Search PubMed⌕ Search

Biomedical subjects

M Wienbeck

Publications and source records attributed to M Wienbeck.

At least 73 records · Page 4Linked to original sources
PubMed1991

[Surgical indications in cricopharyngeal dysfunction].

In 1989, five patients were treated for a cricopharyngeal dysfunction by cervical myotomy. In the past, due to extremely limited indications for surgery, repeated efforts of conservative treatment had been attempted in patients with idiopathic cricopharyngeal dysfunction and tracheopulmonary aspiration and/or permanent inability of oral nourishment. These patients underwent surgery after an interdisciplinary clinical assessment. Four out of five patients showed immediate improvement of their serious symptoms. Cervical myotomy is not expected to be successful in patients with insufficient oropharyngeal propulsion, as we could see in one female patient with severe upper oesophageal sphincter spasm. According to the literature and to our results, approximately 70 to 90% of the patients with idiopathic dysfunction of the cricopharyngeal muscle, who underwent surgery, showed significant improvement or even recovery. Due to the multifactoral genesis of the cricopharyngeal dysfunction it is understandable, that the surgical result is heavily dependent on the preoperative interdisciplinary diagnosis. In summary, for idiopathic cricopharyngeal dysfunction with complications we recommend the early and technically simple operation.

Aged↗
PubMed1991

[Disorders of anorectal function].

Since sophisticated function tests of the anorectal continence organ become more and more available, dysfunction of the anorectum is increasingly diagnosed and differentiated. The examination includes measurements of the pressure in the rectum and anal canal (anorectal manometry), rectal distension by an inflatable balloon to test the sensibility, electromyography and radiological defecography. By these methods the etiology and pathogenesis of the most important anorectal disorders, such as anal incontinence, different forms of constipation and rectal prolapse, may be differentiated. Nowadays, many of these disorders are successfully treated by a specific management which includes a special diet, drugs, surgery and biofeedback training programs.

Anal Canal↗
PubMed1990

[Icteric cholestasis as an early symptom in Hodgkin's disease].

Initial symptoms in a hitherto healthy 23-year-old man were jaundice (bilirubin 21.7 mg/dl) and pruritus, but extensive radiological, endoscopical, microbiological and laboratory investigations failed to reveal the cause. Stool culture positive for Salmonella agona suggested intrahepatic cholestasis resulting from a Salmonella cholangitis. However, antibiotic treatment was not successful. As he was in generally good health the patient declined further investigations. He returned two years later because of fatigue, lack of appetite and weight loss. Further tests now revealed lymphogranulomatosis in stage IVb of the nodular sclerosing type. The case demonstrates that cholestasis as an isolated early symptom of Hodgkin's disease can precede by years any further signs of the disease.

Adult↗
PubMed1990

Evaluation of the Crohn's Disease Activity Index (CDAI) and the Dutch Index for severity and activity of Crohn's disease. An analysis of the data from the European Cooperative Crohn's Disease Study.

In the European Cooperative Crohn's Disease Study a general documentation of clinical and laboratory data was made at the entry into the study in 452 patients. These patients were in different states of their disease from quiescent to very active. In all patients the Crohn's Disease Activity Index of Best (CDAI) and the Dutch Index of van Hees was calculated. Three gastroenterologists did a global clinical rating and a separate laboratory rating without knowledge of the indices. The ratings were then correlated with the indices in the individual patients. The clinical rating correlated well with the CDAI (r = 0.88) and less with the Dutch Index (r = 0.672). On the other hand the laboratory rating showed a better correlation with the Dutch Index (r = 0.742) than with the CDAI (r = 0.573). This demonstrates that the CDAI preferably is an estimate of the clinical severity of the disease and not of the activity of inflammation. Vice versa the Dutch Index is mainly reflecting the activity of the inflammatory process.

Colitis↗
PubMed1990

[Irritable colon and colonic disease due to laxatives].

