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Biomedical subjects

L Tibbling

Publications and source records attributed to L Tibbling.

At least 91 records · Page 5Linked to original sources

Clinical evaluation of different fluid-filled systems for oesophageal manometry.

In a clinical study of oesophageal manometry with fluid-filled catheters, both a non-perfused system and a perfused system with a syringe pump have been compared to a system with a low-compliance perfusion pump, which served as a reference. Significantly lower values of motility amplitudes, motility derivatives, and partly of LES pressures, and a time delay of up to 0.5 sec of the amplitude maximum were obtained with the non-perfused system and the system with a syringe pump in comparison to the low-compliance system. Since the oesophageal function can be erroneously evaluated by use of a non-perfused system or a perfused system with a syringe pump, such systems cannot be recommended for clinical use.

Adult↗

Oesophageal function and coronary angiogram in patients with disabling chest pain.

Sixty-four patients with a history of disabling chest pain belonging to groups III or IV classified according to the NYHA criteria were examined with oesophageal function tests, coronary angiography and bicycle ergometry and also answered a symptom questionnaire. At the exercise test, 52 had effort angina; 45 (89%) of them had a pthological coronary angiogram and 22 (42%) had signs of oesophageal dysfunction (OD). OD as the single possible etiological factor for typical effort angina therefore seemed unlikely. Chest pain was absent or atypical at the exercise test in 12 patients, 11 (92%) of whom had signs of OD. This incidence is significantly higher (p less than 0.01) than that found in the patients with effort-related chest pain. Five (42%) of the 12 patients with atypical chest pain at the exercise test had a pathological coronary angiogram, an incidence which is significantly lower (p less than 0.001) than that found in the group with effort-related chest pain. In patients with a history of disabling chest pain but with atypical chest pain in connection with the exercise test, OD was more frequent than coronary disease and therefore more likely to have caused the symptoms.

Adult↗

Influence of body position, dry and water swallows, smoking, and alcohol on esophageal acid clearing.

Esophageal acid clearing in normal subjects was studied in different body positions, with an assessment of reproducibility, after dry and water swallows, after smoking, and after alcohol intake. A significant increase in the number of swallows to raise the distal esophageal pH to 5.0 was found in the head-down position (p less than 0.003), after smoking (p less than 0.003), and after alcohol intake (p less than 0.001). It is proposed that the outcome of the acid-clearing test reflects both the transporting capacity of the esophageal muscles and the production of saliva. The precision of the acid-clearing test is not satisfactory, which makes it unsuitable for use in individual cases. It seems, however, well fitted for evaluation of esophageal acid clearing in larger samples.

Adolescent↗

Mechanisms affecting lower oesophageal sphincter opening and oesophageal retention. A combined X-ray and manometry study.

Using simultaneous manometry and cineradiography, oesophageal evacuation was studied while contrast medium was infused via a catheter. The distal half of the oesophagus could be filled with contrast medium without triggering peristalsis. The hydrostatic pressure necessary to open the lower oesophageal sphincter (LES) was of approximately the same magnitude as the pressure gradient between oesophagus and LES. No significant relaxation of the LES could be observed at the initiation of swallowing. The LES may be looked upon not only as a sphincter preventing reflux but also as a gate which must be forced open by food.

Adult↗

Oesophageal acid perfusion test as a complement to work test in patients with chest pain.

Out of 121 patients referred to a work test on account of chest pain, 67 with a case history typical for oesophageal dysfunction have been further investigated with an acid perfusion test during continuous ECG monitoring. Neither arrhythmias nor ST-T changes were induced by the procedure. Of the 67 patients, 6 had a "positive related" acid perfusion test, 23 a "positive unrelated" and the remainder a negative test. Five of the 14 patients with pathological effort ECG belonged to the group with a positive acid perfusion test. The acid perfusion test, as a safe routine in close connection with the effort ECG in selected patients, is a useful technique for establishing whether or not the patient's symptoms have an oesophageal component.

Adult↗

Static and dynamic characteristics of fluid-filled esophageal manometry systems.

Esophageal manometric systems with water-filled catheters have been characterized by the use of model experiments. The examined parameters have been: catheter dimension, catheter compliance, catheter resistance, pump type, pump compliance, and perfusion flow. Accurate static pressure measurements have been obtained for perfused systems independently of the investigated parameters. The dynamic characteristics vary with catheter diameter and perfusion flow. For catheters with low diameter, a narrow bandwidth is obtained for the investigated perfusion flows. The results have been expressed in terms of an electric model of the measurement system. Perfusion pumps with low compliance are recommended to improve the dynamic properties of the measurement system.

Catheterization↗

Oesophageal dysfunction in male patients with angina-like pain.

Twenty-eight male patients referred to work ECG due to chest pain, all with a positive oesophageal symptom questionnaire believed to detect oesophageal dysfunction (OD), have been subjected to a graded work test and an oesophageal manometry test and answered a questionnaire believed to detect effort angina. Ischaemic heart disease (IHD) was defined as earlier infarction on ECG at rest or a pathological effort ECG. OD was defined as a positive acid perfusion test, hernia or a clear dysmotility in combination with a lower sphincter incompetence. Twenty patients had a positive effort angina questionnaire. Among these, OD was more common (n = 13) than IHD (n = 8). Five of the 20 patients had signs of both IHD and OD. Eight patients had a negative effort angina questionnaire; OD was found in 7 and IHD in 1 of these patients. It is concluded that in cases with angina-like chest pain OD should be considered.

Adult↗