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)

To determine whether there have been major changes in various aspects of gastric carcinoma, we reviewed the records of 302 patients with gastric cancer diagnosed between 1973 and 1989. Patients were divided into two groups: group I, 1973-80 (n = 163), and group II, 1981-88 (n = 139). On admission, no significant differences in presenting symptoms and physical signs were found, except for an increase in dysphagia (p less than 0.005) in group II. Endoscopy with targeted biopsy and biphasic-contrast examination were of equal merit in detecting malignancy (99.7%). A significant increase in the proportion of patients with cardia carcinoma was noted in group II (p less than 0.02). The proportion of patients with early gastric cancer decreased from 11% to 7.2%. The proportion of patients with intestinal-type carcinoma decreased in period II (p less than 0.05), accompanied by an increase in the proportion of patients with diffuse-type carcinoma during the same period (p less than 0.01). The overall 5-yr survival estimate was 17%. Independent prognostic variables were T stage (p less than 0.0001) and N stage (p less than 0.001), whereas Lauren type and tumor site were only significant in univariate survival analysis (p less than 0.05 and p less than 0.005, respectively).
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PMID:Time trends in gastric carcinoma: changing patterns of type and location. 848 Jul 55

Based on the previous data which indicated a preoperative decrease in cell-mediated immunity (CMI) is associated with the occurrence of infectious complications following surgery on patients with esophageal cancer, we examined possible factors contributing to a decrease in CMI levels. A multiple linear regression analysis was made on data from 76 patients with esophageal cancer and 53 with gastric cancer as the control. In patients with esophageal cancer, both protein-calorie malnutrition (PCM) and age factor contributed to a decrease in CMI, although the contribution of the latter was weak while the stage of the cancer and the grade of dysphagia showed no such contribution. The PCM and stage of the cancer were contributing factors in patients with gastric cancer. Thus, these results indicate that PCM and old age, and not the presence of malignant tumors, play a significant role in deficiency in CMI in patients with esophageal cancer.
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PMID:Factors contributing to deficiencies in cell-mediated immunity in esophageal cancer patients. 139 29

The patient was a 44-year-old female who had Borrmann type 4 gastric cancer with enlarged intra-abdominal lymph node metastasis. L-leucovorin (l-LV, 100 mg/m2/day by intravenous bolus for a period of one minute) and fluorouracil (5-FU, 370 mg/m2/day by intravenous bolus) was administered for 5 consecutive days, with a 28-day interval. Dysphagia was subsided 4 weeks after the initial treatment. After 11 weeks, abdominal lymph node metastasis had been reduced in its size (reduced rate 89%). After 16 weeks, gastric structure were remarkably improved (62.2% enlarged in its focus space) in upper GI X-ray. Therefore, total gastrectomy was performed 20 weeks after the initial combination therapy. She has been alive for the past year after the initial treatment. We concluded a combination therapy of l-LV and 5-FU was effective in this patient.
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PMID:[Borrmann 4 gastric cancer treated with l-LV and 5-FU combination--a case report]. 154 65

Body composition and energy expenditure were investigated before and 10-14 days after surgery in 44 patients with upper gastrointestinal cancer (23 esophageal and 21 gastric cancer) in order to assess the impact of preoperative weight loss on metabolic adaptation to the surgical trauma and on postoperative complications. Patients were divided in three groups with I: 0-5%, II: 5-10% and III: greater than 10% preoperative weight loss related to the usual body weight. 50% of the patients presented with no or just minor weight loss. Even in case of weight loss greater than 10% no decrease below the ideal body weight was observed. Body cell mass and fat mass were significantly (p less than 0.05) reduced in group III when compared with I. Since energy expenditure and substrate oxidation rates were rather normal in most patients weight loss was considered to be due to tumor related stenosis and dysphagia. More than 50% of the energy requirements were gained from fat oxidation. General criteria of malnutrition were not fulfilled. Perioperative weight loss was lowest (1.6 +/- 4.9 kg) in patients of group III related to group I (2.9 +/- 1.7 kg) and II (5.0 +/- 6.9 kg). Similar elevation of energy expenditure and lipid oxidation with concomitant reduction in glucose oxidation was observed in all groups of patients. This led to a similar decrease of body cell mass. Independent of preoperative weight loss major complications occurred in 8 cases--pneumonia in 6 and leakage of the anastomosis in 2 patients; no patient died. From this study can be concluded that with regard to perioperative weight loss the metabolic response to surgical trauma is adequate even in patients with marked preoperative weight loss. These patients remain compensated and preoperative weight loss is without major effect on postoperative complication rate.
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PMID:[Significance of preoperative weight loss for perioperative metabolic adaptation and surgical risk in patients with tumors of the upper gastrointestinal tract]. 156 4

