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| 1 | Passive expansion of sub-maximally dilated transjugular intrahepatic portosystemic shunts and assessment of clinical outcomes显示文摘AIM To assess for passive expansion of sub-maximally dilated transjugular intrahepatic portosystemic shunts(TIPS) and compare outcomes with maximally dilated TIPS.METHODS Polytetrafluoroethylene covered TIPS(Viatorr) from July 2002 to December 2013 were retrospectively reviewed at two hospitals in a single institution. Two hundred and thirty patients had TIPS maximally dilated to 10 mm(m TIPS), while 43 patients who were at increased risk for hepatic encephalopathy(HE), based on clinical evaluation or low pre-TIPS portosystemic gradient(PSG), had 10 mm TIPS sub-maximally dilated to 8 mm(sm TIPS). Group characteristics(age, gender, Model for End-Stage Liver Disease score, post-TIPS PSG and clinical outcomes were compared between groups, including clinical success(ascites or varices), primary patency,primary assisted patency, and severe post-TIPS HE. A subset of fourteen patients with sm TIPS underwent follow-up computed tomography imaging after TIPS creation, and were grouped based on time of imaging(< 6 mo and > 6 mo). Change in diameter and crosssectional area were measured with 3D imaging software to evaluate for passive expansion.RESULTS Patient characteristics were similar between the sm TIPS and m TIPS groups, except for pre-TIPS portosystemic gradient, which was lower in the sm TIPS group(19.4 mm Hg ± 6.8 vs 22.4 mm Hg ± 7.1, P = 0.01). Primary patency and primary assisted patency between sm TIPS and m TIPS was not significantly different(P = 0.64 and 0.55, respectively). Four of the 55 patients(7%) with sm TIPS required TIPS reduction for severe refractory HE, while this occurred in 6 of the 218 patients(3%) with m TIPS(P = 0.12). For the 14 patients with follow-up computed tomography(CT) imaging, the median imaging follow-up was 373 d. There was an increase in median TIPS diameter, median percent diameter change, median area, and median percent area change in patients with CT follow-up greater than 6 mo after TIPS placement compared to follow-up within 6 mo(8.45 mm, 5.58%, 56.04 mm^2, and 11.48%, respectively, P = 0.01).CONCLUSION Passive expansion of sm TIPS does occur but clinical outcomes of sm TIPS and m TIPS were similar. Sub-maximal dilation can prevent complications related to overshunting in select patients. | Michael C Hsu Charles N Weber S William Stavropoulos Timothy W Clark Scott O Trerotola Richard D Shlansky Goldberg Michael C Soulen Gregory J Nadolski | 2017 | World Journal of Hepatology2017，9，12： | 11 |
| 2 | Endoscopic balloon catheter dilatation via retrograde or static technique is safe and effective for cricopharyngeal dysfunction显示文摘AIM To evaluate the safety and efficacy of upper esophageal sphincter(UES) dilatation for cricopharyngeal(CP) dysfunction. To determine if:(1) indication for dilatation; or(2) technique of dilatation correlated with symptom improvement.METHODS All balloon dilatations performed at our institution from over a 3-year period were retrospectively analyzed for demographics, indication and dilatation site. All dilatations involving the UES underwent further review to determine efficacy, complications, and factors that predict success. Dilatation technique was separated into static(stationary balloon distention) and retrograde(brusque pull-back of a fully distended balloon across the UES).RESULTS Four hundred and eighty-eight dilatations were reviewed. Thirty-one patients were identified who underwent UES dilatation. Median age was 63 years(range 27-81)and 55% of patients were male. Indications included dysphagia(28 patients), globus sensation with evidence of UES dysfunction(2 patients) and obstruction to echocardiography probe with cricopharyngeal(CP)bar(1 patient). There was evidence of concurrent oropharyngeal dysfunction in 16 patients(52%) and a small Zenker's diverticula(≤ 2 cm) in 7 patients(23%). Dilator size ranged from 15 mm to 20 mm. Of the 31 patients, 11 had dilatation of other esophageal segments concurrently with UES dilatation and 20 had UES dilatation alone.Follow-up was available for 24 patients for a median of 2.5 mo(interquartile range 1-10 mo), of whom 19 