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Biomedical subjects

M Wienbeck

Publications and source records attributed to M Wienbeck.

At least 109 records · Page 6Linked to original sources
PubMed1988

Drug-induced oesophageal lesions.

Persisting retrosternal pain of sudden onset is suggestive of a drug-induced oesophageal lesion, particularly if it starts at night. After exclusion of a myocardial infarction, a carefully taken history and oesophagoscopy will rapidly clarify the cause and severity of the injury. Since almost any pill may produce oesophageal lesions, care has to be taken that tablets, capsules and other pills are always taken in an upright position together with a fluid chaser of at least 120 ml. If possible, less harmful liquid preparations of the drugs should be preferred. Lesions in the oesophageal wall and perioesophageal tissue are almost unavoidable side-effects of sclerotherapy of oesophageal varices. The patient and the doctor should be particularly aware of bleeding from oesophageal ulcers during the first week after sclerotherapy. Numerous drugs may weaken or strengthen contractions of the oesophagus and lower oesophageal sphincter. These potentially unwanted motor effects of the drugs have to be kept in mind, especially in patients with pre-existing gastro-oesophageal reflux disease and hypermotility states.

Drug-Related Side Effects and Adverse Reactions↗
PubMed1988

Family occurrence of achalasia and diffuse spasm of the oesophagus.

In view of the unknown aetiology of achalasia and diffuse oesophageal spasm we report four families (father/son, mother/son, brother/brother, cousin/cousin) with achalasia and oesophageal spasm examined by radiology, endoscopy and manometry. Family occurrence of oesophageal motor disorders supports the hypothesis that a genetic trait may play a role in the pathogenesis. The family coincidence of achalasia and oesophageal spasm supports a close relationship between the two diseases.

Adult↗
PubMed1988

Effect of sennosides on colon motility in cats.

The actions of sennosides on colonic motility are incompletely understood. We therefore studied the effects of sennosides A + B on colonic myoelectric activity and transit of a radio-opaque meal in 7 conscious cats. Intraduodenal application of sennosides (2 mg/kg body weight) accelerated the half colon transit time from 60 +/- 10 (SEM) to 43 +/- 7 min. At the same time the ratio of long-spike bursts to short-spike bursts was changed from 0.22 to 10.1. Loperamide, an antidiarrheal agent, had the opposite effect. The overall spike activity was not altered by sennosides, but increased by loperamide. It is concluded that the propulsive action of sennosides in the colon is reflected by myoelectric patterns and not by the total number of spikes.

Animals↗
PubMed1988

Computer analysis of pressure tracings from the sphincter of Oddi.

Since the sphincter of Oddi exhibits very regular phasic motor activity it offers itself to the design of a simple computer program in the analysis of gastrointesinal motility. This investigation is the first attempt of a practical application of such a computer program. The signals coming out of the pressure preamplifier are submitted to active filtering in order to prevent aliasing and then to analog to digital conversion. After being fed into a computer they are precessed in a number of controllable and adaptable steps before the final analysis. Computer analysis then yields a detailed quantitative print out of a large variety of variables which compares very favourably with the visual analysis. It speeds up the time of analysis and allows for a study of long-term recording. Computer analysis of pressure tracings from the sphincter of Oddi may serve as a model for a study of motor activity of all parts of the digestive tract with this modern method of data handling.

Ampulla of Vater↗
PubMed1988

Faecal incontinence in diabetes mellitus: is it correlated to diabetic autonomic or peripheral neuropathy?

