Jährlich werden in Deutschland 5190 Neuerkrankungen an einem Ösophaguskarzinom registriert. Diese Tumorentität steht bei Männern an 13. Stelle der Häufigkeiten der Krebserkrankungen und bei den Frauen an 17. Stelle. Die Fünfjahresüberlebensrate wird in der Literatur für männliche Patienten mit 11-22% und für Frauen mit 15-20% angegeben. Somit hat das Ösophaguskarzinom nach wie vor eine schlechte Prognose. Ziel der durchgeführten Studie war es, retrospektiv einen Überblick über die Patienten zu erstellen, welche im Zeitraum von 2007 bis 2011 aufgrund eines Ösophaguskarzinoms in der Klinik für Viszeral-, Transplantations-, Thorax-, und Gefäßchirurgie der Universitätsklinik Leipzig operativ behandelt wurden und die gewonnenen deskriptiven Statistiken und Überlebenszeitanalysen mit denen der Fachliteratur zu vergleichen, sowie gegebenenfalls Rückschlüsse zur Therapieoptimierung zu ziehen. Insgesamt lag die mediane Überlebenszeit der Patienten bei 23,7 Monaten (95%KI 13,7-33,6). Die 5-Jahres-Überlebensrate lag bei 30,3%. Zusammenfassend konnten signifikante Überlebensvorteile für das männliche Geschlecht, eine niedrigere lokale Infiltrationstiefe des Tumors (pT), das Fehlen von regionalen Lymphknotenmetastasen im Gesamtkollektiv und in der Gruppe der Adenokarzinome (pN), ein niedrigeres pUICC-Stadium ebenfalls im Gesamtkollektiv und in der Gruppe der Adenokarzinome, eine R0-Resektion und in der Subgruppe der Plattenepithelkarzinom die alleinige Operation ohne neoadjuvante Therapie festgestellt werden.

This research examined the use of visual feedback provided by electronic instrumentation to reduce air intake times of esophageal speakers during speech management. The subjects were six esophageal speakers from the Portland Metropolitan area. Three subjects made up the experimental group and three were placed in the control group. Prototype instrumentation was used to measure air intake times and give visual feedback to the experimental group during twelve sessions of speech management. The control group participated in traditional speech management procedures to reduce air intake times without benefit of instrumentation. Rate of improvement was measured using the prototype instrumentation without visual feedback for both groups at the end of each session.

The purpose of this study was to determine the judgments by naive listeners of the acceptability of esophageal air intake noise and compare those ratings to their judgments of overall esophageal speech proficiency. The primary question this study sought to answer was: Are naive listener judgments of overall esophageal speech proficiency significantly correlated with naive listener judgments of esophageal air intake noise acceptability? The secondary question asked was: Are naive listener acceptability judgments of air intake noise significantly correlated with sophisticated listener acceptability judgments of air intake noise?

The literature on esophageal speech has identified the problem of extraneous air intake noise, suggested its possible etiology, and provided practical advice for clinical management. Documentation on the efficacy of specific methodology is lacking in the literature. Such documentation would be simplified if objective criteria were used to rate the severity of intake noise. The present study was prompted by the lack of basic data regarding listener evaluation of intake noise. The purpose of this study was to identify physical and perceptual correlates of acceptability of esophageal air intake noise. A primary and a secondary question were asked: Are selected objective measures of esophageal speech significantly correlated with sophisticated listener judgments of air intake noise acceptability? The measures used were: 1. The mean intensity of air intake noise 2. The mean intensity of speech 3. The ratio of mean speech intensity to mean intake noise intensity 4. The number of syllables uttered per intake 5. The rate of speech (in syllables per second) Secondarily, are sophisticated listener judgments of overall esophageal speech proficiency significantly correlated with sophisticated listener judgments of air intake noise acceptability?

No description available.

Diss. (sammanfattning) Stockholm : Karol. inst., 2006. / Härtill 4 uppsatser.

Chest pain is one of the most common symptoms responsible for emergency department and primary care office visits in the United States. Chest pain can be noncardiac and may be attributed to multiple causes. Esophageal disorders including reflux, motility and functional conditions, affect a large proportion of patients with NCCP and lead to significant morbidity. The use of HRM has changed the diagnostic approach to esophageal motility disorders. It is the most specific and sensitive test for diagnosing motor disorders and a promising procedure in detecting dysmotility disorders in patients with NCCP. Despite the increased sensitivity of HRM, the main indications for esophageal manometry exclude NCCP. This study assessed the percentage of undiagnosed esophageal motility disorders in patients with NCCP referred for high resolution manometry. Differences in HRM findings in patients with NCCP versus patients meeting AGA recommendations for the clinical use of esophageal manometry were also compared. A retrospective descriptive design was utilized. Two hundred-nineteen patient charts were reviewed. One hundred sixty-eight (77%) patients underwent HRM and met AGA recommendations for esophageal manometry; 51 (23%) patients underwent the procedure after receiving a NCCP diagnosis. Findings showed that 116 (69%) patients in the AGA group had abnormal findings while 52 (31%) did not. In the NCCP group 34 (67%) had abnormal findings compared to 17 (33%) who did not. To compare normal and abnormal HRM findings in patients with NCCP versus those meeting AGA criteria, Chi-Square analysis was performed between the groups. The results were not statistically significant (p = 0.10). iv There were no significant differences in the results of HRM in both groups indicating the findings on HRM are the same despite the indication for the procedure. The findings support the use of HRM as a diagnostic tool in patients with chest pain after cardiac workup and endoscopic evaluation. This indicates a possible need to update the AGA indications for esophageal manometry and increase the awareness among healthcare providers regarding the use of HRM in patients with chest pain. Implication for future research is also discussed.

