[Swallowing in the elderly : Physiological changes, dysphagia, diagnostics and treatment]. / Schlucken im Alter : Physiologische Veränderungen, Schluckstörungen, Diagnostik und Therapie.

Increasing age leads to a number of physiological as well as disease-related pathological changes that among others also affect structures involved in swallowing. These changes not only increase the risk of developing dysphagia but as a result can lead to pneumonia, malnutrition, exsiccosis, a relevant impairment of the quality of life and increased mortality. To evaluate the nature and extent of dysphagia, clinical swallowing tests as well as instrumental approaches, such as the endoscopic evaluation of swallowing are available. Depending on the findings from these examinations, the underlying disease and estimation of the individual patient prognosis, several treatment approaches ranging from diet adaptation, logopedic exercises and compensatory maneuvers up to tube feeding are available. The optimal treatment requires close cooperation of all disciplines involved.

[Age-related changes in swallowing. Physiology and pathophysiology]. / Schluckstörungen im Alter, Physiologie und Pathophysiologie.

The term presbyphagia refers to all changes of swallowing physiology that are manifested with increasing age. Alterations in the pattern of deglutition that are part of healthy aging are called primary presbyphagia. Primary presbyphagia is not an illness in itself but contributes to a more pervasive naturally diminished functional reserve, making older adults more susceptible to dysphagia. If disorders in swallowing occur in the elderly as a comorbidity of a specific disease, for example stroke or neurodegenerative disorders, this is called secondary presbyphagia. Increasing age has an impact on each stage of deglutition. In the oral preparatory phase a diminished input for smell and taste as well as a usually multifactorial cause of dry mouth are the most important influencing factors. Sarcopenia, the degenerative loss of skeletal muscle mass, strength and quality associated with aging, interferes in particular with the oropharyngeal phase. A decreased sensory feedback from the oropharyngeal mucosa leads to a delayed triggering of the swallowing reflex. Finally, a reduction in connective tissue elasticity and changes of the axial skeleton lead to various modifications of the swallowing pattern with advanced age.

[Pre- and postoperative clearance studies in the individual kidneys in juvenile kidney surgery]. / Seitengetrennte Nieren-Clearance im Rahmen prä- und postoperativer Untersuchungen bei Nierenoperationen im Kindesalter.

In 1978 43 patients have been operated in the Department of Pediatric Surgery, Krankenhaus München-Schwabing, because of recurrent urinary-tract infections with ureterovesical reflux or obstructive urinary-tract diseases. In all patients a split whole body clearance-study with a method modified after the method of Mühle with 131J-Hippuran was carried out pre- or postoperatively, respectively. In 78,5% of these cases the clearance-results were corresponding to the results of x-ray examination; 6 of the remaining patients had a worse clearance result and 3 had a better result than the x-ray findings would have suggested.