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)

Contraction of the crural diaphragm increases the lower esophageal sphincter (LES) pressure, which is important for preventing gastroesophageal reflux. Our objective in this study was to compare the influence of diaphragmatic contraction on LES pressure of Chagas' disease patients with dysphagia, and control volunteers. We studied 17 patients with positive serologic reactions for Chagas' disease, dysphagia and slow transit of barium sulphate through the esophagus. Two also had esophageal dilatation. Twelve healthy volunteers were the control group. LES pressure was measured by the station pull-through (SPT) method with a round manometric catheter with four side holes opened at the same level, 10 cm from the end of the catheter, infused with water at a flow of 0.5 ml/minute. The catheter was introduced through the nose until the four side holes reached the stomach. After five minutes of stabilization it was withdrawn 1 cm every 15 seconds while the patient or volunteer breathed normally. We measured the difference in LES pressure recorded at inspiration and expiration, which is the contribution of the diaphragmatic contraction to LES pressure. There was no difference in this value between controls (18.5 +/- 9.6 mmHg, mean +/- SD) and patients (17.9 +/- 7.6 mmHg, P > 0.05). The value increased with LES pressure, suggesting that the diaphragm may participate in LES pressure asymmetry. We conclude that the diaphragmatic contribution to LES pressure in Chagas' disease patients is the same as that of normal subjects.
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PMID:[Diaphragmatic contraction in the lower esophageal sphincter pressure in Chagas disease patients]. 808 49

To assess the incidence of lung aspiration in acute stroke, and attempt to identify factors which render such patients at risk of aspiration, consecutive patients admitted to hospital within 24 h of their first symptomatic stroke were studied prospectively. Sixty patients who were conscious, and who did not have any preceding neurological or other cause of dysphagia, were assessed clinically and underwent a bedside water-swallowing test and videofluoroscopy within 72 h of stroke. Twenty-five patients (42%) were seen to aspirate at videofluoroscopy; of these 20% did not have overt dysphagia as detected by a simple water-swallowing test. Factors found to be significantly associated with aspiration were reduced pharyngeal sensation, dysphagia and stroke severity. Aspiration is common in the early period following acute stroke; disordered pharyngeal sensation is an important concomitant of this and should be carefully tested in each patient admitted with acute stroke.
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PMID:Aspiration in acute stroke: a clinical study with videofluoroscopy. 810 39

A 45-year-old man with AIDS was treated for a recurrence of cerebral toxoplasmosis with sulphadiazine, 4 g, and pyrimethamine, 75 mg, daily. Owing to a lack of appetite and dysphagia he drank rather little water during the first week of treatment. On the 13th day after starting the drugs he had bilateral renal colics and renal failure was diagnosed (serum creatinine 3.8 mg/dl). Ultrasound examination demonstrated multiple stones with bilateral urinary retention. After parenteral fluid replacement, alkalization of the urine with sodium-potassium-hydrogen citrate and N-butylcopolamine a stone, consisting of sulphadiazine and acetylsulphadiazine, was passed after two days. Three days later the creatinine concentration was within normal limits, and in further two days the ultrasound picture was normal. It is pointed out that diarrhoea, fever or dysphagia often prevent sufficient fluid intake in AIDS patients. Satisfactory oral fluid intake and alkalization of urine is thus of great importance for avoiding complications during sulphadiazine treatment.
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PMID:[Acute kidney failure caused by sulfadiazine stones. A complication of the therapy of toxoplasmosis in AIDS]. 824 40

We reported a rare case of subtotal esophagectomy for esophageal basaloid carcinoma after mitral valve replacement. Up to present, only this case had been printed in Japan. A 51-year-old male who had been performed MVR for mitral stenosis at the 44 complained of dysphagia. On esophageal X-ray and esophagoscopic findings showed round, irregular, and stenotic lesion (type-3) in the middle thoracic esophagus. We performed subtotal esophagectomy, esophagogastrostomy through the posterior mediastinal pathway and lymph node dissection (R2). Despite normal cardiac function before operation, the patient followed lung edema and perioperative measurement of Extra Vascular Lung Water Index (EVLWI) was stable within high level. On microscopic inspection, we revealed lots of basophilic basal cells mainly occupied submucosal layer coexisted with pseudoglandular formation and poorly differentiated squamous cell carcinoma. And the tumor cells strongly invaded into the lymph ducts and blood vessels. We need more detailed exploration for more cases about factors causing poor prognosis.
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PMID:[A case of subtotal esophagectomy for esophageal basaloid carcinoma after mitral valve replacement]. 828 36

We report an unusual presentation of gastroesophageal reflux disease in a 14-yr-old boy with cervical dysphagia and vomiting immediately after swallowing. Reflux disease was diagnosed by the combination of eosinophils on esophageal biopsies and abnormal 24-h pH results. The cervical site of dysphagia demonstrated acid-induced hypersensitivity to esophageal distension with water or air. The patient's symptoms resolved with marked acid suppression, which was made difficult because intact capsules of omeprazole initially could not be ingested.
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PMID:Unusual presentation of mucosal hypersensitivity secondary to gastroesophageal reflux disease. 842 36

