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)

The case of a 60-year-old Japanese man with an early gastric carcinoma in submucosal multiple cysts is presented, and the morphology and histogenesis had complained of dysphagia, and an upper gastrointestinal barium study and endoscopy revealed an irregular-shaped, flat polypoid tumor in the antral mucosa. The resected stomach had a polypoid lesion, 11.0 x 12.0 cm, but no erosion or ulcer in the greater antral curvature was seen, and cut section showed many cysts containing mucus. A subsequent histological examination revealed a well differentiated adenocarcinoma of the mucosal layer. This early carcinoma was sited on and surrounded by multiple cystic lesions. These histological findings suggested that this carcinoma had developed from the mucosa that had an underlay of submucosal cysts.
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PMID:[A type IIa early carcinoma in multiple submucosal cysts of the stomach--a case report]. 238 Oct 46

Well-differentiated thyroid carcinoma infrequently invades the upper aerodigestive tract. However, when invasion occurs it is the source of significant morbidity and excess mortality. The most common structures invaded by thyroid carcinoma are the recurrent laryngeal nerves, larynx, pharynx, and esophagus, which can produce symptoms of airway insufficiency, dysphagia, and hemoptysis. Locally invasive thyroid carcinoma can often be successfully treated while preserving function of the upper airway. If the tumor involves only the wall of the larynx or trachea without intraluminal extension, "shaving" the tumor from the trachea or larynx will produce local control rates comparable to more radical and destructive procedures. Intraluminal extension is a more serious problem that usually requires resection of a portion of the aerodigestive tract. Even in this situation, partial laryngeal or tracheal resection with preservation of function might be possible and should be used. Adjuvant therapy using radioiodine or external beam radiotherapy should be considered an integral part of any treatment plan for these tumors. These modalities will significantly reduce the rate of local recurrence and control symptomatic local disease.
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PMID:Thyroid carcinoma invading the upper aerodigestive system. 238 Dec 58

5-FU intra-arterial infusion and simultaneous irradiation can cure head and neck cancer without leaving any functional disturbance. Catheters were inserted into the bilateral superficial temporal arteries in a case of T4 carcinoma of the oral cavity, and this treatment was performed. The patient was a 54-year-old male with squamous cell carcinoma involving the right tonsil, right and left sides of the soft palate, the uvula, right gingiva, right lingual margin, and right buccal mucous membrane. The right soft palate was partially defective. The total dose of intra-arterial 5-FU was 4,000 mg on the right side and 2,600 mg on the left side, and the total dose of irradiation was 40 Gy. After this treatment, residual cancer was found on the right margin of the uvula only. Due to the defect in the soft palate, the effect of intra-arterial infusion was considered to be insufficient for this region, and it was excised together with the surrounding tissue. Rhinolalia aperta remains, but there is no dysphagia, and the course has been good with no evidence of recurrence so far. When it is found that a catheter cannot be readily inserted, it can usually be inserted properly by using a guide wire. For fixing the catheter, a satisfactory result is obtained by cutting the protruding end to 15-20 cm, attaching a connector, and suturing it to the skin of the temporal region.
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PMID:[T4 carcinoma of the oral cavity responsive to bilateral 5-FU intra-arterial infusion and simultaneous irradiation]. 238 62

Palliative treatment by intracavitary irradiation using the 'Selectron' has been used in 40 patients with advanced carcinoma (all histological types). Relief of dysphagia occurred in 65%. This treatment method is suggested as an effective alternative to intubation.
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PMID:Intracavitary irradiation in palliation of carcinoma of oesophagus and cardia. 241 13

Esophageal prothesis (EP) is a palliative treatment for inoperable neoplastic stenosis. Ninety-one patients were candidates for EP placement between 1978 and 1983. EP placement was successful in 77 patients. Of these: 85% had primary esophageal cancer; 15% had bronchial or mediastinal carcinoma; 83% had stenosis in the middle third. Dysphagia was the main symptom in 84%, and tracheoesophageal fistulae in 16%. The observed median survival was 3.2 months +/- 1.9 (2 standard deviations [SD]), and the survival rate at 1 year was 7%. With the single-factor analysis method, not one of 12 factors presented any significance (age, sex, general status, anterior treatment, lesion site, endoscopic feature, stenosis diameter, histologic features, metastasis, tracheal involvement, symptoms, and type of prothesis). Two factors had a P value approaching significance: there were slightly longer survival rates in patients with a stenosis diameter less than 7 mm (P less than 0.07), and with stenosis located in the lower third and cardia (P less than 0.07). By multivariate analysis (Cox model), prognostic significance was found in only one factor: the location in the lower third and cardia (P = 0.002, relative risk = 3). The quality of life after EP placement was briefly improved: 80% of 73 evaluable patients had improvement in dysphagia for a mean duration of 3.7 months +/- 2 (2 SD), especially patients with a good general status (0 and 1; P less than 0.01); and 45% of patients had improvement of their general status for a mean duration of 4.1 months +/- 2 (2 SD). Minor complications related to EP placement were observed in 40% of patients (pain, obstruction, and mobilization), and severe complications were observed in 20% (perforation, 11 cases; fistulae, 5 cases, with death in 3 cases; hemorrhages, 4 cases). In conclusion, EP is a good palliative treatment, although complications are frequent, and evaluation of patient comfort is required to compare this procedure with other available techniques.
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PMID:Esophageal prothesis for neoplastic stenosis. A prognostic study of 77 cases. 241 40