Objetivos: Avaliar a associação entre a dismotilidade esofágica, caracterizada como Motilidade Esofágica Ineficaz (MEI), com a presença de refluxo ácido patológico avaliado pela pH-metria de 24 horas, controlando por Esfíncter Esofágico Inferior (EEI) estruturalmente defeituoso, Hérnia Hiatal (HH) e Esofagite, em pacientes em investigação de Doença do Refluxo Gastroesofágico. Métodos: Foram estudados 311 pacientes referenciados para investigação de DRGE em laboratório de motilidade esofágica. Os pacientes foram submetidos à Endoscopia Digestiva Alta (EDA), Manometria Esofágica, pHmetria Esofágica de 24 horas e a uma entrevista sobre os sintomas clínicos apresentados. Foram comparados os grupos de pH-metria negativa com o de pH-metria positiva quanto à presença dos fatores de risco – MEI, EEI defeituoso, HH e Esofagite. A associação entre MEI e pH-metria positiva foi primeiramente avaliada através de análise univariada e, posteriormente, através de análise de regressão logística (multivariada). Resultados: Do total de 311 pacientes estudados, 208 preencheram os critérios de inclusão. A idade média foi 47 anos, com 88 pacientes apresentando pH-metria normal e 120 pH-metria positiva. Após a análise univariada, foi observado que a ocorrência de MEI, EEI defeituoso e HH foi significativamente maior no grupo de pH-metria positiva. Após análise de regressão logística, a ocorrência de MEI e EEI defeituoso permaneceram significativamente maior no grupo de pH-metria positiva. Conclusões: MEI está associada à presença de refluxo ácido anormal, avaliado através de pH-metria esofágica de 24 horas, independentemente da presença de EEI defeituoso, HH ou Esofagite. / Objectives: To assess the association between esophageal dysmotility, characterized as inefficient esophageal motility (IEM), and the presence of pathological acid reflux due to a structurally defective lower esophageal sphincter (LES), hiatus hernia (HH), or esophagitis in patients suspected of having gastroesophageal Reflux reflux disease (GERD). Methods: Three hundred and eleven patients referred for GERD diagnostic procedures in a gastroesopahgeal motility laboratory were included in the study. Patients underwent upper endoscopy (UE), esophageal manometry, 24-hour esophageal pH-metry and an interview regarding their clinical symptoms. The following risk factors of patients in the negative pH-metry group were compared to those in the positive pH-metry group: IEM, defective LES, HH, and esophagitis. The association between IEM and positive pH-metry results was first assessed by means of univariate analysis and later determined with logistic regression analysis (multivariate). Results: Of the total 311 patients studied, 208 met the inclusion criteria (mean age 47 years); 88 had normal pH-metry reslults and 120 had positive pH-metry results. Univariate analysis revealed that the occurrence of IEM, defective LES, and HH was significantly greater in the positive pH-metry group. Following logistic regression analysis, the occurrence of IEM remained significantly greater in the positive pH-metry group. Conclusions: IEM is associated with the presence of abnormal acid reflux, as assessed by 24-hour esophageal pH-metry, regardless of the presence of defective LES, HH, or esophagitis.

