Biomedical subjects
L Demling
Publications and source records attributed to L Demling.
A new view of gastric dyspepsia.
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[Further progress in liver transplantation].
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[The laser in gastroenterology].
The use of lasers in gastroenterology is an enrichment of the non-invasive therapeutic methods. Prerequisite is their critical use which, in order to be successful, needs a minimum frequency and thus experience. In form of a strictly constructed survey the paper deals with the potential possibilities of laser application and with the alternative approaches being today at our disposal.
[Minimal invasive surgery. New methods in the treatment of gallstones].
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[The typical patient with disorder of digestive motility].
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[A drive substance for the motor in digestion. Introduction].
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[Spastic colon (irritable colon)].
Spastic colon is a pathological entity whose clinical symptoms are for the most part abdominal pain, constipation and episodes of diarrhea without loss of weight. In all probability, it is merely a particularly striking presentation of a GI tract that is irritable throughout its entirety. The pathophysiological basis is a disordered propulsive bowel motoricity. Etiologically, psychological factors in the presence of an appropriate genetic or acquired disposition are conceivable. Possible mediators are considered to be noradrenalin, beta-endorphin and the corticotropin-releasing factor. The diagnosis can be established with a high degree of probability on the basis of the characteristic clinical picture. A definitive diagnosis, however, requires the very careful exclusion of other possible diagnoses. Therapy includes talks with the patient, physical and dietetic measures and the use of drugs to ameliorate diarrhea or, in the case of prokinetic agents, to re-establish normal propulsive bowel activity.
[Operative endoscopy--an invasion into surgery?].
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Urinary factors of kidney stone formation in patients with Crohn's disease.
An increased frequency of kidney stone formation is reported in patients with inflammatory bowel disease. In order to investigate its pathogenesis, the concentrations of factors known to enhance calcium oxalate stone formation (oxalate, calcium, uric acid) as well as of inhibitory factors for nephrolithiasis (magnesium, citrate) were determined in the urine of 86 patients with Crohn's disease and compared with those of 53 metabolically healthy controls. Six patients with Crohn's disease already had experienced calcium oxalate nephrolithiasis. Patients with Crohn's disease had significantly higher urinary oxalate and lower magnesium and citrate concentrations. Among all patients magnesium and citrate were significantly lower in those with a positive history of kidney stones. Our results demonstrate that the increased propensity for renal stone formation in patients with Crohn's disease is a result not only of increased urinary oxalate, but also of decreased urinary magnesium and citrate concentrations.
Laserlithotripsy of common bile duct stones.
Endoscopic retrograde laser lithotripsy of common bile duct stones is a new technique which can be carried out through the endoscope without anaesthesia using ordinary endoscopic equipment. In the method described here a flashlamp pulsed Neodymium YAG laser (wave length 1064 nm) was used. Light energy was transmitted along a highly flexible quartz fibre with a diameter of 0.2 mm. This new technique was used in nine patients with concrements in the common bile duct, which could not be removed with the established endoscopic techniques. In eight of the nine the concrements (maximum diameter 4.7 x 3.1 cm) could be fragmented and in six the fragments could be extracted from the common bile duct. The total energy required was 80-300 J; complications were not observed.
[The laser in gastroenterology].
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[Gastrointestinal motility disorders: phenomenon or disease? Synopsis and outlook?].
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[Lasers in gastroenterology].
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Laser therapy of tumor stenoses in the upper gastrointestinal tract: an international inquiry.
The results of an international inquiry on palliative laser therapy of malignant inoperable stenoses in the upper gastrointestinal tract are reported. The results of the treatment of a total of 1,359 patients were collected. The data from laser users with experience in more than 50 treated patients (n = 1,184) were analyzed; 68.9% of the tumor stenoses were located in the esophagus, and 55.7% were not passable with the endoscope. The initial treatment was successful in 83.0% and the complication rate was 4.1% (49 of 1,184 patients). The mortality rate was 1.0% (12 of 1,184 patients).
NMR spectrometry. A new method for total stool fat quantification in chronic pancreatitis.
In the present investigation, suitability of nuclear magnetic resonance (NMR) spectrometry for total stool fat quantification in patients with normal or impaired exocrine pancreatic function (chronic pancreatitis) has been analyzed in comparison with a conventional chloroform-methanol extraction technique. Basic temperature-dependence studies of NMR spectrometry (90 degrees/180 degrees radiofrequency pulse sequence) on 21 chloroform-methanol extracted pure total stool lipid standards (weight range: 0.05-1.6 g) revealed significantly (P less than 0.05) improving correlations between NMR signal amplitudes and corresponding weights at increasing temperatures (r = 0.952/40 degrees C, r = 0.965/60 degrees C, r = 0.988/80 degrees C), thus indicating 80 degrees C as optimal temperature for NMR spectrometric total stool fat quantification. In subsequent comparative measurements of lyophilized stool samples, NMR spectrometry (at 80 degrees C) and conventional chloroform-methanol extraction provided significantly (P less than 0.001) correlated results with respect to total fecal fat contents/day of quantitatively collected and homogenized stools in 93 patients with known exocrine pancreatic function (secretin-pancreozymin test), irrespective of whether correlations were determined for all 93 patients (r = 0.983) or separately for patients with normal (N = 45; r = 0.867), moderately reduced (N = 31; r = 0.946), or highly reduced (N = 17; r = 0.992) exocrine pancreatic function and correspondingly increased total fecal fat excretions.