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)

Three cases of granular cell tumor of the esophagus are added to the 17 previously reported in the literature. These tumors, thought to be of neural origin, are difficult to diagnose preoperatively. The diagnosis should be considered in adult females presenting with an intramural mass of the proximal or distal third of the esophagus. Symptoms of dysphagia and substernal discomfort are likely to occur with lesions greater than one centimeter in diameter. Preoperative biopsy is not advised as a mistaken diagnosis of squamous cell carcinoma can result.
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PMID:Granular cell tumors of the esophagus. 20 10

Reflux of gastric contents into the esophagus, pharynx, and larynx does occur. This phenomenon can produce hoarseness, globus, dysphagia, otalgia and laryngospasm. It may be responsible for the appearance of contact granulomata, esophageal webs, and pachyderma. The key to reflux is the lower esophageal sphincter and the nature of the stomach contents. Multiple factors may be influential including those conditions causing aerophagia. The diagnosis of reflux depends on a high index of suspicion. Physical findings may reveal only subtle changes of arytenoid erythema. Thyrohyoid tenderness is not an infrequent sign. Treatment is usually simple, involving first elimination of those factors which increase intragastric pressure or lower the lower esophageal sphincter pressure. Elevation of the head of the bed and antacids will often prevent further gastric insult to the pharynx and larynx and thus eliminate the patient's discomfort.
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PMID:Gastro-esophago-pharyngeal reflux. 89 5

Endoscopic intubation has traditionally been considered unsuitable as a means of palliating cervical esophageal carcinomas involving or within 2 cm of the cricopharyngeus sphincter muscle because of the potential problems of foreign body sensation and proximal prosthesis migration. We attempted to palliate eight such patients, three of whom had tracheo-esophageal fistulas by the endoscopic placement of modified Celestin endoprostheses; the floppy funnel of the prosthesis was positioned above the cricopharyngeus in the hypopharynx. Prosthesis placement and fistula occlusion was possible in all patients. Six patients had a significant long-term improvement in their dysphagia, managing a semi-solid (5 patients) or liquid diet (1 patient); two patients did not improve, despite accurate prosthesis placement, because of marked tracheal aspiration. Six patients reported no foreign body sensation; one patient had minor discomfort, and another moderate throat discomfort. Distal prosthesis migration occurred in two patients (replaced in 1 patient). Endoscopic intubation of high cervical esophageal carcinomas with specially modified endoprostheses is feasible and can provide worthwhile palliation of dysphagia and symptoms due to a tracheo-esophageal fistula. Foreign body sensation and proximal prosthesis migration did not prove troublesome.
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PMID:Treatment of malignant strictures of the cervical esophagus by endoscopic intubation using modified endoprostheses. 137 99

Between 1 January 1980, and 30 September 1989, 93 cases of exposure to herbicides containing glyphosphate and surfactant ('Roundup') were treated at Changhua Christian Hospital. The average amount of the 41% solution of glyphosate herbicide ingested by non-survivors was 184 +/- 70 ml (range 85-200 ml), but much larger amounts (500 ml) were reported to have been ingested by some patients and only resulted in mild to moderate symptomatology. Accidental exposure was asymptomatic after dermal contact with spray (six cases), while mild oral discomfort occurred after accidental ingestion (13 cases). Intentional ingestion (80 cases) resulted in erosion of the gastrointestinal tract (66%), seen as sore throat (43%), dysphagia (31%), and gastrointestinal haemorrhage (8%). Other organs were affected less often (non-specific leucocytosis 65%, lung 23%, liver 19%, cardiovascular 18%, kidney 14%, and CNS 12%). There were seven deaths, all of which occurred within hours of ingestion, two before the patient arrived at the hospital. Deaths following ingestion of 'Roundup' alone were due to a syndrome that involved hypotension, unresponsive to intravenous fluids or vasopressor drugs, and sometimes pulmonary oedema, in the presence of normal central venous pressure.
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PMID:Acute poisoning with a glyphosate-surfactant herbicide ('Roundup'): a review of 93 cases. 167 18

The principal role of the Neodymium yttrium aluminum garnet (Nd-YAG) laser has been to alleviate obstruction and to arrest hemorrhage secondary to metastatic or locally unresectable malignant lesions throughout the gastrointestinal (GI) tract. Between June 1985 and December 1988, 26 patients have been treated for advanced upper GI malignancy: 20 obstructing esophageal carcinomas (three proximal, eight middle, and nine distal third); two prepyloric obstructing and one bleeding gastric lesion; one bleeding pancreatic carcinoma eroding into the duodenum; and two primary duodenal lesions (one partially obstructing and one bleeding). The dysphagia grade improved in all patients with esophageal carcinoma, but less so for those with proximal tumors. The obstructing gastric lesions were recanalized and bleeding was arrested. The pancreatic and duodenal lesions were successfully managed with one treatment. There were no perforations or other laser-related complications. The approaches to palliation must be conceived in a fashion to improve the quality of life with minimal risk and discomfort. Although ultimate survival is determined by the stage of the disease, the Nd:YAG laser can restore gastrointestinal continuity and, in so doing, significantly palliate the patient.
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PMID:Palliative therapy of upper gastrointestinal malignancies using the Nd-YAG laser. 169 May 25

