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

A 23-year-old woman gravely ill with Pseudomonas septicemia secondary to presumed drug-induced bone marrow aplasia received marrow transplantation from two male HL-A identical sibling donors. She had a successful engraftment with excellent but temporary clinical improvement. Subsequently she succumbed to graft-versus-host disease manifested by Pseudomonas and Candida albicans septicemia, cytomegalovirus pneumonitis, three phases of dermatitis, nausea, vomiting, dysphagia, diarrhea, fever, edema and bone pain, with gradual but complete graft suppression by the 74th day after the transplantation. A second marrow transplant on the 70th day was unsuccessful.
 ...
PMID:Bone marrow transplantation in a patient with drug-induced aplastic anemia. 440 93

In a prospective randomized trial highly selective vagotomy (HSV) was compared with truncal vagotomy and pyloroplasty (TVP). One surgeon performed all the operations. Ninety-eight per cent of patients were reviewed by two physicians after 20-97 mth (mean 61 mth). Fifty-nine of 68 patients (87 per cent) had an excellent or very good result after HSV (Visick grades I and II) compared with 48 of 69 (70 per cent) after TVP (P less than 0.05). There was 1 proven recurrence after HSV and 4 after TVP. Diarrhoea, including mild symptoms, occurred in 5 patients (7 per cent) after HSV and in 27 (39 per cent) after TVP (P less than 0.001). Severe diarrhoea did not occur after HSV but was present in 4 patients (6 per cent) after TVP (P less than 0.001). Flatulence, epigastric fullness and weight loss were also significantly more common after TVP. On average HSV took 72 min to perform compared with 44 min for TVP (P less than 0.001). Transient dysphagia occurred in 19 patients after HSV compared with 8 after TVP (P less than 0.05). HSV gave better results than TVP and was associated with a low recurrence rate (1.5 per cent at a mean of 5 yr). Although technically more demanding, HSV in our hands is a better operation than TVP for uncomplicated duodenal ulcer.
 ...
PMID:A comparison of highly selective vagotomy with truncal vagotomy and pyloroplasty--one surgeon's results after 5 years. 634 16

Vagotomy and pyloroplasty are associated with technical complications, the most important being rupture of the esophagus, splenic injury, leak at the pyloroplasty, and intra-abdominal bleeding. This operation can also be associated with other complications including epigastric fullness, dysphagia, vomiting of food, bilious vomiting, dumping, and diarrhea. The historical background and specific complications of each procedure are discussed.
 ...
PMID:Complications of vagotomy and pyloroplasty. 635 95

We analyzed the clinical, radiographic, esophageal manometric, and pathological features of 10 patients referred with jejunal diverticulosis. Nine patients were over age 59 yr and had symptoms of intestinal pseudoobstruction of 5-43 yr duration. Seven had surgery for mechanical obstruction, although none was found. Eight had diarrhea, steatorrhea, and weight loss. Five had Raynaud's phenomenon and heartburn, and 2 had dysphagia. At radiography, 9 had jejunal diverticula with or without duodenal or ileal diverticula, or both. Two each had abnormal structure or motility of the esophagus or stomach. At manometry, 3 of 7 had a nonspecific motor abnormality, and 1 other had low amplitude peristaltic waves. Light microscopy of small intestinal tissue in 7 patients showed that 4 had fibrosis and decreased numbers of normal-appearing muscle cells, findings consistent with progressive systemic sclerosis. Two others had fibrosis associated with degenerated smooth muscle cells, findings consistent with a visceral myopathy. The seventh patient had neuronal and axonal degeneration and neuronal intranuclear inclusions, findings consistent with a visceral neuropathy. We conclude that (a) intestinal pseudoobstruction is a major clinical manifestation of jejunal diverticulosis, (b) jejunal diverticulosis is a heterogenous disorder associated with at least three abnormalities of the smooth muscle or myenteric plexus, (c) in contrast to intestinal pseudoobstruction without diverticulosis, the esophagus, stomach, and colon are less frequently involved in jejunal diverticulosis, and (d) some patients with jejunal diverticulosis probably have clinically inapparent progressive systemic sclerosis.
 ...
PMID:Jejunal diverticulosis. A heterogenous disorder caused by a variety of abnormalities of smooth muscle or myenteric plexus. 640 4

In the surgical treatment of gastric ulcer (G,U,), the same techniques have been employed as have been used in duodenal ulcer (D.U.). This correspondence also holds true with superselective vagotomy and proximal gastric vagotomy (P.G.V.). The technique was primarily indicated in the treatment of D.U. and had very exciting preliminary results, above all owing to its reduced morbidity both immediately and late after surgery, and to its almost null mortality. With a view to analyzing the results of the use of P.G.V. in the treatment of gastric ulcer, thirteen patients were operated upon who were bearers of G.U. not associated with D.U. nor prepyloric ulcer. There were no operating accidents or immediate post-operative complications, nor was there any mortality. In the post-operative period following lasting an average of 17.7 months, we observed the clinical manifestation of the ulcer and symptoms accompaning the operation in addition to performing endoscopy on all of the patients. Eight patients were absolutely asymptomatic after surgery; one had slight dysphagia that diminished about 3 months after P.G.V. Three patients had recurrence of the symptoms of ulcer and one complained of intense epigastric fullness, vomting, weight loss, and a crisis of diarrhea. Radiologic and endoscopic examinations showed that this last patient had hypotonia and marked gastric stasis that were corrected surgically by means of antrectomy and the reconstitution of GI tract by the BI technique, with good results. In three patients endoscopy showed postoperative recurrence of the G.U., one of whom is assymptomatic with the clinical treatment; the other two were submitted to antrectomy with BI anastomosis in one and a 2/3 gastrectomy with BI reconstruction in the other. The cure of the lesion in 23% of the cases in the post-operative follow-up lasting an average of 17.7 months permits us henceforward to contra-indicate the P.G.V. used per se for the treatment of G.U.
 ...
PMID:[Critical analysis of the treatment of gastric ulcer by proximal gastric vagotomy]. 666 Oct 91

