Publisher: Elsevier   (Total: 3161 journals)

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Showing 1 - 200 of 3161 Journals sorted alphabetically
Academic Pediatrics     Hybrid Journal   (Followers: 39, SJR: 1.655, CiteScore: 2)
Academic Radiology     Hybrid Journal   (Followers: 26, SJR: 1.015, CiteScore: 2)
Accident Analysis & Prevention     Partially Free   (Followers: 106, SJR: 1.462, CiteScore: 3)
Accounting Forum     Hybrid Journal   (Followers: 28, SJR: 0.932, CiteScore: 2)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 44, SJR: 1.771, CiteScore: 3)
Achievements in the Life Sciences     Open Access   (Followers: 7)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 6)
Acta Astronautica     Hybrid Journal   (Followers: 446, SJR: 0.758, CiteScore: 2)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 2)
Acta Biomaterialia     Hybrid Journal   (Followers: 30, SJR: 1.967, CiteScore: 7)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription   (Followers: 3)
Acta de Investigación Psicológica     Open Access   (Followers: 2)
Acta Ecologica Sinica     Open Access   (Followers: 11, SJR: 0.18, CiteScore: 1)
Acta Histochemica     Hybrid Journal   (Followers: 5, SJR: 0.661, CiteScore: 2)
Acta Materialia     Hybrid Journal   (Followers: 324, SJR: 3.263, CiteScore: 6)
Acta Mathematica Scientia     Full-text available via subscription   (Followers: 5, SJR: 0.504, CiteScore: 1)
Acta Mechanica Solida Sinica     Full-text available via subscription   (Followers: 9, SJR: 0.542, CiteScore: 1)
Acta Oecologica     Hybrid Journal   (Followers: 12, SJR: 0.834, CiteScore: 2)
Acta Otorrinolaringologica (English Edition)     Full-text available via subscription  
Acta Otorrinolaringológica Española     Full-text available via subscription   (Followers: 2, SJR: 0.307, CiteScore: 0)
Acta Pharmaceutica Sinica B     Open Access   (Followers: 2, SJR: 1.793, CiteScore: 6)
Acta Psychologica     Hybrid Journal   (Followers: 26, SJR: 1.331, CiteScore: 2)
Acta Sociológica     Open Access   (Followers: 1)
Acta Tropica     Hybrid Journal   (Followers: 6, SJR: 1.052, CiteScore: 2)
Acta Urológica Portuguesa     Open Access   (Followers: 1)
Actas Dermo-Sifiliograficas     Full-text available via subscription   (Followers: 3, SJR: 0.374, CiteScore: 1)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 2)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 3, SJR: 0.344, CiteScore: 1)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 1)
Actualites Pharmaceutiques     Full-text available via subscription   (Followers: 7, SJR: 0.19, CiteScore: 0)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 3)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 8)
Acute Pain     Full-text available via subscription   (Followers: 15, SJR: 2.671, CiteScore: 5)
Ad Hoc Networks     Hybrid Journal   (Followers: 11, SJR: 0.53, CiteScore: 4)
Addictive Behaviors     Hybrid Journal   (Followers: 18, SJR: 1.29, CiteScore: 3)
Addictive Behaviors Reports     Open Access   (Followers: 9, SJR: 0.755, CiteScore: 2)
Additive Manufacturing     Hybrid Journal   (Followers: 13, SJR: 2.611, CiteScore: 8)
Additives for Polymers     Full-text available via subscription   (Followers: 22)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 188, SJR: 4.09, CiteScore: 13)
Advanced Engineering Informatics     Hybrid Journal   (Followers: 13, SJR: 1.167, CiteScore: 4)
Advanced Powder Technology     Hybrid Journal   (Followers: 17, SJR: 0.694, CiteScore: 3)
Advances in Accounting     Hybrid Journal   (Followers: 9, SJR: 0.277, CiteScore: 1)
Advances in Agronomy     Full-text available via subscription   (Followers: 17, SJR: 2.384, CiteScore: 5)
Advances in Anesthesia     Full-text available via subscription   (Followers: 30, SJR: 0.126, CiteScore: 0)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 2)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 12, SJR: 0.992, CiteScore: 1)
Advances in Applied Mechanics     Full-text available via subscription   (Followers: 12, SJR: 1.551, CiteScore: 4)
Advances in Applied Microbiology     Full-text available via subscription   (Followers: 24, SJR: 2.089, CiteScore: 5)
Advances In Atomic, Molecular, and Optical Physics     Full-text available via subscription   (Followers: 15, SJR: 0.572, CiteScore: 2)
Advances in Biological Regulation     Hybrid Journal   (Followers: 4, SJR: 2.61, CiteScore: 7)
Advances in Botanical Research     Full-text available via subscription   (Followers: 1, SJR: 0.686, CiteScore: 2)
Advances in Cancer Research     Full-text available via subscription   (Followers: 35, SJR: 3.043, CiteScore: 6)
Advances in Carbohydrate Chemistry and Biochemistry     Full-text available via subscription   (Followers: 9, SJR: 1.453, CiteScore: 2)
Advances in Catalysis     Full-text available via subscription   (Followers: 5, SJR: 1.992, CiteScore: 5)
Advances in Cell Aging and Gerontology     Full-text available via subscription   (Followers: 5)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 14)
Advances in Chemical Engineering     Full-text available via subscription   (Followers: 29, SJR: 0.156, CiteScore: 1)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 11, SJR: 0.713, CiteScore: 1)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 11, SJR: 1.316, CiteScore: 2)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 26, SJR: 1.562, CiteScore: 3)
Advances in Colloid and Interface Science     Full-text available via subscription   (Followers: 21, SJR: 1.977, CiteScore: 8)
Advances in Computers     Full-text available via subscription   (Followers: 14, SJR: 0.205, CiteScore: 1)
Advances in Dermatology     Full-text available via subscription   (Followers: 16)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 14)
Advances in Digestive Medicine     Open Access   (Followers: 13)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 7)