reported symptomatic improvement(79%). For patients undergoing UES dilatation alone, follow-up was available for 15 patients, 12 of whom reported improvement(80%).Nineteen patients underwent retrograde dilatation(84%response) while 5 patients had static dilatation(60%response); however, there was no significant difference in symptom improvement between the techniques(P = 0.5).Successful symptom resolution was also not significantly affected by dilator size, oropharyngeal dysfunction,Zenker's diverticulum, age or gender(P > 0.05). The only complication noted was uvular edema and a shallow ulcer after static dilatation in one patient, which resolved spontaneously and did not require hospital admission.CONCLUSION UES dilatation with a through-the-scope balloon by either static or retrograde technique is safe and effective for the treatment of dysphagia due to CP dysfunction. To our knowledge, this is the first study evaluating retrograde balloon dilatation of the UES. | Vinay Chandrasekhara Joyce Koh Lakshmi Lattimer Kerry B Dunbar William J Ravich John O Clarke | 2017 | World Journal of Gastrointestinal Endoscopy2017，9，4： | 6 |
| 3 | Upper esophageal sphincter abnormalities are strongly predictive of treatment response in patients with achalasia显示文摘AIM: To investigate the relationship between upper esophageal sphincter abnormalities achalasia treatment METHODS: We performed a retrospective study of 41 consecutive patients referred for high resolution esophageal manometry with a final manometric diagnosis of achalasia. Patients were sub-divided by presence or absence of Upper esophageal sphincter(UES) abnormality, and clinical and manometric profiles were compared.Correlation between UES abnormality and sub-type(i.e.,hypertensive, hypotensive or impaired relaxation) and a number of variables, including qualitative treatment response, achalasia sub-type, co-morbid medical illness,psychiatric illness, surgical history, dominant presentingsymptom, treatment type, age and gender were also evaluated.RESULTS: Among all 41 patients, 24(58.54%) had a UES abnormality present. There were no significant differences between the groups in terms of age, gender or any other clinical or demographic profiles. Among those with UES abnormalities, the majority were either hypertensive(41.67%) or had impaired relaxation(37.5%) as compared to hypotensive(20.83%), although this did not reach statistical significance(P = 0.42). There was no specific association between treatment response and treatment type received; however, there was a significant association between UES abnormalities and treatment response. In patients with achalasia and concomitant UES abnormalities, 87.5% had poor treatment response, while only 12.5% had favorable response. In contrast, in patients with achalasia and no UES abnormalities, the majority(78.57%) had good treatment response, as compared to 21.43% with poor treatment response(P = 0.0001). After controlling for achalasia sub-type, those with UES abnormality had 26 times greater odds of poor treatment response than those with no UES abnormality(P = 0.009). Similarly, after controlling for treatment type, those with UES abnormality had 13.9 times greater odds of poor treatment response compared to those with no UES abnormality(P = 0.017).CONCLUSION: The presence of UES abnormalities in patients with achalasia significantly predicted poorer treatment response as compared to those with normal UES function. | Simon C Mathews Maria Ciarleglio Yamile Haito Chavez John O Clarke Ellen Stein Bani Chander Roland | 2014 | World Journal of Clinical Cases2014，2，9： | 5 |
| 4 | Gastric per-oral endoscopic myotomy: Current status and future directions显示文摘Gastroparesis, or symptomatic delayed gastric emptying in the absence of mechanical obstruction, is a challenging and increasingly identified syndrome. Medical options are limited and the only medication approved by the Food and Drug Administration for treatment of gastroparesis is metoclopramide, although other agents are frequently used off label. With this caveat, first-line treatments for gastroparesis include dietary modifications, antiemetics and promotility agents, although these therapies are limited by suboptimal efficacy and significant medication side effects. Treatment