Amitabh Chak

..In this study, we determine whether cancers develop at an earlier age in multiplex Familial Barrett's Esophagus (FBE) kindreds, defined by 3 or more members affected by Barrett's esophagus (BE) or esophageal adenocarcinoma (EAC)...

..The aim of this study was to determine the proportion of patients with these diseases who have familial Barrett's esophagus...

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..The aim of this study was to determine whether familiality and other recognized risk factors are associated with the development of these cancers at an earlier age...

..Obtaining reliable closure of transvisceral defects currently limits natural orifice transluminal endoscopic surgery (NOTES). PEG tubes are potential means of managing NOTES gastrotomies...

..Efforts to develop improved endoscopic therapeutic methods for upper GI bleeding require an effective animal model...

..This approach does not afford mechanically efficient access to all anatomic areas of interest...

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..Real-time visualization of submucosal arterial flow at the base of an ulcer might improve endoscopic hemostasis by permitting more accurate assessment of the artery, precise targeting of therapy, and confirmation of vessel ablation...

..The efficacy and optimal transgastric site for NOTES access in humans, however, has not been determined...

..laparoscopic exploration in the identification of intra-abdominal pathology in a porcine model...

..The relationship of insulin, IGF-1 and IGF binding proteins (IGFBP) with Barrett's oesophagus (BO) has not been well examined...

..63 (95% CI, 32.01-262.29). This segregation analysis provides epidemiologic evidence in support of one or more rare autosomally inherited dominant susceptibility allele(s) in FBE families and, hence, motivates linkage analyses...

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..Measurement of interleukin-1 (IL-1), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) is a validated method to quantify surgical stress. The physiologic and immunologic impact of NOTES is unknown...

..The aim of this meta-analysis was to determine whether temporary stent placement across the main pancreatic-duct orifice lowers the frequency of post-ERCP acute pancreatitis in patients at high risk for this complication...

..Cyst size is an important factor in the management of pancreatic cysts, both in predicting the need for surgery and the frequency of follow-up...

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..However, further modifications, including increased resolution and identification of further potential OCT characteristics of dysplasia, are needed before EOCT can be used clinically...

..Other risk factors for BE, such as gender and age, do not appear to be important determinants for endoscopic referral. Further evaluation of UE as a mechanism to increase screening for BE in primary care patients is merited...

..There is no direct evidence that EUS improves patient outcome...

..There are only limited data regarding the use, effectiveness, and temporal trends of this strategy...

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..An automated registration algorithm was designed to correct such artifacts. The performance of the algorithm was evaluated in images of normal porcine esophagus and demonstrated in images of BE in human patients...

..However, there are significant limitations and barriers to the overall effectiveness of such a pathway in actual clinical practice...

..Our purpose was to evaluate primary-care physician referrals for BE screening when unsedated esophagoscopy is made available...

..A system design based on a spectral-domain OCT platform is reported and validated by acquisition of high quality, volumetric images of swine esophagus in vivo...

..We now examine vimentin methylation in neoplasia of the upper gastrointestinal tract...

..5 cm (range, 1-6 cm) and a mean lateral shift (x-axis) of 0.33 cm (range, 0-1 cm). CONCLUSIONS: Endoscopically placed mucosal metal clips can aid field simulation when planning radiation therapy in patients with esophageal cancer...

..These subsequent cancers are being diagnosed at an earlier stage. Increased surveillance may be one of the factors contributing to this temporal difference...

..Controlled trials support pancreatic-stent placement as an effective intervention for the prevention of post-ERCP acute pancreatitis in high-risk patients...

..Natural orifice transluminal endoscopic surgery (NOTES) can provide access to the peritoneal cavity as a bedside procedure and may decrease the number of patients with unrecognized intra-abdominal catastrophic events...

..By using information otherwise discarded by conventional EUS systems, quantitative spectral analysis of the raw radiofrequency (RF) signals underlying EUS images enables tissue to be characterized more objectively...

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..A familial susceptibility to develop Barrett's epithelium appears to be present in a subset of patients with BE and EAC...

..This study evaluates the utility of hydroperitoneum as an adjunct to EUS-guided access and closure of alternate access sites for NOTES...

..We performed a post hoc analysis of this RCT to explore whether rectal indomethacin can replace PSP in the prevention of PEP and to estimate the potential cost savings of such an approach...

..Continued research into the design of the probes, which could improve durability and extend the depth of penetration, may promote more widespread use of this novel technology...

..CONCLUSIONS: Patients with suspected sphincter of Oddi dysfunction are at higher risk of post-ERCP acute pancreatitis. Sphincter of Oddi manometry by itself does not appear to predispose to this complication...

..30, P(trend) = 0.025). Our data highlight the importance of obesity in the development of early colon neoplasia and suggest substantial racial differences in the measures of obesity most strongly associated with risk of colon adenomas...

