A significant aspect of acting out, and its management on an adolescent ward: "jailification".
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Biomedical subjects
Publications and source records attributed to E L Burke.
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Microscopic squamous cell carcinoma of the esophagus with early submucosal spread was diagnosed in two patients with hiatal hernia and evidence of esophageal reflux. The lesions were not suggestive of malignancy on endoscopic examination. Both patients are known to be alive more than one year after resection and presumably without recurrence. More liberal use of endoscopic brush cytology and biopsy or intubation cytology particularly in the cases at high risk, might substantially improve the chances of very early diagnosis and favorably alter the present grim mortality rate.
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Five patients with Barrett's esophagus, each with a differing presentation, serve as the basis of this report. Hiatal hernia is noted to be frequently present in Barrett's esophagus, and the incidence of adenocarcinoma is thought to be distinctly increased. The condition is easily diagnosed by fiberoptic endoscopy and verified by direct biopsy. The increasing use of fiberoptic panendoscopy may lead to an increased frequency of diagnosis of the columnar cell-lined lower esophagus and its complications.
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Esophagogastric fistula developed in two patients following operations combining fundoplication and other operative procedures on the esophagus. To our knowledge, this complication has not been previously reported or described. Accurate endoscopy and appropriate barium roentgenographic studies provided the definitive diagnosis. A second reconstruction was successful in one patient; conservative treatment was sufficient in the other.
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