of patients that fail first-line treatments represents a significant therapeutic challenge. Recent advances in endoscopic techniques have led to the development of a promising novel endoscopic therapy for gastroparesis via endoscopic pyloromyotomy, also referred to as gastric per-oral endoscopic myotomy or per-oral endoscopic pyloromyotomy. The aim of this article is to review the technical aspects of the per-oral endoscopic myotomy procedure for the treatment of gastroparesis, provide an overview of the currently published literature, and outline potential next directions for the field. | Alexander Podboy Joo Ha Hwang Linda A Nguyen Patricia Garcia Thomas A Zikos Afrin Kamal George Triadafilopoulos John O Clarke | 2019 | World Journal of Gastroenterology2019，25，21： | 3 |
| 5 | Serotonin, tryptophan metabolism and the brain-gut-microbiome axis显示文摘 | S.M. O’Mahony G. Clarke Y.E. Borre T.G. Dinan J.F. Cryan | 2014 | Behavioural Brain Research2014，，： | 2 |
| 6 | Therapeutic microRNA Delivery Suppresses Tumorigenesis in a Murine Liver Cancer Model显示文摘 | Janaiah Kota Raghu R. Chivukula Kathryn A. O’Donnell Erik A. Wentzel Chrystal L. Montgomery Hun-Way Hwang Tsung-Cheng Chang Perumal Vivekanandan Michael Torbenson K. Reed Clark Jerry R. Mendell Joshua T. Mendell | 2009 | Cell2009，，6： | 2 |
| 7 | Prognostic Significance of Myocardial Fibrosis in Hypertrophic Cardiomyopathy显示文摘 | Rory O’Hanlon Agata Grasso Michael Roughton James C. Moon Susan Clark Ricardo Wage Jessica Webb Meghana Kulkarni Dana Dawson Leena Sulaibeekh Badri Chandrasekaran Chiara Bucciarelli-Ducci Ferdinando Pasquale Martin R. Cowie William J. McKenna Mary N. Shep | 2010 | Journal of the American College of Cardiology2010，，11： | 2 |
| 8 | The persistence and degradation of chlorothalonil and chlorpyrifos in a cranberry bog 显示文摘 | Putnam R A Nelson J O Clark J M | 2003 | Agric Food Chem2003，51，： | 1 |
| 9 | N-methyl-D-aspartate and brain-derived neurotrophic factor induce distinct profiles of extracellular signal-regulated kinase,mitogen-and stress-activated kinase,and ribosomal s6 kinase phosphorylation in cortical neurons显示文摘 | Rakhit S Clark CJ O'shaughnessy T C | 2005 | Mol Pharmacol2005，67，4： | 1 |
| 10 | Micrometastases in esophagogastric cancer:high detection rate in resected rib segments显示文摘 | O'SULLIVAN G C SHEEHAN D CLARKE A | 1999 | Gastroenterology1999，116，3： | 1 |
| 11 | The persistence and degradation of chlorothalonil and chlorpyrifos in a cranberry bog显示文摘 | PUTNAN R A NELSON J O CLARK J M | 2003 | Journal of Agricultural and Food Chemistry2003，51，1： | 1 |
| 12 | Estimation of tropical forest structural characteristics using large-footprint lidar显示文摘 | Jason B Drake Ralph O Dubayah David B Clark Robert G Knox J.Bryan Blair Michelle A Hofton Robin L Chazdon John F Weishampel Steve Prince | 2001 | Remote Sensing of Environment2001，，2： | 1 |
| 13 | Review of 'emerging'organic contaminants in biosolids and assessment of international research priorities for the agricultural use of biosolids 显示文摘 | Clarke B O Smith S R | 2011 | Environ Int2011，37，1： | 1 |
| 14 | The detection of cytokeratins in lymph nodes of Duke's B colorectal cancer subjects predicts a poor outcome显示文摘 | Clarke G Ryan E O'Keane JC | 2000 | Eur J Gastroenterol Hepatol2000，12，5： | 1 |
| 15 | Detection of a streptomycin/spectinomycin adenylytransferase gene (aadA) in Enterococcus faecalis显示文摘 | Clark NC Olsvik O Swenson JM | 1999 | Antimicrob Agents Chemother1999，43，： | 1 |
| 16 | Reproducibility of SELDI Speca Across Time and Laboratories显示文摘 | Diao L Clarke CH Coombes KR et o!1 | 2011 | Cancer In- form2011，10，3： | 1 |
| 17 | Self-Similar Evolution of Parabolic Pulses in a Laser显示文摘 | ILDAY F (A) O BUCKLEY J R CLARK W G WISE F W | | 0，，： | 1 |
| 18 | Counterexample-guided abstraction refinement for symbolic model checking 显示文摘 | Clarke E Grumberg O Jha S | 2003 | Journal of the ACM (JACM)2003，50，5： | 1 |
| 19 | Nausea and vomiting fol- lowing thyroid and parathyroid surgery显示文摘 | Sonner JM Hynson JM Clark O | 1997 | J Clin Anesth1997，9，5： | 1 |
| 20 | High-volume he- mofiltration for septic acute kidney injury: a systematic review and meta-analysis显示文摘 | Clark E Molnar A Joannes-Boyau O | 2014 | Crit Care2014，18，1： | 1 |
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