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 influence of anorexia on nutritional status and tumour resectability was prospectively assessed in 50 patients with oesophageal carcinoma and severe dysphagia. Among the 21 patients in whom anorexia was present, objective measurement of clinical status demonstrated that malnutrition was present in 13 (62%) and resection of the tumour was possible only in five (24%). On the contrary, among the 29 patients without anorexia, malnutrition was only present in five (17%) and resection of the tumour was possible in 24 (82%). We conclude that anorexia is a main determinant of malnutrition and that it is related to the tumour development independently of dysphagia. In patients with oesophageal carcinoma, the clinical assessment of anorexia must be used for evaluating nutritional status before surgery. The presence of anorexia suggests a widespread tumour or a disseminated cancer and it might explain the poor nutritional effects of palliative intubation in non resectable tumour.
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PMID:Anorexia in oesophageal carcinoma. 347 24

Experimental autoimmune myasthenia gravis (EAMG) was induced in rhesus monkeys using purified acetylcholine receptor (AChR) from Torpedo california. A single dose of 80 micrograms induced antibody formation two weeks after injection. Two subsequent doses at two-week intervals caused clinical signs (anorexia, fatigability, weight loss, ptosis and dysphagia) which initially responded to treatment with neostigmine. Histologic examination of post-mortem tissues revealed lesions characteristic of myasthenia gravis in man: muscular atrophy, fibrous degeneration and lymphocytic infiltration. Antibodies were quantitated in the sera of three other monkeys which received only 60 micrograms of purified AChR. Abnormally high titers persisted for two years (60-200 micrograms /ml versus 0-10 micrograms/ml for controls). A monkey injected with 60 micrograms AChR as part of reconstituted membrane vesicles had lower titers (30-50 micrograms/ml) than those which received purified receptor. Only those monkeys with antibody titers exceeding 800 micrograms/ml developed overt disease. These titers were 4-100 times higher than those reported for myasthenic humans. The antibody-antigen molar ratios were higher for monkeys with disease than for asymptomatic animals. These data suggest that the diversity of antibody molecules synthesized by the sensitized monkeys determined the appearance of clinical signs, and that the cross reaction of anti-torpedo antibodies with monkey receptor was primarily responsible for the development of EAMG.
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PMID:Induction of experimental myasthenia gravis in rhesus monkeys: a model for the study of the human disease. 379 23

Male Sprague-Dawley rats which survived bilateral subdiaphragmatic vagotomy (with hepatic branch intact) exhibited an acute syndrome of hypophagia, hypodipsia and severe loss of body weight when maintained on solid food and water for 14 days after vagotomy. This postvagotomy syndrome was attenuated when rats were maintained on a liquid diet (116EC) chosen to minimize postvagotomy dysphagia and abnormal gastric retention of food; vagotomized rats were hypophagic and lost body weight, but the degree of weight loss was not so severe as for vagotomized rats eating solid food. When rats with total subdiaphragramatic vagotomy were maintained on palatable sweet milk food, the acute postvagotomy syndrome was abolished; these vagotomized rats ate and drank as much as rats with sham vagotomy and they did not lose weight. When rats that underwent selective hepatic, gastric or coeliac vagotomy were maintained on the sweet milk diet, three different postoperative syndromes occurred: after selective hepatic vagotomy, rats were hyperphagic, hyperdipsic and gained body weight at a greater than normal rate; after selective gastric vagotomy, rats lost weight despite relatively normal food and water intakes; and after selective coeliac vagotomy, there was no change in food or water intakes or body weight. These results demonstrate that a sweet milk diet abolishes the anorexia, hypodipsia and weight loss that usually occur in vagotomized rats maintained on pellets and water. Use of this sweet milk diet revealed different acute syndromes after bilateral and selective vagotomies. The differences among the syndromes suggest that hepatic, gastric and coeliac vagal branches serve different functions in the control of food and water intake and body weight.
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PMID:Specific postoperative syndromes after total and selective vagotomies in the rat. 396 95

Twelve cases of superficial carcinoma of the esophagus, representing 4.9% of patients with carcinoma of the esophagus, were evaluated. All the patients were male smokers who drank alcohol excessively. The main clinical features were dysphagia, asthenia, anorexia, and weight loss. Most of the lesions were elevated and all endoscopic biopsies were positive for cancer. Half of the cases showed invasion of the submucosa; the remainder involved mucosa only. Ten patients are alive and free of metastatic disease.
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PMID:Superficial esophageal carcinoma: a report of 12 cases. 399 61

Thirty consecutive patients with far-advanced cancer affecting the esophagus and gastroesophageal junction underwent palliative endoscopic neodymium-YAG laser therapy. No patients were excluded from treatment, regardless of age, extent of disease, or performance status. Sessions were performed every other day and concluded when an endoscope could be easily passed beyond the previously obstructed area. Treatment was completed in 3.3 sessions (seven days). Luminal patency was achieved in 97%, but did not always equate with functional success. Seventy percent (21 patients) were able to ingest all necessary calories and leave hospital for home (functional success). Reasons for discrepancy between technical success and functional success included radiation-induced pharyngeal dysphagia, anorexia, painful tumor load and debility, and treatment complications. Endoscopic laser therapy of far-advanced esophageal or gastroesophageal junction carcinoma was almost always technically feasible, with relatively low morbidity. While technical success could not always be equated with functional success, therapy was "completely" functionally successful in 70% of patients with far-advanced disease. Poor performance status at accession correlated best with poor functional outcome.
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PMID:Endoscopic laser therapy for malignancies affecting the esophagus and gastroesophageal junction. Analysis of technical and functional efficacy. 402 76

