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Biomedical subjects

H F Weiser

Publications and source records attributed to H F Weiser.

At least 37 records · Page 2Linked to original sources
PubMed1986

[Esophageal function following sclerotherapy of esophageal varices].

Functional disorders of the esophagus were evaluated in 24 patients 4 +/- 2 months after sclerotherapy following the first hemorrhage. The mean volume of polidocanol required per patient was 181 +/- 111 ml. 9 patients complained of dysphagia and/or reflux symptoms; strictures were found in two cases; 4 patients had esophagitis. Manometrically the lower esophageal sphincter was completely insufficient in 14 patients; only 7 patients still had a competent cardia. The first group had received significantly more polidocanol than the latter. Tubular motility was disturbed by nonpropulsive (18%) and repetitive (7%) contractions. By longterm-pH-metry the percentage of oesophageal reflux was elevated in all patients.

Deglutition Disorders↗
PubMed1984

[Control of the intragastric pH value in infection and peritonitis by ranitidine versus cimetidine. A double-blind study].

12 patients of an intensive care unit on respirator with peritonitis respectively septic complications were treated with 300 mg/die Ranitidine or 2000 mg Cimetidine/die administered via perfusor infusion under the conditions of a randomized double blind study. Both groups under investigation were comparable in respect to age, sex and grade of risk of stress induced bleedings. With ranitidine under the dosage mentioned above, a prophylactic sufficient control, yet not a complete control of intragastric pH-value was accomplished. With Cimetidine as monotherapy, however, even under the high dosage of 2000 mg/die, no successful control of the intragastric pH could be achieved. With 3 patients even the combinations of 2000 mg Cimetidine/die and 2 X 10 mg Pirenzepine/die did not prove sufficient. Especially for intensive care patients with a difficult to regulate intragastric pH (patients with peritonitis, sepsis) Ranitidine according to our findings is to prefer to Cimetidine for the prophylaxis of bleeding of gastroduodenal lesions.

Abscess↗
PubMed1983

[Gastro-esophageal reflux: is there a correlation between the degree of reflux and its effects?].

In 77 patients suspected of having gastric reflux, long-term pH measurements obtained by an intraluminal pH probe were compared with manometric or endoscopic findings. There was a definite correlation between gastro-oesophageal reflux and both mild and severe stages of reflux disease. Diagnostically the significance and role of endoscopy in the course of routine diagnosis was confirmed. Analysis of the reflux pattern by long-term pH measurement made it possible to provide appropriate drug or surgical treatment of reflux disease.

Esophagitis, Peptic↗
PubMed1983

A new concept in the surgical treatment of gastroesophageal reflux.

Surgical treatment of gastroesophageal reflux has been thought to depend on the construction of a valve mechanism at the gastroesophageal junction (GEJ). Recently, a silicone prosthesis that does not construct a valve has been introduced, and in preliminary studies in the human, shown to be effective in the treatment of reflux. A precise mode of action has not been demonstrated for the prosthesis. This study was undertaken to investigate the mechanics of the prosthesis and determine its effectiveness in an animal model. Six canine gastroesophageal specimens were excised and the lower esophageal sphincter (LES) simulated by a rubber band placed around the GEJ at a tension calibrated to give 25 mmHg "sphincter" pressure. Circumferential silk ligatures of varying length were then placed on the stomach 3.0 cm distal to the GEJ. With no ligature, the LES opening pressure (LESOP) was 8.0 mmHg, varying to 17.0 mmHg with an 8.0 cm ligature. Further, 24 adult mongrel dogs were randomly divided into four equal groups: controls, circular myomectomy of the LES alone, myomectomy combined with fundoplication, and myomectomy combined with implantation of the silicone antireflux prosthesis. Evaluation included manometry, endoscopy, and histology. Although only the normal sphincter and fundoplication responded physiologically, the prosthesis was just as effective in preventing reflux, as evidenced by reducing acid exposure time of myomectomized dogs from 35.4% to 1.8%, and by preventing endoscopic esophagitis. It was concluded that the silicone antireflux prosthesis acts in the same fashion as the ligature in the model, by interrupting distraction of the LES by gastric wall tension. This concept is an effective method for raising LESOP, treating experimental gastroesophageal reflux, and eliminating the sequelae of reflux. Long-term evaluations of the prosthesis are required.

Animals↗
PubMed1983

[Effect of oxmetidine and ranitidine on reflux behavior in patients with esophagitis].

The behavior of reflux under oxmetidine and ranitidine has been examined by long-term-pH-metry in patients with endoscopic proved oesophagitis and pathological, gastro-oesophageal reflux (GER). Both H2-receptor antagonists lead to a significant decrease of the GER over the entire period of measurement of 18 hours. Statistical significant differences comparing both substances could not be found, so that as well oxmetidine as ranitidine seem to be appropriate for the therapy of reflux diseases.

Esophagitis, Peptic↗
PubMed1982

[Gastro-oesophageal reflux--what if physiological? (author's transl)].

Gastro-oesophageal reflux was examined by taped long-term pH monitoring in 31 healthy subjects (16 men, 15 women; average age 28 years). The following was found: (1) reflux during the day is normal in health subjects, occurring predominantly after meals; (2) healthy persons have practically no reflux at night, after reaching the phase of deep sleep, the decisive difference between the healthy subject and those with reflux concerning the sleep phase, during which the patient with reflux has significantly increased reflux; (3) gastro-oesophageal reflux during the night is dependent upon depth of sleep, while position-dependent reflux was not observed.

Adult↗
PubMed1982

[Silicone anti-reflux prosthesis--an artificial fundoplication?].

