Effect of Lepidium meyenii (maca) on testicular function of mice with chemically and physically induced subfertility.

The aim of this study was to evaluate the effect of Lepidium meyenii (maca) in chemically and physically subfertile mice. After 35 days, the following groups of mice were evaluated: control, sham, chemical subfertility, chemical subfertility-maca-supplemented, physical subfertility, physical subfertility-maca-supplemented and maca-supplemented only. Motility (32.36% ± 5.34%) and sperm count (44.4 ± 5.37 × 10(6) /ml) in the chemically and physically subfertile mice (11.81% ± 4.06%, 17.34 ± 13.07 × 10(6) /ml) decreased compared to the control (75.53% ± 2.97% and 57.4 ± 19.6 10(6) /ml) and sham (53.5% ± 7.86% and 58.4 ± 14.10 10(6) /ml). Maca was able to reverse the deleterious effect of motility (76.36 ± 1.97) as well as sperm count (53.5 ± 9.18 × 10(6) /ml) on chemical subfertility. In contrast, maca did not reverse the effects of induced physical subfertility nor motility (18.78% ± 14.41%) or sperm count (20.17 ± 11.20 × 10(6) /ml). The percentage of sperm DNA fragmentation in the physically subfertile mice increased (11.1% ± 19.29%) compared to the control (0.84% ± 0.85%). However, in the physically subfertile group, maca decreased sperm DNA fragmentation (2.29% ± 2.30%) closer to the sham (1.04% ± 0.62%) and the control (0.84% ± 0.85%). The group supplemented only with maca showed 0.54% ± 0.50% of spermatozoa with DNA fragmentation. Yet, the differences observed were statistically not significant. In conclusion, it appears that maca activates the cytochrome P450 system after chemically induced subfertility. However, it does not reverse the low mitochondrial membrane potential in spermatozoa compromised in the physical subfertility group.

Neuralgia of the glossopharyngeal nerve in a patient with posttonsillectomy scarring: recovery after local infiltration of procaine-case report and pathophysiologic discussion.

We describe a patient with a three-year history of severe progressive left-sided glossopharyngeal neuralgia (GPN) that failed to adequately respond to various drug therapies. The application of lidocaine spray to the posterior pharyngeal wall provided no more than short-term relief. Apart from a large hypertrophic tonsillectomy scar on the left side all clinical and radiologic findings were normal. In terms of therapeutic local anaesthesia, the hypertrophic tonsillectomy scar tissue was completely infiltrated with the local anaesthetic (LA) procaine 1%. The patient has been almost completely pain-free ever since, and the lidocaine spray is no longer needed. Six weeks after the first treatment a repeat infiltration of the tonsillectomy scar led to the complete resolution of all symptoms. The patient has become totally symptom-free without the need to take any medication now for two and a half years. This is the first report of a successful therapeutic infiltration of a tonsillectomy scar using an LA in a patient with GPN that has been refractory to medical treatment for several years. A possible explanation may be that the positive feedback loop maintaining neurogenic inflammation is disrupted and "sympathetically maintained pain" resolved by LA infiltration.

Single-site robotic cholecystectomy (SSRC): an initial review of safety and feasibility.

AIM: This report comprehensively reviews the findings from initial experiences with single-site robotic cholecystectomy (SSRC) across the world, and reports the feasibility of this new approach and novel platform. It attempts to be impartial in evaluating this novel robotic platform and approach. METHODS: A search utilizing MEDLINE®/PubMed® and Google Scholar was undertaken to identify articles about SSRC. Eleven articles met our criteria and were reviewed. Data collected included: patient demographic, preoperative, intraoperative, and postoperative data. Data are presented as weighted means±pooled standard deviations. RESULTS: Age and BMI was 46±13.1 years and 26±4.2 kg/m2, respectively. Operative time was 80±24.1 minutes; robotic console time was 38±16.9 minutes; and docking time was 7±3.1 minutes. Blood loss ranged from 0-150 mL. Ninety-eight percent of SSRC undertaken were completed robotically without the addition of other trocars/incisions, 2% of operations had additional trocars added, and three operations (<1%) were converted to "open". Postoperative hospital stay was 26 hours. Pain ratings, determined 2-3 weeks postoperatively, ranged from 0-2 on a Likert scale. CONCLUSION: This study serves as an overall analysis and review of SSRC. Existing reports of initial experiences with SSRC documents the operation is safe, feasible, and easily learned by surgeons from a broad spectrum of geographic areas. However, a detailed cost analysis is necessary in order to determine what the future holds for this novel approach.