A 40-year-old man who farmed in Mexico and raised dogs as a hobby presented with dysphagia, hydrophobia, insomnia, anorexia, malaise, fever, and decreased strength and sensation in his dominant arm. After a repetitive three-hour history and physical examination, a tentative diagnosis of rabies was made in an atmosphere of patient denial followed by reluctance of hospital personnel to accept such a rare diagnosis. Upon confirmation of the diagnosis by the Center for Disease Control, Atlanta, the patient underwent aggressive therapy, including maximum respiratory support, anticonvulsants, steroids, pressors, hemodialysis and interferon treatment, but died on the 16th day following admission. This case is presented because of its rarity and to review the disease, clinical history, current therapy, and recent literature regarding emergency department differential diagnosis.
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PMID:Human rabies. 618 91

A 4-year-old German Shepherd, with a 3-week history of anorexia, intermittent dysphagia and a serous nasal discharge, had a fluctuant mass protruding from its left pharyngeal wall. Cytologic examination of an aspirate suggested a salivary mucocele. Creation of a window in the mucocele did not prevent recurrence, so the lining of the sac was resected, after which the mucocele did not recur.
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PMID:Salivary mucocele in a dog. 649 7

Six cases of squamous cell carcinoma of the stomach in horses seen at the New York State College of Veterinary Medicine are compared with 15 similar cases reported previously. Clinical signs included anorexia in all cases, emaciation, fever, anaemia and/or palpable abdominal masses in 3, colic in 2 and dysphagia in one case. Haematological studies revealed normochromic, normocytic anaemia in 3 and absolute neutrophilia in 5 cases. Peritoneal fluid analysis was performed in 4 cases and revealed slightly to moderately elevated total protein concentrations in 3 and a markedly elevated number of white blood cells in 2 cases. Exploratory laparotomy, performed in 3 cases, was essential for a definitive diagnosis. The data presented here suggest that squamous cell carcinoma of the equine stomach may be increasing in frequency and demonstrate the need for prospective epidemiological studies.
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PMID:Six cases of squamous cell carcinoma of the stomach of the horse. 710 89

Four cases of pharyngeal trauma in cattle due to improper administration of oral medications are discussed. These cases presented for suspected gastro-intestinal disorders and anorexia. Physical findings included copious drooling of saliva, pharyngeal pain, extended head and neck, forestomach stasis, fever, dysphagia, and pneumonia. Diagnosis was made by manual examination of the oral cavity or endoscopy. Ancillary diagnostic aids included clinical pathology and radiography. Hemograms were consistent with infection, serum electrolytes were normal. Radiographs in 3 of 4 did reveal significant evidence of retropharyngeal cellulitis. The signs of dysphagia and forestomach dysfunction were explained by either a pain induced inhibition of swallowing and eructation or direct involvement of the vagus nerve itself in the retropharyngeal region. An additional consequence of laryngeal motor dysfunction was aspiration pneumonia. Response to treatment with broad spectrum antibiotics, analgesics and symptomatic supportive care over a 7 to 14 day period was good.
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PMID:Pharyngeal trauma in cattle. 722 42

A total of 458 eligible patients, from 21 centres, with microscopically confirmed SCLC were allocated at random to three chemotherapy regimens, each given at 3-week intervals. In two regimens, etoposide, cyclophosphamide, methotrexate and vincristine were given for a total of either three courses (ECMV3) or six courses (ECMV6). In the third regimen, etoposide and ifosfamide were given for six courses (E16). Patients with limited disease also received radiotherapy to the primary site after the third course of chemotherapy in all three groups. As reported by clinicians, 59% of the ECMV3, 67% of the ECMV6 and 63% of the EI6 patients experienced moderate or severe adverse reactions to their chemotherapy. The major symptoms of disease, cough, haemoptysis, chest pain, anorexia, and dysphagia, were palliated in 63% or more of patients and the median duration of palliation was 63% or more of survival, the results being similar in the three groups. Among patients with poor overall condition, physical activity and breathlessness on admission, the proportions who improved were higher in the EI6 group but the differences were small. In all three groups, levels of anxiety fell substantially during treatment. Levels of depression were lower and showed little change. As assessed by patients using a daily diary card, the patterns of nausea, vomiting, activity and mood, associated with courses of chemotherapy were very similar in the three groups. In the EI6 group there was less dysphagia and better overall condition between courses, but these advantages need to be weighed against the inconvenience of the 24-h infusions required, compared with the 30-min infusions of the other two regimens. As reported in the companion paper (MRC Lung Cancer Working Party, 1993a) there was no statistically significant survival advantage to any of the three regimens, although the results do not exclude the possibility of a minor survival advantage with the two six-course regimens. In conclusion, there was no major clinical gain from continuing chemotherapy beyond three courses or from using the ifosfamide regimen.
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PMID:A randomised trial of three or six courses of etoposide cyclophosphamide methotrexate and vincristine or six courses of etoposide and ifosfamide in small cell lung cancer (SCLC). II: Quality of life. Medical Research Council Lung Cancer Working Party. 750 4


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