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  • 1
    ISSN: 1432-0509
    Keywords: Esophagus, motility disorder ; Manometry ; Radiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Radiography and manometry of the esophagus were compared in 77 patients consecutively referred for manometric investigation on suspicion of esophageal motility disorder. Radiography and manometry were carried out simultaneously, and the results were assessed blindly. The examination comprised barium swallow, bread barium swallow, and barium swilling. Considering manometry as the standard, the overall sensitivity and specificity of the radiologic examinations were 90.4% and 92.0%, respectively. We conclude that radiology is an excellent investigation for the separation of patients with and without esophageal motility disorders, but correct subclassification often required manometry.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Cent huit malades atteints d'oesophagite par reflux ont subi une opération de Hill, associée à une vagotomie hypersélective. L'adjonction de ce type de vagotomie à l'opération anti-reflux a pour mérites de donner un meilleur accès au cardia et d'éviter les inconvénients de la vagotomie classique. Elle entraîne ainsi une réduction bénéfique du débit acide basal. Alors que le débit acide était inchangé chez les malades qui présentait des symptômes fonctionnels post opératoires, il était abaissé de façon significative chez les malades indemnes de tout trouble. Par ailleurs, la pression au niveau du sphincter inférieur de l'oesophage était toujours augmentée après l'intervention. Les complications ont été rares. 92% des malades ne présentaient aucun symptôme après 2 mois, 88% après un an et 71% après 2 ans. Une réduction remarquable des troubles pulmonaires a été remarquée, ce fait témoignant de la relation étroite qui existe entre les maladies respiratoires chroniques et le reflux gastro-oesophachez certains malades.
    Notes: Abstract Parietal cell vagotomy (PCV) and the Hill antireflux procedure were used in 108 patients with reflux esophagitis. The addition of PCV provides better access to the cardia and ensures that more extensive vagotomy than intended does not occur. Furthermore, a reduction in the basal acid output (BAO) is preferable. In patients still symptomatic after surgery, the BAO was unchanged, while in those without postoperative symptoms a significant decrease in BAO was found (p 〈 0.01). Gastroesophageal sphincter pressure was significantly higher postoperatively in all patients. Complications were few; 92% were asymptomatic at 2 months, 88% at 1 year, and 71% at 2 years. A remarkable reduction in pulmonary symptoms after operation indicates a close relationship between chronic pulmonary disease and gastroesophageal reflux in some patients.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Journal of hepato-biliary-pancreatic surgery 2 (1995), S. 249-254 
    ISSN: 1436-0691
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1573-2568
    Keywords: functional bowel disorders ; epidemiology ; diagnosis ; demography ; health care use ; work absenteeism
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Our objective was to obtain national data of the estimated prevalence, sociodemographic relationships, and health impact of persons with functional gastrointestinal disorders. We surveyed a stratified probability random sample of U.S householders selected from a data base of a national market firm (National Family Opinion, Inc.). Questions were asked about bowel symptoms, sociodemographic associations, work absenteeism, and physician visits. The sampling frame was constructed to be demographically similar to the U.S. householder population based on geographic region, age of householder, population density, household income and household size. Of 8250 mailings, 5430 were returned suitable for analysis (66% response). The survey assessed the prevalence of 20 functional gastrointestinal syndromes based on fulfillment of multinational diagnostic (Rome) criteria. Additional variables studied included: demographic status, work absenteeism, health care use, employment status, family income, geographic area of residence, population density, and number of persons in household. For this sample, 69% reported having at least one of 20 functional gastrointestinal syndromes in the previous three months. The symptoms were attributed to four major anatomic regions: esophageal (42%), gastroduodenal (26%), bowel (44%), and anorectal (26%), with considerable overlap. Females reported greater frequencies of globus, functional dysphagia, irritable bowel syndrome, functional constipation, functional abdominal pain, functional biliary pain and dyschezia; males reported greater frequencies of aerophagia and functional bloating. Symptom reporting, except for incontinence, declines with age, and low income is associated with greater symptom reporting. The rate of work/school absenteeism and physician visits is increased for those having a functional gastrointestinal disorder. Furthermore, the greatest rates are associated with those having gross fecal incontinence and certain more painful functional gastrointestinal disorders such as chronic abdominal pain, biliary pain, functional dyspepsia and IBS. Preliminary information on the prevalence, socio-demographic features and health impact is provided for persons who fulfill diagnostic criteria for functional gastrointestinal disorders.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Digestive diseases and sciences 34 (1989), S. 1894-1899 
    ISSN: 1573-2568
    Keywords: achalasia ; eosinophils ; eosinophil cationic protein ; cytotoxicity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Smooth-muscle specimens from the lower esophagus of nine patients operated on for esophageal achalasia were examined with routine hematoxylin-eosin staining. This procedure revealed only a few eosinophils in or between the external smooth-muscle layers. Using specific immunohistochemical methods for the detection of the eosinophil cationic protein (ECP), however, varying degrees of eosinophil infiltration and extracellular deposit of ECP were disclosed in the achalasia specimens. The ECP also reacted with the monoclonal antibody, EG2, indicating secretion of the cytotoxic ECP. Few or no eosinophils were seen in the muscularis externa in specimens from six control patients without esophageal disease. In two controls many eosinophils were observed in the muscularis externa. However, no extracellular ECP was detected and very few eosinophils reacted with the monoclonal antibody (EG2), suggesting that these eosinophils were not activated. Depletion or total absence of peptidergic innervation was seen in all achalasia specimens but not in controls. Since the eosinophil cationic protein (ECP), in its activated form, is cytotoxic, we propose a pathogenic role of the eosinophil infiltration in achalasia.
    Type of Medium: Electronic Resource
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