Diarrhea of colonic origin is fairly common in irritable colon and after long term abuse of laxatives. This form of diarrhea causes difficulties not only in diagnosis but also in treatment. Irritable colon is a functional disorder sometimes involving other segments of the bowel. The term "irritable bowel disease" is thus more appropriate. Extraintestinal symptoms are in addition quite common. Although the diagnosis can be established with great reliability using an index we consider some laboratory tests, recto-sigmoidoscopy and abdominal sonography essential to rule out organic lesions. Therapy comprises (small) psychotherapy, dietary measures and eventually transient medication. Symptoms usually persist but tolerance of the disorder should be improved. Laxative-induced colonic dysfunction results usually from false assumptions about normal defecation. Loss of water and potassium deteriorates the symptomatology leading to a vicious circle. Alterations of neurons in the enteric nervous system of the colon can be the cause but eventually the consequence of chronic intake of laxatives. Hidden abuse of laxatives can cause great diagnostic difficulties. The therapy of choice is weaning which usually is only possible gradually. Cisapride can be a useful adjuvant.

Cathartics↗
PubMed1989

[Motility of the large intestine].

Colonic motility has a number of tasks to fulfill: mixing, storage and slow transportation of intestinal contents, and rapid evacuation of feces. All this requires complex motor patterns. Phases of contraction alternate with phases of motor inactivity. Contractile activity is controlled by the myoelectric activity. Spikes and oscillations are superimposed on the electrical control activity. Short spike bursts are associated with contractions of short duration and serve for mixing; long spike bursts and oscillations are accompanied by tonic contractions of long duration, and are mainly propulsive. Giant migrating contractions occur sporadically and result in the emptying of large sections of the colon. Disturbances of colonic motility are of pathogenetic significance in a number of diseases. This has diagnostic and therapeutic consequences.

Colon↗
PubMed1989

Cerebral responses evoked by electrical stimulation of rectosigmoid in normal subjects.

We used electroencephalographic methods to evoke and record cerebral responses to electrical stimulation of the rectosigmoid colon in eight healthy male volunteers, 20-40 years old. The stimulus was applied via a probe equipped with bipolar ring electrodes which were attached by suction to the mucosa. The probe was positioned 20 cm above the anus. Cerebral responses were recorded by EEG electrodes. Evoked potentials (EPs) in response to electrical stimulation consisted of a series of successive peaks and troughs in the EEG with good reproducibility within and between subjects. The shape and latencies of the intestinal EPs were comparable to other types of EPs reported before. It is concluded that reproducible EPs can be recorded from the scalp after electrical stimulation of the rectosigmoid. The similarity in appearance of these EPs to those previously reported suggests that visceral afferents were stimulated. The technique may become a useful tool to study visceral nervous connections to the brain in health and disease.

Adult↗
PubMed1989

Cerebral responses evoked by electrical stimulation of the esophagus in normal subjects.

Cerebral responses to electrical stimulation of the esophagus were investigated in 11 healthy male volunteers, 20-40 yr old. The stimulus was applied via a probe equipped with bipolar ring electrodes. It was positioned in the middle and distal esophagus at 20 and 37 cm from the incisors, respectively, and sucked to the mucosa. Electrical stimuli (0.1-ms duration, different stimulus voltages) were applied at frequencies of 0.1-1.0 Hz or in randomized order. Cerebral responses to electrical stimulation were recorded after 20-40 stimulations and averaged on a time base of 1000 ms. Evoked potentials consisted of successive peaks and troughs in the averaged electroencephalogram with good reproducibility within and between subjects. Amplitudes of evoked potentials showed a significant reduction with electrical stimulation at 37 cm compared with 20 cm, and with stimulation frequencies of 0.5 and 1.0 Hz compared with 0.2 and 0.1 Hz. Evoked potentials from 37 cm showed longer latencies compared with those from 20 cm. Irregular stimulation and stimulation during mental distraction did not alter these responses. It is concluded that reproducible evoked potentials can be recorded from the scalp after electrical stimulation of the esophagus and that these are transferred centrally via vagal afferents. The technique may become a useful tool in the study of visceral nervous connections to the brain in health and disease.

Adult↗