Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Esophageal intramural pseudodiverticulosis is a rare condition of yet unknown etiology. Histologic findings of pseudodiverticulosis are characterized by dilated submucosal mucous glands in the esophagus wall. The clinical features including slowly progressive dysphagia mimic those of esophageal carcinoma. The diagnosis is established by radiologic examination, revealing numerous tiny outpouchings of the esophagus wall filled with contrast material. Endoscopic biopsy of the frequently associated stenosis of the upper esophagus is mandatory. Computer tomography shows localized thickening of the esophagus wall. Manometry reveals motoric dysfunction. Etiology and therapeutic management are discussed.
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PMID:[Intramural pseudodiverticulosis of the esophagus]. 210 34

Computed tomography of the larynx is generally recommended for carcinoma, laryngoceles, and laryngeal trauma. On the basis of several case examples, in which dysphagia and hoarseness were caused by a submucosal thickening of the arytenoid and aryepiglottic fold, the authors propose that these unclear symptoms also be regarded as indication for larynx CT. It must be borne in mind that the underlying process may be one of the rare tumors in the space between the thyroid cartilage and elastic cone, often called the paraglottic space (or paralaryngeal space, by many American authors).
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PMID:[Diagnosis of para-laryngeal tumors using computerized tomography]. 216 76

A 61-year-old male complaining of dysphagia and precordial chest pain was admitted to hospital. A series of upper G.I. examinations revealed an ulcerative tumor, approximately 8 cm in diameter, in the esophagus. A biopsy of a specimen led to the histological diagnosis of a small cell carcinoma (oat cell type). The cells were uniformly argentaffin-negative (Masson-Fontna) and many contained numerous tiny argyrophylic granules (Grimelius). Therefore, a combined therapy of radiation (70 Gy) and CDDP (total dose: 210 mg) was used to treat the lesion, and the disappearance of the mass shadow, as well as no narrowing of the esophagus, was noted without residual ulceration, indicating a complete response. Four months after the therapy, however, an extensive multiple liver metastasis occurred, and the patient died of hepatic and renal failure. His overall survival time was 7 months from start of the combined therapy. It thus is felt that a multi-drug regimen and systemic chemotherapy are important in treating small cell carcinomas of the esophagus.
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PMID:[Combined treatment of esophageal small cell carcinoma with radiation and chemotherapy]. 216 3

A 67-year-old woman who was diagnosed as a relative early primary tracheal adenoid cystic carcinoma by preoperative examination underwent surgical resection. The histopathological extension of this carcinoma into the tracheal wall was much greater than was suggested before operation and 6 tracheal rings was curatively resected circumferentially. Median sternotomy and transection of the left brachiocephalic vein facilitated access to the trachea. To resect the extensive segment of the trachea, the right pulmonary ligament and hilum were mobilized. Additionally Dedo's laryngeal release was performed to lessen the tension at the anastomosis. Then the flap of the pleura and adipose tissue with the right internal mammary artery and vein was wrapped around the anastomosis for revascularization and protection of brachiocephalic artery. The postoperative course was not eventful. The postoperative dysphagia by Dedo's laryngeal release was mild and resolved within 7 days after operation. And the postoperative mammary arteriography showed the vessels around the anastomosis. This wrapping procedure is easy and does not need a laparotomy. So we think it is beneficial for prevention against postoperative complications of tracheoplasty.
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PMID:[A case of primary tracheal adenoid cystic carcinoma performed curative surgical resection]. 216 15

Three cases of squamous cell carcinoma of the thyroid are reported herein. In all cases, the carcinoma occurred in old age and was characterized by a rapidly growing tumor, usually associated with dyspnea and dysphagia. The prognosis of all 3 cases was poor, with a mean survival of only 6.3 months. Although squamous metaplasia is an accepted etiology of this disease, clinical investigation of the cases presented here does not favor it in consideration of the clinical features of papillary carcinoma of the thyroid with squamous metaplasia. The histological findings of our cases revealed areas of cystic formation, suggesting that some of these carcinomas may be derived from remnants of embryonic origin.
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PMID:Squamous cell carcinoma of the thyroid--a report of three cases. 219 80

Although fistulae and hypercalcemia are rare at the time of diagnosis of esophageal carcinoma, they are not uncommon terminal events. Most fistulae communicate with the respiratory tract. Uncommon sites of fistulae due to esophageal carcinoma include extension to the aorta, pleura, pericardium, and mediastinum. We report a patient with a spontaneous pneumomediastinum discovered during radiologic staging of esophageal carcinoma. The symptoms were dysphagia, weight loss, and pneumonia. The patient had hypercalcemia refractory to conventional measures, another adverse prognostic factor. Cisplatin 100 mg/m2 was tolerated without acute toxicity and lowered the serum calcium to normal. However, the patient died due to respiratory failure 2 days after cisplatin therapy. To our knowledge, this is the first report of a spontaneous pneumomediastinum at presentation of an esophageal carcinoma. The course of our patient and a review of the literature suggest that fistulae and/or hypercalcemia are medical emergencies and are often fatal in esophageal carcinoma.
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PMID:Spontaneous pneumomediastinum in esophageal carcinoma. 223 8

