Eg 2990i

UGI endoscopy was performed at our center by one of the board-certified attending gastroenterologists using either a GIF-H260 (Olympus, Tokyo, Japan) or an EG-2990i (Pentax, Tokyo, Japan) endoscope. Endoscopic findings were initially described based on the criteria of the Sydney classification, and additional findings were recorded. With regard to the background gastric mucosa, the presence of H. pylori-related endoscopic findings was recorded (Fig. 1). NG was defined as chicken-skin like mucosal changes on the antrum. CAG was diagnosed when there was permeability of blood vessels with an atrophic border. MG was defined as whitish patches with or without depressed hyperemic lesions. GU and DU were diagnosed as a deep mucosal defect suspicious for submucosal invasion. An old ulcer scar due to a past history was not included as GU or DU subject in this study. A diagnosis of EE was made only when there was an erosion (hyperemic streak) on the low esophagus.

The subjects were asked about their medical history including successful H. pylori eradication, gastrectomy, renal failure, hypertension, diabetes mellitus, coronary heart disease, and cerebrovascular attack. Questionnaires on social history included cigarette smoking (never, past, or current) and alcohol drinking (almost none, social, or heavy). Based on the National Institute for Alcohol Abuse and Alcoholism guideline, heavy drinking was defined as ≥8 drinks/wk for women and ≥15 drinks/wk for men. Recent drug intake within last 3 months were asked before the endoscopic examination.
After 12 hours of fasting, endoscopy was performed with the aid of either EG-2990i (Pentax, Tokyo, Japan) or GIF-H260 (Olympus, Tokyo, Japan). Endoscopic findings suggesting past infection were determined by the presence of gastric xanthoma (yellowish plaque), metaplastic gastritis (irregular whitish elevations and/or depressed patchy erythema), or advanced atrophy as described.17 (link),18 (link) Advanced atrophy was defined as visible submucosal vessels extending up to the body (>closed-type 1 in Kimura-Takemoto classification) in this study, because the gastric cancer risk is increased from closed-type 2.19 (link) Endoscopic images were reviewed by two gastroenterologists (H.K. and S.Y.L.).

Before endoscopy, all patients were subjected to clinical assessment including history taking and physical examination, routine laboratory investigations including complete blood count, liver function profile and serum creatinine, and assessment of the severity of underlying disease by Child-Turcotte-Pugh (CTP) score and Model for End-Stage Liver Disease (MELD) score. All procedures were performed under deep sedation or general anesthesia in the left lateral position. Standard diagnostic upper endoscopy was performed with Pentax EG2990i (PENTAX medical, Tokyo, Japan) to classify the varices according to the classification of Sarin and Kumar. EUS examination was done in all patients with a Pentax linear Echoendoscope EG3870UTK (PENTAX medical, Tokyo, Japan) attached to a Hitachi Avius ultrasound system (Hitachi Medical Systems, Tokyo, Japan). All EUS examinations were done by single endosonographer. The echoendoscope was positioned in the distal esophagus at the level of the cardia to visualize the gastric fundus and to display the vascular anatomy including the size of the varix, color Doppler flow inside the varix and identification of the perforator feeding vein (one or more vein crossing the gastric wall to feed the GV from the peri-gastric veins).

All participants underwent esophagogastroduodenoscopy with white-light examination using a high-definition endoscope (Pentax EG-2990-i; Pentax Medical Co, Japan). Endoscopic procedures were performed with the patient in the left lateral decubitus position under conscious sedation with an intravenous propofol infusion and continuous vital sign monitoring. Endoscopy and forceps biopsy sampling was performed in accordance with the updated Sydney system guidelines
7 (link)
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