Disease relevance of GER

• Ten patients with moderate or severe GER underwent endoscopy, which revealed GER-related esophagitis in 8 cases [1].
• There was no statistical difference of GER frequency and degree according to: age, sex, growth status, presence of type DF508 mutation in CFTR genome and typical GERD symptoms [1].
• The study evaluated GER frequency and characteristics in children with Cystic Fibrosis (CF) as well as its consequences and pharmacological treatment [1].
• CONTEXT: Gastroesophageal reflux (GER) has not previously been widely regarded as a hereditary disease [2].
• Gastroesophageal reflux (GER) was initially diagnosed in two black infants, aged 5 and 9 months, as a cause of their chronic lung disease and failure to thrive [3].
• The presence of a hiatus hernia (P = .028) and reflux esophagitis grading Los Angeles classification C or D (P = .008) were significantly more frequent in the GER group compared with the NGER group [4].

Psychiatry related information on GER

• During the night LES relaxation and GER occurred only during transient arousals from sleep or when the subjects were fully awake, but not during stable sleep [5].
• Physical activity at work was dose dependently associated with increased risk of frequent GER symptoms, and recreational physical activity decreased this risk [6].
• Risk factors for BE include conditions that are associated with GER such as mental retardation, esophageal stricture, esophageal atresia, and reversed gastric tube esophagoplasty [7].
• CONCLUSION: Since rapid food intake produces more GER in healthy volunteers, studies in GERD patients are warranted to evaluate if eating slowly may represent another "life-style modification" aimed at reducing GER [8].
• Furthermore, patient age, duration of preoperative fasting, body mass index, cigarette smoking, alcohol consumption, preoperative anxiety, and a history of preoperative GER were not correlated with significant modifications of gastric volume or pH [9].

High impact information on GER

• The causal agents or pathologic conditions include microbial agents, gastroesophageal reflux, chronic cholecystitis and cholelithiasis, inflammatory bowel disease, and specific agents that cause chronic obstructive or diffuse interstitial lung disease [10].
• Gastroesophageal reflux and adenocarcinoma of the esophagus [11].
• CONCLUSIONS: There is a strong and probably causal relation between gastroesophageal reflux and esophageal adenocarcinoma [12].
• Nine infants with documented gastroesophageal reflux participated in 18 paired two-hour postprandial trials in an infant seat and in the horizontal prone position [13].
• Mechanisms of gastroesophageal reflux in patients with reflux esophagitis [14].

Chemical compound and disease context of GER

• Both infants were treated with bethanechol chloride as part of the management of their GER, but respiratory failure developed in both patients and they required ventilatory support [3].
• We conclude that in these subjects with mild asthma, methacholine-induced bronchospasm produced GER episodes of greater frequency and severity [15].
• All-trans retinoic acid in hematological malignancies, an update. GER (Gruppo Ematologico Retinoidi) [16].
• Because GER is another known risk factor for sudden infant death syndrome, the administration of xanthine derivatives in babies at risk for sudden infant death syndrome should be carefully considered in each case [17].
• We used a radiolabelled mixed solid-liquid meal (technetium-99m for the solid component, indium-111 for the liquid component) to study gastric emptying of solids (GES), liquids (GEL) and indigestible solids (GER) in 50 patients diagnosed as having irritable bowel syndrome (30 with predominant constipation and 20 with predominant diarrhoea) [18].

Biological context of GER

• CONCLUSION: These data suggest that a gene for severe pediatric GER maps to chromosome 13q14 [2].
• OBJECTIVE: To identify a genetic locus that cosegregates with a severe pediatric GER phenotype in families with multiple affected members [2].
• DESIGN: A genome-wide scan of families affected by severe pediatric GER using polymorphic microsatellite markers spaced at an average of 8 centimorgans (cM), followed by haplotyping and by pairwise and multipoint linkage analyses [2].
• RESULTS: In these families, severe pediatric GER followed an autosomal dominant hereditary pattern with high penetrance [2].
• MAIN OUTCOME MEASURES: Determination of inheritance patterns and linkage of a genetic locus with the severe pediatric GER phenotype by logarithm-of-odds (lod) score analysis, considering a lod score of 3 or greater as evidence of linkage [2].