Objetivos: Avaliar a associação entre a dismotilidade esofágica, caracterizada como Motilidade Esofágica Ineficaz (MEI), com a presença de refluxo ácido patológico avaliado pela pH-metria de 24 horas, controlando por Esfíncter Esofágico Inferior (EEI) estruturalmente defeituoso, Hérnia Hiatal (HH) e Esofagite, em pacientes em investigação de Doença do Refluxo Gastroesofágico. Métodos: Foram estudados 311 pacientes referenciados para investigação de DRGE em laboratório de motilidade esofágica. Os pacientes foram submetidos à Endoscopia Digestiva Alta (EDA), Manometria Esofágica, pHmetria Esofágica de 24 horas e a uma entrevista sobre os sintomas clínicos apresentados. Foram comparados os grupos de pH-metria negativa com o de pH-metria positiva quanto à presença dos fatores de risco – MEI, EEI defeituoso, HH e Esofagite. A associação entre MEI e pH-metria positiva foi primeiramente avaliada através de análise univariada e, posteriormente, através de análise de regressão logística (multivariada). Resultados: Do total de 311 pacientes estudados, 208 preencheram os critérios de inclusão. A idade média foi 47 anos, com 88 pacientes apresentando pH-metria normal e 120 pH-metria positiva. Após a análise univariada, foi observado que a ocorrência de MEI, EEI defeituoso e HH foi significativamente maior no grupo de pH-metria positiva. Após análise de regressão logística, a ocorrência de MEI e EEI defeituoso permaneceram significativamente maior no grupo de pH-metria positiva. Conclusões: MEI está associada à presença de refluxo ácido anormal, avaliado através de pH-metria esofágica de 24 horas, independentemente da presença de EEI defeituoso, HH ou Esofagite. / Objectives: To assess the association between esophageal dysmotility, characterized as inefficient esophageal motility (IEM), and the presence of pathological acid reflux due to a structurally defective lower esophageal sphincter (LES), hiatus hernia (HH), or esophagitis in patients suspected of having gastroesophageal Reflux reflux disease (GERD). Methods: Three hundred and eleven patients referred for GERD diagnostic procedures in a gastroesopahgeal motility laboratory were included in the study. Patients underwent upper endoscopy (UE), esophageal manometry, 24-hour esophageal pH-metry and an interview regarding their clinical symptoms. The following risk factors of patients in the negative pH-metry group were compared to those in the positive pH-metry group: IEM, defective LES, HH, and esophagitis. The association between IEM and positive pH-metry results was first assessed by means of univariate analysis and later determined with logistic regression analysis (multivariate). Results: Of the total 311 patients studied, 208 met the inclusion criteria (mean age 47 years); 88 had normal pH-metry reslults and 120 had positive pH-metry results. Univariate analysis revealed that the occurrence of IEM, defective LES, and HH was significantly greater in the positive pH-metry group. Following logistic regression analysis, the occurrence of IEM remained significantly greater in the positive pH-metry group. Conclusions: IEM is associated with the presence of abnormal acid reflux, as assessed by 24-hour esophageal pH-metry, regardless of the presence of defective LES, HH, or esophagitis.

Objetivos: Avaliar a associação entre a dismotilidade esofágica, caracterizada como Motilidade Esofágica Ineficaz (MEI), com a presença de refluxo ácido patológico avaliado pela pH-metria de 24 horas, controlando por Esfíncter Esofágico Inferior (EEI) estruturalmente defeituoso, Hérnia Hiatal (HH) e Esofagite, em pacientes em investigação de Doença do Refluxo Gastroesofágico. Métodos: Foram estudados 311 pacientes referenciados para investigação de DRGE em laboratório de motilidade esofágica. Os pacientes foram submetidos à Endoscopia Digestiva Alta (EDA), Manometria Esofágica, pHmetria Esofágica de 24 horas e a uma entrevista sobre os sintomas clínicos apresentados. Foram comparados os grupos de pH-metria negativa com o de pH-metria positiva quanto à presença dos fatores de risco – MEI, EEI defeituoso, HH e Esofagite. A associação entre MEI e pH-metria positiva foi primeiramente avaliada através de análise univariada e, posteriormente, através de análise de regressão logística (multivariada). Resultados: Do total de 311 pacientes estudados, 208 preencheram os critérios de inclusão. A idade média foi 47 anos, com 88 pacientes apresentando pH-metria normal e 120 pH-metria positiva. Após a análise univariada, foi observado que a ocorrência de MEI, EEI defeituoso e HH foi significativamente maior no grupo de pH-metria positiva. Após análise de regressão logística, a ocorrência de MEI e EEI defeituoso permaneceram significativamente maior no grupo de pH-metria positiva. Conclusões: MEI está associada à presença de refluxo ácido anormal, avaliado através de pH-metria esofágica de 24 horas, independentemente da presença de EEI defeituoso, HH ou Esofagite. / Objectives: To assess the association between esophageal dysmotility, characterized as inefficient esophageal motility (IEM), and the presence of pathological acid reflux due to a structurally defective lower esophageal sphincter (LES), hiatus hernia (HH), or esophagitis in patients suspected of having gastroesophageal Reflux reflux disease (GERD). Methods: Three hundred and eleven patients referred for GERD diagnostic procedures in a gastroesopahgeal motility laboratory were included in the study. Patients underwent upper endoscopy (UE), esophageal manometry, 24-hour esophageal pH-metry and an interview regarding their clinical symptoms. The following risk factors of patients in the negative pH-metry group were compared to those in the positive pH-metry group: IEM, defective LES, HH, and esophagitis. The association between IEM and positive pH-metry results was first assessed by means of univariate analysis and later determined with logistic regression analysis (multivariate). Results: Of the total 311 patients studied, 208 met the inclusion criteria (mean age 47 years); 88 had normal pH-metry reslults and 120 had positive pH-metry results. Univariate analysis revealed that the occurrence of IEM, defective LES, and HH was significantly greater in the positive pH-metry group. Following logistic regression analysis, the occurrence of IEM remained significantly greater in the positive pH-metry group. Conclusions: IEM is associated with the presence of abnormal acid reflux, as assessed by 24-hour esophageal pH-metry, regardless of the presence of defective LES, HH, or esophagitis.