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)

Leiomyoma of the esophagus was surgically treated in 15 patients in 1962-1987. Six patients were asymptomatic and nine presented with dysphagia alone or combined with retrosternal pain, vague thoracic discomfort, dyspnea and cough, or palpitations. Barium swallow and esophagoscopy provided the correct diagnosis preoperatively in most cases. Transthoracic enucleation of the tumor was performed via right thoracotomy in nine patients and left thoracotomy in six. The location of tumor was the upper third of the thoracic esophagus in three cases, middle third in six and lower third in six cases. There was no surgical mortality or morbidity. Surgical removal of esophageal leiomyoma thus gave relief of symptoms, with minimal risk and excellent functional outcome.
 ...
PMID:Leiomyoma of the esophagus. 235 88

As part of a consecutive series of 370 patients who underwent subtotal esophagectomy because of carcinoma of the thoracic area of the esophagus, between January 1965 and July 1988, in the Second Department of Surgery, Kyushu University Hospital, 42 patients (11.4%) with early stage esophageal carcinomas confined to the intraepithelium, mucosa, or submucosa were studied clinicopathologically. Of these 42, 26 (61.9%) had symptoms; slight dysphagia or chest discomfort was the most common symptom. The remaining 16 (38.1%) had no subjective symptoms. Endoscopic examination proved to be more useful than barium studies. Lugol-combined endoscopy was most effective in detecting the presence and spread of small malignant lesions of the esophagus. At the time of surgery, six patients with submucosal carcinoma of the esophagus had lymph node metastasis, and five died of recurrence. Described herein are the diagnostic features, clinicopathologic characteristics, and long-term results of these 42 patients with early stage, and 328 patients with advanced, carcinomas of the esophagus, detected and surgically treated in our clinics.
 ...
PMID:Clinicopathologic study of early stage esophageal carcinoma. 272 99

As part of a consecutive series of 370 patients who underwent subtotal esophagectomy because of carcinoma of the thoracic area of the esophagus, between January 1965 and July 1988, in the Second Department of Surgery, Kyushu University Hospital, 42 patients (11.4%) with early stage esophageal carcinomas confined to the intraepithelium, mucosa, or submucosa were studied clinicopathologically. Of these 42, 26 (61.9%) had symptoms; slight dysphagia or chest discomfort was the most common symptom. The remaining 16 (38.1%) had no subjective symptoms. Endoscopic examination proved to be more useful than barium studies. Lugol-combined endoscopy was most effective in detecting the presence and spread of small malignant lesions of the esophagus. At the time of surgery, six patients with submucosal carcinoma of the esophagus had lymph node metastasis, and five died of recurrence. Described herein are the diagnostic features, clinicopathologic characteristics, and long-term results of these 42 patients with early stage, and 328 patients with advanced, carcinomas of the esophagus, detected and surgically treated in our clinics.
 ...
PMID:Clinicopathologic study of early stage esophageal carcinoma. 276 21

EGD, using 1986 models of either the fiberoptic gastroscope or the videoscope, is a safe and accurate procedure that can be performed by any physician trained in the technique of endoscope passage. It may be performed at large medical centers or small rural hospitals, outpatient clinics, or even private offices. Patients themselves have indicated preference for endoscopic evaluation over the double-contrast barium meal after they have experienced both procedures. The short time of procedure, its accuracy, safety, and its relative lack of discomfort to the patient lend it readily to being an initial component in the primary evaluation of symptoms of abdominal distress, gastrointestinal bleeding, dysphagia, esophageal reflux, persistent vomiting, and odynophagia. It is essential in the evaluation of complications of esophageal reflux and the evaluation of abnormal radiological findings in the upper gastrointestinal tract. It should never be overlooked in evaluating the patient with iron deficiency anemia of unknown etiology. Economic pressures have already moved EGD from the surgery wards to endoscopy labs and to the outpatient setting. These same forces will project more physicians into the role of the diagnostic endoscopist and the patient will benefit by decreased medical costs, quicker diagnosis and treatment, and enhanced continuity of care.
 ...
PMID:Gastroscopy: a primary diagnostic procedure. 304 90

During a 15-year period, 62 patients were treated for achalasia of the esophagus. Pneumatic dilation (PD) had been performed initially in 46 and was successful in 23; failures were due to acute perforation of the esophagus, persistent dysphagia, or pathologic gastroesophageal reflux. Esophagomyotomy alone (EM) was performed in 19 individuals resulting in definite improvement in 12; four patients had moderate reflux or dysphagia, and three of these required another surgical procedure. An extended myotomy with an antireflux procedure (M-NF) was performed in 13 patients with symptomatic relief in 12; one patient required reconstruction of a too-tight fundoplication that caused persistent dysphagia. The advantages of pneumatic dilation were the ease of performance, patient acceptability, and an overall efficacy of 50%. Definitive surgical therapy, while more predictably effective in relieving dysphagia, was considerably more expensive in terms of patient discomfort and time. When pathologic reflux was present following a previous procedure, the M-NF was performed; obstruction of the esophagus did not occur if the fundoplication was "floppy." The M-NF deserves consideration as the surgical procedure of choice for achalasia.
 ...
PMID:Achalasia of the esophagus. Treatment controversies and the method of choice. 370 29