Females without reflux symptoms or gastroesophageal reflux disease have less distal esophageal acid exposure than males without reflux symptoms or gastroesophageal reflux disease.

Ambulatory 24-hour esophageal pH monitoring is the gold standard examination to assess esophageal acid exposure. Gender-related variation is a well-recognized physiologic phenomenon in health and disease. To date, limited gender-specific 24-hour esophageal pH monitoring data are available. The aim of this study was to obtain values of esophageal pH monitoring in males and females without reflux symptoms or gastroesophageal reflux disease (GERD) to determine if gender variation exists in esophageal acid exposure among individuals without these factors. Twenty-four-hour dual esophageal pH monitoring was performed in male and female volunteers without reflux symptoms or GERD. Values for total number of reflux episodes, episodes longer than 5 minutes, total reflux time in minutes, % time with pH below 4, and longest reflux episode in the proximal/distal esophagus were obtained and recorded for both groups. The distal channel was placed 5 cm and proximal channel 15 cm above the manometrically determined lower esophageal sphincter. Means were compared using an independent sample t-test. Sixty-seven males and 69 females were enrolled. All subjects completed esophageal 24-hour pH monitoring without difficulty. There was no age or body mass difference between groups. Females had significantly fewer reflux episodes at both esophageal measuring sites and, significantly less total reflux time and % time with pH below 4 in the distal esophagus than males. All other parameters were similar. Significant gender-related differences exist in esophageal acid exposure, especially in the distal esophagus in individuals without reflux symptoms or GERD. These differences underscore the need for gender-specific reference values for 24-hour pH monitoring, allowing for an accurate evaluation of esophageal acid exposure in symptomatic patients.

Decreased acid suppression therapy overuse after education and medication reconciliation.

BACKGROUND: Acid suppression therapy (AST) is commonly overprescribed in hospitalised patients. This indiscriminate use increases cost and drug-related side effects. Minimal data is available on interventions aimed at reducing the burden of overprescription. The aim of our study was to evaluate the impact of education and medication reconciliation forms use on admission as well as discharge, on AST overuse in hospitalised patients. METHODS: A retrospective chart review of randomly selected patients admitted to the general medicine service at University of Florida Health Science Center/Jacksonville was performed prior to and after the introduction of interventions (education/medication reconciliation) aimed at reducing AST overuse. The percentage of patients started on inappropriate AST, the admitting diagnosis, indications for starting AST and discharge on these medications was compared in the pre and postintervention groups. RESULTS: Acid suppression therapy use declined from 70% (279/400) in the preintervention period to 37% (100/270) postintervention (p < 0.001). There was a reduction in inappropriate prescriptions from 51% (204/400) pre to 22% (60/270) postintervention (p < 0.02). Stress ulcer prophylaxis in low-risk patients or the concomitant use of ulcerogenic drugs continued to motivate inappropriate AST therapy in most patients. Postintervention, only 20% (12/60) of patients were discharged on unneeded AST compared with 69% (140/204) in the preintervention group (p < 0.001). CONCLUSION: Interventions consisting of education and use of medication reconciliation forms decreased inappropriate prescription of AST on admission and discharge. This can significantly decrease cost to the healthcare system and the risk of drug interactions.

BRCA1 and BRCA2 mutations among familial breast cancer patients from Costa Rica.

The contribution of mutations in BRCA1 and BRCA2 genes to the burden of breast cancer in Costa Rica has not been studied. We estimated the frequency of BRCA mutations among 111 Costa Rican women with breast cancer and a family history of breast cancer. These women were mainly from the metropolitan area of San José. A detailed family history was obtained from each patient and a blood sample was processed for DNA extraction. Mutations in BRCA1 and BRCA2 were sought using a combination of techniques and all mutations were confirmed by direct sequencing. Four different mutations were identified in five patients (four in BRCA2 and one in BRCA1) representing 4.5% of the total. Two unrelated patients were found to have a BRCA2 5531delTT mutation. Other BRCA2 mutations included C5507G and 6174delT. Only one BRCA1 mutation was found (C3522T). The family with the BRCA1 mutation had five cases of gastric cancer. Families with BRCA2 mutations were also reported to have cases of gastric and prostate cancers; however, the full range of cancers associated with BRCA1 and BRCA2 mutations in Costa Rica has not yet been established.

