Sample records for cat esophageal smooth

  1. Ca2+-induced contraction of cat esophageal circular smooth muscle cells. (United States)

    Cao, W; Chen, Q; Sohn, U D; Kim, N; Kirber, M T; Harnett, K M; Behar, J; Biancani, P


    ACh-induced contraction of esophageal circular muscle (ESO) depends on Ca2+ influx and activation of protein kinase Cepsilon (PKCepsilon). PKCepsilon, however, is known to be Ca2+ independent. To determine where Ca2+ is needed in this PKCepsilon-mediated contractile pathway, we examined successive steps in Ca2+-induced contraction of ESO muscle cells permeabilized by saponin. Ca2+ (0.2-1.0 microM) produced a concentration-dependent contraction that was antagonized by antibodies against PKCepsilon (but not by PKCbetaII or PKCgamma antibodies), by a calmodulin inhibitor, by MLCK inhibitors, or by GDPbetas. Addition of 1 microM Ca2+ to permeable cells caused myosin light chain (MLC) phosphorylation, which was inhibited by the PKC inhibitor chelerythrine, by D609 [phosphatidylcholine-specific phospholipase C inhibitor], and by propranolol (phosphatidic acid phosphohydrolase inhibitor). Ca2+-induced contraction and diacylglycerol (DAG) production were reduced by D609 and by propranolol, alone or in combination. In addition, contraction was reduced by AACOCF(3) (cytosolic phospholipase A(2) inhibitor). These data suggest that Ca2+ may directly activate phospholipases, producing DAG and arachidonic acid (AA), and PKCepsilon, which may indirectly cause phosphorylation of MLC. In addition, direct G protein activation by GTPgammaS augmented Ca2+-induced contraction and caused dose-dependent production of DAG, which was antagonized by D609 and propranolol. We conclude that agonist (ACh)-induced contraction may be mediated by activation of phospholipase through two distinct mechanisms (increased intracellular Ca2+ and G protein activation), producing DAG and AA, and activating PKCepsilon-dependent mechanisms to cause contraction.

  2. IL-1β activates p44/42 and p38 mitogen-activated protein kinases via different pathways in cat esophageal smooth muscle cells

    Institute of Scientific and Technical Information of China (English)

    Tai Sang Lee; Hyun Ju Song; Ji Hoon Jeong; Young Sil Min; Chang Yell Shin; Uy Dong Sohn


    AIM: To examine the pathway related to the IL-1β-induced activation of mitogen-activated protein (MAP)kinases in cat esophageal smooth muscle cells.METHODS: Culture of the esophageal smooth muscle cells from cat was prepared. Specific inhibitors were treated before applying the IL-1β. Western blot analysis was performed to detect the expressions of COX, iNOS and MAP kinases.RESULTS: In the primary cultured cells, although IL-1βfailed to upregulate the COX and iNOS levels, the levels of the phosphorylated forms of p44/42 MAP kinase and p38 MAP klnase increased in both concentration- and time-dependent manner, of which the level of activation reached a maximum within 3 and 18 h, respectively.The pertussis toxin reduced the level of p44/42 MAP kinase phosphorylation. Tyrphostin 51 and genistein also inhibited this activation. Neomycin decreased the density of the p44/42 MAP kinase band to the basal level.Phosphokinase C (PKC) was found to play a mediating role in the IL-1β-induced p44/42 MAP kinase activity.In contrast, the activation of p38 MAP kinase was inhibited only by a pretreatment with forskolin, and was unaffected by the other compounds.CONCLUSION: Based on these results, IL-1β-Induced p44/42 MAP kinase activation is mediated by the Gi protein, tyrosine kinase, phospholipase C (PLC) and PKC. The pathway for p38 MAP kinase phosphorylation is different from that of p44/42 MAP kinase, suggesting that it plays a different role in the cellular response to IL-1β.

  3. 4-dimensional locally CAT(0)-manifolds with no Riemannian smoothings

    CERN Document Server

    Davis, M; Lafont, J -F


    We construct examples of smooth 4-dimensional manifolds M supporting a locally CAT(0)-metric, whose universal cover X satisfy Hruska's isolated flats condition, and contain 2-dimensional flats F with the property that the boundary at infinity of F defines a nontrivial knot in the boundary at infinity of X. As a consequence, we obtain that the fundamental group of M cannot be isomorphic to the fundamental group of any Riemannian manifold of nonpositive sectional curvature. In particular, M is a locally CAT(0)-manifold which does not support any Riemannian metric of nonpositive sectional curvature.

  4. Smooth Muscle Hgs Deficiency Leads to Impaired Esophageal Motility (United States)

    Chen, Jicheng; Hou, Ning; Zhang, Chong; Teng, Yan; Cheng, Xuan; Li, Zhenhua; Ren, Jie; Zeng, Jian; Li, Rui; Wang, Wei; Yang, Xiao; Lan, Yu


    As a master component of endosomal sorting complex required for transport proteins, hepatocyte growth factor-regulated tyrosine kinase substrate (Hgs) participates multiple cellular behaviors. However, the physiological role of Hgs in smooth muscle cells (SMCs) is by far unknown. Here we explored the in vivo function of Hgs in SMCs by using a conditional gene knockout strategy. Hgs deficiency in SMCs uniquely led to a progressive dilatation of esophagus with a remarkable thinning muscle layer. Of note, the mutant esophagus showed a decreased contractile responsiveness to potassium chloride and acetylcholine stimulation. Furthermore, an increase in the inhibitory neurites along with an intense infiltration of T lymphocytes in the mucosa and muscle layer were observed. Consistently, Hgs deficiency in SMCs resulted in a disturbed expression of a set of genes involved in neurotrophin and inflammation, suggesting that defective SMC might be a novel source for excessive production of cytokines and chemokines which may trigger the neuronal dysplasia and ultimately contribute to the compromised esophageal motility. The data suggest potential implications in the pathogenesis of related diseases such as gastroesophageal reflux disease. PMID:26078721

  5. Circular smooth muscle contributes to esophageal shortening during peristalsis

    Institute of Scientific and Technical Information of China (English)

    Anil K Vegesna; Keng-Yu Chuang; Ramashesai Besetty; Steven J Phillips; Alan S Braverman; Mary F Barbe; Michael R Ruggieri


    AIM:To study the angle between the circular smooth muscle (CSM) and longitudinal smooth muscle (LSM) fibers in the distal esophagus.METHODS:In order to identify possible mechanisms for greater shortening in the distal compared to proximal esophagus during peristalsis,the angles between the LSM and CSM layers were measured in 9 cadavers.The outer longitudinal layer of the muscularis propria was exposed after stripping the outer serosa.The inner circular layer of the muscularis propria was then revealed after dissection of the esophageal mucosa and the underlying muscularis mucosa.Photographs of each specimen were taken with half of the open esophagus folded back showing both the outer longitudinal and inner circular muscle layers.Angles were measured every one cm for 10 cm proximal to the squamocolumnar junction (SCJ) by two independent investigators.Two human esophagi were obtained from organ transplant donors and the angles between the circular and longitudinal smooth muscle layers were measured using micro-computed tomography (micro CT) and Image J software.RESULTS:All data are presented as mean ± SE.The CSM to LSM angle at the SCJ and 1 cm proximal to SCJ on the autopsy specimens was 69.3 ± 4.62 degrees vs 74.9 ± 3.09 degrees,P =0.32.The CSM to LSM angle at SCJ were statistically significantly lower than at 2,3,4 and 5 cm proximal to the SCJ,69.3 ± 4.62 degrees vs 82.58 ± 1.34 degrees,84.04 ± 1.64 degrees,84.87 ± 1.04 degrees and 83.72 ± 1.42 degrees,P =0.013,P =0.008,P =0.004,P =0.009 respectively.The CSM to LSM angle at SCJ was also statistically significantly lower than the angles at 6,7 and 8 cm proximal to the SCJ,69.3 ± 4.62 degrees vs 80.18 ± 2.09 degrees,81.81 ± 1.75 degrees and 80.96 ± 2.04 degrees,P =0.05,P =0.02,P =0.03 respectively.The CSM to LSM angle at 1 cm proximal to SCJ was statistically significantly lower than at 3,4 and 5 cm proximal to the SCJ,74.94 ± 3.09 degrees vs 84.04 ± 1.64 degrees,84.87± 1.04 degrees and 83.72 ± 1

  6. Esophageal stricture caused by rib osteoma in a cat: case report

    Directory of Open Access Journals (Sweden)

    Simone CS Cunha


    Full Text Available Case summary A 6-year-old male domestic shorthair cat presented with frequent food regurgitation and dysphagia. Plain thoracic radiographs revealed a calcified mass overlying the topography of the mediastinum, as well as dilation of the cervical portion of the esophagus due to an accumulation of food. Endoscopic examination showed a severe extraluminal esophageal stricture at the mediastinum entrance. Surgery and a gastric tube were declined by the cat’s owner, with palliative support preferred. However, 1 year later, the cat presented with severe cachexia, dysphagia, salivation, dehydration and inspiratory dyspnea. Thoracic computed tomography was performed to evaluate the possibility of surgical resection. A mass of bone density originating in the second left rib was observed. The mass did not appear to have invaded adjacent structures but marked compression of the mediastinal structures was observed. Surgical resection was performed and a prosthetic mesh was used to reconstruct the thoracic wall. Transient Horner’s syndrome developed in the left eye postoperatively, and was resolved within 4 weeks. Histopathology revealed a benign osteoma. Thirty-two months after surgery, the cat was well and free of disease. Relevance and novel information Rib tumors should be included in a differential diagnosis in cats with extraluminal esophageal stricture. CT should be performed for treatment planning. Surgical treatment was curative in this case.

  7. Infiltration of hypertrophic esophageal smooth muscle by mast cells and basophils. (United States)

    Tung, H N; Schulze-Delrieu, K; Shirazi, S


    Partial obstruction leads to chronic distension and muscular hypertrophy of the opossum esophagus. The smooth muscle cells of the circular muscle layer enlarge, become pleomorphic and are surrounded by an amorphous ground substance in the extracellular space. Here we describe the histological and ultrastructural features of a peculiar cellular infiltrate in the hypertrophic smooth muscle. The infiltrate consisted uniquely of mast cells and basophils. In per unit area, the number of mast cells increased from 0.9 +/- 0.1 cells in controls to 3.7 +/- 0.2 in hypertrophic smooth muscle; the corresponding numbers for basophils were 2.5 +/- 0.2 and 7.2 +/- 0.3 cells. Cells were seen primarily in the septal spaces of the circular muscle layer and at the interface of the circular and longitudinal muscle layer. The cytoplasm of basophils is normally packed with round and oval granules. The granules stain metachromatically and with varying intensity on Wright-Giemsa stains. On transmission electronmicroscopy, granules display a membrane and a great diversity in the structure of their luminal contents. In hypertrophic muscle, most granules were discharging their contents into the cytoplasm or extracellular space. The membranes of adjacent empty granules then fused to form a chain of vacuoles. Similar changes occurred also in the mast cells which differed from the basophil by their lack of nuclear lobulation and by the greater homogeneity of their cytoplasmic granules. It is possible that these inflammatory cells are involved in the reconstruction of the smooth muscle and its connective tissue which occur during esophageal distension and hypertrophy.

  8. Diversity of K+ channels in circular smooth muscle of opossum lower esophageal sphincter. (United States)

    Zhang, Y; Paterson, W G


    We previously demonstrated that a balance of K+ and Ca2+-activated Cl- channel activity maintained the basal tone of circular smooth muscle of opossum lower esophageal sphincter (LES). In the current studies, the contribution of major K+ channels to the LES basal tone was investigated in circular smooth muscle of opossum LES in vitro. K+ channel activity was recorded in dispersed single cells at room temperature using patch-clamp recordings. Whole-cell patch-clamp recordings displayed an outward current beginning to activate at -60 mV by step test pulses lasting 400 ms (-120 mV to +100 mV) with increments of 20 mV from holding potential of -80 mV ([K+]I = 150 mM, [K+]o = 2.5 mM). However, no inward rectification was observed. The outward current peaked within 50 ms and showed little or no inactivation. It was significantly decreased by bath application of nifedipine, tetraethylammonium (TEA), 4-aminopyridine (4-AP), and iberiotoxin (IBTN). Further combination of TEA with 4-AP, nifedipine with 4-AP, and IBTN with TEA, or vice versa, blocked more than 90% of the outward current. Ca2+-sensitive single channels were recorded at asymetrical K+ gradients in cell-attached patch-clamp configurations (100.8+/-3.2 pS, n = 8). Open probability of the single channels recorded in inside-out patch-clamp configurations were greatly decreased by bath application of IBTN (100 nM) (Vh = -14.4+/-4.8 mV in control vs. 27.3+/-0.1 mV, n = 3, P < 0.05). These data suggest that large conductance Ca2+-activated K+ and delayed rectifier K+ channels contribute to the membrane potential, and thereby regulate the basal tone of opossum LES circular smooth muscle.

  9. Signal transduction of bombesin-induced circular smooth muscle cell contraction in cat esophagus

    Institute of Scientific and Technical Information of China (English)

    Sung-Uk Park; Chang-Yell Shin; Jung-Su Ryu; Hyen-O La; Sun-Young Park; Hyun-Ju Song; Young-Sil Min; Dong-Seok Kim; Uy-Dong Sohn


    AIM: To investigate the mechanism of bombesin-induced circular smooth muscle cell contraction in cat esophagus.METHODS: Specific G protein or phospholipase C involved in cat esophagus contraction was identified,muscle cells were permeabilized with saponin. After permeabilization of muscle cells, the Gi3 antibody inhibited bombesin-induced smooth muscle cell contraction.RESULTS: Incubation of permeabilized circular muscle cells with PLC-β3 antibody could inhibit bombesin-induced contraction. H-7, chelerythrine (PKC inhibitor)and genistein (protein tyrosine kinase inhibitor) inhibited bombesin-induced contraction, but DAG kinase inhibitor,R59949, could not inhibit it. To examine which mitogenactivated protein kinase (MAPK) was involved in bombesin-induced contraction, the specific MAPK inhibitors (MEK inhibitor, PD98059 and p38 MAPK inhibitor, SB202190)were used. Preincubation of PD98059 blocked the contraction induced by bombesin in a concentration-dependent manner. However, SB202190 had no effects on contraction.CONCLUSION: Bombesin-induced circular muscle cell contraction in cat esophagus is madiated via a PKC or a PTK-dependent pathway or p44/p42 MAPK pathway.

  10. Inhibitory effects of putative peptidic urotensin-II receptor antagonists on urotensin-II-induced contraction of cat isolated respiratory smooth muscle. (United States)

    Behm, David J; Ao, Zhaohui; Camarda, Valeria; Aiyar, Nambi V; Johns, Douglas G; Douglas, Stephen A


    Urotensin-II is purported to influence pulmonary function by modulating smooth muscle tone/growth. In the present study, Northern blot and reverse transcription polymerase chain reaction (RT-PCR) analysis indicated the presence of UT receptor mRNA in cat trachea, bronchi and lung parenchyma. Urotensin-II contracted cat isolated trachea and bronchi with similar potencies (pEC(50)s 8.61+/-0.07-8.81+/-0.10). Contractile efficacies ranged from 19+/-9% to 63+/-11% KCl in the primary and secondary bronchi. The peptidic UT receptor antagonists BIM-23127, SB-710411 and GSK248451 (7.18+/-0.12, 7.52+/-0.08 and 9.05+/-0.16 cat recombinant UT pK(i)s) inhibited urotensin-II-induced contraction of cat isolated trachea with pK(b)s 6.36+/-0.11, 6.74+/-0.07 and 9.27+/-0.12, respectively. As such, feline lung contains significant amounts of UT mRNA and this receptor appears to be functionally coupled to bronchoconstriction (the peptidic tool compound GSK248451 representing a sub-nanomolar inhibitor of such effects). These findings suggest that the cat represents a suitable species for future studies designed to assess the effects of the urotensin-II receptor on pulmonary (patho)physiology.

  11. Esophageal Cancer (United States)

    ... from your throat to your stomach. Early esophageal cancer usually does not cause symptoms. Later, you may ... You're at greater risk for getting esophageal cancer if you smoke, drink heavily, or have acid ...

  12. Expression of Kir3 gene and its subunits in human esophageal smooth muscle cells%人食管平滑肌细胞Kir3亚型表达的实验观察

    Institute of Scientific and Technical Information of China (English)

    卢强; 黄立军; 张志培; 刘同刚; 李小飞; 韩勇


    OBJECTIVE:To investigate the expression of Kir3 gene and its subunits in esophageal smooth muscles,a series of experiments was designed in this study. The difference of the expression between human esophageal longitudinal muscle(LM) and circular muscle(CM) cells were detected. METHODS:Normal esophageal smooth muscle was selected according to the 24 h esophageal pH testing,esophageal endoscopy.and HE staining. All primers were designed based on human gene sequences. The expression of Kir3. 1 - 3. 4 subunit mRNAs and total proteins were examined in human e-sophageal smooth muscle cells(SMCs) with the methods of reverse transcription polymerase chain reaction(RT-PCR) and western blot. RESULTS:The mRNA expressions of Kir3. 2,Kir3. 3,Kir3. 4 subunits were 0. 121 ±0. 015 and 0. 124± 0. 017,0. 255±0. 018 and 0. 295 ± 0. 028,0. 685 ± 0. 040 and 0. 693 ± 0. 037 respectively. The protein expressions of Kir3. 2.Kir3. 3,Kir3. 4 subunits were 0. 053±0. 010 and 0.068 ± 0.009,0. 160 ± 0.021 and 0. 192 ± 0.032,0.488 + 0.040 and 0. 504 + 0. 033 respectively. The most abundant expression was the Kir3. 4 subunit. The Kir3. 2 and Kir3. 4,Kir3. 3 and Kir3. 4 expression were both significantly differenUP0. 05). CONCLUSIONS:Expression of Kir 3. 2 - 3. 4 subunits was found in human esophageal SMCs except Kir3.1. The Kir3. 4 subunit was the most abundant expression. The expression of Kir3, 2 - 3. 4 was not significantly different in human esophageal LM and CM.%目的:探讨食管下段平滑肌中是否表达Kir3及其各亚型之间表达的差异性,同时明确食管环形平滑肌(CM)与纵行平滑肌(LM)之间表达的区别.方法:根据24 h食管pH值检测、食管镜检查及HE染色结果,分辨、筛选正常人食管平滑肌,按人Kir3.1~3.4序列设计并合成各自的高效引物,利用RT-PCR、蛋白质印迹法检测人食管平滑肌细胞中Kir3的表达及其亚型Kir3.1~3.4表达的差异.结果:在人食管LM、CM层平滑肌细

  13. [The effect of prostatilen on the contractile activity of the smooth-muscle cells of the blood vessels and bladder in cats]. (United States)

    al-Shchukri, S Kh; Barabanov, S V; Barabanova, V V; Bobkov, Iu A; Gorbachev, A G; Parastaeva, M M


    Prostatilene enhanced the functional activity of the bladder and blood vessels' smooth muscle cells. A possibility of activation of the smooth muscle cells contractility with prostatilene by a pharmaco-mechanical association, is discussed.

  14. Esophageal cancer. (United States)

    Vakil, Nimish; Affi, Aboud


    Despite advances in our knowledge of esophageal cancer, 50% of patients present with incurable disease, and the overall survival after diagnosis is poor. The incidence of esophageal adenocarcinoma of the distal esophagus is rising at a rapid rate in developed countries. Recent advances in the epidemiology of esophageal cancer offer insights into preventive strategies in patients who are at risk. New developments in diagnosis may help detect the disease at an early stage. New diagnostic modalities permit more accurate staging procedures and allow appropriate selection of therapy. New studies provide more information on multimodality therapy for esophageal cancer, and new endoscopic techniques allow resection of small lesions without surgery. New stent designs provide better palliation by providing tumor ingrowth. These developments in the treatment of esophageal cancer are the focus of this review.

  15. Esophageal Cancer Prevention (United States)

    ... the lower part of the esophagus, near the stomach. See the following PDQ summaries for more information about esophageal cancer: Esophageal Cancer Screening Esophageal Cancer Treatment Esophageal cancer is found more ...

  16. 旋覆代赭汤对反流性食管炎家兔食管下括约肌L型钙通道的作用研究%Regulation of L-type Calcium Channels by Xuanfu Daizhe Soup in the Lower Esophageal Sphincter Smooth Muscle of Rabbit Reflux Esophagitis Model

    Institute of Scientific and Technical Information of China (English)

    张俊杰; 吴茂申


    Objective]To research the regulation of L-type calcium channels by Xuanfu Daizhe soup in the lower esophageal sphincter(LES) smooth muscle of rabbit reflux esophagitis model induced by mixed perfusion of hydrochloric acid and bile. [Methods]Established the rabbit model of mixed reflux esophagitis, nifedipine was used to block L-type calcium channel.The muscle tension of L-type calcium channel were compared among groups in the experiments. [Results]The calcium releasing and flowing phase of LES in the model group was higher than that in the normal group, the whole recipe group, sweet-scending group, the getting rid of bitter-reducing group and the getting rid of lifting and declining group( P0.05). There was no significant difference between the normal group and the whole recipe group in calcium releasing and flowing phase of LES( P>0.05). [Conclusion]The decreasing of reflux esophagitis model LES tension was relevant with the L-type calcium channel dysfunction;Xuanfu Daizhe soup could improve the LES tension by regulating L-type calcium channels. The sweet-ascending group had a remarkable effect among those dismantle prescription groups.%[目的]研究旋覆代赭汤对酸和胆汁混合致反流性食管炎家兔食管下括约肌(LES)L型钙通道的调控机制。[方法]制备家兔反流性食管炎模型,用硝苯地平(nifedipine)阻断L型钙通道,比较各组LES环行肌L型钙通道阻断前后张力幅度的差异。[结果]L型钙通道阻断前后各组LES环行肌张力比较:正常组、全方组、甘升组、去苦降组、去升降相因组LES环行肌钙释放相、内流相张力均高于模型组(P<0.01),而苦降组、升降相因组、去甘升组LES环行肌钙释放相与模型组相比无显著性差异(P>0.05),正常组与全方组LES环行肌钙释放相、内流相张力相比无显著性差异(P>0.05)。[结论]酸和胆汁混合致反流性食管炎模型家兔LES环行肌张力下降,与L型钙通道功能障碍

  17. Esophageal anastomosis. (United States)

    Yuan, Y; Wang, K-N; Chen, L-Q


    This review gives an overview of the esophageal anastomosis. The history, various techniques and substitution organs, their advantages and disadvantages, healing mechanism, complications, and actual trend of this essential part of esophageal surgery are described. The history of the esophageal anastomosis extending from the first anastomosis in 1901 to today has undergone more than one century. In the early days, the success rate of the anastomosis was extremely low. As the technology progressed, the anastomosis got significant achievement. Various anastomotic techniques are currently being used. However, controversies exist on the choice of anastomotic method concerning the success rate, postoperative complication and quality of life. How to choose the method, no one can give the best answer. We searched the manuscripts about the esophageal anastomoses in recent years and studied the controversy questions about the anastomosis. Performing an esophageal anastomosis is a technical matter, and suture healing is independent of the patient's biologic situation. Every anastomosis technique has its own merit, but the outcomes were different if it was performed by different surgeons, and we also found that the complication rate of the anastomosis was mainly associated with the surgeons. So the surgeons should learn from their previous experience and others to avoid technical errors.

  18. Eosinophilic esophagitis

    Institute of Scientific and Technical Information of China (English)

    Anand R Gupte; Peter V Draganov


    Eosinophilic esophagitis is increasingly recognized in adults. The diagnosis is based on the presence of both typical symptoms and pathologic findings on esophageal biopsy. Patients usually present with dysphagia, food impaction and/or reflux-like symptoms, and biopsy of the esophagus shows more than 15 eosinophils per high-power field. In addition,it is essential to exclude the presence of known causes of tissue eosinophilia such as gastroesophageal reflux disease, infections, malignancy, collagen vascular diseases, hypersensitivity, and inflammatory bowel disease. There are no standardized protocols for the therapy of eosinophilic esophagitis. A variety of therapeutic approaches including acid suppression, dietary modi f icat ions, topical cor t icosteroids and endoscopic dilation can be used alone or in combination.

  19. Esophageal cancer

    DEFF Research Database (Denmark)

    Mortensen, M. B.


    The distribution of adenocarcinomas and squamous cell carcinomas in esophageal cancer (EC) has changed, and focus directed towards tumors of the distal esophagus and the esophagogastric junction. The genetic events leading to EC are not fully clarified, but important risk factors have been...

  20. Esophageal Mucormycosis

    Directory of Open Access Journals (Sweden)

    Benjamin Boatright


    Full Text Available Mucormycosis is a rare invasive fungal infection with high mortality. It usually affects patients with poorly controlled diabetes, immunosuppression, or hematological malignancies. Gastroenterologists need to be aware of this rare infection because endoscopy can facilitate early diagnosis and prompt appropriate therapy. Here we describe a case of invasive esophageal mucormycosis that developed in a 63-year-old man with diabetes, acute promyelocytic leukemia, and prolonged leukopenia after chemotherapy. Upper endoscopy showed distal circumferential esophageal wall thickening with devitalization. The mucosa did not bleed after endoscopic biopsy. Histopathology confirmed mucormycosis. He was treated with various antifungal agents including echinocandins, fluconazole, and liposomal amphotericin B. Despite aggressive antifungal therapy and supportive care, the patient died 24 days later.

  1. Distal esophageal spasm: an update. (United States)

    Achem, Sami R; Gerson, Lauren B


    Distal esophageal spasm (DES) is an esophageal motility disorder that presents clinically with chest pain and/or dysphagia and is defined manometrically as simultaneous contractions in the distal (smooth muscle) esophagus in ≥20% of wet swallows (and amplitude contraction of ≥30 mmHg) alternating with normal peristalsis. With the introduction of high resolution esophageal pressure topography (EPT) in 2000, the definition of DES was modified. The Chicago classification proposed that the defining criteria for DES using EPT should be the presence of at least two premature contractions (distal latencylong acting), calcium-channel blockers, anticholinergic agents, 5-phosphodiesterase inhibitors, visceral analgesics (tricyclic agents or SSRI), and esophageal dilation. Acid suppression therapy is frequently used, but clinical outcome trials to support this approach are not available. Injection of botulinum toxin in the distal esophagus may be effective, but further data regarding the development of post-injection gastroesophageal reflux need to be assessed. Heller myotomy combined with fundoplication remains an alternative for the rare refractory patient. Preliminary studies suggest that the newly developed endoscopic technique of per oral endoscopic myotomy (POEM) may also be an alternative treatment modality.

  2. Effects of puerarin on cat vascular smooth muscle in vitro%葛根素对猫离体血管平滑肌的作用

    Institute of Scientific and Technical Information of China (English)

    王磊一; 赵爱平; 柴象枢


    Puerarin is an isoflavone com-pound isolated from Pueraria lobata (Willd).This study characterized the vascular action of puerarin in order to more clearly elucidate its pharmacological activities. Helically cut strips of cat femoral veins and renal arteries were suspended in an organ chamber filled with Krebs bicarbonate solution for measurement of isometric force development. In the cases of femoral veins and renal arteries isoproterenol(0.01 μmol·L-1 -0. 1 mmol·L-1) caused re- laxation of methoxamine-induced contraction (0. 01 mmol ·L-1) in a concentration-relatedmanner. Puerarin (0. 01-0. 1 mmol·L-1) inhibited the relaxation response to isoproterenol in aconcentration-response fashion. Propra-nolol (0. 1-1 μmol·L-1) inhibited the isopro-terenol-induced relaxationtoo. Puerarin (0. 1mmol· L-1) did not alter the rolaxation response to nitroglycerin (1 μmol·L-1).These results indicated that puerarin acted as a beta-adrenoreceptor an tagonist in isolated arteries and veins.%本文研究葛根素对离体血管的作用.异丙肾上腺素使猫的股静脉及肾动脉对甲氧明引发的收缩产生的舒张作用呈剂量依赖式.葛根素能阻滞此种舒张反应,并呈剂量依赖式.普萘洛尔也能阻滞异丙肾上腺素引起的这种舒张.葛根素不能阻滞硝酸甘油引起的舒张反应.这些结果表明葛根素对猫的离体静脉及动脉具有β-受体阻断作用.

  3. Esophageal Strictures in Children

    Directory of Open Access Journals (Sweden)

    Ahmad Bazrafshan


    Conclusion: Anastomotic stricture after surgical repair of esophageal atresia comprised the most common cause of esophageal stricture. Proximal esophagus was the most common site of stricture. Most of the patients recovered with dilatation, surgery, or a combination of the two.

  4. Cat parasites


    Vošická, Kristýna


    The content of this bachelor thesis describes a different variety of cat parasites. This study discovers that the most infected group of the outdoor cats due to the fact that these animals are not provided with the same care as the household pets. Those cats are usually not vaccinated, not rid of worms, no one takes care of their fur and so they tend to become a host for the parasites. There are several kinds of parasites which attack cats. Among those belong the skin parasites like a cat fle...

  5. Characterization of esophageal physiology using mechanical state analysis

    Directory of Open Access Journals (Sweden)

    Richard Eduard Leibbrandt


    Full Text Available The esophagus functions to transport swallowed fluids and food from the pharynx to the stomach. The esophageal muscles governing bolus transport comprise circular striated muscle of the proximal esophagus and circular smooth muscle of the distal esophagus. Longitudinal smooth muscle contraction provides a mechanical advantage to bolus transit during circular smooth muscle contraction. Esophageal striated muscle is directly controlled by neural circuits originating in the central nervous system, resulting in coordinated contractions. In contrast, the esophageal smooth muscle is controlled by enteric circuits modulated by extrinsic central neural connections resulting in neural relaxation and contraction. The esophageal muscles are modulated by sensory information arising from within the lumen. Contraction or relaxation, which changes the diameter of the lumen, alters the intraluminal pressure and ultimately inhibits or promotes flow of content. This relationship that exists between the changes in diameter and concurrent changes in intraluminal pressure has been used previously to identify the ‘mechanical states’ of the circular muscle; that is when the muscles are passively or actively, relaxing or contracting. Detecting these changes in the mechanical state of the muscle has been difficult and, as the current interpretation of esophageal motility is based largely upon pressure measurement (manometry, subtle changes in the muscle function during peristalsis can be missed. We hypothesized that quantification of mechanical states of the esophageal circular muscles and the pressure-diameter properties that define them, would allow objective characterization of the mechanisms that govern esophageal peristalsis. To achieve this we analyzed barium swallows captured by simultaneous videofluoroscopy and pressure with impedance recording. From these data we demonstrated that intraluminal impedance measurements could be used to determine changes in the

  6. Esophageal lichen planus


    Oliveira,Janine Pichler de; Uribe, Natalia Caballero; Abulafia,Luna Azulay; Quintella, Leonardo Pereira


    Abstract Lichen planus is a chronic inflammatory disease that affects the skin, mucous membranes, nails and scalp. Esophageal lichen planus is a rarely reported manifestation of lichen planus, presenting itself commonly in middle-aged women, with symptoms such as dysphagia. We report a case of esophageal lichen planus in a 54-year-old woman associated with oral, cutaneous and ungual lichen planus. Although lichen planus is a disorder well known by dermatologists, reports of esophageal lichen ...

  7. Esophageal capsule endoscopy

    Institute of Scientific and Technical Information of China (English)

    Ignacio Fernandez-Urien; Cristina Carretero; Raul Armendariz; Miguel Mu(n)oz-Navas


    Capsule endoscopy is now considered as the first imaging tool for small bowel examination.Recently,new capsule endoscopy applications have been developed,such as esophageal capsule endoscopy and colon capsule endoscopy.Esophageal capsule endoscopy in patients with suspected esophageal disorders is feasible and safe,and could be also an alternative procedure in those patients refusing upper endoscopy.Although large-scale studies are needed to confirm its utility in GERD and cirrhotic patients,current results are encouraging and open a new era in esophageal examination.

  8. Esophageal lichen planus. (United States)

    Oliveira, Janine Pichler de; Uribe, Natalia Caballero; Abulafia, Luna Azulay; Quintella, Leonardo Pereira


    Lichen planus is a chronic inflammatory disease that affects the skin, mucous membranes, nails and scalp. Esophageal lichen planus is a rarely reported manifestation of lichen planus, presenting itself commonly in middle-aged women, with symptoms such as dysphagia. We report a case of esophageal lichen planus in a 54-year-old woman associated with oral, cutaneous and ungual lichen planus. Although lichen planus is a disorder well known by dermatologists, reports of esophageal lichen planus are rare in dermatologic literature. The esophageal lichen planus is little known and underdiagnosed, with a significant delay between the onset of symptoms and diagnosis.

  9. Cat Scan

    Institute of Scientific and Technical Information of China (English)


    <正> A man takes his motionless dog to the vet."Doc,I think my dog is dead.”The vet looks the dog over, goes into a backroom,and comes out with a cat.He places the caton the table next to the dog.The cat walks aroundand sniffs at the dog.The dog does not move.The

  10. Brain metastasis from esophageal carcinoma

    Directory of Open Access Journals (Sweden)

    Almasi Saeid


    Full Text Available Brain metastasis from esophageal carcinoma is rare. In our center, among 301 cases of esophageal cancer referred for radiotherapy during a 14-year period, brain metastasis from esophageal carcinoma was detected in one case. An unusual case of esophageal carcinoma that presented with brain metastasis is reported.

  11. Radiation Therapy, Paclitaxel, and Carboplatin With or Without Trastuzumab in Treating Patients With Esophageal Cancer (United States)


    Adenocarcinoma of the Gastroesophageal Junction; Esophageal Adenocarcinoma; Stage IB Esophageal Cancer; Stage IIA Esophageal Cancer; Stage IIB Esophageal Cancer; Stage IIIA Esophageal Cancer; Stage IIIB Esophageal Cancer

  12. Cat and Dog Bites (United States)

    ... Prevention and Wellness Staying Healthy Pets and Animals Cat and Dog Bites Cat and Dog Bites Pets and AnimalsPrevention and WellnessStaying Healthy Share Cat and Dog Bites Cat and dog bites are ...

  13. Cat Scratch Disease (United States)

    Cat scratch disease (CSD) is an illness caused by the bacterium Bartonella henselae. Almost half of all cats carry ... infection does not make cats sick. However, the scratch or bite of an infected cat can cause ...

  14. My Cat

    Institute of Scientific and Technical Information of China (English)

    王悦; 李成梅


    The name of my cat is Naty. This year he is one year old. He isvery fat, but he is very nice. He has a big round white head. His mouth and nose are small. His eyes are interesting. In the day,they are small and black,but at night they are big and blue.

  15. Methylation in esophageal carcinogenesis

    Institute of Scientific and Technical Information of China (English)

    Da-Long Wu; Feng-Ying Sui; Xiao-Ming Jiang; Xiao-Hong Jiang


    Genetic abnormalities of proto-oncogenes and tumor suppressor genes have been demonstrated to be changes that are frequently involved in esophageal cancer pathogenesis. However, hypermethylation of CpG islands, an epigenetic event, is coming more and more into focus in carcinogenesis of the esophagus. Recent studies have proved that promoter hypermethylation of tumor suppressor genes is frequently observed in esophageal carcinomas and seems to play an important role in the pathogenesis of this tumor type. In this review, we will discuss current research on genes that are hypermethylated in human esophageal cancer and precancerous lesions of the esophagus. We will also discuss the potential use of hypermethylated genes as targets for detection, prognosis and treatment of esophageal cancer.

  16. Smooth magnetogenesis

    CERN Document Server

    Campanelli, L


    In the Ratra scenario of inflationary magnetogenesis, the kinematic coupling between the photon and the inflaton undergoes a nonanalytical jump at the end of inflation. Using smooth interpolating analytical forms of the coupling function, we show that such unphysical jump does not invalidate the main prediction of the model, which still represents a viable mechanism for explaining cosmic magnetization. Nevertheless, there is a spurious result associated with the nonanaliticity of the coupling, to wit, the prediction that the spectrum of created photons has a power-law decay in the ultraviolet regime. This issue is discussed using both semiclassical approximation and smooth coupling functions.

  17. Oral and esophageal disorders. (United States)

    Noyer, C M; Simon, D


    This article focused on the approach to oral and esophageal disorders in patients with AIDS. Most of these disorders respond to various therapeutic regimens. Some of the oral complications can be prevented with dental prophylaxis, whereas recurrent esophageal disease in some patients may require long-term suppressive therapy. As patients with AIDS live longer with lower CD4 counts, gastroenterologists need to become familiar with the approach to and management of the more common lesions of the mouth and esophagus.

  18. A Catalogue of Anatomical Fugitive Sheets: Cat. 49-62



    Images Cat. 50 Cat. 51 Cat. 53 Cat. 54 Cat. 55 (a) Cat. 55 (b) Cat. 56 Cat. 57: 1 Cat. 57: 2 Cat. 57: 3 Cat. 57: 4 Cat. 59: 1 Cat. 59: 2 Cat. 59: 3 Cat. 59: 4 Cat. 60 Cat. 61 Cat. 62: 1 (a) Cat. 62: 1 (b) Cat. 62: 2 (a) Cat. 62: 2 (b)

  19. Smoothed Invariants

    CERN Document Server

    Dye, H A


    We construct two knot invariants. The first knot invariant is a sum constructed using linking numbers. The second is an invariant of flat knots and is a formal sum of flat knots obtained by smoothing pairs of crossings. This invariant can be used in conjunction with other flat invariants, forming a family of invariants. Both invariants are constructed using the parity of a crossing.

  20. A Catalogue of Anatomical Fugitive Sheets: Cat. 26-48



    Images Cat. 26: 1 (a) Cat. 26: 1 (b) Cat. 26: 2 (a) Cat. 26: 2(b) Cat. 27: 1 (a) Cat. 27: 1 (b) Cat. 27: 2 (a) Cat. 27: 2 (b) Cat. 28 Cat. 29: 2 (a) Cat. 29: 2 (b) Cat. 30: 1 Cat. 30: 2 Cat. 30: 3 Cat. 33 Cat. 34: 1 Cat. 34: 2 Cat. 35: 1 Cat. 35: 2 Cat. 35: 3 Cat. 36 Cat. 37 Cat. 38: 1 Cat. 38: 2 Cat. 40 Cat. 42 Cat. 43 Cat. 44 Cat. 45: 1 Cat. 45: 2 Cat. 46 Cat. 47: 1 Cat. 47: 2 Cat. 47: 3 Cat. 48: 1 Cat. 48: 2 Cat. 48: 3

  1. black cat

    Institute of Scientific and Technical Information of China (English)



    The black cat is a masterpiece of short fiction of Poe. He successfully solved the problem of creating of the horror effect by using scene description, symbol, repetition and first-person narrative methods. And created a complete and unified mysterious terror, achieved the effect of shocking. This paper aims to discuss the mystery in-depth and to enrich the research system in Poe’s novels.

  2. Esophageal motility disorders; Motilitaetsstoerungen des Oesophagus

    Energy Technology Data Exchange (ETDEWEB)

    Hannig, C.; Rummeny, E. [Klinikum rechts der Isar der Technischen Universitaet Muenchen, Institut fuer Roentgendiagnostik, Muenchen (Germany); Wuttge-Hannig, A. [Gemeinschaftspraxis fuer Radiologie, Nuklearmedizin und Strahlentherapie, Muenchen (Germany)


    For the better understanding of esophageal motility, the muscle texture and the distribution of skeletal and smooth muscle fibers in the esophagus are of crucial importance. Esophageal physiology will be shortly mentioned as far as necessary for a comprehensive understanding of peristaltic disturbances. Besides the pure depiction of morphologic criteria, a complete esophageal study has to include an analysis of the motility. New diagnostic tools with reduced radiation for dynamic imaging (digital fluoroscopy, videofluoroscopy) at 4-30 frames/s are available. Radiomanometry is a combination of a functional pressure measurement and a simultaneous dynamic morphologic analysis. Esophageal motility disorders are subdivided by radiologic and manometric criteria into primary, secondary, and nonclassifiable forms. Primary motility disorders of the esophagus are achalasia, diffuse esophageal spasm, nutcracker esophagus, and the hypertonic lower esophageal sphincter. The secondary motility disorders include pseudoachalasia, reflux-associated motility disorders, functionally caused impactions, Boerhaave's syndrome, Chagas' disease, scleroderma, and presbyesophagus. The nonclassificable motility disorders (NEMD) are a very heterogeneous collective. (orig.) [German] Zum Verstaendnis der Motilitaet des Oesophagus sind muskulaere Architektur und Verteilung der quergestreiften und glatten Muskelfasern von Bedeutung. Die Physiologie des Oesophagus wird in soweit kurz dargestellt, als sie fuer das Verstaendnis von peristaltischen Stoerungen notwendig ist. Neben der Erfassung rein morphologischer Kriterien ist bei der Untersuchung der Speiseroehre eine diagnostische Bewertung der Motilitaet erforderlich. Es stehen uns heute strahlungsarme dynamische Aufzeichnungsverfahren (digitale dynamische Aufzeichnung, Videofluoroskopie) mit Bildsequenzen von 4-30 Bildern/s zur Verfuegung. Die Kombination einer funktionellen Methode zur Darstellung der Morphologie und der

  3. Radiation-Induced Esophagitis is Mitigated by Soy Isoflavones

    Directory of Open Access Journals (Sweden)

    Matthew D Fountain


    Full Text Available Introduction: Lung cancer patients receiving radiotherapy present with acute esophagitis and chronic fibrosis, as a result of radiation injury to esophageal tissues. We have shown that soy isoflavones alleviate pneumonitis and fibrosis caused by radiation toxicity to normal lung. The effect of soy isoflavones on esophagitis histopathological changes induced by radiation was investigated. Methods: C57BL/6 mice were treated with 10 Gy or 25 Gy single thoracic irradiation and soy isoflavones for up to 16 weeks. Damage to esophageal tissues was assessed by H&E, Masson’s Trichrome and Ki-67 staining at 1, 4, 10, 16 weeks after radiation. The effects on smooth muscle cells and leukocyte infiltration were determined by immunohistochemistry using anti-αSMA and anti-CD45 respectively. Results: Radiation caused thickening of esophageal tissue layers that was significantly reduced by soy isoflavones. Major radiation alterations included hypertrophy of basal cells in mucosal epithelium and damage to smooth muscle cells in muscularis mucosae as well as disruption of collagen fibers in lamina propria connective tissue with leukocyte infiltration. These effects were observed as early as one week after radiation and were more pronounced with a higher dose of 25 Gy. Soy isoflavones limited the extent of tissue damage induced by radiation both at 10 and 25 Gy.Conclusions: Soy isoflavones have a radioprotective effect on the esophagus, mitigating the early and late effects of radiation injury in several esophagus tissue layers. Soy could be administered with radiotherapy to decrease the incidence and severity of esophagitis in lung cancer patients receiving thoracic radiation therapy.

  4. Treatment Options by Stage (Esophageal Cancer) (United States)

    ... Cancer Prevention Esophageal Cancer Screening Research Esophageal Cancer Treatment (PDQ®)–Patient Version General Information About Esophageal Cancer ... Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment ...

  5. Esophageal epiphrenic diverticulum associated with diffuse esophageal spasm (United States)

    Matsumoto, Hideo; Kubota, Hisako; Higashida, Masaharu; Manabe, Noriaki; Haruma, Ken; Hirai, Toshihiro


    Introduction Esophageal diverticulum, a relatively rare condition, has been considered to be associated with motor abnormalities such as conditions that cause a lack of coordination between the distal esophagus and lower esophageal sphincter. Presentation of case We herein report a case of esophageal epiphrenic diverticulum associated with diffuse esophageal spasm. A 73-year-old woman presented with dysphagia and regurgitation. Imaging examinations revealed a right-sided esophageal diverticulum located about 10 cm above the esophagogastric junction. High-resolution manometry revealed normal esophageal motility. However, 24-h pH monitoring revealed continuous acidity due to pooling of residue in the diverticulum. An esophageal epiphrenic diverticulum was diagnosed and resected thoracoscopically. Her dysphagia recurred 2 years later. High-resolution manometry revealed diffuse esophageal spasm. Discussion The diverticulum in the present case was considered to have been associated with diffuse esophageal spasm. The motility disorder was likely not identified at the first evaluation. Conclusion In this case, the patient’s symptoms spontaneously resolved without any treatment; however, longer-term follow-up is needed. PMID:26143577

  6. Esophagitis Induced by Doxycycline Treatment

    Directory of Open Access Journals (Sweden)

    Engin Şenel


    Full Text Available Esophagitis is the most common disease of the esophagus. Drug use is one of the reasons of chemical esophagitis. Herein, we report two male patients of 17 and 18 years of age who developed esophagitis in acne treatment with doxycycline. Both patients took doxycycline capsules for approximately one week. Ulcerations were detected at upper and mid-esophagus of the 17-year-old patient. Circular ulcerations were found at mid-esophagus of the 18-year-old case. Doxycycline induced esophagitis is a preventable disease with the physician giving appropriate medication ingestion advice to the patient.

  7. Epidemiological investigation of esophageal carcinoma

    Institute of Scientific and Technical Information of China (English)

    Hong Zhang; Shao-Hua Chen; You-Ming Li


    AIM: To review the characteristics of esophageal carcinoma in recent 30 years in the epidemiological investigation.METHODS: A total of 1 520 cases of esophageal carcinoma in the First Affiliated Hospital of Zhejiang University Medical College admitted from 1970 until now were reviewed. Their age, gender, position of carcinoma and histological type were analyzed.RESULTS: The morbidity of esophageal carcinoma was increasing during the observation period. Compared with the 1970s (9.5%), the ratio of adenocarcinoma significantly increased after the 1980s (19.1%). The difference was significant (P≤0.05).CONCLUSION: The morbidity of esophageal adenocarcinoma was increasing and advanced clinical study should be strengthened.

  8. Atrio-esophageal fistula complicating esophageal achalasia. (United States)

    Achouh, Paul; Pouly, Julia; Azarine, Arshid; Fabiani, Jean-Noël


    A 75-year-old male, known to have achalasia, was admitted to the intensive care unit with massive upper gastrointestinal bleeding and sepsis. He had a history of purulent pericarditis 18 months earlier. He also presented with atrial fibrillation associated with a cerebral transient ischemic accident two months earlier. A contrast computed tomography scan showed an atrio-esophageal fistula with active extravasation of contrast. He was operated on via a median sternotomy, and the defects in the atrial wall, inferior vena cava and diaphragm were closed using pericardial patches. An esophagectomy was to be performed 24 hours later, but the patient died from septic shock and multiple organ failure before his second procedure.

  9. [Giant esophageal fibrovascular polyp]. (United States)

    Palacios, Fernando; Contardo, Carlos; Guevara, Jorge; Vera, Augusto; Aguilar, Luis; Huamán, Manuel; Palomino, Américo; Yabar, Alejandro


    Fibrovascular polyps are extremely rare benign neoplasias of the esophagus, which usually originate in the lower cricoid area. They do not produce any discomfort in the patient for a long time, however it may make itself evident by the patient's regurgitation of the polyp, producing asphyxia or, more frequently, dysphagia. The case of a 58 year old male patient is presented herein, with a 9 month record of dysphagia, weight loss and intermittent melena. The barium x-ray showed a distended esophagus, with a tumor running from the upper esophageal sphincter to the cardia. The endoscopy confirmed the presence of a pediculated tumor, implanted in the cervical esophagus. Surgeons suspected the potential malignancy of the tumor and performed a transhiatal esophagectomy. The final pathologic diagnosis was giant fibrovascular esophageal polyp.

  10. Esophageal Inlet Patch

    Directory of Open Access Journals (Sweden)

    C. Behrens


    Full Text Available An inlet patch is a congenital anomaly consisting of ectopic gastric mucosa at or just distal to the upper esophageal sphincter. Most inlet patches are largely asymptomatic, but in problematic cases complications related to acid secretion such as esophagitis, ulcer, web and stricture may occur. The diagnosis of inlet patch is strongly suggested on barium swallow where the most common pattern consists of two small indentations on the wall of the esophagus. The diagnosis of inlet patch is confirmed via endoscopy with biopsy. At endoscopy, the lesion appears salmon-coloured and velvety and is easily distinguished from the normal grey-white squamous epithelium of the esophagus. The prominent margins correlate with the radiological findings of indentations and rim-like shadows on barium swallow. Histopathology provides the definitive diagnosis by demonstrating gastric mucosa adjacent to normal esophageal mucosa. No treatment is required for asymptomatic inlet patches. Symptomatic cases are treated with proton pump inhibitors to relieve symptoms related to acid secretion. Strictures and webs are treated with serial dilatation and should be biopsied to rule out malignancy.

  11. Effect of Lonicerae Flos extracts on reflux esophagitis with antioxidant activity

    Institute of Scientific and Technical Information of China (English)

    Sae-Kwang Ku; Bu-Il Seo; Ji-Ha Park; Gyu-Yeol Park; Young-Bae Seo; Jae-Soo Kim; Hyeung-Sik Lee; Seong-Soo Roh


    AIM: To observe the effects of traditional antiinflammatory medicine Lonicerae Flos (LF) on rat reflux esophagitis (RE) induced by pylorus and forestomach ligation compared with the well-known proton antioxidant, α-tocopherol. METHODS: Rat s were pret reated wi th three different dosages of LF (500, 250 and 125 mg/kg) orally, once a day for 14 d before pylorus and forestomach ligation. Nine hours after pylorus and forestomach ligation, changes to the stomach and esophagus lesion areas, gastric volumes, acid and pepsin outputs, antioxidant effects, esophageal lipid peroxidation, superoxide dismutase (SOD), catalase (CAT), malondialdehyde (MDA), myeloperoxidase and glutathione (GSH) levels, and collagen contents (marker of flexibility) were observed on the esophageal and fundic histopathology. The results were compared with an α-tocopherol (once orally, 1 h before operation, 30 mg/kg) treated group in which the effects on RE were already confirmed. RESULTS: Pylorus and forestomach ligations caused marked increases of gross esophageal and gastric mucosa lesion areas, which corresponded with histopathological changes. In addition, increases of esophageal lipid peroxidation, decreases of SOD, CAT, and GSH-free radical scavengers, increases of collagen were observed. However, these pylorus and forestomach ligation induced RE were dose-dependently inhibited by treatment of 500, 250 and 125 mg/kg of LF extract, mediated by antioxidant effects. RE at 250 mg/kg showed similar effects α-tocopherol. CONCLUSION: The results suggest that antioxidant effects of LF could attenuate the severity of RE and prevent the esophageal mucosal damage, and validate its therapeutic use in esophageal reflux disease.

  12. Dietary habits and esophageal cancer. (United States)

    Palladino-Davis, A G; Mendez, B M; Fisichella, P M; Davis, C S


    Cancer of the esophagus is an underestimated, poorly understood, and changing disease. Its overall 5-year survival is less than 20%, even in the United States, which is largely a function of a delay in diagnosis until its more advanced stages. Additionally, the epidemiologic complexities of esophageal cancer are vast, rendering screening and prevention limited at best. First, the prevalence of esophageal cancer is unevenly distributed throughout the world. Second, the two histological forms (squamous cell and adenocarcinoma) vary in terms of their geographic prevalence and associated risk factors. Third, some populations appear at particular risk for esophageal cancer. And fourth, the incidence of esophageal cancer is in continuous flux among groups. Despite the varied prevalence and risks among populations, some factors have emerged as consistent associations while others are only now becoming more fully recognized. The most prominent, scientifically supported, and long-regarded risk factors for esophageal cancer are tobacco, alcohol, and reflux esophagitis. Inasmuch as the above are regarded as important risk factors for esophageal cancer, they are not the sole contributors. Dietary habits, nutrition, local customs, and the environment may be contributory. Along these lines, vitamins, minerals, fruits, vegetables, meats, fats, salted foods, nitrogen compounds, carcinogens, mycotoxins, and even the temperature of what we consume are increasingly regarded as potential etiologies for this deadly although potentially preventable disease. The goal of this review is to shed light on the less known role of nutrition and dietary habits in esophageal cancer.

  13. Coexistence of gastrointestinal stromal tumor, esophageal and gastric cardia carcinomas. (United States)

    Zhou, Yong; Wu, Xu-Dong; Shi, Quan; Jia, Jing


    Gastric gastrointestinal stromal tumor (GIST), esophageal squamous cell carcinoma and gastric cardia adenocarcinoma are distinct neoplasms originating from different cell layers; therefore, simultaneous development of such carcinomas is relatively rare. Auxiliary examinations revealed coexistence of esophageal and gastric cardia carcinoma with lymph node metastasis in a 77-year-old man. Intraoperatively, an extraluminal tumor (about 6.0 cm × 5.0 cm × 6.0 cm) at the posterior wall of the gastric body, a tumor (about 2.5 cm × 2.0 cm) in the lower esophagus, and an infiltrative and stenosing tumor (about 1.0 cm × 2.0 cm) in the gastric cardia were detected. Wedge resection for extraluminal gastric tumor, radical esophagectomy for lower esophageal tumor, and cardiac resection with gastroesophageal (supra-aortic arch anastomoses) were performed. Postoperative histological examination showed synchronous occurrence of gastric GIST, esophageal squamous cell carcinoma, and gastric cardia adenocarcinoma. Furthermore, immunohistochemistry indicated strong staining for c-Kit/CD117, Dog-1, Ki-67 and smooth muscle, while expression of S-100 and CD34 was negative.

  14. Relative Smooth Topological Spaces

    Directory of Open Access Journals (Sweden)

    B. Ghazanfari


    Full Text Available In 1992, Ramadan introduced the concept of a smooth topological space and relativeness between smooth topological space and fuzzy topological space in Chang's (1968 view points. In this paper we give a new definition of smooth topological space. This definition can be considered as a generalization of the smooth topological space which was given by Ramadan. Some general properties such as relative smooth continuity and relative smooth compactness are studied.

  15. Gender effects on esophageal motility

    Directory of Open Access Journals (Sweden)

    Dantas R.O.


    Full Text Available It has been suggested that there are no gender effects on esophageal motility. However, in previous studies the subjects did not perform multiple swallows and the quantitative features of esophageal contractions were not evaluated. In order to investigate the gender effects on esophageal motility we studied 40 healthy normal volunteers, 20 men aged 37 ± 15 years (mean ± SD, and 20 women aged 38 ± 14 years. We used the manometric method with an eight-lumen polyvinyl catheter and continuous perfusion. The upper and lower esophageal sphincter pressures were measured by the rapid pull-through method. With the catheter positioned with one lumen opening in the lower esophageal sphincter, and the others at 5, 10 and 15 cm above the sphincter, ten swallows of a 5-ml water bolus alternated with ten dry swallows were performed. Statistical analysis was done by the Student t-test and Mann-Whitney test. Gender differences (P<0.05 were observed for wet swallows in the duration of contractions 5 cm above the lower esophageal sphincter (men: 3.7 ± 0.2 s, women: 4.5 ± 0.3 s, mean ± SEM, and in the velocity of contractions from 15 to 10 cm above the lower esophageal sphincter (men: 4.7 ± 0.3 cm/s, women: 3.5 ± 0.2 cm/s. There was no difference (P>0.05 in sphincter pressure, duration and percentage of complete lower esophageal sphincter relaxation, amplitude of contractions, or in the number of failed, multipeaked and synchronous contractions. We conclude that gender may cause some differences in esophageal motility which, though of no clinical significance, should be taken into consideration when interpreting esophageal motility tests.

  16. [Prevalence of erosive esophagitis and peptic esophageal strictures]. (United States)

    Vasilevskiĭ, D I; Skurikhin, S S; Luft, A V; Mednikov, S N; Silant'ev, D S; Kulagin, V I; Dvoretskiĭ, S Iu; Bagnenko, S F


    Gastroesophageal reflux disease is a widespread among population in economically developed countries including Russia. It was analyzed the results of 34 903 endoscopic examinations of upper gastrointestinal tract in ethnically and socially homogeneous population of Leningrad region with symptoms of gastric dispepsia. Procedures were performed for the period 2007-2013. Prevalence of erosive esophagitis was 4.9%. Peptic esophageal strictures due to chronic reflux-associated inflammation were revealed in 0.2% of examined patients (3.7% of patients with erosive esophagitis). Obtained data allow to considergastroesophageal reflux disease as a socially significant problem in Russia requiring close attention and further study.

  17. Endoscopic appearance of esophageal hematomas

    Institute of Scientific and Technical Information of China (English)

    Rodica Ouatu-Lascar; Gayatri Bharadhwaj; George Triadafilopoulos


    @@INTRODUCTION Esophageal hematomas develop from the dissection of the mucosa from the muscular layers of the esophageal wall and represent an uncommon condition affecting all ages[t-3]. Although the most common cause of esophageal hematomas is iatrogenic mechanical injury-induced by prolonged nasogastric intubation, difficult or forceful endoscopic intubation, or the result of variceal injection sclerotherapy- some may be spontaneous,particularly in patients receiving anticoagulants[3-6]. Presenting symptoms most commonly include dysphagia, hematemesis, and sub-sternal or epigastric pain[5,9].

  18. A Catalogue of Anatomical Fugitive Sheets: Cat. 1-10



    Images Cat. 1 Cat. 2 (a) Cat. 2 (b) Cat. 2 (c) Cat. 2 (d) Cat. 2 (e) Cat. 2 (f) Cat. 3: 1 (a) Cat. 3: 1 (b) Cat. 3: 2 (a) Cat. 3: 2 (b) Cat. 4: 1 Cat. 4: 2 Cat. 6: 1 (a) Cat. 6: 1 (b) Cat. 6: 2 (a) Cat. 6: 2 (b) Cat. 7: 1 (a) Cat. 7: 1 (b) Cat. 7: 2 (a) Cat. 7: 2 (b) Cat. 8: 1 Cat. 9: 1 Cat. 9: 2 Cat. 10: 1 Cat. 10: 2

  19. Embracing change: striated-for-smooth muscle replacement in esophagus development. (United States)

    Krauss, Robert S; Chihara, Daisuke; Romer, Anthony I


    The esophagus functions to transport food from the oropharyngeal region to the stomach via waves of peristalsis and transient relaxation of the lower esophageal sphincter. The gastrointestinal tract, including the esophagus, is ensheathed by the muscularis externa (ME). However, while the ME of the gastrointestinal tract distal to the esophagus is exclusively smooth muscle, the esophageal ME of many vertebrate species comprises a variable amount of striated muscle. The esophageal ME is initially composed only of smooth muscle, but its developmental maturation involves proximal-to-distal replacement of smooth muscle with striated muscle. This fascinating phenomenon raises two important questions: what is the developmental origin of the striated muscle precursor cells, and what are the cellular and morphogenetic mechanisms underlying the process? Studies addressing these questions have provided controversial answers. In this review, we discuss the development of ideas in this area and recent work that has shed light on these issues. A working model has emerged that should permit deeper understanding of the role of ME development and maturation in esophageal disorders and in the functional and evolutionary underpinnings of the variable degree of esophageal striated myogenesis in vertebrate species.