Faecal incontinence is a frequent manifestation of diabetic enteropathy. The purpose of this study was to determine whether faecal incontinence in diabetes mellitus correlates with manifestations of diabetic autonomic or peripheral neuropathy at other organ sites. In 12 incontinent and 15 continent diabetics stool frequency and stool continence, basal and squeeze anal sphincter pressures, and continence to rectally infused isotonic saline solution (1500 ml) were prospectively evaluated. These data were correlated to quantitative measures of autonomic neuropathy as assessed by heart rate variation and pupillary reflex response to light, and to quantitative measures of peripheral neuropathy as assessed by nerve conduction velocity and sensitivity to vibration. Incontinent diabetics exhibited decreased basal and squeeze anal sphincter pressures, and reduced continence for fluid compared to their continent controls. The degree of incontinence correlated well with the maximal volume of retained rectally infused saline solution, but neither with basal and squeeze anal sphincter pressures, nor with the severity of autonomic or peripheral neuropathy at other organ sites. It is concluded that a generalized dysfunction of the autonomic or peripheral nervous system does not play a major role in the pathogenesis of faecal incontinence in diabetes mellitus. The great overlap of basal and squeeze anal sphincter pressures in incontinent and continent diabetics raise evidence for disturbances of additional extrasphincteric factors as part of the pathomechanism of faecal incontinence in diabetes mellitus.

Adolescent↗
PubMed1988

In vivo effects of nifedipine and BAY 1 8201 on ceruletide induced gallbladder contraction.

Studies in animals suggest that calcium channel blockers may influence gallbladder contraction. In order to study possible actions in man we examined by ultrasonography the effects of two dihydropyridine derivatives, i.e. nifedipine (20 mg p. o.) and BAY 1 8201 (100 mg p.o.) on ceruletide induced human gallbladder contraction in 9 healthy male volunteers in a randomized, double-blind, three fold crossover study (latin square design). Blood samples for the measurement of plasma drug concentrations were drawn before and at regular intervals up to 8 h after drug ingestion. Ceruletide decreased gallbladder volumes by 52.1 +/- 8.2% (mean +/- 1 SEM) after nifedipine, 53.1 +/- 8.1% after BAY 1 8201 and by 59.3 +/- 10.1% after placebo (NS). Peak plasma concentrations of 53.7 x/: 2.3 ng/ml (geometric mean x/: geometric standard deviation) and of 35.5 x/: 1.5 ng/ml were reached after oral application of nifedipine and BAY 1 8201, respectively. We conclude that human gallbladder contraction in response to ceruletide is not markedly influenced by dihydropyridine derivates in the dosages used in this study. The results reported here stress the importance of calcium released from intracellular stores for the contractility of smooth muscle in the human gallbladder.

Adult↗
PubMed1988

[Reactions of the liver to high caloric enteral feeding with formula diets].

We studied serum hepatic enzyme alterations in 36 patients receiving continuous enteral hyperalimentation. In 50% of the patients studied a marked increase in liver enzymes could be noticed. Elevations returned to normal either spontaneously during enteral feeding or after feeding was discontinued. In 7 patients, alkaline phosphatase decreased significantly 21 +/- 13 days after institution of tube feeding. The rise in liver enzyme values could not be accounted for by preexistent hepatobiliary affection, caloric load or composition of the formula diet. Further studies are needed to determine whether cyclic isocaloric enteral nutrition will minimize complications and hepatic enzyme changes after enteral nutrition.

Adolescent↗
PubMed1988

[Anorectal motility in systemic scleroderma].

We prospectively compared esophageal and rectal motility data from 7 patients with progressive systemic sclerosis (4 females, 3 males) to esophageal recordings in 22 and anorectal recordings in 9 healthy controls. All patients with sclerosis exhibited motility disturbances in the lower esophageal sphincter (LES): LES resting pressure, LES relaxation amplitude and duration, and the number of incomplete LES relaxations were significantly different compared to the controls. All patients had alterations of anorectal motility: resting pressure, maximal squeeze pressure, and sphincter relaxation amplitude following balloon distension of the rectum were significantly decreased as compared to the control subjects. We conclude that esophageal and anorectal manometry are comparable in their sensitivity to differentiate between patients with systemic sclerosis and normal subjects.

Anal Canal↗
PubMed1988

Gastric phytobezoar: endoscopic removal using the gallstone lithotripter.

