• Title/Summary/Keyword: Esophageal

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The Relationship Between Esophageal Manometry and 24 Hour Double Prove pH-metry with Gastroesophageal Reflax in Pharyrngeal Neurosis Patients. (인두신경증 환자에서 Esophageal manometry와 24hour double prove pH metry 검사 및 위식도 역류와의 관계)

  • 김선태
    • Korean Journal of Bronchoesophagology
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    • v.2 no.1
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    • pp.88-96
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    • 1996
  • In recently the gastroesophageal reflux disease(GERD) has been known to induce the otolaryngologic manifestations. Pharyngeal neurosis is a disease which we could have not found the cause frequently. So we have studied the relation between the pharyngeal neurosis and the GERD among 50 patients who were diagnosed as pharyngeal neurosis after esophagogram and laryngoscopic examination. We performed esophageal manometry and 24hour double-probe pH-metry and then compared with normal control group(n=30). The results are as follows 1 Among 50 patients, 12(24%) patients were diagnosed as GERD by DeMeester scoring. 2. In esophageal manometry, the upper and lower esophageal sphincter between the patients and the control group have no significant difference(p>0.05) and 9 among 50 pateints showed abnormal peristaltic movement in esophageal body contraction. 3. In 24hour double-probe pH-metry, the esophageal probe showed that in GERD group(n= 12) the number of reflux episode, episodes greater than 5 minutes and the percentage of time

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Neoadjuvant Chemotherapy for Resectable Esophageal Carcinoma: A Meta-analysis of Randomized Clinical Trials

  • Xu, Xiao-Hua;Peng, Xue-Hong;Yu, Ping;Xu, Xiao-Yuan;Cai, Er-Hui;Guo, Pi;Li, Ke
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.1
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    • pp.103-110
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    • 2012
  • Neoadjuvant chemotherapy for resectable esophageal carcinoma has been a focus of study, but no agreement has been reached on clinical randomized controlled trials and relevant systematic evaluation. The purpose of this study was to perform a meta-analysis on published randomized controlled trials (RCTs) that compared neoadjuvant chemotherapy and surgery with surgery alone for resectable esophageal carcinoma. Medline and manual searches was conducted in PubMed, ASCO (American Society of Clinical Oncology) meeting summary, Embase, the Cochrane Library (up to October 2010), Chinese Biomedical Literature Database, China National Knowledge Infrastructure, VIP Database, Wanfang Database. The selection contents were to identify all published and unpublished RCTs that compared neoadjuvant chemotherapy and surgery with surgery alone for resectable esophageal carcinoma. Sixteen RCTs which included 2,594 patients were selected. The risk ratio (RR) (95% confidence interval [CI]; P value), expressed as neoadjuvant chemotherapy and surgery versus surgery alone (treatment versus control), was 1.02 (0.95, 1.10; P=0.54) for 1-year survival, 1.29 (1.13, 1.47; P=0.0001) for 3-year survival, 1.31 (1.13, 1.51; P=0.0003) for 5-year survival, 1.00 (0.95, 1.04; P= 0.85) for rate of resection and 0.89 (0.64, 1.23; P=0.48) for operative mortality. The results showed that neoadjuvant chemotherapy for resectable esophageal carcinoma can raise the overall survival rate of patients with esophageal carcinoma, but it does not affect treatment-related mortality.

A Successful Management of an Esophageal Perforation Caused by Esophageal Foreign Body with a Non-operative Treatment in a Dog (개에서 식도 이물에 의한 식도 천공의 비침습적 치료를 통한 성공적 관리 증례)

  • Lee, Hyeon-Suk;Baek, Dae-Seung;Ju, Ho-Jong;Kim, Jun-Hwan;Hong, Yeon-Jung;Park, Jin-Ho;Cho, Ho-Seong;Park, Chul
    • Journal of Veterinary Clinics
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    • v.29 no.6
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    • pp.506-508
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    • 2012
  • A 5-year-old, intact female, Pomeranian was presented with a persistent vomiting for 5 days after swallowing a chicken bone. The dog was diagnosed with an esophageal foreign body, and a small perforation was found after the endoscopic removal of the chicken bone. The dog was determined to be treated with a non-operative management, and a complete closure of the perforation was confirmed by a flexible endoscopy 3 weeks after removal of a chicken bone. This paper reports the case of esophageal perforation caused by foreign body in esophagus managed with the non-operative therapy instead of surgical correction.