Advances in Drug Research     Full-text available via subscription   (Followers: 26)
Advances in Ecological Research     Full-text available via subscription   (Followers: 45, SJR: 2.524, CiteScore: 4)
Advances in Engineering Software     Hybrid Journal   (Followers: 30, SJR: 1.159, CiteScore: 4)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 9)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 52, SJR: 5.39, CiteScore: 8)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 2)
Advances in Fluorine Science     Full-text available via subscription   (Followers: 9)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 68, SJR: 0.591, CiteScore: 2)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 17)
Advances in Genetics     Full-text available via subscription   (Followers: 21, SJR: 1.354, CiteScore: 4)
Advances in Genome Biology     Full-text available via subscription   (Followers: 12, SJR: 12.74, CiteScore: 13)
Advances in Geophysics     Full-text available via subscription   (Followers: 8, SJR: 1.193, CiteScore: 3)
Advances in Heat Transfer     Full-text available via subscription   (Followers: 26, SJR: 0.368, CiteScore: 1)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 11, SJR: 0.749, CiteScore: 3)
Advances in Human Factors/Ergonomics     Full-text available via subscription   (Followers: 26)
Advances in Imaging and Electron Physics     Full-text available via subscription   (Followers: 3, SJR: 0.193, CiteScore: 0)
Advances in Immunology     Full-text available via subscription   (Followers: 37, SJR: 4.433, CiteScore: 6)
Advances in Inorganic Chemistry     Full-text available via subscription   (Followers: 10, SJR: 1.163, CiteScore: 2)
Advances in Insect Physiology     Full-text available via subscription   (Followers: 2, SJR: 1.938, CiteScore: 3)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 6, SJR: 0.176, CiteScore: 0)
Advances in Intl. Accounting     Full-text available via subscription   (Followers: 3)
Advances in Life Course Research     Hybrid Journal   (Followers: 9, SJR: 0.682, CiteScore: 2)
Advances in Lipobiology     Full-text available via subscription   (Followers: 1)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 8)
Advances in Marine Biology     Full-text available via subscription   (Followers: 21, SJR: 0.88, CiteScore: 2)
Advances in Mathematics     Full-text available via subscription   (Followers: 17, SJR: 3.027, CiteScore: 2)
Advances in Medical Sciences     Hybrid Journal   (Followers: 9, SJR: 0.694, CiteScore: 2)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 6)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 5, SJR: 1.158, CiteScore: 3)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 26)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 8)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 7, SJR: 0.182, CiteScore: 0)
Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 5)
Advances in Oncobiology     Full-text available via subscription   (Followers: 2)
Advances in Organ Biology     Full-text available via subscription   (Followers: 2)
Advances in Organometallic Chemistry     Full-text available via subscription   (Followers: 18, SJR: 1.875, CiteScore: 4)
Advances in Parallel Computing     Full-text available via subscription   (Followers: 7, SJR: 0.174, CiteScore: 0)
Advances in Parasitology     Full-text available via subscription   (Followers: 6, SJR: 1.579, CiteScore: 4)
Advances in Pediatrics     Full-text available via subscription   (Followers: 27, SJR: 0.461, CiteScore: 1)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 19)
Advances in Pharmacology     Full-text available via subscription   (Followers: 17, SJR: 1.536, CiteScore: 3)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 10, SJR: 0.574, CiteScore: 1)
Advances in Phytomedicine     Full-text available via subscription  
Advances in Planar Lipid Bilayers and Liposomes     Full-text available via subscription   (Followers: 3, SJR: 0.109, CiteScore: 1)
Advances in Plant Biochemistry and Molecular Biology     Full-text available via subscription   (Followers: 11)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 6)
Advances in Porous Media     Full-text available via subscription   (Followers: 5)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 19)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 20, SJR: 0.791, CiteScore: 2)
Advances in Psychology     Full-text available via subscription   (Followers: 69)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 7, SJR: 0.371, CiteScore: 1)
Advances in Radiation Oncology     Open Access   (Followers: 3, SJR: 0.263, CiteScore: 1)
Advances in Small Animal Medicine and Surgery     Hybrid Journal   (Followers: 3, SJR: 0.101, CiteScore: 0)
Advances in Space Biology and Medicine     Full-text available via subscription   (Followers: 7)
Advances in Space Research     Full-text available via subscription   (Followers: 431, SJR: 0.569, CiteScore: 2)
Advances in Structural Biology     Full-text available via subscription   (Followers: 6)
Advances in Surgery     Full-text available via subscription   (Followers: 13, SJR: 0.555, CiteScore: 2)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 37, SJR: 2.208, CiteScore: 4)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 20)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 15)
Advances in Virus Research     Full-text available via subscription   (Followers: 6, SJR: 2.262, CiteScore: 5)
Advances in Water Resources     Hybrid Journal   (Followers: 56, SJR: 1.551, CiteScore: 3)
Aeolian Research     Hybrid Journal   (Followers: 6, SJR: 1.117, CiteScore: 3)
Aerospace Science and Technology     Hybrid Journal   (Followers: 395, SJR: 0.796, CiteScore: 3)
AEU - Intl. J. of Electronics and Communications     Hybrid Journal   (Followers: 8, SJR: 0.42, CiteScore: 2)