Gastric bezoars are a common late complication of gastric surgery. Their treatment may be difficult. This is the first report on the removal of a very firm gastric phytobezoar by perendoscopic lithotripsy. The bezoar was detected 20 years after an unknown type of operation on the stomach, presumably truncal vagotomy and pyloroplasty. We propose the use of the lithotripter through the endoscope as an alternative treatment of firm and large gastric bezoars.

Bezoars↗
PubMed1987

[Pathophysiology, clinical aspects and rational diagnosis of gastroesophageal reflux disease and axial hiatal hernia].

Low pressure or inappropriate relaxation of the lower esophageal sphincter, disturbances in esophageal peristalsis and delayed gastric emptying are the most important pathogenetic factors of reflux disease. In general, retrosternal and also epigastric and pharyngeal burning or pain are the leading symptoms, but in mild disease eructation may become the major complaint. Diagnosis is usually made on the basis of a typical history and the results of endoscopy. 24-h-pH-recording is indicated in inconclusive endoscopy, chest pain of unknown origin and preoperative evaluation. Manometry may be indicated to exclude systemic sclerosis.

Esophagogastric Junction↗
PubMed1987

Effects of oral laxatives on colonic motor complexes in dogs.

The effect of oral laxatives on the organisation of colonic motor complexes was investigated in four conscious dogs. Six strain gauge transducers were implanted on the colon of each dog. After a control period of two to three hours, dogs were orally dosed with 1, 2, or 4 ml/kg of castor oil, or 0.5 g/kg magnesium citrate. Oral olive oil, 4 ml/kg, was used as control. The recording was continued for another 10 hours or until defecation occurred. Each dog showed spontaneous cyclic bursts of contractions (contractile states) at all recording sites during the control period. Contractile states migrating orad or caudad over at least half the length of the colon were called colonic migrating motor complexes (CMMC). Castor oil and magnesium citrate significantly increased the period of colonic motor complexes, but olive oil had no significant effect. None of the above substances changed the percentage of orad migrating motor complexes, as compared with the control values. Periods in which colonic motor activity was completely absent for at least 60 min over at least three consecutive recording sites occurred more frequently after all of the substances. The occurrence of these periods of inhibition, however, was not a consistent feature and there seemed to be no relationship between the occurrence of inhibitory periods and defecation during the recording period. The dogs defecated within 10 hours after administration of magnesium citrate, 1, 2, and 4 ml/kg of castor oil in 12.5, 25, 37.5, and 88.8% of experiments respectively, but never with olive oil. Defecation was generally accompanied by giant migrating contractions in the colon. We conclude that oral laxatives, magnesium citrate and castor oil have a profound effect on colonic motor complexes and colonic motor activity. The period of CMMC is significantly prolonged after their oral administration because of an increased number of non-migrating motor complexes or periods of inhibition of motor activity.

Animals↗
PubMed1987

[Neural regulation of the secretion of the small and large intestines].

The small bowel and the colon are supplied by a dense network of nerves. Nervous control of secretion is influenced by peripheral and central nerves. The small and large intestine are tonically inhibited by the enteric nervous system, in particular by the submucous plexus, to maximally absorb fluid and electrolytes. Choleratoxin induced intestinal secretion may be suppressed by central opiate receptors, and central gamma-aminobutyric acid receptors may inhibit intestinal absorption. Besides the classical neurotransmitters acetylcholine and noradrenalin, which stimulate and inhibit, respectively, secretion, a large number of regulatory peptides and other substances which mainly act as cotransmitters and neuromodulators affect mucosal transport in the small and large intestine. Secretion induced by nerves appears to play a major role in diabetic and infectious diarrhea. The nervous control of secretion in the small and large intestine is an interesting area of current research in intestinal transport. So far already, the results shed new light in a better understanding of intestinal pathophysiology, and they point towards new therapeutic modalities in diarrhea and constipation.

Animals↗