  20. Drugs Approved for Esophageal Cancer (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for esophageal cancer. The list includes generic names and brand names. The drug names link to NCI's Cancer Drug Information summaries.

  1. Esophageal ulceration complicating doxycycline therapy

    Institute of Scientific and Technical Information of China (English)

    Mohammad A. Al-Mofarreh; Ibrahim A. Al Mofleh


    AIM: To report present state of iatrogenic drug-induced esophageal injury (DIEI) induced by medications in a private clinic.METHODS: Iatrogenic drug-induced esophageal injury (DIEI) induced by medications has been more frequently reported. In a private clinic we encountered 36 cases of esophageal ulcerations complicating doxycycline therapy in a mainly younger Saudi population (median age 29 years).RESULTS: The most frequent presenting symptoms were oclynophagia, retrostemal burning pain and dysphagia (94 %,75 % and 56 %, respectively). The diagnosis was according to medical history and confirmed by endoscopy in all patients.Beside withdrawal of doxycycline, when feasible, all patients were treated with a proton-pump inhibitor (PPI) and a prokinetic. Thirty patients who reported to the clinic after treatment were improved within 1-7 (median 1.7) days.CONCLUSION: Esophageal ulceration has to be suspected in younger patients with odynophagia, retrosternal burning pain and/or clysphagia during the treatment with doxycycline.

  2. Caustic ingestion and esophageal function

    Energy Technology Data Exchange (ETDEWEB)

    Cadranel, S.; Di Lorenzo, C.; Rodesch, P.; Piepsz, A.; Ham, H.R. (Children University Hospital, Brussels (Belgium))


    The aim of the present study was to investigate esophageal motor function by means of krypton-81m esophageal transit scintigraphy and to compare the results with the functional and morphological data obtained by means of triple lumen manometry and endoscopy. In acute and subacute stages of the disease, all clinical, anatomical, and functional parameters were in good agreement, revealing significant impairment. In chronic stages, the severity of the dysphagia was not correlated to the importance of the residual stenosis. Conversely, 81mKr esophageal transit and manometric's findings were in good agreement with the clinical symptoms, during the entire follow-up period ranging between 3 months to 7 years. The 81mKr test is undoubtedly the easiest and probably the most physiological technique currently available for long-term functional evaluation of caustic esophagitis.

  3. Fabrication of a Delaying Biodegradable Magnesium Alloy-Based Esophageal Stent via Coating Elastic Polymer

    Directory of Open Access Journals (Sweden)

    Tianwen Yuan


    Full Text Available Esophageal stent implantation can relieve esophageal stenosis and obstructions in benign esophageal strictures, and magnesium alloy stents are a good candidate because of biodegradation and biological safety. However, biodegradable esophageal stents show a poor corrosion resistance and a quick loss of mechanical support in vivo. In this study, we chose the elastic and biodegradable mixed polymer of Poly(ε-caprolactone (PCL and poly(trimethylene carbonate (PTMC as the coated membrane on magnesium alloy stents for fabricating a fully biodegradable esophageal stent, which showed an ability to delay the degradation time and maintain mechanical performance in the long term. After 48 repeated compressions, the mechanical testing demonstrated that the PCL-PTMC-coated magnesium stents possess good flexibility and elasticity, and could provide enough support against lesion compression when used in vivo. According to the in vitro degradation evaluation, the PCL-PTMC membrane coated on magnesium was a good material combination for biodegradable stents. During the in vivo evaluation, the proliferation of the smooth muscle cells showed no signs of cell toxicity. Histological examination revealed the inflammation scores at four weeks in the magnesium-(PCL-PTMC stent group were similar to those in the control group (p > 0.05. The α-smooth muscle actin layer in the media was thinner in the magnesium-(PCL-PTMC stent group than in the control group (p < 0.05. Both the epithelial and smooth muscle cell layers were significantly thinner in the magnesium-(PCL-PTMC stent group than in the control group. The stent insertion was feasible and provided reliable support for at least four weeks, without causing severe injury or collagen deposition. Thus, this stent provides a new stent for the treatment of benign esophageal stricture and a novel research path in the development of temporary stents in other cases of benign stricture.

  4. Cutaneous Metastases From Esophageal Adenocarcinoma (United States)

    Triantafyllou, Stamatina; Georgia, Doulami; Gavriella-Zoi, Vrakopoulou; Dimitrios, Mpistarakis; Stulianos, Katsaragakis; Theodoros, Liakakos; Georgios, Zografos; Dimitrios, Theodorou


    The aim of this study is to present 2 rare cases of cutaneous metastases originated from adenocarcinoma of the gastro-esophageal junction, thus, underline the need for early diagnosis and possible treatment of suspicious skin lesions among patients with esophageal malignancy. Metastatic cancer to the skin originated from internal malignancies, mostly lung cancer, breast cancer, and colorectal cancer, constitute 0.5 to 9% of all metastatic cancers.5,8,15 Skin metastases, mainly from squamous cell carcinomas of the esophagus, are rarely reported. Cutaneous metastasis is a finding indicating progressiveness of the disease.17 More precisely, median survival is estimated approximately 4.7 months.2,14 This study is a retrospective review of 2 cases of patients with adenocarcinoma of the esophagus and a review of the literature. Two patients aged 60 and 32 years old, respectively, underwent esophagectomy. Both pathologic reports disclosed adenocarcinoma of the gastro-esophageal junction staged T3 N2 M0 (stage IIIB). During follow-up time, the 2 patients were diagnosed with cutaneous metastases originated from the primary esophageal tumor 11 and 4 months after surgery, respectively. The first patient is alive 37 months after diagnosis, while the second one died 16 months after surgery. Cutaneous metastasis caused by esophageal adenocarcinoma is possible. Therefore, follow-up of patients who were diagnosed with esophageal malignancy and underwent esophagectomy is mandatory in order to reveal early surgical stages. PMID:25785344

  5. Esophageal malignancy: A growing concern

    Institute of Scientific and Technical Information of China (English)

    Jianyuan Chai; M Mazen Jamal


    Esophageal cancer is mainly found in Asia and east Africa and is one of the deadliest cancers in the world.However,it has not garnered much attention in the Western world due to its low incidence rate.An increasing amount of data indicate that esophageal cancer,particularly esophageal adenocarcinoma,has been rising by 6-fold annually and is now becoming the fastest growing cancer in the United States.This rise has been associated with the increase of the obese population,as abdominal fat puts extra pressure on the stomach and causes gastroesophageal reflux disease (GERD).Long standing GERD can induce esophagitis and metaplasia and,ultimately,leads to adenocarcinoma.Acid suppression has been the main strategy to treat GERD; however,it has not been proven to control esophageal malignancy effectively.In fact,its side effects have triggered multiple warnings from regulatory agencies.The high mortality and fast growth of esophageal cancer demand more vigorous efforts to look into its deeper mechanisms and come up with better therapeutic options.

  6. Ultrasonographic findings of esophageal varices

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Hyo Seouk; Seol, Byeong Ryong; Rha, Seung Woon [Shilla General Hospital, Seoul (Korea, Republic of)


    To demonstrate the clinical usefulness of ultrasonography for detecting esophageal varices. In 20 cases of esophaged varix, the authors analysed the transabdominal ultrasonographic findings of the esophagogastric junction and compared mural thickness, the anteroposterior diameter of the esophagus, and the echogenic nature of the esophageal mucosal layer with those of 78 normal patients. The anterior and posterior mural thickeness of normal esophagus was 2.2{+-}0.7 and 2.4{+-}0.8mm respectively, but for variceal esophagus, the corresponding readings were 5.9{+-}1.3 and 5.2{+-}1.3mm respectively. The anteroposterior diameter of normal esophagus was 7.9{+-}2.1mm and that of variceal esophagus was 14.0{+-}1.8mm. There was a stastically significant difference (p<0.01) in mural thickness and anteroposterior diameter of the esophagus between a normal and variceal patient with regard to change of echogenic nature at the esphagogastric junction. Normal esophageal mucosa showed a thin and uniform echogenic line, but for variceal mucosa, the echogenic pattern was irregular, tortuous and thick. The athors believe that transabdominal US is helpful for detecting esophageal varices in patients with liver cirrhosis and UGI bleeding. Important clinically useful sonographic findings in diagnosing esophageal varix are as follows:1) mural thickness more than 6mm; 2) anteroposterior diameter of the esophagus of more than 15mm;3) irregular, tortuous and thickened echogenic mucosa.

  7. A Catalogue of Anatomical Fugitive Sheets: Cat. 11-25



    Images Cat. 11 (a) Cat. 11 (b) Cat. 11 (c) Cat. 11 (d) Cat. 12: 1 (a) Cat. 12: 1 (b) Cat. 12: 2 (a) Cat. 12: 2 (b) Cat. 13 Cat. 14 (a) Cat. 14 (b) Cat. 14 (c) Cat. 15 (a) Cat. 15 (b) Cat. 17: 1 Cat. 17: 2 Cat. 18: 1 Cat. 18: 2 Cat. 19: 1 (a) Cat. 19: 1 (b) Cat. 19: 2 (a) Cat. 19: 2 (b) Cat. 20: 1 Cat. 20: 2 (a) Cat. 20: 2 (b) Cat. 21 (a) Cat. 21 (b) Cat. 21 (c) Cat. 21 (d) Cat. 21 (e) Cat. 22 Cat. 24: 1 and 2 Cat. 25: 1 Cat. 25: 2 Cat. 25: 3 Cat. 25: 4

  8. Cat scratch encephalopathy. (United States)

    Silver, B E; Bean, C S


    Cat scratch disease is usually benign, self-limited and without sequelae. Margileth has established four clinical criteria, three of which must be satisfied to make the diagnosis: 1) a history of animal exposure, usually kitten, with primary skin or ocular lesions; 2) regional chronic adenopathy without other apparent cause; 3) a positive cat scratch disease antigen skin test; and 4) lymph node biopsy demonstrating noncaseating granulomas and germinal center hyperplasia. Central nervous system involvement in cat scratch disease has been previously reported, although it is extremely uncommon. In a several-month period, we encountered two cases of cat scratch disease complicated by encephalopathy. The intents of this paper are twofold: 1) to briefly review the current literature on cat scratch disease, 2) to demonstrate that cat scratch disease complicated by encephalopathy presents acutely with seizures, posturing and coma and resolves rapidly with supportive care.

  9. Prevention and Treatment of Esophageal Stenosis after Endoscopic Submucosal Dissection for Early Esophageal Cancer

    Directory of Open Access Journals (Sweden)

    Jing Wen


    Full Text Available Endoscopic submucosal dissection (ESD for the treatment of esophageal mucosal lesions is associated with a risk of esophageal stenosis, especially for near-circumferential or circumferential esophageal mucosal defects. Here, we review historic and modern studies on the prevention and treatment of esophageal stenosis after ESD. These methods include prevention via pharmacological treatment, endoscopic autologous cell transplantation, endoscopic esophageal dilatation, and stent placement. This short review will focus on direct prevention and treatment, which may help guide the way forward.

  10. Smooth Neutrosophic Topological Spaces

    Directory of Open Access Journals (Sweden)

    M. K. EL Gayyar


    Full Text Available As a new branch of philosophy, the neutrosophy was presented by Smarandache in 1980. It was presented as the study of origin, nature, and scope of neutralities; as well as their interactions with different ideational spectra. The aim in this paper is to introduce the concepts of smooth neutrosophic topological space, smooth neutrosophic cotopological space, smooth neutrosophic closure, and smooth neutrosophic interior. Furthermore, some properties of these concepts will be investigated.

  11. Smooth Neutrosophic Topological Spaces




    As a new branch of philosophy, the neutrosophy was presented by Smarandache in 1980. It was presented as the study of origin, nature, and scope of neutralities; as well as their interactions with different ideational spectra. The aim in this paper is to introduce the concepts of smooth neutrosophic topological space, smooth neutrosophic cotopological space, smooth neutrosophic closure, and smooth neutrosophic interior. Furthermore, some properties of these concepts will be investigated.

  12. 21 CFR 878.3610 - Esophageal prosthesis. (United States)


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Esophageal prosthesis. 878.3610 Section 878.3610...) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3610 Esophageal prosthesis. (a) Identification. An esophageal prosthesis is a rigid, flexible, or expandable tubular device...

  13. Gallium-67 imaging in candidal esophagitis

    Energy Technology Data Exchange (ETDEWEB)

    Rundback, J.H.; Goldfarb, C.R.; Ongseng, F. (Beth Israel Medical Center, New York, NY (USA))


    Ga-67 scanning has been used to evaluate esophageal carcinoma. It has demonstrated candidal infection in other body sites and, in one previous case, in the esophagus. The authors present a case of diffuse esophageal uptake of Ga-67 in esophageal candidiasis.

  14. Congenital esophageal atresia with tracheo-esophageal fistula

    Energy Technology Data Exchange (ETDEWEB)

    Rhee, Chung Sik [Ewha Womans University College of Medicine, Seoul (Korea, Republic of)


    Three cases of esophageal atresia with tracheo-esophageal fistula. 1). Case 1: A female infant birth Wt. 1.95 kg , Apgar Score 10, Skeletal anomalies, was delivered after a pregnancy compeicated by hydroamnious on Aug. 17, 1970. The family history was not contributory. 2) Case 2: A male infant birth Wt. 2.8 kg , Apgar Score 8, was forcep delivered after a pregnancy on Feb. 8, 1970. This infant is twin. The family history was not contributory. 3) Case 3: A female infant birth Wt. 2.22 kg , Apgar Score 10, was C-section after a pregnancy on May, 16. 1970. The family history was not contributory. All cases: After 24 hours 5% glucose solution was given and immediately vomited and some of it regurgitating through the nose and mouth with associated cyanosis and dyspnea. A catheter was inserted through the nose into the esophagus under diagnosis of the esophageal atresia.

  15. [Esophageal diseases: GERD, Barrett, achalasia and eosinophilic esophagitis]. (United States)

    Calvet, Xavier; Villoria, Albert


    At Digestive Disease Week (DDW) 2014, developments in esophageal disease were presented. Highlights include: the usefulness of impedancemetry to diagnose reflux disease, or the effectiveness of PPIs for treating non-cardiac chest pain. Concerning Barrett's esophagus, its prevalence is identical in patients with and without reflux symptoms, Barrett segments less than 1cm probably do not require follow-up, and in older patients with long-segment Barrett, initial endoscopies overlooked up to 2% of significant lesions. Regarding achalasia, surgical myotomy is no more effective than endoscopic dilation and may even be less effective than peroral endoscopic myotomy (POEM). In terms of eosinophilic esophagitis, it is important to systematically take biopsies in patients with dysphagia so that cases of eosinophilic esophagitis are not overlooked. In addition, for this condition, routine endoscopic dilations not only do not seem useful in improving the course of the disease, but could also worsen the response to medical treatment.

  16. Cat-scratch disease (United States)

    ... scratch or bite from a cat, your health care provider may suspect cat-scratch disease. A physical examination may also reveal an enlarged spleen . Sometimes, an infected lymph node may form a tunnel ( fistula ) through the skin and drain (leak fluid). This ...

  17. Hyperadrenocorticism in a cat. (United States)

    Zerbe, C A; Nachreiner, R F; Dunstan, R W; Dalley, J B


    A diabetic cat with hyperadrenocorticism had polydipsia, polyuria, ventral abdominal alopecia, thin dry skin, and a pendulous abdomen. Results of laboratory testing indicated persistent resting hypercortisolemia, hyperresponsiveness of the adrenal glands (increased cortisol concentration) to ACTH gel, and no suppression of cortisol concentrations after administration of dexamethasone at 0.01 or 1.0 mg/kg of body weight. Necropsy revealed a pituitary gland tumor, bilateral adrenal hyperplasia, hepatic neoplasia, and demodicosis. Adrenal gland function was concurrently assessed in 2 cats with diabetes mellitus. One cat had resting hypercortisolemia, and both had hyperresponsiveness to ACTH gel (increased cortisol concentration) at one hour. After administration of dexamethasone (0.01 and 1.0 mg/kg), the diabetic cats appeared to have normal suppression of cortisol concentrations. The effects of mitotane were investigated in 4 clinically normal cats. Adrenocortical suppression of cortisol production occurred in 2 of 4 cats after dosages of 25, 37, and 50 mg/kg. Three cats remained clinically normal throughout the study. One cat experienced vomiting, diarrhea, and anorexia.

  18. Cat-Scratch Disease (United States)

    ... bites and scratches well with soap and running water. Do not allow cats to lick your wounds. Contact your doctor if you develop any symptoms of cat-scratch disease or infection. CSD is caused by a bacterium called Bartonella henselae . About 40% ...

  19. That Fat Cat (United States)

    Lambert, Phyllis Gilchrist


    This activity began with a picture book, Nurit Karlin's "Fat Cat On a Mat" (HarperCollins; 1998). The author and her students started their project with a 5-inch circular template for the head of their cats. They reviewed shapes as they drew the head and then added the ears and nose, which were triangles. Details to the face were added when…

  20. Cat scratch colon. (United States)

    Ruiz-Rebollo, M Lourdes; Velayos-Jiménez, Benito; Prieto de Paula, José María; Alvarez Quiñones, María; González Hernández, José Manuel


    Over the past few years, we have read several publications regarding the term "cat scratch colon." This neologism was developed to define some bright red linear markings seen in the colonic mucosa that resemble scratches made by a cat. We would like to communicate a recent case attended at our institution.

  1. Cat Scratch Colon

    Directory of Open Access Journals (Sweden)

    M. Lourdes Ruiz-Rebollo


    Full Text Available Over the past few years, we have read several publications regarding the term “cat scratch colon.” This neologism was developed to define some bright red linear markings seen in the colonic mucosa that resemble scratches made by a cat. We would like to communicate a recent case attended at our institution.

  2. Esophageal tissue engineering: A new approach for esophageal replacement

    Institute of Scientific and Technical Information of China (English)

    Giorgia Totonelli; Panagiotis Maghsoudlou; Jonathan M Fishman; Giuseppe Orlando; Tahera Ansari; Paul Sibbons; Martin A Birchall


    A number of congenital and acquired disorders require esophageal tissue replacement.Various surgical techniques,such as gastric and colonic interposition,are standards of treatment,but frequently complicated by stenosis and other problems.Regenerative medicine approaches facilitate the use of biological constructs to replace or regenerate normal tissue function.We review the literature of esophageal tissue engineering,discuss its implications,compare the methodologies that have been employed and suggest possible directions for the future.Medline,Embase,the Cochrane Library,National Research Register and databases were searched with the following search terms:stem cell and esophagus,esophageal replacement,esophageal tissue engineering,esophageal substitution.Reference lists of papers identified were also examined and experts in this field contacted for further information.All full-text articles in English of all potentially relevant abstracts were reviewed.Tissue engineering has involved acellular scaffolds that were either transplanted with the aim of being repopulated by host cells or seeded prior to transplantation.When acellular scaffolds were used to replace patch and short tubular defects they allowed epithelial and partial muscular migration whereas when employed for long tubular defects the results were poor leading to an increased rate of stenosis and mortality.Stenting has been shown as an effective means to reduce stenotic changes and promote cell migration,whilst omental wrapping to induce vascularization of the construct has an uncertain benefit.Decellularized matrices have been recently suggested as the optimal choice for scaffolds,but smart polymers that will incorporate signalling to promote cell-scaffold interaction may provide a more reproducible and available solution.Results in animal models that have used seeded scaffolds strongly suggest that seeding of both muscle and epithelial cells on scaffolds prior to implantation is a

  3. State of cat genomics. (United States)

    O'Brien, Stephen J; Johnson, Warren; Driscoll, Carlos; Pontius, Joan; Pecon-Slattery, Jill; Menotti-Raymond, Marilyn


    Our knowledge of cat family biology was recently expanded to include a genomics perspective with the completion of a draft whole genome sequence of an Abyssinian cat. The utility of the new genome information has been demonstrated by applications ranging from disease gene discovery and comparative genomics to species conservation. Patterns of genomic organization among cats and inbred domestic cat breeds have illuminated our view of domestication, revealing linkage disequilibrium tracks consequent of breed formation, defining chromosome exchanges that punctuated major lineages of mammals and suggesting ancestral continental migration events that led to 37 modern species of Felidae. We review these recent advances here. As the genome resources develop, the cat is poised to make a major contribution to many areas in genetics and biology.

  4. Comparative study of aural microflora in healthy cats, allergic cats and cats with systemic disease. (United States)

    Pressanti, Charline; Drouet, Clémence; Cadiergues, Marie-Christine


    Twenty healthy cats (group 1) with clinically normal ears, 15 cats with systemic disease (group 2) and 15 allergic cats (group 3) were included in a prospective study. The experimental unit was the ear. A clinical score was established for each ear canal after otoscopic examination. Microbial population was assessed on cytological examination of smears performed with the cotton-tipped applicator smear technique. Fungal population was significantly more prominent in allergic cats (P cats compared with healthy cats (P cats than in healthy cats (P cats suffering from systemic disease (P cats with systemic disease than healthy cats. In cats from group 2, only fungal overgrowth was associated with otitis severity. In group 3, only bacterial overgrowth was associated with otitis severity.

  5. Reflux esophagitis revisited: Prospective analysis of radiologic accuracy

    Energy Technology Data Exchange (ETDEWEB)

    Ott, D.J.; Gelfand, D.W.; Wu, W.C.


    A prospective radiologic-endoscopic study of the esophagogastric region in 266 patients, including 206 normals and 60 with esophagitis, is reported. The endoscopic classification grading severity of esophagitis was grade 1-normal; grades 2. 3. and 4-mild, moderate, and severe esophagitis, respectively. Radiology detected 22% of patient with mild esophagitis, 83% with moderate esophagitis, and 95% with severe esophagitis. Although hiatal hernia was present in 40% of normals and 89% with esophagitis, absence of radiographic hiatal hernia excluded esophagitis with 95% accuracy. The implications of this study regarding the role of radiology in evaluating patient with suspected reflux esophagitis are discussed.

  6. Radionuclide Esophageal Transit Scintigraphy in Primary Hypothyroidism (United States)

    Khan, Shoukat H; Madhu, Vijay P; Rather, Tanveer A; Laway, Bashir A


    Background/Aims Esophageal dysmotility is associated with gastrointestinal dysmotility in various systemic and neuroregulatory disorders. Hypothyroidism has been reported to be associated with impaired motor function in esophagus due to accumulation of glycosaminoglycan hyaluronic acid in its soft tissues, leading to changes in various contraction and relaxation parameters of esophagus, particularly in the lower esophageal sphincter. In this study we evaluated esophageal transit times in patients of primary hypothyroidism using the technique of radionuclide esophageal transit scintigraphy. Methods Thirty-one patients of primary hypothyroidism and 15 euthyroid healthy controls were evaluated for esophageal transit time using 15–20 MBq of Technetium-99m sulfur colloid diluted in 10–15 mL of drinking water. Time activity curve was generated for each study and esophageal transit time was calculated as time taken for clearance of 90% radioactive bolus from the region of interest encompassing the esophagus. Esophageal transit time of more than 10 seconds was considered as prolonged. Results Patients of primary hypothyroidism had a significantly increased mean esophageal transit time of 19.35 ± 20.02 seconds in comparison to the mean time of 8.25 ± 1.71 seconds in healthy controls (P hypothyroidism may have subclinical esophageal dysmotility with prolonged esophageal transit time which can be reversible by thyroxine treatment. Prolonged esophageal transit time in primary hypothyroidism may correlate with serum thyroid stimulating hormone levels. PMID:27444283

  7. Efficacy of Intensity Modulated Radiation Therapy After Surgery in Early Stage of Esophageal Carcinoma; (United States)


    Esophageal Neoplasm; Esophageal Cancer TNM Staging Primary Tumor (T) T2; Esophageal Cancer TNM Staging Primary Tumor (T) T3; Esophageal Cancer TNM Staging Regional Lymph Nodes (N) N0; Esophageal Cancer TNM Staging Distal Metastasis (M) M0

  8. Giardia infection in cats. (United States)

    Janeczko, Stephanie; Griffin, Brenda


    The protozoon Giardia duodenalis is a common gastrointestinal parasite of cats. While most Giardia-infected cats are asymptomatic, acute small bowel diarrhea, occasionally with concomitant weight loss, may occur. Giardia poses a diagnostic challenge, but newer tests, including a commercially available ELISA kit, have improved clinicians' ability to obtain an accurate diagnosis. Several treatment options have been reported, and although none has been shown to be universally effective, most cases can be successfully managed with drug therapy, supportive measures, and environmental control. Current recommendations suggest that combination therapy with fenbendazole and metronidazole may be the safest, most effective treatment option for symptomatic cats.

  9. Clinical Study of Time Optimizing of Endoscopic Photodynamic Therapy on Esophageal and/or Gastric Cardiac Cancer (United States)


    Stage I Esophageal Adenocarcinoma; Stage II Esophageal Adenocarcinoma; Stage III Esophageal Adenocarcinoma; Stage I Esophageal Squamous Cell Carcinoma; Stage II Esophageal Squamous Cell Carcinoma; Stage III Esophageal Squamous Cell Carcinoma

  10. Brain Abscess after Esophageal Dilatation

    DEFF Research Database (Denmark)

    Gaïni, S; Grand, M; Michelsen, J


    with malaise, progressive lethargy, fever, aphasia and hemiparesis. Six days before she had been treated with esophageal dilatation for a stricture caused by accidental ingestion of caustic soda. The brain abscess was treated with surgery and antibiotics. She recovered completely. This clinical case...

  11. Esophageal Cancer Risk Prediction Models (United States)

    Developing statistical models that estimate the probability of developing esophageal cancer over a defined period of time will help clinicians identify individuals at higher risk of specific cancers, allowing for earlier or more frequent screening and counseling of behavioral changes to decrease risk.

  12. Molecular Biology of Esophageal Cancer

    Institute of Scientific and Technical Information of China (English)

    HuanXi; JanBrabender; RalfMetzger; PaulM.Schneider


    There have been many new developments in our understanding of esophageal carcinoma biology over the past several years. Information regarding both of the major forms of this disease, adenocarcinoma and squamous cell carcinoma, has accumulated in conjunction with data on precursor conditions such as Barrett's esophagus. Interesting and promising findings have included overexpression of proto-oncogenes,loss of heterozygosity at multiple chromosomal loci, tumor suppressor gene inactivation, epigenetic silencing by DNA methylation, and mutations and deletions involving the tumor suppressor gene p53. Important cancer pathways, the cyclin kinase inhibitor cascade and the DNA mismatch repair process, implicated in the genesis of multiple tumor types have also been inculpated in esophageal carcinogenesis. Alterations in the p16 and p15 cyclin kinase inhibitors including point mutations and homozygous deletions have been reported in primary esophageal tumors. Further developments in the field of molecular carcinogenesis of esophageal malignancies promise to yield improvements in prevention, early detection, prognostic categorization, and perhaps gene-based therapy of this deadly disease.

  13. StreamCat (United States)

    U.S. Environmental Protection Agency — The StreamCat Dataset provides summaries of natural and anthropogenic landscape features for ~2.65 million streams, and their associated catchments, within the...

  14. IndexCat (United States)

    U.S. Department of Health & Human Services — IndexCat provides access to the digitized version of the printed Index-Catalogue of the Library of the Surgeon General's Office; eTK for medieval Latin texts; and...

  15. Cat tongue Velcro (United States)

    Noel, Alexis; Martinez, Andrea; Jung, Hyewon; Tsai, Ting-Wen; Hu, David


    A cat's tongue is covered in an array of spines called papillae. These spines are thought to be used in grooming and rasping meat from bones of prey, although no mechanism has been given. We use high-speed video to film a cat removing cat food deeply wedged into a 3-D printed fur mat. We show that the spines on the tongue act as Velcro for particles. The tongue itself is highly elastic. As the cat presses it against a substrate, the tongue flattens and the spines separate. When the tongue is removed from the substrate the spines come together, wedging particles between them. This elasticity-driven entrapment permits the surface of the tongue to act as a carrier for hard to reach particles, and to increase the efficacy of grooming and feeding.

  16. Radiation-induced esophagitis in lung cancer

    Directory of Open Access Journals (Sweden)

    Baker S


    Full Text Available Sarah Baker, Alysa Fairchild Department of Radiation Oncology, Cross Cancer Institute, University of Alberta, Edmonton, AB, Canada Abstract: Radiation-induced esophagitis is the most common local acute toxicity of radiotherapy (RT delivered for the curative or palliative intent treatment of lung cancer. Although concurrent chemotherapy and higher RT dose are associated with increased esophagitis risk, advancements in RT techniques as well as adherence to esophageal dosimetric constraints may reduce the incidence and severity. Mild acute esophagitis symptoms are generally self-limited, and supportive management options include analgesics, acid suppression, diet modification, treatment for candidiasis, and maintenance of adequate nutrition. Esophageal stricture is the most common late sequela from esophageal irradiation and can be addressed with endoscopic dilatation. Approaches to prevent or mitigate these toxicities are also discussed. Keywords: non–small cell lung cancer, acute, late, toxicity, stricture

  17. The Changing Face of Esophageal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Melhado, Rachel E., E-mail:; Alderson, Derek; Tucker, Olga [Academic Department of Surgery, Queen Elizabeth Hospital, University Hospitals Birmingham, Birmingham (United Kingdom)


    The two main histological esophageal cancer types, adenocarcinoma and squamous cell carcinoma, differ in incidence, geographic distribution, ethnic pattern and etiology. This article focuses on epidemiology with particular reference to geographic and temporal variations in incidence, along with a review of the evidence supporting environmental and genetic factors involved in esophageal carcinogenesis. Squamous cell carcinoma of the esophagus remains predominantly a disease of the developing world. In contrast, esophageal adenocarcinoma is mainly a disease of western developed societies, associated with obesity and gastro-esophageal reflux disease. There has been a dramatic increase in the incidence of adenocarcinoma in developed countries in parallel with migration of both esophageal and gastric adenocarcinomas towards the gastro-esophageal junction.

  18. Unexpected esophageal diseases appeared in thyroid resections


    Ye-huan, Liu; Shi-xu, Lyu; Yi-li, Zhou; Ou-chen, Wang; Xiao-hua, Zhang


    Objective In order to avoid the misdiagnosis of thyroid diseases, we need to discuss the clinical features and diagnostic methods of cervical esophageal cancer and Zenker’s diverticulum. Methods The clinical and laboratory data of seven cases were reviewed retrospectively, and in all cases, esophageal-related diseases were misdiagnosed as thyroid diseases preoperatively. Among them, two cases were cervical esophageal cancer metastasized to thyroids but initially, they were misdiagnosed as thy...

  19. Oral blastomycosis, laryngeal papillomatosis and esophageal tuberculosis


    Montoya, Manuel; Hospital Regional del Cusco. Cusco, Perú. Universidad Nacional de San Antonio Abad del Cusco. Cusco, Perú. Médico infectólogo.; Chumbiraico, Robert; Hospital Regional del Cusco. Cusco, Perú. Universidad Nacional de San Antonio Abad del Cusco. Cusco, Perú. médico internista.; Ricalde, Melvin; Hospital Regional del Cusco. Cusco, Perú. Universidad Nacional de San Antonio Abad del Cusco. Cusco, Perú. médico neumólogo.; Cazorla, Ernesto; Hospital Regional del Cusco. Cusco, Perú. Universidad Nacional de San Antonio Abad del Cusco. Cusco, Perú. médico gastroenterólogo.; Hernández-Córdova, Gustavo; Universidad Nacional de San Antonio Abad del Cusco. Cusco, Perú. Estudiante de medicina.


    Esophageal involvement is an extremely rare complication of tuberculosis even in countries with high prevalence of infection. We report the case of a 57 year-old hiv-seronegative patient with simultaneous diagnoses of oral blastomycosis and laryngeal papillomatosis. Both were confirmed by anatomopathological analysis. The esophageal biopsy revealed granulomatous esophagitis with necrosis and ziehl–neelsen stain showed acid-fast alcohol resistant bacilli suggestive of tuberculosis. The pat...

  20. Transabdominal US evaluation of esophageal varices: as a prospective screening test

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Seung Yon; Lee, Sun Wha [Ewha Womans University College of Medicine, Seoul (Korea, Republic of)


    To evaluate the efficacy of transabdominal ultrasonography to diagnose esophageal varices and to predict the grade of varices as a screening test for cirrhotic patients. Transabdominal ultrasonography was performed in 41 cirrhotic patients to evaluate esophageal varices prospectively. We measured thickness of the anterior distal esophageal wall three times and calculated the main thickness. We evaluated the pattern of the wall (smooth or irregularly), the presence of Doppler signal flow, the pattern and direction and velocity of Doppler signal flow in the esophageal wall. We considered the mean thickness of the esophageal wall in 44 patients without liver diseases to normal control. The endoscopic grade (grade 1 to 4) of esophageal varices was considered as gold standard. We analyzed the statistical difference between groups of esophageal varices and the normal control group using ANOVA and multiple complication method and t-test. Mean thickness of the normal and variceal group was 2.7 {+-} 0.7 mm and 5.2 {+-} 1.8 mm with statistical deference (p<0.001). Mean thickness between the normal group and each of the three grades of variceal groups was statically different (p<0.001) respectively. Mean thickness of grade I (N=19), grade II (N=10) and grade III and above (N=12) was 4.2 {+-} 1.2 mm, 4.9 mm {+-} 1.1 mm, 7.0 {+-} 1.8 mm respectively and for higher grades, the esophageal wall became thicker. There was statistical difference of mean thickness between grade I and grade III and above, grade II and grade III and above (p<0.001) and no difference between grade I and grade II (P=0.40). The pattern of the esophageal wall was irregular in 17 (41%)patients and the presence of Doppler signal flow was found in 8 (20%) patients. If the diagnostic criteria of mean thickness to diagnose varices was 3.5 mm, accuracy, sensitivity, specificity, positive predictive value and negative predictive value was 85.9%, 82.9%, 88.6%, 87.2%, 84.8% respectively. Transabdominal

  1. Minimally invasive surgery for esophageal achalasia

    Institute of Scientific and Technical Information of China (English)

    Luigi Bonavina


    Esophageal achalasia is the most commonly diagnosed primary esophageal motor disorder and the second most common functional esophageal disorder. Current therapy of achalasia is directed toward elimination of the outflow resistance caused by failure of the lower esophageal sphincter to relax completely upon swallowing. The advent of minimally invasive surgery has nearly replaced endoscopic pneumatic dilation as the first-line therapeutic approach. In this editorial, the rationale and the evidence supporting the use of laparoscopic Heller myotomy combined with fundoplication as a primary treatment of achalasia are reviewed.

  2. Acute Necrotizing Esophagitis Followed by Duodenal Necrosis. (United States)

    Del Hierro, Piedad Magdalena


    Acute Necrotizing Esophagitis is an uncommon pathology, characterized by endoscopic finding of diffuse black coloration in esophageal mucosa and histological presence of necrosis in patients with upper gastrointestinal bleeding. The first case of acute necrotizing esophagitis followed by duodenal necrosis, in 81 years old woman with a positive history of Type 2 Diabetes Mellitus, Hypertension, and usual intake of Nonsteroidal Anti-inflammatory drugs, is reported. Although its etiology remains unknown, the duodenal necrosis suggests that ischemia could be the main cause given that the branches off the celiac axis provide common blood supply to the distal esophageal and duodenal tissue. The massive gastroesophagic reflux and NSAID intake could be involved.

  3. Laboratory animal models for esophageal cancer

    Directory of Open Access Journals (Sweden)

    Dhanya Venugopalan Nair


    Full Text Available The incidence of esophageal cancer is rapidly increasing especially in developing countries. The major risk factors include unhealthy lifestyle practices such as alcohol consumption, smoking, and chewing tobacco to name a few. Diagnosis at an advanced stage and poor prognosis make esophageal cancer one of the most lethal diseases. These factors have urged further research in understanding the pathophysiology of the disease. Animal models not only aid in understanding the molecular pathogenesis of esophageal cancer but also help in developing therapeutic interventions for the disease. This review throws light on the various recent laboratory animal models for esophageal cancer.

  4. Esophageal motility abnormalities in gastroesophageal reflux disease. (United States)

    Martinucci, Irene; de Bortoli, Nicola; Giacchino, Maria; Bodini, Giorgia; Marabotto, Elisa; Marchi, Santino; Savarino, Vincenzo; Savarino, Edoardo


    Esophageal motility abnormalities are among the main factors implicated in the pathogenesis of gastroesophageal reflux disease. The recent introduction in clinical and research practice of novel esophageal testing has markedly improved our understanding of the mechanisms contributing to the development of gastroesophageal reflux disease, allowing a better management of patients with this disorder. In this context, the present article intends to provide an overview of the current literature about esophageal motility dysfunctions in patients with gastroesophageal reflux disease. Esophageal manometry, by recording intraluminal pressure, represents the gold standard to diagnose esophageal motility abnormalities. In particular, using novel techniques, such as high resolution manometry with or without concurrent intraluminal impedance monitoring, transient lower esophageal sphincter (LES) relaxations, hypotensive LES, ineffective esophageal peristalsis and bolus transit abnormalities have been better defined and strongly implicated in gastroesophageal reflux disease development. Overall, recent findings suggest that esophageal motility abnormalities are increasingly prevalent with increasing severity of reflux disease, from non-erosive reflux disease to erosive reflux disease and Barrett's esophagus. Characterizing esophageal dysmotility among different subgroups of patients with reflux disease may represent a fundamental approach to properly diagnose these patients and, thus, to set up the best therapeutic management. Currently, surgery represents the only reliable way to restore the esophagogastric junction integrity and to reduce transient LES relaxations that are considered to be the predominant mechanism by which gastric contents can enter the esophagus. On that ground, more in depth future studies assessing the pathogenetic role of dysmotility in patients with reflux disease are warranted.

  5. Weak Cat-Operads

    CERN Document Server

    Dosen, K


    An operad (this paper deals with non-symmetric operads) may be conceived as a partial algebra with a family of insertion operations, Gerstenhaber's circle-i products, which satisfy two kinds of associativity, one of them involving commutativity. A Cat-operad is an operad enriched over the category Cat of small categories, as a 2-category with small hom-categories is a category enriched over Cat. The notion of weak Cat-operad is to the notion of Cat-operad what the notion of bicategory is to the notion of 2-category. The equations of operads like associativity of insertions are replaced by isomorphisms in a category. The goal of this paper is to formulate conditions concerning these isomorphisms that ensure coherence, in the sense that all diagrams of canonical arrows commute. This is the sense in which the notions of monoidal category and bicategory are coherent. The coherence proof in the paper is much simplified by indexing the insertion operations in a context-independent way, and not in the usual manner. ...

  6. The Feline Mystique: Dispelling the Myth of the Independent Cat. (United States)

    Soltow, Willow


    Describes learning activities about cats for primary and intermediate grades. Primary grade activity subjects include cat behavior, needs, breeds, storybook cats, and celestial cats. Intermediate grade activity subjects include cat history, care, language, literary cats, and cats in art. (BC)

  7. Physiology of oropharyngeal swallow in the cat: a videofluoroscopic and electromyographic study. (United States)

    Kobara-Mates, M; Logemann, J A; Larson, C; Kahrilas, P J


    The majority of animal studies of deglutition have examined electrically stimulated swallows in sedated animals. This present investigation examined oropharyngeal and cervical esophageal swallow physiology in three awake normal domestic cats using concurrent electromyography (EMG) and videofluorography (VFG). Hooked wire electrodes were surgically implanted into six oropharyngeal muscles in each cat. During collection of VFG and EMG data, each cat ate barium-impregnated cat food while the fluorography tube focused on a lateral view of the oral cavity, pharynx, and cervical esophagus. A number of significant differences in the physiology of swallowing were found between the cat and human adult. The oral stage of swallow is much longer in the cat with bolus accumulation in the valleculae. Duration and components of the pharyngeal stage of swallow are much faster, and the pharyngeal stage occurs earlier in relation to bolus passage through the cricopharyngeus. In addition, the cat exhibits a marked superior constrictor bulge at the onset of the pharyngeal contractile wave and summation of the peristaltic waves in the esophagus, whereas the human adult does not. Feline swallow physiology is more similar to that of the human infant than that of human adults.

  8. Pradaxa-induced esophageal ulcer. (United States)

    Wood, Michele; Shaw, Paul


    Pradaxa (dabigatran) is a direct thrombin inhibitor approved for prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation. We describe a case of esophageal ulceration associated with Pradaxa administration in a 75-year-old man. The patient reported difficulty swallowing and a burning sensation after taking his first dose of Pradaxa. An esophagogastroduodenoscopy (EGD) revealed linear ulcerations in the mid-esophagus. Pradaxa was held beginning the day before the EGD. The patient reported that his pain and difficulty swallowing resolved on stopping Pradaxa. Pradaxa is formulated with a tartaric acid excipient to reduce variability in absorption. We hypothesise that the capsule lodged in the patient's esophagus and the tartaric acid may have caused local damage resulting in an esophageal ulcer. It is important to educate patients on proper administration of Pradaxa, to decrease the risk of this rare, but potentially serious adverse event.

  9. Proteomic profiling of fetal esophageal epithelium, esophageal cancer, and tumor-adjacent esophageal epithelium and immunohistochemical characterization of a representative differential protein, PRX6 (United States)

    Guo, Jun-Hui; Xing, Guo-Lan; Fang, Xin-Hui; Wu, Hui-Fang; Zhang, Bo; Yu, Jin-Zhong; Fan, Zong-Min; Wang, Li-Dong


    AIM To understand the molecular mechanism of esophageal cancer development and provide molecular markers for screening high-risk populations and early diagnosis. METHODS Two-dimensional electrophoresis combined with mass spectrometry were adopted to screen differentially expressed proteins in nine cases of fetal esophageal epithelium, eight cases of esophageal cancer, and eight cases of tumor-adjacent normal esophageal epithelium collected from fetuses of different gestational age, or esophageal cancer patients from a high-risk area of esophageal cancer in China. Immunohistochemistry (avidin-biotin-horseradish peroxidase complex method) was used to detect the expression of peroxiredoxin (PRX)6 in 91 cases of esophageal cancer, tumor-adjacent normal esophageal tissue, basal cell hyperplasia, dysplasia, and carcinoma in situ, as well as 65 cases of esophageal epithelium from fetuses at a gestational age of 3-9 mo. RESULTS After peptide mass fingerprint analysis and search of protein databases, 21 differential proteins were identified; some of which represent a protein isoform. Varying degrees of expression of PRX6 protein, which was localized mainly in the cytoplasm, were detected in adult and fetal normal esophageal tissues, precancerous lesions, and esophageal cancer. With the progression of esophageal lesions, PRX6 protein expression showed a declining trend (P PRX6 protein expression showed a declining trend with age (P PRX6 protein expression was significantly higher in well-differentiated esophageal cancer tissues than in poorly differentiated esophageal cancer tissues (P PRX6 protein is associated with fetal esophageal development and cancer differentiation. PMID:28293090

  10. Smooth sandwich gravitational waves

    CERN Document Server

    Podolsky, J


    Gravitational waves which are smooth and contain two asymptotically flat regions are constructed from the homogeneous pp-waves vacuum solution. Motion of free test particles is calculated explicitly and the limit to an impulsive wave is also considered.

  11. Vitiligo associated with esophageal adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Ali Asilian


    Full Text Available Vitiligo is a disease that results in depigmented areas in the skin. It may develop at any age but the average age at onset is 20 years. Association of vitiligo and melanoma has been commonly reported, but malignancies other than melanoma have been rarely associated with vitiligo. We report a 73-year-old patient with new onset vitiligo who developed esophageal adenocarcinoma in the following years.

  12. Optimal lymphadenectomy for esophageal adenocarcinoma. (United States)

    Oezcelik, A


    Recently published data have shown that an extended lymphadenectomy during the en bloc esophagectomy leads to a significant increased long-term survival for esophageal adenocarcinoma. On the other hand some studies indicate that the increased survival is based on stage migration and that the surgical complication rate is increased after extended lymphadenectomy. The aim of this review was to give an overview about all aspects of an extended lymphadenectomy in patients with esophageal adenocarcinoma. The review of the literature shows clearly that the number of involved lymph nodes is an independent prognostic factor in patients with esophageal adenocarcinoma. Furthermore, an extended lymphadenectomy leads to an increased long-term survival. Some studies describe that 23 lymph nodes should be removed to predict survival; other studies 18 lymph nodes or 15 lymph nodes. Opponents indicate that the survival benefit is based on stage migration. The studies with a large study population have performed a Cox regression analyzes and identified the number of lymph nodes removed as an independent factor for improved survival, which means it is significant independently from other parameters. Under these circumstances is stage migration not an option to explain the survival benefit. An important difficulty is, that there is no standardized definition of an extended lymphadenectomy, which means the localization and number of removed lymph nodes differ depending from the performing centre. The controversies regarding the survival benefit of the lymphadenectomy is based on the lack of standardisation of the lymphadenectomy. The main goal of further studies should be to generate a clear definition of an extended lymphadenectomy in patients with esophageal adenocarcinoma.

  13. Novel device to sample the esophageal microbiome--the esophageal string test.

    Directory of Open Access Journals (Sweden)

    Sophie A Fillon

    Full Text Available A growing number of studies implicate the microbiome in the pathogenesis of intestinal inflammation. Previous work has shown that adults with esophagitis related to gastroesophageal reflux disease have altered esophageal microbiota compared to those who do not have esophagitis. In these studies, sampling of the esophageal microbiome was accomplished by isolating DNA from esophageal biopsies obtained at the time of upper endoscopy. The aim of the current study was to identify the esophageal microbiome in pediatric individuals with normal esophageal mucosa using a minimally invasive, capsule-based string technology, the Enterotest™. We used the proximal segment of the Enterotest string to sample the esophagus, and term this the "Esophageal String Test" (EST. We hypothesized that the less invasive EST would capture mucosal adherent bacteria present in the esophagus in a similar fashion as mucosal biopsy. EST samples and mucosal biopsies were collected from children with no esophageal inflammation (n = 15 and their microbiome composition determined by 16S rRNA gene sequencing. Microbiota from esophageal biopsies and ESTs produced nearly identical profiles of bacterial genera and were different from the bacterial contents of samples collected from the nasal and oral cavity. We conclude that the minimally invasive EST can serve as a useful device for study of the esophageal microbiome.

  14. Current knowledge on esophageal atresia

    Institute of Scientific and Technical Information of China (English)

    Paulo Fernando Martins Pinheiro; Ana Cristina Sim(o)es e Silva; Regina Maria Pereira


    Esophageal atresia (EA) with or without tracheoesophageal fistula (TEF) is the most common congenital anomaly of the esophagus.The improvement of survival observed over the previous two decades is multifactorial and largely attributable to advances in neonatal intensive care,neonatal anesthesia,ventilatory and nutritional support,antibiotics,early surgical intervention,surgical materials and techniques.Indeed,mortality is currently limited to those cases with coexisting severe life-threatening anomalies.The diagnosis of EA is most commonly made during the first 24 h of life but may occur either antenatally or may be delayed.The primary surgical correction for EA and TEF is the best option in the absence of severe malformations.There is no ideal replacement for the esophagus and the optimal surgical treatment for patients with long-gap EA is still controversial.The primary complications during the postoperative period are leak and stenosis of the anastomosis,gastro-esophageal reflux,esophageal dysmotility,fistula recurrence,respiratory disorders and deformities of the thoracic wall.Data regarding long-term outcomes and follow-ups are limited for patients following EA/TEF repair.The determination of the risk factors for the complicated evolution following EA/TEF repair may positively impact long-term prognoses.Much remains to be studied regarding this condition.This manuscript provides a literature review of the current knowledge regarding EA.

  15. Smoothing error pitfalls (United States)

    von Clarmann, T.


    The difference due to the content of a priori information between a constrained retrieval and the true atmospheric state is usually represented by a diagnostic quantity called smoothing error. In this paper it is shown that, regardless of the usefulness of the smoothing error as a diagnostic tool in its own right, the concept of the smoothing error as a component of the retrieval error budget is questionable because it is not compliant with Gaussian error propagation. The reason for this is that the smoothing error does not represent the expected deviation of the retrieval from the true state but the expected deviation of the retrieval from the atmospheric state sampled on an arbitrary grid, which is itself a smoothed representation of the true state; in other words, to characterize the full loss of information with respect to the true atmosphere, the effect of the representation of the atmospheric state on a finite grid also needs to be considered. The idea of a sufficiently fine sampling of this reference atmospheric state is problematic because atmospheric variability occurs on all scales, implying that there is no limit beyond which the sampling is fine enough. Even the idealization of infinitesimally fine sampling of the reference state does not help, because the smoothing error is applied to quantities which are only defined in a statistical sense, which implies that a finite volume of sufficient spatial extent is needed to meaningfully discuss temperature or concentration. Smoothing differences, however, which play a role when measurements are compared, are still a useful quantity if the covariance matrix involved has been evaluated on the comparison grid rather than resulting from interpolation and if the averaging kernel matrices have been evaluated on a grid fine enough to capture all atmospheric variations that the instruments are sensitive to. This is, under the assumptions stated, because the undefined component of the smoothing error, which is the

  16. Palliative Endoscopic Therapy of Esophageal Cancer

    Institute of Scientific and Technical Information of China (English)

    H.Schaefer; A.H.Hoelscher


    Patients with locally unresectable esophageal cancer or distant metastasis are usually treated with definite radiotherapy or radiochemotherapy. Dysphagia of these patients should further be treated by endoscopic therapy in order to maintain swallowing and oral food intake as long as possible. The same situation is present in patients with local recurrence of esophageal cancer after surgery or radiochemotherapy.

  17. PET-CT manifestation of Candida esophagitis

    Energy Technology Data Exchange (ETDEWEB)

    Bahk, Yong Whee [Sung-Ae Hospital, Seoul (Korea, Republic of); O, Joo Hyun [Kangnam St. Mary' s Hospital, Catholic University Medical School, Seoul (Korea, Republic of)


    Candida esophagitis (moniliasis) is the most common infection of the gullet and has generally been attributed to as a complication of immune suppressed state. However, as the current case. Holt found the disease to occur in 3 of his 13 patients without predisposing condition. Predisposing factors other than immune deficient conditions include aplastic anemia, alcoholism and Parkinson's disease and age, diabetes mellitus, and disruption of mucosal integrity. Growing prevalence of Candida esophagitis in recent years is accounted for by an increase in the number of patients with organ transplantation, malignancy and AIDS as well as populrization of endoscopy. Microorganisms that reached the esophagus in oral secretions are rarely cultured from the esophageal surface. Of many species C. albicans is the most common offender although C. tropicalis has also been isolated with high prevalence, particularly in the patients with cancer and disseminated candidiasis. Clinically, the patients with Candida esophagitis seek medical care for esophageal or retrosternal pain, dysphagia or distress. Candida esophagitis may be the extension from oropharyngeal infection but in the majority the esophagus is the sole site of infection. The middle and lower thirds of the esophagus are more typically affected than the upper third. Diagnosis can be indicated by double contrast esophagography or endoscopy and confirmed by potassium hydroxide (KOH) stain or biopsy. It is to be noted that the more presence of Candida in smear or cultured specimen cannot indict Candida as definitive offender. Differential diagnosis includes herpes simplex infection, cytomegalovirus infection, reflux esophagitis or radiation esophagitis.

  18. Novel insights into esophageal diagnostic procedures

    DEFF Research Database (Denmark)

    Savarino, Edoardo; Ottonello, Andrea; Tolone, Salvatore;


    The 21st century offers new advances in diagnostic procedures and protocols in the management of esophageal diseases. This review highlights the most recent advances in esophageal diagnostic technologies, including clinical applications of novel endoscopic devices, such as ultrathin endoscopy and...

  19. Iatrogenic esophageal perforation in a newborn

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jeong Mi; Yeon, Kyung Mo; Park, Won Soon; Choi, Jung Hwan [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)


    Esophagus and pharyngeal structures of newborn are very week and so vulnerable. When a parallel longitudinal tubular structure around (especially behind) the esophagus is seen, traumatic esophageal perforation must be differentiated. We report a case of esophageal perforation in a premature twin baby by nasogastric tube insertion.

  20. Esophageal diverticula in Parma wallabies (Macropus parma). (United States)

    Okeson, Danelle M; Esterline, Meredith L; Coke, Rob L


    Four adult, wild caught Parma wallabies (Macropus parma) presented with intermittent, postprandial, midcervical swellings. Esophageal diverticula were discovered in the four animals. One of two wallabies was managed successfully with surgery. A third animal died of other causes. The fourth animal died with possible complications from the diverticulum. This is the first published report of esophageal diverticula in macropods.

  1. Comparative genomic analysis of esophageal cancers. (United States)

    Caygill, Christine P J; Gatenby, Piers A C; Herceg, Zdenko; Lima, Sheila C S; Pinto, Luis F R; Watson, Anthony; Wu, Ming-Shiang


    The following, from the 12th OESO World Conference: Cancers of the Esophagus, includes commentaries on comparative genomic analysis of esophageal cancers: genomic polymorphisms, the genetic and epigenetic drivers in esophageal cancers, and the collection of data in the UK Barrett's Oesophagus Registry.

  2. Esophageal motility abnormalities in gastroesophageal reflux disease

    Institute of Scientific and Technical Information of China (English)

    Irene; Martinucci; Nicola; de; Bortoli; Maria; Giacchino; Giorgia; Bodini; Elisa; Marabotto; Santino; Marchi; Vincenzo; Savarino; Edoardo; Savarino


    Esophageal motility abnormalities are among the main factors implicated in the pathogenesis of gastroesophageal reflux disease. The recent introduction in clinical and research practice of novel esophageal testing has markedly improved our understanding of the mechanisms contributing to the development of gastroesophageal reflux disease, allowing a better management of patients with this disorder. In this context, the present article intends to provide an overview of the current literature about esophageal motility dysfunctions in patients with gastroesophageal reflux disease. Esophageal manometry, by recording intraluminal pressure, represents the gold standard to diagnose esophagealmotility abnormalities. In particular, using novel techniques, such as high resolution manometry with or without concurrent intraluminal impedance monitoring, transient lower esophageal sphincter (LES) relaxations, hypotensive LES, ineffective esophageal peristalsis and bolus transit abnormalities have been better defined and strongly implicated in gastroesophageal reflux disease development. Overall, recent findings suggest that esophageal motility abnormalities are increasingly prevalent with increasing severity of reflux disease, from nonerosive reflux disease to erosive reflux disease and Barrett’s esophagus. Characterizing esophageal dysmotility among different subgroups of patients with reflux disease may represent a fundamental approach to properly diagnose these patients and, thus, to set up the best therapeutic management. Currently, surgery represents the only reliable way to restore the esophagogastric junction integrity and to reduce transient LES relaxations that are considered to be the predominant mechanism by which gastric contents can enter the esophagus. On that ground, more in depth future studies assessing the pathogenetic role of dysmotility in patients with reflux disease are warranted.

  3. [Endoscopic surgery for benign esophageal diseases]. (United States)

    Ozawa, Soji


    Gastroesophageal reflux disease (GERD) and esophageal achalasia are common benign esophageal diseases. Today minimally invasive surgery is recommended to treat these diseases. Surgical indications for GERD are failure of medical management, medical complications attributable to a large hiatal hernia, 'atypical' symptoms (asthma, hoarseness, cough, chest pain, aspiration), etc. according to the Society of American Gastrointestinal Endoscopic Surgeons (SAGES) guidelines. Laparoscopic Nissen fundoplication has emerged as the most widely accepted procedure for GERD patients with normal esophageal motility. Partial fundoplication (e.g., Toupet fundoplication) is also considered to decrease the possibility of postoperative dysphagia. Although pneumatic dilatation has been the first line treatment for esophageal achalasia, laparoscopic Heller myotomy and partial fundoplication (e.g., Dor fundoplication) to prevent reflux is preferred by most gastroenterologists and surgeons as the primary treatment modality. Laparoscopic surgery for GERD and esophageal achalasia are effective in most patients and safe in all patients. Finally, laparoscopic surgery should be performed only by skilled surgeons.

  4. Systemic complications of esophageal lichen planus. (United States)

    Manna, R; Garcovich, S; Giovinale, M; Marinaro, A; Manganelli, C; Zampetti, A; Feliciani, C


    Lichen planus is an uncommon inflammatory mucocutaneous disorder affecting the skin and its appendages, as well as oral and genital mucosa. Involvement of the esophageal mucosa is rare and causes significant morbidity, with dysphagia and risk of long-term complications, such as esophageal strictures and stenosis. Esophageal lichen planus is an underreported condition in the spectrum of lichenoid tissue reactions, presenting the risk of systemic manifestations. We describe a patient with severe, long-standing esophageal lichen planus, which had led to marked weight-loss, malnutrition syndrome and chronic respiratory distress due to recurrent aspiration pneumonia. Diagnosis was confirmed by the presence of concomitant muco-cutaneous lesions and characteristic endoscopic and histological findings. Systemic therapy with cyclosporine A and micronutrient supplementation led to rapid clinical improvement. Early diagnosis of esophageal lichen planus as well as effective systemic immunosuppressive treatment is crucial in order to prevent short- and long-term complications.

  5. Esophageal strictures during treatment for acute lymphoblastic leukemia.

    LENUS (Irish Health Repository)

    Kelly, Kevin


    Esophageal stricture is a rare complication of paediatric cancer treatment that usually occurs after esophageal exposure to radiotherapy. We describe 4 cases of esophageal stricture during chemotherapy for acute lymphoblastic leukemia. All patients presented with refractory vomiting and were diagnosed with radiologic contrast studies. None of the patients had received radiotherapy. Esophageal candidiasis was seen in 2 patients but the remaining 2 patients had earlier systemic candidiasis. High-dose dexamethasone may predispose these children to both esophageal candidiasis and peptic esophagitis. The etiology of esophageal strictures during treatment for acute leukemia is likely to be multifactorial but systemic candidiasis may play a significant role.

  6. Cat Scratch Disease (For Parents) (United States)

    ... Old Feeding Your 1- to 2-Year-Old Cat Scratch Disease KidsHealth > For Parents > Cat Scratch Disease A A A What's in this ... Doctor en español Enfermedad por arañazo de gato Cat scratch disease is a bacterial infection that a ...

  7. A tortoiseshell male cat

    DEFF Research Database (Denmark)

    Pedersen, A. S.; Berg, Lise Charlotte; Almstrup, Kristian


    . Immunostaining using anti-vimentin and anti-VASA (DDX4) showed that only Sertoli cells and no germ cells were observed in the testicular tubules. As no sign of spermatogenesis was detected, we conclude that this is a classic case of a sterile, male tortoiseshell cat with a 39,XXY chromosome complement. © 2013 S...

  8. Vibrational Schroedinger Cats (United States)

    Kis, Z.; Janszky, J.; Vinogradov, An. V.; Kobayashi, T.


    The optical Schroedinger cat states are simple realizations of quantum states having nonclassical features. It is shown that vibrational analogues of such states can be realized in an experiment of double pulse excitation of vibrionic transitions. To track the evolution of the vibrational wave packet we derive a non-unitary time evolution operator so that calculations are made in a quasi Heisenberg picture.

