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)

A prospective randomized study was carried out to evaluate the nutritional and clinical results of two reconstructive procedures after total gastrectomy for gastric cancer: Longmire-Mouchet (LM) operation with loop interposition and maintained duodenal transit and Roux-en-Y (RY) reconstruction with duodenal exclusion. 22 patients, 11 with LM reconstruction and 11 with RY reconstruction were studied pre-and postoperatively. The average follow-up was of 30 +/- 8 months. The clinical results were shown to be substantially similar to the two groups. No patients complained of heartburn or dysphagia. At esophagoscopy no signs of esophagitis were detected in both groups. The two time course curves of body weight variation did not show statistically significant differences even though in RY patients the body weight has reverted more rapidly to basal values.
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PMID:Nutritional effects of total gastrectomy. A prospective randomized study of Roux-en-Y vs Longmire-Mouchet reconstruction. 383 Sep 53

14 primary cancers of the gastric stump developing after low partial gastrectomy for a benign ulcerative gastroduodenal lesion have been treated in 7 years (1976-1982). The necessarily cautious criterion of definition is a postoperative interval of over 15 years. Indeed, it seems very unlikely that a gastric cancer could remain unrecognised and asymptomatic throughout this period. This personal series, together with a review of the recent literature (352 cases), makes it possible to clarify various facts concerning this non-fortuitous anatomic and clinical entity. The clinical aspect is quite characteristic, marked after a silent latent interval (average postoperative delay 27 years) by epigastric pain, vomiting, dysphagia and eventual change in general condition. The frequency is increasing, even though gastric cancer is on the decline whatever the geographic zone considered (in France from 1952 to 1968 the incidence per 100,000 inhabitants fell from 27.2 to 19 per cent). The average frequency of cancer of the gastric stump is estimated as 2.5 per cent of the totality of cancers of the stomach. The risk of developing a cancer of the gastric stump varies around 3 per cent in those undergoing gastrectomy for an ulcer. Moreover, this risk increases with the passage of time. The marked preponderance of the male sex remains unexplained. The initial site of the ulcer is so often unknown as to permit no definitive conclusion. It must therefore be considered that cancer of the gastric stump is really the direct consequence of the surgical procedure of excision.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Cancer of the gastric stump. Apropos of 14 recent cases]. 652 56

The clinicopathological features of 10 cases of superficial oesophageal carcinoma without lymph node metastasis are reported. Superficial oesophageal carcinoma, an uncommon form of oesophageal cancer, is defined as invasive squamous cell carcinoma confined to the mucosa and submucosa. It includes plaque-like, erosive, papillary and occult types but is not associated with the usual macroscopic features of advanced oesophageal cancer. The main presenting symptom of dysphagia and oesophagitis is a frequently quoted endoscopic diagnosis. Superficial oesophageal carcinoma may be preceded by dysplastic and in situ carcinomatous changes and is probable oesophageal counterpart to early gastric cancer.
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PMID:Superficial oesophageal carcinoma: an oesophageal counterpart of early gastric cancer. 728 13

We report herein the case of a 60-year-old woman who presented with dysphagia and anorexia and was subsequently diagnosed as having gastric cancer of the reconstructed stomach tube 36 years after undergoing surgery for a benign esophageal stricture. Reports on carcinoma of the reconstructed stomach tube are rarely found and interestingly, all of the previous cases, which were documented only in the Japanese literature, corresponded to metachronous double cancers after esophageal malignancies. To our knowledge, this is the first case of carcinoma of the reconstructed stomach tube following esophageal resection for a benign stricture, and it is thought that the carcinoma probably developed at the site of the anastomosis a long time after the first operation. We reviewed 30 cases of carcinoma of the reconstructed stomach tube for which the clinicopathological data was complete, and we believe that this new type of cancer needs more than 10 years to develop and should be defined as "carcinoma of the gastric remnant".
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PMID:Carcinoma of the reconstructed stomach tube following esophageal resection for a benign stricture: report of a case and review of the literature. 764 Apr 56

The extent to which the different resections relieve the symptoms of gastric cancer is poorly defined. The symptoms of 57 consecutive patients undergoing standard resection of gastric adenocarcinoma by oesophagogastrectomy (n = 19), total gastrectomy [16] or partial gastrectomy [22] were studied prospectively. Common symptoms were relieved in 80% of cases and this was independent of tumour stage. Symptoms were significantly more frequent after total gastrectomy than after partial gastrectomy or oesophagogastrectomy, the difference being attributable principally to the development of new symptoms after total gastrectomy. While abdominal pain, nausea and vomiting were largely relieved by resection, dyspepsia or dysphagia worsened in 31% of patients following surgery, especially total gastrectomy (P < 0.05). Resection relieves the symptoms of gastric cancer adequately but outcome is influenced by operation type. As total gastrectomy gives a poorer symptomatic outcome, it should be avoided when the performance of an alternative procedure does not compromise established principles of resection.
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PMID:Symptomatic outcome following resection of gastric cancer. 778 Jun 11

