Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Cardia”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 217 records · Page 12Linked to original sources
PubMed1997

Is Barrett's esophagus the precursor of most adenocarcinomas of the esophagus and cardia? A biochemical study.

OBJECTIVE: To obtain biochemical evidence that Barrett's esophagus (BE) is the precursor of most adenocarcinomas (Adc) of the esophagus and cardia. SUMMARY BACKGROUND DATA: Based on morphologic data, BE was previously proposed as the precursor of most Adc of the esophagus. This hypothesis would receive strong support if biochemical evidence were found to demonstrate a pattern common to BE and Adc of the esophagus and cardia. METHODS: We studied the presence of intestinal-type proteins sucrase-isomaltase (SI) and crypt Cell Antigen (CCAg) in BE, Barrett's Adc, and esophageal-cardial Adc without BE. In each case specimens were collected from normal esophagus, stomach, tumor, and BE mucosa when present. To study related conditions, five specimens of peptic esophagitis and of squamous cell carcinoma were also analyzed. An indirect immunofluorescence technique was employed and sections were analyzed with laser confocal microscopy imaging. RESULTS: Most Barrett's mucosa specimens stained positively for SI (93%) and CCAg (89%). These proteins were detected in BE independently of the type of metaplasia, the coexistence of dysplasia, or the presence of associated Adc. SI and CCAg were present in 25 (96%) and 24 (92%) of the cases of Adc respectively. No statistical difference was detected in SI and CCAg expression between Adc samples with and without BE, between BE and Adc samples with or without BE, and between tumors located in the esophagus versus the cardia. No staining for these proteins was detected in stomach or esophageal mucosa, in submucosal glands of the esophagus, in peptic esophagitis or squamous cell carcinoma. CONCLUSION: These data show that BE and Adc of the esophagus and cardia have a similar phenotype and support the hypothesis that most of these tumors probably originate from preexisting BE.

Adenocarcinoma↗
PubMed2002

Relationship of gastroesophageal reflux disease with adenocarcinoma of the distal esophagus and cardia.

BACKGROUND: Recent studies have suggested that gastroesophageal reflux disease (GERD) increases the risk of developing adenocarcinoma of the distal esophagus and cardia. In order to further define this risk, we studied the relationship of GERD in patients with or without gastroesophageal junction adenocarcinomas. METHODS: The records of all patients with adenocarcinoma of the distal esophagus and cardia treated between 1991 and 1999 were reviewed for the following data: gender, age of diagnosis, presence of GERD, presence of GERD for >4 years, and GERD treatment. A control group of patients without gastroesophageal junction adenocarcinoma were matched for age and gender. Data obtained from the control group included presence of GERD and treatment for GERD. RESULTS: 60 patients with adenocarcinoma of the distal esophagus and cardia were identified. 40% of cancer patients had GERD at the time of diagnosis, (odds ratio 39, p < 0.0001). 27% of cancer patients had GERD for >4 years (odds ratio 21, p < 0.0001). 50% of cancer patients with GERD were being treated with either H(2)-blockers or proton pump inhibitors at the time of cancer diagnosis, with an average duration of treatment of 17 months, compared to none of the patients without GERD (p = 0.006). CONCLUSIONS: Patients with gastroesophageal junction adenocarcinoma had a higher prevalence of GERD-like symptoms compared to age- and gender-matched controls. This supports an association between GERD and gastroesophageal junction cancers. In addition, cancer patients with GERD may be treated for prolonged periods of time with acid-suppression medication prior to the diagnosis of cancer, masking the symptoms of cancer. Patients with long-standing GERD or older patients with new onset GERD may need endoscopy or imaging studies to evaluate for cancer of the distal esophagus or cardia.

Adenocarcinoma↗
PubMedDate not supplied

Expression of cyclooxygenase-2 in human adenocarcinomas of the gastric cardia and corpus.