  9. The Fishing Cat

    Institute of Scientific and Technical Information of China (English)

    孙雅飞; 乐伟国


    @@ 一、故事内容 A cat goes fishing every day. He wants to eat fish, but he can't catch any fish. One day, he goes to the river as usual. Suddenly, a fish comes out. He catches the fish and putsthe fish in the basket. He's very happy, but he forgest to put the lid on the basket.

  10. Lichenoid esophagitis: clinicopathologic overlap with established esophageal lichen planus. (United States)

    Salaria, Safia N; Abu Alfa, Amer K; Cruise, Michael W; Wood, Laura D; Montgomery, Elizabeth A


    Lichen planus (LP) affects mucocutaneous surfaces and is characterized by intraepithelial and lamina propria lymphocytosis and squamous cell apoptosis (Civatte bodies). Lichen planus esophagitis (LPE) is underrecognized; concurrent cutaneous disease is present in some patients, but LPE alone is more common. We diagnose patients with characteristic pathologic findings of LPE and known correlation with skin disease or immunofluorescence (IF) results as LPE but use descriptive terminology ("lichenoid esophagitis pattern" [LEP]) when confirmation is unavailable. We reviewed clinicopathologic features of patients diagnosed at our institution with LPE or LEP. There were 88 specimens with LPE or LEP from 65 patients. Most patients were female. Seventeen patients had LPE confirmed by IF. Five patients had both esophageal (1 with IF) and skin LP. Strictures were a prominent presenting feature in LPE patients, with disease distribution more frequent in the upper and lower esophagus. Dysphagia was a common reason for endoscopy in LEP patients. Rheumatologic diseases are more common in patients with LPE compared with LEP. Viral hepatitides and human immunodeficiency virus (HIV) infections are associated with LEP. We defined polypharmacy as patients taking >3 medications; this finding was present in both LPE and LEP cohorts; however, this is a prominent feature in those with established LPE. Progression to dysplasia was noted in both cohorts. About 5% of LPE patients have tandem skin manifestations. LPE is more likely than LEP to arise in women, result in stricture formation, and be associated with rheumatologic disorders and polypharmacy, whereas LEP is associated with viral hepatitis and HIV. Both can progress to neoplasia. As the risk of stricture formation is high in patients with LPE, it is worth performing pertinent IF studies to confirm LPE, although knowledge of the clinical association of LEP with viral hepatitis, HIV, and use of multiple medications is of value in

  11. A comparative analysis by SAGE of gene expression profiles of esophageal adenocarcinoma and esophageal squamous cell carcinoma

    NARCIS (Netherlands)

    van Baal, Jantine W. P. M.; Milana, Francesco; Rygiel, Agnieszka M.; Sondermeijer, Carine M. T.; Spek, C. Arnold; Bergman, Jacques J. G. H. M.; Peppelenbosch, Maikel P.; Krishnadath, Kausilia K.


    Esophageal adenocarcinoma (EA) and esophageal squamous cell carcinoma (ESCC) are the two main types of esophageal cancer. Despite extensive research the exact molecular basis of these cancers is unclear. Therefore we evaluated the transcriptome of EA in comparison to non-dysplastic Barrett's esophag

  12. Giant mid-esophageal diverticulum. Conservative treatment of postoperative leakage. (United States)

    Dallatomasina, S; Casaccia, M; Chessa, M; Serrano, J; Nardi, I; Troilo, B; Miggino, M; Valente, U


    Mid-esophageal diverticula are rare entities. Only symptomatic patients usually receive surgical treatment. Esophageal leakage is one of the most common complications after these procedures. Though in literature, operative management is the preferred treatment for esophageal fistula, conservative approach is described in case of small leaks. We report a case of an operated giant mid-esophageal diverticulum complicated with an esophageal fistula. The patient underwent a surgical treatment and recovered completely.

  13. Revealed smooth nontransitive preferences

    DEFF Research Database (Denmark)

    Keiding, Hans; Tvede, Mich


    consumption bundle, all strictly preferred bundles are more expensive than the observed bundle. Our main result is that data sets can be rationalized by a smooth nontransitive preference relation if and only if prices can normalized such that the law of demand is satisfied. Market data sets consist of finitely...... many observations of price vectors, lists of individual incomes and aggregate demands. We apply our main result to characterize market data sets consistent with equilibrium behaviour of pure-exchange economies with smooth nontransitive consumers....

  14. Activity assessment of eosinophilic esophagitis. (United States)

    Schoepfer, Alain; Safroneeva, Ekaterina


    The activity of eosinophilic esophagitis (EoE) can be assessed with patient-reported outcomes and biologic measures. Patient-reported outcomes include symptoms and quality of life, whereas biologic measures refer to endoscopic, histologic, and biochemical activity (e.g. blood biomarkers). So far, a validated tool to assess EoE activity in the above-mentioned dimensions is lacking. Given the lack of a standardized way to assess EoE activity in the various dimensions, the results of different clinical trials may be difficult to compare. For symptom assessment in adult patients, the symptom 'dysphagia' should be evaluated according to different standardized food consistencies. Furthermore, symptom assessment should take into account the following items: avoidance of specific food categories, food modification, and time to eat a regular meal. A distinct symptom recall period (e.g. 2 weeks) has to be defined for symptom assessment. Performing an 'esophageal stress test' with ingestion of a standardized meal to measure symptom severity bears the potential risk of acute food bolus impaction and should therefore be avoided. The description of endoscopic findings in EoE has meanwhile been standardized. Histologic evaluation of EoE activity should report either the size of the high-power field used or count the eosinophils per mm(2). There is a current lack of blood biomarkers demonstrating a good correlation with histologic activity in esophageal biopsies. The development and validation of an adult and pediatric EoE activity index is urgently needed not only for clinical trials and observational studies, but also for daily practice.

  15. Genetic testing in domestic cats. (United States)

    Lyons, Leslie A


    Varieties of genetic tests are currently available for the domestic cat that support veterinary health care, breed management, species identification, and forensic investigations. Approximately thirty-five genes contain over fifty mutations that cause feline health problems or alterations in the cat's appearance. Specific genes, such as sweet and drug receptors, have been knocked-out of Felidae during evolution and can be used along with mtDNA markers for species identification. Both STR and SNP panels differentiate cat race, breed, and individual identity, as well as gender-specific markers to determine sex of an individual. Cat genetic tests are common offerings for commercial laboratories, allowing both the veterinary clinician and the private owner to obtain DNA test results. This article will review the genetic tests for the domestic cat, and their various applications in different fields of science. Highlighted are genetic tests specific to the individual cat, which are a part of the cat's genome.

  16. Pyramidal cells make specific connections onto smooth (GABAergic neurons in mouse visual cortex.

    Directory of Open Access Journals (Sweden)

    Rita Bopp


    Full Text Available One of the hallmarks of neocortical circuits is the predominance of recurrent excitation between pyramidal neurons, which is balanced by recurrent inhibition from smooth GABAergic neurons. It has been previously described that in layer 2/3 of primary visual cortex (V1 of cat and monkey, pyramidal cells filled with horseradish peroxidase connect approximately in proportion to the spiny (excitatory, 95% and 81%, respectively and smooth (GABAergic, 5% and 19%, respectively dendrites found in the neuropil. By contrast, a recent ultrastructural study of V1 in a single mouse found that smooth neurons formed 51% of the targets of the superficial layer pyramidal cells. This suggests that either the neuropil of this particular mouse V1 had a dramatically different composition to that of V1 in cat and monkey, or that smooth neurons were specifically targeted by the pyramidal cells in that mouse. We tested these hypotheses by examining similar cells filled with biocytin in a sample of five mice. We found that the average composition of the neuropil in V1 of these mice was similar to that described for cat and monkey V1, but that the superficial layer pyramidal cells do form proportionately more synapses with smooth dendrites than the equivalent neurons in cat or monkey. These distributions may underlie the distinct differences in functional architecture of V1 between rodent and higher mammals.

  17. Successful treatment of corrosive esophageal strictures after failed esophageal reconstructions with colon and jejunum

    Institute of Scientific and Technical Information of China (English)

    ZHOU Jing-hai; JIANG Yao-guang; WANG Ru-wen; ZHAO Yun-ping; GONG Tai-qian; TAN Qun-you; MA Zheng; LIN Yi-dan; DENG Bo


    Dense and extensive esophageal strictures after caustic agent ingestion require surgical treatment. Colon, stomach and jejunum can be used to reconstruct esophagus. Here, we report an unusual patient with corrosive esophageal stricture who had received unsuccessful esophageal replacements twice at other hospitals. Colon interposition had been first performed 6 months after corrosive esophageal burn,but the colon graft necrosis occurred. Esophageal reconstruction had been carried out 10 years later in another hospital. However, the graft necrosis developed again 5 months later. A salvage operation was performed to remove the necrotic transplant in our hospital. Then as much food as possible had been given to expand the stomach through the gastrostomy since the procedure. The patient underwent esophagectomy and concomitant gastroesophagostomy in the neck 1.5 years later. Esophageal dilations had been performed to prevent recurrent anastomotic stricture for 1 year. He has eaten a normal diet since being discharged.

  18. The Effects of Environmental Factors on Smooth Muscle Cells Differentiation from Adipose-Derived Stem Cells and Esophagus Tissues Engineering

    DEFF Research Database (Denmark)

    Wang, Fang

    Adipose-derived stem cells (ASCs) are increasingly being used for regenerative medicine and tissue engineering. Smooth muscle cells (SMCs) can be differentiated from ASCs. Oxygen is a key factor influencing the stem cell differentiation. Tissue engineered esophagus has been a preferred solution...... of esophagus was studied. Our results showed that both SMCs and ASCs could attach on the porcine esophageal acellular matrix (EAM) scaffold in vitro after 24 hours and survive until 7 days. Thus ASCs might be a substitute for SMCs in the construction of tissue engineered esophageal muscle layer....

  19. Smoothed Particle Hydrodynamic Simulator

    Energy Technology Data Exchange (ETDEWEB)


    This code is a highly modular framework for developing smoothed particle hydrodynamic (SPH) simulations running on parallel platforms. The compartmentalization of the code allows for rapid development of new SPH applications and modifications of existing algorithms. The compartmentalization also allows changes in one part of the code used by many applications to instantly be made available to all applications.

  20. Cat scratch disease. (United States)

    Bozhkov, V; Madjov, R; Plachkov, I; Arnaudov, P; Chernopolsky, P; Krasnaliev, I


    Approximately 24,000 people are infected with cat scratch disease (CSD) every year. CSD is caused by the bacteria Bartonella henselae, a gram-negative bacteria most often transmitted to humans through a bite or scratch from an infected cat or kitten. Although CSD is often a benign and self-limiting condition, it can affect any major organ system in the body, manifesting in different ways and sometimes leading to lifelong sequelae. It is a disease that is often overlooked in primary care because of the wide range of symptom presentation and relative rarity of serious complications. It is important for health care providers to recognize patients at risk for CSD, know what laboratory testing and treatments are available, and be aware of complications that may arise from this disease in the future.

  1. The Cheshire Cat revisited

    CERN Document Server

    Vento, V


    The concept of effective field theory leads in a natural way to a construction principle for phenomenological sensible models known under the name of the Cheshire Cat Principle. We review its formulation in the chiral bag scenario and discuss its realization for the flavor singlet axial charge. Quantum effects inside the chiral bag induce a color anomaly which requires a compensating surface term to prevent breakdown of color gauge invariance. The presence of this surface term allows one to derive in a gauge-invariant way a chiral-bag version of the Shore-Veneziano two-component formula for the flavor-singlet axial charge of the proton. We show that one can obtain a striking Cheshire-Cat phenomenon with a negligibly small singlet axial charge.

  2. Mineral metabolism in cats


    Pineda Martos, Carmen María


    The present Doctoral Thesis wa metabolism in the feline species. Through a series of studies, the relationship between calcium metabolism and the main hormones involved in it has been determined metabolism during the juvenile stage of growing cats effects linked to feeding calculolytic diets on feline mineral metabolism. The first part of the work was aimed the quantification of intact (I-PTH) and whole PTH) and to characterize the dynamics of PTH secretion, including ...

  3. Updates on esophageal and gastric cancers

    Institute of Scientific and Technical Information of China (English)

    Amy Gallo; Charles Cha


    Esophageal and gastric cancers are both common and deadly. Patients present most often after disease progression and survival is therefore poor. Due to demographic variability and recent changes in disease incidence, much emphasis has been placed on studying risk factors for both esophageal and gastric cancers.However, with increasing understanding of these diseases, low survival rates persist and continued intensive studies are necessary to optimize treatment plans. This review article discusses updates in the evolving epidemiology, clinical presentation, risk factors,and diagnostic and treatment modalities of esophageal and gastric cancers.

  4. Esophageal scintigraphy: A comparison with esophagoscopy

    Energy Technology Data Exchange (ETDEWEB)

    Kjellen, G.; Andersson, P.; Sandstroem, S.


    Fifty consecutive patients with different esophageal symtoms were investigated with esophageal endoscopy, transit scintigraphy, and gastroesophageal (GE) scintigraphy with extra-abdominal compression. Scintigraphic findings were abnormal in 27 of those 31 patients (87%) who were classified as abnormal at endoscopy. A prolonged transit time was the commonest finding, but hiatal hernia and GE reflux were also found. However, the scintigraphic procedure showed abnormalities in 6 of 19 (31%) patients who were classified as normal at endoscopy. Esophageal scintigraphy is recommended as a screening test before endoscopy is decided on. 20 refs.

  5. [Laparoscopic surgery for esophageal achalasia]. (United States)

    Ozawa, S; Ando, N; Ohgami, M; Kitagawa, Y; Kitajima, M


    Laparoscopic surgery for esophageal achalasia was first reported by Shimi et al. in 1991. Subsequently the procedure has been performed all over the world and laparoscopic Heller myotomy and Dor fundoplication (Heller and Dor operation) is now thought to be the operation of first choice. It is indicated for patients who are resistant to medical therapy (calcium blocker etc.) or have pneumatic dilatation and those with frequent aspiration at night. As Csendes et al. reported that surgical treatment was better than pneumatic dilatation and as laparoscopic surgery is less invasive, the indications for the laparoscopic Heller and Dor operation can include all achalasia patients except those who respond to medical therapy, do not accept surgery, or cannot tolerate surgery. We successfully performed the laparoscopic Heller and Dor operation on 22 patients, all of whom had an uneventful postoperative course. Manometric evaluation, endoscopic examination, and 24-hour pH monitoring showed good results. There are six important technical points: 1) flexible laparoscopy; 2) pneumoperitoneum; 3) gauze in the abdominal cavity to absorb blood; 4) laparosonic coagulating shears; 5) extracorporeal knot-tying technique; and 6) intracorporeal knot-tying technique. If an experienced surgeon is in charge, the laparoscopic Heller and Dor operation is an ideal, minimally invasive treatment for esophageal achalasia.

  6. Repair of a sliding (type I hiatal hernia in a cat via herniorrhaphy, esophagoplasty and floppy Nissen fundoplication

    Directory of Open Access Journals (Sweden)

    Jennifer M Gambino


    Full Text Available Case summary A 10-month-old domestic shorthair cat was evaluated for severe esophagitis and protracted vomiting and regurgitation secondary to a sliding (type I hiatal hernia. The hernia and concurrent upper airway obstruction (nasopharyngeal polyp were diagnosed with a multi-modality approach, including thoracic and abdominal radiographs, abdominal ultrasound, computed tomography and endoscopy. Following unsuccessful attempts at medical management, lower esophageal incompetence was successfully treated by employing a combination of surgical techniques, including herniorrhaphy, esophagopexy and modified (floppy Nissen fundoplication. Relevance and novel information A multi-modality imaging approach was valuable in completely assessing the extent of this cat’s disease. Although an untraditional approach, the authors report herein the first clinical description of the use of combined surgical techniques with the floppy Nissen fundoplication technique (an antireflux procedure in a cat. This procedure was used as a first-line surgical technique in this cat with severe lower esophageal incompetence, and may be a viable option for cases non-responsive to other therapeutic interventions. Further investigation of this surgical technique is warranted.


    Institute of Scientific and Technical Information of China (English)

    王立峰; 张伟; 王吾如; 王洪平; 韩双廷; 曲平; 刘义; 李茉; 刘伯齐; 林培中


    To investigate cyclooxygenase- 2(Cox-2) protein expression in esophageal cancer and precancerous lesions. Methods: One hundred twenty biopsy specimens from esophageal carcinoma and 113 from patients with esophageal premalingnant lesions, 27 from individuals with normal esophageal mucosa and 3 from Barrett's esophagus were examined for Cox-2 protein expression by immunohistochemistry. Results: Cox-2 protein was not observed in normal esophageal squamous and glandular epithelium, hyperplasia from mild to severe dysplasia lesions and carcinoma in situ. Positive Cox-2 protein expression was found in 4 of 60 specimens of invasive squamous-cell carcinomas, 21 of 30 specimens of esophageal adenocarcinomas and in 3 of 3 Barret's esophageal tissues. Conclusion: The Cox-2 protein expression may be associated with the development of the esophageal adenocarcinomas but not esophageal squamous-cell carcinomas.

  8. In vitro construction and in vivo regeneration of esophageal bilamellar muscle tissue. (United States)

    Hou, Lei; Gong, Changfeng; Zhu, Yabin


    In order to induce esophageal muscle cells' orientation, the silicon wafer with prototype 1 and prototype 2 was designed. Prototype 1 has micro-channels of 200 µm width and 30 µm depth with 30 µm wide wall as the interval. Prototype 2 has channels of 100 µm width and 30 µm depth with a discontinuous wall which has 30 µm gap for each 100 µm channel. The poly(ester urethane) scaffolds with pattern prototype 1 and prototype 2 were fabricated using solution casting method and abbreviated as PU1 and PU2, respectively. Silk fibroin was grafted individually on PU1 and PU2 surface (PU1-SF, PU2-SF) using our previous protocol, aiming at improving scaffolds' biocompatibility. The primary esophageal smooth muscle cell was seeded to evaluate the scaffolds' cytocompatibility in vitro. Characterizations like MTT assay, immunocytochemistry, scanning electron microscope, and Western blotting were applied. After that, poly(ester urethane) scaffolds with double patterns, prototype 1 on the exterior, and prototype 2 in the lumen were implanted into the rabbit esophagous to test the regeneration of the muscle tissue. Results from these preliminary tests showed that the growth and differentiation of primary smooth muscle cells were promoted, but also the muscle tissue with endocircular and exolongitudinal architecture was in regenerating, against non-constitution in the animals without the patterned scaffold or with poly(ester urethane) plane membrane at the defaulted sites. This micro-channel pattern together with silk fibroin grafting and vascular endothelial growth factor coating greatly promoted the regeneration of esophageal muscle with normal histological structure.

  9. Efficacy and toxicity of an accelerated hypofractionated radiation therapy protocol in cats with oral squamous cell carcinoma. (United States)

    Poirier, Valérie J; Kaser-Hotz, Barbara; Vail, David M; Straw, Rodney C


    Squamous cell carcinoma (SCC) is the most common feline oral tumor. Standard radiation protocols have been reported to achieve tumor control durations of 1.5-5.5 months (45-165 days). The purpose of this study was to describe the efficacy and toxicity of an accelerated hypofractionated radiation therapy protocol in cats with oral SCC. Twenty-one cats with histologically confirmed oral SCC and T1-3N0M0 were treated with 10 once-daily fractions (Monday-Friday) of 4.8 Gy. Seventeen cats had macroscopic disease and four were microscopic after incomplete excision. Acute toxicity consisted of grade 2 mucositis in all cats and this was effectively managed using esophageal or gastric tube feeding, pain medication, and antibiotics. Late toxicity effects for cats with available follow-up data included alopecia (4 cats), leukotricia (6), tongue ulceration (1), and oronasal fistula (1). Response could be assessed in 17 cats (seven complete response and five partial response). Four cats (19%) developed metastatic disease without evidence of local progression. The median progression-free survival (PFS) was 105 days (1 year PFS of 23%), median local progression-free survival (LPFS) was 219 days (1 year LPFS of 41%), and median overall survival (OS) was 174 days (1 year OS of 29%). Only tumor stage was prognostic, with T1 having a median PFS of 590 days. Findings indicated that this accelerated hypofractionated radiation therapy protocol was well tolerated in cats with oral SCC, with manageable adverse events. Tumor response was observed in most cats and long tumor control durations were achieved in some cats.

  10. Effect of omentum graft on esophageal anastomosis in dogs

    Directory of Open Access Journals (Sweden)

    A. K. Mahdi


    Full Text Available The aim of this study was to evaluate the complications and final function outcome of wrapping nonvascularized omentum graft around the suture line of esophageal anastomosis. Twelve adult local breed dogs were used in this study. The animals were divided into two equal groups (control and treated, all animal induced into general anesthesia by injection of atropen sulphate in a dose 0.04 mg/kg B.W, intramuscularly then after 15 minute given mixture of ketamine hydrochloride and xylazine hydrochloride in doses 15 mg/kg and 5 mg/kg B.W intramuscularly respectively. An oblique resection of about 1cm of the esophageal length and anastomosis by double layer of simple interrupted pattern by 2.0 cat gut suture (control group, same procedure was done in treated group except the wrapping the anastomosis site with patch of omentum tissue after lapratomy operation in the left flank region procedure. The clinical signs of treated animal revealed signs of dysphagia and regurgitation in treated group while this signs disappear in the control group. Radiological and histopathological examination of the anastomosis site performed at 15 and 30 days post operation. Radiological study recorded high degree of stenosis in the anastomosis site in treated group at 15 and 30 days post operation in compared with animals in control group that record mean degree of stenosis in treated group at 15 day (57.61±0.2 and at 30 day (55.78±0.2 while it recorded in control group at 15 day (39.34±1.04 and at 30 day (36.0.6 ±0.9, histopathological results recorded enhanced healing of anastomosis site in treated animals more than control animals. In conclusion we found that non vascularized omental graft prevent leak when used around the anastomosis line in esophageal and enhanced healing of anastomosis line but it increase the stenosis, fibrosis and adhesion of anastomosis site with surrounding muscle and this interferes with the swallowing as well as dysphagia and regurgitation

  11. Esophageal transit scintigraphy in systemic sclerosis. (United States)

    Chojnowski, Marek; Kobylecka, Małgorzata; Olesińska, Marzena


    Systemic sclerosis is a rare connective tissue disease, distinctive features of which are fibrosis and microangiopathy. The esophagus is one of the most commonly involved internal organs. Most patients experience dysphagia, difficulties in swallowing and gastro-esophageal reflux. However, in up to one third of cases, the initial onset of esophageal disease may be clinically silent. There are several diagnostic modalities available for assessing both morphological and functional abnormalities of the esophagus. If structural abnormalities are suspected, endoscopy is the method of choice. Functional evaluation is best achieved with manometry. Both endoscopy and manometry are invasive techniques, with low patient acceptance. Barium-contrast study is well tolerated, but qualitative assessment of functional abnormalities is imprecise. Esophageal scintigraphy is an easy, non-invasive, sensitive and specific diagnostic modality. It can detect esophageal dysfunction even in asymptomatic patients. In patients already diagnosed with systemic sclerosis, scintigraphy is useful in evaluating severity and progression of the disease.

  12. PET for Staging of Esophageal Cancer

    Institute of Scientific and Technical Information of China (English)



    FDG-PET is of clinical value especially for detection of distant metastases or recurrent esophageal cancer. For the staging of primary tumor or locoregional lymph node metastasis PET is currently not suitable.

  13. CT findings of esophageal schwannoma: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Man Ho; Ryu, Dae Shick; Eom, Dae Woon; Shin, Dong Rock; Choi, Soo Jung; Ahn, Jae Hong; Park, Man Soo; Yoo, Dong Kon [Gangneung Asan Hospital, College of Medicine, University of Ulsan, Gangneung (Korea, Republic of)


    Esophageal schwannomas are a relative rare benign neoplasm that usually occurs in the upper esophagus, in the middle aged women. We report a case of a 67-year-old man with a lower esophageal schwannoma. This lesion was composed of homogenous density, iso-attenuating with the chest wall muscle on pre- and post-contrast chest computed tomography (CT). The CT findings of the esophageal schwannoma are similar to those of esophageal leiomyoma. Hense, esophageal schwannoma may be a differential diagnosis with esophageal leiomyoma.

  14. Qualitative and Quantitative Studies of Polygene Proteins Expression in Esophageal Precancerous Lesions and Esophageal Carcinoma

    Institute of Scientific and Technical Information of China (English)

    LI Chao-xia; WU Ming-yao; KUANG Li-ping


    Objective: To examine the expressions of MDM2, P53 and P27 proteins in chronic esophagitis, para-cancer mucosa and esophageal carcinoma. Methods: Immunohistochemistry was used to detect the expressions of MDM2, P53 and P27 proteins in forty-seven patients suffering from chronic esophagitis and eighty-five cases of esophageal carcinoma and corresponding para-cancer mucosa. Flow cytometry((FCM) was applied to detect the quantities of these proteins expressed in fresh tissues of 48 cases of esophageal cancer and their para-cancer tissues and 24 cases of relative normal mucosa at the surface of cutting edge. Results: Immunohistochemistry results showed that the expressions of the three studied proteins were very similar in the epithelia of chronic esophagitis and para-cancer mucosa (P>0.05). Both the qualitative and quantitative studies displayed that the P53 protein had no expression and its accumulations would appear only in the early stages of esophagus canceration while the MDM2 and P27 proteins had different degrees of expressions in cases of normal esophageal mucosa. MDM2 protein markedly increased in the advanced stages of esophageal canceration. A quantitative study showed that the expression of P27 protein had a linearity of decreasing tendency (F=9.132,P=0.002) in the course of esophageal canceration. Conclusion: Chronic esophagitis may be a precancerous lesion. Owing to the changes of the P53 and P27 proteins, we can also conclude that these occur in the early stages of esophagus oncogenesis, however the changes of MDM2 expression may occur in the advanced stage of esophageal canceration.

  15. Smoothness of limit functors

    Indian Academy of Sciences (India)

    Benedictus Margaux


    Let be a scheme. Assume that we are given an action of the one dimensional split torus $\\mathbb{G}_{m,S}$ on a smooth affine -scheme $\\mathfrak{X}$. We consider the limit (also called attractor) subfunctor $\\mathfrak{X}_{}$ consisting of points whose orbit under the given action `admits a limit at 0’. We show that $\\mathfrak{X}_{}$ is representable by a smooth closed subscheme of $\\mathfrak{X}$. This result generalizes a theorem of Conrad et al. (Pseudo-reductive groups (2010) Cambridge Univ. Press) where the case when $\\mathfrak{X}$ is an affine smooth group and $\\mathbb{G}_{m,S}$ acts as a group automorphisms of $\\mathfrak{X}$ is considered. It also occurs as a special case of a recent result by Drinfeld on the action of $\\mathbb{G}_{m,S}$ on algebraic spaces (Proposition 1.4.20 of Drinfeld V, On algebraic spaces with an action of $\\mathfrak{G}_{m}$, preprint 2013) in case is of finite type over a field.

  16. Smooth Neighborhood Structures in a Smooth Topological Spaces

    Directory of Open Access Journals (Sweden)

    A. A. Ramadan


    Full Text Available Various concepts related to a smooth topological spaces have been introduced and relations among them studied by several authors (Chattopadhyay, Ramadan, etc. In this study, we presented the notions of three sorts of neighborhood structures of a smooth topological spaces and give some of their properties which are results by Ying extended to smooth topological spaces.

  17. Dysphagia due to Multiple Esophageal Rings

    Directory of Open Access Journals (Sweden)

    Stephen N Sullivan


    Full Text Available A 27-year-old Saudi man with dysphagia due to multiple esophageal rings is reported and the literature reviewed. Dysphagia due to multiple esophageal rings is very rare. Only 15 cases have been reported. The patient is usually male and has had dysphagia for many years when presenting. The cause of the rings is unknown. Theories to explain dysphagia are that the rings are either congenital or an unusual manifestation of gastroesophageal reflux.

  18. Herpetic Esophagitis in Immunocompetent Medical Student


    Andréia Vidica Marinho; Vinícius Mendes Bonfim; Luciana Rodrigues De Alencar; Sebastião Alves Pinto; João Alves de Araújo Filho


    Esophagitis caused by herpes simplex virus (HSV) is often documented during periods of immunosuppression in patients infected with human immunodeficiency virus (HIV); it is rare in immunocompetent diagnosed patients. Case reports of herpetic esophagitis in students of health sciences are extremely rare. The disease presents with a clinical picture characterized by acute odynophagia and retrosternal pain without obvious causes and ulcers, evidenced endoscopically in the middistal esophagus. Di...

  19. Effects of lead on central nervous system development of the cat and rat

    Energy Technology Data Exchange (ETDEWEB)

    Patrick, G.W.


    This study utilizes the kitten as an experimental model because the neuroanatomical development of the cat more closely resembles that of the human, more so than the rat. Each kitten, except one control per litter, was given 20 mg/kg lead acetate daily by esophageal intubation for 35 days. At 35 days of age the kittens were sacrificed and prepared by standard methods for light or Golgi analysis. Body weight, but not brain weight, was reduced in lead-treated cats. However, Golgi-Cox stained material revealed a significant reduction in size and density of the Purkinje cell dendritic arborization in lead-treated animals. The width of the molecular layer was reduced reflecting this reduction in Purkinje cell dendritic field. The granule cell layer was reduced in width, while granule cell density was increased, indicating no reduction in cell number. The pyramidal cells from the motor cortex of lead-treated cats showed a reduction in secondary dendritic branching and a phenomenal increase in spine density on apical and basal dendrites. A series of studies using rats was also performed similar to those described by Pentschew and Garro (1966) for comparative purposes. Exposure to lead pre- and postnatally only caused changes in Purkinje cells similar to those seen in the lead-treated kittens. Histological changes were seen in pre- and postnatally exposed rat pups only. Esophageal intubation of high doses of lead solutions in newborn rat pups produced hemorrhagic lesions in both cerebellar and cerebral hemispheres within 24 hours after lead treatment.

  20. A review of over three decades of research on cat-human and human-cat interactions and relationships. (United States)

    Turner, Dennis C


    This review article covers research conducted over the last three decades on cat-human and human-cat interactions and relationships, especially from an ethological point of view. It includes findings on cat-cat and cat-human communication, cat personalities and cat-owner personalities, the effects of cats on humans, and problems caused by cats.

  1. Anti-smooth muscle antibody (United States)

    ... gov/ency/article/003531.htm Anti-smooth muscle antibody To use the sharing features on this page, please enable JavaScript. Anti-smooth muscle antibody is a blood test that detects the presence ...

  2. Metabolic syndrome is associated with erosive esophagitis

    Institute of Scientific and Technical Information of China (English)

    Jung Ho Park; Dong IL Park; Hong Joo Kim; Yong Kyun Cho; Chong IL Sohn; Woo Kyu Jeon; Byung Ik Kim


    AIM: To clarify whether insulin resistance and metabolic syndrome are risk factors for erosive esophagitis.METHODS: A case-control study was performed using the database of the Kangbuk Semsung Hospital Medical Screening Center.RESULTS: A total of 1679 cases of erosive esophagitis and 3358 randomly selected controls were included.Metabolic syndrome was diagnosed in 21% of the cases and 12% of the controls (P<0.001).Multiple logistic regressions confirmed the association between erosive esophagitis and metabolic syndrome (Odds ratio,1.25; 95% CI,1.04-1.49).Among the components of metabolic syndrome,increased waist circumference,elevated serum triglyceride levels and hypertension were significant risk factors for erosive esophagitis (allP<0.01).Furthermore,increased insulin resistance (Odds ratio,0.91; 95% CI,0.85-0.98)and fatty liver,as diagnosed by ultrasonography (odds ratio,1.39; 95% CI,1.20-1.60),were also related to erosive esophagitis even after adjustment for a series of confounding factors.CONCLUSION: Metabolic syndrome and increased insulin resistance are associated with an increased risk of developing erosive esophagitis.

  3. Laryngopharyngeal reflux in patients with reflux esophagitis

    Institute of Scientific and Technical Information of China (English)

    Yung-Chih Lai; Pa-Chun Wang; Jun-Chen Lin


    AIM: To assess the prevalence of laryngopharyngeal reflux (LPR) in patients with reflux esophagitis and dis-close factors contributing to the development of LPR.METHODS: A total of 167 patients who proved to have reflux esophagitis by endoscopy were enrolled.ings for the diagnosis of LPR. We used validated ques-tionnaires to identify the presence of laryngopharyn-geal symptoms, and stringent criteria of inclusion to increase the specificity of laryngoscopic findings. The data of patients were analyzed statistically to find out factors related to LPR.RESULTS: The prevalence rate of LPR in studied sub-jects with reflux esophagitis was 23.9%. Age, hoarse-ness and hiatus hernia were factors significantly as-sociated with LPR. In 23 patients with a hiatus hernia,the group with LPR was found to have a lower trend of esophagitis grading.CONCLUSION: Laryngopharyngeal reflux is present in patients with reflux esophagitis, and three predicting factors were identified. However, the development of LPR might be different from that of reflux esophagi-tis. The importance of hiatus hernia deserves further study.


    Institute of Scientific and Technical Information of China (English)



    The authors use the functional equation for embedding vector fields to study smooth embedding flows of one-dimensional diffeomorphisms. The existence and uniqueness for smooth embedding flows and vector fields are proved. As an application of embedding flows, some classification results about local and giobal diffeomorphisms under smooth conjugacy are given.

  5. ServCat Document Selection Guidelines (United States)

    US Fish and Wildlife Service, Department of the Interior — The ServCat document selection guidelines were developed for selecting appropriate documents to upload into ServCat. When beginning to upload documents into ServCat,...

  6. Clinical and dosimetric factors of radiation-induced esophageal injury: Radiation-induced esophageal toxicity

    Institute of Scientific and Technical Information of China (English)

    Wen-Bo Qiao; Yan-Hui Zhao; Yan-Bin Zhao; Rui-Zhi Wang


    AIM: To analyze the clinical and dosimetric predictive factors for radiation-induced esophageal injury in patients with non-small-cell lung cancer (NSCLC) during threedimensional conformal radiotherapy (3D-CRT). METHODS: We retrospectively analyzed 208 consecutive patients (146 men and 62 women) with NSCLC treated with 3D-CRT. The median age of the patients was 64 years (range 35-87 years). The clinical and treatment parameters including gender, age, performance status, sequential chemotherapy, concurrent chemotherapy, presence of carinal or subcarinal lymph nodes, pretreatment weight loss, mean dose to the entire esophagus, maximal point dose to the esophagus, and percentage of volume of esophagus receiving >55 Gy were studied. Clinical and dosimetric factors for radiation-induced acute and late grade 3-5 esophageal injury were analyzed according to Radiation Therapy Oncology Group (RTOG) criteria.RESULTS: Twenty-five (12%) of the two hundred and eight patients developed acute or late grade 3-5 esophageal injury. Among them, nine patients had both acute and late grade 3-5 esophageal injury, two died of late esophageal perforation. Concurrent chemotherapy and maximal point dose to the esophagus ≥60 Gy were significantly associated with the risk of grade 3-5 esophageal injury. Fifty-four (26%) of the two hundred and eight patients received concurrent chemotherapy. Among them, 25 (46%) developed grade 3-5 esophageal injury (P = 0.0001<0.01). However, nograde 3-5 esophageal injury occurred in patients who received a maximal point dose to the esophagus <60 Gy (P= 0.0001<0.01).CONCLUSION: Concurrent chemotherapy and the maximal esophageal point dose ≥60 Gy are significantly associated with the risk of grade 3-5 esophageal injury in patients with NSCLC treated with 3D-CRT.

  7. Personal Experience in TCM Treatment of Reflux Esophagitis

    Institute of Scientific and Technical Information of China (English)



    @@ Reflux esophagitis falls into the category of reflux gastroesophagopathy. It is characterized by inflammation, erosion, ulcer formation and fibrosis of the esophageal mucous membrane due to reflux of the content of the stomach and duodenum into the esophagus.

  8. College Students and Their Cats (United States)

    Weinstein, Lawrence; Alexander, Ralph


    Twenty-two Siamese and 32 mixed breed cats' personalities were rated by their respective college student owners and compared. Further, the owners' self rated personality traits were correlated with the pets'; significant Siamese and Mixed differences and correlations were obtained. These are the first data to examine breed of cat on a personality…


    The Contract Administrative Tracking System (CATS) was developed in response to an ORD NHEERL, Mid-Continent Ecology Division (MED)-recognized need for an automated tracking and retrieval system for Cost Reimbursable Level of Effort (CR/LOE) Contracts. CATS is an Oracle-based app...

  10. Oral masses in two cats. (United States)

    Bock, P; Hach, V; Baumgärtner, W


    Incisional biopsies from the oral cavity of 2 adult cats were submitted for histological investigation. Cat No. 1 showed a solitary well-circumscribed neoplasm in the left mandible. Cat No. 2 demonstrated a diffusely infiltrating neoplasm in the left maxilla. Both tumors consisted of medium-size epithelial cells embedded in a fibrovascular stroma. The mitotic index was 0 to 1 mitosis per high-power field. The epithelial cells showed an irregular arrangement forming nests or streams in cat No. 1, whereas a palisading growth was noted in cat No. 2. Both tumors, especially that of cat No. 1, showed multifocal accumulations of amyloid as confirmed by Congo red staining and a distinct green birefringence under polarized light, which lacked cytokeratin immunoreactivity as well as and AL and AA amyloid immunoreactivity. In addition, the amyloid in cat No. 2 was positive for the odontogenic ameloblast-associated protein, formerly termed APin. In sum, both cats suffered from an amyloid-producing odontogenic tumor, but their tumors varied with respect to morphology and type of amyloid produced.

  11. Lumbosacral agenesis in a cat

    Directory of Open Access Journals (Sweden)

    Gabrielle C Hybki


    Full Text Available Case summary Lumbosacral agenesis is a rare congenital condition reported in children. We report a 17-week-old female domestic shorthair cat with lumbosacral agenesis on whole-body radiographs. The cat was euthanized shortly thereafter presentation. A necropsy was not permitted. Relevance and novel information This is the first reported feline case of lumbosacral agenesis.

  12. Effects of anti-hypertensive drugs on esophageal body contraction

    Institute of Scientific and Technical Information of China (English)

    Koichi; Yoshida; Kenji; Furuta; Kyoichi; Adachi; Shunji; Ohara; Terumi; Morita; Takashi; Tanimura; Shuji; Nakata; Masaharu; Miki; Kenji; Koshino; Yoshikazu; Kinoshita


    AIM:To clarify the effects of anti-hypertensive drugs on esophageal contraction and determine their possi-ble relationship with gastro-esophageal reflux disease.METHODS:Thirteen healthy male volunteers were enrolled. Esophageal body peristaltic contractions and lower esophageal sphincter (LES) pressure were measured using high resolution manometry. All subjects were randomly examined on four separate occasions following administrations of nifedipine,losartan,and atenolol,as well as without any drug administ...

  13. [Current status and perspectives of radiotherapy for esophageal cancer]. (United States)

    Wu, S X; Wang, L H


    Esophageal cancer is one of the most common cancers in China. More than 80% of esophageal cancer patients are diagnosed at a late stage and are not eligible for surgery. Radiotherapy is one of the most important modalities in esophageal cancer treatment. Here we reviewed the advances in esophageal cancer radiotherapy and radiotherapy-based combined-modality therapy, such as optimization of radiation dose and target volume, application of precise radiotherapy technique and the integration of radiotherapy with chemotherapy and targeted therapy.

  14. Spectrum of esophageal abnormality seen on thoracic CT

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kyung Hee; Cho, Soon Gu; Jeon, Yong Sun; Jeong, Seok [Inha university Hospital, Incheon (Korea, Republic of); Kim, Hyung Jin [Samsung Medical Center, Seoul (Korea, Republic of)


    A variety of diseases involve the esophagus including esophagitis, benign or malignant tumors, varices, and esophageal perforation. We reviewed the thoracic CT of these various esophageal diseases, and classified them by similar CT findings. The CT findings were circumferential wall thickening, nodular wall thickening, abnormal luminal dilatation, fistula formation, and mass or mass like lesion. Although CT alone has limited diagnostic ability in esophageal disease, it may have an important role in diagnosing submucosal dissection, fistula, perforation, and intramural abscess.

  15. CAT-generation of ideals

    CERN Document Server

    Ueckerdt, Torsten


    We consider the problem of generating all ideals of a poset. It is a long standing open problem, whether or not the ideals of any poset can be generated in constant amortized time, CAT for short. We refine the tree traversal, a method introduced by Pruesse and Ruskey in 1993, to obtain a CAT-generator for two large classes of posets: posets of interval dimension at most two and so called locally planar posets. This includes all posets for which a CAT-generator was known before. Posets of interval dimension at most two generalize both, interval orders and 2-dimensional posets. Locally planar posets generalize for example posets with a planar cover graph. We apply our results to CAT-generate all $c$-orientations of a planar graph. As a special case this is a CAT-generator for many combinatorial objects like domino and lozenge tilings, planar spanning trees, planar bipartite perfect matchings, Schnyder woods, and others.

  16. Eosinophilic esophagitis: A newly established cause of dysphagia


    Yan, Brian M; Shaffer, Eldon A.


    Eosinophilic esophagitis has rapidly become a recognized entity causing dysphagia in young adults. This review summarizes the current knowledge of eosinophilic esophagitis including the epidemiology, clinical presentation, diagnostic criteria, pathophysiology, treatment, and prognosis. An extensive search of PubMed/Medline (1966-December 2005) for available English literature in humans for eosinophilic esophagitis was completed. Appropriate articles listed in the bibliographies were also atta...

  17. Strategies to improve the outcome of esophagectomy for esophageal cancer

    NARCIS (Netherlands)

    Boone, J.


    Esophageal cancer is the 8th most common type of malignancy in the world. For the past decades the incidence of esophageal cancer has rapidly increased, particularly due to a rise in adenocarcinoma of the esophagus. Yet, worldwide the incidence of esophageal squamous cell carcinoma (ESCC) is highest

  18. Black esophagus (acute esophageal necrosis) after spinal anesthesia. (United States)

    Román Fernández, A; López Álvarez, A; Fossati Puertas, S; Areán González, I; Varela García, O; Viaño López, P M


    Acute esophagic necrosis or black esophagus is an uncommon clinical entity that owes its name to the endoscopic view of the necrotic esophageal mucosa. It is always related with a critical medical condition and usually has an ischemic etiology. We report the first case of acute esophageal necrosis after a spinal anesthetic for partial hip joint arthroplasty. We discuss the underlying pathophysiological mechanisms.

  19. Translational Research on Esophageal Cancer: From Cell Line to Clinic

    NARCIS (Netherlands)

    J.J. Boonstra (Jurjen)


    textabstractWorldwide esophageal cancer is a signifi cant and an increasing health problem. In 2005, there were 497,700 new cases, and the prevalence is expected to increase by approximately 140% by 2025. Esophageal squamous cell carcinoma (ESCC) accounts for most of the cases of esophageal cancer w

  20. Toxoplasmosis : Beware of Cats !!!

    Directory of Open Access Journals (Sweden)

    Rubina Kumari Baithalu


    Full Text Available Anthropozoonotic parasite Toxoplasma gondii causes widespread human and animal diseases, mostly involving central nervous system. Human acquires toxoplasmosis from cats, from consuming raw or undercooked meat and from vertical transmission to the fetus through placenta from mother during pregnancy. Socio-epidemiological as well as unique environmental factors also plays a significant role in transmission of this infection. Preventive measures should be taken into account the importance of culture, tradition, and beliefs of people in various communities more than solving poverty and giving health education. Therefore the focus of this article is to create public awareness regarding sense of responsibility of looking after pets to prevent such an important zoonotic disease. [Vet. World 2010; 3(5.000: 247-249

  1. [Influence of prostatilen on smooth muscle organs functional activity in surgical patients (clinical and experimental study)]. (United States)

    Al'-Shukri, S Kh; Aĭvazian, A I; Barabanov, S V; Barabanova, V V; Bobkov, Iu A; Gorbachev, A G; Parastaeva, M M


    The action of prostatilen on contractile activity of smooth muscles of isolated line slices of urine bladder of Wistar rats (myography) and arterial vessels of cat kidneys (resistography) was studied. On the basis of clinical cases effectiveness of prostatilen was analysed as a treatment restorting urine bladder function in acute reflex urinary retention after operations in the area of rectal sphincter, as well as in treatment of patients with chronic prostatitis. It is shown, that prostatilen produces contractile action on smooth muscles of renal blood vessels in cats and urine bladder walls in rats and it raises contractile activity of smooth muscles of human urine bladder. The results of experimental and clinical investigations make it possible to recommend the application of this bioregulating preparation for treatment and prophylaxis of disturbances in urination.

  2. Multidisciplinary approach for patients with esophageal cancer

    Institute of Scientific and Technical Information of China (English)

    Victoria M Villaflor; Marco E Allaix; Bruce Minsky; Fernando A Herbella; Marco G Patti


    Patients with esophageal cancer have a poor prognosis because they often have no symptoms until their disease is advanced.There are no screening recommendations for patients unless they have Barrett's esophagitis or a significant family history of this disease.Often,esophageal cancer is not diagnosed until patients present with dysphagia,odynophagia,anemia or weight loss.When symptoms occur,the stage is often stage Ⅲ or greater.Treatment of patients with very early stage disease is fairly straight forward using only local treatment with surgical resection or endoscopic mucosal resection.The treatment of patients who have locally advanced esophageal cancer is more complex and controversial.Despite multiple trials,treatment recommendations are still unclear due to conflicting data.Sadly,much of our data is difficult to interpret due to many of the trials done have included very heterogeneous groups of patients both histologically as well as anatomically.Additionally,studies have been underpowered or stopped early due to poor accrual.In the United States,concurrent chemoradiotherapy prior to surgical resection has been accepted by many as standard of care in the locally advanced patient.Patients who have metastatic disease are treated palliatively.The aim of this article is to describe the multidisciplinary approach used by an established team at a single high volume center for esophageal cancer,and to review the literature which guides our treatment recommendations.

  3. Esophageal surgery in minimally invasive era

    Institute of Scientific and Technical Information of China (English)


    The widespread popularity of new surgical technologiessuch as laparoscopy, thoracoscopy and robotics has ledmany surgeons to treat esophageal diseases with thesemethods. The expected benefits of minimally invasive surgery (MIS) mainly include reductions of postoperativecomplications, length of hospital stay, and pain andbetter cosmetic results. All of these benefits couldpotentially be of great interest when dealing with theesophagus due to the potentially severe complicationsthat can occur after conventional surgery. Moreover,robotic platforms are expected to reduce many of thedifficulties encountered during advanced laparoscopicand thoracoscopic procedures such as anastomoticreconstructions,accurate lymphadenectomies, andvascular sutures. Almost all esophageal diseases areapproachable in a minimally invasive way, includingdiverticula, gastro-esophageal reflux disease, achalasia,perforations and cancer. Nevertheless, while the limitsof MIS for benign esophageal diseases are mainlytechnical issues and costs, oncologic outcomes remainthe cornerstone of any procedure to cure malignancies,for which the long-term results are critical. Furthermore,many of the minimally invasive esophageal operationsshould be compared to pharmacologic interventionsand advanced pure endoscopic procedures; such acomparison requires a difficult literature analysis andleads to some confounding results of clinical trials. Thisreview aims to examine the evidence for the use of MISin both malignancies and more common benign diseaseof the esophagus, with a particular emphasis on futuredevelopments and ongoing areas of research.

  4. Variability of the pharyngeal phase of swallow in the cat.

    Directory of Open Access Journals (Sweden)

    Daniel G Spearman

    Full Text Available The pharyngeal phase of swallow has been thought to be a stereotypical motor behavior.This is a prospective, preclinical, hypothesis driven, one group by three-task design.We sought to compare the effects of pharyngeal swabbing, water only, and water plus punctate mechanical stimulation on the spatiotemporal features of the pharyngeal phase of swallow in the cat. Swallow was elicited under these three conditions in six anaesthetized cats. Electromyographic activity was recorded from seven muscles used to evaluate swallow: mylohyoid, geniohyoid, thyrohyoid, thyroarytenoid, thyropharyngeus, cricopharyngeus, and parasternal.Pharyngeal swabbing in comparison to the other stimulus conditions, results in decreases in post-swallow cricopharyngeus activity (upper esophageal sphincter; a significant increase in parasternal (schluckatmung; swallow breath activity; and increases in thyrohyoid (laryngeal elevator, thyroarytenoid (laryngeal adductor and parasternal muscles burst duration. Pearson correlations were found of moderate strength between 19% of burst duration comparisons and weak to moderate relationships between 29% of burst amplitude comparisons. However, there were no positive significant relationships between phase durations and electromyogram amplitudes between any of the muscles studied during swallow.The results support the concept that a stereotypical behavior, such as pharyngeal swallowing in animal models, can be modified by sensory feedback from pharyngeal mucosal mechanoreceptors. Furthermore, differences in swallow phase durations and amplitudes provide evidence that separate regulatory mechanisms exist which regulate spatial and temporal aspects of the behavior.

  5. Experimental reconstruction of cervical esophageal defect with artificial esophagus made of polyurethane in a dog model. (United States)

    Jiang, H; Cui, Y; Ma, K; Gong, M; Chang, D; Wang, T


    artificial esophagus staying in situ after migration was not covered by epithelium, and the granulation tissue was infiltrated by a great deal of inflammatory cells. Antibodies against cytokeratin were positively expressed in epithelium of neo-esophagus. Up to 12 months after operation, antibodies against smooth muscle actin and desmin were both negatively expressed in neo-esophagus. The artificial esophagus made of non-degradable polyurethane reconstructing cervical esophageal defect is practicable. Although there are some problems, including anastomotic leakage, migration, and dysphagia, they are not lethal following good supportive therapy. The esophageal epithelium can regenerate with the supporting role of artificial esophagus. In the future, deformable artificial esophagus should be improved, and a much longer follow-up will be performed to evaluate whether the esophageal gland and skeletal muscle can regenerate.

  6. Classification of smooth Fano polytopes

    DEFF Research Database (Denmark)

    Øbro, Mikkel

    Fano polytopes up to isomorphism. A smooth Fano -polytope can have at most vertices. In case of vertices an explicit classification is known. The thesis contains the classification in case of vertices. Classifications of smooth Fano -polytopes for fixed exist only for . In the thesis an algorithm...... for the classification of smooth Fano -polytopes for any given is presented. The algorithm has been implemented and used to obtain the complete classification for .......A simplicial lattice polytope containing the origin in the interior is called a smooth Fano polytope, if the vertices of every facet is a basis of the lattice. The study of smooth Fano polytopes is motivated by their connection to toric varieties. The thesis concerns the classification of smooth...

  7. 2011 update on esophageal achalasia

    Institute of Scientific and Technical Information of China (English)

    Seng-Kee Chuah; Pin-I Hsu; Keng-Liang Wu; Deng-Chyang Wu; Wei-Chen Tai; Chi-Sin Changchien


    There have been some breakthroughs in the diagnosis and treatment of esophageal achalasia in the past few years.First,the introduction of high-resolution manometry with pressure topography plotting as a new diagnostic tool has made it possible to classify achalasia into three subtyPes.The most favorable outcome is predicted for patients receiving treatment for type Ⅱ achalasia (achalasia with compression).Patients with type I (classic achalasia) and type Ⅲ achalasia (spastic achalasia) experience a less favorable outcome.Second,the first multicenter randomized controlled trial published by the European Achalasia Trial group reported 2-year follow-up results indicating that laparoscopic Heller myotomy was not superior to endoscopic pneumatic dilation (PD).Although the follow-up period was not long enough to reach a convincing conclusion,it merits the continued use of PD as a generally available technique in gastroenterology.Third,the novel endoscopic technique peroral endoscopic myotomy is a promising option for treating achalasia,but it requires increased experience and cautious evaluation.Despite all this good news,the bottom line is a real breakthrough from the basic studies to identify the actual cause of achalasia that may impede treatment success is still anticipated.

  8. Neoadjuvant Treatment for Esophageal Cancer

    Institute of Scientific and Technical Information of China (English)

    PaulM.Schneider; HuanXi; StephanE.Baldus; JanBrabender; RalfMetzger


    Because the conflicting data currently available from the performed randomized trials it is very difficult to provide strict guidelines for the treatment of patients with locoregional advanced esophageal cancers. Surgery however, remains the standard of care for potentially resectable disease. Preoperative chemotherapy is still controversial with two large randomized trials resulting in two different conclusions regarding the survival benefit. Preoperative chemoradiation is also controversial since only one randomized trial showed a clear survival benefit however, the patients treated with surgery alone in this trial had an unusually poor outcome. And the study by Urba et al was not powered enough to show a clear survival benefit for patients treated with neoadjuvant chemoradiation. The results of three metaanalysis of these randomized studies show lower rate of resection, higher rate of R0-resection, more often postoperative mortality and better prognosis for patients with neoadjuvant radiochemotherapy. As a consequence one may consider offering neoadjuvant chemotherapy or neoadjuvant radiochemotherapy to patients with locallyadvanced disease under the premise that patients have a good performance status and understand the controversies about this therapeutic option. Larger trials with sufficient power to clearly detect survival benefits for patients treated with neoadjuvant chemotherapy or radiochemotherapy are necessary before this therapeutic option will be the standard of care.

  9. Pemphigus foliaceus in a cat. (United States)

    Kofod, H


    The author's cat started to develop the signs of pemphigus foliaceus one month after he returned home after six months absence. The initial signs included dry coughing and difficulty with purring and swallowing, followed by typical changes of the skin. The cat was treated by a combination of chrysotherapy and systemic glucocorticoid injections, and remained free of clinical signs for one and a half years. The cat then relapsed and showed the initial signs except that coughing was not observed. It was treated as before but after a second relapse and the same treatment it slowly developed a general weakness and was euthanased.

  10. Esophageal stent migration leads to intestinal obstruction

    Directory of Open Access Journals (Sweden)

    Oguzhan Karatepe


    Full Text Available Background: Self-expanding metallic stents are the devices of choice in the treatment of malign or benign strictures of esophagus. Stent migration is a well-known complication of this procedure. Aims: We report a case of intestinal obstruction caused by esophageal stent migration, in which surgical intervention was used. Methods: A 65-year-old woman, who had a medical history of gastric cancer operation and esophageal stent application admitted to our emergeny department with a 48-hour history of abdominal pain, nausea and vomiting. An emergeny laparotomy was performed and the migrated stent leading to intestinal obstruction was removed. Results: The patient recovered without incident and was discharged on postoperative day 3. Conclusion: This case illustrates that esophageal stent migration has to be considered as a potential life-threatening complication.

  11. Minimally invasive surgery for esophageal cancer. (United States)

    Santillan, Alfredo A; Farma, Jeffrey M; Meredith, Kenneth L; Shah, Nilay R; Kelley, Scott T


    Esophageal cancer represents a major public health problem worldwide. Several minimally invasive esophagectomy (MIE) techniques have been described and represent a safe alternative for the surgical management of esophageal cancer in selected centers with high volume and expertise in them. This article reviews the most recent and largest series evaluating MIE techniques. Recent larger series have shown MIE to be equivalent in postoperative morbidity and mortality rates to conventional surgery. MIE has been associated with less blood loss, less postoperative pain, and decreased intensive care unit and hospital length of stay compared with conventional surgery. Despite limited data, conventional surgery and MIE have shown no significant difference in survival, stage for stage. The myriad of MIE techniques complicates the debate of defining the optimal surgical approach for treating esophageal cancer. Randomized controlled trials comparing MIE with conventional open esophagectomy are needed to clarify the ideal procedure with the lowest postoperative morbidity, best quality of life after surgery, and long-term survival.

  12. Herpetic Esophagitis in Immunocompetent Medical Student

    Directory of Open Access Journals (Sweden)

    Andréia Vidica Marinho


    Full Text Available Esophagitis caused by herpes simplex virus (HSV is often documented during periods of immunosuppression in patients infected with human immunodeficiency virus (HIV; it is rare in immunocompetent diagnosed patients. Case reports of herpetic esophagitis in students of health sciences are extremely rare. The disease presents with a clinical picture characterized by acute odynophagia and retrosternal pain without obvious causes and ulcers, evidenced endoscopically in the middistal esophagus. Diagnosis depends on endoscopy, biopsies for pathology studies, and immunohistochemistry techniques. The disease course is often benign; however, treatment with acyclovir speeds the disappearance of symptoms and limits the severity of infection. In this report, we present a case of herpetic esophagitis in an immunocompetent medical student, with reference to its clinical features, diagnosis, and treatment. The disease may have manifested as a result of emotional stress experienced by the patient.

  13. EMG-force relation in dynamically contracting cat plantaris muscle. (United States)

    Herzog, W; Sokolosky, J; Zhang, Y T; Guimarães, A C


    The purpose of this study was to revisit the electromyographical (EMG)-force relationship of dynamically contracting muscles using direct measurements of EMG and force in cat hindlimb muscles during locomotion. EMG signals were recorded from the plantaris muscle using bipolar indwelling wire electrodes, and the corresponding forces were measured using a tendon force transducer. Force-time histories of cat plantaris muscle were predicted by estimating selected force parameters from EMG and timing parameters, and then constructing two smoothly fitting quintic spline functions from the estimated force parameters. The force predictions did not contain information on force-length or force-velocity properties of the cat plantaris and did not use instantaneous contractile conditions as input. It was found that two smoothly fitting quintic spline functions provided the required properties to approximate plantaris force-time histories accurately, and approximations of the force-time histories using EMG and timing parameters as input for the quintic splines were good. The root mean square errors (RMS) of the predicted compared to the actual plantaris forces were smaller than corresponding results reported in the literature, even though the prediction model did not require the force-length-velocity properties or the instantaneous contractile conditions of the target muscles as input. From the results obtained in this study, it appears that force-time histories of the cat plantaris muscle during locomotion can be predicted adequately from information obtained using EMG and video records, without information on either the force-length and force-velocity properties, or the instantaneous contractile conditions of the muscle.

  14. Eosinophilic esophagitis in adults: An update

    Institute of Scientific and Technical Information of China (English)

    Monjur Ahmed


    Eosinophilic esophagitis is a worldwide chronic allergic disease of the esophagus.In the last decade,there is an epidemic of this entity in the western world.Mostly seen in children and young adults,patients present with dysphagia or food impaction in the emergency room.Characteristic endoscopic findings,esophageal eosinophilia and non-responsiveness to proton pump inhibitors help make the diagnosis.Avoidance of foodallergens,administration of steroidal anti-inflammatory medications and dilation of the esophagus are the mainstays of treatment.Investigations are ongoing for mucosal healing and optimum maintenance treatment.

