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)

Dysphagia is the leading symptom in the most frequent and surgically most important disturbances of the passage of the oesophagus. Possibilities and results of the treatment are analysed on the basis of clinical material from the surgical clinic of Halle university. Nevertheless insufficient results in malignant tumours are opposite to favourable results of the operation in benign diseases (diverticles, achalasia, strictures). Measures for the improvement of the situation of treatment are discussed.
Z Gesamte Inn Med 1979 Sep 15
PMID:[The value of the symptom of dysphagia from the surgeon's viewpoint]. 11 48

Dysphagia is a symptom of organically or functionally conditioned diseases of the oesophagus. In all circumstances it demands an immediate clarification of the etiology considering appropriate therapeutical measures and above all may be first reference to the carcinoma of the oesophagus.
Z Gesamte Inn Med 1979 Sep 01
PMID:[Dysphagia, diagnostic and therapeutic measures]. 12 85

The mute or nearly mute patient who is alert and has good understanding of speech and a right hemiparesis could have Broca's aphasia, akinesia of speech (transcortical motor aphasia), or aphemia. The patient who has Broca's aphasia does not write well, and his speech does not improve greatly with repetition. The speech of a patient with akinesia of speech improves with repetition. The aphemic patient writes normally, but his speech does not improve with repetition. The mute patient whose eyes are open but who is poorly responsive and moves little or not at all could be an akinetic mute (with either a cingulate or a thalamomesencephalic lesion) or have a locked-in syndrome. The latter is diagnosed by asking the patient to look up and down or to open and close his eyes. If he obeys these commands, the physician questions him using a code of eye movement responses. If the patient fails to respond at all, he is an akinetic mute; intense stimulation may result in speech or movement. If the patient is drowsy and has third nerve involvement, the lesion is in the thalamomesencephalic reticular formation. If the patient appears alert and has episodes of agitation, he probably has bilateral lesions in the gyri cinguli. Patients with weakness of the bulbar musculature (facial, palatal, and tongue weakness and dysphonia) may have either upper motor neuron or lower motor neuron lesions. Only bilateral upper motor neuron lesions produce permanent dysarthria. As a typical example, a patient has a transient left hemiparesis with dysarthria and almost completely recovers. Later, however, a right hemiparesis develops and the patient experiences severe bilateral facial weakness, drooling, dysphagia, and severe dysarthria. The absence of atrophy of the bulbar musculature, a hyperactive jaw jerk and gag reflex and, sometimes, inappropriate laughing or crying episodes indicate that the lesion is located above the medulla in the corticobulbar tracts. Flaccid paralysis, absence of the jaw jerk or gag reflex, and absence of other upper motor neuron signs, such as upgoing toes, indicate a lower motor neuron or neuromuscular junction problem. Appropriate tests to rule out myasthenia gravis should be done. The other conditions discussed here are often obvious from their clinical presentation. Although the specific disorder of speech sometimes is helpful in localizing the cause, in most patients, the associated deficits on neurologic examination are of greatest value.
Geriatrics 1975 Sep
PMID:Nonlanguage disorders of speech reflect complex neurologic apparatus. 16 83

Myotonic dystrophy or Steinert's disease may be discovered during acute respiratory failure, sometimes caused by a general anaesthetic. It complicates chronic respiratory failure which is present in almost all cases, both restrictive and obstructive, the clinical signs of which progress with the myopathy. Apart from myotonic degeneration of the respiratory muscles, a hypoventilation syndrome of central origin has been described, but the etiology of this respiratory failure is dominated by repeated aspiration pneumonia favoured by constant dysphagia and passage of food into the trachea and poor cough reflex. One should attempt to correct this.
Sem Hop 1977 Sep
PMID:[Myotonic dystrophy and acute respiratory insufficiency]. 19 96

The effects of subcutaneous pentagastrin (6 microgram/kg) on esophageal motility were recorded in patients with achalasia, in patients with idiopathic diffuse esophageal spasm (IDES), and in healthy subjects. In achalasia and IDES, pentagastrin produced an increase in mean lower esophageal sphincter pressure, amplitude of contractions, esophageal pressure, and repetitive wave activity. Also, chest pain or dysphagia occurred after pentagastrin administration in 4 of 9 patients with IDES and in 7 of 12 patients with achalasia. After comparing these observations with those of healthy subjects, we tested the potential for pentagastrin-induced motility changes to improve our ability to diagnose IDES. This was done by administering pentagastrin to 22 patients with clinically "suspected" esophageal motor disease but in whom routine radiologic and manometric studies were nondiagnostic. In none of the 22 did symptoms or manometric changes develop to help establish the diagnosis of IDES. This was true despite additional studies in 10 patients that failed to provide an alternative to IDES as the diagnosis. These results do not support the use of pentagastrin as a provocative test for IDES.
Gastroenterology 1979 Sep
PMID:The effects of pentagastrin in achalasia and diffuse esophageal spasm. 45 41