Several studies indicate that the use of non-steroidal anti-inflammatory drugs (NSAIDs) may reduce the risk of gastric corpus and possibly gastric cardia cancers. The best known action of NSAIDs is to block the enzyme cyclooxygenase, the rate limiting enzyme in the conversion of arachidonic acid to prostaglandins. We investigated the expression of cyclooxygenase-2 (Cox-2) in adenocarcinomas of the gastric cardia (N=19) and corpus (N=15) and in adjacent normal epithelium from a high risk Chinese population. Immunohistochemical detection of Cox-2 revealed positive staining in 36% of the gastric cardia cancer cases and 60% of the gastric corpus cancer cases, whereas histologically normal tissue from the same patients were negative. Smooth muscle, stroma and inflammatory cells were also positive. Our results suggest that Cox-2 is overexpressed in a large proportion of adenocarcinomas of the gastric corpus and in a smaller number of gastric cardia cancer cases.

Adenocarcinoma↗
PubMed1995

Rift Valley fever virus in the cardia of Culex pipiens: an immunocytochemical and ultrastructural study.

In this paper, we consider the movement of Rift Valley fever (RVF) virus from infected mosquito midgut epithelial cells into the hemocoel as an important factor in the ultimate ability of the insect to transmit the virus. Our results are therefore significant in the context of vector competence. The mosquito Culex pipiens was identified as the primary vector of RVF in an epidemic that occurred in Egypt in the 1970s. On this basis, we have carried out several studies of RVF virus in this mosquito species. In the research reported here, we used immunocytochemical and transmission electron microscopic techniques to study the occurrence of RVF virus in the mosquito cardia and aspects of the histology and ultrastructure of this organ. The cardia is a complex organ consisting of both foregut and midgut tissue and is the location of the foregut-midgut junction. The cardia is of interest because it appears to provide routes of RVF virus egress from the midgut lumen and it is consistently infected in mosquitoes with disseminated infections, making it a potentially important site of viral amplification and an ideal site for studying RVF viral morphogenesis. In orally infected mosquitoes, large numbers of RVF virions were observed budding into the basal labyrinth associated with the outer cardial epithelial cells and into the noncellular matrix associated with the inner cardial epithelial cells and the cells of the intussuscepted foregut. In mosquitoes infected by injection of virus into the hemocoel and then held for different incubation periods, viral antigen was first detected in the cells of the intussuscepted foregut in the cardia and later in the cardial epithelial cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMedDate not supplied

Predictors of response to pneumatic dilatation in achalasia cardia.

BACKGROUND: The role of esophageal laboratory testing in predicting response to balloon dilatation in patients with achalasia cardia has been evaluated in the West; data in Indian patients are scant. AIM: To study the predictors of response to pneumatic balloon dilatation in Indian patients with achalasia cardia. METHODS: Twenty-five patients with achalasia cardia who had earlier undergone esophageal manometry before balloon dilatation (Group A) were recalled for clinical evaluation. Another consecutive 25 patients with newly diagnosed achalasia (Group B) underwent esophageal manometry and isotope transit studies before and after dilatation. RESULTS: The overall symptom response to dilatation in the 50 patients at median (range) follow up of 26 (1-60) months was 64%. Pre-dilatation clinical and laboratory parameters did not predict outcome. All patients with 1-week post-dilatation lower esophageal sphincter (LES) basal pressure less than or equal to 10 mmHg and residual pressure less than 6 mmHg were asymptomatic at follow up. CONCLUSION: Post-dilatation LES basal pressure less than or equal to 10 mmHg and residual pressure less than 6 mmHg are predictors of symptom response to balloon dilatation in patients with achalasia cardia.

Adolescent↗
PubMedDate not supplied

Omentoplasty versus no omentoplasty for esophagogastrostomy after surgery for cancer of cardia and esophagus.

