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Biomedical subjects

M Wienbeck

Publications and source records attributed to M Wienbeck.

At least 181 records · Page 10Linked to original sources
PubMed1981

[Simultaneous electromyographic and manometric study of the function of the anorectum (author's transl)].

The contractile and myoelectrical activity of the internal anal sphincter (IAS) and the rectum 2 and 4 cm orad of the IAS were measured in 20 healthy volunteers. Perfused manometry catheters and bipolar wire electrodes penetrating the musculature were used. We evaluated anorectal activity under basal conditions and after provocation of the defecation reflex by inflation (20 to 150 ccm) of a balloon in the rectum. Basal pressure in the IAS was 54.9 +/- 5.2 (SEM) mm Hg. If fluctuated spontaneously. The IAS generated sinusoidal slow potentials (LP) continuously, mean frequency was 21.14 +/- 0.43 cycles/min (cpm). LIP in the rectum 2 and 4 cm orad of the IAS occurred intermittently, their frequency was 9.72 +/- 0.45 and 8.95 +/- 0.30 cpm, respectively. In addition, the rectum generated LP of 3.10 +/- 0.94 cpm temporarily. Provocation of the defecation reflex caused the IAS to relax partially at distending volumes of 20 ccm and completely at volumes of 50 to 100 ccm. At the same time, the myoelectrical activity of the IAS became irregular. An initial interruption of the LP of 4 to 12 second duration occurred in most experiments. The defecation reflex was accompanied by a brief contraction and an increase in spike activity in the rectum. Thus, the simultaneous electromyographic and manometric examination of the anorectum yields quantitative data on the function of this area. The diagnostic values of the procedure has to be tested in comparative studies of patients without and with functional disorders of the colon and anorectum.

Adult↗
PubMed1980

[Esophageal stenosis in sjögren's syndrome].

Dysphagia in Sjögren's syndrome may be caused by xerostomy, pharyngoesophagitis and esophageal membranes. This is the first report on a tubular upper esophageal stenosis in a 71 year old woman with Sjögren's syndrome who developed progressive dysphagia. It is suggested, that this stenosis was due to chronic inflammatory processes and secondary sclerosis of deep layers in the esophageal wall. Bouginage was adequate symptomatic therapy. Tubular esophageal stenosis is regarded as gastrointestinal manifestation of Sjögren's syndrome.

Aged↗
PubMed1980

[Diagnostic problems in the differentiation of achalasia and spasm of the oesophagus (author's transl)].

In 15 patients suspected to have achalasia or diffuse spasm of the oesophagus we were unable to make the final diagnosis of their motility disorder in spite of radiologic, endoscopic, and manometric examinations. In 5 patients the radiologic and manometric results showed a discrepancy. In 4 patients only the lower oesophageal sphincter exhibited failure fo complete relaxations typical of achalasia; however, the motility of the body of the oesophagus was peristaltic in nature. In 6 patients the initial diagnosis had to be changed during follow-up. In conclusion, motility disorders occur in the oesophagus which cannot be classified according to existent definitions. It is possible therefore that achalasia and oesophageal spasm are different and not always fixed expressions of one nosologic entity.

Adult↗
PubMed1979

[Treatment of reflux oesophagitis with cimetidine (author's transl)].

The effect of cimetidine on reflux oesophagitis was studied in a double-blind trial. Sixteen patients were given cimetidine 1.6 g/d, 20 patients received a placebo. Within the first six weeks the oesophagitis improved both on cimetidine and the placebo, but the patients taking the former had fewer complaints during the day than those on a placebo. Continuing the regimen for another six weeks further improved the endoscopic findings in patients with cimetidine but not in those on placebos. Complaints lessened during the sixth to twelfth week during cimetidine treatment, but remained unchanged under placebo administration. Complete healing of the oesophagitis was achieved in only 33% of patients with uncomplicated oesophagitis (grade I-III) and in 6% of those with severe complicated oesophagitis (grade IV). If non-surgical treatment is indicated, it must be continued through at least 6-12 weeks.

Adult↗
PubMed1979

[Prevention of duodenal ulcer recurrence with cimetidine (author's transl)].

