Effective Treatment of Symptomatic Lower Esophageal (Schatzki) Rings With Acid Suppression Therapy: Confirmed on Barium Esophagography.

Objective: Symptomatic lower esophageal (Schatzki) rings are one of the most common causes of dysphagia and esophageal food impaction. Although these rings are often diagnosed fluoroscopically, patients are typically referred for dilation procedures performed by a gastroenterologist. Because these procedures are invasive and carry risks, including esophageal perforation, an alternative treatment option is needed.

Student and faculty performance in clinical simulations with access to a searchable information resource.

In this study we explore how students' use of an easily accessible and searchable database affects their performance in clinical simulations. We do this by comparing performance of students with and without database access and compare these to a sample of faculty members. The literature supports the fact that interactive information resources can augment a clinician's problem solving ability in small clinical vignettes.

Detection of cecal adenocarcinoma by Tc-99m pertechnetate scintigram.

A 23-year-old male presented with occult gastrointestinal bleeding and iron deficiency anemia. A Tc-99m pertechnetate abdominal scan was positive and surgery revealed an adenocarcinoma of the cecum. No Meckel's diverticulum was identified.

Serial carcinoembryonic antigen (CEA) blood levels in patients with ulcerative colitis.

Fifty-seven patients with ulcerative colitis were folloued 1-49 months (mean, 18 months) with serial CEA determinations during periods of remission, mild relapses, and severe relapses. Elevated CEA titers correlated with activity and possibly extent of disease: 12% of patients with proctitis, 47% of patients with left-sided colitis, and 60% of patients with transverse or universal colitis had elevated CEA titers during a flare. Moreover, 24% of patients with mild flares and 86% of patients with severe flares had elevated CEA titers.

Does lower esophageal sphincter incompetency contribute to esophageal bleeding?

The purpose of this study is to determine whether lower esophageal sphincter (LES) incompetency is a common occurrence in patients with liver cirrhosis and contributes to the development of variceal bleeding. Resting LES pressure (17.8 +/- 1.

Strong MJ, Hendrix TR: Response of the human oesophagus to d-tubocurarine and atropine.

Intraluminal manometric studies of normal swallowing activity fail to distinguish between the peristaltic response of striated and smooth muscle. Studies were performed to determine if the two types of musculature differ in their response to pharmacological stimulation. After the administration of d-tubocurarine, peristaltic amplitude in the striated muscle segment decreased by 26 to 51%, while amplitude in the smooth muscle portion was not significantly affected.

Successful treatment of chronic esophageal moniliasis with a viscous suspension of nystatin.

A 35-year-old man with idiopathic hypoparathyroidism and moniliasis developed progressive dysphagia and weight loss. Diagnostic studies established the presence of esophageal moniliasis. Therapy with a viscous suspension of nystatin resulted in rapid clinical improvement; prolonged administration of the drug was associated with progressive widening of a narrowed segment of esophagus and complete disappearance of dysphagia.