Reflux episodes are similar in healthy African Americans and non-Hispanic whites.

Ambulatory esophageal pH monitoring is the current gold standard diagnostic exam for gastroesphageal reflux disease. Presently, no data are available for normal 24-hour esophageal pH monitoring among any US ethnic group. The aim of the present study was to obtain normal values of 24-hour esophageal pH monitoring in healthy adult African American (AA) volunteers and compare these with values obtained in healthy non-Hispanic white (nHw) volunteers to determine if ethnic variation exists in 24-hour esophageal pH testing. Twenty-four-hour dual esophageal pH monitoring was performed in healthy AA and nHw. Values for total number of reflux episodes, episodes longer than 5 min, total reflux time in minutes, and longest reflux episode in the proximal and distal esophagus were obtained for both ethnic groups. Differences between groups were considered significant if P < 0.05. Eighty subjects volunteered for the study and completed 24-hour pH testing. Forty-one were AAs and 39 were nHws, with males making up 49% of each group. The AAs were older and had higher body mass index than the nHws. No difference was observed between the AA and the nHw subjects for any measured pH parameter in either the proximal or distal esophagus. There is no difference in values obtained during esophageal pH monitoring in healthy African Americans and non-Hispanic whites. This indicates that the currently accepted normal values of ambulatory esophageal pH monitoring are readily applicable to African Americans and can be used without compromising diagnostic accuracy in this ethnic group.

Ethnic variation in lower oesophageal sphincter pressure and length.

BACKGROUND: Oesophageal manometry (OM) is used to diagnose oesophageal motor disorders. Normal values of OM among United States ethnic groups are only available for Hispanic Americans (HA). AIM: To obtain normal values of OM in adult African American (AA) volunteers, compare these with those obtained in HA and non-Hispanic white (nHw) volunteers to determine if ethnic variation in normal oesophageal motor function exists. METHODS: Healthy AA, HA and nHw were recruited from the Jacksonville metropolitan area. Ethnicity was self-reported. Exclusion criteria were symptoms suggestive of oesophageal disease, medication use or concurrent illness affecting OM. All underwent OM using a solid-state system with wet swallows. Resting lower oesophageal sphincter (LOS) pressure and LOS length were measured at mid-expiration, while per cent peristaltic contractions, distal oesophageal contraction velocity, amplitude and duration were measured after 5 cc water swallows. RESULTS: Fifty-six AA, 20 HA and 48 nHw were enrolled. All completed OM. AA had significantly higher resting LOS pressure, LOS length and distal oesophageal contraction duration than nHw (P < 0.05). CONCLUSIONS: Significant ethnic exist in OM findings between AA and nHw. These underscore the need for ethnic specific reference values for OM to allow for correct diagnosis of oesophageal motor disorders in AA.

Continuous passive motion applied to whole joints stimulates chondrocyte biosynthesis of PRG4.

UNLABELLED: Continuous passive motion (CPM) is currently a part of patient rehabilitation regimens after a variety of orthopedic surgical procedures. While CPM can enhance the joint healing process, the direct effects of CPM on cartilage metabolism remain unknown. Recent in vivo and in vitro observations suggest that mechanical stimuli can regulate articular cartilage metabolism of proteoglycan 4 (PRG4), a putative lubricating and chondroprotective molecule found in synovial fluid and at the articular cartilage surface. OBJECTIVES: (1) Determine the topographical variation in intrinsic cartilage PRG4 secretion. (2) Apply a CPM device to whole joints in bioreactors and assess effects of CPM on PRG4 biosynthesis. METHODS: A bioreactor was developed to apply CPM to bovine stifle joints in vitro. Effects of 24h of CPM on PRG4 biosynthesis were determined. RESULTS: PRG4 secretion rate varied markedly over the joint surface. Rehabilitative joint motion applied in the form of CPM regulated PRG4 biosynthesis, in a manner dependent on the duty cycle of cartilage sliding against opposing tissues. Specifically, in certain regions of the femoral condyle that were continuously or intermittently sliding against meniscus and tibial cartilage during CPM, chondrocyte PRG4 synthesis was higher with CPM than without. CONCLUSIONS: Rehabilitative joint motion, applied in the form of CPM, stimulates chondrocyte PRG4 metabolism. The stimulation of PRG4 synthesis is one mechanism by which CPM may benefit cartilage and joint health in post-operative rehabilitation.

