Achalasia Overview

What is achalasia?

The esophagus is the muscular tube that extends from the neck to the abdomen and connects the throat to the stomach. Achalasia is a condition where the esophagus is unable to move food into the stomach. The lower esophageal sphincter (LES), a valve located at the end of the esophagus, stays closed during swallowing, resulting in the back up of food. Other symptoms include vomiting undigested food, chest pain, heartburn and weight loss..

Who is affected by achalasia?

Achalasia develops in about 3,000 people in the United States each year. It is typically diagnosed in adults, but can occur in children as well. There is no particular race or ethnic group that is affected, and the condition does not run in families.

Is achalasia serious?

Slowly, over a number of years, people with achalasia experience an increasing difficulty in eating solid food and in drinking liquids. As their

Agenesis of the Corpus Callosum

Agenesis of the corpus callosum (ACC) is a birth defect in which the structure that connects the two hemispheres of the brain (the corpus callosum) is partially or completely absent. ACC can occur as an isolated condition or in combination with other cerebral abnormalities, including Arnold-Chiari malformation, Dandy-Walker syndrome, Andermann syndrome, schizencephaly (clefts or deep divisions in brain tissue), and holoprosencephaly (failure of the forebrain to divide into lobes.) Girls may have a gender-specific condition called Aicardi's syndrome, which causes severe mental retardation, seizures, abnormalities in the vertebra of the spine, and lesions on the retina of the eye. ACC can also be associated with malformations in other parts of the body, such as midline facial defects. The effects of the disorder range from subtle or mild to severe, depending on associated brain abnormalities. Intelligence may be normal with mild compromise of skills requiring matching of visual patterns. But children with the most severe brain malformations may have intellectual retardation, seizures, hydrocephalus, and spasticity.

Is there any treatment?

There is no standard course of treatment for ACC. Treatment usually involves management of symptoms and seizures if they occur.

What is the prognosis?

Prognosis depends on the extent and severity of malformations. ACC does not cause death in the majority of children. Mental retardation does not worsen. Although many children with the disorder have average intelligence and lead normal lives, neuropsychological testing reveals subtle differences in higher cortical function compared to individuals of the same age and education without ACC.

What research is being done?

The NINDS conducts and supports a wide range of studies that explore the complex mechanisms of normal brain development. The knowledge gained from these fundamental studies helps researchers understand how the process can go awry and provides opportunities for more effectively treating, and perhaps even preventing, developmental brain disorders such as ACC.

Acanthosis Nigricans

Acanthosis nigricans is a skin disorder that results in velvety, light-brown-to-black markings that can occur in any location but mainly are found in the skin folds of the neck, armpits, groin, and under the breasts.

What causes acanthosis nigricans?

Acanthosis nigricans can affect otherwise healthy people, or it can be associated with certain medical conditions. Sometimes acanthosis nigricans is congenital (something a person is born with). It is more likely to be seen in people with darker skin. The most common type is found in conditions that are associated with an elevated insulin blood level, such as in diabetes and obesity. There are many other possible causes of acanthosis nigricans, including:

Prostate Cancer Basics

The prostate is a muscular, walnut-sized gland that surrounds part of the urethra, the tube that transports urine and sperm out of the body. (A gland is a group of cells that secretes chemicals that act on or control the activity of other cells or organs.)

The main function of the prostate is to produce semen, the milky fluid that transports sperm. Sperm is produced in the testicles, which also produce the main male hormone testosterone. Testosterone stimulates the growth and function of the prostate during puberty, as well as the production of prostatic fluid for semen.

During sexual climax (orgasm), the muscles of the prostate contract to push the semen through the urethra and out through the penis. The urethra also carries urine, a waste product made by the kidneys and stored in the bladder. When the penis is erect during sexual intercourse, the flow of urine is blocked from the urethra, allowing only semen to be ejaculated at orgasm.

Where is the prostate located?

The prostate is located directly beneath the bladder and in front of the rectum. Because the upper portion of the urethra passes through the prostate, if the gland becomes enlarged it can obstruct the passage of urine or semen through the urethra.

Abnormal Kidney Function

According to the National Kidney Foundation, 26 million Americans have kidney disease and millions more are at an increased risk. If kidney disease worsens, wastes build to high levels in the blood; complications such as high blood pressure, anemia (low blood count), weak bones, and nerve damage can occur and increase the risk of heart and blood vessel disease. Chronic kidney disease (CKD) may be caused by diabetes, high blood pressure and other disorders. When kidney disease progresses, it may eventually lead to kidney failure, requiring dialysis or kidney transplant. Early detection and treatment can often help keep CKD from getting worse.

Abnormal Heart Rhythms

What is an arrhythmia?

An arrhythmia (also called dysrhythmia) is an irregular or abnormal heartbeat.

What are the types of arrhythmias?

• Tachycardia: A fast heart rhythm with a rate of more than 100 beats per minute.
• Bradycardia: A slow heart rhythm with a rate below 60 beats per minute.
• Supraventricular arrhythmias: Arrhythmias that begin in the atria (the heart’s upper chambers). “Supra” means above; “ventricular” refers to the lower chambers of the heart, or ventricles.
• Ventricular arrhythmias: Arrhythmias that begin in the ventricles (the heart’s lower chambers.
• Bradyarrhythmias: Slow heart rhythms that may be caused by disease in the heart’s conduction system, such as the sinoatrial (SA) node, atrioventricular (AV) node or HIS-Purkinje network (see “The Heart’s Electrical System” section on the next page).

What causes arrhythmias?

Arrhythmias can be caused by:

• Coronary artery disease
• High blood pressure
• Changes in the heart muscle (cardiomyopathy)
• Valve disorders
• Electrolyte imbalances in the blood, such as sodium or potassium
• Injury from a heart attack
• The healing process after heart surgery
• Other medical conditions

Heart Rhythms on ECG

The heart’s electrical system triggers the heartbeat. Each beat of the heart is represented on the electrocardiogram (EKG or ECG) by a wave arm.

Normal Heart Rhythm 
The normal heart rhythm (normal sinus rhythm) shows the electrical activity in the heart is following the normal pathway. The rhythm is regular and the node is normal (about 50 to 100 beats per minute).

Tachycardia: fast heart rhythm (greater than 100 beats per minute)

Bradycardia: slow heart rhythm (less than 60 beats per minute)

Ablation for Cardiac Arrhythmias

What is a cardiac arrhythmia?

A cardiac arrhythmia, also called dysrhythmia, is an irregular or abnormal heart rhythm.

What is catheter ablation?

Catheter ablation is a type of treatment for cardiac arrhythmias. During ablation, a doctor inserts a catheter (thin, flexible tube) into the heart. A special machine delivers energy through the catheter to tiny areas of the heart muscle that cause the abnormal heart rhythm. This energy “disconnects” the pathway of the abnormal rhythm.

The ablation procedure also can be used to disconnect the electrical pathway between the upper chambers (atria) and lower chambers (ventricles) of the heart. The type of ablation performed depends upon the type of arrhythmia.