To assess the long term results (a mean of 15 years) of a previously reported method of reconstruction after total gastrectomy, 32 patients, all of whom underwent this type of reconstruction, were studied. The results after endoscopic, cinefluorographic and isotopic emptying studies and the findings concerning assessment of bile reflux and of the capacity of the absorptive function in each individual patient revealed that the majority of the patients studied had normal findings in both functional and morphologic terms of the constructed gastric reservoir. Moreover, a careful clinical assessment which was carried out concerning the presence of various postoperative symptoms and sequelae, such as dumping, dysphagia, regurgitation, postprandial fullness and diarrhea, as well as postoperative weight changes and the ability of each patient to return to his or her preoperative work revealed that 24 patients were graded as Grade I, six as Grade II and two as Grade III. The aforementioned results are considered as satisfactory and the reconstruction is recommended for patients undergoing total gastrectomy.
 ...
PMID:Long term results of a new method of reconstruction for continuity of the alimentary tract after total gastrectomy. 671 Feb 95

A prospective controlled trial of proximal gastric vagotomy (PGV) in 829 patients at three surgical services is presented. Peroperative tests of vagotomy completeness were made in two of the three groups of patients. The follow-up period was four to six years. The hospital stay after PGV averaged 9.2 days. The postoperative mortality rate was 0.2%. The reduction of gastric acidity was maintained four years after PGV. Postoperatively no patient had severe diarrhoea. The incidence of dumping after PGV was 1.5% and of gastric stasis 7.3%. Though 7% of the patients reported pyrosis after PGV, only a few required treatment. Transient dysphagia was reported by 2.5% of the patients. In about 4% of the series there were relatively mild ulcer-like symptoms postoperatively, without confirmation of ulcer. Duodenal ulcer recurred in 2% of cases during the observation period and gastric ulcer appeared in 1.5%. According to the Visick classification, 74% of the series showed grade I clinical result, 18% grade II, 4% grade III and 4% grade IV. There were no intergroup differences in Visick grades.
 ...
PMID:Proximal gastric vagotomy. A prospective study of 829 patients with four-year follow-up. 683 26

Sequelae of vagotomy in peptic ulcer are dysphagia, dumping syndrome, gastric emptying disturbances, diarrhoea, and functional disturbances of liver, bile ducts and pancreas. All these disturbances, except dysphagia, are less pronounced after high selective vagotomy than after surgical procedures including drainage techniques. Relapsing ulcer is the most frequent complication; this is rarely a direct consequence of vagotomy, but it is more likely due to non-complete transection of the nerve or to transections not indicated.
 ...
PMID:[Sequelae of vagotomy in peptic ulcer (author's transl)]. 709 46

The aim of this study was to assess the clinical results after highly selective vagotomy (HSV) when used routinely at a district general hospital. A total of 229 patients with chronic duodenal or prepyloric ulcers was included in a 92 per cent complete follow-up 1-6 years after an elective HSV without drainage. There was no postoperative mortality, and the frequency of postoperative complicatons was low. Transient dysphagia and early fullness each occurred in about a quarter of the patients, whereas persistent dumping was found only in 1.3 per cent and diarrhea in 2.2 per cent of the patients. Recurrent ulcer was diagnosed in 12.7 per cent of the patients, but this figure decreased to 9.3 per cent after exclusion of one of the 24 surgeons involved. The overall clinical results according to the modified Visick classification were recorded as excellent or very good in 70 per cent and unsatisfactory in 20 per cent. The failures were almost exclusively due to a proved or suspected recurrence or to gastric retention, and further operations have been performed on 27 of these patients. After reoperation only 8 patients (3.5 per cent) remained failures according to the patient's own judgement at the time of follow-up. The recurrence ratein this study was considered disquietingly high with regard to the short observation time. However, other obvious advantages of the method and the possibility of improved results after adjustment of the surgical technique were considered to justify continued use of HSV as a routine procedure.
 ...
PMID:Clinical results of 229 patients with duodenal ulcer 1-6 years after highly selective vagotomy. 735 38

12 cases of food-borne botulism were registered in Sion, Switzerland, between 31 December, 1993 and 12 January, 1994. A type B toxin was isolated from the serum of one patient and from the incriminated ham. Clinical data of 10 male patients aged 21 to 54 years and some epidemiologic data are reported. The clinical course was mild to moderate with predominant autonomic and gastro-intestinal symptoms and signs: blurred vision (10 patients of 10), dry mouth with dysphagia (9/10), asthenia (7/10), diarrhea and/or constipation (7/10), nausea and vomiting (6/10), abdominal cramps (5/10), impaired sexual function (5/10), dilated pupils (4/10). Some discomfort (mainly blurred vision, asthenia and impaired sexual function) persisted for several months in most patients. Neuromuscular involvement was never the reason for seeking medical assistance and had often disappeared at the time of the first visit. Two patients were hospitalized, one for transient ileus of unknown origin and the second (first suspected case) for monitoring and infusion of trivalent equine botulinum antitoxin. This treatment was administered on day eight after intoxication and had no effect on this patient's outcome when compared with others. No patient died. Epidemiology, diagnosis, treatment and prognosis of botulism are discussed.
 ...
PMID:[Epidemic of type B botulism: Sion, December 1993-January 1994]. 748 37


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>