..Recommendations by primary care physicians for colorectal screening after polypectomy will influence rates of colonoscopy in open-access systems that do not require consultation by a gastroenterologist before colonoscopy...

..The authors used the Surveillance, Epidemiology and End-Results database of the National Cancer Institute to explore the association of esophageal adenocarcinoma with other primary cancers...

..Our aim was to study the association of receipt of EUS and overall survival in a cohort of patients with esophageal cancer...

..Large flat polyps may be more amenable to endoscopic resection if an endoluminal method for full-thickness closure were available...

..CONCLUSIONS: In vivo OCT is capable of imaging the pancreaticobiliary ductal system and of identifying the epithelial layer. Because of limited depth of imaging (320-845 micron), OCT is unlikely to serve the purpose of tumor staging...

..However, the actual use and clinical impact of upper gastrointestinal endoscopy in screening and surveillance for Barrett esophagus are unknown...

..CONCLUSIONS: Selective use of intraductal US affects the clinical management of a large proportion of patients who undergo C-arm fluoroscopy-guided ERCP for suspected bile duct stones...

..By using the colon adenoma as a model, the endoscopic optical coherence tomography characteristics of dysplasia are loss of tissue organization and reduced light scattering...

..Objective selection criteria such as number of units of packed red blood cells transfused prior to obtaining the scan may increase the overall yield...

..Optimal management of asymptomatic pancreatic cystic neoplasm is not known...

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..CONCLUSIONS: A normal EUS of the pancreas in the setting of subtle radiologic findings, serologic abnormalities, and/or nonspecific symptoms definitively rules out the presence of pancreatic cancer...

..Screening individuals at increased risk for pancreatic cancer (PC) detects early, potentially curable, pancreatic neoplasia...

..Preliminary research suggests that rectally administered nonsteroidal antiinflammatory drugs may reduce the incidence of pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP)...

..We investigated whether ANN models using information available during triage could predict clinical outcome in patients with this disorder...

..Given the current state of endoscopic technology, a minimum diameter of 4 mm is required for satisfactory esophageal imaging...

..Endoscopic TPD closure of standardized NOTES gastric defects results in strong, leak-proof closure; however, injuries can occur. These findings support evaluation of TPD closure in human trials involving noncontrolled gastric defects...

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..In contrast, propofol sedation has already gained acceptance in the community, and the routine use of propofol in endoscopy units will likely increase in the future...

..These data may be informative in predicting resource allocation for therapeutic procedures associated with colonoscopy. Future studies should determine the use and yield of serial colonoscopies for polyp surveillance...

..Pancreatic stents are frequently clogged at the time of removal. There is limited data regarding the factors associated with stent occlusion...

..However, documentation of communication of the results of endoscopy with the patient can be improved...

..Gastric varices may appear similar to enlarged gastric folds and submucosal neoplasms at endoscopy. A simple endoscopic method to diagnose variceal blood flow without formal EUS could be clinically useful...

..These findings suggest that ampullary and colorectal malignancies share common environmental and/or genetic risk factors...

..Unsedated upper endoscopy can provide an efficient, cost-effective alternative to standard endoscopy, should be useful for endoscopic screening, and can be offered as an option to conventional sedated examination...

..Unsedated upper endoscopy can provide an efficient, cost-effective alternative to standard endoscopy, should be useful for endoscopic screening, and can be offered as an option to conventional sedated examination...

..Development of safer wide-field resection techniques, which would effectively remove all Barrett esophagus and obviate the need for long-term surveillance, is needed...

..Obstructive sleep apnea (OSA) has become increasingly prevalent in the United States and often goes undiagnosed...

..Although it appears that over the last decade EUS has become disseminated fairly uniformly on a global basis, a lack of consistent training standards and also inadequate opportunities for EUS training remain important areas of concern...

..Advanced cancers of the bile duct and gallbladder carry an ominous prognosis. Rebeccamycin analogue (RA) is a novel antitumor antibiotic where phase I trials suggested clinical efficacy in patients with biliary cancers...

..This article reviews the status, contemporary body of literature, limitations, and potential future implications accompanying the development of NOTES...

..001). EUS had a positive predictive value of 80% for pathologic tumor regression. CONCLUSIONS: Measurement of tumor size by EUS is a reliable clinical method for assessing pathologic tumor regression before surgery...

..We sought to determine the indications, feasibility, safety, and effect on patient management of ERCP in pediatric patients of varying age...

..Careful consideration of predictive factors of survival may improve patient selection for feeding PEG placement...

..The current ablative techniques used are photodynamic therapy, argon plasma coagulation, laser treatment, and endoscopic mucosal resection...

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..This finding appears to be a function of the portals used for postmastectomy radiation therapy, which do not expose the lowest third of the esophagus, where adenocarcinomas commonly arise...