A technique of laparoscopic cardiomyotomy is described. The procedure has been performed in a patient with manometrically confirmed classical achalasia with complete relief of episodic total dysphagia and no untoward symptoms including reflux. The procedure was followed by minimal postoperative discomfort and the patient was discharged on the third postoperative day. Laparoscopic cardiomyotomy has the advantage of diminished surgical trauma with accelerated recovery, constitutes definitive therapy comparable to standard myotomy, and by being less disruptive of the lower oesophageal fixation it is prone to precipitate gastro-oesophageal reflux.
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PMID:Laparoscopic cardiomyotomy for achalasia. 183 41

After a three day acclimatization period, six healthy, young (aged 4 to 20 days) orphan foals of mixed breeding were fed 100 per cent of their caloric needs (estimated at 523 kjoules/kg bodyweight [bwt] or 125 kcal/kg bwt/day) as a low residue isotonic feeding solution (LRF) for seven days. The solution provided 4.18 kjoules (1 kcal/ml) and was fortified with minerals and protein to meet estimated foal requirements. The solution was fed through an indwelling 12 French feeding tube. Five of the six foals completed the study; the loss of the sixth foal apparently was unrelated to the feeding protocol. The foals tolerated LRF well. Signs of intolerance were noted in two foals and were limited to flatulence, mild bloat and very mild abdominal pain associated with a decreased interval between two feedings during the first 48 h on 100 per cent LRF. Complete recovery without therapy occurred within 6 h and feedings were resumed. Growth in height and weight were comparable to published data for healthy foals raised with their dams. Feeding tubes were easily maintained with no apparent dysphagia, regurgitation or discomfort to foals. This low residue, calorically dense, isotonic feeding solution may be useful for enteral feeding of selected foals aged at least seven days.
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PMID:A preliminary study of the tolerance of healthy foals to a low residue enteral feeding solution. 195 30

Transesophageal atrial pacing (TAP) with the use of standard, thermistor-equipped, esophageal stethoscopes, modified for pacing by incorporation of a 4-French, bipolar TAP probe (pacing esophageal stethoscope [PES]), was evaluated in 100 adult patients under general anesthesia. A commercially available TAP pulse generator supplied 10-ms pulses with current variable between 0 and 40 mA. Pacing distances (in centimeters) were measured from the infraalveolar ridge to midway between PES electrodes (1.5-cm interelectrode distance). Pacing thresholds (milliamperes) were measured at the point of a maximum-amplitude P-wave (PMAX) in the bipolar esophageal electrogram and points 1 cm proximal or 1, 2, or 3 cm distal to PMAX. TAP (70-100 beats per min) was used for sinus bradycardia less than or equal to 60 beats per min (36 patients) or atrioventricular (AV) junctional rhythm (2 patients) and blood pressure changes with TAP documented. In male patients (n = 49), PMAX was 32.7 +/- 0.3 cm (mean +/- SE) and minimum pacing threshold 5.1 +/- 0.4 mA (range, 1-13 mA) at 33.6 +/- 0.3 cm (range, 30-37 cm). In female patients (n = 51), PMAX was 30.4 +/- 0.4 cm and minimum pacing threshold 4.4 +/- 0.4 mA (range, 2-14 mA) at 31.1 +/- 0.4 cm (range, 26-40 cm). TAP produced an average 13-16 mmHg increase in systolic, diastolic, or mean arterial pressure in patients with sinus bradycardia or AV junctional rhythm. There were no subjective patient complaints (epigastric discomfort, dysphagia) that could be attributed to TAP; objective evaluation (esophagoscopy) was not performed.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Atrial pacing thresholds measured in anesthetized patients with the use of an esophageal stethoscope modified for pacing. 202 Dec 1

A 77-yr-old man with chest discomfort and progressive dysphagia was found to have an intraluminal esophageal lesion of remarkable size. A giant fibrovascular polyp (11 x 7 x 3.5 cm) was successfully removed surgically by a transcervical approach. This unusual benign esophageal lesion is discussed in terms of classification and clinical presentation from a historical perspective. Particular attention is focused on the current approach to diagnosis and management. Endoscopic ultrasonography was employed as part of the evaluation.
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PMID:Giant fibrovascular polyps of the esophagus. 217 1

The long-term results after Heller's myotomy for oesophageal achalasia were illustrated by questionnaire sent to 38 out of the original 47 patients submitted to operation during the ten-year period 1.7.1973-30.6.1983. Nine patients had died from other causes during the follow-op period. The minimum period of observation for the remaining patients was five years and the mean period of observation was 10.3 years. Thirty-six questionnaires were returned (95%). 75% of the patients were satisfied with the results of operation but only 25% were symptom-free. The commonest symptom was dysphagia (56%) followed by reflux problems (50%). Every third patient had discomfort from the scar. All of the 25% of the patients who were not satisfied with the result of operation had dysphagia. On the basis of these observations, the authors consider that Heller's myotomy should be reserved for patients on whom dilatation treatment has proved unsatisfactory.
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PMID:[Treatment of esophageal achalasia using Heller's method]. 230 50


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