  15. Esophageal papilloma: Flexible endoscopic ablation byradiofrequency

    Institute of Scientific and Technical Information of China (English)

    Gianmattia del Genio; Federica del Genio; Pietro Schettino; Paolo Limongelli; Salvatore Tolone; Luigi Brusciano; Manuela Avellino; Chiara Vitiello; Giovanni Docimo; Angelo Pezzullo; Ludovico Docimo


    Squamous papilloma of the esophagus is a rare benignlesion of the esophagus. Radiofrequency ablation is anestablished endoscopic technique for the eradication ofBarrett esophagus. No cases of endoscopic ablation ofesophageal papilloma by radiofrequency ablation (RFA)have been reported. We report a case of esophagealpapilloma successfully treated with a single sessionof radiofrequency ablation. Endoscopic ablation ofthe lesion was achieved by radiofrequency using anew catheter inserted through the working channelof endoscope. The esophageal ablated tissue wasremoved by a specifically designed cup. Completeablation was confirmed at 3 mo by endoscopy withbiopsies. This case supports feasibility and safety of asa new potential indication for BarrxTM RFA in patientswith esophageal papilloma.

  16. Avoiding complications in esophageal cancer surgery

    DEFF Research Database (Denmark)

    Mortensen, Michael Bau


    Modern handling of esophageal cancer patients is based on a multidisciplinary concept, but surgery remains the primary curative treatment modality. Improvements in the perioperative care have reduced the overall morbidity and mortality, but 2-7% of the patients may still die within 30 days...... as a direct consequence of complications related to the esophagectomy procedure. Primarily based on results from randomized studies published after 2000 this review describes some of the factors that may contribute to the development of postoperative complications following esophageal cancer surgery as well...

  17. Esophageal web in Plummer-Vinson syndrome. (United States)

    Okamura, H; Tsutsumi, S; Inaki, S; Mori, T


    In Plummer-Vinson syndrome, esophagography often reveals a web at the anterior wall of the cervical esophagus. The pathogenesis of the esophageal web and the cause of dysphagia in this syndrome were investigated radiographically, endoscopically, manometrically, and histologically. It was considered that the web seen in the esophagogram may have been formed due to the restriction of dilation of the esophageal wall, which results from repetitive inflammation and the subsequent healing process. Dysphagia in this syndrome may be explained by a decrease in swallowing power. Iron deficiency anemia may play the main role in the above histological changes and the resulting decrease in swallowing power.

  18. Asymptomatic Esophageal Varices Should Be Endoscopically Treated

    Directory of Open Access Journals (Sweden)

    Nib Soehendra


    Full Text Available Endoscopic treatment has generally been accepted in the management of bleeding esophageal varices. Both the control of acute variceal bleeding and elective variceal eradication to prevent recurrent bleeding can be achieved via endoscopic methods. In contrast to acute and elective treatment, the role of endoscopic therapy in asymptomatic patients who have never had variceal bleeding remains controversial because of the rather disappointing results obtained from prophylactic sclerotherapy. Most published randomized controlled trials showed that prophylactic sclerotherapy had no effect on survival. In some studies, neither survival rate nor bleeding risk was improved. In this article, the author champions the view that asymptomatic esophageal varices should be endoscopically treated.

  19. Fundamentals of ServCat (United States)

    US Fish and Wildlife Service, Department of the Interior — This training manual for the U.S. Fish and Wildlife Service Catalog (ServCat) provides detailed instructions on searching for records, creating records, and managing...

  20. NRPC ServCat priorities (United States)

    US Fish and Wildlife Service, Department of the Interior — This document lists the Natural Resource Program Center’s priority ServCat documents. It is recommended that these documents- which include annual narrative reports,...

  1. Expression of heat shock protein 27 in the esophageal tissue of rats with reflux esophagitis

    Institute of Scientific and Technical Information of China (English)

    ZHENG Chao-xu; WANG Zhuo-qing; LIN Wei-bin; CHU Zhong-hua; CHEN Liu-hua; JI Zhuang-qi


    Background Little attention has been paid to the expression of heat shock protein 27 (HSP27) in patients with reflux esophagitis (RE), and few studies of the importance of HSP27 in esophagitis have been carried out in animal models.This study aimed to explore the expression of HSP27 in the esophageal tissue of rats with RE. Methods Eighty female Wistar rats were randomly divided into experimental groups A and B and control groups C and D (n=20 in each group). To establish RE, rats in the two experimental groups received pylorus and forestomach ligations,while rats in the control group received gastrostomy and gastric perforation repair. The rats in groups A and C were sacrificed 7 days after surgery, and the rats in groups B and D were sacrificed 14 days after surgery. In groups A and B,10 and 8 rats were diagnosed with RE by pathological examination, respectively (they were included in groups A' and B',respectively). The histopathological diagnosis of all the lower esophageal tissues in groups C and D was normal and 20normal specimens were randomly selected for groups C and D' with 10 specimens in each group. Macroscopic and microscopic esophagitis scores were assessed for the specimens in groups A' and B'. Lower esophageal tissues were collected from groups A', B', C, and D', and paraffin-embedded slices were made using part of the tissues. The expression of HSP27 in the tissues was detected using the two-step streptavidin-peroxidase immunohistochemical method. Some collected tissues were frozen, and expressions of HSP27 mRNA were detected using fluorescence quantitative polymerase chain reaction (FQ-PCR). Results Median macroscopic and microscopic esophagitis scores in groups A' (n=10) and B' (n=8) were 1.0 and 1.5,and 2.0 and 2.5, respectively. There were no significant differences in the macroscopic or microscopic esophagitis scores between the two groups (Z=-0.330, P=0.741; Z=-0.142, P=0.887, respectively). Immunohistochemical staining showed that HSP27 was

  2. Pseudoepitheliomatous hyperplasia mimicking esophageal squamous cell carcinoma in a patient with lye-induced esophageal stricture. (United States)

    Han, Jang Soo; Lee, Sang Woo; Suh, Kang Heum; Kim, Seung Young; Hyun, Jong Jin; Jung, Sung Woo; Koo, Ja Seol; Yim, Hyung Joon


    Pseudoepitheliomatous hyperplasia is a benign condition that may be caused by prolonged inflammation, chronic infection, and/or neoplastic conditions of the mucous membranes or skin. Due to its histological resemblance to well-differentiated squamous cell carcinoma, pseudoepitheliomatous hyperplasia may occasionally be misdiagnosed as squamous cell carcinoma. The importance of pseudoepitheliomatous hyperplasia is that it is a self-limited condition that must be distinguished from squamous cell carcinoma before invasive treatment. We report here on a rare case of esophageal pseudoepitheliomatous hyperplasia in a 67-year-old Korean woman with a lye-induced esophageal stricture. Although esophageal pseudoepitheliomatous hyperplasia is infrequently encountered, pseudoepitheliomatous hyperplasia should be considered in the differential diagnosis of esophageal lesions.

  3. Food hypersensitivity in a cat. (United States)

    Medleau, L; Latimer, K S; Duncan, J R


    Food hypersensitivity was diagnosed in a 4-year-old Siamese cat. Clinical signs included intense erythema, with alopecia, excoriations, erosions, and crusts involving the ventral portion of the abdomen, inguinal region, medial aspect of each thigh, and cranial and lateral aspects of all 4 limbs. The cat was intensely pruritic. Histologically, there was cutaneous mast cell hyperplasia and diffuse infiltration of eosinophils in the dermis. Blood eosinophilia also was found. Clinical signs resolved after exclusive feeding of a hypoallergenic diet.

  4. Diagnosis of esophageal motility disorders: esophageal pressure topography vs. conventional line tracing



    OBJECTIVES: Enhanced characterization of esophageal peristaltic and sphincter function provided by esophageal pressure topography (EPT) offers a potential diagnostic advantage over conventional line tracings (CLT). However, high-resolution manometry (HRM) and EPT require increased equipment costs over conventional systems and evidence demonstrating a significant diagnostic advantage of EPT over CLT is limited. Our aim was to investigate whether the inter-rater agreement and/or accuracy of eso...

  5. Schrodinger's cat: much ado about nothing

    CERN Document Server

    Ionicioiu, Radu


    In this note I briefly discuss the Schrodinger's cat Gedankenexperiment. By analysing the information flow in the system I show that no entanglement exists between the atom and the cat. The atom and the cat are connected only through a classical information channel (detector clicks $\\rightarrow$ poison is released $\\rightarrow$ cat is dead). No amount of local operations and classical communication can entangle the atom and the cat. Consequently, the paradox disappears.

  6. Esophageal Granular Cell Tumor and Eosinophilic Esophagitis: Two Interesting Entities Identified in the Same Patient

    Directory of Open Access Journals (Sweden)

    Alfredo J. Lucendo


    Full Text Available We illustrate the case of a 41-year-old male with allergic manifestations since childhood. He sought medical attention for intermittent, progressive dysphagia from which he had been suffering for a number of years, having felt the sensation of a retrosternal lump and a self-limited obstruction to the passage of food. Endoscopy detected a submucosal tumor in the upper third of the esophagus, which was typified, via biopsy, as a granular cell tumor with benign characteristics and probably responsible for the symptoms. Two years later, the patient sought medical attention once again as these symptoms had not abated, hence digestive endoscopy was repeated. This revealed stenosis of the junction between the middle and lower thirds of the organ which had not been detected previously but was passable under gentle pressure. Eosinophilic esophagitis was detected after biopsies were taken. Esophageal manometry identified a motor disorder affecting the esophageal body. Following three months of treatment using fluticasone propionate applied topically, the symptoms went into remission, esophageal stenosis disappeared and the esophageal biopsies returned to normal. This is the first documented case of the link between granular cell tumors and Eosinophilic esophagitis, two different disorders which could cause dysphagia in young patients.

  7. The Topological Effects of Smoothing. (United States)

    Shafii, S; Dillard, S E; Hlawitschka, M; Hamann, B


    Scientific data sets generated by numerical simulations or experimental measurements often contain a substantial amount of noise. Smoothing the data removes noise but can have potentially drastic effects on the qualitative nature of the data, thereby influencing its characterization and visualization via topological analysis, for example. We propose a method to track topological changes throughout the smoothing process. As a preprocessing step, we oversmooth the data and collect a list of topological events, specifically the creation and destruction of extremal points. During rendering, it is possible to select the number of topological events by interactively manipulating a merging parameter. The result that a specific amount of smoothing has on the topology of the data is illustrated using a topology-derived transfer function that relates region connectivity of the smoothed data to the original regions of the unsmoothed data. This approach enables visual as well as quantitative analysis of the topological effects of smoothing.

  8. Smoothness in Binomial Edge Ideals

    Directory of Open Access Journals (Sweden)

    Hamid Damadi


    Full Text Available In this paper we study some geometric properties of the algebraic set associated to the binomial edge ideal of a graph. We study the singularity and smoothness of the algebraic set associated to the binomial edge ideal of a graph. Some of these algebraic sets are irreducible and some of them are reducible. If every irreducible component of the algebraic set is smooth we call the graph an edge smooth graph, otherwise it is called an edge singular graph. We show that complete graphs are edge smooth and introduce two conditions such that the graph G is edge singular if and only if it satisfies these conditions. Then, it is shown that cycles and most of trees are edge singular. In addition, it is proved that complete bipartite graphs are edge smooth.

  9. Histomorphological and Immunophenotypic Features of Pill-Induced Esophagitis.

    Directory of Open Access Journals (Sweden)

    Ji Won Kim

    Full Text Available The aim of this study was to investigate histomorphological and immunophenotypic features in pill-induced esophagitis. We comparatively evaluated the histomorphological, immunophenotypic features of pill-induced esophagitis vs. reflux esophagitis, as well as clinical information and endoscopic findings. Fifty-two tissue pieces from 22 cases of pill-induced esophagitis, 46 pieces from 20 reflux esophagitis, and 16 pieces from 14 control samples were subjected to immunohistochemistry for inflammatory infiltrates (CD3 for T lymphocyte, CD20 for B lymphocyte, CD56 for NK cell, CD68 for macrophage, CD117 for mast cell and eosinophil chemotaxis-associated proteins (Erk, leptin, leptin receptor, pSTAT3, phospho-mTOR. As a result, Histomorphology showed that a diffuse pattern of dilated intercellular spaces was more frequently observed in pill-induced esophagitis, while reactive atypia and subepithelial papillary elongation were more often found in reflux esophagitis (P < 0.05, respectively. Interestingly, intraepithelial eosinophilic microabscess, intraepithelial pustule and diffuse pattern of dilated intercellular spaces were observed in 14% (3 cases, 9% (2 cases and 32% (7 cases of pill-induced esophagitis, respectively, but in no cases of reflux esophagitis. Regarding intraepithelial inflammatory infiltrates in pill-induced esophagitis, T lymphocytes were the most common cells, followed by eosinophil; 11 and 7 in one x400 power field, respectively. Intraepithelial pSTAT3-positive pattern was more frequently observed in pill-induced esophagitis than in reflux esophagitis, at 45% (10 cases versus 10% (2 cases, respectively (P < 0.05. Considering the distal esophageal lesion only, intraepithelial pustule, diffuse dilated intercellular spaces and stromal macrophages were more frequently found in distal pill-induced esophagitis, whereas reactive atypia and intraepithelial mast cells in reflux esophagitis (P < 0.05, respectively. In conclusion, diffuse

  10. Esophageal testing: What we have so far

    Institute of Scientific and Technical Information of China (English)


    Gastroesophageal reflux disease (GERD) is a commondisorder of the gastrointestinal tract. In the last fewdecades, new technologies have evolved and havebeen applied to the functional study of the esophagus,allowing for the improvement of our knowledge of thepathophysiology of GERD. High-resolution manometry(HRM) permits greater understanding of the function ofthe esophagogastric junction and the risks associatedwith hiatal hernia. Moreover, HRM has been found tobe more reproducible and sensitive than conventionalwater-perfused manometry to detect the presenceof transient lower esophageal sphincter relaxation.Esophageal 24-h pH-metry with or without combinedimpedance is usually performed in patients withnegative endoscopy and reflux symptoms who havea poor response to anti-reflux medical therapy toassess esophageal acid exposure and symptom-refluxcorrelations. In particular, esophageal 24-h impedanceand pH monitoring can detect acid and non-acid refluxevents. EndoFLIP is a recent technique poorly appliedin clinical practice, although it provides a large amountof information about the esophagogastric junction.In the coming years, laryngopharyngeal symptomscould be evaluated with up and coming non-invasive orminimally invasive techniques, such as pepsin detectionin saliva or pharyngeal pH-metry. Future studies arerequired of these techniques to evaluate their diagnostic accuracy and usefulness, although the available dataare promising.

  11. Stent placement for esophageal strictures : an update

    NARCIS (Netherlands)

    Hirdes, Meike Madeleine Catharine; Vleggaar, Frank Paul; Siersema, Peter Derk


    The use of stents for esophageal strictures has evolved rapidly over the past 10 years, from rigid plastic tubes to flexible self-expanding metal (SEMS), plastic (SEPS) and biodegradable stents. For the palliative treatment of malignant dysphagia both SEMS and SEPS effectively provide a rapid relief

  12. Esophageal achalasia in adolescence - two case reports

    Directory of Open Access Journals (Sweden)

    Inês Vaz Silva


    Full Text Available Introduction: Achalasia is a rare disorder, particularly in pediatrics, characterized by esophageal aperistalsis and inadequate relaxation of the lower esophageal sphincter. Its etiology remains unclear. Cases: We describe two adolescents with dysphagia for solids and liquids, vomiting, weight loss and nocturnal cough for a few months. Initially it was considered to be an eating disorder, and the diagnosis of achalasia was reached later by esophageal manometry in one case and by intraoperative biopsy in another. The patients were submitted to Heller myotomy with an antireflux procedure, laparoscopically in one case, and by laparotomy in another, both with a favorable outcome. Discussion/Conclusions: We emphasize the rarity and diagnostic challenge of these cases. The nonspecific symptoms often lead to the diagnosis of an eating disorder, delaying the correct treatment. If symptoms persist achalasia must be considered and the esophageal manometry is the diagnostic test of choice. The gold standard in treatment is surgical, and we highlight the effectiveness of the techniques applied.

  13. Axial force measurement for esophageal function testing

    Institute of Scientific and Technical Information of China (English)

    Flemming H Gravesen; Peter Funch-Jensen; Hans Gregersen; Asbjφrn Mohr Drewes


    The esophagus serves to transport food and fluid from the pharynx to the stomach. Manometry has been the "golden standard" for the diagnosis of esophageal motility diseases for many decades. Hence, esophageal function is normally evaluated by means of manometry even though it reflects the squeeze force (force in radial direction) whereas the bolus moves along the length of esophagus in a distal direction. Force measurements in the longitudinal (axial) direction provide a more direct measure of esophageal transport function. The technique used to record axial force has developed from external force transducers over in-vivo strain gauges of various sizes to electrical impedance based measurements. The amplitude and duration of the axial force has been shown to be as reliable as manometry. Normal, as well as abnormal, manometric recordings occur with normal bolus transit, which have been documented using imaging modalities such as radiography and scintigraphy. This inconsistency using manometry has also been documented by axial force recordings. This underlines the lack of information when diagnostics are based on manometry alone. Increasing the volume of a bag mounted on a probe with combined axial force and manometry recordings showed that axial force amplitude increased by 130% in contrast to an increase of 30% using manometry. Using axial force in combination with manometry provides a more complete picture of esophageal motility, and the current paper outlines the advantages of using this method.

  14. Axial force measurement for esophageal function testing. (United States)

    Gravesen, Flemming H; Funch-Jensen, Peter; Gregersen, Hans; Drewes, Asbjørn Mohr


    The esophagus serves to transport food and fluid from the pharynx to the stomach. Manometry has been the "golden standard" for the diagnosis of esophageal motility diseases for many decades. Hence, esophageal function is normally evaluated by means of manometry even though it reflects the squeeze force (force in radial direction) whereas the bolus moves along the length of esophagus in a distal direction. Force measurements in the longitudinal (axial) direction provide a more direct measure of esophageal transport function. The technique used to record axial force has developed from external force transducers over in-vivo strain gauges of various sizes to electrical impedance based measurements. The amplitude and duration of the axial force has been shown to be as reliable as manometry. Normal, as well as abnormal, manometric recordings occur with normal bolus transit, which have been documented using imaging modalities such as radiography and scintigraphy. This inconsistency using manometry has also been documented by axial force recordings. This underlines the lack of information when diagnostics are based on manometry alone. Increasing the volume of a bag mounted on a probe with combined axial force and manometry recordings showed that axial force amplitude increased by 130% in contrast to an increase of 30% using manometry. Using axial force in combination with manometry provides a more complete picture of esophageal motility, and the current paper outlines the advantages of using this method.

  15. Acute esophageal necrosis caused by alcohol abuse

    Institute of Scientific and Technical Information of China (English)

    Tetsu Endo; Juichi Sakamoto; Ken Sato; Miyako Takimoto; Koji Shimaya; Tatsuya Mikami; Akihiro Munakata; Tadashi Shimoyama; Shinsaku Fukuda


    Acute esophageal necrosis (AEN) is extremely rare and the pathogenesis of this is still unknown. We report a case of AEN caused by alcohol abuse. In our case, the main pathogenesis could be accounted for low systemic perfusion caused by severe alcoholic lactic acidosis. After the healing of AEN, balloon dilatation was effective to manage the stricture.

  16. Esophageal testing: What we have so far. (United States)

    de Bortoli, Nicola; Martinucci, Irene; Bertani, Lorenzo; Russo, Salvatore; Franchi, Riccardo; Furnari, Manuele; Tolone, Salvatore; Bodini, Giorgia; Bolognesi, Valeria; Bellini, Massimo; Savarino, Vincenzo; Marchi, Santino; Savarino, Edoardo Vincenzo


    Gastroesophageal reflux disease (GERD) is a common disorder of the gastrointestinal tract. In the last few decades, new technologies have evolved and have been applied to the functional study of the esophagus, allowing for the improvement of our knowledge of the pathophysiology of GERD. High-resolution manometry (HRM) permits greater understanding of the function of the esophagogastric junction and the risks associated with hiatal hernia. Moreover, HRM has been found to be more reproducible and sensitive than conventional water-perfused manometry to detect the presence of transient lower esophageal sphincter relaxation. Esophageal 24-h pH-metry with or without combined impedance is usually performed in patients with negative endoscopy and reflux symptoms who have a poor response to anti-reflux medical therapy to assess esophageal acid exposure and symptom-reflux correlations. In particular, esophageal 24-h impedance and pH monitoring can detect acid and non-acid reflux events. EndoFLIP is a recent technique poorly applied in clinical practice, although it provides a large amount of information about the esophagogastric junction. In the coming years, laryngopharyngeal symptoms could be evaluated with up and coming non-invasive or minimally invasive techniques, such as pepsin detection in saliva or pharyngeal pH-metry. Future studies are required of these techniques to evaluate their diagnostic accuracy and usefulness, although the available data are promising.

  17. Early detection and determinants of esophageal cancer

    NARCIS (Netherlands)

    Bus, P.


    Barrett’s esophagus (BE) is a premalignant condition of the esophagus and characterized by the metaplastic replacement of esophageal squamous epithelium by specialized intestinal-type columnar epithelium. A BE diagnosis is based on endoscopy and histological examination of biopsies taken during endo


    Institute of Scientific and Technical Information of China (English)


    Objective To investigate the diagnostic value of miniprobe ultrasonography (MPS) in the protruding lesions of esophagus. Methods Sixty-two patients with protruding lesions of esophagus were examined with MPS. Results The MPS examination showed diseases of esophageal polyp, inflammatory protruding, esophageal leiomyoma, esophageal leiomyosarcoma, esophageal venous aneurysm, esophageal lipoma, esophageal cyst, esophageal carcinoma, and extra esophageal compression including aorta compression, lung tumor compression and spina compression. Fourteen patients were verified by surgical operations and pathological examinations, resulting in 92.86% (13/14) diagnosis accuracy rate. Forty-eight cases had results of gastroscope examination consistent with that of MPS. Twelve cases had results of CT and MRI examination consistent with that of MPS. Follow-up was completed on 22 patients. Conclusion Besides imaging the esophageal layer, MPS can precisely locate the histological layer of the esophageal protruding lesions and predict their characters. This indicates its value in the diagnosis and differential diagnosis of the protruding lesions of esophagus. Furthermore, the miniature probe used in MPS examination can pass the structured esophagus, enabling wider application of the examination.

  19. Effect of age on proximal esophageal response to swallowing

    Directory of Open Access Journals (Sweden)

    Roberto Oliveira Dantas


    Full Text Available CONTEXT: It has been demonstrated that the ageing process affects esophageal motility. OBJECTIVES: To evaluate the effect of the age on the proximal esophageal response to wet swallows. METHOD: We measured the proximal esophageal response to swallows of a 5 mL bolus of water in 69 healthy volunteers, 20 of them aged 18-30 years (group I, 27 aged 31-50 years (group II, and 22 aged 51-74 years (group III. We used the manometric method with continuous perfusion. The proximal esophageal contractions were recorded 5 cm from a pharyngeal recording site located 1 cm above the upper esophageal sphincter. The time between the onset of the pharyngeal and of the proximal esophageal recording (pharyngeal-esophageal time and the amplitude, duration and area under the curve of the proximal esophageal contraction were measured. RESULTS: The pharyngeal-esophageal time was shorter in group I subjects than in group II and III subjects (P<0.05. The duration of proximal esophageal contractions was longer in group I than in groups II and III (P<0.001. There was no differences between groups in the amplitude or area under the curve of contractions. There were no differences between groups II and III for any of the measurements. CONCLUSION: We conclude that the age may affects the response of the proximal esophagus to wet swallows.

  20. Restenosis following balloon dilation of benign esophageal stenosis

    Institute of Scientific and Technical Information of China (English)

    Ying-Sheng Cheng; Ming-Hua Li; Ren-Jie Yang; Hui-Zhen Zhang; Zai-Xian Ding; Qi-Xin Zhuang; Zhi-Ming Jiang; Ke-Zhong Shang


    AIM: To elucidate the mechanism of restenosis following balloon dilation of benign esophageal stenosis.METHODS: A total of 49 rats with esophageal stenosis were induced in 70 rats using 5 ml of 50 % sodium hydroxide solution and the double-balloon method, and an esophageal restenosis (RS) model was developed by esophageal stenosis using dilation of a percutaneous transluminal coronary angioplasty (PTCA) balloon catheter. These 49 rats were divided into two groups: rats with benign esophageal stricture caused by chemical burn only (control group, n=21) and rats with their esophageal stricture treated with balloon catheter dilation (experimental group, n=28). Imaging analysis and immunohistochemistry were used for both quantitative and qualitative analyses of esophageal stenosis and RS formation in the rats, respectively.RESULTS: Cross-sectional areas and perimeters of the esophageal mucosa layer, muscle layer, and the entire esophageal layers increased significantly in the experimental group compared with the control group. Proliferating cell nuclear antigen (PCNA) was expressed on the 5th day after dilation, and was still present at 1 month. Fibronectin (FN)was expressed on the 1st day after dilation, and was still present at 1 month.CONCLUSION: Expression of PCNA and FN plays an important role in RS after balloon dilation of benign esophageal stenosis.

  1. Magnetic compression anastomosis as a nonsurgical treatment for esophageal atresia

    Energy Technology Data Exchange (ETDEWEB)

    Zaritzky, Mario [Hospital de Ninos de La Plata, Department of Radiology, Buenos Aires (Argentina); University of Chicago Medical Center, Department of Radiology, Chicago, IL (United States); Ben, Ricardo [Hospital de Ninos de La Plata, Department of Gastroenterology, Buenos Aires (Argentina); Zylberg, Gaston I.; Yampolsky, Brian [Hospital de Ninos de La Plata, Department of Radiology, Buenos Aires (Argentina)


    We describe a unique technique to promote a nonsurgical esophageal anastomosis with magnets in children with esophageal atresia. To evaluate the efficacy of magnetic lengthening of atretic esophageal ends to produce an anastomosis and to communicate our results after more than 2 years of follow-up. Between September 2001 and March 2004, five children were selected for treatment. Two of the children had esophageal atresia without fistula (type A) and three had atresia with fistula converted to type A surgically; however, surgeons failed to achieve an anastomosis because of the width of the gap. Neodymium-iron-boron magnets were used. Daily chest radiographs were taken until union of the magnets was observed. They were then replaced with an orogastric tube. Anastomosis was achieved in all patients in an average of 4.8 days. One patient, with signs of early sepsis, was successfully treated with antibiotics. In four of the five patients, esophageal stenosis developed. At the time of this report, two patients were free of treatment and on an oral diet (after 26 months), two patients required periodic balloon dilatation, and one patient had recently undergone surgery due to recurrent esophageal stenosis not amenable to balloon dilatation. Magnetic esophageal anastomosis is a feasible method in selected patients with esophageal atresia. Esophageal anastomosis was achieved in all patients. The only observed complication of significance was esophageal stenosis. One patient needed surgery because of stenosis. (orig.)

  2. Cat Ownership Perception and Caretaking Explored in an Internet Survey of People Associated with Cats.

    Directory of Open Access Journals (Sweden)

    Sarah Zito

    Full Text Available People who feed cats that they do not perceive they own (sometimes called semi-owners are thought to make a considerable contribution to unwanted cat numbers because the cats they support are generally not sterilized. Understanding people's perception of cat ownership and the psychology underlying cat semi-ownership could inform approaches to mitigate the negative effects of cat semi-ownership. The primary aims of this study were to investigate cat ownership perception and to examine its association with human-cat interactions and caretaking behaviours. A secondary aim was to evaluate a definition of cat semi-ownership (including an association time of ≥1 month and frequent feeding, revised from a previous definition proposed in the literature to distinguish cat semi-ownership from casual interactions with unowned cats. Cat owners and semi-owners displayed similar types of interactions and caretaking behaviours. Nevertheless, caretaking behaviours were more commonly displayed towards owned cats than semi-owned cats, and semi-owned cats were more likely to have produced kittens (p<0.01. All interactions and caretaking behaviours were more likely to be displayed towards cats in semi-ownership relationships compared to casual interaction relationships. Determinants of cat ownership perception were identified (p<0.05 and included association time, attachment, perceived cat friendliness and health, and feelings about unowned cats, including the acceptability of feeding unowned cats. Encouraging semi-owners to have the cats they care for sterilized may assist in reducing the number of unwanted kittens and could be a valuable alternative to trying to prevent semi-ownership entirely. Highly accessible semi-owner "gatekeepers" could help to deliver education messages and facilitate the provision of cat sterilization services to semi-owners. This research enabled semi-ownership to be distinguished from casual interaction relationships and can assist

  3. Esophageal Cancer in Iran: A Review

    Directory of Open Access Journals (Sweden)

    Siavosh Nasseri-Moghaddam


    Full Text Available Esophageal cancer is the second and third most common malignancy in Iranian malesand females, respectively, claiming lives of approximately 5800 Iranians each year.Squamous cell carcinoma (SCC is presently the most common type accounting forabout 90% of all esophageal cancers in Iran. Recent studies have shown that there isa gradual increase in the incidence of adenocarcinoma of the distal esophagus alongwith gastric cardia adenocarcinoma. Thirty-five years ago, the age standardizied rate (ASR of esophageal SCC in thecity of Gonbad (Golestan Province, northeast of Iran was found to be one of the highestrates for any single cancer that had been reported worldwide (ASR >100/105/year.Recent studies have shown that the incidence of SCC in Gonbad has declined to lessthan half of what it was in the past. This decline in the incidence of esophageal SCCparallels an improvement in the socioeconomic situation of people living in thisregion. According to recent cancer registry data in Iran there is still an obviousintracountry variability between the incidence of esophageal cancer in the south withan ASR of 3 for males and 2 for females in Kerman and 43 and 36 in the northeasternprovince of Golestan. The reasons for this very high rate of SCC in northeastern Iranhave been the subject of several studies during the past 35 years. According to resultsof these studies the suspected risk factors are: low intake of fruits and vegetables, drinkinghot tea, consumption of opium products and tobacco, H.pyloriinfection in the stomach,using unhealthy drinking water from cisterns and genetic susceptibility. The mainsuspected mutagens are polycyclic aromatic hydrocarbons (PAH and N-nitrosocompounds. In order to embark primary and secondary prevention of this fatal cancer,further prospective studies are presently underway in the region. The Golestanesophageal cancer cohort study which follows of 50,000 subjects is on going. We expectsimple and feasible evidence based

  4. Identification of the smooth muscle excitatory receptors for ergot alkaloids. (United States)

    Innes, I R


    In cats under sodium pentobarbitone anaesthesia the first dose of ergotamine (50 mug/kg) invariably caused retraction of the nictitating membrane and a rise of arterial blood pressure. However, the responses to the dose of ergotamine were strikingly reduced when the cats were previously treated with the adrenaline antagonists phenoxybenzamine (5 mg/kg) or ergotamine (50 mug/kg). Further experiments to identify receptors for ergotamine were carried out on three different isolated smooth muscle preparations: rabbit aorta, rat uterus and dog retractor penis.Receptors for adrenaline were selectively protected by high concentrations of adrenaline throughout exposure of the preparation to a blocking concentration of ergotamine or phenoxybenzamine. Protected muscles responded to ergotamine; unprotected muscles did not. Muscles where receptors for acetylcholine, histamine or 5-hydroxytryptamine were protected by high concentrations of these drugs did not respond to ergotamine. Ergometrine, which has no blocking action on adrenaline receptors, behaved in the same way as ergotamine; muscles which were protected by adrenaline against blockade by phenoxybenzamine responded to ergometrine, but unprotected muscles did not. The stimulant actions of adrenaline, ergotamine and ergometrine were also protected against the blocking action of phenoxybenzamine by treating the muscle with a high concentration of ergometrine instead of adrenaline. It is concluded that, in smooth muscle which can be excited by adrenaline, ergotamine and ergometrine act by combining with adrenaline receptors, and that ergotamine may therefore be regarded not only as an adrenaline antagonist but also as a partial agonist since it excites the same receptors.

  5. Esophageal Manometry in Patients with Chest Pain and Normal Coronary Arteriogram. (United States)

    Ferguson, S C; Hodges, K; Hersh, T; Jinich, H


    Evaluation of the esophagus is helpful in determining the source of chest pain. Eighteen per cent of 72 patients with a normal coronary angiogram had esophageal disease as a source of chest pain. Eight had diffuse esophageal spasm, four had reflux esophagitis and one had an esophageal ulcer. Five of eight patients with diffuse esophageal spasm had relief of symptoms with nitroglycerin. Despite normal coronary arteriogram and normal esophageal manometry 42 of 49 other patients had relief of chest pain with nitroglycerin.

  6. Smooth analysis in Banach spaces

    CERN Document Server

    Hájek, Petr


    This bookis aboutthe subject of higher smoothness in separable real Banach spaces.It brings together several angles of view on polynomials, both in finite and infinite setting.Also a rather thorough and systematic view of the more recent results, and the authors work is given. The book revolves around two main broad questions: What is the best smoothness of a given Banach space, and its structural consequences? How large is a supply of smooth functions in the sense of approximating continuous functions in the uniform topology, i.e. how does the Stone-Weierstrass theorem generalize into in

  7. Energy requirements of adult cats. (United States)

    Bermingham, Emma N; Thomas, David G; Morris, Penelope J; Hawthorne, Amanda J


    A meta-analysis was carried out in order to establish the energy requirements of adult cats. Publications that identified cat body weight (BW) were used to generate allometric relationships between energy requirements and BW of healthy adult cats, using log-log linear regression. Energy requirements were expressed in kcal/kg BW to be consistent with those reported by the National Research Council. Mean maintenance energy requirements were 55.1 (se 1.2) kcal/kg BW (115 treatment groups). Three allometric equations were identified to predict the energy requirements for maintenance of BW in the cat based on BW: light (53.7 kcal/kg BW- 1.061), normal (46.8 kcal/kg BW- 1.115) and heavy (131.8 kcal/kg BW- 0 .366). When reported on lean mass, the allometric equation revealed maintenance requirements were 58.4 kcal/kg lean mass- 1.140 (adjusted R2 0.694; thirty-six treatment groups). The present review suggests that values for maintenance energy requirements based on BW alone may not be an accurate prediction and more detailed information on the age, sex and neuter status, BW and composition would enhance the ability to interpret the maintenance energy requirements of cats.

  8. Esophageal clearance scintigraphy in, diabetic patients; A preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Karayalcin, B.; Karayalcin, U.; Aburano, Tamio; Nakajima, Kenichi; Hisada, Kinichi; Morise, Toshio; Okada, Toshihide; Takeda, Ryoyu (Kanazawa Univ. (Japan). School of Medicine)


    The aim of this preliminary study was to evaluate the predictive value of esophageal clearance scintigraphy (ECS) in the diagnosis of esophageal autonomic neuropathy in diabetic patients without any esophageal symptoms. A single swallon ECS was performed in 12 diabetic patients and 15 normal volunteers, and esophageal transit time (ETT) and esophageal (Es) T 1/2 values were calculated. ETT and Es 1/2 were found to be significantly prolonged in the diabetic group (p<0.01 and p<0.05, respectively). In this preliminary study, our results strongly suggest that ECS may be an important noninvasive diagnostic tool in the evaluation of diabetic patients with asymptomatic esophageal autonomic neuropathy. (author).

  9. Detection of esophageal ulcerations with technetium-99m albumin sucralfate

    Energy Technology Data Exchange (ETDEWEB)

    Goff, J.S.; Adcock, K.A.; Schmelter, R.


    Technetium-99m albumin-sucralfate ((/sup 99m/Tc)Su) can be used to demonstrate peptic ulcer disease in man and animals. We evaluated the usefulness of (/sup 99m/Tc)Su for detecting various grades of esophagitis. (/sup 99m/Tc)Su adhered to the distal esophagus for up to 3 hr in five of six patients with esophageal ulcers but adhered to only two of nine with lesser degrees of esophagitis. No adherence was seen in five patients without esophagitis. Thus, (/sup 99m/Tc)Su may not be useful for detecting any but the most severe grade of esophagitis. Based on these results, we speculate that the previously documented beneficial effects of sucralfate on mild to moderate esophagitis may be due to other mechanisms besides adherence to the ulcerated mucosa.

  10. Epidemiologic differences in esophageal cancer between Asian and Western populations

    Institute of Scientific and Technical Information of China (English)

    Han-Ze Zhang; Guang-Fu Jin; Hong-Bing Shen


    Esophageal cancer is a common cancer worldwide and has a poor prognosis.The incidence of esophageal squamous cell cancer has been decreasing,whereas the incidence of esophageal adenocarcinoma has been increasing rapidly,particularly in Western men.Squamous cell cancer continues to be the major type of esophageal cancer in Asia,and the main risk factors include tobacco smoking,alcohol consumption,hot beverage drinking,and poor nutrition.In contrast,esophageal adenocarcinoma predominately affects the whites,and the risk factors include smoking,obesity,and gastroesophageal reflux disease.In addition,Asians and Caucasians may have different susceptibilities to esophageal cancer due to different heritage backgrounds.However,comparison studies between these two populations are limited and need to be addressed in the near future.Ethnic differences should he taken into account in preventive and clinical practices.

  11. Cox2 and β-Catenin/T-cell Factor Signaling Intestinalize Human Esophageal Keratinocytes When Cultured under Organotypic Conditions

    Directory of Open Access Journals (Sweden)

    Jianping Kong


    Full Text Available The incidence of esophageal adenocarcinoma (EAC is rising in the United States. An important risk factor for EAC is the presence of Barrett esophagus (BE. BE is the replacement of normal squamous esophageal epithelium with a specialized columnar epithelium in response to chronic acid and bile reflux. However, the emergence of BE from squamous keratinocytes has not yet been demonstrated. Our research has focused on this. Wnt and cyclooxygenase 2 (Cox2 are two pathways whose activation has been associated with BE and progression to EAC, but their role has not been tested experimentally. To explore their contribution, we engineered a human esophageal keratinocyte cell line to express either a dominant-active Wnt effector CatCLef or a Cox2 complementary DNA. In a two-dimensional culture environment, Cox2 expression increases cell proliferation and migration, but neither transgene induces known BE markers. In contrast, when these cells were placed into three-dimensional organotypic culture conditions, we observed more profound effects. CatCLef-expressing cells were more proliferative, developed a thicker epithelium, and upregulated Notch signaling and several BE markers including NHE2. Cox2 expression also increased cell proliferation and induced a thicker epithelium. More importantly, we observed cysts form within the epithelium, filled with intestinal mucins including Muc5B and Muc17. This suggests that Cox2 expression in a three-dimensional culture environment induces a lineage of mucin-secreting cells and supports an important causal role for Cox2 in BE pathogenesis. We conclude that in vitro modeling of BE pathogenesis can be improved by enhancing Wnt signaling and Cox2 activity and using three-dimensional organotypic culture conditions.


    Institute of Scientific and Technical Information of China (English)

    Bing-sheng He; Yu-mei Wang


    In this paper, we study the relaxed smoothing problems with general closed convex constraints. It is pointed out that such problems can be converted to a convex quadratic minimization problem for which there are good programs in software libraries.

  13. Esophageal space-occupying lesion caused by Ascaris lumbricoides


    Zheng,Ping-Ping; Wang, Bing-Yuan; Wang, Fei(Physics Department, Zhengzhou University, Henan, 450001, China); Ao, Ran; Wang, Ying


    Ascaris lumbricoides is the largest intestinal nematode parasite of man, which can lead to various complications because of its mobility. As the esophagus is not normal habitat of Ascaris, the report of esophageal ascariasis is rare. An old female presented with dysphagia after an intake of several red bean buns and haw jellies. The barium meal examination revealed a spherical defect in the lower esophagus. Esophageal bezoar or esophageal carcinoma was considered at the beginning. The patient...

  14. Percutaneous endoscopic gastrostomy for nutritional palliation of upper esophageal cancer unsuitable for esophageal stenting

    Directory of Open Access Journals (Sweden)

    Ana Grilo


    Full Text Available CONTEXT: Esophageal cancer is often diagnosed at an advanced stage and has a poor prognosis. Most patients with advanced esophageal cancer have significant dysphagia that contributes to weight loss and malnutrition. Esophageal stenting is a widespread palliation approach, but unsuitable for cancers near the upper esophageal sphincter, were stents are poorly tolerated. Generally, guidelines do not support endoscopic gastrostomy in this clinical setting, but it may be the best option for nutritional support. OBJECTIVE: Retrospective evaluation of patients with dysphagia caused advanced esophageal cancer, no expectation of resuming oral intake and with percutaneous endoscopic gastrostomy for comfort palliative nutrition. METHOD: We selected adult patients with unresecable esophageal cancer histological confirmed, in whom stenting was impossible due to proximal location, and chemotherapy or radiotherapy were palliative, using gastrostomy for enteral nutrition. Clinical and nutritional data were evaluated, including success of gastrostomy, procedure complications and survival after percutaneous endoscopic gastrostomy, and evolution of body mass index, albumin, transferrin and cholesterol. RESULTS: Seventeen males with stage III or IV squamous cell carcinoma fulfilled the inclusion criteria. Mean age was 60.9 years. Most of the patients had toxic habits. All underwent palliative chemotherapy or radiotherapy. Gastrostomy was successfully performed in all, but nine required prior dilatation. Most had the gastrostomy within 2 months after diagnosis. There was a buried bumper syndrome treated with tube replacement and four minor complications. There were no cases of implantation metastases or procedure related mortality. Two patients were lost and 12 died. Mean survival of deceased patients was 5.9 months. Three patients are alive 6, 14 and 17 months after the gastrostomy procedure, still increasing the mean survival. Mean body mass index and laboratory

  15. Wetting on smooth micropatterned defects


    Debuisson, Damien; Dufour, Renaud; Senez, Vincent; Arscott, Steve


    We develop a model which predicts the contact angle hysteresis introduced by smooth micropatterned defects. The defects are modeled by a smooth function and the contact angle hysteresis is explained using a tangent line solution. When the liquid micro-meniscus touches both sides of the defect simultaneously, depinning of the contact line occurs. The defects are fabricated using a photoresist and experimental results confirm the model. An important point is that the model is scale-independent,...

  16. Cat Ownership Perception and Caretaking Explored in an Internet Survey of People Associated with Cats. (United States)

    Zito, Sarah; Vankan, Dianne; Bennett, Pauleen; Paterson, Mandy; Phillips, Clive J C


    People who feed cats that they do not perceive they own (sometimes called semi-owners) are thought to make a considerable contribution to unwanted cat numbers because the cats they support are generally not sterilized. Understanding people's perception of cat ownership and the psychology underlying cat semi-ownership could inform approaches to mitigate the negative effects of cat semi-ownership. The primary aims of this study were to investigate cat ownership perception and to examine its association with human-cat interactions and caretaking behaviours. A secondary aim was to evaluate a definition of cat semi-ownership (including an association time of ≥1 month and frequent feeding), revised from a previous definition proposed in the literature to distinguish cat semi-ownership from casual interactions with unowned cats. Cat owners and semi-owners displayed similar types of interactions and caretaking behaviours. Nevertheless, caretaking behaviours were more commonly displayed towards owned cats than semi-owned cats, and semi-owned cats were more likely to have produced kittens (pcats in semi-ownership relationships compared to casual interaction relationships. Determinants of cat ownership perception were identified (pcat friendliness and health, and feelings about unowned cats, including the acceptability of feeding unowned cats. Encouraging semi-owners to have the cats they care for sterilized may assist in reducing the number of unwanted kittens and could be a valuable alternative to trying to prevent semi-ownership entirely. Highly accessible semi-owner "gatekeepers" could help to deliver education messages and facilitate the provision of cat sterilization services to semi-owners. This research enabled semi-ownership to be distinguished from casual interaction relationships and can assist welfare and government agencies to identify cat semi-owners in order to develop strategies to address this source of unwanted cats.

  17. Exotic smoothness and quantum gravity

    Energy Technology Data Exchange (ETDEWEB)

    Asselmeyer-Maluga, T, E-mail: torsten.asselmeyer-maluga@dlr.d [German Aerospace Center, Berlin, Germany and Loyola University, New Orleans, LA (United States)


    Since the first work on exotic smoothness in physics, it was folklore to assume a direct influence of exotic smoothness to quantum gravity. Thus, the negative result of Duston (2009 arXiv:0911.4068) was a surprise. A closer look into the semi-classical approach uncovered the implicit assumption of a close connection between geometry and smoothness structure. But both structures, geometry and smoothness, are independent of each other. In this paper we calculate the 'smoothness structure' part of the path integral in quantum gravity assuming that the 'sum over geometries' is already given. For that purpose we use the knot surgery of Fintushel and Stern applied to the class E(n) of elliptic surfaces. We mainly focus our attention to the K3 surfaces E(2). Then we assume that every exotic smoothness structure of the K3 surface can be generated by knot or link surgery in the manner of Fintushel and Stern. The results are applied to the calculation of expectation values. Here we discuss the two observables, volume and Wilson loop, for the construction of an exotic 4-manifold using the knot 5{sub 2} and the Whitehead link Wh. By using Mostow rigidity, we obtain a topological contribution to the expectation value of the volume. Furthermore, we obtain a justification of area quantization.

  18. Exotic Smoothness and Quantum Gravity

    CERN Document Server

    Asselmeyer-Maluga, Torsten


    Since the first work on exotic smoothness in physics, it was folklore to assume a direct influence of exotic smoothness to quantum gravity. Thus, the negative result of Duston (arXiv:0911.4068) was a surprise. A closer look into the semi-classical approach uncovered the implicit assumption of a close connection between geometry and smoothness structure. But both structures, geometry and smoothness, are independent of each other. In this paper we calculate the "smoothness structure" part of the path integral in quantum gravity assuming that the "sum over geometries" is already given. For that purpose we use the knot surgery of Fintushel and Stern applied to the class E(n) of elliptic surfaces. We mainly focus our attention to the K3 surfaces E(2). Then we assume that every exotic smoothness structure of the K3 surface can be generated by knot or link surgery a la Fintushel and Stern. The results are applied to the calculation of expectation values. Here we discuss the two observables, volume and Wilson loop, f...

  19. EUROmediCAT signal detection

    DEFF Research Database (Denmark)

    Luteijn, Johannes Michiel; Morris, Joan K; Garne, Ester


    AIMS: Information about medication safety in pregnancy is inadequate. We aimed to develop a signal detection methodology to routinely identify unusual associations between medications and congenital anomalies using data collected by 15 European congenital anomaly registries. METHODS: EUROmediCAT......). CONCLUSIONS: Medication exposure data in the EUROmediCAT central database can be analyzed systematically to determine a manageable set of associations for validation and then testing in independent datasets. Detection of teratogens depends on frequency of exposure, level of risk and teratogenic specificity....

  20. [A case of esophageal achalasia followed by Parkinson's disease]. (United States)

    Mitani, Maki; Kawamoto, Kunihiko; Funakawa, Itaru; Jinnai, Kenji


    In 1992, a 63 year-old woman complained of dysphagia and chest pain, and was diagnosed with esophageal achalasia. Three years later, she developed resting tremor, cog-wheel rigidity, and retro-pulsion, and was diagnosed with Parkinson's disease and given appropriate medication. Several years later, intractable vomitting and aspiration pneumonia developed, and the lower esophageal sphincter was dilated using a pneumatic balloon dilator under gastroscopic guidance in 2004. That procedure improved her symptoms and the esophageal dilation was visualized on chest CT images. Herein, we report this rare case of esophageal achalasia followed by Parkinson's disease and discuss the relationship between the two diseases.

  1. Aortic Pseudoaneurysm Secondary to Mediastinitis due to Esophageal Perforation

    Directory of Open Access Journals (Sweden)

    Claudia Patricia Zuluaga


    Full Text Available Esophageal perforation is a condition associated with high morbidity and mortality rates; it requires early diagnosis and treatment. The most common complication of esophageal rupture is mediastinitis. There are several case reports in the literature of mediastinitis secondary to esophageal perforation and development of aortic pseudoaneurysm as a complication. We report the case of a patient with an 8-day history of esophageal perforation due to foreign body (fishbone with mediastinitis and aortic pseudoaneurysm. The diagnosis was made using Computed Tomography (CT with intravenous and oral water-soluble contrast material. An esophagogastroduodenoscopy did not detect the perforation.

  2. Antipsychotic-induced life-threatening 'esophageal dyskinesia'. (United States)

    Horiguchi, J; Shingu, T; Hayashi, T; Kagaya, A; Yamawaki, S; Horikawa, Y; Kitadai, Y; Inoue, M; Nishikawa, T


    We report two patients with lingual dyskinesia and complaints of food regurgitation following long-term antipsychotic therapy. Esophageal contrast radiography revealed dyskinetic movements extending from the pharynx to the upper portion of the esophagus. The elevation of intraesophageal pressure was confirmed by esophageal manometry. The dyskinetic movements almost disappeared along with improvement of lingual dyskinesia following the administration of sulpiride in one patient. Another patient suddenly died due to asphyxiation of foods before the beginning of treatment. We termed this life-threatening movement, 'esophageal dyskinesia'. It should be emphasized that 'esophageal dyskinesia' associated with lingual dyskinesia is a potentially fatal adverse reaction to antipsychotic therapy.

  3. Esophageal intramural pseudodiverticulosis characterized by barium esophagography: a case report

    LENUS (Irish Health Repository)

    O'Connor, Owen J


    Abstract Introduction Esophageal intramural pseudodiverticulosis is a rare condition characterized by the dilatation of the submucosal glands. Case presentation We present a case of esophageal intramural pseudodiverticulosis in a 72-year-old Caucasian man who presented with dysphagia and with a background history of alcohol abuse. An upper gastrointestinal endoscopy of our patient showed an esophageal stricture with abnormal mucosal appearances, but no malignant cells were seen at biopsy. Appearances on a barium esophagram were pathognomonic for esophageal intramural pseudodiverticulosis. Conclusion We demonstrate the enduring usefulness of barium esophagography in the characterization of abnormal mucosal appearances at endoscopy.

  4. Dangers to Children at Home: Corrosive esophageal burn

    Directory of Open Access Journals (Sweden)

    Ahmet Guven


    Full Text Available Inappropriate storage of cleaners which excessively used in daily is hazardous to children. Ingestion of potent corrosive agents, especially alkaline solutions may lead to acute esophageal burns, esophageal or stomach perforation, and even to death. Early of these injuries may be associated with esophageal strictures in later and the treatment of strictures might be and take long follow-up. This article reviews related issues on the diagnosis and management of esophageal burns, strictures and preventive medicine in children. [TAF Prev Med Bull 2008; 7(6.000: 535-540

  5. Degenerative mucinotic mural folliculitis in cats. (United States)

    Gross, T L; Olivry, T; Vitale, C B; Power, H T


    A novel form of mural folliculitis is described in seven cats. Clinically, all cats exhibited generalized alopecia with scaling or crusting that was more pronounced over the head, neck, and shoulders. The face and muzzle of all cats was unusually thickened. Six of seven cats were progressively lethargic but did not demonstrate any other consistent systemic abnormalities. Histologically, there was severe mixed inflammation of the wall of the follicular isthmus in all cats, accompanied by some follicular destruction in five cats. Sebaceous glands were not affected. All cats had variable, but often striking, follicular mucin deposition, as well as epidermal hyperkeratosis and crusting. The cause of the severe mural folliculitis was not identified, and all cats responded poorly to immunomodulating therapy. Follicular mucinosis may be a nonspecific finding, likely reflective of the follicular lymphocytic milieu, and does not always herald follicular lymphoma.

  6. Cerebral cysticercosis in a cat : clinical communication

    Directory of Open Access Journals (Sweden)

    E.V. Schwan


    Full Text Available The metacestode of Taenia solium, Cysticercus cellulosae, was recovered from the brain of a cat showing central nervous clinical signs ante mortem. This is the first record of cerebral cysticercosis in a cat in South Africa.

  7. Smooth quantum gravity: Exotic smoothness and Quantum gravity

    CERN Document Server

    Asselmeyer-Maluga, Torsten


    Over the last two decades, many unexpected relations between exotic smoothness, e.g. exotic $\\mathbb{R}^{4}$, and quantum field theory were found. Some of these relations are rooted in a relation to superstring theory and quantum gravity. Therefore one would expect that exotic smoothness is directly related to the quantization of general relativity. In this article we will support this conjecture and develop a new approach to quantum gravity called \\emph{smooth quantum gravity} by using smooth 4-manifolds with an exotic smoothness structure. In particular we discuss the appearance of a wildly embedded 3-manifold which we identify with a quantum state. Furthermore, we analyze this quantum state by using foliation theory and relate it to an element in an operator algebra. Then we describe a set of geometric, non-commutative operators, the skein algebra, which can be used to determine the geometry of a 3-manifold. This operator algebra can be understood as a deformation quantization of the classical Poisson alge...

  8. Eosinophilic esophagitis-endoscopic distinguishing findings

    Institute of Scientific and Technical Information of China (English)

    Ana Célia Caetano; Raquel Gon(c)alves; Carla Rolanda


    Eosinophilic esophagitis (EE) is the most frequent condition found in a group of gastrointestinal disorders called eosinophilic gastrointestinal diseases.The hypothetical pathophysiological mechanism is related to a hypersensitivity reaction.Gastroesophageal reflux disease-like complaints not ameliorated by acid blockade or occasional symptoms of dysphagia or food impaction are likely presentations of EE.Due to its unclear pathogenesis and unspecific symptoms,it is difficult to diagnose EE without a strong suspicion.Although histological criteria are necessary to diagnosis EE,there are some characteristic endoscopic features.We present the case of a healthy 55-year-old woman with dysphagia and several episodes of esophageal food impaction over the last six months.This case report stresses the most distinguishing endoscopic findings-mucosa rings,white exudative plaques and linear furrows-that can help in the prompt recognition of this condition.

  9. Eosinophilic Esophagitis in Brazilian Pediatric Patients (United States)

    Pinheiro, Mayra Isabel Correia; de Góes Cavalcanti, Luciano Pamplona; Honório, Rodrigo Schuler; de Alencar Moreno, Luís Hélder; Fortes, Mayara Carvalho; da Silva, Carlos Antônio Bruno


    We examined 11 pediatric patients with eosinophilic esophagitis with a tardy diagnosis. The symptoms were initially thought to be related to other diseases, leading to the use of inadequate therapeutic approaches. The patients were between 3 and 17 years old (mean 7.8 ± 3.8 years), and 8 of the patients were male. Common symptoms included abdominal pain, regurgitation, difficulty in gaining weight, vomiting, dysphagia, and coughing. The mean age for the onset of symptoms was 4.3 ± 2.9 years. Endoscopic findings included normal mucosa in five (45%) patients, thickening of the mucosa with longitudinal grooves in three (27%), erosive esophagitis in two (18%), and a whitish stippling in one (9%) patient. Treatment included the use of a topical corticosteroid for 10 patients. In eight (73%) cases, the treatment made the symptoms disappear. Ten patients underwent histopathological management after treatment, with a decrease in the number of eosinophils. PMID:24106430

  10. Successful tubes treatment of esophageal fistula

    Institute of Scientific and Technical Information of China (English)


    Aim: To discuss the merits of "tubes treatment" for esophageal fistula (EF). Methods: A 66-year-old female who suffered from a bronchoesophageal and esophagothoratic fistula underwent a successful "three tubes treatment" (close chest drainage, negative pressure suction at the leak, and nasojejunal feeding tube), combination of antibiotics, antacid drugs and nutritional support. Another 55-year-old male patient developed an esophagopleural fistula (EPF) after esophageal carcinoma operation. He too was treated conservatively with the three tubes strategy as mentioned above towards a favorable outcome. Results:The two patients recovered with the tubes treatment, felt well and became able to eat and drink, presenting no complaint. Conclusion: Tubes treatment is an effective basic way for EF. It may be an alternative treatment option.

  11. Radiation-Induced Esophagitis Exacerbated by Everolimus

    Directory of Open Access Journals (Sweden)

    Yuji Miura


    Full Text Available Background: Everolimus, a potent mammalian target of rapamycin (mTOR inhibitor, has shown anticancer activity against various types of cancer, including renal cell carcinoma (RCC; however, little information is available on the efficacy and safety of the combination of everolimus and radiotherapy. We report a case of radiation-induced esophagitis that might have been exacerbated by the sequential administration of everolimus. Case Presentation: A 63-year-old Japanese man with RCC complained of back pain, and magnetic resonance imaging revealed vertebral metastases. He received radiotherapy (30 Gy/10 fractions to the T6-10 vertebrae. Everolimus was administered immediately after the completion of radiotherapy. One week later, he complained of dysphagia, nausea and vomiting. An endoscopic examination of the esophagus showed erosive esophagitis in the middle to lower portions of his thoracic esophagus, corresponding to the irradiation field. Conclusion: Clinicians should be aware that everolimus might lead to the unexpected exacerbation of radiation toxicities.

  12. Thoracoscopic esophagectomy for intrathoracic esophageal cancer. (United States)

    Osugi, Harushi; Takemura, Masashi; Lee, Sigeru; Nishikawa, Takayuki; Fukuhara, Kennichirou; Iwasaki, Hiroshi; Higashino, Masayuki


    Thoracoscopic approaches for esophageal cancer are still disparate. Complete scopic technique is feasible for esophagectomy. Mini-thoracotomy is effective for excellent exposure of the mediastinum for lymph node dissection. The magnifying effect of a video, by keeping the camera in close proximity to the dissection is essential to perform the same quality of dissection as open surgery. The benefit, for respiratory morbidity, remains to be studied in a large number of patients. Minimizing the chest wall injury contributed, to the reduction of constrictive pulmonary damage. Survival after the thoracoscopic approach was favorably compared with open surgery, when extensive lymphadenectomy was performed. Because the efficacy improves with the surgeon's experience, satisfactory outcome will only be obtained in a center performing a sufficient volume of esophageal surgery to provide the surgeon with opportunities to refine his necessary skills. Improvements in technique and instrumentation should make the procedure more accessible and steepen the learning curve.

  13. [Surgery in esophageal carcinoma: risks and results]. (United States)

    von Flüe, M; Ackermann, C; Tondelli, P


    Surgical treatment of esophageal cancer is largely palliative. To clarify the indication it is necessary to assess the effectiveness of the palliation in relief of dysphagia and the operative risks. In a retrospective study we analyzed the perioperative morbidity and follow-up in 25 patients with carcinoma of the esophagus treated between 1984 and 1988 (5 years). With combined anesthesia, early extubation and intensive pulmonary therapy, no perioperative respiratory insufficiency was observed. Perioperative mortality was 0%. An anastomotic leak in 2 patients with a cervical anastomosis was healed in both cases by conservative management. On hospital discharge all patients were able to eat normally. 13 patients died after 1 year on average (4 months to 3 years). 12 patients are alive 6 months to 4 years after operation, 10 of them without symptoms. Our results show that with optimal perioperative management of esophageal carcinoma low morbidity is possible and good palliation of dysphagia is feasible.