BACKGROUND: The standard of care of patients with cancer of cardia and esophagus still remains surgery in early stage. One of the most feared complications after such procedure is anastomotic leak. AIM: We present our experience with omental wrapping of anastomosis (omentoplasty) to decrease the anastomotic leak. SETTINGS AND DESIGN: Retrospective study. MATERIALS AND METHODS: An analysis of 50 consecutive patients, who underwent surgical resection for cancer of cardia and esophagus at BPKMCH, is done. For cancer of esophagus, a 10 cm proximal tumor free margin and for lesions of cardia, at least 5 cm margin was achieved. A 5 cm distal tumor free margin was achieved in each case. A subset of patients was considered for omentoplasty after completion of anastomosis. RESULTS: There were 29 male and 21 female with a mean age of 56.3 years. The average postoperative stay was 13.14 days. The stomach was the organ of substitute in 48 and jejunum in 2 cases. Omentoplasty was done in 37 cases, whereas in 13 cases, no omental wrapping was done. The rate of anastomotic leak was 6%. There was no leak from anastomosis placed at chest, whereas three cases of leak was observed in the anastomosis at the level of neck (P=.013). Overall, there was no leak in omentoplasty group, whereas there were three cases with leak in the group without omentoplasty (P=0.003). CONCLUSION: Omentoplasty should be considered in every case after surgical resection for cancer of cardia and esophagus.

Adult↗
PubMed1991

The CARDIA dietary history: development, implementation, and evaluation.

To meet the objectives for dietary assessment in the Coronary Artery Risk Development in Young Adults (CARDIA) prospective study, we developed a dietary history to provide accurate and reliable quantitative data on habitual individual nutrient intakes at baseline. The CARDIA dietary history was an interviewer-administered method that included a short questionnaire regarding general dietary practices followed by a comprehensive food frequency questionnaire about typical intake of foods using the previous month as a reference for recall. For each broad category of foods, participants were questioned in detail about specific foods only if they indicated that they consumed foods from that category. Follow-up questions for selected foods concerned serving size, frequency of consumption, and common additions to these foods. Provision was made for reporting foods not found in the food frequency list. The interview took approximately 45 minutes. Cue cards prompted responses and plastic food models assisted in estimating usual amounts consumed. A precoded format standardized coding for reported items and established the detail needed for recall during the interview. Baseline nutrient analyses from the CARDIA dietary history provided estimates that agreed reasonably well with expected caloric intake for body mass index according to the age- and sex-specific Recommended Dietary Allowances, but were higher than those reported from 24-hour recalls for comparable age, sex, and race groups in the second National Health and Nutrition Examination Survey. The CARDIA dietary history is a comprehensive assessment tool that can provide a dietitian with detailed information regarding habitual eating patterns and nutrient intakes among adults.

Adult↗
PubMedDate not supplied

Recruiting young adults in an urban setting: the Chicago CARDIA experience.

The recruitment goal of Chicago Coronary Artery Risk Development in Young Adults (CARDIA) was 1,100 randomly selected young adults, in equal proportions for men and women, blacks and whites, two age groups, and two education groups. CARDIA is an ongoing multicenter study of the health and lifestyles of young adults designed to trace the development of risk factors for coronary heart disease over time. Participants completed a four-and-one-half hour exam and agreed to return two years later. In Chicago CARDIA, one of the four centers in the national collaborative study, random digit dialing of computer-generated telephone lists was the initial recruitment technique. Initial recruitment efforts resulted in too few low-socioeconomic status (SES) white participants and too few blacks. In response the sampling procedure was modified to focus on census tracts with a high density of blacks, more low-SES whites, and convenient public transportation. By being flexible, Chicago CARDIA improved recruitment in certain hard-to-fill cells and achieved the overall goals: 1,109 participants, 50% black and 50% white, near equal proportions by sex and age, and close to the recommended 40%/60% spread on education. The Chicago experience should benefit others conducting research in an urban setting.

Adult↗
PubMed1994

A study of the reliability and comparative validity of the cardia dietary history.

