title: Feasibility study of corticosteroid treatment for esophageal ulcer after EMR in a canine model.
abstract: BACKGROUND
  Intralesional or systemic steroid administration is a promising strategy for the prevention of esophageal stricture after endoscopic therapy. The aim of this study was to evaluate the influence of steroid therapy on the process of healing of defects in the esophageal mucosa after endoscopic mucosal resection (EMR).
  
  
  METHODS
  Nine beagle dogs were divided into three equal groups: group A, intralesional injection (n = 3), group B, peroral administration (n = 3), and group C, untreated control (n = 3). In group A, triamcinolone acetonide 1 ml (10 mg) was injected directly into the exposed submucosal layer immediately after EMR, and again on postoperative day (POD) 7. In group B, dogs were administered prednisolone 0.5 mg/kg/day orally for 14 days after EMR. In group C, 1 ml normal saline was injected by the same method as that used for group A. On POD 28, histological examination was performed to evaluate epithelialization, inflammation, angiogenesis, and atrophy of the muscularis propria.
  
  
  RESULTS
  In groups A, B, and C, the mean ulcer area was 50.1, 22.7, and 7.4 mm(2), respectively. The difference between groups A and C was significant (p < 0.01). Inflammatory cells were significantly more evident in the lesions of group A than in those of group C (p < 0.05). In all groups, atrophy of the muscularis propria was evident. However, transmural destruction and fibrosis were observed only in group A.
  
  
  CONCLUSIONS
  It was speculated that the esophageal ulcer causes the fibrosis of the submucosa and atrophy of the muscularis propria during process of healing. Intralesional steroid injection deepened the esophageal ulcers and delayed epithelialization, whereas systemic administration did not clearly improve the lesion healing process.
authors: Department of Bioartificial Organs, Institute for Frontier Medical Science, Kyoto University, 53 Kawahara cho, Sakyo-ku, Kyoto, 606-8507, Japan.
authors: Michitaka
authors: M
authors: Honda
authors: Tatsuo
authors: T
authors: Nakamura
authors: Yoshio
authors: Y
authors: Hori
authors: Yoshiki
authors: Y
authors: Shionoya
authors: Kazumichi
authors: K
authors: Yamamoto
authors: Yuji
authors: Y
authors: Nishizawa
authors: Fumitsugu
authors: F
authors: Kojima
authors: Keiji
authors: K
authors: Shigeno
references: Gastrointest Endosc. 2009 Feb;69(2):289-96
references: 18657808
references: Gastrointest Endosc. 2010 Apr;71(4):715-21
references: 20363414
references: J Burn Care Rehabil. 2005 May-Jun;26(3):247-51
references: 15879746
references: Skin Pharmacol Physiol. 2009;22(2):83-93
references: 19188756
references: Gut. 2006 Dec;55(12):1704-10
references: 16709659
references: Anat Rec. 2001 Jun 1;263(2):161-6
references: 11360233
references: Gastrointest Endosc. 1999 Apr;49(4 Pt 1):509-13
references: 10202068
references: Gastrointest Endosc. 2003 Feb;57(2):165-9
references: 12556777
references: Endoscopy. 2009 Aug;41(8):661-5
references: 19565442
references: Am J Gastroenterol. 2005 Nov;100(11):2419-25
references: 16279894
references: Endoscopy. 2004 Apr;36(4):298-305
references: 15057678
references: Anat Rec. 1999 Jan;254(1):147-52
references: 9892428
references: Eur J Pediatr Surg. 1998 Apr;8(2):71-4
references: 9617603
references: Gastrointest Endosc. 1995 Jun;41(6):596-8
references: 7672556
references: Gastrointest Endosc. 1995 Jun;41(6):598-601
references: 7672557
references: Endoscopy. 2005 Nov;37(11):1111-5
references: 16281141
references: Dis Esophagus. 2009;22(7):626-31
references: 19302207
references: Dtsch Arztebl Int. 2009 Sep;106(38):607-13
references: 19890417
references: Biomaterials. 2000 Mar;21(5):489-99
references: 10674814
references: Gastrointest Endosc. 2008 Dec;68(6):1066-72
references: 18620345
references: Wound Repair Regen. 2009 Mar-Apr;17(2):250-9
references: 19320894
references: Dis Esophagus. 2005;18(6):359-64
references: 16336604
references: J Pediatr Surg. 1969 Dec;4(6):646-53
references: 5371094
references: Dig Endosc. 2009 Jul;21 Suppl 1:S4-6
references: 19691732
references: Endoscopy. 2010 Dec;42(12):1092-5
references: 21038294
references: Toxicol Rev. 2005;24(2):125-9
references: 16180932