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Biomedical subjects

T Wittmann

Publications and source records attributed to T Wittmann.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Treatment of achalasia of the cardia using thoracoscopic esophago-myotomy].

We performed left thoracoscopic esophagomyotomy in four patients suffering from achalasia cardiac. In one patients the esophageal mucosa was opened during the myotomy. This was sutured through thoracoscopy and the per os feeding of the patient started on the 8th postoperative day, while in the other three patients this was done on the 2nd postoperative day. The mean emission of the patients was on the 6th postoperative day. Comparison of the status before and 6 weeks following the operation was done on the basis of results of different examinations i. e. x-ray, esophago-gastroscopy, manometry, pH-metry, isotope test. The favourable results of the operations were declared as all examinations revealed marked improvement and all patients have better swallow function and 6-9 kg increase in body weight.

Adult↗
PubMed1997

The ursodeoxycholic acid-p-aminobenzoic acid deconjugation test, a new tool for the diagnosis of bacterial overgrowth syndrome.

OBJECTIVE: To determine the possible complementary role of the ursodeoxycholic acid-p-aminobenzoic acid (UDCA-PABA) loading test in the diagnosis of intestinal bacterial overgrowth. DESIGN: A prospective clinical study. PATIENTS AND METHODS: The hydrogen breath and UDCA-PABA tests were performed simultaneously in 68 patients with suspected contaminated small bowel syndrome (CSBS), and in 10 healthy control subjects. The hydrogen breath test was performed by oral loading of 25 g of lactose and/or 10 g of lactulose. The UDCA-PABA test was carried out by oral loading of 250 mg of UDCA-PABA conjugate, followed by measurement of the amount of PABA excreted in the urine. The diagnosis of bacterial overgrowth was considered to be established when either the hydrogen breath test or the UDCA-PABA test produced abnormal results. RESULTS: Thirty-five of the 68 patients proved to have CSBS. In 13 of these 35 patients, only the enhanced urinary PABA excretion (11.7 +/- 1.42 mg vs. 3.6 +/- 0.68 mg) indicated bacterial overgrowth, 15 of the 35 patients gave only a positive hydrogen breath test, and in the remaining seven cases the results of both tests were abnormal. In eight CSBS patients, the urinary excretion of PABA was decreased significantly following 10-day tinidazole treatment (5.5 +/- 1.29 mg vs. 13.1 +/- 2.07 mg). CONCLUSION: The UDCA-PABA test is a valuable clinical method for the detection of bacterial overgrowth, especially in cases where hydrogen production alone fails to reveal CSBS. It is also a useful procedure for evaluating the efficacy of antibacterial treatment.

4-Aminobenzoic Acid↗
PubMed1996

[Evaluation of complaints and diagnostic methods, considered to be objective, in gastroesophageal reflux].

Authors analyse complaints of 166 patients suffering in gastroesophageal reflux disease, and results of different objective diagnostic methods (X-ray swallowing, endoscopy, 24 hour pH-monitoring, esophageal manometry). The degree of severity of typical complaints and changes found by diagnostic procedures were scored. Individual diagnostic proceduresindicated the characteristic changes of gastroesophageal reflux with great deviations. Hiatal hernia identified by x-ray, esophagitis observed by endoscopy, abnormal reflux revealed by pH-metry together occurred only at 36% of patients. Significant correlation could be revealed only between the degree of changes found by x-ray or pH-metry--applying them one by one--and the complaints of the patients, but with the combination of four diagnostic methods a tight, positive correlation could be demonstrated with the severity of the complaints of the patients in every case. Applying of diagnostic methods as much as possible completing each others, with consideration to the complaints of the patients is suggested for having the diagnosis been precise of the gastroesophageal reflux disease, and for measuring of efficacy of treatment. The importance of tight collaboration of internist, radiologist and surgeon and the significance of complex examination is underlined.

Esophagoscopy↗
PubMed1995

[The intestinal capsule: a new way of investigating the small intestine].

