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T Frieling

Publications and source records attributed to T Frieling.

98 records · Page 6Linked to original sources
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↗
PubMed1986

[Familial dysphagia].

The etiology of achalasia and diffuse esophageal spasm remains unknown. We report on two families (father/son, mother/son) with achalasia and esophageal spasm, respectively, who were examined by radiology, endoscopy and manometry. One patient (mother) died from aspiration pneumonia. These observations support the hypothesis of a genetic trait in some cases of esophageal motility disorders. In addition, the coincidence of familial achalasia and esophageal spasm is in support of a close relationship of both diseases. Achalasia is a potentially letal disorder.

Adult↗
PubMedDate not supplied

Individual fecal alpha 1-antitrypsin excretion reflects clinical activity in Crohn's disease but not in ulcerative colitis.

BACKGROUND/AIMS: The natural course of fecal alpha 1-antitrypsin (AAT) excretion was assessed in patients with inflammatory bowel disease (IBD) to evaluate its role in monitoring their clinical disease activity. METHODOLOGY: A prospective cohort pilot study was performed in 9 patients with Crohn's disease (CD) and 3 individuals with ulcerative colitis (UC). Subjects were investigated at regular monthly intervals for about one year for (a) parallel AAT stool and serum concentrations by standard immunonephelometry, and (b) for clinical disease activity by Crohn's Disease Activity Index (CDAI) in CD patients, and by Clinical Activity Index (CAI) in UC subjects. Absolute results during follow-up were each referred to individual findings at study entry as relative results. RESULTS: While absolute fecal AAT concentration did not correlate with disease activity indices (p > 0.26), relative fecal AAT concentration significantly correlated to concurrent relative CDAI score in CD patients (p < 0.001, r = 0.67), but not to relative CAI score in UC subjects (p = 0.92). Monthly intraindividual variation of fecal AAT excretion did not predict development of either disease activity index (p > 0.14). CONCLUSIONS: Individual fecal AAT excretion closely reflects clinical course in CD subjects, but not in UC patients. It does not predict symptomatic deterioration in these individuals, at least on a short-term basis.

Adult↗
PubMedDate not supplied

Endoscopic treatment of symptomatic choledocholithiasis.

BACKGROUND/AIMS: Today, different endoscopic techniques are available to treat choledocholithiasis. These techniques include mechanical lithotripsy (ML), electrohydraulic lithotripsy (EHL), laserlithotripsy (LL), and extracorporal shock-wave lithotripsy (ESWL). These techniques have to compete with laparoscopic stone removal which is performed with increasing frequency at some centers. METHODOLOGY: We report the results of treatment of choledocholithiasis and compare the results with a meta-analysis of studies in whom endoscopic and laparoscopic techniques were applied. From 1994-1995, 217 patients with symptomatic choledocholithiasis were treated using endoscopic retrograde cholangiography (ERC). RESULTS: Overall, complete stone removal was successful in 98% of all patients and only 5 patients had to undergo surgery. Complete endoscopic removal of stones was achieved in 70% during the first ERC session. In 47 patients consecutive ERC sessions with application of EML, EHL, or ESWL were necessary to completely remove the stones. Complication rate was 5% and included pancreatitis and bleeding from papillotomy. There was no procedure-related mortality. CONCLUSION: The study suggests that today ERC remains the treatment of choice in most patients with symptomatic choledocholithiasis.

Adult↗
PubMedDate not supplied

Palliative treatment of malignant esophageal stenosis: experience with plastic versus metal stents.

BACKGROUND/AIMS: We report on the palliative treatment of 44 patients with malignant dysphagia by placement of plastic (Celestin tubes, n = 24) vs metal stents (Wall stents, Nitinol stents, Gianturco stents, n = 20). METHODOLOGY: Prior to stent insertion, esophageal stenosis was dilated stepwise to 16 mm (plastic tube) and to 10 mm (metal stent). RESULTS: Stent insertion was technically successful in all cases and led to a reduction of dysphagia. Risk of perforation was comparable in both groups (n = 1 in each group). Most of the plastic stents were placed when the tumor was localized in the proximal part of the esophagus close to the upper esophageal sphincter, when esophageal-bronchial fistula was present and in the risk of fistula development after radiation. During follow-up, tumor ingrowth (TI) and stent migration (SM) were the major complications. Whereas tumor ingrowth predominantly occurred in metal stents (TI after 6 weeks, 45% vs. SM, 10%) that required repeated argon beamer therapy, tube migration and bolus impaction (BI) often occurred in patients with plastic stents (TI, 0% vs. SM, 16%; BI, 4%). CONCLUSIONS: The findings of the study suggest that the decision whether plastic tubes or metal stents used should be taken individually considering tumor localization, axis deviation and the presence of esophago-respiratory fistulas. When stepwise dilation of malignant stenoses is performed carefully, perforation risk appears not to be different between placement of plastic prostheses and metal stents.

Aged↗