African J. of Emergency Medicine     Open Access   (Followers: 6, SJR: 0.296, CiteScore: 0)
Ageing Research Reviews     Hybrid Journal   (Followers: 12, SJR: 3.671, CiteScore: 9)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 488, SJR: 1.238, CiteScore: 3)
Agri Gene     Hybrid Journal   (Followers: 1, SJR: 0.13, CiteScore: 0)
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 18, SJR: 1.818, CiteScore: 5)
Agricultural Systems     Hybrid Journal   (Followers: 32, SJR: 1.156, CiteScore: 4)
Agricultural Water Management     Hybrid Journal   (Followers: 46, SJR: 1.272, CiteScore: 3)
Agriculture and Agricultural Science Procedia     Open Access   (Followers: 4)
Agriculture and Natural Resources     Open Access   (Followers: 3)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 58, SJR: 1.747, CiteScore: 4)
Ain Shams Engineering J.     Open Access   (Followers: 5, SJR: 0.589, CiteScore: 3)
Air Medical J.     Hybrid Journal   (Followers: 8, SJR: 0.26, CiteScore: 0)
AKCE Intl. J. of Graphs and Combinatorics     Open Access   (SJR: 0.19, CiteScore: 0)
Alcohol     Hybrid Journal   (Followers: 12, SJR: 1.153, CiteScore: 3)
Alcoholism and Drug Addiction     Open Access   (Followers: 12)
Alergologia Polska : Polish J. of Allergology     Full-text available via subscription   (Followers: 1)
Alexandria Engineering J.     Open Access   (Followers: 2, SJR: 0.604, CiteScore: 3)
Alexandria J. of Medicine     Open Access   (Followers: 1, SJR: 0.191, CiteScore: 1)
Algal Research     Partially Free   (Followers: 11, SJR: 1.142, CiteScore: 4)
Alkaloids: Chemical and Biological Perspectives     Full-text available via subscription   (Followers: 2)
Allergologia et Immunopathologia     Full-text available via subscription   (Followers: 1, SJR: 0.504, CiteScore: 1)
Allergology Intl.     Open Access   (Followers: 5, SJR: 1.148, CiteScore: 2)
Alpha Omegan     Full-text available via subscription   (SJR: 3.521, CiteScore: 6)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 11, SJR: 0.201, CiteScore: 1)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 55, SJR: 4.66, CiteScore: 10)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 6, SJR: 1.796, CiteScore: 4)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 6, SJR: 1.108, CiteScore: 3)
Ambulatory Pediatrics     Hybrid Journal   (Followers: 5)
American Heart J.     Hybrid Journal   (Followers: 58, SJR: 3.267, CiteScore: 4)
American J. of Cardiology     Hybrid Journal   (Followers: 67, SJR: 1.93, CiteScore: 3)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 48, SJR: 0.604, CiteScore: 1)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 13)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 15, SJR: 1.524, CiteScore: 3)
American J. of Human Genetics     Hybrid Journal   (Followers: 39, SJR: 7.45, CiteScore: 8)
American J. of Infection Control     Hybrid Journal   (Followers: 29, SJR: 1.062, CiteScore: 2)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 37, SJR: 2.973, CiteScore: 4)
American J. of Medicine     Hybrid Journal   (Followers: 50)
American J. of Medicine Supplements     Full-text available via subscription   (Followers: 3, SJR: 1.967, CiteScore: 2)
American J. of Obstetrics and Gynecology     Hybrid Journal   (Followers: 264, SJR: 2.7, CiteScore: 4)
American J. of Ophthalmology     Hybrid Journal   (Followers: 67, SJR: 3.184, CiteScore: 4)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 5, SJR: 0.265, CiteScore: 0)
American J. of Orthodontics and Dentofacial Orthopedics     Full-text available via subscription   (Followers: 6, SJR: 1.289, CiteScore: 1)
American J. of Otolaryngology     Hybrid Journal   (Followers: 25, SJR: 0.59, CiteScore: 1)
American J. of Pathology     Hybrid Journal   (Followers: 32, SJR: 2.139, CiteScore: 4)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 30, SJR: 2.164, CiteScore: 4)
American J. of Surgery     Hybrid Journal   (Followers: 39, SJR: 1.141, CiteScore: 2)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 12, SJR: 0.767, CiteScore: 1)
Ampersand : An Intl. J. of General and Applied Linguistics     Open Access   (Followers: 7)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.144, CiteScore: 3)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 67, SJR: 0.138, CiteScore: 0)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 25, SJR: 0.411, CiteScore: 1)
Anales de Cirugia Vascular     Full-text available via subscription   (Followers: 1)
Anales de Pediatría     Full-text available via subscription   (Followers: 3, SJR: 0.277, CiteScore: 0)
Anales de Pediatría (English Edition)     Full-text available via subscription  
Anales de Pediatría Continuada     Full-text available via subscription  
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 6, SJR: 4.849, CiteScore: 10)
Analytica Chimica Acta     Hybrid Journal   (Followers: 44, SJR: 1.512, CiteScore: 5)
Analytica Chimica Acta : X     Open Access  
Analytical Biochemistry     Hybrid Journal   (Followers: 215, SJR: 0.633, CiteScore: 2)
Analytical Chemistry Research     Open Access   (Followers: 13, SJR: 0.411, CiteScore: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 14)
Anesthésie & Réanimation     Full-text available via subscription   (Followers: 2)
Anesthesiology Clinics     Full-text available via subscription   (Followers: 25, SJR: 0.683, CiteScore: 2)
Angiología     Full-text available via subscription   (SJR: 0.121, CiteScore: 0)
Angiologia e Cirurgia Vascular     Open Access   (Followers: 1, SJR: 0.111, CiteScore: 0)
Animal Behaviour     Hybrid Journal   (Followers: 237, SJR: 1.58, CiteScore: 3)
Animal Feed Science and Technology     Hybrid Journal   (Followers: 7, SJR: 0.937, CiteScore: 2)
Animal Reproduction Science     Hybrid Journal   (Followers: 7, SJR: 0.704, CiteScore: 2)
Annales d'Endocrinologie     Full-text available via subscription   (Followers: 3, SJR: 0.451, CiteScore: 1)

