Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0017168 (gastroesophageal reflux disease)
11,783 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The differentiation of DMBA-induced rhabdomyoblastomas was studied during the early stages of tumour growth. Two cell populations were found to constitute the tumour tissue: small cells (SC) and long spindle-shaped cells (LSSC). The SC were the only tumor cells at the earliest detectable stage of tumour growth 10 weeks after intramuscular injection of DMBA. They had small heterochromatic nuclei with a compact nucleolus containing only fibrillar components. The cytoplasm was very rich in SER of tubular type, dense bodies and Golgi apparatus. Centrioles at all stages of the replicative cycle were very frequently observed. The cells did not fuse and showed no tendency to differentiate. The LSSC had large euchromatic nuclei with multiple irregular nucleoli containing both fibrillar and granular components. The cytoplasm had an abundant GER and well-developed Golgi apparatus. These cells formed 100 Angstrom thick cytofilaments the increase of which paralleled reduction of GER. The cells tended to fuse but did not form myofibrils. A rare variant of these cells neither possessed Golgi apparatus nor formed cytofilaments but accumulated dense protein substance in the cisternae of the GER. Myotubes with cross-striated myofibrils were but occasionally observed. The ultrastructural characteristics of both cell types revealed essential differences in the biosynthetic activity and the degree of differentiation. The SC were considered to belong to the myogenic cell line and to be most probably the malignant counterpart of proliferating satellite cells (presumptive myoblasts) and precursors of the LSSC. Morphologically and developmentally the LSSC bore close resemblance to normal myoblasts but the proliferative capacity of some of them seemed to be lost. The differentiation of the malignant myoblasts in the DMBA-induced rhabdomyoblastomas was similar to the early differentiation of the normal muscle tissue.
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PMID:Differentiation of malignant myoblasts in 7,12-dimethyl-benz(a)-anthracene-induced rhabdomyoblastomas. An electron microscopic study. 10 12

A case of adenocarcinoma developing at the squamocolumnar epithelial junction of a Barrett oesophagus is reported. This rare tumour was remarkable because of the youth of the patient and because of the signet-cell cytological pattern of the neoplasm. It is postulated that both the columnar epithelial lining of the lower part of the oesophagus and the malignant change are a consequence of long-standing oesophageal reflux.
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PMID:Adenocarcinoma in a Barrett oesophagus. 115 92

16 HIV seropositive patients among the 180 treated at the Hospital Muniz and the Hospital Posadas in Buenos Aires between December 1988 and December 1989 were referred to the Hospital Posadas Endoscopy Service for esophageal studies. The 16 patients were prospectively studies by means of fiberoscopy, radiology, biopsies, virology, mycology, and brush cytology. Early treatment is of utmost importance because opportunistic infections may aggravate the general condition, increase immune system effects, and probably permit greater replication of HIV, in addition to producing symptoms. 14 patients were male and 2 female. Ages ranged from 18 to 41 and averaged 32 years. 10 were male homo- or bisexuals and the other 6 were intravenous drug users. 14 of the patients consulted because of specifically esophageal symptoms. 12 reported dysphagia, 8 odynophagia, and 6 retrosternal pain. 9 patients presented various symptoms. 15 of the 16 symptomatic patients had some pathology related to HIV. The remaining case presented a small submucus tumor and gastroesophageal reflux. The symptoms had appeared between 10 days and 1 year prior to study. Symptoms did not provide accurate diagnostic clues. 11 cases of esophageal candidiasis were diagnosed endoscopically by isolated or confluent white plaques. 3 patients classified as grade 1 or 2 on the basis of the intensity and density of plaques had mild symptoms, and 8 classified as grade 3 or 4 had more severe symptoms. 7 of the 11 patients also had oral candidiasis. 4 of 6 patients presenting ulcerative pathology were diagnosed virologically with herpes simplex virus type 2. Herpetic ulcers were single or multiple and were deep with slightly raised edges. No ulcers attributable to cytomegalovirus were diagnosed. 4 of the 11 patients with candidiasis also had ulcers, in 2 cases herpetic. The studies indicated a change in the stage of HIV infection following Centers for Disease Control criteria in 10 cases. AIDS was diagnosed in 7 cases based on esophageal findings. Endoscopic study and the samples obtained guided treatment in the 16 patients. In 1 case a repeat endoscopy led to a change in treatment. It is recommended that endoscopy be performed in all patients with esophageal symptoms. Radiology was relatively ineffective, with 50% of diagnoses in error. Histopathology required multiple biopsies and was less sensitive than endoscopy and cytology. Cytology was highly specific and sensitive.
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PMID:[Esophageal pathology in patients with the AIDS virus. Etiology and diagnosis]. 182 Jun 92