The effect of long-term prophylaxis of duodenal ulceration with cimetidine was tested in a double blind trial. In 20 patients treated with cimetidine there was a four-fold reduction in the relapse rate when compared with 18 placebo-treated patients. However, treatment of the acute phase of ulceration with cimetidine increased the recurrence rate more than five-fold when compared with placebo treatment. Slow healing of ulceration was followed by a two-fold incidence of recurrence when compared with rapid healing. From the results it is concluded that recurrence occurs in patients after slow healing and (or) previous cimetidine treatment if long-term prophylaxis with cimetidine is not carried out.

Adult↗
PubMed1979

[Cimetidine treatment of reflux esophagitis: results of a double-blind study].

The effect of cimetidine on healing of reflux esophagitis was investigated in a double blind study in which 16 patients received 1.6 g cimetidine/day and 20 patients placebo. After 6 weeks endoscopic healing or amelioration of the esophagitis was observed in 10 of 20 patients on placebo (50%) and in 9 of 16 patients receiving cimetidine (56%). Continuation of double blind therapy in 24 patients for another 6 weeks led to improved healing in 12 cimetidine patients but not in 10 placebo patients. In only 4 of 16 cimetidine patients there was complete healing of esophagitis at the end of the study. The cimetidine patients had fewer symptoms to a statistically significant degree after 6 and 12 weeks, respectively. It is concluded that, despite its statistically significant effects on esophagitis and reflux symptoms, cimetidine therapy of reflux disease is not satisfactory. If cimetidine therapy appears to be indicated, it should be continued for at least 12 weeks.

Adult↗
PubMed1979

[The treatment of hepatic emergencies].

Hepatic emergency means impending or manifest hepatic insufficiency. It is caused by acute and even more often by chronic liver diseases. The patient has to be hospitalized for treatment. Basic treatment is of utmost importance. It can be done in every intensive-care unit: Careful monitoring and treatment of any complication as well as reduction of toxic protein degradation products by protein restriction, bowel emptying, and enteral application of lactulose and/or neomycin. The infusion of special aliphatic amino acid solutions is still an experimental treatment. In addition to this basic treatment there are only very few indications for a special treatment: These are the prophylactic application of cimetidine in fulminant hepatitis, the hemoperfusion in intoxications by amanita or paracetamol, and the forceful hyperventilation (respiration volume 25-30 l/min) in intoxications by halogenated carbohydrates, and perhaps steroid treatment in severe alcoholic hepatitis. All heroic forms of treatment like exchange transfusion and monkey liver perfusion still have to prove their effectiveness.

Cimetidine↗
PubMed1979

Does dopamine predispose to gastroesophageal reflux?

In the American opossum dopamine causes a dose-dependant fall in the lower esophageal sphincter (LES) pressure. The effect in man is unknown. Therefore, the effect of two dosages of dopamine (1 mcg.kg-1 body weight.minute-1 and 5 mcg.kg-1 body weight.minute-1) was studied in ten healthy volunteers by pullthrough manometry. The results show that neither dopamine nor normal saline solution as a control changed LES pressure which is an important determinant of gastroesophageal sphincter competence. Thus, dopamine in clinically used doses does not appear to predispose to gastroesophageal reflux.

Adult↗
PubMed1979

[Localized retroperitoneal xanthofibrogranuloma simulating a pancreatic tumor].

The diagnosis of xanthofibrogranuloma is difficult. This is examplified by observations in a 46-year-old man with a palpable tumor in the left upper abdomen. Even modern diagnostic procedures like ultrasound, angiography and ERCP were unable to clarify the diagnosis. Only when laparotomy demonstrated a circumscript tumor, 7 x 7 x 10 cm in size, below the pancreas which was enucleated, the suspicion of a pancreatic tumor could be dismissed. The different clinical pictures of xanthofibrogranuloma ware discussed. Etiology is still unknown. Therapy as a rule should be surgical.

Celiac Artery↗
PubMed1979

[Whole gut irrigation for cleansing the bowel (author's transl)].

Whole gut irrigation with an isotonic electrolyte solution is said to be an effective, easily and rapidly performed cleansing preparation for colonoscopy. We studied the effect of this method upon water and electrolyte metabolism and on intestinal transit. 35 patients were prepared for colonoscopy by whole gut irrigation via a gastric or duodenal tube. We observed a weight gain of 1.8 +/- 0.3 kg (mean +/- SD) and an increase in serum sodium and chloride. These changes were almost completely reversible within 24 hours. During the irrigation the intestinal transit time shortened by about 50%. The results demonstrate that whole gut irrigation has only slight side effects, but caution is warranted in patients with disturbed tolerance of sodium and water.

Adult↗