Surgical treatment of pharyngeal carcinoma implies different reconstructive procedures. Despite primary healing, in some cases cicatricial shrinkage occurs, resulting in dysphagia. Of 113 patients with carcinoma of the oro- and hypopharynx in the last 4 years, 35 patients were studied in a specific follow-up examination. Deglutition was evaluated via subjective responses to a questionnaire. Reproducible information was gained by videofluoroscopy and manometry of the pharyngo-esophageal segment. To assess deglutition, an arbitrary number scale was established with 7 for excellent and 1 for poor deglutition. After local tumour excision, partial and total pharyngectomy, pharyngolaryngectomy and additional myocutaneous grafting, the deglutition index ranged from 5.8 to 4.5 showing more striking differences in the time required for eating. Manometric analysis showed pressure peaks 10 times lower (3.5 hPa) than in normal subjects with prolongation of each swallow. Videofluoroscopy reveals even slight motility disturbances after ablative pharyngeal surgery. Typical findings are presented. The swallowing function after pharyngeal tumour operations requires the reconstruction of both the horizontal (oral) and vertical (pharyngeal) phase of deglutition. Since the base of the tongue seems to be the major driving force in bolus movement, it is not the extension of resection but the availability of remaining contractile tissue in the neopharynx, especially in the base of the tongue region, that determines the postoperative rehabilitation of deglutition.
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PMID:[Rehabilitation of deglutition in patients with pharyngeal carcinoma]. 224 50

An unusual case of gastric carcinoma with diffuse intrasinusoidal metastasis to the liver (DIML) presenting as fulminant hepatic failure is reported. The patient was a 59-year-old man admitted to the hospital complaining of dysphagia. Seven weeks after performance of total gastrectomy, he developed jaundice and consciousness disturbance and died 4 days later. The surgical material was diagnosed as advanced cancer (poorly differentiated adenocarcinoma) of the stomach and postmortem examination disclosed massive and diffuse infiltration of the tumor cells into the hepatic sinusoids with no grossly detectable metastatic nodules. It is important to be aware that, although uncommon, gastric carcinomas may cause fulminant hepatic failure attributable to DIML. The clinicopathologic features of such cases are detailed and a review of the relevant literature included.
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PMID:Diffuse intrasinusoidal metastasis of gastric carcinoma to the liver leading to fulminant hepatic failure. A case report. 229 61

In spite of the development of upper digestive tract fiberoptic endoscopy (FE) within the last 10 years, early detection of esophageal carcinoma (EC) is rare except in certain high-risk groups such as patients with head and neck cancers. The aim of this study was to assess the value of a meticulous histoendoscopic examination with vital toluidine blue (TB) staining in all alcohol and tobacco abusers undergoing FE for any reason except dysphagia. In 18 months, 100 patients (90 men, 10 women) who were over 40 years old and who consumed more than 80 g of alcohol and 20 g of tobacco per day underwent FE. No patient had a history of head and neck or esophageal cancer. FE was decided in 48 patients for epigastric pain, in 28 for esophageal varices, in 8 for weight loss, in 8 for anemia, in 7 for peptic disease, and in 1 for diarrhea. Staining with TB was carried out at the end of the examination and two routine biopsies were obtained 5 cm above the lower esophageal sphincter. Specimens were obtained from each abnormal area (TB + or TB -). Clinical ENT examination was recommended for all patients. Two esophageal carcinomas (1 microinvasive, 1 in situ) and 15 cases of dysplasia were detected. Dysplasia was classified as severe in 1 case, moderate in 9 cases, and mild in 5 cases.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Endoscopic detection of dysplasia and subclinical cancer of the esophagus. Results of a prospective study using toluidine blue vital staining in 100 patients with alcoholism and smoking]. 231 48

The aim of this study was to evaluate the independent influence of clinical and pathological variables on survival of patients with gastric carcinoma using the Cox regression proportional hazard model. Of 156 patients operated on for gastric adenocarcinoma, 46 (29.5%) underwent palliative operation, 24 (15.5%) had a palliative resection, and 86 (55%) had a curative resection. The overall 5-year survival rate was 25 +/- 4%. After curative resection, the 5-year survival rate was 44 +/- 6%. Univariate analysis applied to these patients showed that poor survival was related (p less than 0.01) to: age (over 80 years), absence of epigastric pain, vomiting and dysphagia, total gastrectomy, tumor size (more than 4 cm), lymph node involvement (LNI), invasion through the muscularis propria, absence of intestinal metaplasia near the tumor, and linitis plastica. In multivariate analysis, lymph node involvement was found to be the only independent prognostic factor. The 5-year survival rate was 75.5 +/- 8% without LNI, 28 +/- 10% with proximal LNI and 7 +/- 6% with distal LNI. Our results suggest that classification into 3 LNI groups is the best staging system for curative resection in gastric carcinoma.
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PMID:[Lymph node involvement: the only prognostic factor after curative resection of cancer of the stomach. Results of a multivariate analysis]. 235 43


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