According to our study, aVD has a more prominent short-term beneficial effect on bone metabolism and disease activity in CD compared with pVD.

Background: The neuroendocrine marker, chromogranin A (CgA) increases during medium- or long-term proton-pump inhibitor (PPI) treatment. Aims: To analyze the effect of ultra-short-term and diverse dose of PPI therapy on serum CgA and gastrin levels and evaluate the effect of PPI treatment cessation. Patients and Methods: Fasting serum CgA and gastrin were determined in newly diagnosed gastroesophageal reflux disease (GERD) patients (n = 54) treated with diverse doses of PPI during a 28-day period, in patients treated with PPIs for at least 6 months (n = 42), and in subjects where PPI treatment could be stopped (n = 11). Results: A significant stepwise increase of CgA levels was observed after 5 days during the 28-day period treatment with all PPI doses. Gastrin increased significantly also in the standard and high-dose PPI subgroups. The most prominent increase of CgA was observed in the high-dose PPI subgroup. Serum CgA and gastrin were markedly elevated after 6 months of PPI treatment, and decreased significantly after 5 days of PPI discontinuation. Conclusions: Serum CgA increases significantly even after ultra-short-term (5 days) PPI therapy. After long-term treatment, 5-day cessation of PPI therapy is sufficient to decrease significantly both CgA and gastrin levels.

these alterations may be early events in carcinogenesis. Quantification of these parameters in Barrett's esophagus might be useful to identify patients at higher risk for progression to cancer. © 2007 The WJG Press. All rights reserved.Key words: Glutathione S-transferase; Matrix metallop ro t e i n a s e -9 ; B a r re tt 's m e t a p l a s i a ; E s o p h a g u s ; Adenocarcinoma; Dysplasia INTRODUCTIONEsophageal cancer is still one of the most widespread diseases, and the early diagnosis of esophageal carcinoma correlates closely with improvement in prognosis. Barrett's esophagus (BE) is a precancerous condition of the lower esophagus in which the normal stratified squamous epithelium is replaced with specialized metaplastic columnar epithelium. Barrett's mucosa represents a type of epithelium that is completely different from the normal esophageal mucosa. BE is the main precancerous condition in the development of esophageal adenocarcinoma [1,2] . BE is diagnosed in up to 20% of patients with documented chronic gastroesophageal reflux disease (GERD). Follow-up studies have shown that BE has a 30-to 125-fold increased risk of developing into an adenocarcinoma, which emerges at a rate of approximately one cancer per 100 patient-years [3] . Barrett's adenocarcinoma displays the most rapidly increasing incidence for gastrointestinal tract cancer in the Western world. Diagnosis of Barrett's adenocarcinoma is usually made late, and consequently, is associated with poor prognosis [4][5][6] . Carcinogens are one of the inducing etiological factors for esophageal adenocarcinoma. Glutathione S-transferase (GST), a family of detoxification enzymes, plays an important role in the prevention of cancer by detoxifying numerous potentially carcinogenic compounds, ESOPHAGEAL CANCERAlterations of glutathione S-transferase and matrix metalloproteinase-9 expressions are early events in esophageal carcinogenesis www Abstract AIM: To investigate the role of glutathione S-transferase (GST) and matrix metalloproteinase-9 (MMP-9) expressions in the development and progression of reflux esophagitis-Barrett's metaplasia-dysplasia-adenocarcinoma sequence in the esophagus. METHODS:GST and MMP-9 expressions were analyzed in 51 paraffin-embedded tissue samples by immunohistochemistry including patients with reflux esophagitis (n = 7), Barrett's metaplasia (n = 14), Barrett and esophagitis (n = 8), Barrett and dysplasia (n = 7), esophageal adenocarcinoma (n = 8) and a control group without any histological changes (n = 7). Immunostaining was determined semiquantitatively. Statistical analysis with one-way ANOVA, LSD test and correlation analysis were performed. P value of < 0.05 was considered significant. RESULTS:GST expression was significantly higher while MMP-9 expression was significantly lower in control group compared to Barrett's metaplasia and the other groups. No major changes were observed between Barrett, esophagitis, and Barrett and concomitant esophagitis. Barrett and concomitant dysplasia, and adenocarcinoma revealed a si...

Background: An occupation-related susceptibility of professional singers to experience gastroesophageal reflux has been suggested. Aims: To investigate the prevalence of gastroesophageal reflux symptoms in a series of professional opera choristers, wind players, glassblowers and water polo players in comparison with a sample of general population. Subjects and Methods: A total of 202 professional opera choristers from well-known choirs in different Hungarian regions, 71 professional wind players, 43 glassblowers, 54 water polo players were identified and 115 control subjects were compared prospectively. Reflux symptoms together with selected individual characteristics and lifestyle habits were investigated in study groups through a reflux questionnaire. Results:Professional opera choristers reported a statistically significantly higher prevalence of heartburn, regurgitation and hoarseness than control subjects (p < 0.001). Among professional wind players, heartburn and regurgitation were significantly more frequent compared with controls (p < 0.05 and p < 0.01, respectively). Glassblowers reported a significantly higher prevalence of acid regurgitation in comparison with controls (p < 0.01). The prevalence of reflux symptoms in water polo players was similar to that of controls. In opera choristers, wind players and glassblowers, reflux symptoms appeared to be significantly correlated with the cumulative lifetime duration of professional singing, playing and working activity, respectively (p < 0.05). Conclusions: Our results demonstrate that professional opera choristers, professional wind players and glassblowers have a higher prevalence of reflux symptoms compared with control subjects. Gastroesophageal reflux in these professions should be considered as a work-related disorder that may have an impact on quality of life and may negatively interfere with professional performance.