This study evaluated the reliability and comparative validity of the dietary history survey method developed for CARDIA, a longitudinal investigation of life-styles and the evolution of cardiovascular risk factors in young adults. The method was tested in a sample of 30 white men, 33 white women, 33 black men, and 32 black women, aged 18 to 35 years, in four regions reflecting the race, sex, age, and geographical distribution of CARDIA participants. For 64 of the participants, two dietary history interviews, 1 month apart, were conducted by trained nutritionists. These data were used to examine the reliability of the method. For all participants, seven telephone- assessed 24-hour dietary recalls were randomly scheduled during a 28-day period and were followed by a dietary history interview. These data were used to examine the comparative validity of the method. Calories, total fat, saturated fat, polyunsaturated fat, monounsaturated fat, dietary cholesterol, protein, carbohydrate, alcohol, potassium, calcium, and vitamin A were selected by the CARDIA Nutrition Working Group as the nutrients for comparison. Mean nutrient values from the first history tended to be higher than those obtained from the last history. However, for a majority of the nutrients, the differences were significant for blacks but not for whites. The correlations for the log-transformed nutrient values and calorie-adjusted nutrient values from the two histories were generally in the range of 0.50 to 0.80 for whites. For blacks, the correlations were lower, with a majority in the range of 0.30 to 0.70. The average nutrient values estimated from the histories were higher than those estimated from the average of the seven 24-hour recalls. The differences in blacks were larger than in whites. For both the log-transformed nutrient values and the calorie-adjusted nutrient values, the correlations between the two methods were generally larger than 0.50 for whites. However, for blacks, the correlations were lower, and for several macronutrients, the correlations were close to zero. These results suggest that the CARDIA dietary history is a reasonably reliable and valid dietary survey method for obtaining information about habitual intakes in whites. In blacks, the results are less consistent. The black-white differences remained when the analyses were stratified by education. These results raise a question about differences in reporting between blacks and whites.

Adolescent↗
PubMed1998

Relationship of manometric findings to symptomatic response after pneumatic dilation in achalasia cardia.

BACKGROUND: Achalasia cardia is usually treated by pneumatic dilation or surgical esophagomyotomy. The role of esophageal manometry for objective assessment of symptom response is controversial. AIM: To study the relationship between symptoms and manometric parameters before and after pneumatic dilation in patients with achalasia cardia. METHODS: Sixteen patients with achalasia cardia underwent esophageal manometry before and after undergoing pneumatic dilation. At each time, lower esophageal sphincter (LES) pressure and mean basal esophageal-gastric pressure gradient (MIEP-MIGP) were measured. RESULTS: Good symptom response was obtained in 12 of 16 patients. Median (range) LES pressure fell from 42 (17-51) mmHg to 18 (8-39) mmHg in those patients with a good response, and from 51 (25-68) mmHg to 29.5 (23-42) mmHg in those who responded poorly. Mean intraesophageal pressure fell below mean intragastric pressure in both the groups. CONCLUSIONS: Esophageal manometry does not correlate with symptom improvement after pneumatic dilation in achalasia cardia. Dysphagia may persist in spite of reversal of the MIEP-MIGP gradient.

Adolescent↗
PubMed2004

Achalasia cardia and alacrima in an infant.

Achalasia cardia is a very rare entity in children and may go undiagnosed for many months if not suspected. We report a case of a 4 months old child who presented with regurgitation of milk and solids and failure to thrive. She was initially treated as gastro-oesophageal reflux. There was a family history of achalasia cardia in the kins with resultant death in one and grossly delayed milestones in the other. Along with achalasia cardia, our patient had alacrima, which brought attention to the associations of achalasia with 'double A', 'triple A' and the '4 A' syndromes.

Adrenocorticotropic Hormone↗
PubMed1995

A 15-year review of esophagectomy for carcinoma of the esophagus and cardia.

OBJECTIVE: To evaluate the effect of surgical approach and adjuvant therapy on patients with carcinoma of the esophagus and/or cardia. DESIGN: Retrospective analysis of 157 consecutive patients who underwent esophagectomy. SETTING: A private university medical center and its affiliated community hospital. PATIENTS: One hundred twenty men and 37 women (mean age, 61.7 years) with carcinoma of the esophagus and/or cardia that was surgically treated between 1978 and 1993. INTERVENTIONS: Three approaches were used for resection: Transhiatal esophagectomy (THE) (n = 67), transthoracic esophagectomy (TTE) (n = 71), and abdominal-only esophagectomy (AOE) (n = 19). Sixty-five patients received adjuvant radiotherapy and chemotherapy. MAIN OUTCOME MEASURES: Surgical mortality, morbidity, and survival and the effect of adjuvant therapy. RESULTS: The overall surgical mortality rate was 7.6%: 12.7% with the TTE, 4.5% with the THE, and 0% with the AOE approach. A significantly increased incidence of adult respiratory distress syndrome (P < .001) and empyema (P < .001) was seen with the TTE approach. The average intraoperative blood loss (P = .08) and the median intensive care unit stay (P = .26) and hospital stay (P = .40) were decreased with the THE and AOE approaches when compared with the TTE approach without significance. The overall median survival time was 17 months, with a 5-year survival rate of 21%. There was no significant difference in survival by pathologic stage between approaches. The addition of adjuvant therapy did not affect the overall median survival time or the 5-year survival rate. Node-positive patients did benefit from adjuvant radiotherapy and chemotherapy, with increased median survival times from 7 to 15 months and a 5-year survival rate from 0% to 15% (P = .01). CONCLUSIONS: The THE and AOE approaches have fewer early complications than does TTE. Both THE and TTE have equal long-term survival rates. Adjuvant therapy provides increased survival to node-positive patients with carcinoma of the esophagus and/or cardia.