One hundred and one consecutive patients with oesophageal cancer, cancer of the cardia and gastric cancer extending upwards from the stomach to the oesophagus were treated from 1979 to 1985 with a policy that included radiotherapy treatment for 58. This heterogeneous group, which was considered together as oesophageal cancer, was subdivided according to anatomical location, histology and pretreatment staging. Those patients who could be treated surgically by a resection and anastomosis performed below the diaphragm were excluded. Thirty-five had surgery which was either an oesophagogastrectomy or oesophagojejunostomy with an intrathoracic anastomosis, except for two who were nonresectable. Eight patients were to ill or refused treatment. The role of radiotherapy was assessed in three groups: i. Operable squamous cell carcinoma of the oesophagus was treated by radical radiotherapy (22) with a 46% 1-year and 14% 5-year survival. ii. Inoperable squamous cell carcinoma of the oesophagus was given radical or palliative radiotherapy (25) with a 16% 1-year and 4% 5-year survival. iii. Non-resectable adenocarcinoma of the stomach or oesophagus was treated palliatively by radiotherapy to debulk the intraluminal tumour (11), all of whom had symptomatic relief of dysphagia. The results of radical radiotherapy for operable squamous cell carcinoma of the oesophagus were similar to the best results achieved by surgical resection in other series in which there is comparable staging. Radiotherapy should be included in the treatment options for oesophageal cancer.
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PMID:101 oesophageal cancers: a surgeon uses radiotherapy. 168 32

Eight years of experience with endoscopic Nd:YAG laser photocoagulation were analyzed in retrospect in an attempt to identify factors relating to both failures and complications of laser therapy, and to delineate its limits and pitfalls in benign and malignant tumors. Three hundred and seventy-eight patients were studied, including 42 with gastroesophageal cancer, 180 with colorectal adenoma and 156 with colorectal malignancy. Patients with gastroesophageal cancer (n = 42) were referred mainly for obstruction in esophageal cancer and for bleeding in gastric cancer, with successful palliation in 86 and 81%. Hemorrhage was the only complication seen, twice during and twice after treatment. Pain, heat and smoke-induced complaints and sometimes temporary increased dysphagia were mentioned. Two white-surfaced tumors did not react at all. Patients with colorectal adenoma (n = 150) were divided into groups according to the size of the lesion. Definitive, histologically documented eradication of adenomatous tissue was achieved in 43% of the extensive, in 69% of the intermediate, and in 97% of the small adenomas. Major complications, mainly stenosis and hemorrhage, occurred in 6.4%, 7.6% and none of the lesions, respectively, and minor complications were seen in 57.4, 30.8 and 13.8%, respectively. Stenosis appeared to be related only to prior electrocoagulation and to excessive delivery of energy. Post-treatment hemorrhage occurred at about day 7. In familial polyposis (n = 30) surveillance of the rectal stump was successful in 84%, with major and minor complications in 4% and 12%. In colorectal cancers (n = 156) treated for palliation of bleeding and obstruction, success was obtained in 91%. major complications (13%) consisted mainly of stenosis and perforation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Analysis of failures and complications of neodymium: YAG laser photocoagulation in gastrointestinal tract tumors. A retrospective survey of 18 years' experience. 168 58