Due to limitations in available technology it has been difficult to obtain data on upper esophageal sphincter (UES) and pharyngeal (P) function under varying physiologic conditions. We used a manometry system with solid-state intraluminal transducers, including a circumferential sphincter transducer, and computer analysis to measure pressure changes in UES and P during wet (5 ml H2O) swallows as the head was moved through a 75 degree arc in nine normal volunteers. UES residual pressure increased markedly and duration of UES relaxation decreased with increasing head extension. Similar decreases were also seen with time between P peak and both UES nadir and UES end. There were no changes in either pharyngeal peak pressures or the duration of the pharyngeal contraction. Head extension produces major changes in UES relaxation and UES/P coordination. These effects may be clinically important when feeding neurologically impaired patients.
Dysphagia 1993
PMID:Effect of head position on the dynamics of the upper esophageal sphincter and pharynx. 843 16

Establishing reliable nutrient requirements for individuals over the age of 65 years is a difficult task. Research on nutrient requirements in the aged is sparse and often contradictory. However, there are important clues in the literature suggesting that requirements for certain nutrients are altered with age and that preventable nutrient deficiencies exist. Energy expenditure and caloric intake typically decline with age. Unless nutrient density of the diet improves, a parallel decline in vitamin and mineral intake is inevitable. Deficiencies or suboptimal intakes of water-soluble vitamins, vitamin D, calcium, zinc, copper, chromium, and water are reported in groups of older adults. Marginal nutrient deficiencies in this population may easily go undetected and contribute to morbidity.
Dysphagia 1993
PMID:Nutrition and nutritional requirements for the older adult. 843 22

Studies of esophageal manometry during eating have demonstrated abnormal motility in patients with dysphagia in whom standard water-swallow manometry was normal. However, there have been few concurrent motility studies making a direct comparison of food swallows with water swallows. This paper presents the results of such a study in 20 healthy volunteers. A comparison of bread swallows with water swallows revealed that both peristaltic amplitude in the proximal esophagus and peristaltic duration throughout the esophagus were significantly increased (p < 0.05). Peristaltic propagation velocity was significantly decreased in the proximal and mid-esophagus (p < 0.05). Percentages of nonconducted and nonperistaltic contractions were significantly increased (p < 0.05-0.001) during bread-swallow manometry. Therefore, the response of the normal esophagus to food has been shown to be different from its response to water swallows. In particular, the high percentage of nonpropagated swallows in normal subjects when eating indicates that the results of food manometry in patients with dysphagia must include wider limits of normality.
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PMID:A comparison of esophageal motility in response to bread swallows and water swallows. 843 39

Scintigraphic data are provided for 20 normal control subjects, 39-65 years of age. Each subject swallowed 10 cc of water and 10 cc of a more viscous material (1,100 centipoise) consisting of apple juice thickened with Thick-It, a commercial food thickener. The test substances were combined with 2.5 mCi Tc-99m sulfur colloid. Scintigraphic data were acquired in dynamic mode for 10 sec at 25 frames/sec as the subject swallowed. Time-activity (TA) data were used to compute transit times, percentage residues in the mouth and pharynx, percent ingested, and a derived swallow efficiency score. The liquid was ingested in a single swallow by all subjects, and 9 cc was actually transferred to the esophagus. In contrast, for the viscous material, 11/20 subjects performed a second clearing swallow within the 10-sec interval. On the first swallow with the viscous substance, an average of 7 cc was transferred to the esophagus. Scintigraphy offers an excellent technique for determining natural and preferred volumes for swallowing a variety of bolus consistencies, since it can quantify the volume of each swallow or partial swallow. In this group of subjects the oral discharge time was shorter with the viscous material than with the water, but the pharyngeal transit times were not significantly different for the two bolus consistencies. Numerical efficiency scores were lower for the viscous material, indicating that such a measure is bolus dependent.
Dysphagia 1996
PMID:Normal adult swallowing of liquid and viscous material: scintigraphic data on bolus transit and oropharyngeal residues. 855 78

Eight patients were studied 6 weeks to 16 months following pharyngo-oesophageal reconstruction using a free jejunal interposition graft. Ambulatory manometry was carried out using an intraluminal strain gauge assembly linked to a portable microprocessor. In one patient, the assembly could not be passed because of a redundant jejunal loop. In four subjects, the jejunal interposition appeared to function as a passive conduit with very little manometric activity. In the remaining three patients, however, there was evidence of both propagated peristaltic waves within the graft and regular contractile activity, characteristic of Phase III of the intestinal Migrating Motor Complex (MMC). The presence of MMC activity at only 7 weeks following surgery confirms its independence of extrinsic intestinal innervation. Spontaneous contractile activity, however, was not interrupted by propagated water swallows and may contribute to post-operative dysphagia in some individuals.
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PMID:The function of free jejunal autografts in the pharyngo-oesophageal segment. 858 35


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