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Query: UMLS:C0017168 (gastroesophageal reflux disease)
 11,783 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Combined surgical and conservative therapy (voice therapy, treatment of infections, allergy, oesophageal reflux, and psychogenic stress) has been used in the treatment of non-specific vocal cord granuloma. Such tumors have a great tendency to recur. The 41 patients with vocal cord granuloma in our study (4 women, 37 men, mean age 56 years) were treated at our hospital during 1980-1986. Nine patients were healed with conservative treatment, 32 were treated by laryngomicrosurgery under general anesthesia and jet-ventilation. The latter group was divided into three treatment groups; 8 of these patients were treated with cryotherapy, 9 with postoperative steroids (Prednisolone 40 mg/day in decreasing doses) and antibiotics, and 15 only with microsurgery. At some phase in their treatment 41% of the patients were able to participate in voice therapy. The most recurrences were found in the group treated with cryotherapy, 2.7 rec./pat.; 1.8 rec./pat. were found in the group that underwent surgery, and 1.7 rec./pat. among the patients treated with steroid-antibiotics. In all three groups, some patients experienced recurrences. In the cryotherapy group, however, recurrent granulomas were large and required reoperation, while those in patients treated with steroid-antibiotics were small and could be cured using conservative therapy. If granuloma does not disturb the voice, cause respiratory obstruction or demand histopathological diagnosis, surgery is contraindicated. Cryotherapy does not help traditional surgery, while steroid-antibiotics administered postoperatively seem to help the healing process.
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PMID:Treatment of vocal cord granuloma. 292 28

The ultrastructure of plexus muscularis profundus (PMP) of the mouse small intestine was investigated subsequent to vascular perfusion with ruthenium red-containing and routine aldehyde fixatives. Four types of nerve terminals were revealed. Type I: numerous 500-A agranular vesicles and few 1,000-A granular vesicles. Type II: predominantly large (1,000-1,500 A), granular vesicles and fewer 500-A agranular vesicles. Type III: an abundance of mitochondria and many flattened vesicles (300 A X 700-1,300 A). Type IV was identified by abundant smooth cisternae 200 A in width. Types I-III formed close (200 A), synapse-like contacts to interstitial cells of Cajal (ICC-III). Presynaptic densities were frequent in type I endings. A direct innervation of muscle cells via PMP was only very occasionally suggested. ICC-III possessed a basal lamina and numerous caveolae associated with subsurface SER-cisternae. Mitochondria were very abundant in ICC-III-processes. ICC-III formed multiple, large gap junctions with outer circular-muscle cells and with other ICC-III. Also reflexive gap junctions were observed. Fibroblastlike cells (FLC) were distinguished by their prominent GER, the frequent presence of lipid droplets, and the lack of caveolae and a basal lamina. FLC never participated in synaptic arrangements or gap junctions. Macrophage-like cells were occasionally encountered. It is concluded that possible efferent and afferent nerve terminals in PMP may chiefly, if not exclusively, innervate ICC-III, the ultrastructure of which is compatible with efferent and/or afferent modulatory actions.
Anat Rec 1982 May
PMID:Plexus muscularis profundus and associated interstitial cells. II. Ultrastructural studies of mouse small intestine. 710 20

The hypothesis that reflux of upper intestinal content, particularly of bile acids (BA), is responsible for a unique postgastrectomy syndrome, alkaline reflux gastritis, was tested on 28 occasions in 21 postoperative patients (14 symptomatic patients, 7 controls). Parameters evaluated: recumbent (rec.), upright, p.c. intragastric pH, {BA}, net BA reflux per hour, specific BA fractions, fasting and p.c. gastrin, maximal acid output (MAO), gastric emptying of solids by delta-scintigraphy), and the severity of nonstomal histologic gastritis, the "gastritis score," graded 0-15 by an independent senior pathologist. For the entire group, gastritis severity correlated positively with intragastric {BA} and net BA reflux per hour, both in recumbency and p.c. Five symptomatic patients demonstrated rec. and p.c. {BA} and net BA reflux per hour greater than two standard deviations from comparable mean values in control patients. They differed significantly from the remaining symptomatic patients as follows: increased intragastric {BA} and net BA reflux per hour, increased intragastric pH and decreased MAO. They also demonstrated a more severe grade of gastritis. Lithocholic acid was present in their reflux content significantly more often. Bilious vomiting was also more frequent. No other differences could be identified, either objectively or clinically, between the symptomatic groups. Four patients with excessive reflux underwent Roux-en-Y revision and restudy 6-22 months later. BA reflux was completely abolished, histologic gastritis improved, hematocrit rose, MAO increased, and gastric emptying slowed. Burning pain, bilious vomiting, and symptoms of esophageal reflux were eliminated. Vomiting and nausea were improved. Diarrhea was unchanged. The objective criteria outlined can identify symptomatic postgastrectomy patients with a greater than normal reflux and gastritis. Clinical criteria alone cannot. Revisional surgery in these patients eliminates reflux, improves gastritis, and produces symptomatic improvement. The hypothesis under consideration is strengthened but not proven.
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PMID:Alkaline reflux gastritis. An objective assessment of its diagnosis and treatment. 741 26

