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Biomedical subjects

W Berges

Publications and source records attributed to W Berges.

At least 55 records · Page 3Linked to original sources
PubMed1982

[A method to transmucosal transport in the human esophagus (author's transl)].

A modified 9-luminal manometric tube served to perfuse the esophagus with 3.2 mmolar hydrochloric acid containing 2% polyethylene glycol (PEG) and to aspirate the esophageal contents. The esophageal secretion was calculated from the PEG dilution in the aspirates. Neutral red injected intravenously reddened selectively gastric juice. Red esophageal aspirates were discarded., In 6 health subjects esophageal secretion was 1.0/+-0.2 ml/min after 1 hour perfusion. It contained 38 /+-11 mmol/l na+, 3.3/+-1.4 mmol/l K+, 27/+-6 mmol/l Cl-, and 50/+-13 mumol/l N-acetylneuraminic acid (NANA). Thus this method allows measurement of the barrier function of the esophageal mucosa.

Barrett Esophagus↗
PubMed1982

[The effects of sympathicolysis on interdigestive small bowel motility (author's transl)].

The effect of the alpha-sympathicolytic agent dihydroergotamin-heparin (DHEH) on small bowel motility was examined in a double-blind cross-over study. Intraluminal pressure of the duodenum and jejunum was measured manometrically in 10 healthy volunteers. Sympathicolysis by subcutaneous injection of DHEH increased the number of contractions in the duodenum and jejunum significantly. Under the influence of DHEH, the number of activity fronts of the interdigestive migrating motor complex was higher than in the placebo experiments; however, the difference was not statistically significant. These results may give an explanation for the beneficial effects of this alpha-sympathicolytic agent seen in the prophylaxis and therapy of paralytic ileus.

Adult↗
PubMed1982

Salivary secretion in reflux esophagitis.

It has been speculated that impaired salivary flow and contents contribute to abnormal acid clearance in patients with reflux esophagitis. To test this hypothesis, salivary secretion of volume, bicarbonate, and N-acetylneuraminic acid was measured in patients with reflux esophagitis, in age- and sex-matched controls, and in healthy young volunteers. Resting saliva was collected by permitting the saliva to drip into a flask every 30 s. Parotid saliva was collected by means of a Lashley capsule during stimulation by oral infusion of 1 ml/min of 2% citric acid. Total mixed saliva was collected by a dental sucker during esophageal perfusion with water and 10-mM hydrochloric acid. The volume of resting saliva and its concentration of bicarbonate were similar in the three groups. The concentration and the output of N-acetylneuraminic acid were higher in the young volunteers than in the two other groups. The volume flow and the composition of stimulated parotid saliva were similar in the three groups of subjects. Volume of total mixed saliva and concentration of bicarbonate and N-acetylneuraminic acid during esophageal perfusion with water were higher in patients with reflux esophagitis than in age- and sex-matched controls and were similar to the values found in young healthy volunteers. Acid perfusion increased the secreted volume of total mixed saliva by 150% and the concentration of bicarbonate by 30% in healthy young volunteers, but not in patients with reflux esophagitis and in the healthy age- and sex-matched controls; the concentration of N-acetylneuraminic acid was left unaffected by acid perfusion in all three groups. These findings disprove the hypothesis of impaired salivation in reflux esophagitis. The age-related loss of salivary response to acidic esophageal perfusion might be the reason why reflux esophagitis with peptic lesions affects predominantly elder people.

Adult↗
PubMed1982

Clomethiazol tablets induce ulcers in the esophoagus.

A 55 year old woman developed severe retrosternal pain and odynophagia four hours after taking a tablet of clomethiazol. Endoscopy revealed extensive ulceration of the upper esophagus 19-23 cm from the incisors. Esophageal manometry showed reduced contraction amplitudes in this area. The lesions healed rapidly after the medication was stopped, and the motility disturbances of the esophagus improved. Thus, clomethiazol tablets have to be included in the list of drugs which can damage the esophageal mucosa. This damage is probably due to the acid salt ethanedisulfonate of the clomethiazol tablets. Clomethiazol capsules are preferable since they do not appear to be harmful to the esophagus.

Acute Disease↗
PubMed1981

[Cervical dysphagia in scleroedema adultorum Buschke (author's transl)].

Scleroedema adultorum Buschke is characterized by progressive hardening of the skin. In contrast to scleroderma the hardening occurs in the skin of the trunk while extremities remain largely free. Internal organs are said not to be involved in scleroedema adultorum Buschke. The full picture of the persistent form of scleroedema adultorum Buschke was observed in two patients. One patient complained of increasing dysphagia with regurgitation and aspiration. Manometry and X-ray cinematographic investigation showed inappropriate relaxation of the upper oesophageal sphincter. In the other patient who had not previously had swallowed difficulties manometry showed achalasia of the upper oesophageal sphincter. The functional disturbances of the upper oesophagus indicate the possibility of an involvement of internal organs in scleroedema adultorum Buschke. However, proof of an aetiological connection between disturbances of oesophageal motility and skin disease requires systematic investigations in a larger group of patients.