Adult↗
PubMed1999

Surgical resection for cancer of the cardia.

From the pathogenic and therapeutic point of view, adenocarcinomas of the esophagogastric junction (AEG) should be classified into adenocarcinoma of the distal esophagus (Type I), true carcinoma of the cardia (Type II), and subcardial carcinoma (Type III). This classification can be easily performed by summarizing the information available from contrast radiography, endoscopy, and intra-operative findings; it allows comparison of data between various centers and facilitates the choice of surgical therapy. A complete removal of the primary tumor and its lymphatic drainage has to be the primary goal of any surgical approach to adenocarcinoma of the esophagogastric junction. In patients with potentially resectable, true carcinoma of the cardia (AEG Type II), this can be achieved by a total gastrectomy with transhiatal resection of the distal esophagus and en bloc removal of the lymphatic drainage in the lower posterior mediastinum and along the celiac axis and superior border of the pancreas. This approach is associated with lower morbidity and provides equal long-term survival as compared to the more radical transmediastinal or abdominothoracic esophagogastrectomy. Whether a routine splenectomy for lymphadenectomy in the splenic hilus offers a survival benefit in these patients is questionable. In patients with early tumors staged as uT1 on pre-operative endosonography, a limited resection of the proximal stomach, cardia, and distal esophagus with interposition of a pedicled isoperistaltic jejunal segment appears justified since this procedure allows a complete tumor removal with adequate lymphadenctomy and offers excellent functional results. Multimodal therapy with pre-operative polychemotherapy or combined radio-chemotherapy appears to offer a significant survival benefit in patients with locally advanced tumors. With this tailored approach, extensive pre-operative staging becomes mandatory for an adequate selection of the appropriate therapeutic concept.

Adenocarcinoma↗
PubMed1992

Cigarette and alcohol use in patients with adenocarcinoma of the gastric cardia or lower esophagus.

The authors studied the cigarette and alcohol use of 243 patients with adenocarcinoma of the cardia or lower esophagus, including 66 with Barrett's metaplasia (esophagocardia group). They compared results of that investigation with the cigarette and alcohol use of 303 patients with squamous carcinoma of the esophagus, a cancer in which an etiologic association is proven, and of 338 patients with stomach cancer not involving the cardia, a cancer in which there is little or no association with cigarettes or alcohol. Controlled for other variables, patients with squamous cancer used more cigarettes and alcohol than the other two groups. There was no significant difference in cigarette or alcohol use between patients with esophagocardia and stomach cancer or between those in the esophagocardia group with or without Barrett's metaplasia. Because cigarette and alcohol use was not greater in patients with esophagocardia than in those with stomach cancer, the authors do not think that such factors explain the increasing incidence of adenocarcinoma of the cardia or lower esophagus.

Adenocarcinoma↗
PubMed2004

Surgical treatment for cancer of the oesophagus and gastric cardia in Hebei, China.

