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)

Thirty-nine unselected patients suffering from inoperable, recurrent, or residual adenocarcinoma of the stomach were referred for palliation with fast neutrons from the Medical Research Council's cyclotron at Hammersmith Hospital. A full course of 1440 rads given in 12 treatments over 26 days was administered to the patients. Because of the relatively low energy (7-5 MeV) of the beam from this particular machine, it was not possible to deliver the full dose uniformly throughout the tumour except in extremely thin patients. Pain, dysphagia, vomiting, and bleeding were relieved in the majority of cases. The side effects were minimal and easily controlled. Palpable masses disappeared. Five patients required surgery after neutron therapy. All the incisions were made through irradioated tissue and all except one healed normally. Tumour was present outside the treated area, but the absence of any palpable mass within the treated area was a consistent finding. Radiologically, the stomachs remained abnormal and later changes included gross mucosal abnormality and shrinkage. Fourteen patients came to necropsy and in 10 no tumour was present macroscopocally. Tumour cells were seen in all except two cases but these were few, surrounded by dense fibrous tissue, and may not have been viable. The remaining stomach was abnormal with a thickened wall and destruction of mucosa. Three of the four cases in which macroscopic tumour was present received less than the standard dose because of the inadequate penetration of the beam. Excellent regression of tumors was achieved by the neutrons, but the stomachs did not recover from this satisfactorily. Gastrectomy four to six months after treatment is therefore suggested. This operation and other surgical procedures in other patients were successfully carried out. There is a need for higher energy neutrons to improve treatment and extend it to patients of thick-set build.
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PMID:The effects of fast neutrons on inoperable carcinoma of the stomach. 4 31

Benign tumors of the esophagus are rare and require an alert suspicion for early diagnosis. These tumors may not cause symtoms before attaining large size, yet they may prove fatal when small. Because of the possibility of malignancy and their tendency to obstruct, benign tumors of the esophagus should be resected when diagnosed. This report details our experience in 20 patients with benign esophageal tumors seen at Emory University Hospital between 1955 and 1975. There were 15 men and five women in the group, ranging in age from 17 to 75 years. The tumor series included 13 leiomyomas, four cysts, two cases of multiple polyps, and one case of granular cell myoblastoma. Six of the tumors were asymptomatic; the remaining 14 had symptoms of dysphagia, pain, and hematemesis. In one instance, episodic hematemesis and melena were so severe that they produced hemorrhagic shock. Characteristic radiologic features helped in making the preoperative diagnosis in 18 of the 20 cases. Two patients had coexisting disease masking the presence of the esophageal tumor. Seventeen patients had surgical resection. There were no operative deaths and follow-up results have been satisfactory.
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PMID:Benign tumors of the esophagus: experience with 20 cases. 19 36

Seventy patients had an upper gastrointestinal examination following Nissen fundoplication for reflux esophagitis associated with hiatal hernia. Thirty-nine were asymptomatic and the fundoplication appeared normal. Of the 31 patients with symptoms (dysphagia, pain, or vomiting), 15 had spontaneous relief and demonstrated a normal postsurgical radiographic appearance of the stomach. The other 16 had both persistent symptoms and radiographic abnormalities, including 5 stenoses, 3 recurrent hernias, and 8 pouch deformities of the fundus. The roentgenographic features and etiology of these surgical failures are discussed and the importance of the radiographic examination in discerning successful surgical repair from failure despite similar postsurgical symptoms is stressed.
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PMID:The radiographic appearance of complications following Nissen fundoplication. 42 79

A 62-year-old man presented with a grand mal seizure, progressive abdominal distention, and refractory hypotension 18 years after colonic bypass of a benign stricture of the low middle third of the esophagus. He died 3 hours after admission to the hospital. The patient had a history of liniment ingestion in childhood plus a long history of dysphagia and substernal pain. Autopsy disclosed a large ulcer of the anterior wall of the distal esophagus, which had eroded through the posterior wall of the left atrium. Histologic examination revealed chronic esophagitis with fibrous obliteration of the esophageal wall, pericardium, and left atrial myocardium near the site of perforation. Foreign material was present within small arteries of multiple viscera, and in several of these fragments transverse striations were demonstrated. Esophageal-atrial perforation is a rare but fatal complication of chronic esophageal ulceration. The clinical and pathological features of this and previously reported cases of nontraumatic esophageal-atrial perforation are reviewed.
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PMID:Esophageal-atrial perforation due to recurrent esophagitis 18 years after esophageal bypass surgery. 45 25

A 38-year-old man developed pain and peripheral-type weakness on the right side of his face and was discovered to have decreased hearing bilaterally, as well as optic nerve swelling on the right. The pain and optic nerve swelling subsided over a period of six weeks, but hearing loss and facial weakness persisted. Thirty months later, he developed dysphagia, ataxia, dysarthria, nystagmus, and progressive spastic quadriparesis. He died approximately four years after the onset of the illness. Although no evidence of disease was found other than in the central nervous system during life, two nodules in the right lower lung were found on autopsy. The examination of these nodules, as well as the brain stem, showed an angiocentric and angionecrotic process with lymphoreticular and plasmacytoid invasion.
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PMID:Lymphomatoid granulomatosis clinically confined to the CNS. A case report. 58 1