One hundred consecutive patients had a primary Nissen fundoplication for gastroesophageal reflux disease. None of the patients had previous gastric or esophageal surgery or evidence of esophageal stricture or motility disorder. The primary symptom was persistent heartburn in 89 patients and aspiration in 11. An abnormal pattern of esophageal acid exposure was documented in all patients with 24-hour esophageal pH monitoring. By actuarial analysis, the operation was 91% effective in the control of reflux symptoms over a 10-year period. The incidence of postoperative symptomatic gas bloat and increased flatus was lower in patients with preoperative abnormal manometric measurements of the distal esophageal sphincter (p less than 0.05). Three modifications in operative technique were made during the course of the study to minimize the side effects of the operation. First, enlarging the caliber of the bougie to size the fundoplication reduced the incidence of temporary swallowing discomfort from 83 to 39% (p less than 0.01). Second, shortening the length of the fundoplication decreased the incidence of persistent dysphagia from 21 to 3% (p less than 0.01). Third, mobilizing the gastric fundus for construction of the fundoplication increased the incidence of complete distal esophageal sphincter relaxation on swallowing from 31 to 71% (p less than 0.05). This was done to prevent the delayed esophageal acid clearance secondary to incomplete sphincter relaxation observed after operation in five of 36 studied patients. It is concluded that by proper patient selection and the incorporation of the above surgical techniques, the Nissen fundoplication can re-establish a competent cardia and provide relief of reflux symptoms with minimal side effects.
 ...
PMID:Nissen fundoplication for gastroesophageal reflux disease. Evaluation of primary repair in 100 consecutive patients. 372 89

The medical records of 179 patients were reviewed to identify complications related to the use of the halo external skeletal-fixation device. The complications that were identified included pin-loosening in 36 per cent of the patients, pin-site infection in 20 per cent, pressure sores under either a plastic vest or a plaster cast in 11 per cent, nerve injury in 2 per cent, dural penetration in 1 per cent, dysphagia in 2 per cent, cosmetically disfiguring scars in 9 per cent, and severe pin discomfort in 18 per cent. One hundred and eighty (25 per cent) of the 716 pins used had become loose at least once, and an infection had developed at sixty-seven pin sites (9 per cent). Two-thirds of the pins that were loose or associated with infection required change or removal. These complication rates, particularly of pin-loosening and infection, are exceedingly high. Attention to details in pin application, pin maintenance, and proper pin-site care may minimize the number of complications.
 ...
PMID:Complications in the use of the halo fixation device. 394 26

The cause of chest pain associated with mitral valve prolapse remains unclear. A young woman with chest pain ascribed to mitral valve prolapse is described. Response of chest discomfort to atenolol therapy had been poor. The patient's chest discomfort and concomitant esophageal spasm were provoked by intravenous infusion of edrophonium chloride during esophageal manometry. A Bernstein acid infusion test also induced her chest pain. Review of systems revealed intermittent dysphagia and postprandial heartburn. In certain patients with mitral valve prolapse, esophageal motility disorders may be the cause of chest discomfort.
 ...
PMID:Chest pain associated with mitral valve prolapse. Evidence for esophageal origin. 396 63

Balloon esophageal dilatation offers many theoretical advantages (safety, speed, and patient comfort) over dilatation with mercury-filled bougies or with the Eder-Puestow system. The authors used balloon dilators in 22 patients with dysphagia secondary to benign or malignant strictures. Dilatation was performed with fluoroscopic guidance, blindly, or by a combination of these techniques. For "blind" stricture dilatation, an Eder-Puestow spring-tipped guide wire is placed into the stomach using a fiberoptic endoscope. The distance from the incisor teeth to the stricture is measured, and the balloon shaft is marked to indicate when the middle of the balloon is within the stricture. Dilatation is then performed using the antegrade or, the preferred, retrograde technique. Finally, the dilated stricture is calibrated by pulling an inflated balloon through the previously strictured area without difficulty. An attempt was made to achieve an esophageal diameter of 15 mm at the initial dilatation episode, and patient discomfort was used as a guide as to the final diameter. The balloon dilatation technique was highly successful, and a stricture diameter of 15 mm (45-47 French) was achieved at the initial dilatation in most instances. Malignant strictures were easily dilated. Balloon dilatation is convenient, effective, quick, and potentially safer than the previous Eder-Puestow or mercury-filled bougie techniques.
 ...
PMID:Balloon dilatation of benign and malignant esophageal strictures. Blind retrograde balloon dilatation. 400 34

Spontaneous pneumomediastinum is an uncommon disease that often presents with subtle clinical and radiographic findings. During a two-week period, three patients presented with complaints of throat and neck pain. The first complained of difficulty swallowing and throat and chest discomfort; accurate diagnosis was delayed because of the unusual presenting symptoms. The second had severe throat pain. The third presented with unstable vital signs, throat and neck pain, and air in the pericardium and mediastinum. Review of the first case facilitated the correct diagnosis of spontaneous pneumomediastinum in the subsequent cases. All three patients were discharged free of symptoms.
 ...
PMID:An unusual presentation of spontaneous pneumomediastinum. 403 67


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