Anatomical context of GER

• Data on gastroesophageal reflux (GER), adherence to the gastrostomy feeding program, and sputum culture were also assessed [19].
• We conclude that in asymptomatic recumbent subjects GER is related to transient inappropriate LES relaxations rather than to low steady-state basal LES pressure and also, that primary perstalsis is the major mechanism that clears the esophagus of refluxed material [5].
• The aim of this study was to evaluate the relationship between esophageal body and lower esophageal sphincter (LES) motor events and the occurrence of GER [20].
• Biochemical evidence will be presented that the B cell line derived from the individual GER expresses five distinct types of DR molecules [21].
• Attempting to tie together the pieces of the puzzle, numerous investigators have struggled to show that in patients with asthma, GER symptoms occur too frequently, gastric acid dwells for too long in the esophageal lumen, and refluxed gastric acid injures the esophageal mucosa more than expected [22].

Associations of GER with chemical compounds

• These significantly improved during cisapride, suggesting that GER can trigger many complications in CF [23].
• Identification in collagen type I of an integrin alpha2 beta1-binding site containing an essential GER sequence [24].
• Further, based on the reported number of reflux episodes occurring during 24-hour pH monitoring, airway hyperresponsiveness to methacholine challenge tends to increase as GER worsens [25].
• Thus, our study failed to demonstrate any adverse effect of a slow-release theophylline preparation on GER in patients with asthma [26].
• Physiologic recordings of sleep (electroencephalogram, 'ear-o-gram', behavioral observations), cardiorespiratory function (end-tidal CO2, O2 saturation, heart rate, respiratory movements), swallowing (pharyngeal or esophageal pressures) and GER (signaled by a fall in esophageal pH) were displayed and stored on a computer [27].

Regulatory relationships of GER

• We describe two patients who demonstrated therapeutic responses to high dose H2-receptor antagonists after high dose omeprazole failed to suppress gastric acidity and GER [28].
• Endogenous cholecystokinin enhances postprandial gastroesophageal reflux in humans through extrasphincteric receptors [29].
• Increased acid exposure in patients with gastroesophageal reflux disease influences cyclooxygenase-2 gene expression in the squamous epithelium of the lower esophagus [30].
• In 1979, Angelchik and Cohen [1] reported a series of 46 patients in whom a Silastic prosthesis was used to control gastroesophageal reflux [31].
• In five patients a primary respiratory disorder (PRD) induced gastroesophageal reflux [32].

Other interactions of GER

• While no casanova orthologs have been identified in tetrapods, the F-type SOX, SOX7, is supplied maternally in Xenopus (Fawcett and Klymkowsky, 2004. GER 4, 29) [33].
• GER alone presents a neutrophilic pattern of inflammation when determined by elevated concentrations of IL-6 in sputum cell analysis [34].
• MEASUREMENTS AND RESULTS: GER-related asthma is characterized by an eosinophilic inflammation, as determined by elevated concentrations of IL-4 in breath condensate and sputum supernatant, and by sputum cell analysis [34].
• The identification of a novel NCA-related pancreatic tumour-associated antigen, DD9-antigen: a comparison with the expression of other tumour antigens by the pancreatic tumour cell line GER [35].
• These results demonstrate that GER+IMT and GER alone are equally effective in improving exercise performance in patients with COPD [36].

Analytical, diagnostic and therapeutic context of GER

• The early diagnosis of GER in these infants may have led to a delay in diagnosis and treatment of CF [3].
• Patients with clinical evidence of GER (n = 11) had significantly lower weight gain after gastrostomy (delta WAZ, -0.32 +/- 0.26 vs. 0.03 +/- 0.39; P = 0.03) [19].
• Gastroesophageal reflux (symptomatic and silent): a potentially significant problem in patients with cystic fibrosis before and after lung transplantation [37].
• METHODS: Concurrent esophageal manometry and pH monitoring was conducted for 4 hours postprandially in 37 children referred for evaluation of suspected pathological GER [20].
• Sequence alignment was used to investigate the occurrence of related motifs in other human fibrillar collagens, and located a conserved array of novel GER motifs within their triple helical domains [38].

References