Evaluation of Neck Node Dissection for Thoracic Esophageal Carcinoma (흉부식도암 수술에서 경부림프절 절제의 의의)

  • 전상훈;박창률;이응배;박준식;장봉현;이종태;김규태
    • Journal of Chest Surgery
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    • v.31 no.11
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    • pp.1081-1084
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    • 1998
  • Background: Esophageal surgery in esophageal cancer has low curative resection rate and its resut has not improved even after the extended lymphnode dissection. To evaluate the effectiveness of cervical lymph node dissection, we compare the node of cervical lymph node metastasis in patients esophageal cancer. Materials and methods: We studied a series of 32 patients who underwent operation for thoracic esophageal carcinoma at our institution. The 25 patient who underwent curative surgery were divided into two groups. Both groups A and B underwent transthoracic esophagectomies with mediastinal and abdominal lymphadenectomies only, but group B also underwent bilateral lower neck node dissection. Results: The rate of operative complications did not differ significantly between two groups. No operative and hospital mortalities were noted in either group. However, the mean anesthetic time was significantly longer in group B(mean: 90 minutes). Neck node metastasis was revealed in 27% of group B. Conclusions: Therfore, neck node dissection is meaningful for surgical treatment of the thoracic esophageal carcinoma. The longterm survival rate should be compared later.

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Free Jejunal Transfer Used by Intercostal Artery in the Intrathoracic Esophageal Reconstruction (흉강내 식도재건시 늑간동맥을 이용한 유리 공장 전이술)

  • Kim, Han-Soo;Choi, Sang-Mook;Chung, Chan-Min;Suh, In-Seock
    • Archives of Reconstructive Microsurgery
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    • v.5 no.1
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    • pp.99-105
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    • 1996
  • The reconstruction of esophageal defect after ablative surgery have more difficult than other digestive tract tumor because the restoration of anatomical and physiologic function is difficult, the risk of tumor invasion into the adjacent tissue is large. The reconstruction of cervical esophus was depended on the degree of resection of the esophagus, various reconstruction method was developed to minimize functional deficiency and deformity of cervical region. Recently, the free jejunal transfer or free radial forearm flap was commonly utilized for esophageal reconstruction due to development of technique of the microvascular anastomosis. After the esophageal reconstruction used by free jejunal transfer was reported by Seidenberg in 1951, jejunum is most commonly used for reconstruction of esophgus. Becaue of, it have been tubed anatomical similarity with muscular layer, relative small risk of complication, possible of oral intake within 10 days after operation, and early rehabilitaion. Authors have been treated esophageal defect with free jejunal transfer in 7 patients after resection of lesion in 6 eshageal cancer and 1 esophageal stricture from December 1994 to January 1996. We were transferred jejunum used by intercostal artery as recipient artery in 3 cases, it was satisfied with results. If intercostal artery was utilized as recipient artery for free jejunal transfer, we believe that any site of intrathoracic or intraabdominal esophageal defect is possible to recontruction.

