Empiric Esophageal Dilatation for Solid-Food Dysphagia: Presence of Mucosal Tear on Relook Endoscopy Predicts Symptomatic Response.

We hypothesized that a mucosal tear on relook endoscopy after empiric dilatation predicts symptomatic response. We evaluated symptomatic response (modified Ogilvie dysphagia score) after 161 consecutive esophageal dilatations. Comparing visible strictures, empiric dilatations with mucosal tear, and empiric dilatations without tear, baseline dysphagia scores were similar ( P = 0.34). Successful symptomatic response to dilatation occurred in 82% of visible strictures, 80% of those with tear, compared to only 37% of those with no tear ( P < 0.001). Patients with a mucosal tear after empiric dilatation have a superior symptomatic response to those without, and comparable to patients with visible strictures. We infer the tear represents disruption of an endoscopically inapparent stricture.

Antigenic similarities among estuarine soft-bottom benthic taxa.

Antisera prepared against whole-organism extracts of benthic invertebrates from Puget Sound, Washington, and North Inlet, South Carolina, were tested for specificity with extracts from both coasts. Immunological similarities among taxa reflected conventional phylogenetic relationships both within each of these areas and also between both areas. Antisera also cross-reacted with extracts to a lesser degree at higher taxonomic levels. The existence of common antigens among phylogenetically related taxa makes feasible the use of serological methods to document trophic interactions in environments where it is difficult to obtain sufficient material to serve as immunogen for production of highly specific antisera. Deep-sea or other high diversity food webs may be investigated using serological methods that are already well-developed for use in terrestrial and shallow-water environments.