Adult↗
PubMed1981

[Hiatal hernia--reflux disease. Indications for surgery and initial results of a new treatment method].

Indications for the operative treatment of hiatus hernia with reflux oesophagitis are grade III and IV reflux oesophagitis; if the total acid period equals or exceeds 1.3% of the time of the period of time during which the patient was in supine position (pH-examination); if acid clearance lasts 2.86 min or more after a single reflux period; if radioisotopic counts over the sternal region exceed 3.5--4% of those obtained over the stomach area. Since 1977 we performed a new anti-reflux-operation, which we call "Teres-plasty"in 42 patients with axial hiatus hernia. The procedure is a modified gastropexy by using the ligamentum teres. First results seem to prove that this method can avoid reflux without postoperative syndromes as gas bloat syndrome and dysphagia, which are known to occur after fundoplication.

Adult↗
PubMed1980

[Esophageal stenosis in sjögren's syndrome].

Dysphagia in Sjögren's syndrome may be caused by xerostomy, pharyngoesophagitis and esophageal membranes. This is the first report on a tubular upper esophageal stenosis in a 71 year old woman with Sjögren's syndrome who developed progressive dysphagia. It is suggested, that this stenosis was due to chronic inflammatory processes and secondary sclerosis of deep layers in the esophageal wall. Bouginage was adequate symptomatic therapy. Tubular esophageal stenosis is regarded as gastrointestinal manifestation of Sjögren's syndrome.

Aged↗
PubMed1980

[Ulcer of the esophagus after intake of emeproniumbromide (author's transl)].

Two female patients were treated because of pollakiuria with emeproniumbromide tablets. They developed extended ulcers of the esophageal mucosa. The tablets had been taken late in the evening with only little fluid. Ulcer formation is thought to be due to prolonged passage time and to a locally damaging effect of the hygroscopic compound. There may be lesions of the esophageal musculature as well, as demonstrated by considerable disturbance of esophageal motility. Ulcers tend to be painfull; they heel fast without formation of scars.

Adult↗
PubMed1980

[Diagnostic problems in the differentiation of achalasia and spasm of the oesophagus (author's transl)].

In 15 patients suspected to have achalasia or diffuse spasm of the oesophagus we were unable to make the final diagnosis of their motility disorder in spite of radiologic, endoscopic, and manometric examinations. In 5 patients the radiologic and manometric results showed a discrepancy. In 4 patients only the lower oesophageal sphincter exhibited failure fo complete relaxations typical of achalasia; however, the motility of the body of the oesophagus was peristaltic in nature. In 6 patients the initial diagnosis had to be changed during follow-up. In conclusion, motility disorders occur in the oesophagus which cannot be classified according to existent definitions. It is possible therefore that achalasia and oesophageal spasm are different and not always fixed expressions of one nosologic entity.

Adult↗
PubMed1979

[Treatment of reflux oesophagitis with cimetidine (author's transl)].

The effect of cimetidine on reflux oesophagitis was studied in a double-blind trial. Sixteen patients were given cimetidine 1.6 g/d, 20 patients received a placebo. Within the first six weeks the oesophagitis improved both on cimetidine and the placebo, but the patients taking the former had fewer complaints during the day than those on a placebo. Continuing the regimen for another six weeks further improved the endoscopic findings in patients with cimetidine but not in those on placebos. Complaints lessened during the sixth to twelfth week during cimetidine treatment, but remained unchanged under placebo administration. Complete healing of the oesophagitis was achieved in only 33% of patients with uncomplicated oesophagitis (grade I-III) and in 6% of those with severe complicated oesophagitis (grade IV). If non-surgical treatment is indicated, it must be continued through at least 6-12 weeks.

Adult↗
PubMed1979

[Cimetidine treatment of reflux esophagitis: results of a double-blind study].

The effect of cimetidine on healing of reflux esophagitis was investigated in a double blind study in which 16 patients received 1.6 g cimetidine/day and 20 patients placebo. After 6 weeks endoscopic healing or amelioration of the esophagitis was observed in 10 of 20 patients on placebo (50%) and in 9 of 16 patients receiving cimetidine (56%). Continuation of double blind therapy in 24 patients for another 6 weeks led to improved healing in 12 cimetidine patients but not in 10 placebo patients. In only 4 of 16 cimetidine patients there was complete healing of esophagitis at the end of the study. The cimetidine patients had fewer symptoms to a statistically significant degree after 6 and 12 weeks, respectively. It is concluded that, despite its statistically significant effects on esophagitis and reflux symptoms, cimetidine therapy of reflux disease is not satisfactory. If cimetidine therapy appears to be indicated, it should be continued for at least 12 weeks.

Adult↗