caa a22 4500 445794518 CHVBK 20180317145120.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1007/s10620-011-1804-x doi (NATIONALLICENCE)springer-10.1007/s10620-011-1804-x Is Intercellular Space Different Among Layers in Normal Esophageal Mucosa? An Electron Microscopic Study [Elektronische Daten] [Sanghoon Park, Hoon Chun, Jin Jang, Bora Keum, Yeon Seo, Yong Kim, Yoon-Tae Jeen, Hong Lee, Soon Um, Chang Kim, Ho Ryu, Chang-Sub Uhm, Sung Lee] Background/Introduction: Dilatation of intercellular space (IS) of esophageal epithelial cells is described as a sensitive early marker for epithelial damage by refluxate. Esophageal epithelia are morphologically subdivided into three layers according to the shape of the cells and nuclei. Meanwhile, ten transmission electron microscopy (TEM) photographs and ten randomly selected measurements per photo from gastroesophageal reflux disease (GERD) patients have been widely accepted without any theoretical criticism. We assumed that the IS differs among each layer and thus studied IS according to subdivided layers of normal esophageal epithelium. We also evaluated an optimal number of IS measurements per photograph. Materials and Methods: Esophagogastroduodenoscopy was performed in 15 healthy adults without any symptom of GERD, taking biopsies from mucosa above 5cm from the squamo-columnar junction. Tissues were handled and prepared for TEM, verifying three layers of esophageal mucosa, i.e., squamous cell layer, prickle cell layer, and basal layer. Ten digital photomicrographs were taken from each three layers by TEM, and ISs were measured with a computerized image analysis program. For the method of measuring IS, 5, 10, 20, 30, and 40 measurements per photomicrograph were respectively performed by four different examiners. Mean value and intraclass correlation coefficient (ICC) was also yielded. Results: Mean IS of lower esophagus irrelevant to three epithelial layers were 0.39±0.30μm. When subdivided into three layers, however, mean IS of squamous cell layer was 0.62±0.23μm, prickle cell layer 0.23±0.19μm, and basal layer 0.55±0.36μm, with their difference statistically significant (p<0.05). On the other hand, ICC of 5, 10, 20, 30, and 40 measurements were 0.688, 0.917, 0.837, 0.790, and 0.765, respectively. Conclusions: Mean IS values of each three layers of esophageal epithelium in normal subjects were significantly different, and reconsideration of the standard measurement method is needed. Ten measurements per photo had an adequate inter-observer agreement. Springer Science+Business Media, LLC, 2011 Esophagus nationallicence Gastroesophageal reflux disease nationallicence Transmission electron microscopy nationallicence Intercellular space nationallicence Inter-observer variation nationallicence Park Sanghoon Institute of Digestive Disease and Nutrition, Department of Internal Medicine, Korea University College of Medicine, Korea University Medical Center, Inchon-ro 73, Seongbuk-gu, 136-705, Seoul, Korea aut Chun Hoon Institute of Digestive Disease and Nutrition, Department of Internal Medicine, Korea University College of Medicine, Korea University Medical Center, Inchon-ro 73, Seongbuk-gu, 136-705, Seoul, Korea aut Jang Jin Institute of Digestive Disease and Nutrition, Department of Internal Medicine, Korea University College of Medicine, Korea University Medical Center, Inchon-ro 73, Seongbuk-gu, 136-705, Seoul, Korea aut Keum Bora Institute of Digestive Disease and Nutrition, Department of Internal Medicine, Korea University College of Medicine, Korea University Medical Center, Inchon-ro 73, Seongbuk-gu, 136-705, Seoul, Korea aut Seo Yeon Institute of Digestive Disease and Nutrition, Department of Internal Medicine, Korea University College of Medicine, Korea University Medical Center, Inchon-ro 73, Seongbuk-gu, 136-705, Seoul, Korea aut Kim Yong Institute of Digestive Disease and Nutrition, Department of Internal Medicine, Korea University College of Medicine, Korea University Medical Center, Inchon-ro 73, Seongbuk-gu, 136-705, Seoul, Korea aut Jeen Yoon-Tae Institute of Digestive Disease and Nutrition, Department of Internal Medicine, Korea University College of Medicine, Korea University Medical Center, Inchon-ro 73, Seongbuk-gu, 136-705, Seoul, Korea aut Lee Hong Institute of Digestive Disease and Nutrition, Department