Four cases related with the long stenosis of lower part of esophagus are referred to in children. These were stenoses of fibromuscular type, due to achalasia and resulting from etching with sulphuric acid as well as from tumor. The extramucous myotomy, esophagotomy and colonic replacement of long esophageal stenosis were elected. The condition is repairable by esophagomyotomy or esophagotomy when the function of stenotic portion of esophagus is preserved. To prevent postoperative complications such as fistula, diverticulum, gastroesophageal reflux and restenosis, the covering of incision with a patch from gastric fundus is recommended with subsequent fundoplication. Anatomical and functional lesion of esophageal wall in the presence of long stenosis requires its esophagoplasty as well as replacement with the intestinal interposition.
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PMID:[Surgical reconstruction of long esophageal stenoses in children]. 226 15

Results obtained in 120 patients with gastric carcinoma, and submitted between 1982 and 1989, to a total gastrectomy and a new technique of reconstruction with jejunum, are analyzed retrospectively. This technique associates, a jejunoplication around the terminal esophagus with the purpose to eliminate the entero-esophageal reflux and the risk of dehiscence, and a double jejuno-jejunostomy with the target to delay the emptying of foods and to increase the reservoir function of the neo-stomach. In 63 of these patients a lymphadenectomy type R2-R3 has been held and in the remainder a type R1 lymph node dissection. Pre-operative chemotherapy was done when there was significant weight loss or proved obstruction of the cardia or pylorus by a radioisotopic method. Post-operative chemotherapy was continued immediately after operation in all the patients with pre-operative improvement. Operative mortality until the 60th day of Hospital stay was 5.8% and was mainly related with the advanced age of the patients and the spread and localization of the tumor. Operative morbidity was also more marked in tumors spreading to the cardia. The five years actuarial survival rate was 17.2% to the stage III and IV and 38.8% to the stage I and II. The quality of life of the patients has been favored by the kind of gastric reconstruction that has been used: Jejunoplication reduce the entero-esophageal reflux to nearly 20% and the double enterostomy, specially if the duodenal transit is maintained, induce a more slow post-operative emptying than other kinds of reconstruction. This fact is related with a more physiologic absorption of glucose and to a more favorable nutritional condition.
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PMID:[Total gastrectomy with creation of a new stomach using the jejunum. A retrospective study of 120 patients]. 227 12

Pathologic evidence of gastroesophageal reflux demonstrated by either Barrett's esophagus or esophagitis was present in 33% of patients undergoing laryngopharynoesophagectomy, while secondary esophageal squamous cell carcinomas were present in 25% of the specimens. Overall, 54% of all the patients undergoing laryngopharyngoesophagectomy had esophageal disease. This incidence of reflux and secondary esophageal malignant neoplasia is higher than in the general population. Careful assessment of the patient's preoperative history for gastroesophageal reflux, contrast swallowing studies, and esophagoscopies correctly diagnosed most but not all of the esophageal lesions found on pathologic examination. Interestingly, all of the esophageal carcinomas removed in the laryngopharyngoesophagectomy specimens were small and sometimes not evident clinically. Although gastroesophageal reflux has been postulated as an additional etiologic agent in the development of laryngeal carcinoma, all the patients in our study had heavy alcohol and tobacco consumption, and therefore reflux could not be evaluated separately as a risk factor.
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PMID:Esophageal reflux and secondary malignant neoplasia at laryngoesophagectomy. 229 5