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A Life-Threatening Case of Tubular Esophageal Duplication Complicated with Aneurysm of the Aorta (대동맥류를 초래한 식도 중복 1례)

  • Jung, Yeon Kyung;Lee, Gyeong Hoon;Chung, Hai Lee;Park, Ki Sung;Jung, Kyung-Jae;Cho, Chang Ho
    • Clinical and Experimental Pediatrics
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    • v.48 no.6
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    • pp.655-659
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    • 2005
  • Esophageal duplication cysts are rare congenital lesions that occur as a result of a failure in the tubulation of the esophagus. They are most frequently single, tubular, or cystic. They may cause compressive symptoms or may be discovered incidentally on chest radiographs. They become symptomatic when complications develop. Symptoms often are related to the location of the duplication; esophageal lesions can create respiratory difficulties. The definitive diagnosis of esophageal duplication cysts requires the pathological evaluation of the cyst after surgical removal. We experienced a rare tubular esophageal duplication, in a 2-month old girl who presented with fever and grunting. This is the first reported case in which the sequence of events of ruptured tubular esophageal duplication with empyema, mediastinitis and aneurysm occured.

Epigenetic Changes within the Promoter Regions of Antigen Processing Machinery Family Genes in Kazakh Primary Esophageal Squamous Cell Carcinoma

  • Sheyhidin, Ilyar;Hasim, Ayshamgul;Zheng, Feng;Ma, Hong
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.23
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    • pp.10299-10306
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    • 2015
  • The esophageal squamous cell carcinoma (ESCC) is thought to develop through a multi-stage process. Epigenetic gene silencing constitutes an alternative or complementary mechanism to mutational events in tumorigenesis. Posttranscriptional regulation of human leukocyte antigen class I (HLA-I) and antigen processing machinery (APM) proteins expression may be associated with novel epigenetic modifications in cancer development. In the present study, we determined the expression levels of HLA-I antigen and APM components by immunohistochemistry. Then by a bisulfite-sequencing PCR (BSP) approach, we identified target CpG islands methylated at the gene promoter region of APM family genes in a ESCC cell line (ECa109), and further quantitative analysis of CpG site specific methylation of these genes in cases of Kazakh primary ESCCs with corresponding non-cancerous esophageal tissues using the Sequenom MassARRAY platform. Here we showed that the development of ESCCs was accompanied by partial or total loss of protein expression of HLA-B, TAP2, LMP7, tapasin and ERp57. The results demonstrated that although no statistical significance was found of global target CpG fragment methylation level sof HLA-B, TAP2, tapasin and ERp57 genes between ESCC and corresponding non-cancerous esophageal tissues, there was significant differences in the methylation level of several single sites between the two groups. Of thesse only the global methylation level of LMP7 gene target fragments was statistically higher ($0.0517{\pm}0.0357$) in Kazakh esophageal cancer than in neighboring normal tissues ($0.0380{\pm}0.0214$, p<0.05). Our results suggest that multiple CpG sites, but not methylation of every site leads to down regulation or deletion of gene expression. Only some of them result in genetic transcription, and silencing of HLA-B, ERp57, and LMP7 expression through hypermethylation of the promoters or other mechanisms may contribute to mechanisms of tumor escape from immune surveillance in Kazakh esophageal carcinogenesis.

Esophageal tolerance to high-dose stereotactic radiosurgery

  • Lee, Bo Mi;Chang, Sei Kyung;Ko, Seung Young;Yoo, Seung Hoon;Shin, Hyun Soo
    • Radiation Oncology Journal
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    • v.31 no.4
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    • pp.234-238
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    • 2013
  • Purpose: Esophageal tolerance is needed to guide the safe administration of stereotactic radiosurgery (SRS). We evaluated comprehensive dose-volume parameters of acute esophageal toxicity in patients with spinal metastasis treated with SRS. Materials and Methods: From May 2008 to May 2011, 30 cases in 27 patients with spinal metastasis received single fraction SRS to targets neighboring esophagus. Endpoints evaluated include length (mm), volume (mL), maximal dose (Gy), and series of dose-volume thresholds from the dose-volume histogram (volume of the organ treated beyond a threshold dose). Results: The median time from the start of irradiation to development of esophageal toxicity was 2 weeks (range, 1 to 12 weeks). Six events of grade 1 esophageal toxicity occurred. No grade 2 or higher events were observed. $V_{15}$ of external surface of esophagus was found to predict acute esophageal toxicity revealed by multivariate analysis (odds radio = 1.272, p = 0.047). Conclusion: In patients with spinal metastasis who received SRS for palliation of symptoms, the threshold dose-volume parameter associated with acute esophageal toxicity was found to be $V_{15}$ of external surface of esophagus. Restrict $V_{15}$ to external surface of esophagus as low as possible might be safe and feasible in radiosurgery.

