Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0014848 (achalasia)
 2,804 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two neonates with cricopharyngeal achalasia are presented. In one of them myotomy of the cricopharyngeus relieved the obstruction. In the other baby, the symptoms disappeared without surgical treatment.
Z Kinderchir 1984 Dec
PMID:Idiopathic cricopharyngeal achalasia. 652 93

Verapamil hydrochloride is an organic calcium antagonist that is known to decrease the contraction of smooth muscle. The purpose of our study was to determine if verapamil has a similar effect on the resting lower esophageal sphincter pressure in normal subjects and in patients with achalasia. Esophageal manometry was performed using a continuously perfused catheter assembly. Infusion of verapamil (0.15 mg/kg) over a 2-min period resulted in a statistically significant decrease in resting lower esophageal sphincter pressure in both normal subjects (n = 8) and patients with achalasia (n = 7) within 10 min postinfusion. This study suggests that verapamil may have potential as a drug therapy in treating the clinical symptoms of achalasia and diffuse esophageal spasm.
Am J Gastroenterol 1983 Dec
PMID:The effect of verapamil on the lower esophageal sphincter pressure in normal subjects and in achalasia. 665 Apr 65

Over the past 28 years, one of us (W. E. N.) has reconstructed the esophagus with the right colon for congenital and benign disease in 84 patients. The first patient in the series, who was operated on in 1955, remains asymptomatic. Nine patients had congenital tracheoesophageal fistula with atresia; 4, esophageal varices; 30, advanced obliterative esophagitis; and 23, corrosive destruction. In 7, severe esophagitis followed esophagogastrectomy; 4 had unsuccessful operations for achalasia; and 7 had colon bypass following esophageal perforation. Eleven early nonfatal complications occurred. Late nonfatal complications were seen in 6 patients. There were 4 early deaths (4%): following dehiscence of an intrathoracic esophagocolic anastomosis and 1 due to peritonitis. Four individuals died over the years, and 5 patients were lost to follow-up. The late results in 71 patients show that 60 (84.5%) believe they have a satisfactory result. Nine (13%) individuals are symptomatic, and 2 (2.8%) must be classified as failures. Early complications have been minimized by using preoperative intestinal angiography, anastomotic stapling techniques, and the Doppler study intraoperatively to prognosticate colon blood flow. Several important observations have been made: anastomosis in the neck is preferable; the transplanted colon dilates from loss of motor activity but is functionally adequate; an isoperistaltic segment is preferable, but an antiperistaltic implant suffices; colonic mucosa is relatively resistant to acid-peptic digestion; and hyperalimentation is mandatory in very ill and debilitated patients.
Ann Thorac Surg 1983 Dec
PMID:Colon replacement of the esophagus for congenital and benign disease. 665 76

This study was intended to specify the most appropriate procedure of myotomy and fundoplication in the modified Belsey Mark IV operation toward the esophageal achalasia to prevent post-operative refluxes. Adult mongrel dogs were prepared under surgical operation of, short myotomy, short fundoplication, long myotomy, long fundoplication, long myotomy, long fundoplication of artificial hiatus hernia type control. After the well recovery, they were examined on their simultaneous evaluation of pH and inner pressure at three points, i.e. the esophagus, the high pressure zone (HPZ), and the stomach. At the same time, withdrawal pH curves, etc. were also determined. The discussion resulted that the group of short myotomy, short fundoplication and the group of artificial hiatus hernia type long myotomy, long fundoplication were significantly superior to the group of long myotomy, long fundoplication. As the consequence of the experiment, firstly, the possibility that the surgical operation of long myotomy, long fundoplication causes hypertension of the intrathoracic esophagus, which resulted in the dysfunction of the anti-reflux mechanism of the valves was suggested. Secondly, it has been revealed that this dysfunction did not occur in the surgical operations on the length of HPZ. And thirdly, when the conventional Mark IV operation, which buries all the portions of the fundoplication under the diaphragm, causes hypertension to the intrathoracic esophagus, the surgical operation of artificial hiatus hernia type shall be applied to herniate the upper portion of the fundoplication to the thoracic cavity.
Nihon Heikatsukin Gakkai Zasshi 1983 Dec
PMID:[An experimental study on post-operative anti-reflux effect by modified Mark IV operation to esophageal achalasia]. 667 63

This study was intended to elucidate possible temporal changes of the valve and fundoplication which are formed by modified Mark IV operation as a surgical treatment of esophageal achalasia. Heller's procedure was also studied in terms of its comparison with the above operation. Adult mongrel dogs were operated on as follows and studied at the following postoperative points: Heller's procedure at the forth postoperative week, Modified Mark IV operation at the forth postoperative week, Modified Mark IV operation at the third postoperative month. Postoperative comparative studies were made on temporal changes of the anti-reflux effect by intraesophagogastric pressure and withdrawal pH examinations, measurements of intragastric pressure at reflux through simultaneous evaluation of intraesophageal pH and inner pressures at 3 points, i.e. the esophagus, the high pressure zone and the stomach, and histological and morphological examination. From the above the following conclusion was drawn: The valve formed by modified Mark IV operation showed temporally a shortening tendency, and a significant shortening of the length of valve was observed also in comparisons of values between the forth postoperative week and the third postoperative month. Also in terms of the measurement of inner pressures, a significant decrease was observed in the length and the force of high pressure zone. However, comparisons of the intragastric pressure values at reflux revealed no significant difference in values between the forth week and the third month after the modified Mark IV operation and almost similar anti-reflux effects between both in spite of a shortening of the valve. The above results suggested that more reliable and long-term sustaining of the anti-reflux effect needed more extensive formation of the fundoplication.
Nihon Heikatsukin Gakkai Zasshi 1983 Dec
PMID:[An experimental study on temporal changes of post-operative anti-reflux effect by modified Mark IV operation for esophageal achalasia]. 667 66