The small bowel is difficult to explore because of its location far away from the natural orifices. The aim of this study is to describe a telemetric, autonomous and multifunctional capsule (39 mm in length and 11 mm in diameter) designed according to a modular system to explore the small bowel. It consists of a central cylinder containing a location detector which allows permanent data collection concerning its position in the small bowel, the length of the small bowel and the transit velocity; secondly, several interchangeable tips allow either aspiration of a sample of intestinal juice, or release of a substance previously placed in the capsule, or to perform a mucosal biopsy. After having been swallowed by the patient, the capsule passes through the whole gut and is then recovered in the stools between 24 and 48 hours later. The preliminary study consisted of comparing, in patients undergoing a surgical procedure, the small bowel length measured by telemetry (542.3 +/- 113.8 cm) to that measured intraoperatively by the arithmetical mean of the mesenteric and antimesenteric edges (515 +/- 112.7 cm), p = 0.28. These different interchangeable working tips have already been used to determine the level of absorption of various substances, the discovery of absorption sites and the performance of mucosal biopsies without any material link between patient and the measuring or recording equipment. The main advantages of this intestinal capsule are the possibility to continuously transmit its location, its total autonomy and remote control of the desired action.

Biopsy↗
PubMed1994

[Radioisotope study of esophageal transit].

Diagnostics relating to esophageal motility disorders has come into the focus of attention in recent years. A review is made of the possibilities of application of radioisotope esophageal transit measurement. The methods employed and the models of data recording and processing in this field are listed. The value of this procedure in different esophageal disorders is discussed in detail. Two characteristic cases are reported to illustrate the method. It is concluded that measurement of the radionuclide esophageal transit is a noninvasive, simple and safe technique for the screening of esophageal motility dysfunction.

Esophageal Motility Disorders↗
PubMed1992

Variations of magnesium, iron, copper and zinc during the colonic wound healing process: experimental study on rabbits.

The role of trace elements in the wound-healing process is still controversial. Their variations within a normal colonic wound healing have never been studied. An experimental study on rabbits was designed to study magnesium, iron, copper and zinc variations in blood, normal colonic walls and colonic anastomoses on each of the first 7 postoperative days. No major variations of Mg could be observed. Fe decreased in blood as well as in colonic walls and anastomoses. Cu increased in blood, whereas it decreased in colonic walls and anastomoses. Zn decreased in blood, whereas it increased in colonic walls without significant changes in anastomoses. The role of Fe seemed to be rather difficult to understand. Plasma mobilization seems to explain the local use of Zn, while early tissue release with further return in blood occurred for Cu. The importance of a well-balanced nutritional status is underlined to prevent and correct the variations of trace elements in the postoperative course.

Anastomosis, Surgical↗
PubMed1991

Autonomous telemetric capsule to explore the small bowel.

An intestinal telemetric capsule has been developed to study the small bowel in man. It consists of a cylinder (11 mm in diameter and 39 mm in length) containing a location detector, a radiotransmitter, a lithium battery and an interchangeable tip. After having been swallowed by the patient, the capsule passes through the whole gut and is recovered in the stools. During the transit through the small bowel, the information provided by the radiotransmitter allows continuous monitoring of the distance covered from the pylorus, the direction and the velocity of progression. Moreover, according to the type of interchangeable tip, it is possible, by remote control, to sample 0.5 ml of intraluminal fluid for subsequent analysis or to release 1 ml of any liquid substance in a precisely determined place for pharmacological studies. The main originality of the capsule is its ability to transmit its precise location inside the small bowel.

Gastrointestinal Motility↗
PubMed1990

Long-duration stress. Immediate and late effects on small and large bowel motility in rat.

No extensive information exists in literature concerning the late or residual effects of stress on motility of small bowel and colon. Moreover, the duration and magnitude of the intestinal motor response to stress are still ignored. Therefore, the aim of our work was to determine, in rat, the effect of long-duration stress induced by restraint on the motility of small bowel and colon. Observations were made during physical restraint and 60 h later. Bipolar electrodes were implanted on the gastrointestinal serosa from the pylorus to the sigmoid colon in male Wistar rats. Electromyographic (EMG) recordings were made during fasting state, and a control EMG recording session was performed during 12 hr, followed by a 12-hr recording during restraint stress. After a 60-hr resting period, another EMG recording session was performed during 3 hr. During stress in the pylorus and small bowel, the recurrence of migrating myoelectrical complexes (MMCs) was immediately interrupted and replaced by a continuous and irregular activity. The motility index (number of spike bursts/10 min) was augmented rapidly on the jejunum and ileum, but it increased only gradually on the pylorus. Only on the transverse colon were the number of spike bursts/hour and their relative duration increased after 7 hr of physical restraint. In contrast, the sigmoid colon displayed a gradual decrease in the relative duration of contractile activity during the first 6-7 hr of stress. At 60 hr after stress in the pylorus and small bowel, a normal control motor activity was restored (MMC, motility index) on the jejunum and on the ileum, but the motility index on the pylorus was decreased.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

[Improvement in the healing of colonic anastomoses by vitamin B5 and C supplements. Experimental study in the rabbit].