Effect of Lepidium meyenii (Maca), a root with aphrodisiac and fertility-enhancing properties, on serum reproductive hormone levels in adult healthy men.

Lepidium meyenii (Maca) is a Peruvian hypocotyl that grows exclusively between 4000 and 4500 m in the central Andes. Maca is traditionally employed in the Andean region for its supposed aphrodisiac and/or fertility-enhancing properties. This study was a 12-week double-blind, placebo-controlled, randomized, parallel trial in which active treatment with different doses of Maca Gelatinizada was compared with a placebo. The study aimed to test the hypothesis that Maca has no effect on serum reproductive hormone levels in apparently healthy men when administered in doses used for aphrodisiac and/or fertility-enhancing properties. Men aged between 21 and 56 Years received 1500 mg or 3000 mg Maca. Serum levels of luteinizing hormone, follicle-stimulating hormone, prolactin, 17-alpha hydroxyprogesterone, testosterone and 17-beta estradiol were measured before and at 2, 4, 8 and 12 weeks of treatment with placebo or Maca (1.5 g or 3.0 g per day). Data showed that compared with placebo Maca had no effect on any of the hormones studied nor did the hormones show any changes over time. Multiple regression analysis showed that serum testosterone levels were not affected by treatment with Maca at any of the times studied (P, not significant). In conclusion, treatment with Maca does not affect serum reproductive hormone levels.

Effect of Lepidium meyenii (MACA) on sexual desire and its absent relationship with serum testosterone levels in adult healthy men.

This study was a 12-week double blind placebo-controlled, randomized, parallel trial in which active treatment with different doses of Maca Gelatinizada was compared with placebo. The study aimed to demonstrate if effect of Maca on subjective report of sexual desire was because of effect on mood or serum testosterone levels. Men aged 21-56 years received Maca in one of two doses: 1,500 mg or 3,000 mg or placebo. Self-perception on sexual desire, score for Hamilton test for depression, and Hamilton test for anxiety were measured at 4, 8 and 12 weeks of treatment. An improvement in sexual desire was observed with Maca since 8 weeks of treatment. Serum testosterone and oestradiol levels were not different in men treated with Maca and in those treated with placebo (P:NS). Logistic regression analysis showed that Maca has an independent effect on sexual desire at 8 and 12 weeks of treatment, and this effect is not because of changes in either Hamilton scores for depression or anxiety or serum testosterone and oestradiol levels. In conclusion, treatment with Maca improved sexual desire.

Lepidium meyenii (Maca) improved semen parameters in adult men.

AIM: The present study was designed to determine the effect of a 4-month oral treatment with tablets of Lepidium meyenii (Maca) on seminal analysis in nine adult normal men aged 24-44 years old. METHODS: Nine men received tablets of Maca (1500 or 3000 mg/day) for 4 months. Seminal analysis was performed according to guidelines of the World Health Organization (WHO). Serum luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin (PRL), testosterone (T) and estradiol (E2) were measured before and after treatment. RESULTS: Treatment with Maca resulted in increased seminal volume, sperm count per ejaculum, motile sperm count, and sperm motility. Serum hormone levels were not modified with Maca treatment. Increase of sperm count was not related to dose of Maca. CONCLUSION: Maca improved sperm production and sperm motility by mechanisms not related to LH, FSH, PRL, T and E2.

Changing pattern of esophageal cancer incidence in New Mexico.

