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Background. This study investigated the risk factors for synchronous esophageal neoplasia in patients with head and neck squamous cell carcinoma (HNSCC). Methods. All 315 consecutive patients with newly diagnosed HNSCC received endoscopic esophageal screening with image-enhanced endoscopy. Results. Sixty-nine patients (21.9%) had synchronous esophageal neoplasia, 37 (53.6%) with superficial neoplasia and 21 (30.4%) with multiple esophageal lesions. Univariate analysis revealed age <50 years, drinking alcohol, and location of index HNSCC were significant risk factors for developing synchronous esophageal neoplasia. In multivariate analysis, drinking alcohol (odds ratio [OR], 3.792; p = .0035), index oropharynxgeal cancers (OR, 3.618; p = .0045) and hypopharyngeal cancers (OR, 2.627; p = .0029) were independent risk factors. Drinking alcohol was clearly dose- response related (p = .001). Conclusion. Alcohol consumption and index tumor location are associated with the development of synchronous esophageal neoplasia in patients with HNSCC. Because of the high prevalence, routine endoscopic examination of the esophagus should be recommended, especially in patients with the risk factors identified. [ABSTRACT FROM AUTHOR]

Background: Obesity has become a major worldwide public health issue. There is a need for tools to measure patient-reported outcomes. The Moorehead-Ardelt Quality of Life Questionnaire II (MA II) contains six items. The objective of this study was to translate the MA II into Chinese and validate it in patients with morbid obesity. Methods: The MA II was translated into Chinese and back-translated into English by two language specialists to create the Taiwan version, which was validated by correlations with two other generic questionnaires of health-related quality of life (HRQOL), Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and World Health Organization Quality of Life (WHOQOL)-BREF Taiwan version. The convergent validity was accomplished by a series of Spearman rank correlations. Reliability of the MA II Taiwan version was determined by internal consistency obtained by Cronbach's alpha coefficient and test-retest reliability obtained by intraclass correlation coefficient. Results: One hundred subjects with morbid obesity were enrolled to test the MA II Taiwan version convergent validity and internal consistency. Test-retest studies (2 weeks apart) were applied to 30 morbidly obese patients. Satisfactory internal consistency was demonstrated by a Cronbach's alpha coefficient of 0.79. Good test-retest reliability was shown by intraclass correlations ranging from 0.73 to 0.91. The total sum of MA II scores was significantly correlated with all four domains of the WHOQOL-BREF and two major components of SF-36 (all correlations, p < 0.01; range, 0.44-0.64). All six MA II items showed significant correlations with each other ( r = 0.34-0.69, p < 0.01), and the total sum of MA II scores was negatively correlated with body mass index ( r = −0.31, p < 0.01), indicating a one-dimensional questionnaire of HRQOL. Conclusions: The MA II Taiwan version is an obesity-specific questionnaire for QOL evaluation with satisfactory reliability and validity. It has the advantages of extensive evaluation for HRQOL, cross-cultural application, rapid completion, high response rates, and an advanced scoring system. [ABSTRACT FROM AUTHOR]

A higher prevalence of erosive esophagitis is found in obese than in nonobese patients; however, it remains unclear why some obese patients develop this disease, whereas others do not. Accordingly, we elucidated the risk factors associated with erosive esophagitis in severely obese Chinese patients. Between June 2007 and January 2009, a total of 260 Chinese patients with morbid obesity referred for bariatric surgery were enrolled in this cross-sectional study. All patients received preoperative endoscopy for evaluation of the presence and severity of erosive esophagitis. Demographic variables, anthropometric measurements, and metabolic factors were included in a logistic regression model to identify the factors predictive of erosive esophagitis. The prevalence of erosive esophagitis was 32.3%. Multiple logistic regression showed that increased waist circumference (odds ratio (OR) = 1.03, 95% confidence interval (CI) = 1.01-1.04), increased insulin resistance (OR = 1.57, 95% CI = 1.06-2.31), and presence of reflux symptoms (OR = 2.40, 95% CI = 1.22-4.74) were independent risk factors associated with erosive esophagitis. In conclusion, among Chinese patients with morbid obesity, increased waist circumference and insulin resistance were risk factors for erosive esophagitis, which highlights the critical role of visceral adiposity in the pathogenesis of erosive esophagitis. [ABSTRACT FROM AUTHOR]