To study the effects of vitamins B5 and C on the healing process of colonic anastomoses, 3 groups of 20 rabbits were given daily either placebo (group A), or vitamin B5 (100 mg/kg: group B) or vitamin C (100 mg/kg: group C). After 8 days of supplementation, via a midline incision and under general anaesthesia, 2 colonic segments were removed, and the continuity was restored. On the 3rd post-operative day, the rabbits were killed and the anastomoses were removed. Mechanical properties of both normal colon and anastomoses were determined by using bursting pressure tests, number of burst anastomoses, fibroblast count, hydroxyproline concentration and determination by microanalysis of trace element content: Mg, P, S, Ca, Fe, Cu, Zn and Mn. Vitamin B5 (p = 0.03) and vitamin C (p less than 0.01) both decreased the number of burst anastomoses. Furthermore the required bursting pressure values were higher with vitamin C (p = 0.01) than in controls. Both vitamins restored normal Zn levels at the anastomotic site, whereas these levels decreased on the 3rd post-operative day during the normal healing process of colonic anastomosis. Moreover, vitamins B5 and C increased Fe, Cu and Mn levels, which are intimately all involved in collagen synthesis. Vitamins B5 and C enhance the colonic wound healing process in the rabbit, acting together in synergy in vivo as well as in vitro, as previously demonstrated.

Anastomosis, Surgical↗
PubMed1990

[Difference in the action of prostaglandin E2 (PGE2) on longitudinal circular muscle contractions of the colon. Experimental study in dogs].

The effect of prostaglandin E2 (PgE2) on the circular and longitudinal contractions of the canine colon was studied in chronic conditions. A mechanical transducer developed in our laboratory and implanted on the canine colon collected simultaneously and separately the variations of length in two perpendicular directions. The recordings started at the 6 postoperative day. The colonic motility was recorded two hours before (as control period) and two hours after the intravenous injection of PgE2 at three different doses: 0.1-1.0 and 10 micrograms/kg. PgE2, at the three doses, induced, progressively over time, a significant decrease in duration and amplitude of the circular contractions, while the amplitude of longitudinal contractions remained unchanged. 10 micrograms/kg of PgE2 immediately induced a significant increase in the duration of longitudinal contractions followed by a decrease in this value during the 2nd hour after PgE2 administration. Each dose of PgE2 shortened the period of recurrence of longitudinal contractions, inducing rapid or immediate bursts of contractions. This effect was moderate or absent for the circular contractions. It is concluded, that PgE2 has different actions on circular and longitudinal contractions of the colon. According to the dose used, it induces hypokinesia (relaxation) in the circular muscle and premature strong contractions in the longitudinal motor activity.

Animals↗
PubMed1988

Adaptive changes in postprandial motility after intestinal resection and bypass. Electromyographic study in rats.

An electromyographic technique was used to study the changes in postprandial motility induced by jejunal and ileal resection and jejunal bypass (50% reduction of total length of small bowel). Electrodes were implanted in rats throughout the intestine. Compared to control animals, the duration of postprandial interruption of the myoelectric complex (DIMC) was rapidly increased after jejunal resection, more gradually augmented after jejunal bypass, and remained constant after ileal resection. The frequency of occurrence of spike bursts during the postprandial period was significantly decreased in the short remaining proximal segment after jejunal resection and was not changed in the ileum. The jejunal bypass induced no change in the frequency throughout the remaining bowel. Ileal resection was followed by a decrease on the jejunum. The percentage of slow waves superimposed by a spike burst remained constant after jejunal resection and bypass but was significantly decreased after ileal resection on the whole remaining intestine. These results show important modifications in postprandial motor activity of the small bowel, which appear rapidly after jejunal resection, more gradually after jejunal bypass, and which are less pronounced after ileal resection. This electromyographic study emphasizes the role of intestinal motility in the development of adaptation after small bowel resection or bypass.

