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Toothpicks have been used since antiquity as instruments for mouth cleansing and as eating utensils. Toothpick injury to the gastrointestinal tract is often suspected only at the time of operation because patients rarely relate a history of swallowing toothpicks and most toothpicks are not radiopaque. The spectrum of toothpick injury to the gastrointestinal(More)
Coronary heart disease (CHD) risk factors were studied in 250 monozygotic (MZ) and 264 dizygotic (DZ) male veteran twin pairs, aged 42-56. All coronary heart disease risk factors studied showed significant correlations in both MZ and DZ twins. Substantial genetic variation was detected for height, blood pressure, glucose intolerance, uric acid, plasma(More)
CONTEXT Identification of intestinal-type goblet cells (ITGCs) in hematoxylin-eosin-stained sections of esophageal biopsies is essential for the diagnosis of Barrett metaplasia. However, we have seen cases diagnosed as Barrett metaplasia based solely on cells that pose morphologic similarity to ITGCs on hematoxylin-eosin staining or stain positive with(More)
A prospective trial was performed in which biopsy and cytology specimens were obtained on 202 consecutive patients including 47 with esophageal or gastric carcinomas. The first biopsy specimen yielded a correct diagnosis in the majority of instances: 70% of gastric carcinomas and 93% of esophageal carcinomas. Three additional biopsy specimens increased the(More)
We prospectively compared the efficacy of polyvinyl bougies (Savary type) passed over a guide wire and through-the-scope balloons for the dilation of peptic esophageal strictures in a randomized study. Thirty-four patients, 17 in each treatment arm, were studied. At entry, dysphagia was assessed according to a six-point scale (0, unable to swallow; 5,(More)
Although bougienage is widely used to treat benign esophageal stricture, the rate of stricture recurrence and the long-term effectiveness of bougienage are unknown. We studied the natural history of esophageal stricture in 154 patients in whom bougienage was used as primary therapy. Dilatations were considered successful in terms of relief or major(More)