BACKGROUND: Southern Hebei Province has one of the highest incidences of oesophageal cancer in the world. This study describes a single-centre experience with oesophagectomy for this condition. METHODS: The reported articles on surgical treatment for cancer of the oesophagus and gastric cardia from a single department between September 1952 and December 2000 were summarized and the results compared. RESULTS: Between September 1952 and December 2000, the resectability rate increased from 78.8 to 96.0 per cent for oesophageal cancer and from 69.6 to 94.8 per cent for cancer of the cardia. The surgical mortality rate decreased from 4.6 to 1.1 per cent. There was little change in the overall 5-year survival rate; it increased from 21.2 to 23.9 per cent for patients with oesophageal cancer and from 15.2 to 17.6 per cent for those with cancer of the cardia. CONCLUSION: The rate of postoperative complications and deaths following oesophagectomy for cancer has fallen steadily over the past five decades but long-term survival remains disappointing. Improved survival is likely to be dependent on earlier diagnosis and adjunctive therapies.

Cardia↗
PubMed2005

Prospective analysis of patients with adenocarcinoma of the gastric cardia and lymph node metastasis in the proximal field of the chest.

BACKGROUND: The extent to which adenocarcinoma of the cardia with lymph node metastasis in the upper mediastinum is amenable to cure by radical surgery is open to debate. It remains unclear whether these relatively distant metastases have an effect on long-term survival. The aim of this study was to identify the incidence of such positive nodes and evaluate their prognostic significance. METHODS: Some 50 patients with adenocarcinoma of the gastric cardia and substantial invasion of the oesophagus (junctional type II), who underwent an extended transthoracic oesophagectomy as part of a prospective randomized trial between 1994 and 2000, were studied. RESULTS: Eleven patients (22 per cent) had lymph node metastasis in the proximal field of the chest. These patients had more positive nodes overall (P = 0.020) and a shorter median survival (P = 0.009) than those without such metastasis. Multivariate analysis identified positive nodes in the proximal field as an independent predictor of poor survival. CONCLUSION: Lymph node metastasis in the proximal field of the chest is common and is an indicator of poor prognosis in patients with adenocarcinoma of the cardia.

Adenocarcinoma↗
PubMed2007

Proposal for a new definition of true cardia carcinoma.

BACKGROUND AND OBJECTIVES: It remains controversial whether cardia carcinoma should be categorized and treated as esophageal cancer or gastric cancer. The purpose of this study was to develop a reasonable definition of cardia carcinoma. METHODS: Patients with Siewert type II carcinomas were divided into two subgroups: 25 patients with a tumor center within 1 cm of the esophagogastric junction (EGJ) (type IIA) and 22 patients with tumor center 1-2 cm aboral of the EGJ (type IIB). Patients with subcardia carcinomas, 40 with invasion to the EGJ (type III) and 110 without (type IIIe-), were used as controls. RESULTS: The patients with type IIB carcinomas showed no different characteristics from those with type III or type IIIe- carcinomas, except for the stage of the disease. On the other hand, those with type IIA carcinomas were associated with a higher male/female ratio, higher incidences of elevated appearance, differentiated histology, and mediastinal node metastasis, and a significantly lower survival rate as compared with patients with subcardia carcinomas. Multivariate survival analysis revealed that type IIA is a significant prognostic determinant, but that type IIB is not. CONCLUSION: Type IIA carcinomas should be treated as true cardia carcinoma; type IIB as subcardia carcinoma. Our results should be confirmed by a prospective study.

Adenocarcinoma↗
PubMed1989

Results of surgical treatment in 6,123 cases of carcinoma of the esophagus and gastric cardia.

Six thousand one hundred twenty-three cases of carcinoma of the esophagus and gastric cardia were treated surgically from 1965 to 1985. Overall resectability was 89.9%. Postoperative mortality was 3%, and incidence of postoperative complication, 10.3%. Follow-up rate was 91.3%, with 5 year survival of 36.8% (esophageal nearly twice that of gastric cardia), and 10 year survival of 17.2%. Factors affecting long-term survival were clinicopathologic staging and preoperative irradiation. Early discovery and timely treatment are the key to high resectability and improved long-term survival. More efficacious combined therapies are needed for the predominant late cases. We propose more radical resection because of the multifocal tendency of esophageal and extensive submucosal infiltration of cardia carcinoma. Continuing refinements of surgical technique helped to reduce postoperative leakage and structure.

Adult↗