  14. Esophageal Foreign Body Causing Direct Aortic Injury

    Directory of Open Access Journals (Sweden)

    ECS Lam


    Full Text Available Foreign bodies in the esophagus are uncommon causes of esophageal perforation. Many nonperforating cases are successfully managed by flexible gastroscopy. However, complicated foreign bodies such as those that result in esophageal perforation and vascular injury are best managed surgically. Gastroscopy remains the primary method of diagnosis. A case of a 59-year-old woman who developed retrosternal and intrascapular pain, odynophagia and hematemesis after eating fish is reported. Flexible gastroscopy showed arterial bleeding from the midthoracic esophagus. Computed tomography scan localized a 3 cm fish bone perforating the esophagus with surrounding hematoma. An aortogram did not reveal an actively bleeding aortoesophageal fistula. The fish bone was surgically removed and the patient recovered with no postoperative complications. This case illustrates the importance of early consideration for surgical intervention when confronted with a brisk arterial bleed from the esophagus with suggestive history of foreign body ingestion.

  15. “Layer-to-Layer” Esophagogastric Anastomosis Combined with Intrathoracic Esophageal Mucosal Extention in Patients with Esophageal and Cardia Cancer

    Institute of Scientific and Technical Information of China (English)

    SHIZhongqi; CAIPing; YANYu; CHENYinchun; LIUJunhua; YOUQinshen; CAIJixiang; XIZhongxia


    Objective: To evaluate the clinical value of intrathoracic esophagogastric “layer-to-layer” anastomosis with esophageal mucosa extended varied in plane and to study the effective methods to prevent anastomotic leaking or stricture postoperatively. Methods: From May 1985 to December 2002, 2 240 esophageal and stomach cardia cancer patients treated by intrathoracic esophagogastric “layer-to-layer”anastomosis with esophageal mucosa extended varied in plane were retrospectively analyzed. Results:There was no anastomotic leaking and severe stricture in all above cases. Conclusion: Intrathoracic esophagogastric “layer-to-layer” anastomosis with esophageal mucosal extended varied in plane is an effective method to prevent anastomotic leaking and stricture postoperatively.

  16. Technological advances in radiotherapy for esophageal cancer

    Institute of Scientific and Technical Information of China (English)

    Milan; Vosmik; Jiri; Petera; Igor; Sirak; Miroslav; Hodek; Petr; Paluska; Jiri; Dolezal; Marcela; Kopacova


    Radiotherapy with concurrent chemotherapy and surgery represent the main treatment modalities in esophageal cancer.The goal of modern radiotherapy approaches,based on recent technological advances,is to minimize post-treatment complications by improving the gross tumor volume definition (positron emission tomography-based planning),reducing interfraction motion (image-guided radiotherapy) and intrafraction motion (respiratory-gated radiotherapy),and by better dose delivery to the precisely defined planning ...

  17. Multidisciplinary management for esophageal and gastric cancer

    Directory of Open Access Journals (Sweden)

    Boniface MM


    Full Text Available Megan M Boniface,1 Sachin B Wani,2 Tracey E Schefter,3 Phillip J Koo,4 Cheryl Meguid,1 Stephen Leong,5 Jeffrey B Kaplan,6 Lisa J Wingrove,7 Martin D McCarter1 1Section of Surgical Oncology, Division of GI, Tumor and Endocrine Surgery, Department of Surgery, 2Division of Gastroenterology and Hepatology, Department of Therapeutic and Interventional Endoscopy, 3Department of Radiation Oncology, 4Division of Radiology-Nuclear Medicine, Department of Radiology, 5Division of Medical Oncology, 6Department of Pathology, University of Colorado Denver, 7Department of Food and Nutrition Services, University of Colorado Hospital Cancer Center, Aurora, CO, USA Abstract: The management of esophageal and gastric cancer is complex and involves multiple specialists in an effort to optimize patient outcomes. Utilizing a multidisciplinary team approach starting from the initial staging evaluation ensures that all members are in agreement with the plan of care. Treatment selection for esophageal and gastric cancer often involves a combination of chemotherapy, radiation, surgery, and palliative interventions (endoscopic and surgical, and direct communication between specialists in these fields is needed to ensure appropriate clinical decision making. At the University of Colorado, the Esophageal and Gastric Multidisciplinary Clinic was created to bring together all experts involved in treating these diseases at a weekly conference in order to provide patients with coordinated, individualized, and patient-centered care. This review details the essential elements and benefits of building a multidisciplinary program focused on treating esophageal and gastric cancer patients. Keywords: tumor board, upper gastrointestinal malignancies, patient centered

  18. Radiotherapy of double primary esophageal carcinoma

    Institute of Scientific and Technical Information of China (English)

    Ze Fen Xiao; Zong Yi Yang; Zong Mei Zhou; Wei Bo Yin; Xian Zhi Gu


    @@ INTRODUCTION Double primary esophageal carcinoma is defined as having two foci of squamous cell cancer simultaneously or consecutively developing in different sites of esophagus. This rare disease appears mostly in the literature as case reports[1-4],reports about its treatment are even more infrequent. Here we present our experiences of radiation therapy in 37 patients with this disease and focus the discussion on the optimum method of treatment and complications.

  19. Non-surgical treatment of esophageal achalasia

    Institute of Scientific and Technical Information of China (English)

    Vito Annese; Gabrio Bassotti


    Esophageal achalasia is an infrequent motility disorder characterized by a progressive stasis and dilation of the oesophagus; with subsequent risk of aspiration,weight loss, and malnutrition. Although the treatment of achalasia has been traditionally based on a surgical approach, especially with the introduction of laparoscopic techniques, there is still some space for a medical approach. The present article reviews the non-surgical therapeutic options for achalasia.

  20. Medicolegal aspects of esophageal cancer surgery. (United States)

    De Giorgio, Fabio


    Forensic implications of esophageal cancer surgery are varied and complex depending on the field of specialization involved i.e. civil law, criminal law, insurance or social security and for the distinct probative requirements related to each field. The aim of this article is to reconstruct the logical procedure of a forensic doctor who actually examines a practical case to establish the profiles of professional responsibility in particular in civil or criminal law.

  1. Black esophagus: Acute esophageal necrosis syndrome

    Institute of Scientific and Technical Information of China (English)

    Grigoriy; E; Gurvits


    Acute esophageal necrosis (AEN), commonly referred to as "black esophagus", is a rare clinical entity arising from a combination of ischemic insult seen in hemodynamic compromise and low-flow states, corrosive injury from gastric contents in the setting of esophago-gastroparesis and gastric outlet obstruction, and decreased function of mucosal barrier systems and reparative mechanisms present in malnourished and debilitated physical states. AEN may arise in the setting of multiorgan dysfunction, hypoperfusi...

  2. Toxoplasmosis: An Important Message for Cat Owners (United States)

    ... a s t is O : wAnneIrmsportant What role do cats play in the spread of toxoplasmosis? Cats get Toxoplasma infection by eating infected rodents, birds ... animals, or anything contaminated with feces from another cat that is shedding the microscopic parasite in its ...

  3. Getting a CAT Scan (For Kids) (United States)

    ... What Happens in the Operating Room? Getting a CAT Scan (Video) KidsHealth > For Kids > Getting a CAT Scan (Video) A A A en español Obtención de una tomografía computada (video) CAT stands for "computerized axial tomography." Translated, that means ...

  4. Dipylidium (Dog and Cat Flea Tapeworm) FAQs (United States)

    ... the most common kind of tapeworm dogs and cats get? The most common tapeworm of dogs and cats in the United States is called Dipylidium caninum . ... infected with a tapeworm larvae. A dog or cat may swallow a flea while self-grooming. Once ...

  5. Cats & Dogs%猫狗大战

    Institute of Scientific and Technical Information of China (English)



    @@ ( Dogs and cats are permanent enemies. A dog named Bubby is catnapped by the cats. The whole cats' world is shocked and alert. ) Dog Chairman: Gentlemen, a few moments ago I received word of the gravest nature. The key agent working the Brody case has been catnapped. Although he is safe, new must replace him as soon as possible.

  6. EUROmediCAT signal detection

    DEFF Research Database (Denmark)

    Given, Joanne E; Loane, Maria; Luteijn, Johannes Michiel


    AIMS: To evaluate congenital anomaly (CA)-medication exposure associations produced by the new EUROmediCAT signal detection system and determine which require further investigation. METHODS: Data from 15 EUROCAT registries (1995-2011) with medication exposures at the chemical substance (5th level...

  7. A strange cat in Dublin (United States)

    O'Raifeartaigh, Cormac


    Not many life stories in physics involve Nazis, illicit sex, a strange cat and the genetic code. Thus, a new biography of the great Austrian physicist Erwin Schrödinger is always of interest, and with Erwin Schrödinger and the Quantum Revolution, veteran science writer John Gribbin does not disappoint.

  8. Eosinophilic esophagitis: From pathophysiology to treatment. (United States)

    D'Alessandro, Alessandra; Esposito, Dario; Pesce, Marcella; Cuomo, Rosario; De Palma, Giovanni Domenico; Sarnelli, Giovanni


    Eosinophilic esophagitis (EoE) is a chronic immune disease, characterized by a dense eosinophilic infiltrate in the esophagus, leading to bolus impaction and reflux-like symptoms. Traditionally considered a pediatric disease, the number of adult patients with EoE is continuously increasing, with a relatively higher incidence in western countries. Dysphagia and food impaction represent the main symptoms complained by patients, but gastroesophageal reflux-like symptoms may also be present. Esophageal biopsies are mandatory for the diagnosis of EoE, though clinical manifestations and proton pump inhibitors responsiveness must be taken into consideration. The higher prevalence of EoE in patients suffering from atopic diseases suggests a common background with allergy, however both the etiology and pathophysiology are not completely understood. Elimination diets are considered the first-line therapy in children, but this approach appears less effective in adults patients, who often require steroids; despite medical treatments, EoE is complicated in some cases by esophageal stricture and stenosis, that require additional endoscopic treatments. This review summarizes the evidence on EoE pathophysiology and illustrates the safety and efficacy of the most recent medical and endoscopic treatments.

  9. Surgical Treatment of Perforation Esophageal Carcinoma

    Institute of Scientific and Technical Information of China (English)

    Depu Duan; Jihua Zou; Zhigang Cai; Shengyong Wu; Haibo Xiao; Yiyong Zhou; Xiang Liang; Dekui Sun; Songchang Wu


    OBJECTIVE To determine the ideal method of surgical preoperative treatment for perforation with esophageal carcinoma.METHODS 36 cases of perforation with esophageal carcinoma were treated surgically in this series.Perforations occurred into the right lung in14 cases ,the mediastinum in 17 cases and trachea in 5 cases.Open thoracic surgery was performed in 34 cases,in which the right thoracic approach using a 3-incision method was applied in 16 cases,and operation by stages in 15 cases.Of the 34 cases,retrosternal substitution of the esophagus with stomach or colon was performed in 26 cases.RESULTS Surgery was successful in 31 cases and operative death occurred in 3 cases.The postoperative follow up study was from 3~72months.Of these cases 15 wree alive at 7~12 months, 2 at 24 months,and 1 at 72 months. The results can be considered satisfactory.CONCLUSION The therapeutic results of surgical treatment of perforation with esophageal carcinoma were markedly superior to that of conventional conservative treatment. The authors suggest that surgical intervention without delay should be undertaken for patients having a perforation with carcinoma of the esophagus. A right thoracic approach with a 3-incision method (retrosternal replacement of esophagus with stomach or colon) or operation by stages is preferable.

  10. Herpes simplex ulcerative esophagitis in healthy children

    Directory of Open Access Journals (Sweden)

    Abdulrahman A Al-Hussaini


    Full Text Available Herpes simplex virus is a common cause of ulcerative esophagitis in the immunocompromised or debilitated host. Despite a high prevalence of primary and recurrent Herpes simplex virus infection in the general population, Herpes simplex virus esophagitis (HSVE appears to be rare in the immunocompetent host. We report three cases of endoscopically-diagnosed HSVE in apparently immunocompetent children; the presentation was characterized by acute onset of fever, odynophagia, and dysphagia. In two cases, the diagnosis was confirmed histologically by identification of herpes viral inclusions and culture of the virus in the presence of inflammation. The third case was considered to have probable HSVE based on the presence of typical cold sore on his lip, typical endoscopic finding, histopathological evidence of inflammation in esophageal biopsies and positive serologic evidence of acute Herpes simplex virus infection. Two cases received an intravenous course of acyclovir and one had self-limited recovery. All three cases had normal immunological workup and excellent health on long-term follow-up.

  11. Surgical treatment of giant esophageal leiomyoma

    Institute of Scientific and Technical Information of China (English)

    Bang-Chang Cheng; Sheng Chang; Zhi-Fu Mao; Mao-Jin Li; Jie Huang; Zhi-Wei Wang; Tu-Sheng Wang


    AIM: To summarize the operative experiences for giant leiomyoma of esophagus.METHODS: Eight cases of giant esophageal leiomyoma (GEL) whose tumors were bigger than 10 cm were treated surgically in our department from June 1980 to March 2004.and esophagoscopy. Leiomyoma located in upper thirds of the esophagus in one case, middle thirds of the esophagus in five cases, lower thirds of the esophagus in two cases. Resection of tumors was performed successfully in all of these cases. Operative methods included transthoracic extramucosal enucleation and buttressing the muscular defect with pedicled great omental flap (one case), esophagectomy and esophagogastrostomy above the arch of aorta (three cases), total esophagectomy and esophageal replacement with colon (four cases). Histological examination confirmed that all of these cases were leiomyoma.RESULTS: All of the eight patients recovered approvingly with no mortality and resumed normal diet after operation. Vomiting during meals occurred in one patient with esophagogastrostomy, and remained 1 mo. Reflux esophagitis occurred in one patient with esophagogastrostomy and was alleviated with medication. Thoracic colon syndrome (TCS) occurred in one patient with colon replacement at 15 mo postoperatively. No recurrence occurred in follow-up from 6 mo to 8 years.CONCLUSION: Surgical treatment for GEL is both safe and effective. The choices of operative methods mainly depend on the location and range of lesions. We prefer to treat GEL via esophagectomy combined with esophagogastrostomy or esophagus replacement with colon. The long-time quality of life is better in the latter.

  12. [Minimally Invasive Treatment of Esophageal Benign Diseases]. (United States)

    Inoue, Haruhiro


    As a minimally invasive treatment of esophageal achalasia per-oral endoscopic myotomy( POEM) was developed in 2008. More than 1,100 cases of achalasia-related diseases received POEM. Success rate of the procedure was more than 95%(Eckerdt score improvement 3 points and more). No serious( Clavian-Dindo classification III b and more) complication was experienced. These results suggest that POEM becomes a standard minimally invasive treatment for achalasia-related diseases. As an off-shoot of POEM submucosal tumor removal through submucosal tunnel (per-oral endoscopic tumor resection:POET) was developed and safely performed. Best indication of POET is less than 5 cm esophageal leiomyoma. A novel endoscopic treatment of gastroesophageal reflux disease (GERD) was developed. Anti-reflux mucosectomy( ARMS) is nearly circumferential mucosal reduction of gastric cardia mucosa. ARMS is performed in 56 consecutive cases of refractory GERD. No major complications were encountered and excellent clinical results. Best indication of ARMS is a refractory GERD without long sliding hernia. Longest follow-up case is more than 10 years. Minimally invasive treatments for esophageal benign diseases are currently performed by therapeutic endoscopy.

  13. Clinical and endoscopic features of Chinese reflux esophagitis patients

    Institute of Scientific and Technical Information of China (English)

    Wei Li; Shu-Tian Zhang; Zhong-Lin Yu


    AIM: To analyze the clinical and endoscopic features of Chinese patients with reflux esophagitis (RE).METHODS: A total of 1405 RE patients were analyzed retrospectively. Data on gender, age, presence/absence of H pylori infection and associated esophageal hiatal hernia were collected. Esophagitis was divided into different grades according to Los Angeles Classification.RESULTS: Of 18823 patients, 1405 were diagnosed as RE. The ratio of male to female patients was 1.75:1 (P < 0.01). The mean age of male and female patients was significantly different (P = 0.01). The peak age at onset of the disease was 40-60 years. According to Los Angeles Classification, there were significant differences in the age of patients with grades A and B compared to patients with grades C and D (P < 0.01). Two hundred and seventy-seven patients were infected with H pylori, the infection rate was low (P < 0.01). Complication of esophageal hiatal hernia was found to be significantly associated with the severity of esophagitis and age in 195 patients (P < 0.01). Esophageal mucosa damages were mainly located at the right esophageal wall.CONCLUSION: The peak age of onset of RE is 40-60 years and higher in males than in females. The mean age of onset of RE is lower in males than in females. The infection rate of H pylori is significantly decreased in patients with esophagitis. Old age and esophageal hiatal hernia are associated with more severe esophagitis. Right esophageal mucosal damage can occur more often in RE patients.

  14. Attributable causes of esophageal cancer incidence and mortality in China.

    Directory of Open Access Journals (Sweden)

    Jian-Bing Wang

    Full Text Available BACKGROUND: To estimate the contribution of tobacco smoking, alcohol drinking, low vegetable intake and low fruit intake to esophageal cancer mortality and incidence in China. METHODOLOGY/PRINCIPAL FINDINGS: We calculated the proportion of esophageal cancer attributable to four known modifiable risk factors [population attributable fraction (PAF]. Exposure data was taken from meta-analyses and large-scale national surveys of representative samples of the Chinese population. Data on relative risks were also from meta-analyses and large-scale prospective studies. Esophageal cancer mortality and incidence came from the 3(rd national death cause survey and population-based cancer registries in China. We estimated that 87,065 esophageal cancer deaths (men 67,686; women: 19,379 and 108,206 cases (men: 83,968, women: 24,238 were attributable to tobacco smoking, alcohol drinking, low vegetable intake and low fruit intake in China in 2005. About 17.9% of esophageal cancer deaths among men and 1.9% among women were attributable to tobacco smoking. About 15.2% of esophageal cancer deaths in men and 1.3% in women were caused by alcohol drinking. Low vegetable intake was responsible for 4.3% esophageal cancer deaths in men and 4.1% in women. The fraction of esophageal cancer deaths attributable to low fruit intake was 27.1% in men and 28.0% in women. Overall, 46% of esophageal cancers (51% in men and 33% in women were attributable to these four modifiable risk factors. CONCLUSIONS/SIGNIFICANCE: Tobacco smoking, alcohol drinking, low vegetable intake and low fruit intake were responsible for 46% of esophageal cancer mortality and incidence in China in 2005. These findings provide useful data for developing guidelines for esophageal cancer prevention and control in China.

  15. Diagnosis of esophageal motility disorders: esophageal pressure topography versus conventional line tracing (United States)

    Carlson, DA; Ravi, K; Kahrilas, PJ; Gyawali, CP; Bredenoord, AJ; Castell, DO; Spechler, SJ; Halland, M; Kanuri, N; Katzka, DA; Leggett, CL; Roman, S; Saenz, JB; Sayuk, GS; Wong, AC; Yadlapati, R; Ciolino, JD; Fox, MR; Pandolfino, JE


    Background Enhanced characterization of esophageal peristaltic and sphincter function provided by esophageal pressure topography (EPT) offers a potential diagnostic advantage over conventional line tracings (CLT). However, high-resolution manometry (HRM) and EPT require increased equipment costs over conventional systems and evidence demonstrating a significant diagnostic advantage of EPT over CLT is limited. Our aim was to investigate whether the inter-rater agreement and/or accuracy of esophageal motility diagnosis differed between EPT and CLT. Methods Forty previously-completed patient HRM studies were selected for analysis using a customized software program developed to perform blinded independent interpretation in either EPT or CLT (six pressure sensors) format. Six experienced gastroenterologists with a clinical focus in esophageal disease (attendings) and six gastroenterology trainees with minimal manometry experience (fellows) from three academic centers interpreted each of the 40 studies using both EPT and CLT formats. Rater diagnoses were assessed for inter-rater agreement and diagnostic accuracy, both for exact diagnosis and for correct identification of a major esophageal motility disorder. Results The total group agreement was moderate (κ = 0.57; 95% CI 0.56–0.59) for EPT and fair (κ = 0.32; 0.30–0.33) for CLT. Inter-rater agreement between attendings was good (κ = 0.68; 0.65–0.71) for EPT and moderate (κ = 0.46; 0.43–0.50) for CLT. Inter-rater agreement between fellows was moderate (κ = 0.48; 0.45–0.50) for EPT and poor to fair (κ = 0.20; 0.17–0.24) for CLT. Among all raters, the odds of an incorrect exact esophageal motility diagnosis were 3.3 times higher with CLT assessment than with EPT (OR 3.3; 95% CI 2.4–4.5; p<0.0001) and the odds of incorrect identification of a major motility disorder were 3.4 times higher with CLT than EPT (OR 3.4; 2.4–5.0; p<0.0001). Conclusions Superior inter-rater agreement and diagnostic accuracy

  16. Esophageal Perforation: A Rare Complication of Transesophageal Echocardiography in a Patient with Asymptomatic Esophagitis

    Directory of Open Access Journals (Sweden)

    Kabir Ahmed


    Full Text Available Transesophageal echocardiography (TEE is a commonly used procedure in patients with suspected endocarditis. A rare but dreadful complication of this procedure is perforation of the esophagus. We report the case of an elderly female with multiple comorbidities, who presented with polyarticular septic arthritis. TEE was performed to rule out endocarditis. Though the standard procedure protocol was followed, she developed esophageal perforation. It was managed with esophageal stenting but she developed multiorgan failure and did not survive. This case highlights the potential of severe morbidity and mortality associated with TEE. Appropriate screening must be done and high-risk individuals must be identified before such procedures are attempted.

  17. [Esophageal diseases: gastroesophageal reflux disease, Barrett's esophagus, achalasia and eosinophilic esophagitis]. (United States)

    Calvet, Xavier; Villoria, Albert


    Important new advances were presented in esophageal disease in Digestive Disease Week 2013. A highlight was confirmation of the high efficacy of weight loss to treat symptoms of reflux and an interesting pilot study suggesting that a simple ligature with supra- and infracardial bands could be an effective technique in esophageal reflux. If the excellent results and safety and efficacy of this technique are confirmed in the long term, it could revolutionize the management of gastroesophageal reflux disease. Also of note this year was the presentation of multiple studies validating a new technique, peroral endoscopic myotomy (POEM) for the endoscopic treatment of achalasia. This technique seems to have excellent efficacy and safety.

  18. Selective Smoothed Finite Element Method

    Institute of Scientific and Technical Information of China (English)


    The paper examines three selective schemes for the smoothed finite element method (SFEM) which was formulated by incorporating a cell-wise strain smoothing operation into the standard compatible finite element method (FEM). These selective SFEM schemes were formulated based on three selective integration FEM schemes with similar properties found between the number of smoothing cells in the SFEM and the number of Gaussian integration points in the FEM. Both scheme 1 and scheme 2 are free of nearly incompressible locking, but scheme 2 is more general and gives better results than scheme 1. In addition, scheme 2 can be applied to anisotropic and nonlinear situations, while scheme 1 can only be applied to isotropic and linear situations. Scheme 3 is free of shear locking. This scheme can be applied to plate and shell problems. Results of the numerical study show that the selective SFEM schemes give more accurate results than the FEM schemes.

  19. My Experience of Feeding a Cat

    Institute of Scientific and Technical Information of China (English)



    I liked cat very much. In my old opinion, cat was cute and gentle. One day, my friend asked me to feed the cat for him. So I went to his house in order to take care of his cat. His neighbor was an old woman. When I was doing some cleaning, the old woman asked me if I needed some help. Suddenly, the cat stretched out its sharp claws, and clawed me and bit me with its sharp teeth. WowA It was too abrupt. The old woman got scared. “It goes crazyA” I said and asked her to get out of the room, otherwise she woul...

  20. Jejunum for bridging long-gap esophageal atresia

    NARCIS (Netherlands)

    Bax, Klaas (N) M. A.


    OBJECTIVE: Exploring pros and cons of bridging long-gap esophageal atresia with an orthotopic jejunal pedicle graft. Retrospective series of 19 patients. METHODS: From 1988 through 2005, 19 patients with long-gap esophageal atresia received a jejunal graft. Median age at reconstruction was 76 days.

  1. High Prevalence of Esophageal Dysmotility in Asymptomatic Obese Patients

    Directory of Open Access Journals (Sweden)

    Justin Côté-Daigneault


    Full Text Available BACKGROUND: Obesity is an important health problem affecting >500 million people worldwide. Esophageal dysmotility is a gastrointestinal pathology associated with obesity; however, its prevalence and characteristics remain unclear. Esophageal dysmotilities have a high prevalence among obese patients regardless of gastrointestinal symptoms.

  2. Case report: Antenatal MRI diagnosis of esophageal duplication cyst. (United States)

    Rangasami, Rajeswaran; Chandrasekharan, Anupama; Archana, Lal; Santhosh, Joseph


    Esophageal duplication cysts are classified as a subgroup of foregut duplication cysts. They are very rare and are predominantly detected in children. Antenatal detection is very rare. We report a case of an esophageal duplication cyst that was accurately identified antenatally by USG and MRI.


    Institute of Scientific and Technical Information of China (English)

    张力建; 叶国经; 黄信孚; 谢玉泉


    A case of esophageal Crohn's disease in a 52-year-old man is described.The patient was treated successfully by surgical excision of the esophagus.Because esophageal Crohn's disease is uncommon,we would like to discuss its clinical characteristics and to teview theliterature.

  4. 21 CFR 868.1920 - Esophageal stethoscope with electrical conductors. (United States)


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Esophageal stethoscope with electrical conductors... stethoscope with electrical conductors. (a) Identification. An esophageal stethoscope with electrical conductors is a device that is inserted into the esophagus to listen to a patient's heart and breath...

  5. Eosinophilic esophagitis: manometric and pHmetric findings

    Directory of Open Access Journals (Sweden)

    Monica Maria Cardoso Monnerat


    Full Text Available CONTEXT: Eosinophilic esophagitis is an entity characterized by an esophageal inflammatory infiltrate of eosinophils, manifested by dysphagia, intermittent food impactions and symptoms similar to gastroesophageal reflux disease (GERD, that predominantly affects young adults. There may be association of eosinophilic esophagitis with GERD, and motor abnormalities have been described. OBJECTIVE: The main objectives of this study are to describe the findings at esophageal manometry and pH monitoring in patients with eosinophilic esophagitis. METHODS: Cross-sectional study of 20 patients with a diagnosis of eosinophilic esophagitis, submitted to esophageal manometry and 24h pH monitoring. Were analysed the manometric changes and the presence of abnormal reflux on pH monitoring. RESULTS: Twenty patients (15 men, 5 women had a mean age of 29 years. Motility disorders were found in 25% (5/20 patients with ineffective esophageal motility being the most common finding. pH monitoring revealed abnormal reflux on 25%, without any relationship with manometric findings. CONCLUSIONS: Manometric abnormalities were observed in 25% of patients and abnormal reflux on pH monitoring also in 25%. This study showed no relationship between abnormal reflux and the presence of manometric changes.

  6. Esophageal Cancer: Role of Imaging in Primary Staging and Response Assessment Post Neoadjuvant Therapy. (United States)

    Griffin, Yvette


    Advances in the early detection and treatment of esophageal cancer have meant improved survival rates for patients with esophageal cancer. Accurate pretreatment and post-neoadjuvant treatment staging of esophageal cancer is essential for assessing operability and determining the optimum treatment plan. This article reviews the multimodality imaging approach in the diagnosis, staging, and assessment of treatment response in esophageal cancer.

  7. α-compactness in smooth topological spaces

    Directory of Open Access Journals (Sweden)

    Chun-Kee Park


    Full Text Available We introduce the concepts of smooth α-closure and smooth α-interior of a fuzzy set which are generalizations of smooth closure and smooth interior of a fuzzy set defined by Demirci (1997 and obtain some of their structural properties.

  8. Unilateral Renal Ischemia as a Model of Acute Kidney Injury and Renal Fibrosis in Cats. (United States)

    Schmiedt, C W; Brainard, B M; Hinson, W; Brown, S A; Brown, C A


    The objectives of this study were to define the acute and chronic effects of 1-hour unilateral in vivo renal ischemia on renal function and histology in cats. Twenty-one adult purpose-bred research cats were anesthetized, and 1 kidney underwent renal artery and vein occlusion for 1 hour. Serum creatinine and urea concentrations, urine protein:creatinine ratio, urine-specific gravity, glomerular filtration rate, hematocrit, platelet concentration and function, and white blood cell count were measured at baseline and variable time points after ischemia. Renal histopathology was evaluated on days 3, 6, 12, 21, 42, and 70 postischemia; changes in smooth muscle actin and interstitial collagen were examined. Following ischemia, whole animal glomerular filtration rate was significantly reduced (57% of baseline on day 6; P acute epithelial necrosis accompanied by evidence of regeneration of tubules predominantly within the corticomedullary junction. At later periods, postischemic kidneys had evidence of tubular atrophy and interstitial inflammation with significantly more smooth muscle actin and interstitial collagen staining and interstitial fibrosis when compared with the contralateral control kidneys. This study characterizes the course of ischemic acute kidney injury in cats and demonstrates that ischemic acute kidney injury triggers chronic fibrosis, interstitial inflammation, and tubular atrophy in feline kidneys. These late changes are typical of those observed in cats with naturally occurring chronic kidney disease.

  9. Wetting on smooth micropatterned defects

    CERN Document Server

    Debuisson, Damien; Senez, Vincent; Arscott, Steve


    We develop a model which predicts the contact angle hysteresis introduced by smooth micropatterned defects. The defects are modeled by a smooth function and the contact angle hysteresis is explained using a tangent line solution. When the liquid micro-meniscus touches both sides of the defect simultaneously, depinning of the contact line occurs. The defects are fabricated using a photoresist and experimental results confirm the model. An important point is that the model is scale-independent, i.e. the contact angle hysteresis is dependent on the aspect ratio of the function, not on its absolute size; this could have implications for natural surface defects.

  10. Lansap in treatment of esophagitis in patients with systemic sclerosis

    Directory of Open Access Journals (Sweden)

    R T Alekperov


    Full Text Available Objective. To study the efficacy of Lansap (Lansoprasole in treatment of esophagitis in pts with systemic sclerosis (SS. Methods. 30 SS pts with clinical manifestations and endoscopic signs of esophagitis received lansap 30 or 60 mg/day during two weeks. All pts had a standard endoscopic examination before and after the treatment. Results. Clinical symptoms of esophagitis were reduced significantly in most pts during the first day of treatment and resolved completely to the eleventh day. Endoscopic examination after two weeks revealed decrease of esophagitis severity in all pts. Esophagial erosions were healed in 16 from 18 pts. Conclusion. Lansap is an effective drug for treatment of reflux esophagitis in pts with SS.

  11. Expression of cyclooxygenase-2 in human esophageal squamous cell carcinomas

    Institute of Scientific and Technical Information of China (English)

    Jian-Gang Jiang; Dao-Wen Wang; Jiang-Bo Tang; Chun-Lian Chen; Bao-Xing Liu; Xiang-Ning Fu; Zhi-Hui Zhu; Wei Qu; Katherine Cianflone; Michael P. Waalkes


    AIM: To determine whether cyclooxygenase-2 (COX-2) was expressed in human esophageal squamous cell carcinoma.METHODS: Quantitative reverse transcription-polymerase chain reaction (RT-PCR), western blotting, immunohistochemistry and immunofluorescence were used to assess the expression level of COX-2 in esophageal tissue.RESULTS: COX-2 mRNA levels were increased by >80-fold in esophageal squamous cell carcinoma when compared to adjacent noncancerous tissue. COX-2 protein was present in 21 of 30 cases of esophageal squamous cell carcinoma tissues, but was undetectable in noncancerous tissue. Immunohistochemistry was performed to directly show expression of COX-2 in tumor tissue.CONCLUSION: These results suggest that COX-2 may be an important factor for esophageal cancer and inhibition of COX-2 may be helpful for prevention and possibly treatment of this cancer.

  12. Current treatment options for the management of esophageal cancer

    Directory of Open Access Journals (Sweden)

    Mawhinney MR


    Full Text Available Mark R Mawhinney, Robert E GlasgowDepartment of Surgery, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, USAAbstract: In recent years, esophageal cancer characteristics and management options have evolved significantly. There has been a sharp increase in the frequency of esophageal adenocarcinoma and a decline in the frequency of squamous cell carcinoma. A more comprehensive understanding of prognostic factors influencing outcome has also been developed. This has led to more management options for esophageal cancer at all stages than ever before. A multidisciplinary, team approach to management in a high volume center is the preferred approach. Each patient should be individually assessed based on type of cancer, local or regional involvement, and his or her own functional status to determine an appropriate treatment regimen. This review will discuss management of esophageal cancer relative to disease progression and patient functional status.Keywords: esophageal adenocarcinoma, squamous cell carcinoma, treatment regimen, disease progression, patient functional status

  13. The fecal microbiome in cats with diarrhea.

    Directory of Open Access Journals (Sweden)

    Jan S Suchodolski

    Full Text Available Recent studies have revealed that microbes play an important role in the pathogenesis of gastrointestinal (GI diseases in various animal species, but only limited data is available about the microbiome in cats with GI disease. The aim of this study was to evaluate the fecal microbiome in cats with diarrhea. Fecal samples were obtained from healthy cats (n = 21 and cats with acute (n = 19 or chronic diarrhea (n = 29 and analyzed by sequencing of 16S rRNA genes, and PICRUSt was used to predict the functional gene content of the microbiome. Linear discriminant analysis (LDA effect size (LEfSe revealed significant differences in bacterial groups between healthy cats and cats with diarrhea. The order Burkholderiales, the families Enterobacteriaceae, and the genera Streptococcus and Collinsella were significantly increased in diarrheic cats. In contrast the order Campylobacterales, the family Bacteroidaceae, and the genera Megamonas, Helicobacter, and Roseburia were significantly increased in healthy cats. Phylum Bacteroidetes was significantly decreased in cats with chronic diarrhea (>21 days duration, while the class Erysipelotrichi and the genus Lactobacillus were significantly decreased in cats with acute diarrhea. The observed changes in bacterial groups were accompanied by significant differences in functional gene contents: metabolism of fatty acids, biosynthesis of glycosphingolipids, metabolism of biotin, metabolism of tryptophan, and ascorbate and aldarate metabolism, were all significantly (p<0.001 altered in cats with diarrhea. In conclusion, significant differences in the fecal microbiomes between healthy cats and cats with diarrhea were identified. This dysbiosis was accompanied by changes in bacterial functional gene categories. Future studies are warranted to evaluate if these microbial changes correlate with changes in fecal concentrations of microbial metabolites in cats with diarrhea for the identification of potential diagnostic or


    NARCIS (Netherlands)

    LIMBURG, A.J.; Beekhuis, H; Smit, A.J; Kallenberg, Cees; Piers, D.A; Kleibeuker, Jan


    Esophageal motility was assessed by manometry and scintigraphy in 25 patients with primary Raynaud's phenomenon and 24 patients with secondary Raynaud's phenomenon as part of a connective tissue disorder. Methods: For each scintigraphic study, transit time was evaluated after three separate swallows

  15. Safrole-DNA adducts in tissues from esophageal cancer patients: clues to areca-related esophageal carcinogenesis. (United States)

    Lee, Jang-Ming; Liu, Tsung-Yung; Wu, Deng-Chyang; Tang, Hseau-Chung; Leh, Julie; Wu, Ming-Tsang; Hsu, Hsao-Hsun; Huang, Pei-Ming; Chen, Jin-Shing; Lee, Chun-Jean; Lee, Yung-Chie


    Epidemiological studies have demonstrated that areca quid chewing can be an independent risk factor for developing esophageal cancer. However, no studies are available to elucidate the mechanisms of how areca induces carcinogenesis in the esophagus. Since the areca nut in Taiwan contains a high concentration of safrole, a well-known carcinogenic agent, we analyzed safrole-DNA adducts by the 32P-postlabelling method in tissue specimens from esophageal cancer patients. In total, we evaluated 47 patients with esophageal cancer (16 areca chewers and 31 non-chewers) who underwent esophagectomy at the National Taiwan University Hospital between 1996 and 2002. Of the individuals with a history of habitual areca chewing (14 cigarette smokers and two non-smokers), one of the tumor tissue samples and five of the normal esophageal mucosa samples were positive for safrole-DNA adducts. All patients positive for safrole-DNA adducts were also cigarette smokers. Such adducts could not be found in patients who did not chew areca, irrespective of their habits of alcohol consumption or cigarette smoking (psafrole was also tested in vitro in three esophageal cell lines and four cultures of primary esophageal keratinocytes. In two of the esophageal keratinocyte cultures, adduct formation was increased by treatment with safrole after induction of cytochrome P450 by 3-methyl-cholanthrene. This paper provides the first observation of how areca induces esophageal carcinogenesis, i.e., through the genotoxicity of safrole, a component of the areca juice.

  16. Dynamic smoothing of nanocomposite films

    NARCIS (Netherlands)

    Pei, Y.T.; Turkin, A; Chen, C.Q.; Shaha, K.P.; Vainshtein, D.; Hosson, J.Th.M. De


    In contrast to the commonly observed dynamic roughening in film growth we have observed dynamic smoothing in the growth of diamondlike-carbon nanocomposite (TiC/a-C) films up to 1.5 mu m thickness. Analytical and numerical simulations, based on the Edwards-Wilkinson model and the Mullins model, visu

  17. Nonlinear smoothing for random fields

    NARCIS (Netherlands)

    Aihara, Shin Ichi; Bagchi, Arunabha


    Stochastic nonlinear elliptic partial differential equations with white noise disturbances are studied in the countably additive measure set up. Introducing the Onsager-Machlup function to the system model, the smoothing problem for maximizing the modified likelihood functional is solved and the exp

  18. Myeloproliferative disease in a cat

    Energy Technology Data Exchange (ETDEWEB)

    Yates, R.W.; Weller, R.E.; Feldman, B.F.


    Myeloproliferative disorders, a complex of cytologic abnormalities arising in the bone marrow, are among domestic animals most frequently recognized in cats but are relatively uncommon. A 4-year-old female Siamese, with splenomegaly and weight loss, was listless, anorectic, pale and dehydrated. A hemogram showed severe, macrocytic normochromic anemia, leukocytosis and reticulocytosis, with abnormally high numbers of nucleated RBC and undifferentiated blast cells. Bone marrow smears contained predominantly undifferentiated blast cells, RBC precursors and myeloblasts. The fluorescent antibody test for FeLV was positive. The cat died 66 days later despite a blood transfusion and chemotherapy. Necropsy confirmed a diagnosis of myeloproliferative disease, with hepatic and splenic invasion. 15 references, 5 figures, 1 table.

  19. Eosinophilic leukaemia in a cat. (United States)

    Sharifi, Hassan; Nassiri, Seyed Mahdi; Esmaelli, Hossein; Khoshnegah, Javad


    A 14-year-old female domestic shorthair cat was presented to Tehran University Veterinary Teaching Hospital for a persistent fever, anorexia, intermittent vomiting, weight loss and weakness. The main clinical signs were pale mucous membranes, dehydration and splenomegaly. The complete blood count and serum biochemistry tests revealed non-regenerative anaemia, thrombocytopenia and increased alkaline phosphatase (ALP) activity. An enzyme-linked immunosorbent assay (ELISA) test for feline leukaemia virus was negative. Blood film and bone marrow examination revealed a large number of immature eosinophils with variable sizes and numbers of faintly azurophilic granules. Cytochemical staining of blood film demonstrated 70% positive cells for ALP activity. Four percent CD34 positive cells were detected by flow cytometry. As eosinophilic leukaemia is difficult to identify by light microscopy, well-defined diagnostic criteria and the use of flow cytometry and cytochemical staining can improve the ability to correctly diagnose this type of leukaemia in cats.

  20. Cats, Cancer and Comparative Oncology


    Cannon, Claire M.


    Naturally occurring tumors in dogs are well-established models for several human cancers. Domestic cats share many of the benefits of dogs as a model (spontaneous cancers developing in an immunocompetent animal sharing the same environment as humans, shorter lifespan allowing more rapid trial completion and data collection, lack of standard of care for many cancers allowing evaluation of therapies in treatment-naïve populations), but have not been utilized to the same degree in the One Medici...

  1. Cat Scratch Disease: Expanded Spectrum (United States)

    Aziz, Hassan A.; Plesec, Thomas P.; Sabella, Camille; Udayasankar, Unni K.; Singh, Arun D.


    Background To expand the spectrum of ophthalmic manifestations in cat scratch disease. Methods Case report. Results A 7-year-old male was referred for evaluation of his left optic disc after failing vision screening test at school. His visual acuity was 20/20 OD and light perception OS. Fundus examination showed a left optic disc lesion associated with an exudative retinal detachment and vitreous seeding. Ultrasonography revealed a 7 × 7.5 × 3.8 mm lesion with a possible 6.3 mm of retrolaminar extension into the substance of the optic nerve. Brain MRI did not show evidence of optic nerve involvement but revealed a 6-mm nodule of the pineal gland suggestive of a pineoblastoma. Enucleation was performed and histopathology revealed a suppurative granulomatous inflammation suggestive of Bartonella infection. Upon further questioning, the patient had recent exposure to kittens with areas of cat scratches along both of his arms. He was subsequently referred to and treated with a 2-week course of trimethoprim-sulfamethoxazole and rifampin by the pediatric infectious disease specialist. Repeat brain MRI showed interval total resolution of enlarged pineal gland. Conclusion: Optic nerve granulomas are a rare presentation of cat scratch disease and could potentially masquerade as retinoblastoma. PMID:27843905

  2. Schroedinger's Cat is not Alone

    CERN Document Server

    Gato, Beatriz


    We introduce the `Complete Wave Function' and deduce that all living beings, not just Schroedinger's cat, are actually described by a superposition of `alive' and `dead' quantum states; otherwise they would never die. Therefore this proposal provides a quantum mechanical explanation to the world-wide observation that we all pass away. Next we consider the Measurement problem in the framework of M-theory. For this purpose, together with Schroedinger's cat we also place inside the box Rasputin's cat, which is unaffected by poisson. We analyse the system identifying its excitations (catons and catinos) and we discuss its evolution: either to a classical fight or to a quantum entanglement. We also propose the $BSV\\Psi$ scenario, which implements the Complete Wave Function as well as the Big Bang and the String Landscape in a very (super)natural way. Then we test the gravitational decoherence of the entangled system applying an experimental setting due to Galileo. We also discuss the Information Loss paradox. For ...

  3. Bacterial pericarditis in a cat

    Directory of Open Access Journals (Sweden)

    Nicole LeBlanc


    Full Text Available Case summary A 4-year-old male neutered domestic shorthair cat was presented to the Oregon State University cardiology service for suspected pericardial effusion. Cardiac tamponade was documented and pericardiocentesis yielded purulent fluid with cytologic results supportive of bacterial pericarditis. The microbial population consisted of Pasteurella multocida, Actinomyces canis, Fusobacterium and Bacteroides species. Conservative management was elected consisting of intravenous antibiotic therapy with ampicillin sodium/sulbactam sodium and metronidazole for 48 h followed by 4 weeks of oral antibiotics. Re-examination 3 months after the initial incident indicated no recurrence of effusion and the cat remained free of clinical signs 2 years after presentation. Relevance and novel information Bacterial pericarditis is a rare cause of pericardial effusion in cats. Growth of P multocida, A canis, Fusobacterium and Bacteroides species has not previously been documented in feline septic pericarditis. Conservative management with broad-spectrum antibiotics may be considered when further diagnostic imaging or exploratory surgery to search for a primary nidus of infection is not feasible or elected.

  4. Radiological Imaging in Patients with Esophageal Carcinoma

    Institute of Scientific and Technical Information of China (English)

    BarbaraKrug; ClaudiaMorgenroth


    Diagnostic imaging is carried out in patients with esophageal carcinoma in order to decide on the therapeutical procedure, to control therapy, to document complications and to assess concomitant diseases.Chest X-rays and esophagograms give a 2-dimensional view of the X-ray absorption ill 3-dimensional examination volumes, the diagnostic accuracy thus being limited by overshadowing. Because of the robust examination technique, the broad availability and the low costs chest X-rays are usually used for short-term controls under therapy and follow-up. Esophagography is carried out in order to asses the exact location and length of a known esophageal carcinoma prior to therapy and in order to assess peristaltic disturbances and fistulas. CT and MRI provide tomographic images with a spatial resolution of up to 1mm3 allowing the reconstruction of high-resolution images not only in the transversal but also in any other plain. The diagnostic accuracy of esophagography is comparatively high in T1 T3 stages (80%-90%). T1 and T2 tumors cannot be diagnosed by CT and MRI, because both methods do not visualize the mucosa(unlike esophagography and endoscopy) and the esophageal wall layers (unlike EUS). Infiltration depth tends to be overestimated in T1 and T2 carcinomas and to be underestimated in T3 and T4 cancers. CT and MRI cannot detect metastases in normally sized lymph nodes and cannot accurately differelltiate between benign and malignant lymphadenopathy in enlarged nodes with a reported sensitivities and spccifities of 60% and 74%, respectively. However, further prospective studies using up to date CT and NIR technology are needed to assess the present diagnostic situation. CT and MRI do not only visualize the inediastinum,but also the lungs, the pleura and the skeleton as well as the neck and the abdomen thus providing a comprehensive overview of the TNM stage in 3 body regions.

  5. Pathophysiological mechanisms linking obesity and esophageal adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    Leo; Alexandre; Elizabeth; Long; Ian; LP; Beales


    In recent decades there has been a dramatic rise in the incidence of esophageal adenocarcinoma(EAC) in the developed world. Over approximately the same period there has also been an increase in the prevalence of obesity. Obesity, especially visceral obesity, is an important independent risk factor for the development of gastro-esophageal reflux disease, Barrett’s esophagus and EAC. Although the simplest explanation is that this mediated by the mechanical effects of abdominal obesity promoting gastro-esophageal reflux, the epidemiological data suggest that the EAC-promoting effects are independent of reflux. Several, not mutually exclusive, mechanisms have been implicated, which may have different effects at various points along the refluxBarrett’s-cancer pathway. These mechanisms include a reduction in the prevalence of Helicobacter pylori infection enhancing gastric acidity and possibly appetite byincreasing gastric ghrelin secretion, induction of both low-grade systemic inflammation by factors secreted by adipose tissue and the metabolic syndrome with insulin-resistance. Obesity is associated with enhanced secretion of leptin and decreased secretion of adiponectin from adipose tissue and both increased leptin and decreased adiponectin have been shown to be independent risk factors for progression to EAC. Leptin and adiponectin have a set of mutually antagonistic actions on Barrett’s cells which appear to influence the progression of malignant behaviour. At present no drugs are of proven benefit to prevent obesity associated EAC. Roux-en-Y reconstruction is the preferred bariatric surgical option for weight loss in patients with reflux. Statins and aspirin may have chemopreventative effects and are indicated for their circulatory benefits.

  6. Management of obesity in cats

    Directory of Open Access Journals (Sweden)

    Hoelmkjaer KM


    Full Text Available Kirsten M Hoelmkjaer, Charlotte R Bjornvad Department of Veterinary Clinical and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark Abstract: Obesity is a common nutritional disorder in cats, especially when they are neutered and middle-aged. Obesity predisposes cats to several metabolic and clinical disorders, including insulin resistance, diabetes mellitus, lameness, and skin disease. Prevention and treatment of obesity is therefore of great importance in veterinary practice. Correct assessment of body composition is important for recognizing early states of obesity and for monitoring success of weight-loss programs. Various methods for assessing body composition have been proposed, of which a 9-point body-condition score has been validated in cats, and is possibly the most simple to use in the clinic; however, for extremely obese individuals, it is less useful. When calculating the appropriate daily caloric intake for a weight-loss plan, the aim is to maintain a safe weight-loss rate, increasing the chance of preserving lean body mass and decreasing the risk of developing hepatic lipidosis, while also producing a sufficient weight-loss rate to keep owners motivated. A weight-loss rate of 0.5%–2% per week is recommended, which for a cat that needs to lose 3 kg body weight results in an anticipated time for reaching the target weight of 24–60 weeks. There are several purpose-made weight-loss diets available. The optimal composition of a weight-loss diet for cats is unknown, but most of the available products have lower caloric density, an increased nutrient:energy ratio, and higher protein and fiber content. Regular follow-up visits allow the caloric intake to be adjusted based on progress, and possibly increase the chance of success. This review discusses the risk factors for and consequences of obesity, and gives directions for formulating a weight-loss plan, including daily caloric

  7. Skin Metastasis from an Occult Esophageal Adenocarcinoma

    Directory of Open Access Journals (Sweden)

    F Fereidooni


    Full Text Available Metastases to the skin from carcinoma arising in other organs are uncommon, yet they may be the first presentation of neoplastic disease. They usually originate from primary tumours in the breast, lung or colon. Skin metastases from esophageal adenocarcinoma are extremely rare. A unique case of an otherwise healthy patient who presented with a small, painless, mobile, clinically localized facial skin nodule is reported. A biopsy revealed metastatic adenocarcinoma, and subsequent investigations detected the primary tumour in the esophagus, despite no symptoms.

  8. Progressive transformation of immortalized esophageal epithelial cells

    Institute of Scientific and Technical Information of China (English)

    Zhong-Ying Shen; Li-Yan Xu; Min-Hua Chen; Jian Shen; Wei-Jia Cai; Yi Zeng


    AIM: To investigate the progressive transformation of immortal cells of human fetal esophageal epithelium induced by human papillomavirus, and to examine biological criteria of sequential passage of cells, including cellular phenotype, proliferative rate, telomerase, chromosome and tumorigenicity.METHODS: The SHEE cell series consisted of immortalized embryonic esophageal epithelium which was in malignant transformation when cultivated over sixty passages without co-carcinogens. Cells of the 10th, 31st, 60th and 85th passages were present in progressive development after being transfected with HPV. Cells were cultivated in a culture flask and 24-hole cultural plates. Progressive changes of morphology, cell growth, contact-inhibition, and anchoragedependent growth characteristics were examined by phase contrast microscopy. The cell proliferation rate was assayed by flow cytometry. The modal number of chromosomes was analyzed. HPV18E6E7 was detected by Western blot methods and activities of telomerase were analyzed by TRAP.Tumorigenicity of cells was detected with soft agar plates cultivated and with tumor formation in SCID mice.RESULTS: In morphological examination the 10th passage cells were in good differentiation, the 60th and 85th passages cells were in relatively poor differentiation, and the 31st passage cells had two distinct differentiations. The characteristics of the 85th and 60th passage cells were weakened at contact-inhibition and anchorage-dependent growth. Karyotypes of four stages of cells belonged to hyperdiploid or hypotriploid, and bimodal distribution of chromosomes appeared in the 31st and 60th passage cells. All of these characteristics combined with a increasing trend. The activities of telomerase were expressed in the latter three passages. Four fourths of SCID mice in the 85th passage cells and one fourth of SCID mice in the 60th passage cells developed tumors, but the cells in the 10th and 31st passage displayed no tumor formation

  9. Misdiagnosed Chest Pain: Spontaneous Esophageal Rupture (United States)

    Inci, Sinan; Gundogdu, Fuat; Gungor, Hasan; Arslan, Sakir; Turkyilmaz, Atila; Eroglu, Atila


    Chest pain is one of themost common complaints expressed by patients presenting to the emergency department, and any initial evaluation should always consider life-threatening causes. Esophageal rupture is a serious condition with a highmortality rate. If diagnosed, successful therapy depends on the size of the rupture and the time elapsed between rupture and diagnosis.We report on a 41-year-old woman who presented to the emergency department complaining of left-sided chest pain for two hours. PMID:27122690

  10. Esophageal stricture in a cougar (Puma concolor). (United States)

    Desmarchelier, Marion; Lair, Stéphane; Defarges, Alice; Lécuyer, Manon; Langlois, Isabelle


    A 7-mo-old female cougar (Puma concolor) was presented with a 2-wk history of anorexia and a 1-wk history of regurgitation. Barium contrast esophagogram and gastroesophagoscopy revealed the presence of a segmental intraluminal esophageal stricture in the middle third of the esophagus. The stricture was potentially secondary to a previous anesthetic episode. Three endoscopic balloon dilations allowed increasing the luminal diameter to a size that enabled the cougar to eat food softened with water without any signs of discomfort or regurgitation. Two months after being discharged, the cougar was doing well, had gained weight and was eating horsemeat softened with water.

  11. Retrotracheal thymoma masquerading as esophageal submucosal tumor

    Institute of Scientific and Technical Information of China (English)

    Sheung-Fat Ko; Yuan-Hsiung Tsai; Hsuan-Ying Huang; Shu-Hang Ng; Fu-Ming Fang; Yeh Tang; Ming-Tse Sung; Ming-Jang Hsieh


    A 42-year-old man presented with a two-year history of progressive dysphagia and hoarseness. Esophagogram and endoscopy revealed submucosal mass effect on the upper esophagus. Computed tomography and magnetic resonance imaging revealed an elongated mass in the retrotracheal region of the lower neck with extension to the posterior mediastinum. Partial tumor resection and histopathological evaluation revealed a WHO type B2 thymoma. Adjuvant radiation and chemotherapy were subsequently administered resulting in complete tumor regression. To our knowledge, this is the first report of ectopic retrotracheal thymoma with clinical and imaging manifestations mimicking those for esophageal submucosal tumor.

  12. Minimal Invasive Surgery for Esophageal Cancer

    Institute of Scientific and Technical Information of China (English)

    A.H.Hoelscher; Ch.Gutschow


    Thoracoscopic esophagectomy is only established in some centers and affords a cervical anastomosis because intrathoracic anastomosis as a routine is technically too difficult. Laparoscopic mobilisation of the stomach (gastrolysis) is an important contribution for minimal invasive surgery of esophageal cancer.This procedure reduces the stress of the two cavity operation for the patient and allows the construction of a comparable gastric conduit like by open surgery. The technique of laparoscopic gastrolysis as preparation for transthoracic en bloc esophagectomy is described in detail and preliminary results are briefly mentioned.

  13. NcoI TNF-beta gene polymorphism and TNF expression are associated with an increased risk of developing Barrett's esophagus and esophageal adenocarcinoma

    NARCIS (Netherlands)

    Menke, Vivianda; van Zoest, Katinka P. M.; Moons, Leon M. G.; Hansen, Bettina; Pot, Raymond G. J.; Siersema, Peter D.; Kusters, Johannes G.; Kuipers, Ernst J.


    Objective. Esophageal cancer development is a sequence that starts with reflux esophagitis (RE), followed by Barrett's esophagitis (BE), dysplasia, and finally esophageal adenocarcinoma (EAC). Tumor necrosis factor (TNF) is a potent antineoplastic agent, hence DNA polymorphisms that reduce TNF level

  14. Eosinophilic esophagitis: current perspectives from diagnosis to management. (United States)

    Moawad, Fouad J; Cheng, Edaire; Schoepfer, Alain; Al-Haddad, Sahar; Bellizzi, Andrew M; Dawson, Heather; El-Zimaity, Hala; Guindi, Maha; Penagini, Roberto; Safrooneva, Ekaterina; Chehade, Mirna


    Eosinophilic esophagitis (EoE) is a chronic antigen-mediated immune disease of the esophagus characterized by symptoms related to esophageal dysfunction, as well as significant esophageal eosinophilia. Although dense eosinophilia is the hallmark of EoE, other characteristic histologic features have been described that may help distinguish EoE from other competing diagnoses, although none are specific to EoE. One or more foods and, at times, environmental allergens trigger EoE. Left untreated, esophageal inflammation in EoE may lead to esophageal remodeling and stricture formation. Symptoms in EoE vary with age, as they relate to the progression of the disease from an inflammatory to a fibrostenotic phenotype over time. There are currently no U.S. Food and Drug Administration-approved therapies for EoE. Current options include various dietary-restriction therapies, topical corticosteroids, and esophageal dilations. Several emerging therapies aiming at restoring the esophageal barrier function or targeting various inflammatory cells or their mediators are under investigation.


    Institute of Scientific and Technical Information of China (English)

    郭惠琴; 李泽坚; 张帆; 张志庸; 徐乐天; 李卫东; 王秀琴; 吴旻


    To study how to prolong the postoperative survival time of the patients with malignant esophageal tumors. Theclinical data of 1098 patients with malignant esophageal tumors from 1961 to 1992 were retrospectively analyzed.The deletion of fragile histamine triplet (FHIT) gene (a tumor suppressor gene) in 30 fresh esophageal samplesobtained in 1996 was detected with PCR and RT-PCR method. The resectability was raised gradually and the opera-tive morbiditv and mortality decreased year by year, but there was no significant improvement on the postoperative5-year survival rate. Delayed diagnosis and irradical resection influenced the long-term survival. The deletion ofcDNA of FHIT gene was 64.2% in esophageal cancer and 20% in the resected margin of the cancer. We believethat high-grade atypical hyperplasia in esophageal epithelium and deletion of FHIT gene in esophageal cancer andits resected margin are pathological and molecular markers for early diagnosis of esophageal cancer respectively,and the latter may be one of the molecular markers for the resection. Early diagnosis and treatment, radical resec-tion, and postoperative nutritional support are very important for the improvement of the postoperative survivaltime of the patients.``

  16. Endoscopic assessment and management of early esophageal adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    Ghassan; M; Hammoud; Hazem; Hammad; Jamal; A; Ibdah


    Esophageal carcinoma affects more than 450000people worldwide and the incidence is rapidly increasing.In the United States and Europe,esophageal adenocarcinoma has superseded esophageal squamous cell carcinoma in its incidence.Esophageal cancer has a high mortality rates secondary to the late presentation of most patients at advanced stages.Endoscopic screening is recommended for patients with multiple risk factors for cancer in Barrett’s esophagus.These risk factors include chronic gastroesophageal reflux disease,hiatal hernia,advanced age,male sex,white race,cigarette smoking,and obesity.The annual risk of esophageal cancer is approximately 0.25%for patients without dysplasia and 6%for patients with high-grade dysplasia.Twenty percent of all esophageal adenocarcinoma in the United States is early stage with disease confined to the mucosa or submucosa.The significant morbidity and mortality of esophagectomy make endoscopic treatment an attractive option.The American Gastroenterological Association recommends endoscopic eradication therapy for patients with high-grade dysplasia.Endoscopic modalities for treatment of early esophageal adenocarcinoma include endoscopic resection techniques and endoscopic ablative techniques such as radiofrequency ablation,photodynamic therapy and cryoablation.Endoscopic therapy should be precluded to patients with no evidence of lymphovascular invasion.Local tumor recurrence is low after endoscopic therapy and is predicted by poor differentiation of tumor,positive lymph node and submucosal invasion.Surgical resection should be offered to patients with deep submucosal invasion.