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Similar Journals
Journal Cover
Advances in Digestive Medicine
Number of Followers: 13  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2351-9797
Published by Elsevier Homepage  [3161 journals]
  • Barrett's esophagus and esophageal adenocarcinoma: East versus West

    • Authors: Chi-Yang Chang; Chun-Ying Wu
      Pages: 121 - 122
      Abstract: Publication date: Available online 10 August 2015
      Source:Advances in Digestive Medicine
      Author(s): Chi-Yang Chang, Chun-Ying Wu


      PubDate: 2015-08-11T07:01:51Z
      DOI: 10.1016/j.aidm.2015.04.006
      Issue No: Vol. 2, No. 4 (2015)
       
  • Analysis of ascitic fluid lactoferrin levels in the diagnosis of
           spontaneous bacterial peritonitis after systemic antibiotic treatment

    • Authors: Chi-Huan Wu; Tsung-Hsing Chen; Chun-Yen Lin; Cheng-Hsun Chiu; Ming-Yao Su; Cheng-Tang Chiu
      Pages: 123 - 127
      Abstract: Publication date: December 2015
      Source:Advances in Digestive Medicine, Volume 2, Issue 4
      Author(s): Chi-Huan Wu, Tsung-Hsing Chen, Chun-Yen Lin, Cheng-Hsun Chiu, Ming-Yao Su, Cheng-Tang Chiu
      Aims Spontaneous bacterial peritonitis (SBP) is one of the most frequent complications of liver cirrhosis. Ascitic fluid lactoferrin has been proved to be a good diagnostic tool for SBP. However, lactoferrin in ascites may be checked after antibiotic treatment in these patients. Our study aims to assess the utility of ascitic fluid lactoferrin levels for the diagnosis of SBP after antibiotic treatment. Materials and methods Twenty-two ascites samples were collected from patients with cirrhosis. Samples were examined for bacterial culture, lactoferrin concentration, and polymorphonuclear leukocyte count. Clinical symptoms and indications for ascitic paracentesis were obtained from medical records. The diagnosis of SBP was based on an elevated ascitic fluid polymorphonuclear leukocyte count of ≥250 cells/mm3. Results Four (18.1%) samples fulfilled the diagnostic criteria for SBP. Three ascites samples showed a positive result for bacterial culture. Patients who received antibiotics for treatment of SBP constituted Group B (n = 9), whereas those who did not receive any antibiotics comprised Group A (n = 9). Lactoferrin concentration was significantly elevated (mean: 261.69 ± 145.5 ng/mL) in the three cases with a positive bacterial culture compared to those without SBP, in both Group A (mean: 19.64 ± 6.32 ng/mL, p = 0.002) and Group B (mean: 23.64 ± 9.53 ng/mL, p = 0.001). Conclusion After systemic antibiotic treatment, elevated lactoferrin levels in the ascites of cirrhotic patients appear to be a promising predictor for the presence of SBP having positive ascitic bacterial culture.

      PubDate: 2015-11-20T03:00:21Z
      DOI: 10.1016/j.aidm.2014.06.010
       
  • IL28B polymorphism and early anemia predict the rapid null response in
           genotype-1 chronic hepatitis C with dual therapy

    • Authors: Wei Teng; Tzu-Ching Chang; Chien-Hao Huang; Wen-Juei Jeng; Wei-Ting Chen; Chang-Wen Huang; Yu-Pin Ho; Chun-Yen Lin; I-Shyan Sheen
      Pages: 128 - 134
      Abstract: Publication date: December 2015
      Source:Advances in Digestive Medicine, Volume 2, Issue 4
      Author(s): Wei Teng, Tzu-Ching Chang, Chien-Hao Huang, Wen-Juei Jeng, Wei-Ting Chen, Chang-Wen Huang, Yu-Pin Ho, Chun-Yen Lin, I-Shyan Sheen
      Background and aims Rapid null response (rNR), defined as less than one log decline of Hepatitis C virus (HCV-RNA) at Week 4 of treatment with pegylated interferon-α and ribavirin (PegIFN/RBV), is highly correlated with treatment failure in patients with chronic hepatitis C (CHC), genotype-1 (GT-1). In this study, we investigate the possible predictors of rNR. Methods We retrospectively analyzed a cohort of 199 GT-1 CHC naive patients who had been treated with a dual therapy of PegIFN/RBV. Clinical parameters and genotypes of rs12979860, the single nucleotide polymorphisms (SNPs) of interleukin-28B (IL28B) were analyzed for their relationship with rNR. Results Of the patients analyzed, 41.7% did not exhibit a rapid virological response (RVR). Only 13.1% of patients who experienced a rNR showed an RVR. The treatment failure rate was 36.2%. High baseline viral load (OR: 5.74; p = 0.028), nonrapid virological response (non-RVR; OR: 4.32; p = 0.004) and rNR (OR: 51.82; p < 0.001) were the predictors of treatment failure. In addition, both the non-CC allele of rs12979860 (OR: 13.8; p < 0.001) and the Hb (hemoglobin) decline to < 3 g/dL within 4 weeks of treatment (no early anemia; OR: 4.6; p = 0.024) were predictors of rNR. Conclusions rNR predicted treatment failure early in GT-1 CHC patients treated with PegIFN/RBV. Non-CC genotype of rs12979860 and no early anemia were significant predictors of rNR.

      PubDate: 2015-11-20T03:00:21Z
      DOI: 10.1016/j.aidm.2015.01.005
       
  • Barrett's esophagus and risk of esophageal adenocarcinoma: A retrospective
           analysis

    • Authors: Hung-Wei Wang; Chia-Jung Kuo; Wey-Ran Lin; Chen-Ming Hsu; Yu-Pin Ho; Chun-Jung Lin; Kuang-Hua Chen; Ming-Yao Su; Cheng-Tang Chiu
      Pages: 135 - 140
      Abstract: Publication date: December 2015
      Source:Advances in Digestive Medicine, Volume 2, Issue 4
      Author(s): Hung-Wei Wang, Chia-Jung Kuo, Wey-Ran Lin, Chen-Ming Hsu, Yu-Pin Ho, Chun-Jung Lin, Kuang-Hua Chen, Ming-Yao Su, Cheng-Tang Chiu
      Background and aim Barrett's esophagus (BE) is the most common cause or precursor of esophageal adenocarcinoma (EAC), a condition with a poor prognosis. This study aimed to investigate the clinical characteristics and risk of EAC in patients with BE. Materials and methods From January 2001 to December 2012, a total of 425 patients with histologically proven BE were identified and analyzed retrospectively. Patients' personal data (smoking, alcohol consumption), underlying systemic disease data (diabetes mellitus and hypertension), endoscopic findings (hiatal hernia, peptic ulcer, endoscopically suspected esophageal metaplasia, severity of reflux esophagitis, rapid urease test), and pathological findings (degree of dysplasia, Helicobacter pylori infection) were collected for further analysis. Results In this retrospective study, 15 patients were diagnosed with EAC. Only one patient was found to have EAC during endoscopic surveillance for BE. The majority of patients (14/15 patients) suffered alarm symptoms and were diagnosed to have BE and EAC concurrently. Meanwhile, EAC is already relatively at an advanced stage. The mean age for diagnosis of EAC in a patient with BE was 67.67 ± 9.92 years old. All patients were male. From a total of 15 patients, 33.3% (5 patients) demonstrated erosive esophagitis under endoscopy and 60% (3 of 5 patients) of these were classified as Los Angeles grade C or D disease. Conclusion Our study found that BE-associated EAC mostly occurred in older men. In the group with BE-associated EAC, the majority of patients were discovered due to alarm symptoms, at the same time as esophageal adenocarcinoma had already developed. Further prospective study is needed to stratify the risk of disease progression in BE patients.

