMID:Capsule endoscopy--state of the art. 1782 50

Despite the large amount of research and reporting on potential biomarkers in cancer, very few markers have been brought to use in the clinic. Disorganization plays a large part in this low yield. The Early Detection Research Network (EDRN) of the National Cancer Institute has been initiated to foster collaboration among independent institutions/ laboratories to facilitate, standardize, and centralize discovery and validation of candidate biomarkers. EDRN comprises four components: biomarker reference laboratories; biomarker developmental laboratories; clinical epidemiology and validation centers; and a data management and coordinating center. Biomarker validation proceeds through five phases-the preclinical exploratory, clinical assay and validation, retrospective longitudinal, prospective screening, and cancer control phases. A number of candidate markers in colon cancer, esophageal adenocarcinoma, and hepatocellular carcinoma (HCC) currently are moving through the developmental process. Ongoing EDRN collaborations assessing the potential utility of des-gamma carboxyprothrombin (DCP) in discriminating early HCC in patients with cirrhosis and the ability of DNA methylation analysis to predict progression from Barrett's esophagus to esophageal cancer are summarized. EDRN welcomes collaboration in biomarker validation and assembly of sample reference libraries.
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PMID:Cancer biomarker discovery and development in gastrointestinal cancers: early detection research network-a collaborative approach. 1936 Jan 50

Epigenetics is defined as heritable changes in gene expression that are, unlike mutations, not attributable to alterations in the sequence of DNA. The predominant epigenetic mechanisms are DNA methylation, modifications to chromatin, loss of imprinting and non-coding RNA. Epigenetic regulation of gene expression appears to have long-term effects and wide-ranging effects on health. Diet and environmental exposures may potentially alter the level and scope of epigenetic regulation, thus interesting developments in the study of epigenetics might explain correlations that researchers have found between lifestyle and risk of disease. Aberrant epigenetic patterns have been linked to a number of digestive diseases including Barrett's esophagus, cirrhosis, inflammatory bowel disease, and numerous gastrointestinal malignancies. In fact, many exciting discoveries about epigenetics in general have been made by studying diseases of the gastrointestinal tract and hepatobiliary tree. Epigenetic modifications of DNA in cancer and precancerous lesions offer hope and the promise of novel biomarkers for early cancer detection, prediction, prognosis, and response to treatment. Furthermore, reversal of epigenetic changes represents a potential target of novel therapeutic strategies and medication design. In the future, it is anticipated that innovative diagnostic tests, treatment regimens, and even lifestyle modifications will be based on epigenetic mechanisms and be incorporated into the practice of medicine.
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PMID:Epigenetics: principles and practice. 2173 76

Monoclonal antibodies against cell surface markers are powerful tools in the study of tissue regeneration, repair, and neoplasia, but there is a paucity of specific reagents to identify stem and progenitor cells in tissues of endodermal origin. The epitope defined by the GCTM-5 monoclonal antibody is a putative marker of hepatic progenitors. We sought to analyze further the distribution of the GCTM-5 antigen in normal tissues and disease states and to characterize the antigen biochemically. The GCTM-5 epitope was specifically expressed on tissues derived from the definitive endoderm, in particular the fetal gut, liver, and pancreas. Antibody reactivity was detected in subpopulations of normal adult biliary and pancreatic duct cells, and GCTM-5-positive cells isolated from the nonparenchymal fraction of adult liver expressed markers of progenitor cells. The GCTM-5-positive cell populations in liver and pancreas expanded greatly in numbers in disease states such as biliary atresia, cirrhosis, and pancreatitis. Neoplasms arising in these tissues also expressed the GCTM-5 antigen, with pancreatic adenocarcinoma in particular showing strong and consistent reactivity. The GCTM-5 epitope was also strongly displayed on cells undergoing intestinal metaplasia in Barrett's esophagus, a precursor to esophageal carcinoma. Biochemical, mass spectrometry, and immunochemical studies revealed that the GCTM-5 epitope is associated with the mucin-like glycoprotein FCGBP. The GCTM-5 epitope on the mucin-like glycoprotein FCGBP is a cell surface marker for the study of normal differentiation lineages, regeneration, and disease progression in tissues of endodermal origin.
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PMID:The GCTM-5 epitope associated with the mucin-like glycoprotein FCGBP marks progenitor cells in tissues of endodermal origin. 2276 Oct 39

Obesity is an increasingly serious health problem in nearly all Western countries. It represents an important risk factor for several gastrointestinal diseases, such as gastroesophageal reflux disease, erosive esophagitis, hiatal hernia, Barrett's esophagus, esophageal adenocarcinoma, Helicobacter pylori infection, colorectal polyps and cancer, non-alcoholic fatty liver disease, cirrhosis, and hepatocellular carcinoma. Surgery is the most effective treatment to date, resulting in sustainable and significant weight loss, along with the resolution of metabolic comorbidities in up to 80% of cases. Many of these conditions can be clinically relevant and have a significant impact on patients undergoing bariatric surgery. There is evidence that the chosen procedure might be changed if specific pathological upper gastrointestinal findings, such as large hiatal hernia or Barrett's esophagus, are detected preoperatively. The value of a routine endoscopy before bariatric surgery in asymptomatic patients (screening esophagogastroduodenoscopy) remains controversial. The common indications for endoscopy in the postoperative bariatric patient include the evaluation of symptoms, the management of complications, and the evaluation of weight loss failure. It is of critical importance for the endoscopist to be familiar with the postoperative anatomy and to work in close collaboration with bariatric surgery colleagues in order to maximize the outcome and safety of endoscopy in this setting. The purpose of this article is to review the role of the endoscopist in a multidisciplinary obesity center as it pertains to the preoperative and postoperative management of bariatric surgery patients.
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PMID:Role of endoscopy in the bariatric surgery of patients. 2497 15

Patients with Barrett's esophagus (BE) and cirrhosis who develop high-grade dysplasia (HGD) or adenocarcinoma in the setting of esophageal varices present a unique therapeutic dilemma. There is limited literature regarding the optimal management of varices prior to invasive procedures or surgery involving the distal esophagus. We present a case of variceal decompression with a transjugular intrahepatic portosystemic shunt (TIPS) allowing for successful endoscopic mucosal resection (EMR) of BE with HGD overlying esophageal varices.
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PMID:Transjugular Intrahepatic Portosystemic Shunt Prior to Endoscopic Mucosal Resection for Barrett's Esophagus in the Setting of Varices. 2615 72

Obesity usually is associated with morbidity related to diabetes mellitus and cardiovascular diseases. However, there are many gastrointestinal and hepatic diseases for which obesity is the direct cause (eg, nonalcoholic fatty liver disease) or is a significant risk factor, such as reflux esophagitis and gallstones. When obesity is a risk factor, it may interact with other mechanisms and result in earlier presentation or complicated diseases. There are increased odds ratios or relative risks of several gastrointestinal complications of obesity: gastroesophageal reflux disease, erosive esophagitis, Barrett's esophagus, esophageal adenocarcinoma, erosive gastritis, gastric cancer, diarrhea, colonic diverticular disease, polyps, cancer, liver disease including nonalcoholic fatty liver disease, cirrhosis, hepatocellular carcinoma, gallstones, acute pancreatitis, and pancreatic cancer. Gastroenterologists are uniquely poised to participate in the multidisciplinary management of obesity as physicians caring for people with obesity-related diseases, in addition to their expertise in nutrition and endoscopic interventions.
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PMID:Gastrointestinal Complications of Obesity. 2819 7


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