  17. Palliative Endoscopic Therapy for Cancer Patients with Esophageal Fistula

    Institute of Scientific and Technical Information of China (English)

    ZHANG Ji-chang; ZHANG Li-jian; WU Qi; ZHANG Jun; ZHOU Zong-hui; WU Yang; XU Zhao-li


    Objective:To find an effective treatment for advanced cancer patients with esophageal fistula. Methods:From 1998 to 2006, we studied 42 patients with advanced esophageal cancer and 5 lung cancer patients with carcinomatous esophageal fistula(3 females,44 males,aged 29-92 years). Ten patients with both esophageal cancer stricture and fistula were first dilated under endoscope,then a memory stent with a membrane was placed in the esophageal lumen. Others were treated only with a memory stent with a membrane,three of them with a large fistula(diameter>1.5 cm)were treated with bio-protein glue after placement of an esophageal metal stent.Results:The fistulas were covered by a stent and the patients could eat and drink immediately.Their quality of life was improved and their survival was prolonged, 44 out of 47 patients survived for>3 mo. Conclusion:Placement of esophageal stent with membrane or in combination with bio-protein glue through endoscope is an effective method for treating the bronchoesophageal fistula.

  18. Very Smooth Points of Spaces of Operators

    Indian Academy of Sciences (India)

    T S S R K Rao


    In this paper we study very smooth points of Banach spaces with special emphasis on spaces of operators. We show that when the space of compact operators is an -ideal in the space of bounded operators, a very smooth operator attains its norm at a unique vector (up to a constant multiple) and ( ) is a very smooth point of the range space. We show that if for every equivalent norm on a Banach space, the dual unit ball has a very smooth point then the space has the Radon–Nikodým property. We give an example of a smooth Banach space without any very smooth points.

  19. Radionuclide esophageal transit test to detect esophageal disorders in patients with mitral valve prolapse

    Energy Technology Data Exchange (ETDEWEB)

    Kao Chiahung [Dept. of Nuclear Medicine, Taichung Veterans General Hospital (Taiwan); Tsai Shihchuan [Dept. of Nuclear Medicine, Show-Chwan Memorial Hospital, Changhua (Taiwan); Hsieh Jihfang [Dept. of Nuclear Medicine, Chi-Mei Foundation Hospital, Tainan (Taiwan); Ho Yungjen [Dept. of Radiology, Jen-Ai Hospital, Taichung (Taiwan); Ding Hueischjy [Dept. of Nuclear Medicine, Kaohsiung Medicine Coll. (Taiwan)


    Aim: The origin of chest discomfort in patients with mitral valve prolapse (MVP) is controversial. Our aim was to prospectively determine the incidence of esophageal disorders in MVP patients with or without chest pain. Methods: Twenty-five MVP patients with chest pain (group A) and 25 MVP patients without chest pain (group B) underwent evaluation of esophageal motility. None of the total of 50 MVP patients had significant coronary artery disease on cardiac catheterization. Esophageal motility including esophageal mean transit time (MTT), residual fraction (RF), and retrograde index (RI) was analyzed by the radionuclide esophageal transit test (RETT). Results: In comparison with 25 age and sex-matched healthy volunteers, the results showed that: (1) 19 patients in group A (76%) had abnormal RETT findings (48% of cases with prolonged MTT, 44% of cases with higher RF, and 60% of cases with higher RI); (2) 3 patients in group B (12%) had abnormal RETT findings (8% of cases with prolonged MTT, 4% of cases with higher RF, and 8% of cases with higher RI). In addition, mean values of MTT, RF, and RI in group A patients were significantly higher than in group B patients and healthy volunteers. Conclusion: We found that the chest pain in some MVP patients may be related to abnormal esophageal motility, based on the evidence from a simple and noninvasive RETT. (orig.) [German] Ziel: Die Ursache thorakaler Beschwerden bei Patienten mit Mitralklappenprolaps (MVP) wird kontrovers diskutiert. Wir bestimmten prospektiv die Haeufigkeit oesophagealer Stoerungen in MVP-Patienten mit oder ohne thorakale Beschwerden. Methode: Bei jeweils 25 MVP-Patienten mit thorakalen Beschwerden (Gruppe A) und 25 MVP-Patienten ohne thorakale Beschwerden (Gruppe B) wurde die oesophageale Motilitaet untersucht. Keiner der 50 MVP-Patienten hatte eine koronarangiographisch nachweisbare koronare Herzkrankheit. Mittels der Oesophagus-Funktionsszintigraphie (OeFZ) wurden oesophageale Motilitaet inklusive

  20. Molecular Detection of Rickettsia felis in Humans, Cats, and Cat Fleas in Bangladesh, 2013-2014. (United States)

    Ahmed, Rajib; Paul, Shyamal Kumar; Hossain, Muhammad Akram; Ahmed, Salma; Mahmud, Muhammad Chand; Nasreen, Syeda Anjuman; Ferdouse, Faria; Sharmi, Rumana Hasan; Ahamed, Farid; Ghosh, Souvik; Urushibara, Noriko; Aung, Meiji Soe; Kobayashi, Nobumichi


    High prevalence of Rickettsia felis in patients with fever of unknown origin was revealed in the north-central Bangladesh from 2012 to 2013. Subsequently, in this study, prevalence of R. felis in cats and cat fleas (Ctenocephalides felis), together with febrile patients, was studied by PCR detection of 17 kDa antigen gene and DNA sequencing. R. felis was detected in 28% (28/100) and 21% (14/68) of cat blood and cat flea samples, respectively, whereas 42% (21/50) of patients were positive for R. felis. R. felis-positive cat fleas were detected at significantly higher rate on R. felis-positive cats. The results suggested a potential role of cats and cat fleas for transmission of R. felis to humans in Bangladesh.

  1. Incidence of pyometra in Swedish insured cats. (United States)

    Hagman, Ragnvi; Ström Holst, Bodil; Möller, Lotta; Egenvall, Agneta


    Pyometra is a clinically relevant problem in intact female cats and dogs. The etiology is similar in both animal species, with the disease caused by bacterial infection of a progesterone-sensitized uterus. Here, we studied pyometra in cats with the aim to describe the incidence and probability of developing pyometra based on age and breed. The data used were reimbursed claims for veterinary care insurance or life insurance claims or both in cats insured in a Swedish insurance database from 1999 to 2006. The mean incidence rate (IR) for pyometra was about 17 cats per 10,000 cat years at risk (CYAR). Cats with pyometra were diagnosed at a median age of 4 years and a significant breed effect was observed. The breed with the highest IR (433 cats per 10,000 CYAR) was the Sphynx, and other breeds with IR over 60 cats per 10,000 CYAR were Siberian cat, Ocicat, Korat, Siamese, Ragdoll, Maine coon, and Bengal. Pyometra was more commonly diagnosed with increasing age, with a marked increase in cats older than 7 years. The mean case fatality rate in all cats was 5.7%, which is slightly higher than corresponding reports in dogs of 3% to 4%. Geographical location (urban or rural) did not affect the risk of developing the disease. The present study provides information of incidence and probability of developing pyometra based on age, breed, and urban or rural geographical location. These data may be useful for designing cat breeding programs in high-risk breeds and for future studies of the genetic background of the disease.

  2. Smoothing of mixed complementarity problems

    Energy Technology Data Exchange (ETDEWEB)

    Gabriel, S.A.; More, J.J. [Argonne National Lab., IL (United States). Mathematics and Computer Science Div.


    The authors introduce a smoothing approach to the mixed complementarity problem, and study the limiting behavior of a path defined by approximate minimizers of a nonlinear least squares problem. The main result guarantees that, under a mild regularity condition, limit points of the iterates are solutions to the mixed complementarity problem. The analysis is applicable to a wide variety of algorithms suitable for large-scale mixed complementarity problems.

  3. Esophageal Perforation with Unilateral Fluidothorax Caused by Nasogastric Tube

    Directory of Open Access Journals (Sweden)

    Lukas P. Mileder


    Full Text Available Preterm infants are highly susceptible to injuries following necessary and often life-saving medical interventions. Esophageal perforation is a rare, yet serious complication that can be caused by aerodigestive tract suction, endotracheal intubation, or nasogastric tube placement. We present the case of a neonate born at 23 weeks plus three days of gestation with chest radiography showing malposition of the nasogastric feeding tube and massive right-sided effusion of Iopamidol in the pleural cavity due to esophageal perforation. In addition, the article summarizes common signs and symptoms associated with esophageal perforation in infants and discusses diagnostic approaches.

  4. Dumping syndrome after esophageal atresia repair without antireflux surgery. (United States)

    Michaud, Laurent; Sfeir, Rony; Couttenier, Frédéric; Turck, Dominique; Gottrand, Frédéric


    In childhood, the surgical treatment of gastroesophageal reflux is the main cause of dumping syndrome. We report the cases of 2 children with esophageal atresia who presented with dumping syndrome without any precipitating known factors, such as gastroesophageal reflux surgery or associated microgastria. Our data suggest (1) that dumping syndrome can occur after primary anastomosis of esophageal atresia without antireflux surgery and (2) that dumping syndrome should be considered in every child treated surgically for esophageal atresia presenting with digestive symptoms, malaise, failure to thrive, or refusal to eat.

  5. Plummer-Vinson Syndrome with Proximal Esophageal Web. (United States)

    Changela, Kinesh; Haeri, Nami Safai; Krishnaiah, Mahesh; Reddy, Madhavi


    Plummer-Vinson Syndrome is a condition where iron deficiency is associated with difficulty swallowing due to the presence of an esophageal web. Deficiency of iron-dependent oxidative enzymes causes gradual degradation of the pharyngeal muscles which lead to mucosal atrophy and formation of webs. Although it is a very rare condition, an increased risk of esophageal squamous cell carcinoma makes its identification very important. Dilation of the esophageal web using a Savary dilator is a more effective and safer approach compared to conventional balloon dilation.

  6. Quality Management and Key Performance Indicators in Oncologic Esophageal Surgery. (United States)

    Gockel, Ines; Ahlbrand, Constantin Johannes; Arras, Michael; Schreiber, Elke Maria; Lang, Hauke


    Ranking systems and comparisons of quality and performance indicators will be of increasing relevance for complex "high-risk" procedures such as esophageal cancer surgery. The identification of evidence-based standards relevant for key performance indicators in esophageal surgery is essential for establishing monitoring systems and furthermore a requirement to enhance treatment quality. In the course of this review, we analyze the key performance indicators case volume, radicality of resection, and postoperative morbidity and mortality, leading to continuous quality improvement. Ranking systems established on this basis will gain increased relevance in highly complex procedures within the national and international comparison and furthermore improve the treatment of patients with esophageal carcinoma.

  7. Esophageal Gastrointestinal Stromal Tumor: Diagnostic Complexity and Management Pitfalls

    Directory of Open Access Journals (Sweden)

    Charalampos G. Markakis


    Full Text Available Introduction. Gastrointestinal stromal tumors of the esophagus are rare. Case Presentation. This is a case of a 50-year-old male patient who was referred to our department complaining of atypical chest pain. A chest computed tomographic scan and endoscopic ultrasound revealed a submucosal esophageal tumor measuring 5 cm in its largest diameter. Suspecting a leiomyoma, we performed enucleation via right thoracotomy. The pathology report yielded a diagnosis of an esophageal gastrointestinal stromal tumor. The patient has shown no evidence of recurrence one year postoperatively. Conclusions. This report illustrates the complexity and dilemmas inherent in diagnosing and treating esophageal GISTs.

  8. Maximal right smooth extension chains

    CERN Document Server

    Huang, Yun Bao


    If $w=u\\alpha$ for $\\alpha\\in \\Sigma=\\{1,2\\}$ and $u\\in \\Sigma^*$, then $w$ is said to be a \\textit{simple right extension}of $u$ and denoted by $u\\prec w$. Let $k$ be a positive integer and $P^k(\\epsilon)$ denote the set of all $C^\\infty$-words of height $k$. Set $u_{1},\\,u_{2},..., u_{m}\\in P^{k}(\\epsilon)$, if $u_{1}\\prec u_{2}\\prec ...\\prec u_{m}$ and there is no element $v$ of $P^{k}(\\epsilon)$ such that $v\\prec u_{1}\\text{or} u_{m}\\prec v$, then $u_{1}\\prec u_{2}\\prec...\\prec u_{m}$ is said to be a \\textit{maximal right smooth extension (MRSE) chains}of height $k$. In this paper, we show that \\textit{MRSE} chains of height $k$ constitutes a partition of smooth words of height $k$ and give the formula of the number of \\textit{MRSE} chains of height $k$ for each positive integer $k$. Moreover, since there exist the minimal height $h_1$ and maximal height $h_2$ of smooth words of length $n$ for each positive integer $n$, we find that \\textit{MRSE} chains of heights $h_1-1$ and $h_2+1$ are good candidates t...

  9. The Value of Cat Ownership to Elderly Women Living Alone. (United States)

    Mahalski, Pauline A.; And Others


    Surveyed elderly women in two New Zealand cities; one allowed pet cats, one did not. Attitudes toward pet cats were more positive in city allowing pets and among pensioners who owned, or wished to own, cats. Since positive attitudes outweighed negative ones, City Authority banning cats reversed its policy. Found conflicting evidence about cats'…

  10. 42 CFR 71.51 - Dogs and cats. (United States)


    ... 42 Public Health 1 2010-10-01 2010-10-01 false Dogs and cats. 71.51 Section 71.51 Public Health... QUARANTINE Importations § 71.51 Dogs and cats. (a) Definitions. As used in this section the term: Cat means all domestic cats. Confinement means restriction of a dog or cat to a building or other enclosure at...

  11. Rare cause of odynophagia: Giant esophageal ulcer. (United States)

    Veroux, Massimiliano; Aprile, Giuseppe; Amore, Francesca F; Corona, Daniela; Giaquinta, Alessia; Veroux, Pierfrancesco


    Gastrointestinal complications are a frequent cause of morbidity after transplantation and may affect up to 40% of kidney transplant recipients. Here we report a rare case of idiopathic giant esophageal ulcer in a kidney transplant recipient. A 37-year-old female presented with a one-week history of odynophagia and weight loss. Upon admission, the patient presented cold sores, and a quantitative cytomegalovirus polymerase chain reaction was positive (10(5) copies/mL). An upper endoscopy demonstrated the presence of a giant ulcer. Serological test and tissue biopsies were unable to demonstrate an infectious origin of the ulcer. Immunosuppression was reduced and everolimus was introduced. An empirical i.v. therapy with acyclovir was started, resulting in a dramatic improvement in symptoms and complete healing of the ulcer. Only two cases of idiopathic giant esophageal ulcer in kidney transplant recipients have been reported in the literature; in both cases, steroid therapy was successful without recurrence of symptoms or endoscopic findings. However, this report suggests that correction of immune imbalance is mandatory to treat such a rare complication.

  12. Postoperative Intensive Care Treatment after Esophageal Resection

    Institute of Scientific and Technical Information of China (English)

    DirkL.Stippel; K.TobiasE.Beckurts


    The aim of this article is to give a short review of problems associated with the intensive care treatment of patients after esophageal resection. Pulmonary dysfunction, supraventricular tachyarrhythmia, anastomotic leakage and mental disorders are the topics covered. Systemic inflammatory reaction and sepsis is the linking topic between these specific complications. Pulmonary dysfunction having an incidence of up to 40% is the most important complication. Low tidal volume ventilation, pain management including epidural analgesia and early tracheostomy are the mainstay of therapy. Supraventricular tachyarrhythmia is an early indicator of emerging complications. Its symptomatic treatment is standardized using electric cardioversion, beta-blockers and amiodarone. Anastomotic leakage must be suspect in any septic episode.Endoscopy and contrast studies allow for precise diagnosis. Interventional endoscopy is increasingly successful in the therapy of these leakages. Microbiological surveillance and specific antibiotic therapy ensure that a complication does not cause a septic cascade leading to multiorgan failure. The workload on ICU caused by a patient after esophageal resection still exceeds that of most other patients with gastrointestinal surgery.

  13. Controlled Archaeological Test Site (CATS) Facility (United States)

    Federal Laboratory Consortium — CATS facility is at the Construction Engineering Research Laboratory (CERL), Champaign, IL. This 1-acre test site includes a variety of subsurface features carefully...

  14. Pharmacology of airway smooth muscle proliferation

    NARCIS (Netherlands)

    Gosens, Reinoud; Roscioni, Sara S.; Dekkers, Bart G. J.; Pera, Tonio; Schmidt, Martina; Schaafsma, Dedmer; Zaagsma, Johan; Meurs, Herman


    Airway smooth muscle thickening is a pathological feature that contributes significantly to airflow limitation and airway hyperresponsiveness in asthma. Ongoing research efforts aimed at identifying the mechanisms responsible for the increased airway smooth muscle mass have indicated that hyperplasi

  15. Circumferential mucosal dissection and esophageal perforation in a patient with eosinophilic esophagitis

    Institute of Scientific and Technical Information of China (English)

    Gennaro Liguori; Maurizio Cortale; Fabrizio Cimino; Michele Sozzi


    A young man with a previous history of episodes of mild solid food dysphagia was admitted with a total dysphagia.The esophagogastroduodenoscopy (EGDS) showed an extensive disruption of mucosal layer with a cul-de-sac in the lower part of the esophagus.Soon after the procedure,the patient suffered from an acute chest pain and subsequent CT scan demonstrated an intramural circumferential dissection of thoracic esophagus,and a mediastinal emphysema.An emergency right thoracotomy was performed,followed by a total esophagectomy with esophagogastroplasty and jejunostomy.The histopathology confirmed that mucosal and submucosal layers were circumferentially detached from muscular wall and showed an eosinophilic infiltration of the whole organ with necrosis and erosions of mucosal,submucosal and muscular layers.The diagnosis was esophageal perforation in eosinophilic esophagitis.

  16. Smooth Optimization Approach for Sparse Covariance Selection


    Lu, Zhaosong


    In this paper we first study a smooth optimization approach for solving a class of nonsmooth strictly concave maximization problems whose objective functions admit smooth convex minimization reformulations. In particular, we apply Nesterov's smooth optimization technique [Y.E. Nesterov, Dokl. Akad. Nauk SSSR, 269 (1983), pp. 543--547; Y. E. Nesterov, Math. Programming, 103 (2005), pp. 127--152] to their dual counterparts that are smooth convex problems. It is shown that the resulting approach...

  17. Esophago-pleural fistula with multiple esophageal ulcers in human immunodeficiency virus infected patients: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Soo Hee; Lee, Young Kyung; Choi, Jae Phil; Son, Jin Sung [Seoul Medical Center, Seoul(Korea, Republic of)


    Esophagitis is a common complication in patients with human immunodeficiency virus (HIV) infection. Esophagitis in HIV infected patient is caused by candidiasis, cytomegalovirus, herpes simplex virus, or idiopathic esophagitis with no detectable etiology. Esophagitis in HIV infected patient is occasionally combined with esophageal ulcers. We report chest CT findings and clinical manifestation of esophago-pleural fistula with pneumothorax in a HIV infected patient, who was treated for aspiration pneumonia and esophageal ulcers.

  18. Cats (United States)

    ... Dogs Farm Animals Backyard Poultry Ferrets Fish Horses Reptiles and Amphibians Turtles Kept as Pets Key Messages ... L. Feline Bartonellosis. The Veterinary Clinics of North America. Small Animal Practice. 2010 Nov;40(6):1073- ...

  19. A SAS IML Macro for Loglinear Smoothing (United States)

    Moses, Tim; von Davier, Alina


    Polynomial loglinear models for one-, two-, and higher-way contingency tables have important applications to measurement and assessment. They are essentially regarded as a smoothing technique, which is commonly referred to as loglinear smoothing. A SAS IML (SAS Institute, 2002a) macro was created to implement loglinear smoothing according to…

  20. Hydroferrate fluid, MRN-100, provides protection against chemical-induced gastric and esophageal cancer in Wistar rats. (United States)

    Ghoneum, Mamdooh H; Badr El-Din, Nariman K; Abdel Fattah, Salma M; Pan, Deyu; Tolentino, Lucilene


    In the current study, we examined the protective effect of hydroferrate fluid MRN-100 against the carcinogen methylnitronitrosoguanidine (MNNG)-induced gastric and esophageal cancer in rats. MRN-100 is an iron-based compound composed of bivalent and trivalent ferrates. At 33 weeks post treatment with MNNG, rats were killed and examined for the histopathology of esophagus and stomach; liver, spleen, and total body weight; and antioxidant levels in the blood and stomach tissues. Results showed that 17/20 (85%) gastroesophageal tissues from carcinogen MNNG-treated rats developed dysplasia and cancer, as compared to 8/20 (40%) rats treated with MNNG plus MRN-100. In addition, MRN-100 exerted an antioxidant effect in both the blood and stomach tissues by increasing levels of GSH, antioxidant enzymes SOD, CAT, and GPx, and total antioxidant capacity (TAC) level. This was accompanied by a reduction in the total free-radical and malondialdehyde levels. Furthermore, MRN-100 protected against body and organ weight loss. Thus, MRN-100 exhibited significant cancer chemopreventive activity by protecting tissues against oxidative damage in rats, which may suggest its effectiveness as an adjuvant for the treatment of gastric/esophageal carcinoma.

  1. Comparison of esophageal capsule endoscopy and esophagogastroduodenoscopy for diagnosis of esophageal varices

    Institute of Scientific and Technical Information of China (English)

    Catherine T Frenette; John G Kuldau; Donald J Hillebrand; Jill Lane; Paul J Pockros


    AIM: To investigate the utility of esophageal capsule endoscopy in the diagnosis and grading of esophageal varices.METHODS: Cirrhotic patients who were undergo-ing esophagogastroduodenoscopy (EGD) for variceal screening or surveillance underwent capsule endos-copy. Two separate blinded investigators read each capsule endoscopy for the following results: variceal grade, need for treatment with variceal banding or prophylaxis with beta-blocker therapy, degree of portal hypertensive gastropathy, and gastric varices.RESULTS: Fifty patients underwent both capsule and EGD. Forty-eight patients had both procedures on the same day, and 2 patients had capsule endoscopy within 72 h of EGD. The accuracy of capsule endos-copy to decide on the need for prophylaxis was 74%,with sensitivity of 63% and specificity of 82%. Inter-rater agreement was moderate (kappa = 0.56). Agree-ment between EGD and capsule endoscopy on grade of varices was 0.53 (moderate). Inter-rater reliability was good (kappa = 0.77). In diagnosis of portal hyper.tensive gastropathy, accuracy was 57%, with sensitiv-ity of 96% and specificity of 17%. Two patients had gastric varices seen on EGD, one of which was seen on capsule endoscopy. There were no complications from capsule endoscopy.CONCLUSION: We conclude that capsule endoscopy has a limited role in deciding which patients would benefit from EGD with banding or beta-blocker thera-py. More data is needed to assess accuracy for staging esophageal varices, PHG, and the detection of gastric varices.

  2. XAF1 is frequently methylated in human esophageal cancer

    Institute of Scientific and Technical Information of China (English)

    Xiang-Yu Chen; Qiao-Yu He; Ming-Zhou Guo


    AIM:To explore epigenetic changes in the gene encoding X chromosome-linked inhibitor of apoptosis-associated factor 1 (XAF1) during esophageal carcinogenesis.METHODS:Methylation status of XAF1 was detected by methylation-specific polymerase chain reaction (MSP) in four esophageal cancer cell lines (KYSE30,KYSE70,BIC1 and partially methylated in TE3 cell lines),nine cases of normal mucosa,72 cases of primary esophageal cancer and matched adjacent tissue.XAF1 expression was examined by semi-quantitative reverse transcriptional polymerase chain reaction and Western blotting before and after treatment with 5-aza-deoxycytidine (5-aza-dc),a demethylating agent.To investigate the correlation of XAF1 expression and methylation status in primary esophageal cancer,immunohistochemistry for XAF1 expression was performed in 32 cases of esophageal cancer and matched adjacent tissue.The association of methylation status and clinicopathological data was analyzed by logistic regression.RESULTS:MSP results were as follows:loss of XAF1 expression was found in three of four esophageal cell lines with promoter region hypermethylation (com pletely methylated in KYSE30,KYSE70 and BIC1 cell lines and partially in TE3 cells); all nine cases of normal esophageal mucosa were unmethylated; and 54/72 (75.00%) samples from patients with esophageal cancer were methylated,and 25/72 (34.70%) matched adjacent tissues were methylated (75.00% vs 34.70%,x2 =23.5840,P =0.000).mRNA level of XAF1 measured with semi-quantitative reverse transcription polymerase chain reaction was detectable only in TE3 cells,and no expression was detected in KYSE30,KYSE70 or BIC1 cells.Protein expression was not observed in KYSE30 cells by Western blotting before treatment with 5-aza-dc.After treatment,mRNA level of XAF1 was detectable in KYSE30,KYSE70 and BIC1 cells.Protein expression was detected in KYSE30 after treatment with 5-aza-dc.Immunohistochemistry was performed on 32 cases of esophageal cancer and

  3. Intrathoracic electrical impedance measurements from an esophageal probe. (United States)

    Mitchell, M M; Newbower, R S


    The sensing of intrathoracic electrical impedance from an esophageal probe may allow relatively noninvasive monitoring of cardiac and respiratory functions of particular interest in anesthesia and intensive care. We have obtained a partial solution of the intrathoracic current-field problem for impedance measurements made from a four-terminal linear array of electrodes located in the esophagus. It allows prediction that aortic root motion will exceed aortic distension as a major determinant of the cardiac intrathoracic esophageal impedance signal. This prediction was confirmed for a specific carefully selected and placed electrode array in anesthetized dogs. In general, motions of organs will be more important than volume changes in affecting the esophageal impedance signal. Thus, timing information (preejection period and left ventricular ejection time) is available from electrodes on an esophageal probe, but cardiac output information appears to be inaccessible for fundamental reasons.

  4. Dysphagia after Colon Interposition Graft for Esophageal Carcinoma

    Directory of Open Access Journals (Sweden)

    C. Spitali


    Full Text Available Colon interposition is an established technique for esophageal reconstruction. We describe the case of primary adenocarcinoma arising in a colonic interposition graft that was performed after total esophagectomy for recurrence adenocarcinoma derived from the Barrett esophagus.

  5. Esophageal and gastric cancer incidence and mortality in alendronate users

    DEFF Research Database (Denmark)

    Abrahamsen, Bo; Pazianas, Michael; Eiken, Pia Agnete


    their esophageal or gastric location could be accurately distinguished. We conducted a register-based, open cohort study using national healthcare data for Denmark. Upper endoscopy frequency, cancer incidence and mortality was examined in 30,606 alendronate users (female, age 50¿+¿) and 122,424 matched controls......Recent studies have reached conflicting conclusions regarding the risk of esophageal cancer with oral bisphosphonates. Prior studies did not record the number of cancer deaths or endoscopy rates, which could be higher in bisphosphonate users and lead to more cancers being diagnosed at a stage when....... Primary outcomes were esophageal cancer incidence and death due to esophageal cancer. The analysis showed that alendronate users were more likely to have undergone recent upper endoscopy (4.1 vs 1.7%, p¿...

  6. Herpes Simplex Virus-2 Esophagitis in a Young Immunocompetent Adult

    Directory of Open Access Journals (Sweden)

    Deepak K. Kadayakkara


    Full Text Available Herpes simplex esophagitis (HSE is commonly identified in immunosuppressed patients. It is rare among immunocompetent patients and almost all of the reported cases are due to HSV-1 infection. HSV-2 esophagitis is extremely rare. We report the case of a young immunocompetent male who presented with dysphagia, odynophagia, and epigastric pain. Endoscopy showed multitudes of white nummular lesions in the distal esophagus initially suspected to be candida esophagitis. However, classic histopathological findings of multinucleated giant cells with eosinophilic intranuclear inclusions and positive HSV-2 IgM confirmed the diagnosis of HSV-2 esophagitis. The patient rapidly responded to acyclovir treatment. Although HSV-2 is predominantly associated with genital herpes, it can cause infections in other parts of the body previously attributed to only HSV-1 infection.

  7. Preoperative Chemotherapy, Radiation Improve Survival in Esophageal Cancer (Updated) (United States)

    Patients with esophageal cancer who received chemotherapy and radiation before surgery survived, on average, nearly twice as long as patients treated with surgery alone, according to results of a randomized clinical trial published May 31, 2012, in NEJM.

  8. Esophagectomy in esophageal lipoma: report of a case. (United States)

    Algin, Cem; Hacioğlu, Alper; Aydin, Tayfun; Ihtiyar, Enver


    Lipoma is an uncommon benign tumor of the alimentary tract and its overall incidence is 4.1%, but that of the esophagus is extremely rare, with an incidence of only 0.4%. We present a case of esophageal lipoma. A 55-year-old man had a two-year history of dysphagia and odynophagia. Upper gastrointestinal system endoscopy showed a mass in the wall of the esophagus, occupying the lumen, and causing obstruction. Computed tomography and abdominal ultrasonography were performed because of endoscopic suspicion of submucosal tumor, and the mass was confirmed to be a lipoma in the wall of the esophagus. It was removed surgically by a thoracic approach. His symptoms resolved after the operation. Surgical excision by enucleation of the tumor is the preferred treatment of esophageal lipoma, but opening of the esophageal mucosa during this procedure is a rare cause for esophageal resection.

  9. 2013 Update on Celiac Disease and Eosinophilic Esophagitis

    Directory of Open Access Journals (Sweden)

    Marco Astegiano


    Full Text Available Celiac disease is a chronic, immune-mediated disorder, characterized by small intestinal inflammation and villous atrophy after the ingestion of gluten by genetically susceptible individuals. Several extraintestinal manifestations have been associated to celiac disease. Eosinophilic esophagitis is a primary disorder of the esophagus characterized by upper gastrointestinal symptoms, absence of gastroesophageal reflux disease and more than 15 eosinophils per high-power field in biopsy specimens. Both celiac disease and eosinophilic esophagitis are caused by aberrant, but distinct, immune responses to ingested antigens and can be responsive to restricted food intake. The aim of this review is to assess whether there is an association between these two pathologies. In the majority of the studies examined, including the studies in pediatric population, the prevalence of eosinophilic esophagitis in subjects with celiac disease was about 10-times that of the general population. We suggest searching for eosinophilic esophagitis in all children undergoing endoscopy for suspicious celiac disease.

  10. Acute esophageal necrosis and liver pathology, a rare combination

    Institute of Scientific and Technical Information of China (English)

    Amir Maqbul Khan; Rangit Hundal; Vijaya Ramaswamy; Mark Korsten; Sunil Dhuper


    Acute esophageal necrosis (AEN) or "black esophagus" is a clinical condition found at endoscopy. It is a rare entity the exact etiology of which remains unknown. We describe of liver cirrhosis and hepatic encephalopathy.

  11. Estrogen, male dominance and esophageal adenocarcinoma: Is there a link?

    Institute of Scientific and Technical Information of China (English)

    Huiqi Yang; Olga A Sukocheva; Damian J Hussey; David I Watson


    Esophageal adenocarcinoma is a cancer with poor prognosis, and its incidence has risen sharply over recent decades. Obesity is a major risk factor for developing this cancer and there is a clear male gender bias in the incidence that cannot be fully explained by known risk factors. It is possible that a difference in the expression of estrogen, or its signaling axes, may contribute to this gender bias. We undertook a comprehensive literature search and analyzed the available data regarding estrogen and estrogen receptor expression, and the possible sex-specific links with esophageal adenocarcinoma development. Potentially relevant associations between visceral vs subcutaneous fat deposition and estrogen expression, and the effect of crosstalk between estrogen and leptin signaling were identified. We also found limited studies suggesting a role for estrogen receptor β expression in esophageal adenocarcinoma development. The current literature supports speculation on an etiological role for estrogen in the male gender bias in esophageal adenocarcinoma, but further studies are required.

  12. Study Points to Genetic Subtypes of Esophageal Cancer (United States)

    A Cancer Currents blog post about a study by The Cancer Genome Atlas Research Network that identified distinct genetic and molecular changes in esophageal cancers that could improve their classification and identify potential new treatments.

  13. [Management of the esophageal candidiasis by the primary care physician]. (United States)

    Behrens, Garance; Bocherens, Astrid; Senn, Nicolas


    Esophageal candidiasis is one of the most common opportunistic infections in patients infected by human immunodeficiency virus (HIV). This pathology is also found in patients without overt immunodeficiency. Other risk factors are known to be associated with this disease like inhaled or systemic corticosteroid treatment or proton-pump inhibitors and H2 receptor antagonists. In the absence of identified risk factors, a primary immune deficiency should be sought. Prevention of esophageal candidiasis is based primarily on the identification of risk factors, and a better control of them. This article presents a review of the physiopathology, clinical presentation and management of esophageal candidiasis by primary care physicians. We will also discuss ways of preventing esophageal candidiasis when necessary.

  14. Selective approach in the treatment of esophageal perforations

    NARCIS (Netherlands)

    Amir, AI; von Dullemen, H; Plukker, JTM


    Background: Treatment of esophageal perforation remains controversial and recommendations vary from initially non-operative to aggressive surgical management. Several factors are responsible for this life-threatening event, which has led to more individualized treatment ensuring adequate pleuromedia

  15. [Lugol's solution in endoscopic diagnosis of early esophageal cancer]. (United States)

    Wang, G; Zhou, M; Cong, Q


    About 1500 high-risk subjects of esophageal cancer were found during screening by balloon cytology and all of them were examined endoscopically. Among them, 120 were considered as having early esophageal cancer and precancerous lesions. During the examination, Lugol's solution staining was used and guiding biopsy was taken. 98 subjects with unstained lesions were found, and biopsy showed early esophageal cancer in 60 (61.2%) and moderate and severe dysplasia in 38 (38.8%). It is usually extremely difficult to detect and localize the very early esophageal mucosal and submucosal carcinoma. But endoscopic examination and using Lugol's solution staining with multiple spots biopsy from unstained area are of great assistance. Minute malignant lesions may not be overlooked.

  16. A preliminary study on ras protein expression in human esophageal cancer and precancerous lesions

    Institute of Scientific and Technical Information of China (English)

    Jian Li; Chang Wei Feng; Zhi Guo Zhao; Qi Zhou; Li Dong Wang


    @@INTRODUCTION The esophageal carcinoma is a common malignant tumor in Linzhou City (Linxian) of Henan Province in northern China. Although the etiology and natural history of esophageal carcinoma are not clear, a substantial amount of evidence has been provided to suggest that the development of human esophageal squamous cell carcinomas (SCC) is a multistage progressive process[1-4] An early indicator of abnormality in persons predisposed to esophageal SCC is an increased proliferation of esophageal epithelial cells,morphologically manifested as basal cell hyperplasia (BCH), and dysplasia (DYS), and carcinoma in situ, which could be considered precancerous lesions of esophageal SCC[1-4].

  17. Cats, Cancer and Comparative Oncology

    Directory of Open Access Journals (Sweden)

    Claire M. Cannon


    Full Text Available Naturally occurring tumors in dogs are well-established models for several human cancers. Domestic cats share many of the benefits of dogs as a model (spontaneous cancers developing in an immunocompetent animal sharing the same environment as humans, shorter lifespan allowing more rapid trial completion and data collection, lack of standard of care for many cancers allowing evaluation of therapies in treatment-naïve populations, but have not been utilized to the same degree in the One Medicine approach to cancer. There are both challenges and opportunities in feline compared to canine models. This review will discuss three specific tumor types where cats may offer insights into human cancers. Feline oral squamous cell carcinoma is common, shares both clinical and molecular features with human head and neck cancer and is an attractive model for evaluating new therapies. Feline mammary tumors are usually malignant and aggressive, with the ‘triple-negative’ phenotype being more common than in humans, offering an enriched population in which to examine potential targets and treatments. Finally, although there is not an exact corollary in humans, feline injection site sarcoma may be a model for inflammation-driven tumorigenesis, offering opportunities for studying variations in individual susceptibility as well as preventative and therapeutic strategies.

  18. Domestic cat allergen and allergic sensitisation in young children

    NARCIS (Netherlands)

    Chen, Chih-Mei; Gehring, Ulrike; Wickman, Magnus; Hoek, Gerard; Giovannangelo, Mariella; Nordling, Emma; Wijga, Alet; de Jongste, Johan; Pershagen, Goeran; Almqvist, Catarina; Kerkhof, Marjan; Bellander, Tom; Wichmann, H. -Erich; Brunekreef, Bert; Heinrich, Joachim


    Studies have presented conflicting associations between cat allergen exposure and sensitisation and atopic disease. We therefore investigated the association between the observed domestic cat allergen level and cat sensitisation in young children in four study populations from three European countri

  19. Darier disease with oral and esophageal involvement: A case report

    Directory of Open Access Journals (Sweden)

    Magesh Karuppur Thiagarajan


    Full Text Available A 58-year-old man presented with itchy papular eruptions all over the body since 15 years. Intraoral examination revealed raised papular lesions on the labial mucosa, hard palate, and tongue. The histopathology of the oral and skin lesions was confirmative of Darier disease (DD. This patient also showed esophageal involvement, which was confirmed histopathologically. Such a presentation of DD, with oral and esophageal involvement, is rare.

  20. Esophageal Gastrointestinal Stromal Tumors Presenting as Mediastinal Mass

    Directory of Open Access Journals (Sweden)

    M. Kafeel


    Full Text Available Gastrointestinal stromal tumors (GISTs are the most common mesenchymal tumors of the gastrointestinal tract and are predominant in the stomach and intestine but rare in the esophagus. Here, we report a case of esophageal GIST which presented as a mediastinal mass on chest X-ray and dyspnea. The case was initially diagnosed as leiomyosarcoma, which could create a diagnostic dilemma. Therefore, recognizing this uncommon presentation as a mediastinal mass with esophageal GIST is important in the differential diagnosis.

  1. Pathogenic role of mast cells in experimental eosinophilic esophagitis


    Niranjan, Rituraj; Mavi, Parm; Rayapudi, Madhavi; Dynda, Scott; Mishra, Anil


    Eosinophilic esophagitis (EoE) is a chronic allergic disease characterized by esophageal intraepithelial eosinophils, extracellular eosinophil granule deposition, induced mast cell accumulation, and epithelial cell hyperplasia. However, the processes involved in the development of a number of these characteristics are largely unknown. Herein, we tested the hypothesis whether induced mast cell accumulation in the esophagus has a role in promoting EoE pathogenesis. Accordingly, we induced exper...

  2. Coexistence of gastrointestinal stromal tumor, esophageal and gastric cardia carcinomas


    Zhou, Yong; Wu, Xu-Dong; Shi, Quan; Jia, Jing


    Gastric gastrointestinal stromal tumor (GIST), esophageal squamous cell carcinoma and gastric cardia adenocarcinoma are distinct neoplasms originating from different cell layers; therefore, simultaneous development of such carcinomas is relatively rare. Auxiliary examinations revealed coexistence of esophageal and gastric cardia carcinoma with lymph node metastasis in a 77-year-old man. Intraoperatively, an extraluminal tumor (about 6.0 cm × 5.0 cm × 6.0 cm) at the posterior wall of the gastr...

  3. Is the schatzki ring a unique esophageal entity?

    Institute of Scientific and Technical Information of China (English)

    Michaela Müller; Ines Gockel; Philip Hedwig; Alexander J Eckardt; Kathrin Kuhr; Jochem K(o)nig; Volker F Eckardt


    AIM: To study, whether the association of Schatzki rings with other esophageal disorders support one of the theories about its etiology.METHODS: From 1987 until 2007, all patients with newly diagnosed symptomatic Schatzki rings (SRs)were prospectively registered and followed. All of them underwent structured interviews with regards to clinical symptoms, as well as endoscopic and/or radiographic examinations.Endoscopic and radiographic studies determined the presence of an SR and additional morphological abnormalities.RESULTS: One hundred and sixty-seven patients (125 male, 42 female) with a mean age of 57.1 ± 14.6 years were studied. All patients complained of intermittent dysphagia for solid food and 113 (79.6%) patients had a history of food impaction. Patients experienced symptoms for a mean of 4.7 ± 5.2 years before diagnosis. Only in 23.4% of the 64 patients who had endoscopic and/or radiological examinations before their first presentation to our clinic, was the SR previously diagnosed. At presentation, the mean ring diameter was 13.9 ± 4.97 mm. One hundred and sixty-two (97%) patients showed a sliding hiatal hernia. Erosive reflux esophagitis was found in 47 (28.1%) patients. Twenty-six (15.6%) of 167 patients showed single or multiple esophageal webs; five (3.0%) patients exhibited eosinophilic esophagitis; and four (2.4%) had esophageal diverticula. Four (7%) of 57 patients undergoing esophageal manometry had nonspecific esophageal motility disorders.CONCLUSION: Schatzki rings are frequently associated with additional esophageal disorders, which support the assumption of a multifactorial etiology. Despite typical symptoms, SRs might be overlooked.

  4. Smoothing of Piecewise Linear Paths

    Directory of Open Access Journals (Sweden)

    Michel Waringo


    Full Text Available We present an anytime-capable fast deterministic greedy algorithm for smoothing piecewise linear paths consisting of connected linear segments. With this method, path points with only a small influence on path geometry (i.e. aligned or nearly aligned points are successively removed. Due to the removal of less important path points, the computational and memory requirements of the paths are reduced and traversing the path is accelerated. Our algorithm can be used in many different applications, e.g. sweeping, path finding, programming-by-demonstration in a virtual environment, or 6D CNC milling. The algorithm handles points with positional and orientational coordinates of arbitrary dimension.

  5. Quantum Computer Games: Schrodinger Cat and Hounds (United States)

    Gordon, Michal; Gordon, Goren


    The quantum computer game "Schrodinger cat and hounds" is the quantum extension of the well-known classical game fox and hounds. Its main objective is to teach the unique concepts of quantum mechanics in a fun way. "Schrodinger cat and hounds" demonstrates the effects of superposition, destructive and constructive interference, measurements and…

  6. Malassezia spp. overgrowth in allergic cats. (United States)

    Ordeix, Laura; Galeotti, Franca; Scarampella, Fabia; Dedola, Carla; Bardagí, Mar; Romano, Erica; Fondati, Alessandra


    A series of 18 allergic cats with multifocal Malassezia spp. overgrowth is reported: atopic dermatitis was diagnosed in 16, an adverse food reaction in another and one was euthanized 2 months after diagnosis of Malassezia overgrowth. All the cats were otherwise healthy and those tested (16 out of 18) for feline leukaemia or feline immunodeficiency virus infections were all negative. At dermatological examination, multifocal alopecia, erythema, crusting and greasy adherent brownish scales were variably distributed on all cats. Cytological examination revealed Malassezia spp. overgrowth with/without bacterial infection in facial skin (n = 11), ventral neck (n = 6), abdomen (n = 6), ear canal (n = 4), chin (n = 2), ear pinnae (n = 2), interdigital (n = 1) and claw folds skin (n = 1). Moreover, in two cats Malassezia pachydermatis was isolated in fungal cultures from lesional skin. Azoles therapy alone was prescribed in seven, azoles and antibacterial therapy in eight and azoles with both antibacterial and anti-inflammatory therapy in three of the cats. After 3-4 weeks of treatment, substantial reduction of pruritus and skin lesions was observed in all 11 cats treated with a combined therapy and in five of seven treated solely with azoles. Malassezia spp. overgrowth may represent a secondary cutaneous problem in allergic cats particularly in those presented for dermatological examination displaying greasy adherent brownish scales. The favourable response to treatment with antifungal treatments alone suggests that, as in dogs, Malassezia spp. may be partly responsible for both pruritus and cutaneous lesions in allergic cats.

  7. Criptococose em felino Cryptococcosis in cat

    Directory of Open Access Journals (Sweden)

    F.J.F. Sant’Ana


    Full Text Available A case of cryptococcosis in a cat refferred to the Hospital Veterinário da Universidade Federal Rural de Pernambuco is described. The cat was euthanized and the microscopic examination of a firm mass observed in the nasal cavity was accomplished. Cryptococcus sp. and a chronic inflammatory process was observed throughout the tissue.

  8. Intestinal obstruction by trichobezoars in five cats. (United States)

    Barrs, V R; Beatty, J A; Tisdall, P L; Hunt, G B; Gunew, M; Nicoll, R G; Malik, R


    Between 1997 and 1999, five domestic crossbred cats (four long haired, one short haired) presented with a palpable abdominal mass and were shown to have small intestinal trichobezoars at laparotomy or necropsy. Hair balls were associated with partial or complete intestinal obstruction and were situated in the proximal jejunum to distal ileum. In four cats obstructions were simple, while the remaining cat had a strangulating obstruction. Three of the cats were 10 years or older, and two were less than 4 years. In the three older cats abdominal neoplasia was suspected and investigations were delayed or declined in two of these cats because of a perceived poor prognosis. Predisposing factors identified in this series of cats included a long-hair coat, flea allergy dermatitis, inflammatory bowel disease and ingestion of non-digestible plant material. This report shows that the ingestion of hair is not always innocuous and that intestinal trichobezoars should be considered in the differential diagnoses of intestinal obstruction and intra-abdominal mass lesions, particularly in long-haired cats.

  9. A cross-species alignment tool (CAT)

    DEFF Research Database (Denmark)

    Li, Heng; Guan, Liang; Liu, Tao;


    sensitive methods which are usually applied in aligning inter-species sequences. RESULTS: Here we present a new algorithm called CAT (for Cross-species Alignment Tool). It is designed to align mRNA sequences to mammalian-sized genomes. CAT is implemented using C scripts and is freely available on the web...

  10. Cool Cats: Feline Fun with Abstract Art. (United States)

    Lambert, Phyllis Gilchrist


    Presents a lesson that teaches students about abstract art in a fun way. Explains that students draw cats, learn about the work of Pablo Picasso, and, in the style of Picasso, combine the parts of the cats (tail, legs, head, body) together in unconventional ways. (CMK)

  11. Getting a CAT Scan (For Kids) (United States)

    ... A Kid's Guide to Fever Getting a CAT Scan (Video) KidsHealth > For Kids > Getting a CAT Scan (Video) A A A en español Obtención de ... of what's going on inside your body. The scan itself is painless. All you'll need to ...

  12. Eosinophilic esophagitis: New insights in pathogenesis and therapy

    Institute of Scientific and Technical Information of China (English)

    Michele Pier Luca Guarino; Michele Cicala; Jose Behar


    Eosinophilic esophagitis(Eo E) is a clinico-pathological entity with esophageal symptoms and dense esophageal eosinophilic infiltration throughout the esophagus that may persist despite treatment with proton pump inhibitors. This eosinophilic infiltration is usually absent in the stomach, small intestine and colon, although there are a number of reports of patients with a multiorgan involvement. EoE is associated with abnormalities involving TH2-dependent immunity, with multiple environmental factors strongly contributing to disease expression. The layer of the esophagus affected by the eosinophilic infiltration causes the specific symptoms. Esophageal involvement results mostly in dysphagia for solids that can be severe enough to cause recurrent esophageal obstruction with typical endoscopic features suggesting esophageal remodeling and pathological changes of eosinophilic infiltration of the mucosa, sub-epithelial fibrosis and muscle hypertrophy. This disease is frequently associated with other allergic conditions such as allergic asthma, allergic dermatitis and eosinophilia. The treatment of patients with Eo E depends on the severity of the symptoms and of the inflammatory process as well as to their response to a gradual step-up treatment. The first line of treatment consists of steroid containing local inhalers. If unresponsive they are then treated with oral steroids. Intravenous interleukin blockers seem to have a consistent positive therapeutic effect.

  13. Tissue-Specific Effects of Esophageal Extracellular Matrix. (United States)

    Keane, Timothy J; DeWard, Aaron; Londono, Ricardo; Saldin, Lindsey T; Castleton, Arthur A; Carey, Lisa; Nieponice, Alejandro; Lagasse, Eric; Badylak, Stephen F


    Biologic scaffolds composed of extracellular matrix (ECM) have been used to facilitate repair or remodeling of numerous tissues, including the esophagus. The theoretically ideal scaffold for tissue repair is the ECM derived from the particular tissue to be treated, that is, site-specific or homologous ECM. The preference or potential advantage for the use of site-specific ECM remains unknown in the esophageal location. The objective of the present study was to characterize the in vitro cellular response and in vivo host response to a homologous esophageal ECM (eECM) versus nonhomologous ECMs derived from small intestinal submucosa and urinary bladder. The in vitro response of esophageal stem cells was characterized by migration, proliferation, and three-dimensional (3D) organoid formation assays. The in vivo remodeling response was evaluated in a rat model of esophageal mucosal resection. Results of the study showed that the eECM retains favorable tissue-specific characteristics that enhance the migration of esophageal stem cells and supports the formation of 3D organoids to a greater extent than heterologous ECMs. Implantation of eECM facilitates the remodeling of esophageal mucosa following mucosal resection, but no distinct advantage versus heterologous ECM could be identified.

  14. Data analyses and perspectives on laparoscopic surgery for esophageal achalasia. (United States)

    Tsuboi, Kazuto; Omura, Nobuo; Yano, Fumiaki; Hoshino, Masato; Yamamoto, Se-Ryung; Akimoto, Shunsuke; Masuda, Takahiro; Kashiwagi, Hideyuki; Yanaga, Katsuhiko


    In general, the treatment methods for esophageal achalasia are largely classified into four groups, including drug therapy using nitrite or a calcium channel blocker, botulinum toxin injection, endoscopic therapy such as endoscopic balloon dilation, and surgery. Various studies have suggested that the most effective treatment of esophageal achalasia is surgical therapy. The basic concept of this surgical therapy has not changed since Heller proposed esophageal myotomy for the purpose of resolution of lower esophageal obstruction for the first time in 1913, but the most common approach has changed from open-chest surgery to laparoscopic surgery. Currently, the laparoscopic surgery has been the procedure of choice for the treatment of esophageal achalasia. During the process of the transition from open-chest surgery to laparotomy, to thoracoscopic surgery, and to laparoscopic surgery, the necessity of combining antireflux surgery has been recognized. There is some debate as to which type of antireflux surgery should be selected. The Toupet fundoplication may be the most effective in prevention of postoperative antireflux, but many medical institutions have selected the Dor fundoplication which covers the mucosal surface exposed by myotomy. Recently, a new endoscopic approach, peroral endoscopic myotomy (POEM), has received attention. Future studies should examine the long-term outcomes and whether POEM becomes the gold standard for the treatment of esophageal achalasia.

  15. Prevalence of laryngeal alterations in patients with erosive esophagitis

    Directory of Open Access Journals (Sweden)

    Coelho, Marina Serrato


    Full Text Available Introduction: The association between gastroesophageal reflux disease (GERD and laryngeal disorders has been much debated in recent years. Recent studies suggest an association between laryngeal symptoms and pharyngeal symptoms extra-esophageal reflux, as atypical presentation of Gastroesophageal Reflux Disease. Objectives: To correlate the presence of laryngeal to the grades of erosive esophagitis. Methods: A prospective study. Patients with findings of esophagitis on endoscopy were categorized according to LosAngeles and submitted a questionnaire followed by laryngoscopy. The chi-square test was used for statistical analysis (p<0.05. Results: Patients with typical symptoms of gastroesophageal reflux disease accounted for 96.6%. Eighteen had changes consistent with class A (60%, class B with seven (7% and 5 with classes C + D (16.6%. The presence of laryngeal changes were more prevalent in more severe esophagitis (grades C and D Los Angeles when compared to milder forms (classes A and B, a statistically significant difference (p<0.05. Conclusion: The laryngeal disorders are frequent findings in patients with esophagitis, more frequent the greater the degree of esophageal injury.

  16. Polycystic kidney disease in a Chartreux cat. (United States)

    Volta, Antonella; Manfredi, Sabrina; Gnudi, Giacomo; Gelati, Aldo; Bertoni, Giorgio


    Polycystic kidney disease (PKD) is one of the most common genetic diseases in cats. It has been widely described in Persians and Persian-related cats and sporadically in other breeds. The purpose of the present paper is to describe the first reported case of PKD in a 12-year-old female Chartreux cat. The cat was referred with polyuria and polydipsia and enlarged and irregular kidneys at palpation. Multiple renal cysts and a single liver cyst were identified by ultrasound and the inherited pattern was confirmed by genetic test (polymerase chain reaction/restriction fragment length polymorphism (PCR/RFLP) assay). Chartreux cats should be included in the screening programme of PKD, and PKD should be always considered as a possible cause of chronic renal failure in this breed.

  17. The Near Eastern origin of cat domestication. (United States)

    Driscoll, Carlos A; Menotti-Raymond, Marilyn; Roca, Alfred L; Hupe, Karsten; Johnson, Warren E; Geffen, Eli; Harley, Eric H; Delibes, Miguel; Pontier, Dominique; Kitchener, Andrew C; Yamaguchi, Nobuyuki; O'brien, Stephen J; Macdonald, David W


    The world's domestic cats carry patterns of sequence variation in their genome that reflect a history of domestication and breed development. A genetic assessment of 979 domestic cats and their wild progenitors-Felis silvestris silvestris (European wildcat), F. s. lybica (Near Eastern wildcat), F. s. ornata (central Asian wildcat), F. s. cafra (southern African wildcat), and F. s. bieti (Chinese desert cat)-indicated that each wild group represents a distinctive subspecies of Felis silvestris. Further analysis revealed that cats were domesticated in the Near East, probably coincident with agricultural village development in the Fertile Crescent. Domestic cats derive from at least five founders from across this region, whose descendants were transported across the world by human assistance.

  18. Income and Consumption Smoothing among US States

    DEFF Research Database (Denmark)

    Sørensen, Bent; Yosha, Oved

    states. The fraction of a shock to gross state products smoothed by the federal tax-transfer system is the same for various regions and other clubs of states. We calculate the scope for consumption smoothing within various regions and clubs, finding that most gains from risk sharing can be achieved......We quantify the amount of cross-sectional income and consumption smoothing achieved within subgroups of states, such as regions or clubs, e.g. the club of rich states. We find that there is much income smoothing between as well as within regions. By contrast, consumption smoothing occurs mainly...... within regions but not between regions. This suggests that capital markets transcend regional barriers while credit markets are regional in their nature. Smoothing within the club of rich states is accomplished mainly via capital markets whereas consumption smoothing is dominant within the club of poor...

  19. Secondary prophylaxis for esophageal variceal bleeding. (United States)

    Albillos, Agustín; Tejedor, Marta


    Combination therapy with beta-blockers and endoscopic band ligation (EBL) is the standard prophylaxis of esophageal variceal rebleeding in cirrhosis. Beta-blockers are the backbone of combination therapy, since their benefit extend to other complications of portal hypertension. EBL carries the risk of post-banding ulcer bleeding, which explains why overall rebleeding is reduced when beta-blockers are added to EBL, and not when EBL is added to beta-blockers. TIPS is the rescue treatment, but it could be considered as first choice in patients that first bleed while on beta-blockers, those with contraindications to beta-blockers or with refractory ascites, and those with fundal varices.

  20. Advances in Radiotherapy Management of Esophageal Cancer (United States)

    Verma, Vivek; Moreno, Amy C.; Lin, Steven H.


    Radiation therapy (RT) as part of multidisciplinary oncologic care has been marked by profound advancements over the past decades. As part of multimodality therapy for esophageal cancer (EC), a prime goal of RT is to minimize not only treatment toxicities, but also postoperative complications and hospitalizations. Herein, discussion commences with the historical approaches to treating EC, including seminal trials supporting multimodality therapy. Subsequently, the impact of RT techniques, including three-dimensional conformal RT, intensity-modulated RT, and proton beam therapy, is examined through available data. We further discuss existing data and the potential for further development in the future, with an appraisal of the future outlook of technological advancements of RT for EC. PMID:27775643

  1. Tumour Debulking for Esophageal Cancer - Thermal Modalities

    Directory of Open Access Journals (Sweden)

    David Fleischer


    Full Text Available Esophageal cancer usually is discovered at a late stage and curative therapy seldom is possible. The prognosis is poor and most therapy is palliative. Endoscopic therapy commonly is employed; two common treatments involve thermal modalities. The Nd:YAG laser has been employed for 10 years and is effective in relieving obstruction in approximately 90% of cases. Re-ohstruction usually occurs in two to three months and repeat treatment may be necessary. Limitations to laser use include the fact that equipment is expensive and there are technical restrictions. An alternative thermal modality is the bipolar coagulation tumour probe which employs bipolar electrocoagulation. It is less expensive and, if the tumour is circumferential, tends to be easier to use. (It should not be used if the cancer is noncircumferential. The advantages and limitations of each modality are addressed.

  2. Axial force measurement for esophageal function testing

    DEFF Research Database (Denmark)

    Gravesen, Flemming Holbæk; Funch-Jensen, Peter; Gregersen, Hans


    force transducers over in-vivo strain gauges of various sizes to electrical impedance based measurements. The amplitude and duration of the axial force has been shown to be as reliable as manometry. Normal, as well as abnormal, manometric recordings occur with normal bolus transit, which have been...... force (force in radial direction) whereas the bolus moves along the length of esophagus in a distal direction. Force measurements in the longitudinal (axial) direction provide a more direct measure of esophageal transport function. The technique used to record axial force has developed from external...... documented using imaging modalities such as radiography and scintigraphy. This inconsistency using manometry has also been documented by axial force recordings. This underlines the lack of information when diagnostics are based on manometry alone. Increasing the volume of a bag mounted on a probe...

  3. Foscarnet-Resistant Cytomegalovirus Esophagitis with Stricturing

    Directory of Open Access Journals (Sweden)

    Vinaya Gaduputi


    Full Text Available We report the case of a 52-year-old man with HIV-AIDS, non-complaint with highly active antiretroviral therapy, who presented with long-standing dysphagia. He was treated for three episodes of severe Candida esophagitis with fluconazole and later caspofungin due to poor response. In spite of the prolonged treatment courses the patient did not report an improvement in his symptoms. He was also concomitantly being treated for other opportunistic infections including cytomegalovirus (CMV retinitis with i.v. foscarnet for almost 2 months prior to the index presentation. Upper esophagogastroduodenoscopy revealed multiple superficial ulcers with stricturing. Bougie dilatation was attempted but failed. The biopsy specimens revealed multiple intracellular inclusion bodies pathognomonic of CMV infection. We aim to highlight the increasing resistance of CMV to conventional first-line antiviral agents such as foscarnet.

  4. Feline Epitheliotropic Mastocytic Conjunctivitis in 15 Cats. (United States)

    Beckwith-Cohen, B; Dubielzig, R R; Maggs, D J; Teixeira, L B C


    Mast cell infiltration occurs in malignant, inflammatory (eg, allergic, infectious), and idiopathic disease processes in humans and animals. Here, we describe the clinical and histological features of a unique proliferative conjunctivitis occurring in 15 cats. Ocular specimens were examined histologically, and polymerase chain reaction (PCR) for feline herpesvirus 1 (FHV-1) was performed on ocular tissues obtained from 10 cats. Cats had a median age of 8 years (range: 7 months-17.5 years). The known median duration of ocular lesions prior to biopsy was 4 months (range: 1 week-3 years). Ocular disease was unilateral in 12 cats, and 9 cats had coexisting corneal disease. Clinically and histologically, proliferative or nodular conjunctival lesions were noted in 13 cats. The nictitating membrane was affected in 10 cats. Histologically, lesions were characterized by mixed inflammatory infiltrates with an abundance of Giemsa-positive and toluidine blue-positive intraepithelial and subepithelial mast cells, marked edema, and papillary epithelial hyperplasia. Feline herpesvirus 1 was demonstrated by PCR in 1 of 10 cats tested. Follow-up information was available for 14 cats: 8 had no recurrence during a median follow-up period of 17.5 months (range: 4.5-30 months), 2 underwent orbital exenteration, 3 had recurrence that was medically managed, and 1 cat had diffuse conjunctivitis at the time of biopsy and recurrence was deemed irrelevant. Various ocular medications were administered before and after surgical biopsy. This condition was designated as feline epitheliotropic mastocytic conjunctivitis, with intraepithelial mast cells being an essential feature and papillary epithelial proliferation being characteristic but not diagnostic alone. The condition appears to be uncommon and benign. Although the cause is unknown, an allergic component is possible.

