Dermatomyositis (DM) is a kind of idiopathic inflammatory myopathy characterized by chronic proximal skeletal muscle weakness and unique skin lesions. However, DM with exfoliation of esophageal mucosa is rare. A 36-year-old male patient complained of muscular soreness of extremities, dysphagia, and pharyngalgia was diagnosed with DM with exfoliation of esophageal mucosa. After treatment with glucocorticoid, immunosuppressant, acupuncture, and endoscopic submucosal dissection (ESD), the above symptoms were disappeared. During the 3-year follow-up period, the results of routine physical examination, laboratory examination, gastroscopy, and imaging examination were normal. High-dose of corticosteroid is needed in the initial treatment, but it must be reduced regularly to avoid adverse reactions. Acupuncture and ESD are also effective as adjuvant therapy.
Adult ; Dermatomyositis/complications* ; Endoscopic Mucosal Resection ; Esophageal Mucosa ; Esophageal Neoplasms ; Gastroscopy ; Humans ; Male ; Treatment Outcome

OBJECTIVE: To evaluate the safety and prognosis for patients with early esophageal cancer and precancerous lesions after endoscopic submucosal dissection (ESD).
 METHODS: A total of 89 patients were admitted to the Department of internal medicine in the First People's Hospital of Anqing from August 2008 to August 2011. All patients were treated with ESD at the early stage of esophageal cancer and precancerous lesions. The patients' laboratory data and relevant medical history were collected. The postoperative complications and long-term effects of ESD were analyzed.
 RESULTS: Eighty-nine patients were followed up with 100% response rate. Among 89 cases, 16 were early esophageal cancer, 38 were high-grade esophageal neoplasia and 35 were low-grade esophageal neoplasia. The one-time whole piece resection rate, complete resection rate and curative resection rate was 93.3% (84/89), 92.1% (82/89) and 92.1% (82/89), respectively. Two cases suffered intraoperative perforation with a rate of 2.2% and these 2 patients performed the intraoperative endoscopic repair; one case suffered the postoperative delayed bleeding with a rate of 1.1% and the patient underwent the conservative treatment; three cases suffered the esophageal stenosis with a rate of 3.4%. All patients were followed-up for 10-58 (36.3±21.2) months. In this period, one case recurred after ESD for 3 years with a rate of 1.1%; two cases were dead. The three-year survival rate was 97.8%.
 CONCLUSION The early esophageal cancer and precancerous lesions can be treated with ESD. The method is safe and the prognosis is good.
Dissection ; Endoscopy ; adverse effects ; Esophageal Neoplasms ; surgery ; Esophageal Perforation ; Esophageal Stenosis ; Humans ; Postoperative Complications ; Postoperative Hemorrhage ; Prognosis

Esophageal Neoplasms ; complications ; genetics ; Humans ; Infant ; Leiomyomatosis ; complications ; genetics ; Male ; Nephritis, Hereditary ; complications ; genetics

OBJECTIVE: To explore the clinical characteristics and prognosis of multiple myeloma(MM) patients with secondary primary malignancies. METHODS: The clinical data of newly diagnosed MM patients admitted to the First Affiliated Hospital of Zhengzhou University from January 2011 to December 2019 were retrospectively analyzed. The patients with secondary primary malignancies were retrieved, and their clinical features and prognosis were evaluated. RESULTS: A total of 1 935 patients with newly diagnosed MM were admitted in this period, with a median age of 62 (18-94) years old, of which 1 049 cases were hospitalized twice or more. There were eleven cases with secondary primary malignancies (the incidence rate was 1.05%), including three cases of hematological malignancies (2 cases of acute myelomonocytic leukemia and 1 case of acute promyelocytic leukemia) and eight cases of solid tumors (2 cases of lung adenocarcinoma, and 1 case each of endometrial cancer, esophageal squamous cell carcinoma, primary liver cancer, bladder cancer, cervical squamous cell carcinoma, and meningioma). The median age of onset was 57 years old. The median time between diagnosis of secondary primary malignancies and diagnosis of MM was 39.4 months. There were seven cases with primary or secondary plasma cell leukemia, the incidence rate was 0.67%, and the median age of onset was 52 years old. Compared with the randomized control group, the β2-microglobulin level in the secondary primary malignancies group was lower (P=0.028), and more patients were in stage I/II of ISS (P=0.029). Among the 11 patients with secondary primary malignancies, one survived, ten died, and the median survival time was 40 months. The median survival time of MM patients after the secondary primary malignancies was only seven months. All seven patients with primary or secondary plasma cell leukemia died, with a median survival time of 14 months. The median overall survival time of MM patients with secondary primary malignancies was longer than that of the patients with plasma cell leukemia (P=0.027). CONCLUSION The incidence rate of MM with secondary primary malignancies is 1.05%. MM patients with secondary primary malignancies have poor prognosis and short median survival time, but the median survival time is longer than that of patients with plasma cell leukemia.
Humans ; Middle Aged ; Aged ; Aged, 80 and over ; Multiple Myeloma/complications* ; Leukemia, Plasma Cell ; Retrospective Studies ; Esophageal Neoplasms/complications* ; Esophageal Squamous Cell Carcinoma/complications* ; Prognosis ; Neoplasms, Second Primary