OBJECTIVE: Multiple reports indicate that esophageal adenocarcinoma incidence has increased during the past 20 yr, especially in non-Hispanic white men. We retrospectively reviewed adenocarcinoma and squamous cell carcinoma cases in our heterogeneous state population to determine the effect of ethnicity on histology. METHODS: We searched the New Mexico Tumor Registry for all cases of esophageal cancer from 1973 to 1997. Inclusion criteria included histological diagnosis of adenocarcinoma or squamous cell carcinoma, self-reported ethnicity, and gender. Age-adjusted incidence rates for both adenocarcinoma or squamous cell carcinoma were compared among ethnic groups in 5-yr intervals. RESULTS: Six hundred fifteen patients met inclusion criteria. Esophageal adenocarcinoma age-adjusted incidence rates/100,000 increased significantly during the 25-yr period: 1973-1977, 0.25 cases; 1978-1982, 0.33 cases; 1983-1987, 0.45 cases; 1988-1992, 0.85 cases; and 1993-1997, 1.19 cases; p < 0.001. In comparison, squamous cell carcinoma age-adjusted incidence rates did not increase significantly during the study period. In non-Hispanic whites, the histological age-adjusted incidence rate changed during the 1993-1997 period compared to other periods: 1993-1997, squamous cell carcinoma 1.01 and adenocarcinoma 1.42, p < 0.001. In Hispanics, the age-adjusted incidence rate of adenocarcinoma increased significantly in the fifth period compared to other periods, p < 0.001. In all minority groups, squamous cell carcinoma remained the predominant type. CONCLUSIONS: Esophageal adenocarcinoma age-adjusted incidence increased in New Mexico from 1973 to 1997. This increase was found in non-Hispanic whites and Hispanics and became predominant in non-Hispanic whites. Squamous cell carcinoma remains the primary type in minorities. This study suggests that ethnicity may influence esophageal cancer histology or ethnic background may place an individual at increased risk for certain types of esophageal cancer.

High-resolution endoluminal sonography assessment of the hematocystic spots of esophageal varices.

BACKGROUND: Many variables are associated with an increased potential for esophageal variceal rupture, especially the presence of hematocystic spots and other red signs on upper endoscopy. The etiology of hematocystic spots is unknown. High-resolution endoluminal sonography has been shown to be an accurate and sensitive imaging modality for detection, as well as the qualitative and quantitative assessment of esophageal varices. Because the high-resolution endoluminal sonography transducer permits detailed resolution of submucosal structures thereby allowing more precise examination of the actual wall of the varix, we sought to image variceal hematocystic spots in an effort to better define their anatomy. METHODS: Simultaneous upper endoscopy and high-resolution endoluminal sonography were performed in 68 patients with cirrhosis. Endoscopy was performed as part of screening for varices during evaluation for liver transplantation or in patients with previous presumed variceal bleeding. On endoscopy and high-resolution endoluminal sonography, two independent reviewers identified the same 10 patients having esophageal varices with hematocystic spots. The patients who had bled from their varices had not received prior endoscopic treatment. RESULTS: Hematocystic spots as seen with high-resolution endoluminal sonography imaging appeared as saccular aneurysm like projections on the variceal surface in 6 of 10 patients. Four of six patients would later have recurrent bleeding; two of these patients were again noted to have hematocystic spots on endoscopy with a similar corresponding high-resolution endoluminal sonography appearance. Patients without hematocystic spots did not have similar high-resolution endoluminal sonography imaging. CONCLUSION: Aneurysm-like projections in the wall of varices may represent focal weaknesses of the variceal wall and thus play a role in the pathophysiology of esophageal variceal rupture. The present findings may help to explain why there is an increased risk of variceal hemorrhage associated with the presence of hematocystic spots on esophageal varices.

Epidemiologic pattern of esophageal cancer at an inner-city university hospital.

The incidence of esophageal adenocarcinoma has increased significantly during the past 25 years in the United States and Europe. This increase has occurred predominantly among white men. To determine the effect of ethnicity and selected clinical features on the type of esophageal cancer in an urban, minority population, we retrospectively reviewed esophageal cancer at our institution. All patients with esophageal cancer from 1980 to 1995 were identified using the tumor registry data base and patient medical records at UMDNJ-University Hospital. Inclusion criteria were self-reported ethnicity and a confirmed pathologic diagnosis of either esophageal adenocarcinoma (ADENO) or squamous cell carcinoma (SCCA). Data abstracted from the record included age and year of diagnosis, weeks of survival, and risk factors, such as Barrett's esophagus and tobacco and alcohol abuse. Of 150 cases of esophageal cancer, 139 (93%) were SCCA and 11 (7%) were ADENO; the male:female ratio was 11:4. African and Latino Americans comprised 87% and white Americans 13% of the group. The incidence of ADENO increased during the study period: 1980-1984, 1 case; 1985-1989, 3 cases; and 1990-1995, 7 cases (P = .022); whereas the incidence of SCCA remained constant during the same intervals: 51, 52, and 36 cases, respectively (P > .05). By ethnicity, ADENO occurred more frequently among whites (7/19, 37%) than among African and Latino Americans (4/131, 3%); SCCA was more common among African and Latino Americans (127/131, 97%) than among whites (12/19, 63%) (P < .001). Other risk factors did not influence the type of esophageal cancer. The study concluded that the incidence of ADENO increased, primarily among white men, from 1980 to 1995 at UMDNJ-University Hospital. In contrast, the incidence of SCCA remained constant and was the primary type of esophageal cancer in African and Latino Americans. This study supports previous reports that ethnicity influences the histology of esophageal cancer.