Obesity has become a major health issue not only in the West but also in Asia. Morbid obesity can lead to much comorbidity and can markedly interfere with quality of life. The aim of this study was to compare the health-related quality of life (HRQL) between patients with morbid obesity coming for bariatric surgery and the healthy population in Taiwan. Patients were between age 18 and 65 years. Patients had a BMI between 32 and 40 kg/m2 with obesity-related comorbidities or a BMI > 40 kg/m2. Patients were enrolled for bariatric surgery by a modified recommendation of the Asia-Pacific consensus. Physical and psychiatric evaluations were accomplished simultaneously. The World Health Organization Quality of Life (WHOQOL-BREF), Taiwan version, was administered 1 month before the operation. The quality of life of the obese patients was compared with age-, sex-, education-, marriage-, and municipality-matched healthy control patients taken from a national survey in Taiwan. Multiple regression analyses were conducted to study risk factors for impairment of HRQL. A total of 114 consecutive patients with obesity coming for bariatric surgery at our hospital were enrolled in 2007. Obese subjects had poorer WHOQOL-BREF scores than those of the healthy referents in physical, psychological, and social domains but not in environmental domain ( P < 0.05). Patients with BMI levels above 32 kg/m2 had consistently poorer scores in various facets after adjusting for other risk factors. The higher the BMI level the poorer the HRQL. Our findings seem to support the recommendations of Asia-Pacific consensus based on HRQL considerations. [ABSTRACT FROM AUTHOR]

Obesity has proven to be associated with respiratory symptoms and impaired pulmonary function, which could increase the incidence of postoperative complications after bariatric surgery. However, the component of obesity that has the most influence on pulmonary function has not been identified, especially in Asian-Pacific populations. This cross-sectional study enrolled obese Chinese patients ≥18 years of age with a body mass index (BMI) >32 kg/m2, who were being evaluated for bariatric surgery. All patients performed pulmonary function test, and the results were analyzed according to various anthropometric measurements. Multiple-regression analyses were also conducted and adjusted for age, sex, and smoking history to determine the factors that impaired the pulmonary function of the obese patients. A total of 150 consecutive patients were enrolled from July 2007 to August 2008. We found that body weight, BMI, waist circumference (WC), hip circumference, and waist-to-height ratio but not waist-to-hip ratio had a significant correlation with decreased forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), total lung capacity (TLC), vital capacity (VC), and increased diffusing capacity of the lung for carbon monoxide to alveolar gas volume. After multiple linear regression analysis, only WC was associated with reductions in FEV1, FVC, TLC, and VC. Obesity is associated with a restrictive pattern of impaired pulmonary function in various anthropometric parameters measured in obese Chinese adults in Taiwan. Among these parameters, WC had the greatest impact on pulmonary function, which could also implicate the rate of postoperative complication and the need of more intensive care after bariatric surgery. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To investigate the prevalence of endoscopically suspected esophageal metaplasia (ESEM) in an ethnic Chinese population by endoscopic and pathologic evaluation and to assess the utility of Prague C and M criteria. METHODS: Consecutive patients who received esophagogastroduodenoscopy either as a part of therapy for various upper abdominal symptoms or as an annual health check-up were evaluated for the existence of ESEM and Barrett's esophagus (BE). Biopsy with standardized random four pieces every 2 cm from the four quarters of esophagus with ESEM lesion was performed. BE was defined by histological verification of specialized intestinal metaplasia and gastric metaplasia and was categorized according to the Prague C and M criteria. RESULTS: A total of 5,179 subjects were screened from Jan. 2007 to Dec. 2007. This study enrolled 4,797, including 3,386 for referral endoscopy and 1,411 for screening endoscopy. Prevalence of BE among the referral endoscopy, screening endoscopy, and overall was 1.06%, 0.35%, and 0.85%, respectively. A total of 41 subjects with BE were detected among 93 ESEM subjects. Short segment BE (75.6%, n = 31) was more prevalent than long segment BE (24.4%, n = 10). The proportions of BE from subjects with ESEM by Prague C and M criteria were C≤1M1 38.9% (19/50), C≤1M2 40% (12/30), and C×M ≥3 76.9% (10/13). CONCLUSIONS: On the basis of the standardized protocol with random four-quadrate endoscopic biopsy, we have demonstrated the utility of Prague C and M criteria to characterize the BE in an ethnic Chinese population. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 59-year-old woman with hepatitis C virus-related cirrhosis and esophageal varices. The patient developed hernia after three months of laparotomy and right salpingo-oophorectomy for right ovarian fibroma. The patient was again admitted to the hospital as she was passing blood through stool. It states that computed tomography (CT) angiography was performed for obscure gastrointestinal bleeding (OGIB).

The article presents a case study of a 33-year-old man, who underwent vertical-banded gastroplasty (VBG) to manage morbid obesity and achieved weight loss wherein he was administered with esophagogastroduodenoscopy (EGD) that shows the gastroplasty mesh eroding into the stomach.