We report a familial recombination of a pericentric inversion of chromosome 10 resulting in 2 affected relatives who had 10p trisomy and 10q monosomy with the karyotypic abnormality designated rec(10) dup p,inv(10) (p11.2q26). Both of these individuals had the typical characteristics of 10p trisomy, however, at birth the proposita had mild facial anomalies suggesting that the distinct facial characteristics may be of postnatal onset in some cases. In addition, the proposita had gastroesophageal reflux causing severe anemia. The phenotype of our patients is compared to 41 patients with 10p trisomy reported in the literature.
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PMID:Familial 10p trisomy resulting from a maternal pericentric inversion. 820 87

Combinations of acepromazine maleate, pethidine hydrochloride and atropine sulphate (0.05 mg/kg) or acepromazine maleate and pethidine hydrochloride and acepromazine maleate alone or atropine sulphate (0.1 mg/kg) alone were used to premedicate cats before they were anaesthetised with thiopentone, to investigate their effects on gastric pressure, lower oesophageal sphincter pressure and barrier pressure under anaesthesia. Manometric measurements were made by using a non-perfused manometric technique. The lower oesophageal sphincter pressure was lowest in the cats premedicated with atropine sulphate alone. The difference in barrier pressure between the atropine (0.1 mg/kg) and acepromazine treated cats was highly significant. The risk of gastro-oesophageal reflux appeared to be highest with atropine (0.1 mg/kg) if barrier pressure is used as an indicator of the likelihood of reflux.
Vet Rec 1993 Aug 14
PMID:Effects of acepromazine, pethidine and atropine premedication on lower oesophageal sphincter pressure and barrier pressure in anaesthetised cats. 823 2

Lower oesophageal pH was monitored in 240 anaesthetised dogs. The incidence of gastro-oesophageal reflux was 16.3 per cent and most of the reflux episodes occurred shortly after the induction of anaesthesia. The refluxate was nearly always acid (pH < 4.0), but in 10.3 per cent of the cases it was alkaline (pH > 7.5); gastric contents of pH below 2.5 were refluxed on 19 occasions (7.9 per cent). Regurgitation occurred in only one dog. Prolonging preoperative fasting was associated with an increased incidence of reflux and increased gastric acidity. Premedication with diazepam was associated with fewer reflux episodes than premedication with atropine and propionylpromazine.
Vet Rec 1995 Nov 04
PMID:Gastro-oesophageal reflux during anaesthesia in the dog: the effect of preoperative fasting and premedication. 857 60

Lower oesophageal pH was monitored in 270 dogs under anaesthesia. There were 47 episodes of gastro-oesophageal reflux (17.4 per cent), most of which occurred shortly after the induction of anaesthesia. The refluxate was usually acid (pH < 4.0), but in four of the episodes (8.5 per cent) it was alkaline (pH > 7.5). Gastric contents with a pH below 2.5 were refluxed on 27 occasions (10 per cent) for an average period of about 44 minutes. Regurgitation occurred in two of the dogs. Increased age seemed to be associated with an increased incidence of reflux and an increased gastric acidity. Body position (sternal, dorsal and left or right lateral) and the tilt of the body during surgery (horizontal or tilted to an 8 degrees head-up or head-down position) had no influence on the incidence of gastro-oesophageal reflux. Dogs undergoing intra-abdominal surgery had significantly more reflux episodes than dogs undergoing non-abdominal surgery.
Vet Rec 1995 Nov 11
PMID:Gastro-oesophageal reflux during anaesthesia in the dog: the effect of age, positioning and type of surgical procedure. 858 77

Gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux (LPR) are sibling diseases that are a modern-day plague. Millions of Americans suffer from their sequelae, ranging from subtle annoyances to life-threatening illnesses such as asthma, sleep apnea, and cancer. Indeed, the recognized prevalence of GERD alone has increased threefold throughout the 1990s. Knowledge of the precise etiologies for GERD and LPR is becoming essential for proper treatment. This review focuses on the anatomical, physiological, neurobiological, and cellular aspects of these diseases. By definition, gastroesophageal reflux (GER) is the passage of gastric contents into the esophagus; when excessive and damaging to the esophageal mucosa, GERD results. Reflux that advances to the laryngopharynx and, subsequently, to other regions of the head and neck such as the larynx, oral cavity, nasopharynx, nasal cavity, paranasal sinuses, and even middle ear results in LPR. While GERD has long been identified as a source of esophageal disease, LPR has only recently been implicated in causing head and neck problems. Recent research has identified four anatomical/physiological "barriers" that serve as guardians to prevent the cranial incursion of reflux: the gastroesophageal junction, esophageal motor function and acid clearance, the upper esophageal sphincter, and pharyngeal and laryngeal mucosal resistance. Sequential failure of all four barriers is necessary to produce LPR. While it has become apparent that GER must precede both GERD and LPR, the head and neck distribution of the latter clearly separates these diseases as distinct entities warranting specialized focus and treatment.
Anat Rec B New Anat 2006 Nov
PMID:Anatomy of reflux: a growing health problem affecting structures of the head and neck. 1710 21