      PubDate: 2015-11-20T03:00:21Z
      DOI: 10.1016/j.aidm.2014.06.011
       
  • Severe diarrhea caused by cytomegalovirus in an elderly man

    • Authors: Szu-Chia Liao; Chung-Wang Ko; Hong-Zen Yeh; Chi-Sen Chang
      Pages: 141 - 144
      Abstract: Publication date: December 2015
      Source:Advances in Digestive Medicine, Volume 2, Issue 4
      Author(s): Szu-Chia Liao, Chung-Wang Ko, Hong-Zen Yeh, Chi-Sen Chang


      PubDate: 2015-11-20T03:00:21Z
      DOI: 10.1016/j.aidm.2015.01.006
       
  • Ileal ulcers in a patient with Henoch-Schönlein purpura

    • Authors: Ying-Yu Shih; Cheng-Chao Liang; Cheng-Kuan Lin; Wei-Fan Hsu; Chien-Sheng Wu; Chen-Shuan Chung
      Pages: 145 - 148
      Abstract: Publication date: Available online 27 April 2015
      Source:Advances in Digestive Medicine
      Author(s): Ying-Yu Shih , Cheng-Chao Liang , Cheng-Kuan Lin , Wei-Fan Hsu , Chien-Sheng Wu , Chen-Shuan Chung
      Henoch-Schönlein purpura (HSP) is a systemic vasculitis characterized by a classic tetrad of nonthrombocytopenic palpable purpura, arthritis, gastrointestinal, and renal involvement. The most common gastrointestinal complaint is abdominal pain. The characteristic endoscopic findings are ulcers seen in the second portion of the duodenum. We present the case of a 45-year-old man suffering from abdominal pain. Erythematous purpura over bilateral lower extremities and soreness of the joints developed 3 days before abdominal pain. An abdominal computed tomography showed an edematous change of the intestinal wall and the distal part of the ileum. A retrograde single balloon enteroscopy revealed several discrete ulcers and hyperemic mucosa in the distal ileum. The middle, proximal, and terminal ileum and ileocecal valve to the rectum were not affected. Under the impression of HSP, nonsteroidal anti-inflammatory drugs and prednisolone were administered. We concluded that balloon-assisted enteroscopy is helpful for differential diagnosis of small bowel lesions in adult patients with HSP.

      PubDate: 2015-05-04T09:04:02Z
      DOI: 10.1016/j.aidm.2014.06.009
       
  • Endoscopic submucosal tunnel dissection for a large esophageal
           subepithelial leiomyoma to prevent postprocedural stenosis

    • Authors: Wen-Hsin Hsu; Meng-Shun Sun Hoi-Wan Ching-Yang Tsai Yu-Jou Tsai
      Abstract: Publication date: Available online 19 December 2015
      Source:Advances in Digestive Medicine
      Author(s): Wen-Hsin Hsu, Meng-Shun Sun, Hoi-Wan Lo, Ching-Yang Tsai, Yu-Jou Tsai
      A 27-year-old man with a huge esophageal leiomyoma, 4.5 cm in size, at the distal esophagus suffered from postprandial belching and chest discomfort. Endoscopic submucosal tunnel dissection was implemented to resect his leiomyoma. His symptoms resolved after tumor resection without any sequelae, such as luminal stricture that often occurs after large-size esophageal lesion resection. Endoscopic submucosal tunnel dissection has been reported to be a useful method for the resection of esophageal submucosal tumors; however, such large-size tumors are rare.

      PubDate: 2015-12-24T23:20:12Z
       
  • Intraobserver and interobserver agreement for identifying extraluminal
           manifestations of Crohn's disease with magnetic resonance enterography

    • Authors: I-Lun Shih; Tsung-Chun Lee; Chia-Hung Tu; Chin-Chen Chang; Yu-Fen Wang; Yao-Hui Tseng; Han-Mo Chiu; Ming-Shiang Wu; Hsiu-Po Wang; Tiffany Ting-Fang Shih; Kao-Lang Liu
      Abstract: Publication date: Available online 24 October 2015
      Source:Advances in Digestive Medicine
      Author(s): I-Lun Shih, Tsung-Chun Lee, Chia-Hung Tu, Chin-Chen Chang, Yu-Fen Wang, Yao-Hui Tseng, Han-Mo Chiu, Ming-Shiang Wu, Hsiu-Po Wang, Tiffany Ting-Fang Shih, Kao-Lang Liu
      Background Magnetic resonance (MR) enterography has emerged as a new imaging modality in evaluating patients with Crohn's disease. However, whether interpretations of MR enterography findings are consistent among radiologists has not yet been fully investigated. The purpose of this study is to evaluate the intraobserver and interobserver agreement for identifying extraluminal manifestations of Crohn's disease with MR enterography. Methods MR enterography was performed with a 3-tesla system. We retrospectively enrolled patients with Crohn's disease that had MR enterography between November 2011 and March 2013. Three radiologists reviewed the images independently. Extraluminal findings of these patients were recorded and described. Intraobserver and interobserver agreement were calculated using the kappa statistic. Results A total of 22 sessions of MR enterography were performed on 15 patients (12 men and 3 women) with Crohn's disease. The mean age was 38.7 ± 11.4 years. We identified extraluminal manifestations such as engorged vasa recta, enlarged mesenteric lymph nodes, fibrofatty proliferation, fistulas, and abscesses. In addition, avascular necrosis of the femoral head as a complication of long-term steroid treatment was also depicted. The intraobserver agreement was almost perfect (κ = 0.83; p < 0.001), and the interobserver agreement was substantial (κ = 0.65; p < 0.001). Conclusion MR enterography is a clinically useful tool for evaluating extraluminal manifestations of Crohn's disease with good intraobserver and interobserver agreement.

