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Biomedical subjects

L Demling

Publications and source records attributed to L Demling.

At least 109 records · Page 6Linked to original sources
PubMed1981

[Coeliac sprue and gut hormones: pathophysiological and clinical aspects (author's transl)].

In adult coeliac sprue patients, intraduodenal instillation of a hypertonic glucose-citric acid solution may release gastrointestinal hormones of the proximal (secretin, gastric inhibitory polypeptide, motilin) and distal (enteroglucagon, neurotensin) small intestine and, indirectly, of the pancreas (glucagon, insulin, pancreatic polypeptide). Characteristic plasma hormone profiles can be measured radioimmunologically. The reduced secretin response reflects most sensitively the impaired function of the small intestine. Exposure of the distal small bowel to greater nutrient loads leads to markedly and constantly elevated plasma levels of enteroglucagon. Only after complete functional as well as morphologic mucosal restoration, the increased enteroglucagon concentrations return to normal. On the other hand, the neurotensin response, which is likewise enhanced in active coeliac sprue, is sooner corrected during treatment. Gastrointestinal hormones with predominantly neurocrine action, such as vasoactive intestinal peptide (VIP), are apparently less affected by coeliac sprue. Pancreatic hormones are involved in the pathophysiology of sprue only indirectly, e. g. via diminished glucose absorption.

Adult↗
PubMed1981

The "Internal Leak" as a possible cause in the pathogenesis of peptic ulcer.

In cat gastric mucosa stimulated with histamine and damaged by direct application of acetylsalicylic acid, the fluorescent dye acridine orange may be found outside the parietal cell. Normally it is distributed throughout, or bound to the limiting membrane of, the vesicles in the parietal cell. The special properties of this cationic dye in an acid environment, support the hypothesis that a so-called "internal leak" may possibly play an important role in the pathogenesis of peptic ulcer.

Acridine Orange↗
PubMed1980

[Irrigation treatment of concrements in the common bile duct with octanoate (Capmul 8210) (author's transl)].

An irrigation treatment using the octanoate mixture Capmul 8210 of a maximum duration of 10 days was performed in 11 patients with concrements in the common bile duct using either a T-drain (n = 6) or a permanent naso-biliary tube (n = 5). In 6 out of the 11 cases total or partial dissolution led to voiding of concrements without further operative or invasive procedures. The treatment was tolerated in all but two cases. There was no evidence of systemic toxic side effects. Local inflammatory mucous membrane damage due to the instillation was observed in two cases.

Adult↗
PubMed1980

The healing process of experimentally produced bleeding lesions after hemostatic electrocoagulation with simultaneous instillation of water.

Fifty experimentally induced, standardized gastric bleeding lesions were successfully arrested in the dog using electrocoagulation with simultaneous instillation of water (EHT-coagulation). The contact pressure of the coagulating electrode was kept almost constant by means of a spring mechanism. The coagulated lesions healed without secondary enlargement of the coagulation effect and without complication. No secondary perforations were observed. Even when coagulation was carried out at an output power about 30% higher than the mimimum power necessary for reliable hemostatic coagulation, no complications were observed. Only with additional post bleeding arrest coagulation in excess of 10 seconds at this higher output, were two primary performations produced in 2 out of 12 cases. The non-perforated remaining 10 lesions healed without complication. With additional coagulation (at power output setting 6 for 20 seconds - 8 cases; at power setting 7 for 10 seconds - 6 cases), no perforations were observed and healing was without complications. Thus, in animal experiments, the therapeutic range for the arrest of bleeding using the electro-hydro-thermo-electrode is adequately large. The technique should be tested in clinical trials.

Animals↗
PubMed1980

On the efficacy of ready-made-up commercially available salicylazosulphapyridine enemas in the treatment of proctitis, proctosigmoiditis and ulcerative colitis involving rectum, sigmoid and descending colon.

To investigate efficacy and possible side effects, double-blind studies were carried out using 3% salicylazosulphapyridine enemas and appropriate placebo enemas. In a first study involving peranal therapy along, the success rate was 73%; in a second study employing a combination of oral and peranal medication, the success rate was 75%. This shows that the efficacy of the peranal form of administration is comparable to that obtained with oral medication. No side effects were observed throughout the period of observation of this study.

Administration, Oral↗
PubMed1980

Further evidence of gastric back diffusion. Autoradiographic and mass spectrographic studies.