In a study designed to evaluate reflux scintigraphy in 79 patients with gastro-esophageal reflux disease, quantitated reflux scintigraphy was found to have predictive values of 73% in detecting reflux as judged by esophageal pH monitoring, of 63% in detecting esophagitis as judged by esophagoscopy and biopsy, and of 77% in detecting the presence of either esophagitis or reflux. However, its sensitivity was only 48, 58 and 42%, respectively. Gastro-esophageal reflux scanning has little value in the routine clinical diagnosis of mild to moderate gastroesophageal reflux disease, but none of the other tests (biopsy, endoscopic appearances of 24 hour esophageal pH monitoring) were sufficiently specific to be taken as a sole diagnostic criterion ("gold standard"). Investigation of gastro-esophageal reflux disease could probably best be limited to endoscopy (especially to detect ulceration or metaplasia and to exclude neoplasia) with 24 hour pH monitoring in addition for those patients with suspected reflux disease but negative endoscopy.
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PMID:Assessment of gastro-esophageal reflux disease: comparison of reflux scintigraphy with endoscopy biopsy and esophageal pH monitoring. 234 Nov 14

In spite of a decrease in the frequency of gastric carcinoma as shown in some statistics this malignoma still is an almost daily challenge in surgery. The prognosis of the gastric cancer, in general, depends upon the time of onset of therapy and the tumor grading. At present, chemotherapy and radiation therapy cannot be regarded as alternatives to surgical therapy. An improvement in the preoperative diagnostic procedures including the use of CT has not altered the prognosis of the gastric carcinoma. The procedure of choice in the treatment of gastric cancer should be total gastrectomy. The only exception to this rule is the small antrum carcinoma of the intestinal type, in which subtotal resection seems sufficient. This should comprise a 4/5-resection of the stomach and should be carried out with the same radicality concerning lymphadenectomy in the extragastric region as in total gastrectomy. The problem of intraluminal recurrency is declining provided that sufficient safety distances are maintained. An additive Brachy-radiation type therapy with intraoperative application of 125Jodine-seeds into remaining metastatic lymph-nodes seem to be a new approach to improve the prognosis of the palliatively resected gastric carcinoma. In our experience esophago-jejunoplication for reestablishment of passage following gastrectomy serves best the demand for creating a food reservoir and in preventing intestino-esophageal reflux. It seems to be of prime importance to prepare the patient psychologically for the loss of the stomach and to endow him with dietary plans for the food intake later on.
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PMID:[Determination of surgical status: stomach cancer]. 241 20

Barrett esophagus, the columnar-lined distal esophagus acquired as a consequence of chronic gastroesophageal reflux, is associated with the development of columnar epithelial dysplasia and esophageal adenocarcinoma. To determine the efficacy of cytopathology in identifying Barrett esophagus and related neoplasia, observations were compared on 150 esophageal cytology samples with concurrent endoscopic biopsy specimens. Sixty-six specimens that contained benign columnar epithelium in either cytologic or biopsy material were identified. Distinctive-type Barrett mucosa with incomplete intestinalization, considered diagnostic of Barrett esophagus, was found in 34 of 66 cases (52%) and was present only in cytologic material in 11 cases. Twenty-two specimens contained cardiac-type mucosa (present only in cytology in ten cases), a finding of uncertain significance due to lack of localization of the sample with respect to the gastroesophageal junction. Fundic-type mucosa was not observed in any specimen. Two cases of distinctive-type Barrett mucosa with columnar epithelial dysplasia were identified in both biopsy and cytology specimens. Among eight Barrett-associated carcinomas (seven adenocarcinomas and one squamous), cytologic material was diagnostic for malignancy in seven and highly suspicious in one. It was concluded that cytopathologic studies are a useful adjunct to biopsy histopathology in the diagnosis of Barrett esophagus and associated carcinoma. The role of cytopathology in the diagnosis of Barrett-related columnar epithelial dysplasia requires further study, and at present a cautious approach with biopsy confirmation is recommended.
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PMID:Diagnostic value of cytopathology in Barrett esophagus and associated carcinoma. 335 1

Pull-through esophageal intubation with a composite, detachable prosthesis allows insertion of the tube only in the narrowing due to the tumor. Using this easy technique, which permits a convenient low, small 3 millimeter gastrotomy, the intra-abdominal contamination is reduced. The end of the tube does not pass across the cardia, so the patient is free from gastroesophageal reflux and its consequences.
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PMID:A new reflux-free surgical esophageal intubation technique. 366 Feb 1


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