of Internal Medicine, Korea University College of Medicine, Korea University Medical Center, Inchon-ro 73, Seongbuk-gu, 136-705, Seoul, Korea aut Um Soon Institute of Digestive Disease and Nutrition, Department of Internal Medicine, Korea University College of Medicine, Korea University Medical Center, Inchon-ro 73, Seongbuk-gu, 136-705, Seoul, Korea aut Kim Chang Institute of Digestive Disease and Nutrition, Department of Internal Medicine, Korea University College of Medicine, Korea University Medical Center, Inchon-ro 73, Seongbuk-gu, 136-705, Seoul, Korea aut Ryu Ho Institute of Digestive Disease and Nutrition, Department of Internal Medicine, Korea University College of Medicine, Korea University Medical Center, Inchon-ro 73, Seongbuk-gu, 136-705, Seoul, Korea aut Uhm Chang-Sub Department of Anatomy, Korea University College of Medicine, Seoul, Korea aut Lee Sung Department of Internal Medicine, Kangwon National University College of Medicine, Kangwon National University Hospital, Baengnyeong-ro 156, 200-722, Chuncheon-si, Gangwon-do, Korea aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/12(2011-12-01), 3492-3497 0163-2116 56:12<3492 2011 56 10620 https://doi.org/10.1007/s10620-011-1804-x text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-011-1804-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Park Sanghoon Institute of Digestive Disease and Nutrition, Department of Internal Medicine, Korea University College of Medicine, Korea University Medical Center, Inchon-ro 73, Seongbuk-gu, 136-705, Seoul, Korea aut NATIONALLICENCE 700 1- Chun Hoon Institute of Digestive Disease and Nutrition, Department of Internal Medicine, Korea University College of Medicine, Korea University Medical Center, Inchon-ro 73, Seongbuk-gu, 136-705, Seoul, Korea aut NATIONALLICENCE 700 1- Jang Jin Institute of Digestive Disease and Nutrition, Department of Internal Medicine, Korea University College of Medicine, Korea University Medical Center, Inchon-ro 73, Seongbuk-gu, 136-705, Seoul, Korea aut NATIONALLICENCE 700 1- Keum Bora Institute of Digestive Disease and Nutrition, Department of Internal Medicine, Korea University College of Medicine, Korea University Medical Center, Inchon-ro 73, Seongbuk-gu, 136-705, Seoul, Korea aut NATIONALLICENCE 700 1- Seo Yeon Institute of Digestive Disease and Nutrition, Department of Internal Medicine, Korea University College of Medicine, Korea University Medical Center, Inchon-ro 73, Seongbuk-gu, 136-705, Seoul, Korea aut NATIONALLICENCE 700 1- Kim Yong Institute of Digestive Disease and Nutrition, Department of Internal Medicine, Korea University College of Medicine, Korea University Medical Center, Inchon-ro 73, Seongbuk-gu, 136-705, Seoul, Korea aut NATIONALLICENCE 700 1- Jeen Yoon-Tae Institute of Digestive Disease and Nutrition, Department of Internal Medicine, Korea University College of Medicine, Korea University Medical Center, Inchon-ro 73, Seongbuk-gu, 136-705, Seoul, Korea aut NATIONALLICENCE 700 1- Lee Hong Institute of Digestive Disease and Nutrition, Department of Internal Medicine, Korea University College of Medicine, Korea University Medical Center, Inchon-ro 73, Seongbuk-gu, 136-705, Seoul, Korea aut NATIONALLICENCE 700 1- Um Soon Institute of Digestive Disease and Nutrition, Department of Internal Medicine, Korea University College of Medicine, Korea University Medical Center, Inchon-ro 73, Seongbuk-gu, 136-705, Seoul, Korea aut NATIONALLICENCE 700 1- Kim Chang Institute of Digestive Disease and Nutrition, Department of Internal Medicine, Korea University College of Medicine, Korea University Medical Center, Inchon-ro 73, Seongbuk-gu, 136-705, Seoul, Korea aut NATIONALLICENCE 700 1- Ryu Ho Institute of Digestive Disease and Nutrition, Department of Internal Medicine, Korea University College of Medicine, Korea University Medical Center, Inchon-ro 73, Seongbuk-gu, 136-705, Seoul, Korea aut NATIONALLICENCE 700 1- Uhm Chang-Sub Department of Anatomy, Korea University College of Medicine, Seoul, Korea aut NATIONALLICENCE 700 1- Lee Sung Department of Internal Medicine, Kangwon National University College of Medicine, Kangwon National University Hospital, Baengnyeong-ro 156, 200-722, Chuncheon-si, Gangwon-do, Korea aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; 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