      PubDate: 2015-10-25T18:14:28Z
      DOI: 10.1016/j.aidm.2015.05.004
       
  • Giant colonic lipoma arising from the ileocecal valve and causing
           cecal-transverse colonic intussusception

    • Authors: Ching-Chih Hu; Rong-Nan Chien; Chih-Lang Lin; Ching-Jung Liu
      Abstract: Publication date: Available online 24 October 2015
      Source:Advances in Digestive Medicine
      Author(s): Ching-Chih Hu, Rong-Nan Chien, Chih-Lang Lin, Ching-Jung Liu
      Intussusception is rare in adults, representing only 1% of bowel obstruction and 5% of all intussusceptions. Previous reports have shown that > 90% of adults diagnosed with intussusception had an identifiable pathological leading point—a malignant tumor in 43–63% of the cases. Colonic lipomas are rare nonepithelial neoplasms, but represent the most common benign tumors in the large intestine. Most colonic lipomas present as submucosal, sessile polypoid masses with intact mucosa, and they rarely produce symptoms when < 2 cm in diameter. However, all the intussuscepted lipomas in the literature had a tumor size > 4 cm in diameter. As the clinical presentations of adult intussusception are not pathognomonic and the image study may not provide a typical presentation, a precise preoperative diagnosis of whether a benign or malignant tumor is causing the colon intussusception can be difficult. Here, we report the case of a 50-year-old man who presented with abdominal pain and lower gastrointestinal bleeding and was diagnosed postoperatively with ileocecal valve lipoma with cecal-transverse colon intussusception. This report emphasizes colonic lipomas > 4 cm in diameter should receive surgical resection before intussusception develops. However, if the nature of the tumor causing colon intussusception cannot be identified before the operation, en bloc resection is recommended as there is a high risk of malignancy spreading.

      PubDate: 2015-10-25T18:14:28Z
      DOI: 10.1016/j.aidm.2015.08.001
       
  • Establishing a risk scoring system for predicting erosive esophagitis

    • Authors: Hung-Hsu Hung; Chien-Wei Yuan-Jen Wang Jiing-Chyuan Luo Hsin-Bang Leu Hui-Chun
      Abstract: Publication date: Available online 26 September 2015
      Source:Advances in Digestive Medicine
      Author(s): Hung-Hsu Hung, Chien-Wei Su, Yuan-Jen Wang, Jiing-Chyuan Luo, Hsin-Bang Leu, Hui-Chun Huang, Ying-Ying Yang, Tseng-Shing Chen, Ching-Liang Lu, Ming-Chih Hou, Wan-Leong Chan, Han-Chieh Lin, Full-Young Chang, Fa-Yauh Lee, Shou-Dong Lee
      Objective This study aims to establish a noninvasive scoring system to predict the risk of erosive esophagitis (EE). Methods From 2002 to 2009, a total of 34,346 consecutive adults who underwent health check-ups and upper gastrointestinal endoscopy were retrospectively enrolled. Of the participants, 22,892 in the earlier two-thirds period of examination were defined as the training set and the remaining 11,454 as the validation set. EE was diagnosed by upper gastrointestinal endoscopy. Independent risk factors associated with EE were analyzed by multivariate analysis using a logistic regression model with the forward stepwise selection procedure in the training set. Subsequently, an EE risk scoring system was established and weighted by β coefficient. This risk scoring system was further validated in the validation set. Results In the training set, older age, male gender, higher body mass index, higher waist circumference, higher serum triglyceride, and lower high-density lipid cholesterol levels were independent risk factors for predicting EE. According to the β coefficient value of each independent risk factor, the total score ranging from 0 to 10 was established, and then low- (0–3), moderate- (4–6), and high-risk (7–10) groups were identified. In the validation set, the prevalence rates of EE in the low-, moderate-, and high-risk groups were 5.15%, 15.76% and 26.11%, respectively (p < 0.001). Conclusion This simple noninvasive risk scoring system, including factors of age, gender, body mass index, waist circumference, triglyceride, and high-density lipid cholesterol, effectively predicted EE and stratified its incidence.

      PubDate: 2015-10-01T00:40:11Z
       
  • Interleukin-23p19 expression in patients with ulcerative colitis and its
           relation to disease severity

    • Authors: Hanan El-Bassat; Lobna AboAli Sahar Yamany Hanan Shenawy Rasha Din
      Abstract: Publication date: Available online 8 September 2015
      Source:Advances in Digestive Medicine
      Author(s): Hanan El-Bassat, Lobna AboAli, Sahar El Yamany, Hanan Al Shenawy, Rasha A. Al Din, Atef Taha
      Background The purpose of this study was to determine whether the mucosal expression of interleukin (IL)-23p19 has a role in the pathogenesis of ulcerative colitis, and to determine its relation to disease severity. Methods This study was performed on 50 patients with ulcerative colitis and 10 normal individuals as the controls. They were divided into Group I (27 patients with mild to moderate disease), Group II (23 patients with severe disease), and Group III (10 normal individuals). All patients and the controls were subjected to histopathological study, IL-23p19 immunohistochemical staining, IL-23R expression by flow cytometry, and serum IL-23 by enzyme-linked immunoassay. Results There was a significant increase in IL-23p19 gene expression and IL-23R level in patients with ulcerative colitis, compared to the controls. A significant positive correlation was detected between increased expression of the IL-23p19 gene, IL-23R, high serum IL-23, and the severity of the disease. Conclusion Increased expression of the IL-23p19 gene has a role in the pathogenesis of ulcerative colitis. Targeted therapy directed against IL-23p19 may be effective in its treatment. Increased expression of the IL-23p19 gene and IL-23R with high serum IL-23 is correlated positively with disease severity.