In further studies of the phenomenon of back diffusion (acid, hydrogen (H+) ions), two different experimental approaches were used. 1. Autoradiographic studies with tritium-labelled water instilled in the stomach of fasted rats, revealed the activity to be overwhelmingly concentrated in the mucus layer. In contrast, following aspirin-induced gastric mucosal barrier disruption, radioactivity was prevalent in the mucosal membrane, diffusely scattered. 2. To answer the question as to whether tritium has moved in the gastric mucosa as an ion or as a water molecule, mass spectrographic studies were performed. Using the same experimental approach, comparison of tritium-labelled water with water containing another isotope (O18-water) demonstrated that after damage to the gastric mucosa, a change in the mass spectra of the gastric tissue occurred with tritium-labelled water, but not with O18-water. The results indicate that, indeed, it is not water molecules, but ionic particles represented by tritium that back diffuse, thus giving reason to believe that this mechanism also applies in the case of hydrogen ions.

Animals↗
PubMed1980

New methods in gastroenterology.

Major advances in gastroenterology are due in part to the rapid development of fiberendoscopes. Originally intended to improve gastroenterological diagnostics, the field of application was broadened by a variety of therapeutic procedures which now concur with the corresponding surgical approach. Endoscopic electro- and photocoagulation has considerably improved the outcome of acute gastrointestinal hemorrhage: endoscopic polypectomy is the procedure of choice today in benign and occasionally in malignant bowel tumors. Biliary tract surgery was revolutionized by endoscopic sphincterotomy, offering a low-risk procedure in high-risk patients with common bile duct stones. Endoscopic treatment of chronic pancreatitis by duct occlusion is just the beginning, and the old dream of dissolving gallstones rapidly by perfusing the biliary system with litholytic agents is now reality. Finally, the transhepatic or internal drainage in obstructive jaundice leads to transitory preoperative or permanent relief in malignant blockade of bile flow.

Ampulla of Vater↗
PubMed1979

[Endoscopic papillotomy (author's transl)].

Endoscopic papillotomy is a method of incising the papillary spincters without opening the abdominal wall or the duodenum. It is successful in over 95% of cases. In over 80% of cases passage of choledochus concrement occurs, about half of these stones being excreted spontaneously and the rest having to be extracted actively with a small Domia basket. For large concrements which cannot be removed endoscopically even after wide papillotomy incision, there is the electrohydraulic lithotrite which crushes them so that they can be passed spontaneously or be actively extracted. Dissolution by a substance instilled through a catheter passed through the papilla into the common bile duct is still in the experimental stage. Altogether for this reason endoscopic papillotomy and removal of stones is an advance for the patient at risk, as it involves a lower lethality than the corresponding surgical method.

Ampulla of Vater↗
PubMed1979

Complications of diagnostic and therapeutic colonoscopy in the Federal Republic of Germany. Results of an inquiry.

In April, 1978, we carried out a survey covering 27 hospitals, in which colonoscopy is performed on a routine basis. With respect to the size of the hospital, the equipment available and the level of training of the examiner, this selection may be regarded as representative. A total of 35,892 colonoscopies, 7,365 polypectomies, 58 electrocoagulations and 14 rugectomies were analysed with respect to the nature, localization and treatment of any complications that arose. The rate of complications seen in diagnostic colonoscopy was 0.008% for bleeding and 0.14% for perforation, the mortality rate being 0.02%. As expected, the complication rate for colonoscopic polypectomy was higher. Bleedings were reported in 2.24%, perforations in 0.34% and deaths in 0.1% of the examinations. Of particular importance would seem to be the possibilities of preventing complications. It was shown on the basis of the survey that a good, standardized training of the endoscopist, the strict observance of the contraindications, the non-use of analgesics and general anaesthesia, fluoroscopic control of "difficult" colons and the use of the best instruments and aids presently available, reduce the complication rate to a minimum.

Colon↗
PubMed1979

Modified electrocoagulation and its possibilities in the control of gastrointestinal bleeding.

In acute experiments in the stomach of dogs electrocoagulation with simultaneous instillation of water (EHT-electrode i.e. electro-hydro-thermo-electrode) proved the most effective electrocoagulation method for controlling standardized bleeding: Optimal visibility at the bleeding site, extension of the therapeutic range as well as the avoidance of charring at the bleeding site are its major advantages. Disturbing adhesion of coagulated material on the electrode is also avoided. The electro-hydro-thermo-electrode is a cheap and portable means of controlling bleeding.

Animals↗
PubMed1978

[Methods and possibilities of surgical endoscopy].

In a number of diseases, operative or therapeutic endoscopy permits an effective therapy without the necessity to open up the abdominal wall and the digestive organs themselves. Included here are the removal of foreign bodies, haemostasis, papillotomy with concrement dislodgement, polypectomy and the obliteration of the excretory pancreas. The evaluation of the achieved results and the examination of operative endoscopy in respect of its clinical value cooperation with the pathologisz should not be neglected. The refined endoscopic methods and the highly developed technology can only be applied successfully, when it is possible to get enough skillful endoscopists and to prevent an everyman's endoscopy by which the new methods could be brought into discredit.

Cholelithiasis↗