Adenoma ; diagnosis ; etiology ; Adult ; Esophageal Neoplasms ; complications ; diagnosis ; Humans ; Male ; Parathyroid Neoplasms ; diagnosis ; etiology

No abstract availble.
Esophageal Neoplasms/complications/pathology/*radiography ; Esophageal Perforation/etiology/*radiography/therapy ; Humans ; Male ; Middle Aged ; Stents ; Tomography, X-Ray Computed

OBJECTIVETo investigate the correlation between helicobacter pylori L-form (Hp-L) infection in human esophageal carcinoma (EC) and tumor angiogenesis, and study the effect of Hp-L on the malignant biological behaviors of EC.

METHODSHp-L was examined in 98 patients with EC and 30 controls by Gram stain, electronmicroscopic technique and immunohistochemical stain (ABC method). VEGF, p53 protein and microvessel density (MVD) were examined by immunohistochemical stain (SP method) with their relationship with the clinicopathologic factors analyzed.

RESULTSThe positive rate of Hp-L was 60.2% in EC group. Two types of Hp-L were detected in the tissue of EC by electronmicroscopic technique, which lay in the outer or inner carcinoma cells. The positive rates of Hp-L, MVD, VEGF and p53 in the cancer group were significantly higher than those in control group (P < 0.005-0.001). The positive rates of MVD, VEGF and p53 in the Hp-L positive group of EC were significantly higher than those in Hp-L negative group (P < 0.005-0.001). The positive rate of Hp-L was correlated with MVD (r = 0.46, P < 0.01) and the expression of VEGF and p53 (r = 0.31, P < 0.01). The positive rate of Hp-L in the EC group was correlated with vessel invasion, depth of invasion, metastasis to the para-esophageal and distant lymph nodes except tumor size.

CONCLUSIONHp-L infection in EC is closely related with tumor angiogenesis and may be an important promoting factor in esophageal carcinoma growth, invasion and metastasis.

Adult ; Aged ; Esophageal Neoplasms ; complications ; Female ; Helicobacter Infections ; complications ; Helicobacter pylori ; Humans ; Male ; Middle Aged ; Neovascularization, Pathologic ; complications

Aged ; Bronchoscopy ; Esophageal Neoplasms ; complications ; Female ; Humans ; Male ; Middle Aged ; Stents ; Thyroid Neoplasms ; complications ; Tracheal Stenosis ; etiology ; therapy

Alkaline esophagitis is a postoperative complication of a gastrectomy due to gastroesophageal reflux. A lymph-node dissection around the abdominal esophagus, a truncal vagotomy, and dissection to the phrenoesophageal membrane are performed during a radical subtotal gastrectomy, resulting in anatomical and functional changes in the lower esophageal sphincter which is an important structure in the antireflux mechanism. This study evaluated the changes in the esophageal functions and the degree of esophageal reflux before and after a radical subtotal gastrectomy.Ten patients with a relatively early stage of stomach cancer were included, and esophageal manometric studies were performed on all patients before and after the radical subtotal gastrectomy. The pressure and the length of the lower esophageal sphincter and the function of the upper esophageal sphincter were measured. In addition, 24-hour ambulatory esophageal pH monitoring was done before and after the radical subtotal gastrectomy to obtain the percent of the total time for which pH<4, pH>7, and pH>8 and the pre-and post-operative values were compared. There was no significant difference between the pressure and the total abdominal length of the lower esophageal sphincter before the radical subtotal gastrectomy and those after the operation. The pressure in the lower esophageal sphincter was slightly decreased after the operation, but fell within the normal range (pre-op.: 19.7 3.2 mmHg; post-op.: 15.9 5.4 mmHg). There was no increase in the percent of the total time for which pH<4 and pH>8 in the 24-hour ambulatory esophageal pH monitoring. In conclusion, functional changes after a subtotal gastrectomy and alkaline reflux might not be affected by the anatomical derangement due to the surgical procedure itself.
Esophageal pH Monitoring ; Esophageal Sphincter, Lower ; Esophageal Sphincter, Upper ; Esophagitis ; Esophagus ; Gastrectomy* ; Gastroesophageal Reflux ; Humans ; Membranes ; Postoperative Complications ; Reference Values ; Stomach Neoplasms ; Vagotomy, Truncal

We report our experience with 2 cases of perforation of intrathoracic stomach after Ivor Lewis operation for esophageal cancer. There was no problem in the anastomotic site, but the drainage from pleural cavity increased after oral intake. The stomach perforation was proved by rethoracotomy. The perforation site was repaired by sutures with pedicled intercostal muscle.
Drainage ; Esophageal Neoplasms* ; Intercostal Muscles ; Pleural Cavity ; Postoperative Complications ; Stomach* ; Sutures