Experimental Study for Effect of Banhasasim-tang on Mice with Reflux Esophagitis (역류성 식도염 유발 생쥐의 반하사심탕(半夏瀉心湯)투여 효과에 대한 실험 연구)

  • Jang, Myeong-Woong;Lim, Seong-Woo
    • The Journal of Internal Korean Medicine
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    • v.34 no.4
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    • pp.362-374
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    • 2013
  • Objectives : This study was carried out to investigate the inhibitory effect of Banhasasim-tang on early reflux esophagitis by control of gastric peristalsis and the lower esophageal sphincter in mice. Methods : Experimental mice were classified into three groups. The normal group were mice with no inflammation. The control group were mice with gastroesophageal reflux elicited by alcohol. The sample group were mice administered Banhasasim-tang after gastroesophageal reflux elicitation. We observed morphological change and production of ghrelin, substance P, and inducible nitric oxide synthase (iNOS) in gastroesophageal junction mucosa. In addition, we examined change of epithelial junction in esophageal mucosa and change of lower esophageal sphincter distribution. Results : The migration of inflammation-related cells in lamina propria of gastroesophageal junction decreased more in the sample group than in the control group. The positive reaction of ghrelin, substance P, and iNOS significantly decreased more in the sample group than in the control group (p<0.05). Injury of the epithelial junction in the esophageal mucosa and outer oblique layer in the lower esophageal sphincter were significantly mitigated by Banhasasim-tang administration in the sample group (p<0.05). Conclusions : According to the above results, it is supposed that Banhasasim-tang inhibits early reflux esophagitis by controlling not only gastric peristalsis and acid secretion through ghrelin, and substance P but also the lower esophageal sphincter through iNOS.

Twenty-Four Hour pH Study and Manometry in Gastric Esophageal Substitutes in Children

  • Kekre, Geeta;Dikshit, Vishesh;Kothari, Paras;Laddha, Ashok;Gupta, Abhaya
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.4
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    • pp.257-263
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    • 2018
  • Purpose: Studies on the physiology of the transposed stomach as an esophageal substitute in the form of a gastric pull-up or a gastric tube in children are limited. We conducted a study of motility and the pH of gastric esophageal substitutes using manometry and 24-hour pH measurements in 10 such patients. Methods: Manometry and 24 hour pH studies were performed on 10 children aged 24 to 55 months who had undergone gastric esophageal replacement. Results: Six gastric tubes (4, isoperistaltic; 2, reverse gastric tubes) and 4 gastric pull-ups were studied. Two gastric tubes and 4 gastric pull-ups were transhiatal. Four gastric tubes were retrosternal. The mean of the lowest pH at the midpoint of the substitute was 4.0 (range, 2.8-5.0) and in the stomach remaining below the diaphragm was 3.3 (range, 1.9-4.2). In both types of substitute, the difference between the peak and the nadir pH recorded in the intra-thoracic and the sub-diaphragmatic portion of the stomach was statistically significant (p<0.05), with the pH in the portion below the diaphragm being lower. The lowest pH values in the substitute and in the remnant stomach were noted mainly in the evening hours whereas the highest pH was noted mainly in the morning hours. All the cases showed a simultaneous rise in the intra-cavitatory pressure along the substitute while swallowing. Conclusion: The study suggested a normal gastric circadian rhythm in the gastric esophageal substitute. Mass contractions occurred in response to swallowing. The substitute may be able to effectively clear contents.