Esophageal manometric tracings obtained using low-compliance pneumohydraulic infusion systems were reviewed from patients with symptoms of chest pain and/or dysphagia. Using this sytem, we report on 7 symptomatic patients with markedly increased esophageal peristaltic amplitude. Maximal peristaltic amplitude for these 7 patients (225-430 mmHg) was greater than for normals (75-175 mmHg). Mean peristaltic amplitude for the 7 was 170 mmHg, which was greater than for normals (81 +/- 30 mmHg, mean +/- 2 SD). This finding is believed to reflect the sensitivity of currently available manometric systems. It may be possible with these techniques to define more clearly the bulk of presumed esophageal dysfunction, which is at present poorly characterized. The relationship of clinical symptoms to abnormal esophageal motility is often less than optimal and may result from an inability to define "normal" or from inadequacies of currently available techniques. Our observations of a subset of symptomatic patients having peristaltic contractions with amplitudes exceeding the normal range seem to characterize one form of esophageal motility defect. This abnormality was seen more frequently than diffuse esophageal spasm in our laboratory.
Gastroenterology 1979 Sep
PMID:High amplitude, peristaltic esophageal contractions associated with chest pain and/or dysphagia. 45 42

Amyotrophic lateral sclerosis (ALS) is a degenerative neurologic disease having both upper and lower motor neuron signs and symptoms. When the speech musculature is involved, a mixed dysarthria and dysphagia usually result. In a 49-year-old man with ALS, dysarthria and dysphagia progressed from mild to severe forms over 17 months. Eleven months after the patient first experienced symptoms, neurologic examination showed fasciculations of the extremities and tongue, limb weakness, and hyperreflexia of the limbs and velopharyngeal mechanism. Tongue strength was one-fourth that of normal. Lingual alternate motions rates for consonant-vowel syllables were also reduced. To enhance lingual strength and swallowing, a tongue-strengthening program was developed for use with articulation training; to augment velopharyngeal function, a palatal lift was fitted; and to increase extremity strength, physical therapy was initiated. Six months after the initial neurologic examination, medical and speech reevaluation showed progressive weakness of the body parts affected initially; continued decline in tongue strength and lingual alternate motion rate; hypoactive reflex activity, indicative of progressive involvement of the lower motor neuron system; and continued deterioration of articulation and phonation owing to the progressive nature of the disease.
Arch Phys Med Rehabil 1979 Sep
PMID:Progressive speech deterioration and dysphagia in amyotrophic lateral sclerosis: case report. 49 10

Progression of dysphagia after vagotomy to the stage of complete obstruction due to a peri-oesophageal fibrotic collar needing operation is a rare event. Review of the 4 such cases previously described, all needing further operation and all after truncal vagotomy, indicates that the oesophageal mucosa was normal on oesophagoscopy and that bouginage appeared to make the condition worse. This paper describes the first patient in whom (a) the vagotomy was selective and (b) no bouginage was carried out before the condition was relieved by a further surgical operation.
Br J Surg 1979 Sep
PMID:Dysphagia following selective vagotomy. 49 42

Gastric adenocarcinomas often spread to the distal oesophagus. Failure to control the disease in this area during total and proximal subtotal gastrectomy results in recurrence at the oesophageal anastomosis. The incidence of recurrence in a series of 351 such patients was 10 per cent and was influenced by the location of the main lesion, the stage of the disease, the presence of tumour at the margin of resection and the length of clearance of the oesophageal margin. Recurrence were prevented only with in vivo margins greater than 12 cm. Dysphagia combined with radiological signs of oesophageal obstruction was diagnostic of anastomotic recurrence regardless of the results obtained by oesophagoscopy and biopsy. Treatment was seldom effective in patients developing recurrence. Complete excision of the entire recurrent process offered the only hope for a long survival in these patients. Prevention by obtaining adequate oesophageal clearance at the time of gastrectomy is the only reasonable approach to this problem. The adequacy of resection cannot be judged accurately by intraoperative palpation of the oesophagus or by frozen section examination of the surgical margins.
Br J Surg 1979 Sep
PMID:Anastomotic recurrence in the oesophagus complicating gastrectomy for adenocarcinoma of the stomach. 49 43

A Case of chordoma of the base of the skull is reported. It had been present with minimal symptoms for six years during which the clinical picture was limited to nasal obstruction and headache. Comparison of initial X-rays and the preoperative assessment revealed progressive destruction of the base of the skull which indicated the likelihood of considerable difficulties in excision. Surgical treatment posed the problem of the approach and emphasised the absence of encapsulation and the incomplete nature of the operation. The development of new symptoms (diplopia, dysphagia) resulted in complementary radiotherapy. The authors take the opportunity to point out the polymorphous clinical nature of these tumours in relation to their site and the criteria of the histological diagnosis. The possibilities of treatment are discussed. Abstention from treatment is formally rejected and, on the contrary, the emphasis is placed upon the need for early treatment. The consequences of excision should be limited by using a minimal surgical technique when possible. Complementary radiotherapy is necessary and may be repeated, up to certain limits, in the case of recurrence if the first irradiation is felt to be effective. There is no parallel between histological appearances and the response to treatment. The possibilities of chemotherapy would appear to be limited.
Ann Otolaryngol Chir Cervicofac 1979 Sep
PMID:[Chordoma of the base of the skull. Clinical and histological study. Therapeutic possibilities (author's transl)]. 52 48


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