      PubDate: 2015-09-11T00:20:05Z
       
  • Pravastatin inhibits tumor growth through elevating the levels of
           apolipoprotein A1

    • Authors: Chun Yeh; Chun-Chia Cheng Hua-Ching Lin Tsai-Yueh Luo Jungshan Chang
      Abstract: Publication date: Available online 10 August 2015
      Source:Advances in Digestive Medicine
      Author(s): Chun Yeh, Chun-Chia Cheng, Hua-Ching Lin, Tsai-Yueh Luo, Jungshan Chang, Ai-Sheng Ho
      Background Statins are a class of drugs used to lower cholesterol levels, accompanying increased high-density lipoprotein (HDL) levels. Previous studies have suggested that statins can inhibit inflammation, and also reduce tumor proliferation. We therefore hypothesized that pravastatin, a member of the statins, mediating the inhibitory functions in tumor growth may be associated with the upregulated HDL constituent, apolipoprotein A1 (ApoA1). Methods Pravastatin-induced inhibition in tumor proliferation in vitro and in xenografts was investigated. Reduced ApoA1 expressions were detected in the tumor regions in specimens from tumor patients as well in xenografts using Western Blotting. Moreover, ApoA1 was administered to inhibit tumor proliferation, and pravastatin was given to enhance the chemotherapeutic efficacy of doxorubicin (DOX). Results We found a significant statistical reduction of ApoA1 in the tumor regions of specimens from gastric cancer and colorectal cancer patients. MKN45 cells proliferation was inhibited by 18% under the growing medium containing pravastatin. ApoA1 levels were elevated in liver Clone 9 cells administered pravastatin, but not in MKN45 cells. In vitro studies revealed that ApoA1 can reduce MKN45 tumor proliferation. Moreover, the tumor volume was significantly reduced in in vivo xenografts after the administration of pravastatin. Combined treatments of pravastatin with DOX significantly minimized the size of tumors, leading to a better therapeutic efficacy. Conclusion This study demonstrated that pravastatin elevated ApoA1, an HDL major constituent with anti-inflammatory characteristics, which displayed strong adversary associations with tumor developments and growth. Increasing the amounts of ApoA1 by pravastatin coupled with DOX may improve the therapeutic efficacy for cancer treatment.

      PubDate: 2015-08-11T07:01:51Z
       
  • Influence of replacing percutaneous endoscopic gastrostomy for nasogastric
           tube feeding on gastroesophageal reflux disease with erosive esophagitis

    • Authors: Chun-Nan Chen; Ming-Shun Gi-Shih Lien Fat-Moon Suk
      Abstract: Publication date: Available online 10 August 2015
      Source:Advances in Digestive Medicine
      Author(s): Chun-Nan Chen, Ming-Shun Wu, Gi-Shih Lien, Fat-Moon Suk
      Background The occurrence rate and severity of gastroesophageal reflux disease with erosive esophagitis (EE) in patients after converting nasogastric tube (NGT) feeding to percutaneous endoscopic gastrostomy (PEG) are not well-known. The aim of this study was to determine the influence of PEG placement on the occurrence and severity of EE in patients with long-term PEG feeding. Methods This retrospective study included patients with NGT feeding who were converted to PEG feeding and received pre- and post-PEG endoscopy between January 2000 and June 2013. Factors predictive of the occurrence of EE after PEG were analyzed. Results One-hundred and twenty patients with NGT feeding were converted to PEG, and 47 patients were included. Before PEG, 21 (44.7%) NGT-feeding patients had EE. The mean follow-up time was 45.7 months (range, 6–147 months). Erosive esophagitis occurred in nine (19.1%) patients after PEG. The occurrence rate (p < 0.01) and severity (p < 0.05) of EE significantly improved after PEG, compared to before PEG. Hill’s classification of gastroesophageal valve was associated with the occurrence of EE after PEG (p < 0.01). Conclusion The occurrence and severity of esophagitis improved after converting the patient to PEG. Hill’s grading of gastroesophageal valve provides useful information for predicting the occurrence of EE after PEG.

      PubDate: 2015-08-11T07:01:51Z
       
  • Clinical factors associated with the survival of patients with
           intrahepatic cholangiocarcinoma

    • Authors: Chun-Fu Ting; Wen-Hsin Huang Chun-Lung Feng Cheng-Ju Cheng-Yuan Peng Wen-Pang
      Abstract: Publication date: Available online 23 April 2015
      Source:Advances in Digestive Medicine
      Author(s): Chun-Fu Ting , Wen-Hsin Huang , Chun-Lung Feng , Cheng-Ju Yu , Cheng-Yuan Peng , Wen-Pang Su , Hsueh-Chou Lai , Ken-Sheng Cheng , Po-Heng Chuang , Jung-Ta Kao
      Background and aim Intrahepatic cholangiocellular carcinoma (ICC) is an uncommon but lethal cancer. The aim of this study is to assess the factors affecting the survival of ICC patients and to evaluate the benefit of these factors when various therapeutic modalities are used. Methods Between October 2007 and June 2012, 66 ICC cases among 2255 liver cancer patients were identified by pathology and divided into two groups: Group I (surgery group; n = 17) and Group II (nonsurgery group; n = 49). Group II was further divided into Group IIa (those receiving palliative treatment; n = 19) and Group IIb (no treatment received; n = 30). Factors affecting patient survival over the study period were assessed (3- and 6-month results were reported) and therapeutic benefits identified within each of the groups were evaluated. Results Of the 66 patients identified (male/female = 36/30), 10.6% (7/66) were in the early stages of illness. Overall, the mean patient survival duration was 3.50 ± 0.92 months (1.69–5.31 months). The mean survival duration of Group I patients was 10.50 ± 2.84 months (4.94–16.06 months). The mean survival duration of Group II patients was 3.50 ± 0.65 months (2.24–4.76 months) with Group IIa patients surviving on average 9.50 ± 3.27 months (3.10–15.90 months) and Group IIb patients surviving on average 1.50 ± 0.12 months (1.26–1.74 months). Better survival outcomes were observed in the groups receiving treatment, Group I and Group IIa, than in Group Iib, which did not receive treatment [9.50 ± 1.73 months (6.12–12.89 months) vs. 1.50 ± 0.12 months (1.26–1.74 months), p < 0.001]. Lower albumin, higher bilirubin, higher CA19-9, advanced tumor stage, and no treatment were identified as important predictors of patient mortality at the 3- and 6-month time-points. These factors remained relevant throughout the entire study period (p = 0.002, 0.029, 0.027, 0.028, < 0.001, respectively). Conclusion This study identified surgery as the treatment that provided the best survival prognosis for patients with ICC. Treatment involving either chemotherapy or radiotherapy could also prolong ICC patient survival. Better liver preservation, lower CA19-9, and less aggressive tumor conditions were identified as factors which play crucial roles in enhancing patient survival.