  5. Video-thoracoscopic enucleation of esophageal leiomyoma

    Directory of Open Access Journals (Sweden)

    Luh Shi-Ping


    Full Text Available Abstract Background Leiomyoma is the most common benign tumor of the esophagus. Surgical enucleation is indicated in case of symptoms or an unclear diagnosis, and open thoracotomy has long been the standard approach for this procedure. However, enucleation through video assisted thoracoscopic surgery (VATS has been developed as a preferred approach for most lesions in recent years. Method Herein we report our twelve patients (seven men and five women, with median age of 42 years from 2001 to 2009, who underwent enucleation through VATS for esophageal leiomyomas, with a size from 1 to 8 cm in diameter (median: 5, and at different locations, from the thoracic outlet to near the diaphragmatic level of the thoracic esophagus. Intraoperative fiberoptic esophagoscopy was performed in two patients for localization by illumination. A right-sided approach was performed in eight cases (upper two thirds of esophagus and the left-sided in another four cases (lower third of esophagus. Result The median operative time was 95 minutes (70 to 230 minutes. Four of them required small utility incisions (4-6 cm for better exploration and manipulation. There were no major complications, such as death or empyema due to leaks from mucosal tears, and the presenting symptoms were improved during the follow-up period, from 12 to 98 months. Conclusion VATS can be considered as an initial approach for most patients with esophageal leiomyomas, even large in size, irregular in shape, or at unfavorable location. It is a safe, minimally invasive, and effective treatment. However, conversion to open thoracotomy should be required for the sake of clinical or technical concern.

  6. Lesions of structures showing FOS expression to cat presentation: effects on responsivity to a Cat, Cat odor, and nonpredator threat. (United States)

    Blanchard, D Caroline; Canteras, Newton S; Markham, Chris M; Pentkowski, Nathan S; Blanchard, Robert J


    Exposure of rats to a cat elicits Fos activity in a number of brain areas or structures. Based on hodological relationships of these, Canteras has proposed a medial hypothalamic defense system, with input from several forebrain sites. Both electrolytic and neurotoxic lesions of the dorsal premammillary nucleus, which shows the strongest Fos response to cat exposure, produce striking decrements in a number of defensive behaviors to a cat or to cat odor stimuli, but do not have a major effect on either postshock freezing, or responsivity to the odor of a female in estrus. Neurotoxic lesions of the medial amygdala produce decrements in defensiveness to predator stimuli, particularly odor stimuli, that are consistent with a view of this structure as involved with allomonal cues. While dorsal hippocampal lesions had little effect on responsivity to predator stimuli, neurotoxic lesions of the ventral hippocampus reduced freezing and enhanced a variety of nondefensive behaviors to both cat odor and footshock, with similar reductions in defensiveness during context conditioning tests for cat odor, cat exposure and footshock. These results support the view that the dorsal premammillary nucleus is strongly and selectively involved in control of responsivity to predator stimuli. Structures with important input into the medial hypothalamic defense system appear also to be functionally involved with antipredator defensive behaviors, and these lesion studies may suggest specific hypotheses as to the particular defense functions of different areas.

  7. The association between reflux esophagitis and airway hyper-reactivity in patients with gastro-esophageal reflux

    Directory of Open Access Journals (Sweden)

    Ashraf Karbasi


    Full Text Available Background: The association of gastro-esophageal reflux (GER with a wide variety of pulmonary disorders was recognized. We aimed to evaluate the effect of GER-induced esophagitis on airway hyper-reactivity (AHR in patients and the response to treatment. Materials and Methods: In this cohort study, 30 patients attending the gastrointestinal clinic of a university hospital with acid reflux symptoms were included. All patients were evaluated endoscopically and divided into case group with esophagitis and control group without any evidence of esophagitis. Spirometry and methacholine test were done in all patients before and after treatment of GER with pantoprazole 40 mg daily for six months. Results: There was a significant difference in the rate of positive methacholine test between the cases (40% and the controls (6.7% prior to anti-acid therapy (P < 0.0001. After six months of treatment, the frequency of positive methacholine test diminished from 40 to 13.3% in the case group (P < 0.05 but did not change in the controls (P = 0.15. Conclusion: The presence of esophagitis due to GER would increase the AHR and treatment with pantoperazole would decrease AHR in patients with proved esophagitis and no previous history of asthma after six months.

  8. CAT — EDRN Public Portal (United States)

    The CAT gene product, catalase, occurs in the peroxisome of almost all respiring organismÃÆ'¢â‚¬â„¢s cells. Catalase is a heme enzyme that converts the reactive oxygen species hydrogen peroxide to water and oxygen, diminishing the toxic effects of hydrogen peroxide on the cell. Catalase promotes growth of cells including T-cells, B-cells, myeloid leukemia cells, melanoma cells, mastocytoma cells and normal and transformed fibroblast cells. Polymorphisms in this gene have been associated with decreases in catalase activity but, to date, acatalasemia is the only disease known to be caused by this gene.

  9. Laparoscopic anterior esophageal myotomy and toupet fundoplication for achalasia. (United States)

    Heniford, B T; Matthews, B D; Kercher, K W; Yavorski, R; Greer, S F; Goldstein, S L; Deal, S E; Paccico, T; Drake, S; Colvin, A; Cyzner, R; Sing, R F


    Achalasia is an esophageal motility disorder characterized by the failure of lower esophageal sphincter relaxation and the absence of esophageal peristalsis. The purpose of this study was to evaluate the clinical outcomes of patients undergoing laparoscopic esophageal myotomy and Toupet fundoplication for achalasia. A 9-cm myotomy was performed in most cases extending 7 cm above and 2 cm below the gastroesophageal junction. Severity of dysphagia, heartburn, chest pain, and regurgitation was graded preoperatively and postoperatively using a five-point symptomatic scale (0-4). Patients also graded their outcomes as excellent, good, fair, or poor. Between December 1995 and November 2000 a total of 49 patients (23 male, 26 female) with a mean age of 44.3 years (range 23-71 years) were diagnosed with achalasia. Mean duration of symptoms was 40.2 months (range 4-240 months). Thirty-seven patients (76%) had had a previous nonsurgical intervention or combinations of nonsurgical interventions [pneumatic dilation (23), bougie dilation (five), and botulinum toxin (19)], and two patients had failed esophageal myotomies. Forty-five patients underwent laparoscopic esophageal myotomy and Toupet fundoplication. Two patients received laparoscopic esophageal myotomies without an antireflux procedure, and two were converted to open surgery. One patient presented 10 hours after a pneumatically induced perforation and underwent a successful laparoscopic esophageal myotomy and partial fundoplication. Mean operative time was 180.5 minutes (range 145-264 minutes). Mean length of stay was 1.98 days (range 1-18 days). There were five (10%) perioperative complications but no esophageal leaks. There was a significant difference (P < 0.05) between the preoperative and postoperative dysphagia, chest pain, and regurgitation symptom scores. All patients stated that they were improved postoperatively. Eighty-six per cent rated their outcome as excellent, 10 per cent as good, and 4 per cent as fair

  10. External air compression: A rare cause of blunt esophageal injury, managed by a stent

    Directory of Open Access Journals (Sweden)

    Mohammed Muneer


    CONCLUSION: High index of suspicion is needed for early diagnosis of esophageal perforation after blunt trauma. Appropriate drainage, antibiotic and temporary endoscopic esophageal stenting may be an optimal approach in selected patients, especially with delayed diagnosis.

  11. Clinical significance of expression of Klotho and β-Catenin in esophageal squamous cell carcinoma

    Institute of Scientific and Technical Information of China (English)



    Objective To investigate the clinical significance of expression of Klotho and β-Catenin in esophageal carcinoma. Methods Tissue microarray technique and immunohistochemistry were used to examine Klotho and β-Catenin expression in 75 esophageal carcinoma tissue

  12. Does Impaired Gallbladder Function Contribute to the Development of Barrett's Esophagus and Esophageal Adenocarcinoma?

    LENUS (Irish Health Repository)

    Nassr, Ayman O


    Esophageal adenocarcinoma is aetiologically associated with gastro-esophageal reflux, but the mechanisms responsible for the metaplasia-dysplasia sequence are unknown. Bile components are implicated. Impaired gallbladder function may contribute to duodenogastric reflux (DGR) and harmful GERD.

  13. Effect of S1P5 on proliferation and migration of human esophageal cancer cells


    Hu, Wei-Min; Li, Li; Jing, Bao-Qian; Zhao, Yong-Sheng; Wang, Chao-Li; Feng, Li; Xie, Yong-En


    AIM: To investigate the sphingosine 1-phosphate (S1P) receptor expression profile in human esophageal cancer cells and the effects of S1P5 on proliferation and migration of human esophageal cancer cells.

  14. Treatment of esophageal stricture due to lichen planus with intralesional corticosteroid injection. (United States)

    Köksal, Aydin S; Yildiz, Hakan; Odemiş, Bülent; Sengül, Ayşegül


    Herein we presented a male patient with esophageal stricture due to lichen planus successfully treated with repeated injections of intralesional triamcinolone and review the current literature on esophageal lichen planus with special emphasis on its treatment.

  15. Cutaneous amelanotic signet-ring cell malignant melanoma with interspersed myofibroblastic differentiation in a young cat. (United States)

    Hirz, Manuela; Herden, Christiane


    The diagnosis of malignant melanoma can be difficult because these tumors can be amelanotic and may contain diverse variants and divergent differentiations, of which the signet-ring cell subtype is very rare and has only been described in humans, dogs, cats, and a hamster. We describe herein histopathologic and immunohistochemical approaches taken to diagnose a case of signet-ring cell malignant melanoma with myofibroblastic differentiation in a cat. A tumor within the abdominal skin of a 2-year-old cat was composed of signet-ring cells and irregularly interwoven streams of spindle cells. Both neoplastic cell types were periodic-acid-Schiff, Fontana, and Sudan black B negative. Signet-ring cells strongly expressed vimentin and S100 protein. Spindle cells strongly expressed vimentin and smooth muscle actin; some cells expressed S100, moderately neuron-specific enolase, and others variably actin and desmin. A few round cells expressed melan A, and a few plump spindle cells expressed melan A and PNL2, confirming the diagnosis of amelanotic signet-ring cell malignant melanoma with myofibroblastic differentiation in a cat. Differential diagnoses were excluded, including signet-ring cell forms of adenocarcinomas, lymphomas, liposarcomas, leiomyosarcomas, squamous cell carcinomas, basal cell carcinomas, and adnexal tumors.

  16. Environmental Aspects of Domestic Cat Care and Management: Implications for Cat Welfare (United States)

    Stella, Judith L.


    Domestic cats (Felis silvestris catus) are the most commonly kept companion animals in the US with large populations of owned (86 million), free-roaming (70 million), research (13,000), and shelter (2-3 million) cats. Vast numbers of cats are maintained in homes and other facilities each year and are reliant on humans for all of their care. Understanding cat behavior and providing the highest quality environments possible, including positive human-cat interactions, based on research could help improve the outcomes of biomedical research, shelter adoptions, and veterinary care, as well as overall cat welfare. Often, however, cats' needs are inadequately met in homes and some aspects may also not be well met in research colonies and shelters, despite the fact that similar problems are likely to be encountered in all of these environments. This paper provides a brief overview of common welfare challenges associated with indoor housing of domestic cats. Essential considerations for cage confinement are reviewed, along with implications of poor cat coping, such as weakening of the human-animal bond and relinquishment to shelters. The important role that environmental management plays in cat behavior and welfare outcomes is explored along with the need for additional research in key areas.

  17. The CATS Service: An Astrophysical Research Tool

    Directory of Open Access Journals (Sweden)

    O V Verkhodanov


    Full Text Available We describe the current status of CATS (astrophysical CATalogs Support system, a publicly accessible tool maintained at Special Astrophysical Observatory of the Russian Academy of Sciences (SAO RAS ( allowing one to search hundreds of catalogs of astronomical objects discovered all along the electromagnetic spectrum. Our emphasis is mainly on catalogs of radio continuum sources observed from 10 MHz to 245 GHz, and secondly on catalogs of objects such as radio and active stars, X-ray binaries, planetary nebulae, HII regions, supernova remnants, pulsars, nearby and radio galaxies, AGN and quasars. CATS also includes the catalogs from the largest extragalactic surveys with non-radio waves. In 2008 CATS comprised a total of about 109 records from over 400 catalogs in the radio, IR, optical and X-ray windows, including most source catalogs deriving from observations with the Russian radio telescope RATAN-600. CATS offers several search tools through different ways of access, e.g. via Web-interface and e-mail. Since its creation in 1997 CATS has managed about 105requests. Currently CATS is used by external users about 1500 times per day and since its opening to the public in 1997 has received about 4000 requests for its selection and matching tasks.

  18. Smooth ergodic theory for endomorphisms

    CERN Document Server

    Qian, Min; Zhu, Shu


    This volume presents a general smooth ergodic theory for deterministic dynamical systems generated by non-invertible endomorphisms, mainly concerning the relations between entropy, Lyapunov exponents and dimensions. The authors make extensive use of the combination of the inverse limit space technique and the techniques developed to tackle random dynamical systems. The most interesting results in this book are (1) the equivalence between the SRB property and Pesin’s entropy formula; (2) the generalized Ledrappier-Young entropy formula; (3) exact-dimensionality for weakly hyperbolic diffeomorphisms and for expanding maps. The proof of the exact-dimensionality for weakly hyperbolic diffeomorphisms seems more accessible than that of Barreira et al. It also inspires the authors to argue to what extent the famous Eckmann-Ruelle conjecture and many other classical results for diffeomorphisms and for flows hold true. After a careful reading of the book, one can systematically learn the Pesin theory for endomorphis...

  19. Learning Smooth Pattern Transformation Manifolds

    CERN Document Server

    Vural, Elif


    Manifold models provide low-dimensional representations that are useful for processing and analyzing data in a transformation-invariant way. In this paper, we study the problem of learning smooth pattern transformation manifolds from image sets that represent observations of geometrically transformed signals. In order to construct a manifold, we build a representative pattern whose transformations accurately fit various input images. We examine two objectives of the manifold building problem, namely, approximation and classification. For the approximation problem, we propose a greedy method that constructs a representative pattern by selecting analytic atoms from a continuous dictionary manifold. We present a DC (Difference-of-Convex) optimization scheme that is applicable to a wide range of transformation and dictionary models, and demonstrate its application to transformation manifolds generated by rotation, translation and anisotropic scaling of a reference pattern. Then, we generalize this approach to a s...

  20. Resolution of smooth group actions

    CERN Document Server

    Albin, Pierre


    A refined form of the `Folk Theorem' that a smooth action by a compact Lie group can be (canonically) resolved, by iterated blow up, to have unique isotropy type is proved in the context of manifolds with corners. This procedure is shown to capture the simultaneous resolution of all isotropy types in a `resolution structure' consisting of equivariant iterated fibrations of the boundary faces. This structure projects to give a similar resolution structure for the quotient. In particular these results apply to give a canonical resolution of the radial compactification, to a ball, of any finite dimensional representation of a compact Lie group; such resolutions of the normal action of the isotropy groups appear in the boundary fibers in the general case.

  1. Role of robotic-assisted surgery in benign esophageal diseases. (United States)

    Saurabh, Shireesh; Unger, Eric; Grossman, Julie; Couto, Francisco; Singh, Namrata; Lind, David Scott; Panait, Lucian; Castellanos, Andres


    Laparoscopic treatment of benign esophageal conditions is technically complex with several inherent limitations. Robotic-assisted surgery provides technical improvement and helps to overcome some of these limitations. We therefore report a single surgeon's experience in management of benign esophageal diseases by robotic-assisted surgery. Over a period of 8 consecutive years, a retrospective chart review was performed of 105 patients who underwent robotic-assisted surgery for benign esophageal diseases by a single surgeon. Demographic data and outcome measures were studied. The robotic-assisted procedures included 85 Nissen fundoplications with and without mesh repair, 12 Heller myotomies and eight para-esophageal hernia repairs. The mean total operating time was lowest for the Nissen group (94 min) and highest for the para-esophageal group (183 min). Operating time decreased from a mean of 105 min in the first 20 cases to 84 min in the last 20 cases for the Nissen group (P = 0.014). The mean length of stay was 1.3, 1.6, 1.5 and 4.8 days for the groups, respectively. Persistent symptoms of dysphagia/reflux/dysphonia requiring further investigation were seen in nine (8 %) of these patients. Two of these patients required repeat Nissen fundoplication in the mesh group. Our complication rate, total operating time and length of stay for robotic-assisted benign esophageal surgery are comparable to those reported in the literature. When performed by an experienced surgeon, robotic-assisted surgery is safe and effective in the management of benign esophageal diseases.

  2. Esophageal contractions in type 3 achalasia esophagus: simultaneous or peristaltic? (United States)

    Kim, Tae Ho; Patel, Nirali; Ledgerwood-Lee, Melissa; Mittal, Ravinder K


    Absence of peristalsis and impaired relaxation of lower esophageal sphincter are the hallmarks of achalasia esophagus. Based on the pressurization patterns, achalasia has been subdivided into three subtypes. The goal of our study was to evaluate the esophageal contraction pattern and bolus clearance in type 3 achalasia esophagus. High-resolution manometry (HRM) recordings of all patients diagnosed with achalasia esophagus in our center between the years 2011 and 2013 were reviewed. Recordings of 36 patients with type 3 achalasia were analyzed for the characteristics of swallow-induced "simultaneous esophageal contraction." The HRM impedance recordings of 14 additional patients with type 3 achalasia were analyzed for bolus clearance from the impedance recording. Finally, the HRM impedance along with intraluminal ultrasound imaging was conducted in six patients to further characterize the simultaneous esophageal contractions. Among 187 achalasia patients, 30 were type 1, 121 type 2, and 36 type 3. A total of 434 swallows evaluated in type 3 achalasia patients revealed that 95% of the swallow-induced contractions met criteria for simultaneous esophageal contraction, based on the onset of contraction. Interestingly, the peak and termination of the majority of simultaneous esophageal contractions were sequential. The HRM impedance revealed that 94% of the "simultaneous contractions" were associated with complete bolus clearance. Ultrasound image analysis revealed that baseline muscle thickness of patients in type 3 achalasia is larger than normal but the pattern of axial shortening is similar to that in normal subjects. The majority of esophageal contractions in type 3 achalasia are not true simultaneous contractions because the peak and termination of contraction are sequential and they are associated with complete bolus clearance.

  3. VIDEOFLUOROSCOPIC SWALLOWING STUDY: esophageal alterations in patients with dysphagia

    Directory of Open Access Journals (Sweden)

    Betina SCHEEREN


    Full Text Available Context Videofluoroscopic swallowing study is a dynamic exam and allows the evaluation of the complete swallowing process. However, most published studies have only reported alterations in the oropharynx and pharyngoesophageal transition, leaving the analysis of the esophagus as a secondary goal. Objectives The goal of this study was to investigate the prevalence of alterations in the esophageal phase thorough videofluoroscopic swallowing study in patients with dysphagia. Methods Consecutive patients with dysphagia who underwent videofluoroscopic swallowing study including esophageal analysis between May 2010 and May 2012 had their exams retrospectively reviewed. Patients were classified into two groups: Group I - without a pre-established etiological diagnosis and Group II - with neurological disease. During the exam, the patients ingested three different consistencies of food (liquid, pasty and solid contrasted with barium sulfate and 19 items were analyzed according to a protocol. The esophageal phase was considered abnormal when one of the evaluated items was compromised. Results Three hundred and thirty-three (n = 333 consecutive patients were studied - 213 (64% in Group I and 120 (36% in Group II. Esophageal alterations were found in 104 (31% patients, with a higher prevalence in Group I (36.2%, especially on the items esophageal clearance (16.9% and tertiary contractions (16.4%. It was observed that 12% of individuals in Group I only presented alterations on the esophageal phase. Conclusion Evaluation of the esophageal phase of swallowing during videofluoroscopic swallowing study detects abnormalities in patients with cervical dysphagia, especially in the group without pre-established etiological diagnosis.

  4. Nondestructive measurement of esophageal biaxial mechanical properties utilizing sonometry (United States)

    Aho, Johnathon M.; Qiang, Bo; Wigle, Dennis A.; Tschumperlin, Daniel J.; Urban, Matthew W.


    Malignant esophageal pathology typically requires resection of the esophagus and reconstruction to restore foregut continuity. Reconstruction options are limited and morbid. The esophagus represents a useful target for tissue engineering strategies based on relative simplicity in comparison to other organs. The ideal tissue engineered conduit would have sufficient and ideally matched mechanical tolerances to native esophageal tissue. Current methods for mechanical testing of esophageal tissues both in vivo and ex vivo are typically destructive, alter tissue conformation, ignore anisotropy, or are not able to be performed in fluid media. The aim of this study was to investigate biomechanical properties of swine esophageal tissues through nondestructive testing utilizing sonometry ex vivo. This method allows for biomechanical determination of tissue properties, particularly longitudinal and circumferential moduli and strain energy functions. The relative contribution of mucosal-submucosal layers and muscular layers are compared to composite esophagi. Swine thoracic esophageal tissues (n  =  15) were tested by pressure loading using a continuous pressure pump system to generate stress. Preconditioning of tissue was performed by pressure loading with the pump system and pre-straining the tissue to in vivo length before data was recorded. Sonometry using piezocrystals was utilized to determine longitudinal and circumferential strain on five composite esophagi. Similarly, five mucosa-submucosal and five muscular layers from thoracic esophagi were tested independently. This work on esophageal tissues is consistent with reported uniaxial and biaxial mechanical testing and reported results using strain energy theory and also provides high resolution displacements, preserves native architectural structure and allows assessment of biomechanical properties in fluid media. This method may be of use to characterize mechanical properties of tissue engineered esophageal

  5. Bacterial biota in reflux esophagitis and Barrett's esophagus

    Institute of Scientific and Technical Information of China (English)

    Zhiheng Pei; Liying Yang; Richard M Peek; Jr Steven M Levine; David T Pride; Martin J Blaser


    AIM: To identify the bacterial flora in conditions such as Barrett's esophagus and reflux esophagitis to determine if they are similar to normal esophageal flora.METHODS: Using broad-range 16S rDNA PCR,esophageal biopsies were examined from 24 patients [9with normal esophageal mucosa, 12 with gastroesophageal reflux disease (GERD), and 3 with Barrett's esophagus].Two separate broad-range PCR reactions were performed for each patient, and the resulting products were cloned.In one patient with Barrett's esophagus, g9 PCR clones were analyzed.RESULTS: Two separate clones were recovered from each patient (total = 48), representing 24 different species, with 14 species homologous to known bacteria,5 homologous to unidentified bacteria, and 5 were not homologous (<97% identity) to any known bacterial 16S rDNA sequences. Seventeen species were found in the reflux esophagitis patients, 5 in the Barrett's esophagus patients, and 10 in normal esophagus patients.Further analysis concentrating on a single biopsy from an individual with Barrett's esophagus revealed the presence of 21. distinct bacterial species. Members of four phyla were represented, including Bacteroidetes,Firmicutes, Proteobacteria, and Actinobacteria.Microscopic examination of each biopsy demonstrated bacteria in intimate association with the distal esophageal epithelium, suggesting that the presence of these bacteria is not transitory.CONCLUSION: These findings provide evidence for a complex, residential bacterial population in esophageal reflux-related disorders. While much of this biota is present in the normal esophagus, more detailed comparisons may help identify potential disease associations.

  6. Exocrine Pancreas in Cats With Diabetes Mellitus. (United States)

    Zini, E; Ferro, S; Lunardi, F; Zanetti, R; Heller, R S; Coppola, L M; Guscetti, F; Osto, M; Lutz, T A; Cavicchioli, L; Reusch, C E


    Pancreatitis has been described in cats with diabetes mellitus, although the number of studies currently available is very limited. In addition, ketoacidosis has been hypothesized to be associated with pancreatitis in diabetic cats. The aims of the present study were to investigate whether diabetic cats have pancreatitis and to determine if pancreatitis is more frequent with ketoacidosis. Samples of pancreas were collected postmortem from 37 diabetic cats, including 15 with ketoacidosis, and 20 control cats matched for age, sex, breed, and body weight. Sections were stained with hematoxylin and eosin, double-labeled for insulin/CD3, insulin/CD20, insulin/myeloperoxidase, insulin/PCNA, and glucagon/Ki67, and single-labeled for Iba1. A previously proposed semiquantitative score was used to characterize pancreatitis, along with counts of inflammatory cells. Scores of pancreatitis and the number of neutrophils, macrophages, and lymphocytes in the exocrine pancreas did not differ between diabetic and control cats or between diabetic cats with and without ketoacidosis. Of note, PCNA-positive acinar cells were increased (P = .002) in diabetic cats, particularly near islets (P < .001). Ki67-positive acinar cells were increased only near islets (P = .038). Ketoacidosis was not linked to proliferation. The results suggest that histopathologic evidence of pancreatitis may not be more frequent in diabetic cats and that ketoacidosis may not be associated with it at the time of death. Augmented PCNA-positive acinar cells might indicate increased proliferation due to chronic pancreatitis. The reason behind the prevalent proliferation of acinar cells surrounding pancreatic islets deserves further investigation.

  7. Endocrine Pancreas in Cats With Diabetes Mellitus. (United States)

    Zini, E; Lunardi, F; Zanetti, R; Heller, R S; Coppola, L M; Ferro, S; Guscetti, F; Osto, M; Lutz, T A; Reusch, C E; Cavicchioli, L


    Pancreatic amyloidosis and loss of α and β cells have been shown to occur in cats with diabetes mellitus, although the number of studies currently available is very limited. Furthermore, it is not known whether pancreatic islet inflammation is a common feature. The aims of the present study were to characterize islet lesions and to investigate whether diabetic cats have inflammation of the pancreatic islets. Samples of pancreas were collected postmortem from 37 diabetic and 20 control cats matched for age, sex, breed, and body weight. Histologic sections were stained with hematoxylin and eosin and Congo red; double labeled for insulin/CD3, insulin/CD20, insulin/myeloperoxidase, insulin/proliferating cell nuclear antigen, and glucagon/Ki67; and single labeled for amylin and Iba1. Mean insulin-positive cross-sectional area was approximately 65% lower in diabetic than control cats (P = .009), while that of amylin and glucagon was similar. Surprisingly, amyloid deposition was similar between groups (P = .408). Proliferation of insulin- and glucagon-positive cells and the number of neutrophils, macrophages, and T (CD3) and B (CD20) lymphocytes in the islets did not differ. The presence of T and B lymphocytes combined tended to be more frequent in diabetic cats (n = 8 of 37; 21.6%) than control cats (n = 1 of 20; 5.0%). The results confirm previous observations that loss of β cells but not α cells occurs in diabetic cats. Islet amyloidosis was present in diabetic cats but was not greater than in controls. A subset of diabetic cats had lymphocytic infiltration of the islets, which might be associated with β-cell loss.

  8. Preferential Secretion of Thymic Stromal Lymphopoietin (TSLP by Terminally Differentiated Esophageal Epithelial Cells: Relevance to Eosinophilic Esophagitis (EoE.

    Directory of Open Access Journals (Sweden)

    Prasanna M Chandramouleeswaran

    Full Text Available Eosinophilic esophagitis (EoE is a chronic Th2 and food antigen-mediated disease characterized by esophageal eosinophilic infiltration. Thymic stromal lymphopoetin (TSLP, an epithelial derived cytokine which bridges innate and Th2-type adaptive immune responses in other allergic conditions, is overexpressed in esophageal biopsies of EoE subjects. However, the triggers of TSLP expression in the esophageal epithelium are unknown. The objective of the current study was to characterize TSLP expression in human esophageal epithelium in EoE in vivo and to determine the role of food antigens upon epithelial TSLP expression in vitro. Using immunohistochemistry (IHC, we localized TSLP in esophageal biopsies of active EoE (≥15 eos/hpf, inactive EoE (<15 eos/hpf and non-EoE control subjects, and found that TSLP expression was restricted to the differentiated suprabasal layer of the epithelium in actively inflamed EoE biopsies. Consistent with these results in vivo, inducible TSLP protein secretion was higher in CaCl2 differentiated telomerase-immortalized esophageal epithelial cells (EPC2-hTERT compared to undifferentiated cells of the basal phenotype, following stimulation with the TLR3 ligand poly(I:C. To determine whether food antigens could directly induce epithelial TSLP secretion, differentiated and undifferentiated primary esophageal epithelial cells from EoE and non-EoE subjects were challenged with food antigens clinically relevant to EoE: Chicken egg ovalbumin (OVA, wheat, and milk proteins beta-lactoglobulin (blg and beta-casein. Food antigens failed to induce TSLP secretion by undifferentiated cells; in contrast, only OVA induced TSLP secretion in differentiated epithelial cells from both EoE and control cell lines, an effect abolished by budesonide and NF-κb inhibition. Together, our study shows that specific food antigens can trigger innate immune mediated esophageal TSLP secretion, suggesting that esophageal epithelial cells at the

  9. Aspergillus species cystitis in a cat. (United States)

    Adamama-Moraitou, K K; Paitaki, C G; Rallis, T S; Tontis, D


    A Persian male cat with a history of lower urinary tract disease was presented because of polydipsia, polyuria, constipation and nasal discharge. Ten weeks before admission, the cat had been treated for lower urinary tract disease by catheterisation and flushing of the bladder. The animal was thin, dehydrated, anaemic and azotaemic. Urine culture revealed Aspergillus species cystitis. Antibodies against Aspergillus nidulans were identified in serum. Fluconazole was administered orally (7.5 mg/kg, q 12 h) for 10 consecutive weeks. The azotaemia was resolved, the kidney concentrating ability was recovered and the cat has remained healthy without similar problems.

  10. Esophageal Cancer in Canada: Trends according to Morphology and Anatomical Location

    Directory of Open Access Journals (Sweden)

    Michael C Otterstatter


    Full Text Available BACKGROUND: Esophageal adenocarcinoma has one of the fastest rising incidence rates and one of the lowest survival rates of any cancer type in the Western world. However, in many countries, trends in esophageal cancer differ according to tumour morphology and anatomical location. In Canada, incidence and survival trends for esophageal cancer subtypes are poorly known.

  11. Smooth halos in the cosmic web

    CERN Document Server

    Gaite, Jose


    Dark matter halos can be defined as smooth distributions of dark matter placed in a non-smooth cosmic web structure. This definition of halos demands a precise definition of smoothness and a characterization of the manner in which the transition from smooth halos to the cosmic web takes place. We introduce entropic measures of smoothness, related to measures of equality previously used in economy and with the advantage of being connected with standard methods of multifractal analysis already used for characterizing the cosmic web structure in $N$-body simulations. These entropic measures provide us with a quantitative description of the transition from the small scales portrayed as a distribution of halos to the larger scales portrayed as a cosmic web and, therefore, allow us to assign definite sizes to halos. However, these "smoothness sizes" have no direct relation to the virial radii.

  12. Membrana-covered Esophageal Self-expanding Metallic Stent for Malignant Esophageal Stricture and Tracheoesophageal Fistula%自膨式食管金属加膜支架治疗恶性食管狭窄和气管食管瘘

    Institute of Scientific and Technical Information of China (English)

    徐怀阳; 钟竑; 陆善伟; 赵华


    目的:探讨自膨式食管金属加膜支架治疗恶性食管狭窄和气管食管瘘的疗效和并发症.方法:2004年1月至2009年6月对63例恶性食管狭窄和气管食管瘘患者实施食管支架置入,男45例,女28例;年龄45~81岁,平均69.3岁.支架为MTN型形状记忆钛镍合金食管加膜支架(南京微创医学科技有限公司生产),支架植入均在DSA监视下操作完成.结果:63例均一次性放置成功,即刻口服造影通过顺利剂.结论:自膨式食管金属加膜支架是治疗恶性食管狭窄和气管食管瘘的有效方法.%Objective: To explore the effect and complication of membrana-covered esophageal self-expanding metallic stent in the treatment of malignant esophageal stricture and tracheoesophageal fistula.Methods: From January 2004 to June 2009, 63 patients(45 males and 28 females), aged from 45 to 81 years old with an average age of 69.3, suffering from malignant esophageal stricture or tracheoesophageal fistula were treated by esophageal stent deployment under DSA monitoring.The esophageal stent was a kind of MTN typed shape memory Titanium stent covered with membrane (Made in Nanjing minimally invasive medicial Technology Co.,Ltd).Results: Stent implantation was successful in all the 63 patients during their first deployment.Immediately, oral contrast material could be swallowed through the esophagus smoothly.Concultion: Membrana-covered esophageal self-expanding metallic stent implantation is an effective and safe method for the treatment of malignant esophageal stricture and tracheoesophageal fistula.

  13. Airway Epithelium Stimulates Smooth Muscle Proliferation


    Malavia, Nikita K.; Raub, Christopher B.; Mahon, Sari B.; Brenner, Matthew; Reynold A Panettieri; George, Steven C.


    Communication between the airway epithelium and stroma is evident during embryogenesis, and both epithelial shedding and increased smooth muscle proliferation are features of airway remodeling. Hence, we hypothesized that after injury the airway epithelium could modulate airway smooth muscle proliferation. Fully differentiated primary normal human bronchial epithelial (NHBE) cells at an air–liquid interface were co-cultured with serum-deprived normal primary human airway smooth muscle cells (...

  14. Smooth Crossed Products of Rieffel's Deformations (United States)

    Neshveyev, Sergey


    Assume is a Fréchet algebra equipped with a smooth isometric action of a vector group V, and consider Rieffel's deformation of . We construct an explicit isomorphism between the smooth crossed products and . When combined with the Elliott-Natsume-Nest isomorphism, this immediately implies that the periodic cyclic cohomology is invariant under deformation. Specializing to the case of smooth subalgebras of C*-algebras, we also get a simple proof of equivalence of Rieffel's and Kasprzak's approaches to deformation.

  15. Smooth GERBS, orthogonal systems and energy minimization (United States)

    Dechevsky, Lubomir T.; Zanaty, Peter


    New results are obtained in three mutually related directions of the rapidly developing theory of generalized expo-rational B-splines (GERBS) [7, 6]: closed-form computability of C∞-smooth GERBS in terms of elementary and special functions, Hermite interpolation and least-squares best approximation via smooth GERBS, energy minimizing properties of smooth GERBS similar to those of the classical cubic polynomial B-splines.

  16. Properties of the extremal infinite smooth words

    Directory of Open Access Journals (Sweden)

    Srecko Brlek


    Full Text Available Smooth words are connected to the Kolakoski sequence. We construct the maximal and the minimal infinite smooth words, with respect to the lexicographical order. The naive algorithm generating them is improved by using a reduction of the De Bruijn graph of their factors. We also study their Lyndon factorizations. Finally, we show that the minimal smooth word over the alphabet {1,3} belongs to the orbit of the Fibonacci word.

  17. A case of plummer-vinson syndrome showing rapid improvement of Dysphagia and esophageal web after two weeks of iron therapy. (United States)

    Tahara, Tomomitsu; Shibata, Tomoyuki; Okubo, Masaaki; Yoshioka, Daisuke; Ishizuka, Takamitsu; Sumi, Kazuya; Kawamura, Tomohiko; Nagasaka, Mitsuo; Nakagawa, Yoshihito; Nakamura, Masakatsu; Arisawa, Tomiyasu; Ohmiya, Naoki; Hirata, Ichiro


    Plummer-Vinson syndrome (PVS) is a rare entity characterized by upper esophageal webs and iron deficiency anemia. We report a case of PVS whose esophageal web was rapidly improved by iron therapy. A 77-year-old woman was admitted to our hospital with complaints of dysphagia, vomiting, shortness of breath and weight loss for 1 month. Physical examination revealed conjunctival pallor, koilonychia, angular cheilitis and smooth tongue, and laboratory findings were consistent with microcytic hypochromic anemia with iron deficiency. Gastrointestinal endoscopy and barium-swallow esophagography detected a web that prevented passage of the endoscope into the upper portion of the esophagus. The patient received oral iron therapy daily; the hemoglobin concentration rose to 8.9 g/dl and the complaints of dysphagia were dramatically improved after 2 weeks, with improvement of luminal stenosis confirmed by gastrointestinal endoscopy and barium-swallow esophagography. The PVS described in this report had a distinct clinical course, showing very rapid improvement of dysphagia and esophageal web after 2 weeks of oral iron therapy.

  18. A Case of Plummer-Vinson Syndrome Showing Rapid Improvement of Dysphagia and Esophageal Web after Two Weeks of Iron Therapy

    Directory of Open Access Journals (Sweden)

    Tomomitsu Tahara


    Full Text Available Plummer-Vinson syndrome (PVS is a rare entity characterized by upper esophageal webs and iron deficiency anemia. We report a case of PVS whose esophageal web was rapidly improved by iron therapy. A 77-year-old woman was admitted to our hospital with complaints of dysphagia, vomiting, shortness of breath and weight loss for 1 month. Physical examination revealed conjunctival pallor, koilonychia, angular cheilitis and smooth tongue, and laboratory findings were consistent with microcytic hypochromic anemia with iron deficiency. Gastrointestinal endoscopy and barium-swallow esophagography detected a web that prevented passage of the endoscope into the upper portion of the esophagus. The patient received oral iron therapy daily; the hemoglobin concentration rose to 8.9 g/dl and the complaints of dysphagia were dramatically improved after 2 weeks, with improvement of luminal stenosis confirmed by gastrointestinal endoscopy and barium-swallow esophagography. The PVS described in this report had a distinct clinical course, showing very rapid improvement of dysphagia and esophageal web after 2 weeks of oral iron therapy.

  19. Voxel based statistical analysis method for microPET studies to assess the cerebral glucose metabolism in cat deafness model: comparison to ROI based method

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Su; Lee, Jae Sung; Park, Min Hyun; Lee, Jong Jin; Kang, Hye Jin; Lee, Hyo Jeong; Oh, Seung Ha; Kim, Chong Sun; Jung, June Key; Lee, Myung Chul; Lee, Dong Soo [Seoul National University College of Medicine, Seoul (Korea, Republic of); Lim, Sang Moo [KIRAMS, Seoul (Korea, Republic of)


    Imaging research on the brain of sensory-deprived cats using small animal PET scanner has gained interest since the abundant information about the sensory system of ths animal is available and close examination of the brain is possible due to larger size of its brain than mouse or rat. In this study, we have established the procedures for 3D voxel-based statistical analysis (SPM) of FDG PET image of cat brain, and confirmed using ROI based-method. FDG PET scans of 4 normal and 4 deaf cats were acquired for 30 minutes using microPET R4 scanner. Only the brain cortices were extracted using a masking and threshold method to facilitate spatial normalization. After spatial normalization and smoothing, 3D voxel-wise and ROI based t-test were performed to identify the regions with significant different FDG uptake between the normal and deaf cats. In ROI analysis, 26 ROIs were drawn on both hemispheres, and regional mean pixel value in each ROI was normalized to the global mean of the brain. Cat brains were spatially normalized well onto the target brain due to the removal of background activity. When cerebral glucose metabolism of deaf cats were compared to the normal controls after removing the effects of the global count, the glucose metabolism in the auditory cortex, head of caudate nucleus, and thalamus in both hemispheres of the deaf cats was significantly lower than that of the controls (P<0.01). No area showed a significantly increased metabolism in the deaf cats even in higher significance level (P<0.05). ROI analysis also showed significant reduction of glucose metabolism in the same region. This study established and confirmed a method for voxel-based analysis of animal PET data of cat brain, which showed high localization accuracy and specificity and was useful for examining the cerebral glucose metabolism in a cat cortical deafness model.

  20. Salinomycin-induced polyneuropathy in cats: Morphologic and epidemiologic data

    NARCIS (Netherlands)

    Linde-Sipman, J.S. van der; Inch, T.S.G.A.M. van den; Nes, J.J. van; Verhagen, H.; Kersten, J.G.T.M.; Beynen, A.C.; Plekkringa, R.


    In April 1996, an outbreak of toxic polyneuropathy in cats occurred in the Netherlands. All cats had been fed one of two brands of dry cat food from one manufacturer. Chemical analyses of these foods, stomach contents, and liver and kidney of affected cats revealed contamination with the ionophor sa

  1. Smoothing techniques for macromolecular global optimization

    Energy Technology Data Exchange (ETDEWEB)

    More, J.J.; Wu, Zhijun


    We study global optimization problems that arise in macromolecular modeling, and the solution of these problems via continuation and smoothing. Our results unify and extend the theory associated with the use of the Gaussian transform for smoothing. We show that the, Gaussian transform can be viewed as a special case of a generalized transform and that these generalized transforms share many of the properties of the Gaussian transform. We also show that the smoothing behavior of the generalized transform can be studied in terms of the Fourier transform and that these results indicate that the Gaussian transform has superior smoothing properties.

  2. Epidemiology of esophageal cancer in Japan and China. (United States)

    Lin, Yingsong; Totsuka, Yukari; He, Yutong; Kikuchi, Shogo; Qiao, Youlin; Ueda, Junko; Wei, Wenqiang; Inoue, Manami; Tanaka, Hideo


    In preparation for a collaborative multidisciplinary study of the pathogenesis of esophageal cancer, the authors reviewed the published literature to identify similarities and differences between Japan and China in esophageal cancer epidemiology. Esophageal squamous cell carcinoma (ESCC) is the predominant histologic type, while the incidence of esophageal adenocarcinoma remains extremely low in both countries. Numerous epidemiologic studies in both countries show that alcohol consumption and cigarette smoking are contributing risk factors for ESCC. There are differences, however, in many aspects of esophageal cancer between Japan and China, including cancer burden, patterns of incidence and mortality, sex ratio of mortality, risk factor profiles, and genetic variants. Overall incidence and mortality rates are higher in China than in Japan, and variation in mortality and incidence patterns is greater in China than in Japan. During the study period (1987-2000), the decline in age-adjusted mortality rates was more apparent in China than in Japan. Risk factor profiles differed between high- and low-incidence areas within China, but not in Japan. The association of smoking and drinking with ESCC risk appears to be weaker in China than in Japan. Genome-wide association studies in China showed that variants in several chromosome regions conferred increased risk, but only genetic variants in alcohol-metabolizing genes were significantly associated with ESCC risk in Japan. A well-designed multidisciplinary epidemiologic study is needed to examine the role of diet and eating habits in ESCC risk.

  3. Eosinophilic esophagitis: A newly established cause of dysphagia

    Institute of Scientific and Technical Information of China (English)

    Brian M Yan; Eldon A Shaffer


    Eosinophilic esophagitis has rapidly become a recognized entity causing dysphagia in young adults. This review summarizes the current knowledge of eosinophilic esophagitis including the epidemiology, clinical presentation, diagnostic criteria, pathophysiology, treatment,and prognosis. An extensive search of PubMed/Medline (1966-December 2005) for available English literature in humans for eosinophilic esophagitis was completed. Appropriate articles listed in the bibliographies were also attained. The estimated incidence is 43/105 in children and 2.5/105 in adults. Clinically, patients have a long history of intermittent solid food dysphagia or food impaction. Some have a history of atopy. Subtle endoscopic features may be easily overlooked, including a "feline"or corrugated esophagus with fine rings, a diffusely narrowed esophagus that may have proximal strictures, the presence of linear furrows, adherent white plaques, or a friable (crepe paper) mucosa, prone to tearing with minimai contact. Although no pathologic consensus has been established, a histologic diagnosis is critical. The accepted criteria are a dense eosinophilic infiltrate (>20/high power field) within the superficial esophageal mucosa. In contrast, the esophagitis associated with acid reflux disease can also possess eosinophils but they are fewer in number. Once the diagnosis is established, treatment options may include specific food avoidance, topical corticosteroids, systemic corticosteroids, leukotriene inhibitors,or biologic treatment. The long-term prognosis of EE is uncertain; however available data suggests a benign,albeit inconvenient, course. With increasing recognition,this entity is taking its place as an established cause of solid food dysphagia.

  4. Eosinophilic esophagitis: a newly established cause of dysphagia. (United States)

    Yan, Brian-M; Shaffer, Eldon-A


    Eosinophilic esophagitis has rapidly become a recognized entity causing dysphagia in young adults. This review summarizes the current knowledge of eosinophilic esophagitis including the epidemiology, clinical presentation, diagnostic criteria, pathophysiology, treatment, and prognosis. An extensive search of PubMed/Medline (1966-December 2005) for available English literature in humans for eosinophilic esophagitis was completed. Appropriate articles listed in the bibliographies were also attained. The estimated incidence is 43/10(5) in children and 2.5/10(5) in adults. Clinically, patients have a long history of intermittent solid food dysphagia or food impaction. Some have a history of atopy. Subtle endoscopic features may be easily overlooked, including a "feline" or corrugated esophagus with fine rings, a diffusely narrowed esophagus that may have proximal strictures, the presence of linear furrows, adherent white plaques, or a friable (crepe paper) mucosa, prone to tearing with minimal contact. Although no pathologic consensus has been established, a histologic diagnosis is critical. The accepted criteria are a dense eosinophilic infiltrate (>20/high power field) within the superficial esophageal mucosa. In contrast, the esophagitis associated with acid reflux disease can also possess eosinophils but they are fewer in number. Once the diagnosis is established, treatment options may include specific food avoidance, topical corticosteroids, systemic corticosteroids, leukotriene inhibitors, or biologic treatment. The long-term prognosis of EE is uncertain; however available data suggests a benign, albeit inconvenient, course. With increasing recognition, this entity is taking its place as an established cause of solid food dysphagia.

  5. Cervical cellulitis and mediastinitis following esophageal perforation: A case report

    Institute of Scientific and Technical Information of China (English)

    Christian A Righini; Basilide Z Tea; Emile Reyt; Karim A Chahine


    Chicken bone is one of the most frequent foreign bodies (FB) associated with upper esophageal perforation.Upper digestive tract penetrating FB may lead to life threatening complications and requires prompt management.We present the case of a 52-year-old man who sustained an upper esophageal perforation associated with cervical cellulitis and mediastinitis.Following CT-scan evidence of FB penetrating the esophagus,the impacted FB was successfully extracted under rigid esophagoscopy.Direct suture was required to close the esophageal perforation.Cervical and mediastinal drainage were made immediately.Nasogastric tube decompression,broad-spectrum intravenous antibiotics,and parenteral hyperalimentation were administered for 10 d postoperatively.An esophagogram at d 10 revealed no leak at the repair site,and oral alimentation was successfully reinstituted.Conclusion:Rigid endoscope management of FB esophageal penetration is a simple,safe and effective procedure.Primary esophageal repair with drainage of all affected compartments are necessary to avoid life-threatening complications.

  6. Esophageal aerodynamics in an idealized experimental model of tracheoesophageal speech (United States)

    Erath, Byron D.; Hemsing, Frank S.


    Flow behavior is investigated in the esophageal tract in an idealized experimental model of tracheoesophageal speech. The tracheoesophageal prosthesis is idealized as a first-order approximation using a straight, constant diameter tube. The flow is scaled according to Reynolds, Strouhal, and Euler numbers to ensure dynamic similarity. Flow pulsatility is produced by a driven orifice that approximates the kinematics of the pharyngoesophageal segment during tracheoesophageal speech. Particle image velocimetry data are acquired in three orthogonal planes as the flow exits the model prosthesis and enters the esophageal tract. Contrary to prior investigations performed in steady flow with the prosthesis oriented in-line with the flow direction, the fluid dynamics are shown to be highly unsteady, suggesting that the esophageal pressure field will be similarly complex. A large vortex ring is formed at the inception of each phonatory cycle, followed by the formation of a persistent jet. This vortex ring appears to remain throughout the entire cycle due to the continued production of vorticity resulting from entrainment between the prosthesis jet and the curved esophageal walls. Mean flow in the axial direction of the esophagus produces significant stretching of the vortex throughout the phonatory cycle. The stagnation point created by the jet impinging on the esophageal wall varies throughout the cycle due to fluctuations in the jet trajectory, which most likely arises due to flow separation within the model prosthesis. Applications to tracheoesophageal speech, including shortcomings of the model and proposed future plans, are discussed.

  7. The spectrum of benign esophageal lesions: imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Kyung Mi; Lee, Kyung Soo; Lee, Soon Jin; Kim, Eun A; Kim, Tae Sung; Han, Dae Hee; Shim, Young Mog [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)


    Benign esophageal lesions occur in various diseases. Barium studies are useful for the evaluation of mucosal surface lesions but provide little information about the extramucosal extent of disease. Computed tomography and magnetic resonance imaging, on the other hand, permit the assessment of wall thickness, mediastinal involvement, adjacent lymphadenopathy, and distant spread. In diseases such as fibrovascular polyps, duplication cysts, scleroderma, trauma, caustic esophagitis, hiatal hernia, esophageal diverticulum, achalasia, and paraesophageal varices, the findings of imaging studies are specific, obviating the need for further invasive diagnostic work-up. The advent of helical computed tomography and its volume data set allows the acquisition of multiplanar images, and magnetic resonance imaging is useful both for this and for tissue characterization. Thus, multiplanar cross-sectional imaging further extends the role of imaging modalities to the evaluation of benign esophageal lesions. Through an awareness of the multiplanar cross-sectional appearances of various benign esophageal lesions, the radiologist can play an important role in the detection, diagnosis, further diagnostic planning, and treatment of the diseases in which they occur.

  8. [Endoscopic and histopathological studies of experimental esophageal cancer in beagles]. (United States)

    Takeshita, K; Sunagawa, M; Nakajima, A; Ochi, K; Habu, H; Hoshi, K


    In order to obtain a reliable experimental model simulating human esophageal cancer, endoscopic and histopathological studies were undertaken in the esophageal cancer produced in the beagle dog. Thirty-seven dogs had been given a solution of N-Ethyl-N'-nitro-N-nitrosoguanidine (ENNG) at a concentration of 150 micrograms/ml for 3-9 months. Follow-up studies included serial endoscopy and biopsy, and almost all animals were eventually sacrificed for histological examination. The results were as follows: Squamous cell carcinoma was observed in 5 out of 22 female dogs, while none in male dogs at all. For the induction of squamous cell carcinoma in the esophagus, administration in the condition of 150 micrograms/ml (75mg/day) for 6-9 months was most suitable. Almost all of esophageal lesions were protruding and well-differentiated squamous cell carcinoma with invasion of the submucosa. The stages of hyperplasia, dysplasia and squamous cell carcinoma in the esophagus were chronologically followed. Carcinoma had been observed in the stomach about 4 months prior to the appearance of esophageal carcinoma. This experimental model was proved to be useful for studies on histogenesis of human esophageal cancer both light and electron microscopically.

  9. Aspirin and esophageal squamous cell carcinoma: bedside to bench

    Institute of Scientific and Technical Information of China (English)

    Li Peng; Cheng Rui; Zhang Shutian


    Objective To review the advances of studies on clinical results of aspirin's chemopreventive effect against esophageal squamous cell carcinoma (ESCC) and evidences for mechanisms of the antitumoural effects of aspirin in experimental research.Data sources A comprehensive search of the PubMed literatures without restriction on the publication date was carried out using keywords such as aspirin and esophageal cancer.Study selection Articles associated with aspirin and esophageal cancer are analyzed.Results This review focuses on the current evidence for use of aspirin as a chemopreventive agent in ESCC.Aspirin is the most widely used among all nonsteroidal anti-inflammatory drugs (NSAIDs),which is cheap and acceptable to patients.Several observational results provide the further investigation of prevention and therapy of aspirin or similar drugs in esophageal cancer.Data from case control studies,cohort studies and randomized controlled trials (RCTs) also give some support of a beneficial role of aspirin on ESCC.Experimental data suggest that aspirin may prevent carcinogenesis of ESCC by favorably affecting proliferation,apoptosis,or other as yet unidentified growth-regulating processes.But the mechanism by which aspirin influence on esophageal squamous cell carcinoma needs further investigation.Conclusion A wealth of evidences ranging from clinical data to experimental results are building to suggest that aspirin has significant effects in reducing both the incidence and mortality of ESCC.

  10. Transabdominal sonographic findings of the distal esophagus in esophageal varices

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Yong Seok; Kim, Jun Young; Ko, Myoung Kwan; Kim, Dong Hyun; Byun, Ju Nam; Kim, Young Suk; Kim, Young Cheol; Oh, Jae Hee [Chosun University College of Medicine, Kwangju (Korea, Republic of)


    To assess transabdominal sonographic findings of the distal esophagus in the patients with esophageal varices. Transabdominal sonography was performed on two groups which considered of 42 normal subjects (25 males and 17 female, age: 20-65) and 45 cirrhotic patients (34 males and 11 females, age: 30-70) with esophageal varices. The thickness of the anterior wall of the distal esophagus (AWDE) was measured and the shape of its surface was observed. Then these findings were compared between the two groups. The mean thickness of the AWDE in the 42 normal subjects was 2.4 {+-} 0.62 mm (2-4 mm), while that of the 45 cirrhotic patients was 6.0 {+-} 1.27 mm (3-10 mm). Whereas the irregular surface of the AWDE was observed in 4 of the 42 normal subjects (9.5%), it was seen in 30 of the 45 cirrhotic patients with esophageal varices (66.7%). When as AWDE having more than 5 mm in thickness was used as a diagnostic criterion for the esophageal varices, the sensitivity, specificity, and accuracy was 89%, 100% and 94% respectively. When an irregular wall surface was used as a diagnostic standard, the results were 67%, 90% and 70% respectively. In the cirrhotic patients, esophageal varix can be presumed with reasons of the thickening AWDE (more than 5 mm) and irregularity of its surface in the transabdominal sonography.

  11. Silane surface modification for improved bioadhesion of esophageal stents (United States)

    Karakoy, Mert; Gultepe, Evin; Pandey, Shivendra; Khashab, Mouen A.; Gracias, David H.


    Stent migration occurs in 10-40% of patients who undergo placement of esophageal stents, with higher migration rates seen in those treated for benign esophageal disorders. This remains a major drawback of esophageal stent therapy. In this paper, we propose a new surface modification method to increase the adhesion between self-expandable metallic stents (SEMS) and tissue while preserving their removability. Taking advantage of the well-known affinity between epoxide and amine terminated silane coupling agents with amine and carboxyl groups that are abundant in proteins and related molecules in the human body; we modified the surfaces of silicone coated esophageal SEMS with these adhesive self-assembled monolayers (SAMs). We utilized vapor phase silanization to modify the surfaces of different substrates including PDMS strips and SEMS, and measured the force required to slide these substrates on a tissue piece. Our results suggest that surface modification of esophageal SEMS via covalent attachment of protein-binding coupling agents improves adhesion to tissue and could offer a solution to reduce SEMS migration while preserving their removability.

  12. SWMM-CAT User’s Guide (United States)

    The Storm Water Management Model Climate Adjustment Tool (SWMM-CAT) is a simple to use software utility that allows future climate change projections to be incorporated into the Storm Water Management Model (SWMM).

  13. Notoedres cati in cats and its management. (United States)

    Sivajothi, S; Sudhakara Reddy, B; Rayulu, V C; Sreedevi, C


    Notoedres cati was observed in two domestic cats. Cats exhibited crust formation, hyperkeratosis, alopecia and intense pruritus. Distribution of lesions observed at the ear margins, face, and legs. Owners also had intense pruritus over the hands, small erythematic crusted papules on the wrists and both the legs. Laboratory examination of skin scrapings from the cat revealed the presence of ova, adult mites of N. cati. The infected cats were treated with weekly twice oral administration of ivermectin at 200 μg/kg body weight, oral administration of 2 ml of multi-vitamin and mineral syrup daily. Improvement was noticed by complete clinical recovery along with absence of mites in skin scrapings, after completion of four doses of oral ivermectin along with supportive therapy.

  14. Cat Island NWR Recreational Hunting Plan (United States)

    US Fish and Wildlife Service, Department of the Interior — A natural resource management plan describing the regulations and decision processes for sport hunting at Cat Island NWR. This plan has been replaced by a more...

  15. Nutritional secondary hyperparathyroidism in two cats

    DEFF Research Database (Denmark)

    Dimopoulou, Maria; Kirpensteijn, Jolle; Nielsen, Dorte Hald


    severely affected cat, postmortem examination revealed changes consistent with nutritional secondary hyperparathyroidism and fibrous osteodystrophy, such as cortical thinning, massive connective tissue invasion in the diaphysis of long bones, and hypertrophy of the chief cells in both parathyroid glands...

  16. Suppression of fertility in adult cats

    DEFF Research Database (Denmark)

    Goericke-Pesch, Sandra Kathrin; Wehrend, A.; Georgiev, P.


    Contents: Cats are animals with highly efficient reproduction, clearly pointing to a need for suppression of fertility. Although surgical contraception is highly effective, it is not always the method of choice. This is predominantly because it is cost-intensive, time-consuming and irreversible......, with the latter being of major importance for cat breeders. This article reviews the use of progestins, scleroting agents, immunocontraception, melatonin, GnRH antagonists and finally, GnRH agonists, in adult male and female cats in detail, according to the present state of the art. By now, various scientific...... and clinical options are available for the suppression of fertility in adult cats and the decision as to which should be chosen - independent of the legal registration of any state - depends on different facts: (i) feral or privately owned animal? (ii) temporary or permanent suppression of fertility wanted...

  17. Endometrial stromal sarcoma with smooth muscle and glandular differentiation of the feline uterus. (United States)

    Sato, T; Maeda, H; Suzuki, A; Shibuya, H; Sakata, A; Shirai, W


    The intra-abdominal tumor developing in the uterus and lung of a domestic Shorthair cat was examined histopathologically and immunohistochemically. The tumor showed a proliferation of both endometrial stromal and smooth muscle cells accompanied by prominent vasculature. There were well-differentiated endometrial glands, and tubuli made up a monolayer of eosinophilic cuboidal epithelium. Immunohistochemically, the spindle-shaped cells and half of the stromal-like cells reacted to caldesmon and desmin antibodies. The neoplastic epithelium expressed AE1/AE3 cytokeratin. Feline endometrial stromal tumor has, to the best of our knowledge, not been reported previously and has smooth muscle and glandular components that are a unique variant to the human counterpart.