In order to identify the most effective approaches for detecting early carcinoma of the esophagus, 46 patients with such lesions, including three epithelial, 13 mucosal and 30 submucosal carcinomas, were studied. Among 16 patients with epithelial and mucosal carcinomas, five (31%) were symptomatic, and in 15 (94%), the lesions were detected by endoscopy. Among 30 submucosal carcinomas, 17 (57%) were associated with symptoms such as mild dysphagia and a sharp pain, and 22 (73%) were detected by endoscopy. With respect to the gross appearance of early esophageal carcinoma, a protruded type frequently caused symptoms (70%) and was often detected by radiology (50%). Although endoscopy always permitted a correct diagnosis of the lesion (100%), radiology often failed to detect it (47%), especially when the lesion was of the superficial type. In asymptomatic patients, most early esophageal carcinomas were detected during the follow-up of gastric diseases, mass-screening or medical examination for gastric cancer, and in connection with abdominal pain due to other diseases. These results indicate that, in order to detect early carcinoma of the esophagus, it is important to perform Lugol-combined endoscopy with biopsy rather than radiology.
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PMID:How to detect early carcinoma of the esophagus. 832 84

Esophageal manometry with a catheter microtransducer was performed as a functional diagnostic method on 30 patients after total gastrectomy because of gastric cancer (18 men, 12 women with a mean age of 64 +/- 3.7 years). Subsequently their symptoms were recorded. 21 of the patients (70%) complained of reflux discomfort and symptoms of disturbed peristalsis (dysphagia, odynophagia). 29 patients (93%) showed pathological patterns of contraction (repetitive, simultaneous, deformed, multipeak contractions) especially in the distal part of the esophagus. The contractile force was decreased on average by 10 mmHg in that area. The resting pressure of the upper sphincter was also decreased by about 10 mmHg. These results can be explained by an increased postoperative reflux (absence of the lower sphincter) and the changed biomechanics of the esophagus (decreased longitudinal tension) caused by the operation. The results of this study demonstrate the importance of postoperative manometry in total gastrectomized patients.
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PMID:Disturbed esophageal motility after total gastrectomy. 839 29

Medical records have often been found to be less reliable than interviews to patients when data on the initial signs and symptoms of cancer, and the out-of-hospital diagnostic process are sought; in spite of this, a large body of research on "diagnostic delay" in cancer is based on clinical records. As part of a study on delay in neoplasms of the digestive tract we analyzed the agreement on the type and date of the initial symptom between hospital records and a structured personal interview. Records were abstracted for a random sample (N = 60) of 183 patients interviewed. Concordance on the date of the first symptom was deemed to exist if the difference was +/- 30 days. The Kappa index (kappa) and the overall proportion of agreement (with its corresponding 95% confidence interval) were used. Medical records and structured personal interviews were concordant on the type of the first neoplastic symptom in only 61% of cases (kappa = 0.50): 67% in esophagus cancer (kappa = 0.49), 60% in stomach cancer (kappa = 0.52), and 61% in colorectal cancer (kappa = 0.50). Records underestimated the occurrence of anorexia as first symptom and overestimated weight loss and dysphagia. Only 56% of cases were date-concordant, the agreement being lower in colorectal cancer (46%) than in esophageal (67%) and stomach cancer (75%). Records indicated the first symptom to have occurred at a later date than interviews in 33% of cases; overall, a study based on hospital records would have underestimated the symptom to diagnosis interval by 2.2 months per patient. Only 40% of cases were totally (symptom and date) concordant. Marked discrepancies may exist between the information contained in medical records and what patients report during a structured interview. The quality of medical records data on the duration and nature of cancer symptoms should be assessed before its use in etiologic and evaluative research.
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PMID:Disagreement between hospital medical records and a structured patient interview on the type and date of the first symptom in cancers of the digestive tract. 855 51

An elderly black man was admitted to our institution with macrocytic anemia, dysphagia, and significant weight loss. Results of an esophagogram were suggestive of achalasia. Gastric adenocarcinoma infiltrating the gastric cardia was seen on gastroscopy. The mode of presentation of gastric cancer in this case has not been previously reported in association with pernicious anemia. Patients with pernicious anemia are at higher risk of having gastrointestinal neoplasms than is the general population. We review the current literature and address the controversy concerning the need to subject patients with pernicious anemia to surveillance with upper gastrointestinal endoscopy.
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PMID:Gastric cancer and pernicious anemia appearing as pseudoachalasia. 879 Mar 17

A 40-year-old woman was admitted to the hospital because of dysphagia and severe anemia (Hb 4.5 g/dl). She was diagnosed as having an advanced gastric cancer, which was unresectable because of liver metastasis, esophageal invasion and paraaortic lymph node metastasis. Combination chemotherapy with CDDP/5'-DFUR was started. CDDP of 80 mg/m2 was administered twice every 4 weeks by a 24-hour drip infusion method, and oral 5'-DFUR of 1,400 mg/m2 was administered for 4 days prior to the first administration of CDDP. Then, 5'-DFUR of 500 mg/m2 was given every day except for 7 days after the first administration of CDDP. Her performance status before the chemotherapy was 3, and improved to 1 a month after the first administration of CDDP. The patient was discharged very much improved on the 45th day after the first administration of CDDP. The side effect was nausea but tolerable. Six months after the first administration, her cancer disappeared on X-ray films, endoscopic and CT examinations. Her PS improved to 0, and she has remained alive with a good QOL for 10 months after the second administration of CDDP.
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PMID:[Unresectable gastric cancer followed by remarkably effective tumor disappearance and good quality of life for 10 months after CDDP/5'-DFUR combination chemotherapy--a case report]. 893 96


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