Introduction Oesophageal adenocarcinoma is an increasingly common diagnosis and cause of death; risk factors include ‘Barrett's epithelium’ (BE). Endoscopic surveillance is most commonly used but is expensive. Other methods of surveillance have been suggested including nonendoscopic balloon cytology, but are handicapped by relying on cytological techniques; hence the need for a partner technology such as a biomarker. From earlier work we know the most commonly expressed oesophageal stress response proteins are SEP 53, SEP70 and anterior gradient-2 (AG-2). We set out to map the expression of these stress response proteins and explore their potential as prototype biomarkers of BE. Methods Patients (n=192) presenting to the endoscopy unit of a large teaching hospital with symptoms of gastro-oesophageal reflux disease or a known BE were recruited, endoscopically examined and the biopsies obtained were examined for heat shock protein expression. Results and discussion Normal controls and those with oesophagitis predominantly expressed SEP 53 (76.9/91.95%) and SEP 70 (79.48/89.65%). Although those with BE expressed AG-2; using this expression as a marker for BE, gives a sensitivity of 65.15% and specificity of 89.68% (positive predictive value of 76.78% and negative predictive value of 84.9%) and in gastro-oesophageal reflux disease a sensitivity of 65.15% and specificity of 90.80% (positive predictive value of 84.31% and negative predictive value of 77.45%). We confirmed that AG-2 is preferentially expressed in BE; suggesting its use would allow a screening tool with specificity of around 90%.

s / Posters P 1 The global prevalence of the gastroesophageal reflux disease symptoms heartburn and acid regurgitation within the general population Vicki Strugala, Peter W. Dettmar Technostics, Hull, UK Contact email: vicki.strugala@technostics.com Background. Heartburn (HB) and acid regurgitation (AR) are globally considered to be the primary symptoms of gastroesophageal reflux disease (GORD). The prevalence of GORD varies across the world with Westernized countries having the greatest burden while it is less frequently reported in Eastern/developing countries. Aim. The aim of this study was to review the published literature for studies that assessed the prevalence of HB and/or AR in the general population and ascertain the global prevalence. Methods. A literature search was performed to find published articles that had assessed the presence of GORD symptoms. The inclusion criteria for an article being selected for analysis were: the study randomly sampled the general population; the presence of HB, AR or both were assessed; prevalence was stated either weekly, monthly or yearly (not 3 or 6 monthly); studies were performed in adults (not solely the elderly or children); and were published after 1990. Results. 30 studies fitted the inclusion criteria covering 4 continents, 13 countries and 127,134 subjects. The yearly prevalence of HB ranged from 4.6% in Singapore to 48.2% in Brazil (mean (SD) 23.6 (13)%, 12 studies). The yearly prevalence of AR ranged from 11% in Canada to 45% in the USA (mean (SD) 27.8 (14)%, 9 studies). The yearly prevalence of HB and/ or AR ranged from 9% in China to 58.7% in the USA (mean (SD) 32.2 (12)%, 15 studies). Due to the large variation in the number of subjects in individual studies the percentage values were converted to numbers of symptomatic subjects. The sum was converted to a percentage of the combined number of subjects across the studies. HB was experienced by 12% weekly, 19% monthly and 24% yearly; AR was experienced by 10% weekly, 19% monthly and 22% yearly; HB and/or AR was experienced by 11% weekly, 17% monthly and 30% yearly. There was no significant difference (p /0.05, one sample t-test) between the mean prevalence values obtained by either analysis protocol. Discussion. The prevalence of symptoms of HB and/or AR, which are indicative of the presence of GORD, varies immensely across the World. On average 30% of the population suffer GORD symptoms on a yearly basis. This analysis maintains that Westernized countries have a higher prevalence of GORD than developing/traditional populations. This suggests that the excessive Western lifestyle may be a contributing factor to, or the high prevalence of H. pylori infection in Eastern countries may be protective against, GORD.

This is the second annual report of an international collaborative research group that is examining the cellular impact of laryngopharyngeal reflux (LPR) on laryngeal epithelium. The results of clinical and experimental studies are presented. Carbonic anhydrase (CA), E-cadherin, and MUC gene expression were analyzed in patients with LPR, in controls, and in an in vitro model. In patients with LPR, we found decreased levels of CAIII in vocal fold epithelium and increased levels in posterior commissure epithelium. The experimental studies confirm that laryngeal CAIII is depleted in response to reflux. Also, cell damage does occur well above pH 4.0. In addition, E-cadherin (transmembrane cell surface molecules, which have a key function in epithelial cell adhesion) was not present in 37% of the LPR laryngeal specimens. In conclusion, the laryngeal epithelium lacks defenses comparable to those in esophageal epithelium, and these differences may contribute to the increased susceptibility of laryngeal epithelium to reflux-related injury.

ing function of peritoneal Mfs against Candida parapsilosis with or without anti-Mac-I, and Mac-l-deficient mice, which lack this receptor, for to elucidate that phagocytic killing by Mfs required the signal via Mac-I.METHODS Peritoneal Mfs were isolated from normal mice and Mac-I knockout mice after glycogen injection into the peritoneal space.Phagocytic Killing by Mfs was evaluated using acridine orange-crystal violet staining assay under the fluorescence microscope (AmJ.Physiol.1996).RESULTS Anti-Mac-I down inhibited Phagocytic killing by Mfs.And, phagocytic killing of peritoneal Mfs, which were isolated from Mac-I knockout mice, was suppressed compared with that of control mice.DISCUSSION Previous study showed that Mac-I was required for phagocytosis of PML.Furthermore we elucidated the signal via Mac-I effected phagocytic killing function of Mfs as a matter of fact.It was reported that Mac-I antibody reduced the incremental production of O 2 in polymorpho- nuclear leukocytes (PML).Our results showed that there was possibility O 2, which worked on phagocytic killing in Mfs against Cparapsilosis, was increased by the signal via Mac-I.