Idiopathic esophageal ulceration in acquired immunodeficiency syndrome: successful treatment with misoprostol and viscous lidocaine.

OBJECTIVE: Esophageal ulceration is a common and important cause of morbidity in patients with acquired immunodeficiency syndrome (AIDS). After known causes are excluded, a subgroup remains with unexplained esophageal ulceration, known as idiopathic esophageal ulceration (IEU). The current therapy of IEU includes corticosteroids or, less frequently, thalidomide, although no placebo-controlled trials have been reported. The aim of this retrospective study was to determine the outcome of treating IEU with misoprostol and viscous lidocaine. METHODS: A retrospective review of esophageal ulceration in AIDS identified seven subjects with IEU at our institution. IEU in these subjects was treated successfully with misoprostol, 200 microg, crushed and suspended in 2% viscous lidocaine, 15 ml, given orally a.c. and h.s. for 4 wk. RESULTS: All patients reported symptomatic improvement within 2-3 days and complete resolution of their symptoms within 15 days. Healing of esophageal ulcerations was confirmed in five of seven subjects at a repeat endoscopy 8-12 wk later. CONCLUSIONS: Misoprostol, an antiulcer drug, has GI cytoprotective properties, and viscous lidocaine, a topical anesthetic, coats mucosal surfaces. We speculate that misoprostol when delivered topically is 3-6 times more effective than when delivered systemically. Considering the rapid resolution of symptoms, healing of ulcers, and lack of side effects, we believe that misoprostol crushed and suspended in viscous lidocaine should be considered for further evaluation in prospective, placebo-controlled trials of IEU.

Noncirrhotic portal hypertension in the adult: case report and review of the literature.

Noncirrhotic portal hypertension results from thrombosis of the extrahepatic portal vein that subsequently is recanalized. Liver function is preserved. In the adult, esophageal variceal hemorrhage is the most common presentation and may occur years after the portal vein thrombosis. We report the case of a 34-year-old man who presented with recurrent esophageal variceal hemorrhage. After ultrasonographic and angiographic evaluation, a diagnosis of idiopathic noncirrhotic portal hypertension was made. Due to recurrent esophageal variceal bleeding, the patient required surgical intervention to control bleeding. The incidence of noncirrhotic portal hypertension is unknown. Multiple etiologies may cause the disorder, although nearly half are idiopathic. The pathogenesis, clinical manifestations, diagnostic evaluation, natural history, prognosis, and management of noncirrhotic portal hypertension are discussed. Endoscopic management of esophageal variceal bleeding is the preferred therapy. However, when endoscopic treatment fails to control variceal hemorrhage, a distal splenorenal shunt is likely to be the most successful operation.

Esophageal candidoma in a patient with acquired immunodeficiency syndrome.

Oral thrush and esophagitis caused by Candida are common in patients infected with the human immunodeficiency virus. We present the case of a 33-year-old man with acquired immunodeficiency syndrome who developed dysphagia during a hospitalization for pneumonia. Signs and symptoms were consistent with Candida esophagitis. Despite therapy with fluconazole, the patient's symptoms persisted. At upper endoscopy, a 1-cm, polypoid esophageal mass at 30 cm from the incisors and several other nodular lesions were observed; white plaques were noted throughout the esophagus. Biopsy specimens of the mass contained hyphal forms consistent with Candida species. Therapy with amphotericin B improved the patient's symptoms, and resolution of the mass was confirmed by repeat upper endoscopy. We believe this is the first case in the medical literature of a Candida mass (candidoma) causing dysphagia in a patient with acquired immunodeficiency syndrome. Candidoma should be considered in the differential diagnosis of dysphagia in patients with human immunodeficiency virus infection or immunosuppression due to other causes.