      PubDate: 2015-05-04T09:04:02Z
       
  • Reticulocyte production index as a predictor of clinically significant
           anemia in chronic hepatitis C patients receiving pegylated interferon
           combination therapy

    • Authors: Sheng-Lei Yan; Cheng-Shyong Chang Chien-Hua Chen Yung-Hsiang Yeh Chien-Yu Tsai
      Abstract: Publication date: Available online 22 April 2015
      Source:Advances in Digestive Medicine
      Author(s): Sheng-Lei Yan , Cheng-Shyong Chang , Chien-Hua Chen , Yung-Hsiang Yeh , Chien-Yu Tsai
      Background This work was conducted to study the relationship of reticulocyte production index to clinically significant anemia in chronic hepatitis C patients receiving pegylated interferon combination therapy. Methods A total of 69 chronic hepatitis C patients receiving pegylated interferon combination therapy were included. Clinically significant anemia was defined as a hemoglobin level of < 10 g/dL. Reticulocyte count values were determined at the baseline and during treatment (4 weeks, 12 weeks, and 24 weeks). Reticulocyte production indices were calculated according to formulae. Clinical variables were analyzed using univariate analysis. Variables that were found to be significant on univariate analysis were included in multivariate analysis. A p value < 0.05 was regarded as statistically significant. Results Clinically significant anemia was observed in 30 patients (43.5%), and 39 patients (56.5%) never developed clinically significant anemia during the whole treatment course. On multivariate analysis, age > 60 years [odds ratio (OR), 2.94; 95% confidence interval (CI), 1.09–7.93], pretreatment hemoglobin level < 14 g/dL (OR, 5.76; 95% CI, 2.01–16.48), and reticulocyte production index < 0.9% (OR, 5.50; 95% CI, 1.78–16.97) at Week 4 were significantly associated with clinically significant anemia. Conclusion Besides old age and low pretreatment hemoglobin level, our study showed that a reticulocyte production index < 0.9% at Week 4 was a significant factor associated with clinically significant anemia during pegylated interferon combination treatment.

      PubDate: 2015-05-04T09:04:02Z
       
  • A man with progressive abdominal distension

    • Authors: Chien-Chu Lin; Yen-Ling Chiu
      Abstract: Publication date: Available online 22 April 2015
      Source:Advances in Digestive Medicine
      Author(s): Chien-Chu Lin , Yen-Ling Chiu


      PubDate: 2015-05-04T09:04:02Z
       
  • Colon perforation after esophagogastroduodenoscopy in an asymptomatic
           diverticulitis patient

    • Authors: Li-Wen Huang; Chun-Che Lin Tan-Hsia Chen Hsiang-Lin Lee Chung-Hung Tsia
      Abstract: Publication date: Available online 22 April 2015
      Source:Advances in Digestive Medicine
      Author(s): Li-Wen Huang , Chun-Che Lin , Tan-Hsia Chen , Hsiang-Lin Lee , Chung-Hung Tsia
      Esophagogastroduodenoscopy (EGD) is regarded as a relatively safe procedure; however, it carries a very low incidence of severe adverse events. Perforation is a rare complication of EGD, and it may further lead to pneumoperitoneum or pneumoretroperitoneum. The occurrence of large bowel perforation after EGD is extremely rare, and it has never been reported in the international literature. Herein, we present a case of concurrence of pneumoperitoneum and pneumoretroperitoneum as a result of sigmoid perforation after EGD. In our case, the probable mechanism of the perforation may have stemmed from the excessive inflation of air that passed through the gastrointestinal tract to the sigmoid colon, causing the increased intraluminal pressure, and then prompting a healed asymptomatic diverticulitis leak again.

      PubDate: 2015-05-04T09:04:02Z
       
  • Immunoglobulin G4-related disease with recurrent obstructive jaundice

    • Authors: Yu-Hsiang Chiu; De-Chuan Chan Yu-Lueng Shih
      Abstract: Publication date: Available online 16 April 2015
      Source:Advances in Digestive Medicine
      Author(s): Yu-Hsiang Chiu , De-Chuan Chan , Yu-Lueng Shih
      A 51-year-old man was referred to our clinic for recurrent obstructive jaundice and underwent pylorus-preserving pancreaticoduodenectomy for a suspected malignancy. The pathology showed immunoglobulin G4 positive plasma cell infiltrated at the pancreas and the gallbladder. We discuss the cost-effectiveness of serum immunoglobulin G4 level prior to arranging for a pancreaticoduodenectomy, which would reduce the possibility of surgical complications as well as costs.

      PubDate: 2015-05-04T09:04:02Z
       
  • Condoms used to assist difficult endoscopic removal of impacted upper
           esophageal foreign bodies

    • Authors: Lian Feng; Lin
      Abstract: Publication date: Available online 16 April 2015
      Source:Advances in Digestive Medicine
      Author(s): Lian Feng Lin
      The use of a homemade balloon dilator and protector hood composed of condoms for assisting the removal of sharp foreign bodies lodged in the upper esophagus in difficult cases is reported. A conventional endoscopic method failed to remove two sharp bones and two press-through packages became impacted in the upper esophagus. A condom was used to make a balloon dilator that was attached to a flexible endoscope in an attempt to dilate the upper esophageal sphincter to dislodge the impacted sharp bones. This handmade condom balloon dilator succeeded in dislodging the two tightly impacted sharp bones and assisted in removing the impacted objects in the upper esophagus. Additionally, a condom was tied to the distal end of the scope to act as a protector hood to protect the esophageal mucosa when removing the sharp packages. The two impacted press-through packages were pushed into the lower esophagus or stomach and removed uneventfully using the condom protector hood. Subsequent endoscopy disclosed no relevant mucosal damage after the successful removal and the patients did well after discharge from the emergency department. In conclusion, condom-based endoscopic balloon dilatation is a simple and accessible method for assisting the endoscopic removal of tightly impacted, sharp foreign bodies in the upper esophagus. A condom can also be used as a protector hood to avoid mucosal injury when removing impacted, sharp press-through packages when a commercial protector hood is not available.

      PubDate: 2015-05-04T09:04:02Z
       
 
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