  18. Prevalence of feline haemoplasma in cats in Denmark

    DEFF Research Database (Denmark)

    Rosenqvist, Maja Benedicte; Meilstrup, Ann-Katrine Helene; Larsen, Jesper


    cats in different age groups. The presence was detected by a conventional polymerase chain reaction (PCR) assay on blood samples as well as by real-time PCR (RT-PCR). Results The study revealed a prevalence of 14.9% Candidatus Mycoplasma haemominutum positive cats and 1.5% Mycoplasma haemofelis...... positive cats. No cats were found positive for Candidatus Mycoplasma turicensis. The results showed a statistically significant higher prevalence in older (>8 years) cats compared to younger cats and a higher prevalence among domestic cats compared to purebred cats. As part of this study, we developed...... a cloning strategy to obtain Danish positive controls of haemoplasma 16S rRNA. Conclusion From convenience-sampled cats in Denmark, we found that 16.4% were carriers of feline haemotropic mycoplasmas. Haemoplasma was mostly found in older and domestic cats. The prevalence found in Denmark is similar...

  19. Cloning, Expression and Bioinformatics Analysis of Porcine CatSperB and CatSperG Genes%猪CatSperB和CatSperG基因的克隆、表达及生物信息学

    Institute of Scientific and Technical Information of China (English)

    宋成义; 周家庆; 冯晓军; 谢雨琇; 李庆平; 吴晗; 高波; 王霄燕


    [目的]揭示猪CatSperB和CatSperG基因的存在、蛋白的结构特征、进化关系及时空表达特性.[方法]利用电子和分子克隆技术鉴定猪CatSperB和CatSperG基因全长cDNA,并利用定性RT-PCR和荧光定量RT-PCR进行CatSperB和CatSperG基因的时空表达研究.[结果]①分别获得了3 508 bp CatSperB和3 715 bp CatSperG电子转录子,分别包含3 3 30和3 483 bp开放阅读框,并经TA克隆测序验证,其CDS序列与人、牛、马和狗等的CatSperB和CatSperG基因的序列相似性在80%以上;②CatSperB分子质量为125.79 kD,为稳定蛋白;CatSperG分子质量为133.40 kD,为不稳定蛋白;③CatSperB和CatSperG都包含7个通道蛋白保守的跨膜结构域,CatSperG蛋白C端含一个超螺旋结构,而CatSperB蛋白无明显的超螺旋结构信号;猪CatSperB和CatSperG与牛、狗和马的CatSperB和CatSperG蛋白同源关系较近,与人和小鼠的同源关系较远;④RT-PCR分析表明,CatSperB和CatSperG基因主要在辜丸中表达,但CatSperB在其它组织也有表达信号;⑤CatSperB和CatSperG基因mRNA表达水平在猪性发育的重要阶段,精子发生(60日龄)、初情期(90日龄)和性成熟(150日龄)前后都有显著提高(P< 0.05).[结论]获得了猪CatSperB和CatSperG基因的cDNA克隆及其一系列生物信息学参数,揭示了CatSperB和CatSperG蛋白含7个保守的跨膜结构域及不同物种间的进化关系,证实CatSperB和CatSperG基因主要在睾丸表达,且其mRNA表达变化与公猪的性发育相一致.%[Objective] The aim of the current study is to confirm the existence of porcine CatSperB and CatSperG genes, and investigate the protein structures, evolutionary relationship and the spatial-temporal expression profiles of CatSperB and CatSperG. [Method] The in silico and molecular cloning was used to identify the full length cDNAs of porcine CatSperB and CatSperG, and the spatial-temporal expression profile was investigated by qualitative and

  20. Food hypersensitivity to lamb in a cat. (United States)

    Reedy, L M


    Severe facial pruritus in a cat was caused by food hypersensitivity to lamb. The cat had been fed an exclusive diet of lamb for 2 years after it had been diagnosed to have food hypersensitivity to fish. Signs, including erythema, alopecia, and excoriations of the head and neck, were poorly responsive to corticosteroid administration, but resolved within a few weeks after removal of the suspected allergen.

  1. Mandibular Osteosarcoma in Cat: Case report



    The primary malignant bone tumors are uncommon in cats. Osteosarcoma is the most frequently observed in old animals. This tumors affects the appendicular skeleton, however the axial skeleton is also affected, but the bones of the head and pelvis frequent sites of injury. This paper reports a case of a cat with a history of progressive swelling in the left mandible, with follow-up period of four months. The presumptive diagnosis of osteopathy, signed by clinical and radiographic observations w...

  2. Agonistic Vocalisations in Domestic Cats : A Case Study


    Schötz, Susanne


    Introducing a new cat to a home with resident cats may lead to stress, aggression and even fights. In this case study 468 agonistic cat vocalisations were recorded as one cat was introduced to three resident cats in her new home. Six vocalisation types were identified: growl, howl, howl-growl, hiss, spit and snarl. Numerous other intermediate and complex vocalisations were also observed. An acoustic analysis showed differences within and between all types. Future studies include further acous...

  3. Primary esophageal and gastro-esophageal junction cancer xenograft models: clinicopathological features and engraftment. (United States)

    Dodbiba, Lorin; Teichman, Jennifer; Fleet, Andrew; Thai, Henry; Sun, Bin; Panchal, Devang; Patel, Devalben; Tse, Alvina; Chen, Zhuo; Faluyi, Olusola O; Renouf, Daniel J; Girgis, Hala; Bandarchi, Bizhan; Schwock, Joerg; Xu, Wei; Bristow, Robert G; Tsao, Ming-Sound; Darling, Gail E; Ailles, Laurie E; El-Zimaity, Hala; Liu, Geoffrey


    There are very few xenograft models available for the study of esophageal (E) and gastro-esophageal junction (GEJ) cancer. Using a NOD/SCID model, we implanted 90 primary E and GEJ tumors resected from patients and six endoscopic biopsy specimens. Of 69 resected tumors with histologically confirmed viable adenocarcinoma or squamous cell carcinoma, 22 (32%) was engrafted. One of 11 tumors, considered to have had a complete pathological response to neo-adjuvant chemo-radiation, also engrafted. Of the 23 patients whose tumors were engrafted, 65% were male; 30% were early stage while 70% were late stage; 22% received neo-adjuvant chemo-radiation; 61% were GEJ cancers. Engraftment occurred in 18/54 (33%) adenocarcinomas and 5/16 (31%) squamous cell carcinomas. Small endoscopic biopsy tissue had a 50% (3/6) engraftment rate. Of the factors analyzed, pretreatment with chemo-radiation and well/moderate differentiation showed significantly lower correlation with engraftment (P<0.05). In the subset of patients who did not receive neo-adjuvant chemo-radiation, 18/41 (44%) engrafted compared with those with pretreatment where 5/29 (17%, P=0.02) engrafted. Primary xenograft lines may be continued through 4-12 passages. Xenografts maintained similar histology and morphological characteristics with only minor variations even after multiple passaging in most instances.

  4. A second primary esophageal cancer developing 7 years after chemoradiotherapy for advanced esophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Suto, Ryuichiro; Enjoji, Akihito; Okudaira, Sadayuki; Furui, Junichiro; Kanematsu, Takashi [Nagasaki Univ. (Japan). School of Medicine; Matsuo, Takeshi


    We report a rare case of advanced carcinoma and a second primary carcinoma of the esophagus, both of which were successfully cured by chemotherapy and operation at different times. In 1991, a 38-year-old Japanese man was diagnosed with advanced esophageal cancer, which was unresectable because of the bronchial invasion of the tumor. He was given chemotherapy with cisplatin (CDDP), combined with radiotherapy. During a 4-year follow-up, neither regrowth of the primary tumor nor distant metastasis occurred. In 1995, esophagoscopy demonstrated a lugol-unstained region located 3 cm distal from the area of radiation to the primary lesion shown by esophagography. Histological examination of a biopsy specimen showed the mucosa to be normal. Nevertheless, yearly surveillance by endoscopy and histological examinations showed that the mucosa of the esophagus gradually began to demonstrate mild dysplasia, followed by severe dysplasia; in 1998, a diagnosis of squamous cell carcinoma was made. Esophagectomy with lymph node dissection was performed. Microscopic examination revealed that there had been pathologic complete response for the original advanced esophageal cancer. (author)

  5. Coexistence of esophageal blue nevus, hair follicles and basaloid sqamous carcinoma: A case report

    Institute of Scientific and Technical Information of China (English)


    We present the case of a 57-year-old man who underwent esophagectomy for esophageal carcinoma found at barium meal and gastroscopic examination. He was diagnosed as esophageal basaloid squamous carcinoma (BSC) and gastric stromal tumor, which were associated with focal proliferation of melanocytes/ pigmentophages and hair follicles in esophageal mucosa. Melanocytic hyperplasia (melanocytosis) has previously been recognized as an occasional reactive lesion, which can accompany esophageal inflammation and invasive squamous carcinoma. The present case is unusual because of its hyperplasia of not only melanocytes but also hair follicles. To our knowledge, this is the first report of esophageal blue nevus and hair follicle coexisting with BSC.

  6. Complete Esophageal Obstruction after Endoscopic Variceal Band Ligation in a Patient with a Sliding Hiatal Hernia (United States)

    Mansour, Munthir; Abdel-Aziz, Yousef; Awadh, Hesham; Shah, Nihar


    Complete esophageal obstruction is a rare complication of endoscopic variceal banding, with only 6 cases in the English literature since the introduction of endoscopic variceal banding in 1986. We report a case of complete esophageal obstruction following esophageal banding due to entrapment of part of a sliding hiatal hernia. To our knowledge, our case is one of few with esophageal obstruction post-banding, and the first associated with a hiatal hernia. We recommend caution when performing esophageal banding on patients with a hiatal hernia.

  7. MicroRNA and esophageal carcinoma

    Institute of Scientific and Technical Information of China (English)

    Xiaoting He; Xiufeng Cao


    Objective:An abundant class of non-coding small RNA molecules, 21-25 nucleotide in length, are widely found in animals and plants and named microRNA(miRNA)[1-2]. MiRNAs are highly evolutionarily conserved, expressing in specific tissue and timing[2], and negatively regulate the gene expressions at the posttranscriptional level[3], and subsequently control crucial physiological processes such as metabolism, amplification, differentiation, development and apoptosis[4-7]. Therefore, miRNAs could provide an access to many human diseases in theory. Recent evidence demonstrates that miRNAs play an important role in the initiation and progression of human cancer, mainly by interrupting the cell cycle at the cellular level and by interacting with signaling [7-11] The expression profiling of miRNAs can be used as a tool of diagnosis, staging, prognosis and biotherapy of some tumors, as has already been proven to have superiority to mRNA, in the categorization of tumors. This review focuses on the genesis, mechanism of action of miRNA and its relationship to tumors, detection methods and its potential effect on the diagnosis, staging, and biotherapy in esophageal carcinoma.

  8. Doxycyclin induced esophageal injury: A Case series

    Directory of Open Access Journals (Sweden)

    İsmail Demiryılmaz


    Full Text Available Some drugs have been known to damage to esophagusfor a long time. Half of the cases reported are of tetracyclineand its derivatives. The damage caused by thesedrugs is depends on the drug itself and the patient.In this paper we present 5 patients having diagnosedesophageal damage endoscopically after due to doxycyclinuse. The mean age of the patients was 26 years.Three of them for acne and 2 for heir complaints gynecologicalinfection were taking these drugs. Lesions werelocated at the middle in 4 cases and lover part in 1 patient.The common complaint was retrosternal pain and heartburnafter taking the drug with insufficient water or withoutwater. All the patients were relieved by symtomatic teratment.Esophageal damage is to be remembered in patientscomplaning sudden pain and difficult swallowing on doxycyclintreatment and endoscopic procedure should beemployed for definition of diagnosis and evaluation of theseverity of the damage. After treatment, endoscopic controlis not necessary. Physicians must not forget to advicethe patients to take these drugs with splendid amount ofwater.Key words: Doxycycline, esophagus damage, endoscopy

  9. [Microvascular anastomoses in cervical esophageal reconstruction]. (United States)

    Takushima, A; Harii, K; Asato, H


    Ischemia or hemostasis in the gastric, jejunal, and colonic pedicle after esophagectomy is believed to contribute significantly to postoperative complications. With the advent of microvascular anastomoses, many surgeons have adopted vascular augmentation (supercharge) as a means of avoiding these difficulties. Microsurgical free tissue transfer represented by the free jejunum and forearm flap also plays an important role in esophageal reconstruction. In this paper, the authors introduce the technical points important for successful revascularization including the choice of recipient vessels, setting up of the reconstructive materials, and postoperative monitoring. In cases of gastric pull-up elevated via posterior mediastinum, the left gastroduodenal vessels are anastomosed to the cervical transverse or superior thyroidal vessels. In cases of duodenal or colonic pull-up elevated via the anterosternal route, the vascular pedicles are anastomosed to the internal mammary vessels which are dissected by resecting the costal cartilage. When the free jejunum flap is used, the cervical transverse or superior thyroidal vessels are most frequently used as recipients. Postoperative monitoring of free flaps is performed using Doppler ultrasound or through a small skin incision made above the transferred tissue. Although gastric or colonic pull-up is difficult to monitor, color Doppler sonography permits quantitative analysis of blood flow and may be a useful option.

  10. Smooth horizons and quantum ripples

    Energy Technology Data Exchange (ETDEWEB)

    Golovnev, Alexey [Saint Petersburg State University, High Energy Physics Department, Saint-Petersburg (Russian Federation)


    Black holes are unique objects which allow for meaningful theoretical studies of strong gravity and even quantum gravity effects. An infalling and a distant observer would have very different views on the structure of the world. However, a careful analysis has shown that it entails no genuine contradictions for physics, and the paradigm of observer complementarity has been coined. Recently this picture was put into doubt. In particular, it was argued that in old black holes a firewall must form in order to protect the basic principles of quantum mechanics. This AMPS paradox has already been discussed in a vast number of papers with different attitudes and conclusions. Here we want to argue that a possible source of confusion is the neglect of quantum gravity effects. Contrary to widespread perception, it does not necessarily mean that effective field theory is inapplicable in rather smooth neighbourhoods of large black hole horizons. The real offender might be an attempt to consistently use it over the huge distances from the near-horizon zone of old black holes to the early radiation. We give simple estimates to support this viewpoint and show how the Page time and (somewhat more speculative) scrambling time do appear. (orig.)

  11. Local Transfer Coefficient, Smooth Channel

    Directory of Open Access Journals (Sweden)

    R. T. Kukreja


    Full Text Available Naphthalene sublimation technique and the heat/mass transfer analogy are used to determine the detailed local heat/mass transfer distributions on the leading and trailing walls of a twopass square channel with smooth walls that rotates about a perpendicular axis. Since the variation of density is small in the flow through the channel, buoyancy effect is negligible. Results show that, in both the stationary and rotating channel cases, very large spanwise variations of the mass transfer exist in he turn and in the region immediately downstream of the turn in the second straight pass. In the first straight pass, the rotation-induced Coriolis forces reduce the mass transfer on the leading wall and increase the mass transfer on the trailing wall. In the turn, rotation significantly increases the mass transfer on the leading wall, especially in the upstream half of the turn. Rotation also increases the mass transfer on the trailing wall, more in the downstream half of the turn than in the upstream half of the turn. Immediately downstream of the turn, rotation causes the mass transfer to be much higher on the trailing wall near the downstream corner of the tip of the inner wall than on the opposite leading wall. The mass transfer in the second pass is higher on the leading wall than on the trailing wall. A slower flow causes higher mass transfer enhancement in the turn on both the leading and trailing walls.

  12. Smooth horizons and quantum ripples

    CERN Document Server

    Golovnev, Alexey


    Black Holes are unique objects which allow for meaningful theoretical studies of strong gravity and even quantum gravity effects. An infalling and a distant observer would have very different views on the structure of the world. However, a careful analysis has shown that it entails no genuine contradictions for physics, and the paradigm of observer complementarity has been coined. Recently this picture was put into doubt. In particular, it was argued that in old Black Holes a firewall must form in order to protect the basic principles of quantum mechanics. This AMPS paradox has already been discussed in a vast number of papers with different attitudes and conclusions. Here we want to argue that a possible source of confusion is neglection of quantum gravity effects. Contrary to widespread perception, it does not necessarily mean that effective field theory is inapplicable in rather smooth neighbourhoods of large Black Hole horizons. The real offender might be an attempt to consistently use it over the huge di...

  13. [Differencial diagnosis of gastroesophageal reflux disease -- eosinophilic esophagitis: case report]. (United States)

    Franzius, M; Stolte, M; Porschen, R


    We report on a 22-year-old man with dysphagia and repeated bolus impaction in the esophagus for 10 years. Bolus impactions were frequently mobilised using an endoscope. At endoscopy, esophagitis IV degrees was described. After treatment with omeprazol there was no improvement. The patient was submitted to our hospital for fundoplication. pH-metry demonstrated an increased reflux. At endoscopy of the esophagus, we found red stripes which did not show the typical appearance of erosions. Manometry and X-ray films of the esophagus did not reveal any pathological findings. In combination with anamnesis, symptoms, and endoscopy, the diagnosis of eosinophilic esophagitis was documented by histology. After administration of oral corticosteroids a rapid improvement of the clinical symptoms was observed. The diagnosis of eosinophilic esophagitis should be kept in mind in patients with chronic symptoms of gastroesophageal reflux persisting despite medical therapy, pathological pH-metry and repeated bolus impactions.

  14. Type II congenital cystic pulmonary malformation in an esophageal lung. (United States)

    Martínez-Martínez, Blanca E; Furuya, María Elena Yuriko; Martínez-Muñiz, Irma; Vargas, Mario H; Flores-Salgado, Rosalinda


    A seven-month-old girl, born prematurely (birth weight 1000 g) from a twin pregnancy, was admitted to hospital due to recurrent pneumonia and atelectasis. She experienced cough and respiratory distress during feeding. The right hemithorax was smaller than the left, with diminished breath sounds and dullness. Chest x-rays revealed decreased lung volume and multiple radiolucent images in the right lung, as well as overdistention of the left lung. An esophagogram revealed three bronchial branches arising from the lower one-third of the esophagus, corresponding to the right lung and ending in a cul-de-sac. A diagnosis of esophageal lung was established. On bronchography, the right lung was absent and the trachea only continued into the left main bronchus. Echocardiography and angiotomography revealed agenesis of the pulmonary artery right branch. The surgical finding was an esophageal right lung, which was removed; the histopathological diagnosis was type II congenital pulmonary airway malformation in an esophageal lung.

  15. Esophageal Perforation due to Transesophageal Echocardiogram: New Endoscopic Clip Treatment

    Directory of Open Access Journals (Sweden)

    John Robotis


    Full Text Available Esophageal perforation due to transesophageal echocardiogram (TEE during cardiac surgery is rare. A 72-year-old female underwent TEE during an operation for aortic valve replacement. Further, the patient presented hematemesis. Gastroscopy revealed an esophageal bleeding ulcer. Endoscopic therapy was successful. Although a CT scan excluded perforation, the patient became febrile, and a second gastroscopy revealed a big perforation at the site of ulcer. The patient's clinical condition required endoscopic intervention with a new OTSC® clip (Ovesco Endoscopy, Tübingen, Germany. The perforation was successfully sealed. The patient remained on intravenous antibiotics, proton pump inhibitors and parenteral nutrition for few days, followed by enteral feeding. She was discharged fully recovered 3 months later. We clearly demonstrate an effective, less invasive treatment of an esophageal perforation with a new endoscopic clip.

  16. Esophageal Achalasia: An Uncommon Complication during Pregnancy Treated Conservatively

    Directory of Open Access Journals (Sweden)

    Dimitrios Spiliopoulos


    Full Text Available A 38-year-old Caucasian woman, gravida 3 para 2, was admitted at 29 weeks of gestation because of vomiting, dysphagia for solids and liquids, and loss of weight. An enlargement of the anterior left neck region was noted on the palpation of the thyroid gland. An MRI of the neck showed a marked esophageal dilatation with the presence of food remnants along its length and the displacement of the trachea to the right. The findings of the upper gastrointestinal endoscopy and manometry were suggestive of esophageal achalasia. Conservative management with total parenteral nutrition (TPN through a peripheral line proved to be successful. A healthy male baby was born by a cesarean section at 37 weeks. The patient underwent laparoscopic esophageal myotomy and fundoplication seven days postpartum.

  17. Colon interposition for esophageal reconstruction: A report of 46 cases

    Institute of Scientific and Technical Information of China (English)

    SUN Yao-chang; XU Zhi-fei; LI Jian-qiu; ZHAO Xue-wei; ZHONG Lei; QIN Xiong


    Objective:To evaluate the role of colonic interposition for reconstruction of the esophagus. Methods: From April 1979 to October 1998, Thirty-one patients with benign esophageal stenosis and 15 patients graft from the esophageal bed after the esophagus was pulled out without thoracotomy. Results: There was no perioperative death. All 31 cases of the benign esophageal stenosis got long term survival and normal life.The 3- and 5-year survival rates of patients with the carcinoma of the esophagus were 63.6% and 40. 6% respectively. Conclusion: The colonic interposition graft is a choice for the patien ts with the cervical stenosis of the esophagus, especially for those already had subtotal gastrectomy. Using the left colonic artery as the supporting vessel and using the colon segment in an isoperistaltic position is the optimal choice. Improving the operative techniques and decreasing the complications are important for the extension use of this method.

  18. Thermal smoothing of rough surfaces in vacuo (United States)

    Wahl, G.


    The derivation of equations governing the smoothing of rough surfaces, based on Mullins' (1957, 1960, and 1963) theories of thermal grooving and of capillarity-governed solid surface morphology is presented. As an example, the smoothing of a one-dimensional sine-shaped surface is discussed.

  19. Smoothing the output from a DAC (United States)

    Wagner, C.


    Circuit smooths stepped waveform from analog-to-digital converter without appreciable phase shift between stepped input signal and smoothed output signal and without any effect from stepping rate. Waveform produced is suitable for driving controls used in manufacturing processes, aerospace systems, and automobiles.

  20. DDEC: Dragon database of genes implicated in esophageal cancer

    KAUST Repository

    Essack, Magbubah


    Background: Esophageal cancer ranks eighth in order of cancer occurrence. Its lethality primarily stems from inability to detect the disease during the early organ-confined stage and the lack of effective therapies for advanced-stage disease. Moreover, the understanding of molecular processes involved in esophageal cancer is not complete, hampering the development of efficient diagnostics and therapy. Efforts made by the scientific community to improve the survival rate of esophageal cancer have resulted in a wealth of scattered information that is difficult to find and not easily amendable to data-mining. To reduce this gap and to complement available cancer related bioinformatic resources, we have developed a comprehensive database (Dragon Database of Genes Implicated in Esophageal Cancer) with esophageal cancer related information, as an integrated knowledge database aimed at representing a gateway to esophageal cancer related data. Description: Manually curated 529 genes differentially expressed in EC are contained in the database. We extracted and analyzed the promoter regions of these genes and complemented gene-related information with transcription factors that potentially control them. We further, precompiled text-mined and data-mined reports about each of these genes to allow for easy exploration of information about associations of EC-implicated genes with other human genes and proteins, metabolites and enzymes, toxins, chemicals with pharmacological effects, disease concepts and human anatomy. The resulting database, DDEC, has a useful feature to display potential associations that are rarely reported and thus difficult to identify. Moreover, DDEC enables inspection of potentially new \\'association hypotheses\\' generated based on the precompiled reports. Conclusion: We hope that this resource will serve as a useful complement to the existing public resources and as a good starting point for researchers and physicians interested in EC genetics. DDEC is

  1. Peptidergic innervation of human esophageal and cardiac carcinoma

    Institute of Scientific and Technical Information of China (English)

    Shuang-Hong Lü; Yan Zhou; Hai-Ping Que; Shao-Jun Liu


    AIM: To investigate the distribution of neuropeptideimmunoreactive nerve fibers in esophageal and cardiac carcinoma as well as their relationship with tumor cells so as to explore if there is nerve innervation in esophageal and cardiac carcinoma.METHODS: Esophageal and cardiac carcinoma specimens were collected from surgical operation. One part of them were fixed immediately with 4 % paraformaldehyde and then cut with a cryostat into 40-pm-thick sections to perform immunohistochemical analysis. Antibodies of ten kinds of neuropeptide including calcitonin gene-related peptide (CGRP), galanin (GAL), substance P (SP), etc. were used for immunostaining of nerve fibers. The other part of the tumor specimens were cut into little blocks (1 mm3) and cocultured with chick embryo dorsal root ganglia (DRG) to investigate if the tumor blocks could induce the neurons of DRG to extend processes, so as to probe into the possiblereasons for the nerve fibers growing into tumors. RESULTS: Substantial amounts of neuropeptide including GAL-, NPY-, SP-immunoreactive nerve bundles and scattered nerve fibers were distributed in esophageal and cardiac carcinomas. The scattered nerve fibers waved their way among tumor cells and contacted with tumor cells closely. Some of them even encircled tumor cells. There were many varicosities aligned on the nerve fibers like beads. They were also closely related to tumor cells. In the co-culture group, about 63 %and 67 % of DRG co-cultured with esophageal and cardiac tumor blocks respectively extended enormous processes,especially on the side adjacent to the tumor, whereas in the control group (without tumor blocks), no processes grew out.CONCLUSION: Esophageal and cardiac carcinomas may be innervated by peptidergic nerve fibers, and they can induce neurons of DRG to extend processes in vitro.

  2. Improved Edge Awareness in Discontinuity Preserving Smoothing

    CERN Document Server

    Heinrich, Stuart B


    Discontinuity preserving smoothing is a fundamentally important procedure that is useful in a wide variety of image processing contexts. It is directly useful for noise reduction, and frequently used as an intermediate step in higher level algorithms. For example, it can be particularly useful in edge detection and segmentation. Three well known algorithms for discontinuity preserving smoothing are nonlinear anisotropic diffusion, bilateral filtering, and mean shift filtering. Although slight differences make them each better suited to different tasks, all are designed to preserve discontinuities while smoothing. However, none of them satisfy this goal perfectly: they each have exception cases in which smoothing may occur across hard edges. The principal contribution of this paper is the identification of a property we call edge awareness that should be satisfied by any discontinuity preserving smoothing algorithm. This constraint can be incorporated into existing algorithms to improve quality, and usually ha...

  3. Smoothed dynamics in the central field problem

    CERN Document Server

    Santoprete, Manuele


    Consider the motion of a material point of unit mass in a central field determined by a homogeneous potential of the form $(-1/r^{\\alpha})$, $\\alpha>0,$ where $r$ being the distance to the centre of the field. Due to the singularity at $r=0,$ in computer-based simulations, usually, the potential is replaced by a similar potential that is smooth, or at least continuous. In this paper, we compare the global flows given by the smoothed and non-smoothed potentials. It is shown that the two flows are topologically equivalent for $\\alpha < 2,$ while for $\\alpha \\geq 2,$ smoothing introduces fake orbits. Further, we argue that for $\\alpha\\geq 2,$ smoothing should be applied to the amended potential $c/(2r^2)-1/r^{\\alpha},$ where $c$ denotes the angular momentum constant.

  4. Multimodality Imaging Evaluation of an Uncommon Entity: Esophageal Heterotopic Pancreas

    Directory of Open Access Journals (Sweden)

    Takman Mack


    Full Text Available A 25-year-old male was referred to the Radiology Department with new onset of right upper quadrant and epigastric abdominal pain. He had no past medical or surgical history. Physical exam was unremarkable. The patient underwent computed tomography (CT, fluoroscopic upper gastrointestinal (GI evaluation, endoscopic ultrasound (EUS, and positron emission tomography (PET evaluation, revealing the presence of a heterogeneous esophageal mass. In light of imaging findings and clinical workup, the patient was ultimately referred for thorascopic surgery. Surgical findings and histology confirmed the diagnosis of esophageal heterotopic pancreas.

  5. Esophageal cancer; Cancer de l'oesophage

    Energy Technology Data Exchange (ETDEWEB)

    Dupuis, O.; Ganem, G.; Denis, F. [Centre Jean-Bernard, clinique Victor-Hugo, 72 - Le Mans (France); Bera, G.; Pointreau, Y. [Clinique d' oncologie radiotherapie, Centre Henry S. Kaplan, CHU Bretonneau, 37 - Tours (France); Pradier, O. [Departement de radiotherapie, CHU de Morvan, 29 - Brest (France); Martin, P. [Centre Bourgogne, 59 - Lille (France); Mirabel, X. [Departement universitaire de radiotherapie, centre Oscar-Lambret, 59 - Lille (France)


    Esophageal cancers are highly malignant tumours with often a poor prognosis, except for minimal lesions treated with surgery. Radiation therapy, or combined radiation and chemotherapy is the most used therapeutic modality, alone or before oesophagectomy. The delineation of target volumes is now more accurate owing the possibility to use routinely the new imaging techniques (mainly PET). The aim of this work is to precise the radio-anatomical particularities, the pattern of spread of esophageal cancer and the principles of 3D conformal radiotherapy illustrated with a clinical case. (authors)

  6. Medical image of the week: esophageal-pleural fistula

    Directory of Open Access Journals (Sweden)

    Alzoubaidi M


    Full Text Available A 51 year old woman with rheumatoid arthritis, diabetes mellitus and gastroesophageal reflux disease had a transoral incisionless fundoplication for a hiatal hernia 6 months before admission. She presented with left lower lobe pneumonia and empyema. The esophagram showed a fistulous tract communicating with the pleural space (Figure 1. CT scan of the chest also showed air in the mediastinum (Figure 2 as well a fistulous tract in the three dimensional reconstruction (Figure 3. Esophagogastroduodenoscopy (EGD showed an esophageal defect 5 cm above the gastroesophageal junction. An esophageal stent was placed with success.

  7. Synchronous advanced gastric adenocarcinoma and advanced esophageal squamous cell carcinoma

    Directory of Open Access Journals (Sweden)

    Fernando Augusto Mardiros Herbella


    Full Text Available CONTEXT: Synchronous associations of esophageal and gastric cancers are not a common finding, especially with differing histological types and both tumors in advanced forms. A case with such an association is presented, in which an unusual therapy was proposed: palliative gastrectomy and esophageal intubation. CASE REPORT: A 75-year-old white man was referred to our service complaining of malaise and weight loss for one year and dysphagia and vomiting for 2 months. The patient had sought out medical consultation as a result of the latter two complaints.

  8. Esophageal rupture due to Sengstaken-Blakemore tube misplacement

    Institute of Scientific and Technical Information of China (English)

    Chee-Fah Chong


    The author presents three cases of esophageal rupture during the treatment of massive esophageal variceal bleeding with Sengstaken-Blakemore (SB) tube. In each case, simple auscultation was used to guide SB tube insertion, with chest radiograph obtained only after complete inflation of the gastric balloon. Two patients died of hemorrhagic shock and one died of mediastinitis.The author suggests that confirmation of SB tube placement by auscultation alone may not be adequate.Routine chest radiographs should be obtained before and after full inflation of the gastric balloon to confirm tube position and to detect tube dislocation.

  9. Endoscope-guided pneumatic dilation for treatment of esophageal achalasia

    Institute of Scientific and Technical Information of China (English)

    Seng-Kee; Chuah; Tsung-Hui; Hu; Chi-Sin; Changchien


    Pneumatic dilation(PD) is considered to be the first line nonsurgical therapy for achalasia.The principle of the procedure is to weaken the lower esophageal sphincter by tearing its muscle fibers by generating radial force.The endoscope-guided procedure is done without fluoroscopic control.Clinicians usually use a lowcompliance balloon such as Rigiflex dilator to perform endoscope-guided PD for the treatment of esophageal achalasia.It has the advantage of determining mucosal injury during the dilation proce...

  10. Esophageal mucocele. Radiological finds. Mucocele esofagico. Hallazgos radiologicos

    Energy Technology Data Exchange (ETDEWEB)

    Hernandez Moreno, L.; Lafuente Martinez, F.J.; Perez Diaz, M. (Hospital General Gregorio Maranon, Madrid (Spain). Servicio de Radiodiagnostico)


    A case of esophageal mucocele which started with respiratory symptoms due to tracheobronchial compression is presented. Most of mucocele cases are asymptomatic by sometimes can show complications.Therefore, early diagnosis is very important for adequate treatment. It should be suspected in those patients who underwent thoracic surgery because of esophageal pathology in whom isolation was performed preservation and surgical isolation of esophagus was performed. Simple radiologic studies and CT show a mediastinal mass presenting cystic lesion features, anatomically located in esophagus located in the esophagus anatomic place. (author)

  11. Circulating microRNAs: Novel biomarkers for esophageal cancer

    Institute of Scientific and Technical Information of China (English)


    Esophageal carcinogenesis is a multi-stage process, involving a variety of changes in gene expression and physiological structure change. MicroRNAs (miRNAs) are a class of small non-coding endogenous RNA molecules. Recent innovation in miRNAs profiling technology have shed new light on the pathology of esophageal carcinoma (EC), and also heralded great potential for exploring novel biomarkers for both EC diagnosis and treatment. Frequent dysregulation of miRNA in malignancy highlights the study of molecular...

  12. Esophageal ulcer of unknown origin complicated by left atrial myxoma. (United States)

    Nishizaki, Yuji; Yamagami, Shinichiro; Hayakawa, Daisuke; Takashima, Shiori; Nomura, Osamu; Sai, Eiryu; Kon, Kazuyoshi; Matsuyama, Shujiro; Watanabe, Sumio; Daida, Hiroyuki


    Myxoma induces the onset of paraneoplastic syndromes by excreting various humoral mediators and is therefore known to present with diverse symptoms. A 40-year-old woman was admitted to our hospital for the treatment of an esophageal ulcer, the cause of which could not be identified on various examinations. Notably, a left atrial tumor was incidentally found on chest enhanced computed tomography. The esophageal ulcer, which was intractable to conventional therapy, improved with the administration of 5-aminosalicylate, a drug known to inhibit IL-1β. This inhibitory action effectively suppressed the development of myxoma-induced paraneoplastic syndrome.

  13. Treatment of esophageal cancer with vindesine: an open trial. (United States)

    Bezwoda, W R; Derman, D P; Weaving, A; Nissenbaum, M


    Fifty-two patients with advanced esophageal cancer have been entered in an open study with vindesine. The regimen consisted of vindesine at a dose of 3 mg/m2 as a continuous infusion over 48 hours followed by 3 mg/m2 iv weekly for 4 weeks and then by monthly maintenance therapy using the same dose. Objective response was seen in 14 (27%) patients. Patients who responded to treatment had significant prolongation of survival. Major pretreatment prognostic factors included performance status and serum albumin concentration. It is concluded that vindesine has definite, although limited, activity against esophageal cancer.

  14. Intestinal Behcet's disease with esophageal ulcers and colonic longitudinal ulcers

    Institute of Scientific and Technical Information of China (English)

    Soichiro Fujiwara; Ichiro Shimizu; Momoko Ishikawa; Kohzo Uehara; Hirofumi Yamamoto; Michiyo Okazaki; Takahiro Horie; Arata Iuchi; Susumu Ito


    Intestinal Behcet's disease in a 38-year-old woman was diagnosed because of the history of recurrent oral aphthous ulcers, erythema nodosum-like eruptions,genital ulcer, and endoscopic findings of esophageal and ileocolonic punched-out ulcers with colonic longitudinal ulcers. Esophageal lesions and colonic longitudinalulcers are rarely seen in intestinal Behcet's disease. The ulcers of esophagus and ileocolon healed with 3 wk of treatment with prednisolone and mesalazine without any adverse effect. Mesalazine may decrease the total dose of prednisolone required to treat the disease.

  15. Esophageal Candidiasis as the Initial Manifestation of Acute Myeloid Leukemia. (United States)

    Komeno, Yukiko; Uryu, Hideki; Iwata, Yuko; Hatada, Yasumasa; Sakamoto, Jumpei; Iihara, Kuniko; Ryu, Tomiko


    A 47-year-old woman presented with persistent dysphagia. A gastroendoscopy revealed massive esophageal candidiasis, and oral miconazole was prescribed. Three weeks later, she returned to our hospital without symptomatic improvement. She was febrile, and blood tests showed leukocytosis (137,150 /μL, blast 85%), anemia and thrombocytopenia. She was diagnosed with acute myeloid leukemia (AML). She received chemotherapy and antimicrobial agents. During the recovery from the nadir, bilateral ocular candidiasis was detected, suggesting the presence of preceding candidemia. Thus, esophageal candidiasis can be an initial manifestation of AML. Thorough examination to detect systemic candidiasis is strongly recommended when neutropenic patients exhibit local candidiasis prior to chemotherapy.

  16. The association between obesity factor and esophageal caner. (United States)

    Chen, Qi; Zhuang, Hengguo; Liu, Yanhui


    Accumulating epidemiological studies have supported the link between increased body mass index, central obesity and esophageal adenocarcinoma. This association appears stronger than that for other types of obesity-related cancers. Central obesity or visceral fat, more often observed in men, is much more strongly associated with adenocarcinoma than body mass index alone, possibly contributing to the imbalance of disease occurrence between the sexes. Potential mechanisms underlying the association between obesity and esophageal adenocarcinoma have been recently identified, including the insulin-like growth factor pathway, adipokines and sex hormone disturbances. These findings are summarized in this review; however, more research is warranted before these mechanisms are conclusively established.

  17. Esophageal lung – A rare bronchopulmonary foregut malformation

    Directory of Open Access Journals (Sweden)

    S.V. Parelkar


    Full Text Available Esophageal lung is a rare variety of communicating bronchopulmonary foregut malformation characterized by a fistula between an isolated portion of respiratory tissue and esophagus or stomach. It may involve the entire lung or one of the pulmonary lobes. Only 20 cases have been reviewed in 2011. Fifty percent of cases are associated with a tracheoesophageal fistula. We report a case of a 6 month old girl who was previously operated for TEF repair, with esophageal lobe which was successfully excised. The relevant literature is reviewed.

  18. The catheter hub disinfection cap as esophageal foreign body. (United States)

    Tawfik, Kareem O; Myer, Charles M; Shikary, Tasneem; Goldschneider, Kenneth R


    Disinfection caps are increasingly being used to prevent catheter-associated bloodstream infections. These devices, designed for continuous passive disinfection of catheter hubs, are typically small and often brightly colored. As such, they have the potential to become pediatric airway and esophageal foreign bodies. We report two patients who developed esophageal foreign body following ingestion of disinfection caps. Given the increasing use of these devices, it is imperative that health care providers be aware of this potential iatrogenic problem. We propose that the use of disinfection caps may not be appropriate in pediatric patients with risk factors for foreign body ingestion.

  19. Time esophageal pH < 4 overestimates the prevalence of pathologic esophageal reflux in subjects with gastroesophageal reflux disease treated with proton pump inhibitors

    Directory of Open Access Journals (Sweden)

    Sloan Sheldon


    Full Text Available Abstract Background A Stanford University study reported that in asymptomatic GERD patients who were being treated with a proton pump inhibitor (PPI, 50% had pathologic esophageal acid exposure. Aim We considered the possibility that the high prevalence of pathologic esophageal reflux might simply have resulted from calculating acidity as time pH Methods We calculated integrated acidity and time pH Results The prevalence of pathologic 24-hour esophageal reflux in both studies was significantly higher when measured as time pH Conclusion In GERD subjects treated with a PPI, measuring time esophageal pH


    Bach, R.


    The computer program SMACK (SMoothing for AirCraft Kinematics) is designed to provide flightpath reconstruction of aircraft forces and motions from measurements that are noisy or incomplete. Additionally, SMACK provides a check on instrument accuracy and data consistency. The program can be used to analyze data from flight-test experiments prior to their use in performance, stability and control, or aerodynamic modeling calculations. It can also be used in the analysis of aircraft accidents, where the actual forces and motions may have to be determined from a very limited data set. Application of a state-estimation method for flightpath reconstruction is possible because aircraft forces and motions are related by well-known equations of motion. The task of postflight state estimation is known as a nonlinear, fixed-interval smoothing problem. SMACK utilizes a backward-filter, forward-smoother algorithm to solve the problem. The equations of motion are used to produce estimates that are compared with their corresponding measurement time histories. The procedure is iterative, providing improved state estimates until a minimum squared-error measure is achieved. In the SMACK program, the state and measurement models together represent a finite-difference approximation for the six-degree-of-freedom dynamics of a rigid body. The models are used to generate time histories which are likely to be found in a flight-test measurement set. These include onboard variables such as Euler angles, angular rates, and linear accelerations as well as tracking variables such as slant range, bearing, and elevation. Any bias or scale-factor errors associated with the state or measurement models are appended to the state vector and treated as constant but unknown parameters. The SMACK documentation covers the derivation of the solution algorithm, describes the state and measurement models, and presents several application examples that should help the analyst recognize the potential

  1. Contractile properties of extraocular muscle in Siamese cat. (United States)

    Lennerstrand, G


    Siamese cats are albinos with poor visual resolution and severely impaired binocular vision. Eey muscle phyiology was studied in Siamese cats as a part of a more extensive project on eye muscle properties in cats with deficient binocular vision. Isometric contractions of the inferior oblique muscle were recorded in response to single and repetitive muscle nerve stimulation. Speed of contraction, measured as twitch contraction time, fusion frequency and rate of tetanic tension rise, was lower in Siamese than in normal cats. Eye muscles of Siamese cats fatiqued more easily to continuous activation than normal cat eye mucle. These functional changes have also been found in cats with binocular defects from monocular lid suture, but were much more marked in Siamese cats. It is suggested that the eye muscle changes represent muscular adaptations to genetically caused impairments of binocular vision and visual resolution in Siamese cats.

  2. Risk factors for feline infectious peritonitis in Australian cats. (United States)

    Worthing, Kate A; Wigney, Denise I; Dhand, Navneet K; Fawcett, Anne; McDonagh, Phillip; Malik, Richard; Norris, Jacqueline M


    The objective of this study was to determine whether patient signalment (age, breed, sex and neuter status) is associated with naturally-occurring feline infectious peritonitis (FIP) in cats in Australia. A retrospective comparison of the signalment between cats with confirmed FIP and the general cat population was designed. The patient signalment of 382 FIP confirmed cases were compared with the Companion Animal Register of NSW and the general cat population of Sydney. Younger cats were significantly over-represented among FIP cases. Domestic crossbred, Persian and Himalayan cats were significantly under-represented in the FIP cohort, while several breeds were over-represented, including British Shorthair, Devon Rex and Abyssinian. A significantly higher proportion of male cats had FIP compared with female cats. This study provides further evidence that FIP is a disease primarily of young cats and that significant breed and sex predilections exist in Australia. This opens further avenues to investigate the role of genetic factors in FIP.

  3. Catalase overexpression in aortic smooth muscle prevents pathological mechanical changes underlying abdominal aortic aneurysm formation. (United States)

    Maiellaro-Rafferty, Kathryn; Weiss, Daiana; Joseph, Giji; Wan, William; Gleason, Rudolph L; Taylor, W Robert


    The causality of the associations between cellular and mechanical mechanisms of abdominal aortic aneurysm (AAA) formation has not been completely defined. Because reactive oxygen species are established mediators of AAA growth and remodeling, our objective was to investigate oxidative stress-induced alterations in aortic biomechanics and microstructure during subclinical AAA development. We investigated the mechanisms of AAA in an angiotensin II (ANG II) infusion model of AAA in apolipoprotein E-deficient (apoE(-/-)) mice that overexpress catalase in vascular smooth muscle cells (apoE(-/-)xTg(SMC-Cat)). At baseline, aortas from apoE(-/-)xTg(SMC-Cat) exhibited increased stiffness and the microstructure was characterized by 50% more collagen content and less elastin fragmentation. ANG II treatment for 7 days in apoE(-/-) mice altered the transmural distribution of suprarenal aortic circumferential strain (quantified by opening angle, which increased from 130 ± 1° at baseline to 198 ± 8° after 7 days of ANG II treatment) without obvious changes in the aortic microstructure. No differences in aortic mechanical behavior or suprarenal opening angle were observed in apoE(-/-)xTg(SMC-Cat) after 7 days of ANG II treatment. These data suggest that at the earliest stages of AAA development H(2)O(2) is functionally important and is involved in the control of local variations in remodeling across the vessel wall. They further suggest that reduced elastin integrity at baseline may predispose the abdominal aorta to aneurysmal mechanical remodeling.

  4. Tetrathyridiosis in a domestic shorthair cat

    Directory of Open Access Journals (Sweden)

    Dorothee Dahlem


    Full Text Available Case summary This report describes the clinical and parasitological findings in a domestic shorthair cat with isolated thoracic tetrathyridiosis. The cat was a stray from Malta that had lived in Germany for several years since as an indoor-only cat. Therefore, the process of infection remains very unusual. In this case it must be considered that the cat had been infected years previously while in Malta, and had lived at least 4 years without any clinical signs. It was possible to diagnose this uncommon disease and initiate an effective treatment with fenbendazole, praziquantel and supportive care. Clinical signs, as well as radiographic findings, were regressive with this treatment. Relevance and novel information Tetrathyridiosis is a rare finding in cats, especially in Germany, but it seems to be a potential differential diagnosis of pleural effusion. Mesocestoides corti, which was the causative parasite in this case, has not previously been isolated in Germany. Because tetrathyridiosis is only diagnosed post mortem in most cases, little is known about effective therapeutic options. Furthermore, clinical signs of this disease can be absent for several years and can potentially be triggered by neoplastic conditions or immunosuppression. Tetrathyridiosis seems to be a treatable disease that can be controlled by adequate antiparasitic therapy.

  5. Social referencing and cat-human communication. (United States)

    Merola, I; Lazzaroni, M; Marshall-Pescini, S; Prato-Previde, E


    Cats' (Felis catus) communicative behaviour towards humans was explored using a social referencing paradigm in the presence of a potentially frightening object. One group of cats observed their owner delivering a positive emotional message, whereas another group received a negative emotional message. The aim was to evaluate whether cats use the emotional information provided by their owners about a novel/unfamiliar object to guide their own behaviour towards it. We assessed the presence of social referencing, in terms of referential looking towards the owner (defined as looking to the owner immediately before or after looking at the object), the behavioural regulation based on the owner's emotional (positive vs negative) message (vocal and facial), and the observational conditioning following the owner's actions towards the object. Most cats (79 %) exhibited referential looking between the owner and the object, and also to some extent changed their behaviour in line with the emotional message given by the owner. Results are discussed in relation to social referencing in other species (dogs in particular) and cats' social organization and domestication history.

  6. The CATS Service: an Astrophysical Research Tool

    CERN Document Server

    Verkhodanov, O V; Andernach, H; Chernenkov, V N


    We describe the current status of CATS (astrophysical CATalogs Support system), a publicly accessible tool maintained at Special Astrophysical Observatory of the Russian Academy of Sciences (SAO RAS) ( allowing one to search hundreds of catalogs of astronomical objects discovered all along the electromagnetic spectrum. Our emphasis is mainly on catalogs of radio continuum sources observed from 10 MHz to 245 GHz, and secondly on catalogs of objects such as radio and active stars, X-ray binaries, planetary nebulae, HII regions, supernova remnants, pulsars, nearby and radio galaxies, AGN and quasars. CATS also includes the catalogs from the largest extragalactic surveys with non-radio waves. In 2008 CATS comprised a total of about 10e9 records from over 400 catalogs in the radio, IR, optical and X-ray windows, including most source catalogs deriving from observations with the Russian radio telescope RATAN-600. CATS offers several search tools through different ways of access, e.g. via web inte...

  7. ParCAT: Parallel Climate Analysis Toolkit

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Brian E. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Steed, Chad A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Shipman, Galen M. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Ricciuto, Daniel M. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Thornton, Peter E. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Wehner, Michael [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Williams, Dean N. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)


    Climate science is employing increasingly complex models and simulations to analyze the past and predict the future of Earth s climate. This growth in complexity is creating a widening gap between the data being produced and the ability to analyze the datasets. Parallel computing tools are necessary to analyze, compare, and interpret the simulation data. The Parallel Climate Analysis Toolkit (ParCAT) provides basic tools to efficiently use parallel computing techniques to make analysis of these datasets manageable. The toolkit provides the ability to compute spatio-temporal means, differences between runs or differences between averages of runs, and histograms of the values in a data set. ParCAT is implemented as a command-line utility written in C. This allows for easy integration in other tools and allows for use in scripts. This also makes it possible to run ParCAT on many platforms from laptops to supercomputers. ParCAT outputs NetCDF files so it is compatible with existing utilities such as Panoply and UV-CDAT. This paper describes ParCAT and presents results from some example runs on the Titan system at ORNL.

  8. Nonequilibrium Flows with Smooth Particle Applied Mechanics. (United States)

    Kum, Oyeon

    Smooth particle methods are relatively new methods for simulating solid and fluid flows though they have a 20-year history of solving complex hydrodynamic problems in astrophysics, such as colliding planets and stars, for which correct answers are unknown. The results presented in this thesis evaluate the adaptability or fitness of the method for typical hydrocode production problems. For finite hydrodynamic systems, boundary conditions are important. A reflective boundary condition with image particles is a good way to prevent a density anomaly at the boundary and to keep the fluxes continuous there. Boundary values of temperature and velocity can be separately controlled. The gradient algorithm, based on differentiating the smooth particle expressions for (urho) and (Trho), does not show numerical instabilities for the stress tensor and heat flux vector quantities which require second derivatives in space when Fourier's heat -flow law and Newton's viscous force law are used. Smooth particle methods show an interesting parallel linking them to molecular dynamics. For the inviscid Euler equation, with an isentropic ideal gas equation of state, the smooth particle algorithm generates trajectories isomorphic to those generated by molecular dynamics. The shear moduli were evaluated based on molecular dynamics calculations for the three weighting functions, B spline, Lucy, and Cusp functions. The accuracy and applicability of the methods were estimated by comparing a set of smooth particle Rayleigh -Benard problems, all in the laminar regime, to corresponding highly-accurate grid-based numerical solutions of continuum equations. Both transient and stationary smooth particle solutions reproduce the grid-based data with velocity errors on the order of 5%. The smooth particle method still provides robust solutions at high Rayleigh number where grid-based methods fails. Considerably fewer smooth particles are required than atoms in a corresponding molecular dynamics

  9. Dual-support Smoothed Particle Hydrodynamics

    CERN Document Server

    Ren, Huilong; Zhuang, Xiaoying; Rabczuk, Timon


    In this paper we develop a dual-support smoothed particle hydrodynamics (DS-SPH) that naturally satisfies the conservation of momentum, angular momentum and energy when the varying smoothing length is utilized. The DS-SPH is based on the concept of dual-support, which is introduced to consider the unbalanced interactions between the particles with different smoothing lengths. Our DS-SPH formulation can be implemented in traditional SPH with little changes and improve the computational efficiency. Several numerical examples are presented to demonstrate the capability of the method.

  10. Born to roam? Surveying cat owners in Tasmania, Australia, to identify the drivers and barriers to cat containment. (United States)

    McLeod, Lynette J; Hine, Donald W; Bengsen, Andrew J


    Free-roaming domestic cats, Felis catus, are a major public nuisance in neighbourhoods across the world, and have been linked to biodiversity loss and a host of community health problems. Owners who let their cats roam, also place their cats at risk of serious injury. One management strategy that is gaining considerable support involves encouraging cat owners to contain their pets within their property. Contemporary behaviour change models highlight the importance of identifying drivers and barriers that encourage and discourage target behaviours such as cat containment. Results from a random dial phone survey of 356 cat owners in northern Tasmania identified four distinct cat containment profiles: owners who contained their cat all the time, owners who only contained their cat at night, owners who sporadically contained their cat with no set routine, and owners who made no attempt to contain their pet. Our results indicated that cat-owners' decisions to contain or not contain their cats were guided by a range of factors including owners' beliefs about their ability to implement an effective containment strategy and their views about the physical and psychological needs of their cats. The results are discussed in terms of improving the behavioural effectiveness of cat containment interventions by selecting appropriate behavioural change tools for the identified drivers and barriers, and developing targeted engagement strategies and messaging.

  11. A simple technique to remove migrated esophageal stents. (United States)

    Noyer, C M; Forohar, F


    A 51-yr-old man with a tracheoesophageal fistula from an esophageal carcinoma had two expandable covered stents placed, which migrated distally. After several unsuccessful attempts to remove the stents, we fashioned a homemade snare to entrap and remove the stents under endoscopic and fluoroscopic guidance.

  12. Esophageal space-occupying lesion caused by Ascaris lumbricoides

    Institute of Scientific and Technical Information of China (English)

    Ping-Ping Zheng; Bing-Yuan Wang; Fei Wang; Ran Ao; Ying Wang


    Ascaris lumbricoides is the largest intestinal nematode parasite of man,which can lead to various complications because of its mobility.As the esophagus is not normal habitat of Ascaris,the report of esophageal ascariasis is rare.An old female presented with dysphagia after an intake of several red bean buns and haw jellies.The barium meal examination revealed a spherical defect in the lower esophagus.Esophageal bezoar or esophageal carcinoma was considered at the beginning.The patient fasted,and received fluid replacement treatment as well as some oral drugs such as proton pump inhibitor and sodium bicarbonate.Then upper gastrointestinal endoscopy was done to further confirm the diagnosis and found a live Ascaris lumbricoides in the gastric antrum and two in the duodenal bulb.The conclusive diagnosis was ascariasis.The esophageal space-occupying lesion might be the entangled worm bolus.Anthelmitnic treatment with mebendazole improved patient's clinical manifestations along with normalization of the radiological findings during a 2-wk follow-up.Authors report herein this rare case of Ascaris lumbricoides in the esophagus,emphasizing the importance of awareness of this parasitic infection as it often presents with different and unspecific symptoms.

  13. Preoperative management of children with esophageal atresia: current perspectives

    Directory of Open Access Journals (Sweden)

    Parolini F


    Full Text Available Filippo Parolini,1 Anna Lavinia Bulotta,1 Sonia Battaglia,1 Daniele Alberti1,2 1Department of Pediatric Surgery, “Spedali Civili” Children’s Hospital, 2Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy Abstract: Esophageal atresia remains one of the most challenging congenital anomalies of the newborn. In recent years, because of the advances in prenatal diagnosis, neonatal critical care, and surgical procedures, overall outcomes have improved substantially, including for premature children. Nowadays, most of the research is focused on medium- and long-term morbidity, with particular reference to respiratory and gastroesophageal problems; the high frequency of late sequelae in esophageal atresia warrants regular and multidisciplinary checkups throughout adulthood. Surprisingly, there are few studies on the impact of prenatal diagnosis and there is continuing debate over the prenatal and preoperative management of these complex patients. In this review, we analyze the literature surrounding current knowledge on the management of newborns affected by esophageal atresia, focusing on prenatal management and preoperative assessment. Keywords: prenatal diagnosis, esophageal atresia, tracheoesophageal fistula, ultrasound scan, tracheobronchoscopy

  14. Aorto-esophageal fistula secondary to penetrating atherosclerotic ulcer

    Directory of Open Access Journals (Sweden)

    Ranjana Gupta


    Full Text Available Aorto-esophageal fistula (AEF is a rare and life threatening condition, which can be rapidly fatal. More than half of such cases are secondary to aortic aneurysm rupture. There are only two previous reports describing AEF caused by penetrating atherosclerotic ulcer. We present multidetector computed tomography findings in a case of AEF secondary to penetrating atherosclerotic ulcer.

  15. Large mid-esophageal granular cell tumor: benign versus malignant

    Directory of Open Access Journals (Sweden)

    Prarthana Roselil Christopher


    Full Text Available Granular cell tumors are rare soft tissue neoplasms, among which only 2% are malignant, arising from nervous tissue. Here we present a case of a large esophageal granular cell tumor with benign histopathological features which metastasized to the liver, but showing on positron emission tomography-computerized tomography standardized uptake value suggestive of a benign lesion.

  16. Esophageal Atresia and Tracheoesophageal Fistula with Unilateral Pulmonary Agenesis - Hypoplasia

    Directory of Open Access Journals (Sweden)

    Shraddha Verma


    Full Text Available Association of unilateral severe pulmonary hypoplasia or agenesis and esophageal atresia (EA with or without tracheoesophageal fistula (TEF is an exceedingly rare and highly lethal combination. We report a case of full term male baby who had EA with TEF and right lung hypoplasia, managed at our centre. He is alive and doing well at 10 years of age.

  17. Esophageal Atresia and Tracheoesophageal Fistula with Unilateral Pulmonary Agenesis - Hypoplasia

    Directory of Open Access Journals (Sweden)

    Katragadda Laxmi Narsimha Rao


    Full Text Available Association of unilateral severe pulmonary hypoplasia or agenesis and esophageal atresia (EA with or without tracheoesophageal fistula (TEF is an exceedingly rare and highly lethal combination. We report a case of full term male baby who had EA with TEF and right lung hypoplasia, managed at our centre. He is alive and doing well at 10 years of age.

  18. Esophageal space-occupying lesion caused by Ascaris lumbricoides. (United States)

    Zheng, Ping-Ping; Wang, Bing-Yuan; Wang, Fei; Ao, Ran; Wang, Ying


    Ascaris lumbricoides is the largest intestinal nematode parasite of man, which can lead to various complications because of its mobility. As the esophagus is not normal habitat of Ascaris, the report of esophageal ascariasis is rare. An old female presented with dysphagia after an intake of several red bean buns and haw jellies. The barium meal examination revealed a spherical defect in the lower esophagus. Esophageal bezoar or esophageal carcinoma was considered at the beginning. The patient fasted, and received fluid replacement treatment as well as some oral drugs such as proton pump inhibitor and sodium bicarbonate. Then upper gastrointestinal endoscopy was done to further confirm the diagnosis and found a live Ascaris lumbricoides in the gastric antrum and two in the duodenal bulb. The conclusive diagnosis was ascariasis. The esophageal space-occupying lesion might be the entangled worm bolus. Anthelmitnic treatment with mebendazole improved patient's clinical manifestations along with normalization of the radiological findings during a 2-wk follow-up. Authors report herein this rare case of Ascaris lumbricoides in the esophagus, emphasizing the importance of awareness of this parasitic infection as it often presents with different and unspecific symptoms.

  19. A Critical Appraisal of Circumferential Resection Margins in Esophageal Carcinoma

    NARCIS (Netherlands)

    Pultrum, Bareld B.; Honing, Judith; Smit, Justin K.; van Dullemen, Hendrik M.; van Dam, Gooitzen M.; Groen, Henk; Hollema, Harry; Plukker, John Th. M.


    In esophageal cancer, circumferential resection margins (CRMs) are considered to be of relevant prognostic value, but a reliable definition of tumor-free CRM is still unclear. The aim of this study was to appraise the clinical prognostic value of microscopic CRM involvement and to determine the opti

  20. Pharmacological and other treatment modalities for esophageal pain

    DEFF Research Database (Denmark)

    Hoff, Dag Arne Lihaug; Brock, Christina; Farmer, Adam D;


    are the mainstay in esophageal pain treatment, many patients are nonresponders to these drugs. The current concise review focuses on other systems affecting pain processing, where better understanding may serve as a framework for therapy. These are the parasympathetic nervous system, exercise, and personality...