In a series of 230 patients with carcinoma of the hypopharynx, esophagus and cardia, 114 patients with squamous cell tumors and 86 patients with adenocarcinomas were resected (rate of restability, 87 per cent). Mortality at 30 days was 17.5 per cent. Over-all hospital mortality was 22.0 per cent. The one year survival rate was 40.0 per cent and the five year survival rate was 19.5 per cent. Reflux esophagitis occurred in 26 per cent of survivors, benign stricture in 9 per cent and local recurrence in 7 per cent. Eighty-two per cent of patients were permanently free of dysphagia postoperatively. Aggressive surgical procedures provide effective palliation and a worthwhile proportion of long term survivors.
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PMID:Carcinoma of the hypopharynx, esophagus and cardia. 242 18

Although esophagogastrectomy offers the best chance for cure and alleviation of dysphagia in the treatment of esophageal carcinoma, the operative mortality and morbidity can be prohibitively high. To investigate means for reducing the rate of surgical complication, a study was made of a six-year series of 36 procedures involving 32 esophagogastrostomies and four colon interpositions. Patient survival rates were 60 percent at one year, 40 percent at two years, and 9 percent at five years with a mean survival of 22 months. Histology of the tumor did not significantly affect prognosis. The three operative mortalities were caused by pulmonary insufficiency in one overhydrated patient, and coagulopathy in two alcoholic patients with underlying liver disease. Anastomotic leakage, the precipitating factor for the majority of operative mortalities in the recent literature, occurred in one non-fatal case. This low incidence is linked to the implementation of steps to maximize blood supply and minimize tension on the anastomosis line. Anastomotic stricture was seen and easily dilated in three patients. The five cases of intra-esophageal tumor recurrence which occurred despite tumor-free margins may have been avoided by more extensive resection.
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PMID:Esophagogastrectomy. Successful palliation for esophageal carcinoma. 242 May 38

Carcinoma of the esophagus remains difficult to detect while it is localized to the mucosa. The ideal treatment is removal of all tissue that contains tumor. Usually reconstruction using the stomach is preferred over the use of gastric tubes, colon, and jejunum, although these will serve satisfactorily. Maximal palliation with relief of dysphagia is best achieved by removal of the obstructing lesion when possible, even if some tumor remains. When resection is not practical, bypass anastomoses proximal to the tumor occasionally may be used to relieve the obstruction and the associated dysphagia. Irradiation and chemotherapy may improve the results of therapy. To permit earlier detection, better screening tests are needed.
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PMID:Carcinoma of the esophagus. 242 7

Thirty-three patients who have suffered with dysphagia to solids and liquids for a varying number of years are reviewed. They all had a history and radiologic findings suggestive of achalasia of the esophagus. Thirty-one of the cases who had uncomplicated achalasia benefited from a transthoracic modified Heller's procedure. Lower esophageal diaphragm and carcinoma arising in the proximal half of the distal third of the esophagus occurred in association with achalasia in two patients. Over 90 percent had symptomatic relief of their symptoms. The only mortality was recorded in a patient who had palliative esophagogastrectomy for associated carcinoma. A properly performed anterior extramucosal esophagomyotomy is the safest and most effective procedure available, even in places with minimal facilities.
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PMID:Achalasia of the esophagus: reflections upon a clinical study of 33 cases. 243 61

Seventeen patients with esophageal carcinoma treated by radiation therapy (RT) at our hospital between 1981 and 1984 had initial diagnostic esophagrams and 1 or more repeat esophagrams after completing RT. Total regression of the tumor was observed radiographically in 10 patients (59%) with a normal esophagus (24%) or benign-appearing residual stricture (35%) at the site of the previous lesion. Partial regression was observed in 4 patients, and progression of the tumor in 3. No correlation was found between the size, stage, or morphology of the lesion and its response to therapy. Although local recurrences were relatively uncommon, patient survival was often limited by the development of distant metastases. Fourteen of 15 patients with clinical follow-up initially had significant relief from dysphagia as the tumor regressed. However, 9 of those patients had recurrent or increased dysphagia over a subsequent 3-9-month period. Exacerbation of symptoms did not necessarily indicate recurrent carcinoma; it also resulted from benign radiation strictures, opportunistic esophagitis, or other complications of RT detected on esophagography.
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PMID:Radiation therapy of esophageal carcinoma: correlation of clinical and radiographic findings. 243 2


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