Of all anti-reflux operations fundoplication has proved the most effective method in experimental and clinical examinations [3, 5, 9, 12, 13]. In 1979 Angelchik reported a silicon prosthesis as an anti-reflux barrier which proved effective in examinations on patients. An explanation for these results is still missing [1]. Our examinations in dogs show that: 1. anti-reflux prosthesis is an effective anti-reflux barrier in dogs after circular myectomy; 2. silicon prosthesis proved to be equally as effective as fundoplication with regard to reflux prevention; 3. the mechanism of action is a mechanical one. The difference between silicon prosthesis and fundoplication is, that the fundoplication represents a 'ring' around the LES, which is elastic and is subject to the same regulations as the LES, and that it can relax in a swallowing reflex manner. In the silicon prosthesis the 'ring-formation' is only mechanical.

Animals↗
PubMed1982

Effect of liquid meals on duodenogastric reflux in humans.

In humans duodenogastric reflux and gastric emptying were measured simultaneously by a two-marker technique that avoids transpyloric intubation. The duodenal marker consisted of 99mTc-labeled Hepatobida and was infused intravenously at a constant rate. Hepatobida was cleared almost exclusively by the liver and entered the duodenum at a constant rate via the bile. The gastric marker consisted of 51CrCl2 and was used to measure total intragastric volume by the double-sampling technique. Duodenogastric reflux occurred both after meals and under fasting conditions. Reflux rate was on the average 13 times smaller than emptying rate. It was higher with a lipid than with a protein meal and was independent of the rate of gastric emptying. The gastric concentration and total amount of duodenal contents were higher after lipid than protein meals. Since gastric emptying of a protein meal was faster than emptying of a lipid meal, the increased gastric concentration and accumulation of duodenal contents after lipid meals are due to a slowed gastric clearing and increased reflux of duodenal contents. Under fasting conditions, the reflux was lower and the gastric concentration of duodenal contents was higher than with both types of meals. Hence regurgitated duodenal contents may cause more damage to the gastric mucosa under fasting conditions than postprandially.

Adult↗
PubMed1980

[Therapeutic results of peptic stenosis in the esophagus (author's transl)].

Of 118 patients treated for peptic stenosis between 1970 and 1979, 89 cases (75.4%) had developed in connection with endobrachyesophagus, i. e., as the result of primary reflux disease; 26 cases were the consequence of secondary reflux disease without endobrachyesophagus. In three cases the peptic stenosis had to be explained as the result of a local acid secretion. The treatment which followed was conservative (bougienage + Cimetidine/Antacids) or operative (bougienage + fundoplication). The results of the therapy varied according to the type of stenosis. In cases where the stenosis was located in the upper part (endobrachyesophagus), good results could be achieved with conservative therapy in 38.3% and with operative therapy, in 67.3%. The results were worse in terminal stenosis (conservative therapy, 45.5%; operative therapy, 60%). Retrospective analysis of unsuccessful treatment shows that predominantly scarred stenosis shows worse results than florid stenosis with recent esophagitis.

Adult↗
PubMed1980

[Komarov-oesophagostomy and duodenocutaneous jejunal segment: a simple model for examination of the gastroduodenal region in the dog (author's transl)].

Direct and partially indirect methods to quantify gastro-duodenal motility in the dog require direct access to the stomach or duodenum without disturbance of the structures to be assessed. A procedure is presented, which combines Komarov-oesophagostomy and the process of duodenocutaneous jejunal segment. This procedure has proven to be simple and secure in technique and without problem in chronic experimentation.

Animals↗
PubMed1980

[Endoscopic-pneumatic dilation (EPD) for the treatment of achalasia (author's transl)].

The endoscopic pneumatic dilation (EPD) procedure introduces an instrument which can be used in combination with fiberoptic-endoscopes types GIF-P and GIF-P2. The dilator is characterized by simple, easy, and gentle handling, even with extreme deviation at the gastro-esophageal junction. In daily clinical routine it has been shown to be effective in the treatment of achalasia.

Dilatation↗
PubMed1979

[The effect of Ca++ on gastrin output and LESP before and after antrectomy (author's transl)].

Previous investigations show that calcium infusion stimulates gastrin output in healthy volunteers, whereas after antrectomy calcium does not cause any significant change of IRG levels. Both healthy volunteers and antrectomized patients (B II) show a continuous increase of LESP, reaching a maximum after 120 minutes. These results suggest a direct interaction of Ca++-ions and gastrointestinal smooth muscle cells.

Adult↗
PubMed1979

Phasic and tonic types of smooth muscle activity in lower oesophageal sphincter and stomach of the dog.

Mechanical activity of isolated circular muscle strips from the lower oesophageal sphincter (LES), fundus, corpus and antrum of canine stomach was recorded. Nifedipine (10(-6) mol/l) selectively suppressed the phasic components of spontaneous, acetylcholine (ACh)- and noradrenaline (NA)-induced activity of gastric strips. The nifedipine-resistant tonic components of gastric strips were suppressed by nitroprusside sodium (NP) (10(-5) mol/l). LES strips exhibited only weak spontaneous activity. Their ACh-induced activation was nearly completely suppressed by nifedipine. Only NA was able to elicit a strong nifedipine-resistant activation which was, in contrast to the activation of fundus strips, not suppressed by NP.

Acetylcholine↗
PubMed1979

[Endobrachyesophagus and adenocarcinoma of the esophagus].

The columnar epithelium lined esophagus is usually the result of a chronic reflux disease. In the literature one can find more and more references to a malignant transformation of this columnar epithelium. Our own observations of 14 patients with an adenocarcinoma in a columnar-lined esophagus support this suspicion. Because the adenocarcinoma of the esophagus has therapeutic consequences other than a squamous carcinoma of the esophagus, the surgery has to give attention to this malignant transformation of the columnar-lined esophagus.

Adenocarcinoma↗