Based on data indicating that decreases in body weight (BW), arm muscle circumference (AMC), and rapid-turnover proteins (RTPs) correlate with fatal septic complications after surgery for esophageal cancer, we examined possible factors contributing to protein-calorie malnutrition (PCM) in patients with this disease. Eight parameters of nutritional status were assessed. Associations between sex, age, stage of cancer, and degree of dysphagia and PCM were analyzed via multiple linear regression for 75 patients with esophageal cancer and 58 with gastric cancer. These four factors independently contributed to PCM in patients with esophageal cancer, whereas malignant tumor and age contributed to PCM in those with gastric cancer. The degree of dysphagia was related to decreases in serum albumin and RTP and weakly related to decreases in BW and AMC. Stage of cancer, age, and sex were associated with reductions in albumin and/or RTP. Thus, we conclude that simple starvation, malignant tumor, age, and sex contribute to PCM and probably to the occurrence of fatal septic complications postoperatively.
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PMID:Factors related to malnutrition in patients with esophageal cancer. 180 92

A rare case of esophageal carcinoma metastasizing to early gastric cancer is reported herein. A 66 year old man who had experienced dysphagia for 8 months was preoperatively diagnosed as simultaneously having esophageal and gastric cancers. Thus, a lower esophagectomy and total gastrectomy with paraesophageal and paragastric lymph node dissection were performed. The surgical specimen revealed an ulcerative tumor in the lower esophagus and a slightly depressed lesion with a central elevation similar to that of early type IIc + IIa gastric cancer in the upper part of the stomach. Microscopically, the esophageal tumor was revealed to be well differentiated squamous cell carcinoma while the gastric tumor was found to be early gastric cancer with a metastatic focus of esophageal cancer in the center. Though less than one hundred cases of metastasis of cancer to cancer have previously been reported, metastasis from cancer of one digestive organ to that of another digestive organ is very rare. To our knowledge, this report represents the first case of an esophageal carcinoma metastasizing to a gastric carcinoma.
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PMID:Metastasis of cancer to cancer: report of a case of esophageal carcinoma metastasizing to early gastric cancer. 185 41

Local recurrence in anastomotic region after resection of stomach cancer is not a rare event. The role of radiotherapy in palliative treatment is commonly underestimated. Our experiences were demonstrated in 2 treatment groups (megavoltage therapy alone, 23 cases; in combination with neutrons, 13 patients). Decrease in dysphagia in 75% of patients was comparable with roentgenologic findings, where reduced tumor in 63% was established. These encourageable findings were confirmed in examination of anastomotic region in autopsy (megavoltage therapy 14 cases, combined neutron therapy 12 cases). Smaller tumors could be totally destroyed by megavoltage therapy. The local tumor destroying rate increased by combination with neutrons (6/12 cases). No advantage in life prolongation could be stated, because local recurrence was quickly followed by widespread disease (77%). Finally we demonstrate a treatment plan, which bases on our clinical experience. With 3-4 fractions of 5-7 Gy a real clinical and radiological demonstrable palliation effect is to be reached.
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PMID:[Results of high-voltage and neutron therapy in the treatment of the postoperative anastomotic recurrence of stomach cancer]. 243 91

A total of 237 patients with confirmed malignancies of the upper-gastrointestinal tract (UGIT) were studied. Of these, 143 (60.34%) were gastric cancers, 66 (27.85) were oesophageal malignancies and 28 (11.81%) were in the small intestine. Epigastric pain accompanied by vomiting after meals was the commonest first symptom in patients of gastric cancer whereas dysphagia formed the commonest first symptom in oesophageal cancer. However, no definite first symptom could be attributed to those with small intestinal tumors. As many as 134 patients (56.54%) had advanced malignancies at presentation itself. The usefullness of first symptoms in early diagnosis and prognosis is discussed.
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PMID:Malignancies of upper gastrointestinal tract in Nigerians: early symptoms and prognosis. 271 53


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