A survey of 102 patients with achalasia of the cardia treated by cardiomyotomy is reported. The technique of operation was unchanged throughout and the patients were followed up for a maximum of 22 years. Only 6 patients (5.8 per cent) developed renewed symptoms of reflux and 7 patients (6.8 per cent) had peptic strictures. Over 80 per cent of the patients had no dysphagia or regurgitation postoperatively, but 61 per cent still complained of achalasic pain. The development of mucosal hernias after cardiomyotomy and the use of drinking times in the assessment of outflow at the cardia are discussed.
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PMID:Results of Heller's operation for achalasia of the cardia. 66 43

Functional disroders are the most important cause for complaints in the gastrointestinal tract. Dysfunction may concern one or more physiologic properties like tonus, motility, secretion, sometimes also resorption and digestion, or their interaction. Functional disorders of the esophagus (esophagospasm and achalasia) become manifest as dysphagia. Halitosis, bad taste, burning tongue, and flatulent abdomen are frequent symptoms of functional disorders of the gastrointestinal tract. Irritable bowel syndrome is probably the functional disorder most freqently found in the gastrointestinal tract. Characteristic symptoms are pain in the lower and upper middle abdominal region, obstipation and/or diarrhea, flatulent abdomen, mucous discharge with the stools and urgent defecation with cramps relieved after discharge. Prognosis quoad vitam is good, the course, however, is subject to many changes. Therapie is symptomatic. Diagnostic and psychotherapeutic measures are intended to help remove carcinophobia and to overcome conflicts and fears.
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PMID:[Functional disorders of the gastrointestinal tract (author's transl)]. 68 14

During the past ten years 7 men and 15 women with diffuse esophageal spasm have been seen at the Duke University Medical Center. Dysphagia and severe substernal pain were the two characteristic symptoms. Eleven of the 22 patients were treated with a long esophageal myotomy. Two had a diverticulum of the lower esophagus excised in addition, while 6 had an associated sliding hiatal hernia repaired. Three patients in whom the diagnosis was made retrospectively all had an epiphrenic diverticulum excised without a myotomy; in 1 an esophageal leak occurred. These 3 patients still have mild symptoms of their diffuse esophageal spasm. The results of myotomy have been satisfactory. Although this operation does not correct the cause of the disorder, the improvement in symptoms makes it worthwhile in selected patients.
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PMID:Diffuse spasm of the esophagus. 80 72

Nine cases of acute epiglottitis in adults, seen over a period of ten years, are presented. The presence of severe pain and dysphagia as universal presenting features are stressed, and the frequent absence of pharyngeal injection is noted. We found that the disease in adults differs from that in children in that pain and dysphagia are more marked, that stridor is a less prominent feature, and that Haemophilus influenzae appears not to be the sole causative organism.
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PMID:Acute epiglottitis in adults. 85 52

One hundred and forty-two pediatric patients between age 1 month and 20 years had 163 endoscopic procedures. Of 66 with chronic abdominal pain, 21 had a source identified endoscopically that was seen in only 15 by esophagogram and upper gastrointestinal series. Of 31 with nausea, vomiting, dysphagia, and/or odynophagia and retrosternal pain, endoscopy demonstrated the source in 19 patients and radiographic studies in 14. Of 34 with hematemesis and/or melena, 26 had a bleeding site identified endoscopically but only 4 of 28 had an identified source by radiographic studies. Duodenal and gastric ulcers and hemorrhagic gastritis were the commonest cases of upper gastrointestinal bleeding and organically of chronic adbominal pain. Functional abdominal pain was the commonest cause of chronic abdominal pain in those endoscoped. Foreign bodies were removed from the esophagus and stomach of 6 patients and dislodged in 2 others. Caustic ingestion was recognized in the esophagus and stomach of 2 patients who did not have mouth burns. The GIF-P2-prototype with four-way tip control and ability to retroflex 180 degree up, 60 degree down, and 100 degree right and left was superior to GIF-P1 and CF-P-prototype for visualization of the entire esophagus, stomach, duodenal bulb, and postbulbar area in patients less than 10 years old. Visualization of the duodenal bulb was possible in 28 of 29 pediatric patients, and of the postbulbar area in 25 of 26 in whom it was attempted. Infants who weighed as little as 3 to 5 kg were successfully examined. Retroflexion was possible in 29 of 30 to see the fundus and cardioesophageal junction. Patients older than 10 years were better examined with the GIF-D because of its increased ability to transmit light. Sedation for the school-age child with 0.5 to 1.0 mg per kg of diazepam and 1 to 2 mg per kg of meperidine given intravenously provides excellent sedation in most instances. General anesthesia is preferable for the preschooler and infant. Minor complications occurred in 2 patients who received less than adequate sedation and in 1 patient with general anesthesia.
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PMID:Upper gastrointestinal fiberoptic endoscopy in pediatric patients. 87 Mar 72


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