Adaptation, Physiological↗
PubMed1986

Cyclic motor activity and trophicity after jejunal resection and bypass in rats.

The aim of the study was to examine the changes in intestinal motility induced by an extensive jejunal resection and bypass in rats using an electromyographic technique. The relationship, if any, between the development of motility and adaptive modifications of intestinal trophicity was also studied. A massive jejunal resection, preserving a 7-cm segment distal to the ligament of Treitz, was performed in one group of animals. In a second group, the jejunum was bypassed as a self-emptying blind loop. Two sham-operated groups underwent transection and reanastomosis on the proximal jejunum or ileum. Electromyographic activity was studied at the 10th and 30th postoperative days by means of electrodes implanted throughout the remaining or bypassed bowel and was expressed by means of the pattern of recurrence of the migrating myoelectric complex (MMC). After a month, the animals were sacrificed. Mucosal and muscular wet weight and protein content (mg/cm) of the intestine were then determined. The results showed that 10 days after the jejunal resection in the fasting state, MMC cycle duration is different in the remaining jejunum and in the ileum. However, the distribution of MMC phases in the jejunum was modified and was similar to the one in the ileum. Thirty days after resection, MMC cycle duration, as well as phase distribution in the remaining jejunum, resemble the MMC patterns in the ileum. These changes were not observed after bypass. After the return of MMCs after postprandial inhibition produced by a meal, MMC duration in the ileum was greatly decreased until a month after jejunal resection. In contrast, the jejunal bypass did not produce this modification.

Action Potentials↗
PubMed1986

Electromyographic characteristics of small bowel motility in the rat.

Rats are widely used in intestinal motility studies, but no precise observation has yet been carried out on the organization of motility throughout the whole small bowel of the rat. The aim of this work was to investigate the characteristics of small intestinal motility of the rat using an electromyographic technique. The variables describing the pattern of occurrence of the migrating myoelectric complex (MMC) were studied as well as the relative distribution of the 3 phases within the MMC cycles. The mean duration of the MMC was 20 min on the jejunum, and it increased up to twofold along the ileum. The propagation of the MMCs was regular in the jejunum, but about half the MMCs disappeared along the ileum and did not reach the caecum. The electromyographic characteristics of the jejunum are greatly different from those of the ileum, and the motility of a segment is not representative of the whole small bowel motility. Considering these particularities of intestinal motility, rats differ in many details from other species.

Animals↗
PubMed1985

[Pancreatic and intestinal adaptation following proximal or distal resection of the small intestine in the rat].

The comparative effect of a 50% proximal or distal enterectomy on the exocrine pancreas and the remaining intestine has been studied in the rat one month after operation. Distal enterectomy induces (1) growth of the pancreas, characterized by a parallel increase in pancreatic weight, protein, DNA, RNA, amylase, lipase and chymotrypsin content, (2) preferential adaptation of the remaining ileum. Proximal enterectomy did not modify the pancreatic parameters studied but brings about an adaptation of the duodenum, the remaining jejunum and the ileum. It is concluded that pancreatic and intestinal adaptations differ after proximal and distal enterectomy.

Adaptation, Physiological↗
PubMed1985

Changes in motility after jejunal and ileal resection: electromyographic study in rats.

The aim of this work was to compare the effects of massive jejunal and ileal resections on intestinal motility using an electromyographic technique. Male Wistar rats were used: in the first group a massive jejunal resection was performed, conserving a 7-cm segment after the ligament of Treitz; the rats of the second group underwent an ileal resection, preserving 7 cm of the terminal ileum. Motility was studied at the 10th and 30th postoperative days by means of electrodes implanted throughout the remaining bowel and was expressed by the pattern of recurrence of the migrating myoelectric complex (MMC). In a fasting state, in both transected and resected animals at the 10th postoperative day, the gradient in the duration of MMC along the intestine still existed. However, on the 30th postoperative day, in animals with jejunal resection only, there was an adaptive process: the duration of MMC in the remaining jejunum was significantly increased to the duration in the ileum. After the end of the postprandial inhibition of the appearance of the MMC, on the 10th postoperative day there was a significant decrease in the duration of MMC in the ileum in both types of resection, compared to the controls. However, on the 30th postoperative day, the duration of MMC returned to its control value. In conclusion, jejunal resection seems to induce more important adaptive processes in intestinal motility than does ileal resection. The different results are discussed.

Animals↗