Five healthy volunteers were studied for the effect on oesophageal motility of a single subcutaneous injection of a synthetic analogue of enkephalin as compared with an injection of an equivalent volume (0.5 ml) of saline. The injections were given at random on separate days, and each was followed after 40 minutes by 2 mg naloxone given intravenously. Pressures were measured by manometry after dry and wet (5 ml) swallows at one-minute intervals, and traces were coded and analysed "blind". Twenty-five minutes after the injection of enkephalin the percentage relaxation of the lower oesophageal sphincter pressure was significantly less (p less than 0.005) than at the same time after saline. Within two minutes after intravenous naloxone this effect had disappeared completely. Enkephalin had no noticeable effect on pressure of the sphincter or on amplitude and duration of oesophageal peristalsis. The mechanism of action of enkephalin in selectively inhibiting relaxation of the lower oesophageal sphincter remains to be determined. That naloxone rapidly reversed the inhibition may be relevant in achalasia and warrants further study.
Br Med J (Clin Res Ed) 1982 Dec 04
PMID:Enkephalin inhibits relaxation of the lower oesophageal sphincter. 681 69

The present study was designed to investigate basic and clinical problems of intraluminal lower esophageal sphincter (LES) manometry. As for the basic study, manometry apparatuses, measuring conditions and methods were revalued. For clinical study, effects of gastric contents and gastrin were studied with special reference to the asymmetry of the LES. The results obtained may be summarized as follows: Occlusion test performed in a LES model and dogs showed that the rate of pressure increase was greater in proportion to the greater perfusion rate as well as to smaller calibre of the manometry tube. The lower esophageal sphincter pressure (LESP) became greatest when the perfusion rate was increased up to a certain level and also when the withdrawal speed of a manometry tube was slowed down to a certain speed. Analysis of LES from the point of respiratory reversal disclosed that the pressure was greatest at the direction of 8 o'clock followed by those at 0 and 4 o'clock. The length of LES was longest at 4 o'clock followed by those at 0 and 8 o'clock. These differences in length of LES was mostly in accordance with the length of LES caudal to the point of respiratory reversal. LESP measured in different postures was greatest in the prone position suggesting the effect of intraabdominal pressure. Intragastric instillation of saline resulted in increase of intragastric pressure and LESP. Asymmetry of the LES in patients with sliding hiatal hernia, esophageal varices and achalasia showed profiles specific to the individual lesion.
Nihon Heikatsukin Gakkai Zasshi 1982 Dec
PMID:[Experimental and clinical studies on the lower esophageal sphincter in reference to its asymmetry and to the effects of respiration, posture and gastric contents]. 718 58

We report identical male twins with secretory diarrhea, craniofacial abnormalities often found in G syndrome, hypospadias, and abnormalities of the cholinergic nervous system including achalasia, decreased tearing, corneal hypesthesia, positive Mecholyl test (eye and esophagus), and decreased sweating. The children also lacked fungiform papillae but were clinically distinct from patients with either the Riley-Day syndrome or acquired dysfunction of the autonomic nervous system. Assessment of autonomic nervous system function should be considered in infants with recurrent diarrhea or swallowing disorders or in children with morphologically characteristics suggesting G syndrome.
Ann Neurol 1981 Dec
PMID:Congenital cholinergic nervous system dysfunction in identical twins. 719 89

Not only the conservative dilatation treatment achalasia is at disposal, but also the operative cardiomyotomy. The former treatment followed often by recurrent danger of perforation as well as both methods lead in a definite percentage of cases to refluxesophagitis. Therefore, in our department since 1973 a combination of cardiomyotomy and fundoplication are performed consecutively. By using this method the reflux is surely, according to our experiences, avoidable. The indication of conservative treatment is to be performed by inoperable patients.
Helv Chir Acta 1980 Dec
PMID:[Surgical therapy of achalasia for prevention of reflux esophagitis]. 720 73

13 patients of 23 who had been treated for achalasia by a modified esophagomyotomy were reexamined by objective assessment of esophageal function with special regard to the problems mentioned above. Pull-through-manometry displayed a decrease of resting tonicity from 37 to 8 mm Hg. In the reflux-provocation-test all patients had a normal test result. In endoscopy normal histological findings raised 70% preoperatively to 83% postoperatively. The esophageal diameter was reduced in 11 of 13 patients. No patient had symptoms to suggest the presence of reflux and relapse.
Helv Chir Acta 1980 Dec
PMID:[Modified cardiomyotomy using Rapant's method - guaranteed prevention of esophageal reflux in the operative therapy of achalasia?]. 720 74


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