[Simultaneous long-term measurement of duodenogastric reflux and gastroduodenal motility]. / Simultane Langzeitmessung des duodenogastralen Refluxes und der gastroduodenalen Motilität.

We combined a newly developed ambulatory fiberoptic system for detecting intragastric bilirubin (Bilitec 2000, Synectics Medical Inc., Sweden) with prolonged measurement of gastroduodenal motility in 10 healthy volunteers and 10 patients followed BI resection. Circadian intragastric bilirubin exposure and the total number of tremendous changes of bilirubin absorption (more than 20%, over a period of at least 5 min) were significantly increased in the BI-resected patients (P < 0.05). In patients the interdigestive motility cycle (IMC) was characterized by the appearance of several types of abnormally propagated phase III activity fronts. Of the tremendous increases of bilirubin absorption in the patient group, 90.1% were associated with abnormally propagated phase III activity fronts. In cases of increased duodenogastric reflux, the combination of ambulatory intragastric bilirubin measurement and long-term manometry seems to be feasible to assess motility and reflux simultaneously.

[Computer-assisted analysis of the pressure behavior of the esophagogastric junction during increase in intragastric pressure]. / Rechnergestützte Analyse des Druckverhaltens am ösophagogastralen Ubergang während intragastrischer Drucksteigerung.

Two factors are to determine increasing lower esophageal sphincter pressure during intragastric pressure rising mainly: 1. the active intrinsic muscle tone and 2. the efficiency of the law by La Place. The purpose of the study was to estimate the part of both of them in this measurable phenomenon. We investigated 15 healthy volunteers and 5 patients post Nissen fundoplication. A simultaneous manometric examination of gaster and LES was carried out during gradual compression of abdominal wall. Analysis of dependence of LES-pressure on intragastric pressure, based on computer usage, was established. A linear equation described this dependence with the best correlation coefficient (r = 0.98) followed by potential and exponential equation. Fundoplication caused a steeper ascent without any changing of linear character of function. Considering linear equation is compatible with the law by La Place out not with a simultaneous pressure depending change of intrinsic muscle tone, these results indicate that the law by La Place has major importance in the measurable rising of high pressure zone during intragastric pressure increasing.

[Urinary incontinence in the female over 60 years of age--urodynamic findings]. / Die harninkontinente Frau über 60--urodynamische Befunde.

A group of 20 urinary continent postmenopausal women and two stress incontinent groups in the age of 60-69 and 70-79 years have been examined concerning standardized conditions without and with stress. The measurements using the pneumatic-hydraulic pump perfusion were recorded under standardized conditions. The whole pressure profile without stress decreased with increasing age and with stress incontinence. The maximum urethra closure pressure has been displaced in the distal part of the urethra. The stress profile demonstrated a shortening of the continence zone, a clear decrease of the urethra closure pressure and a bad pressure transmission in the whole urethra, especially in its distal part. These fluctuations make us expect, that there are only a few promising possibilities of conservative treatment in stress incontinent postmenopausal women over 70 years.

[Insulin and glucagon secretion of the preserved dog pancreas]. / Die Insulin- und Glukagonsekretion des konservierten Hundepankreas.

Well defined results can be obtained quickly by in vitro test concerning the preservation effect of the preserved dog's pancreas. Clinical and chemical parameters were received during the hypothermic perfusion respectively during the refrigerant storage. The in vitro function tests were carried out after the preservation by insulin and glucagon stimulation. The results showed that the A and B cells of the dog's pancreas are completely able to function after a preservation of 24 hours. Thereby a strong formation of edemas by releasing high enzyme activities is caused during the mechanical perfusion of the organs. The simple refrigerant storage of the pancreata therefore, is the more suitable preservation form for organ transplantations.

[Effect of local estriol therapy on the urethral pressure profile in the postmenopausal period]. / Zum Einfluss einer lokalen Estrioltherapie auf das Urethradruckprofil in der Postmenopause.

Measurements of the pressure in the urethra were performed under standardized conditions with the aid of perfused catheters in 20 fertile and 20 postmenopausal women, from it 12 women after local estrogen therapy by means of Ostriol-Ovula. Hormone-cytological swabs from the urethra, vagina and from the urinary cells were done. Proliferation of the urogenital epithelialia under the estriol-therapy and an ascent of the MUP and MUCP in the urethra pressure profile under resting conditions could be achieved. The maximum of the pressure profile could be displaced proximaly. In the urethra pressure profile the distal pressure transmission increased. Estriol therapy was without secondary effects and is suitable for the conservative therapy of the stress incontinence type I to III.

The effect of potassium, calcium and magnesium concentration on insulin and glucagon secretion of the perfused dog pancreas.

The effect of different potassium, calcium and magnesium concentrations in the perfusate on the hormone secretion of the isolated dog pancreas was investigated. A potassium concentration above 15 mMol/l shortly stimulates the insulin and glucagon secretion. Potassium ions (greater than or equal to 15 mMol/l) completely inhibit the early phase of glucose-induced insulin release. At a low Ca2+-level (0.25 mMol/l) the glucose-stimulated insulin secretion is reduced to basal values. On the other hand, the glucagon release is stimulated under these conditions. An increase of magnesium ions from 1.0 mMol/l to 2.5-7.5 mMol/l strikingly inhibits insulin and glucagon release by approximately 50%, which is compensated for insulin by increasing the Ca2+-content of the medium. Perfusates for normothermic pancreas perfusion should contain electrolyte concentrations within the physiological range.

[Dynamics of the measurement of urethral pressure in the evaluation of the urethral stress profile]. / Zur Dynamik urethraler Druckmessverfahren bei der Aufzeichnung des Urethrastressprofils.

To obtain exact recordings of the urethral stress profile a pressure rise rate greater than 150 kPa/s is necessary. In this point of view Micro-transducers are advantageous. The different perfusion methods can be improved by the aid of pneumatic-hydraulic infusion systems and low-compliance catheters. Membrane Catheters are involved with some difficulties.

[Oxygen requirements of the isolated dog pancreas]. / Zum Sauerstoffbedarf des isolierten Hundepankreas.

This contribution reports about the oxygen requirement of the isolated perfused dog pancreas. A solution with the content of red blood corpuscles, a stroma-free hemoglobin solution or a perfusate--free from oxygen carriers--were applied. The oxygen requirement of the pancreas amounts to 0.59 ml/min . 100 g. The oxygen supply of the organ is possible with a flow of 0.50 ml/min . g and an oxygen partial pressure of 65 kPa (487.5 mmHg) also by means of a perfusate free from oxygen carriers.

[Hypothermic perfusion and cold storage of the dog pancreas]. / Die hypotherme Perfusion und Kühllagerung des Hundepankreas.

The results of 18-hours of hypothermic pulsatile perfusion and 18-hours of cold storage of canine pancreas are compared. Both methods of preservation yield the same endocrine pancreas function. However preservation of pancreas by perfusion results in considerable oedema of the gland and high enzyme activity in the perfusate. Therefore, cold storage should be used for the preservation of pancreas.

[Diagnosis, classification and therapy of urge incontinence]. / Zur Diagnostik, Klassifikation und Therapie der Dranginkontinenz.

The motor urge incontinence is characterized through a hyperactivity of the detrusor muscle. Whereas in the secundar form of motor urge incontinence the evoked moment must be abolished in the primar form no method of choice exist. Many different drugs are used in the pharmacological therapy. Biofeedback will be more important in the future. The sensor urge incontinence is caused through urethral relaxation. For the objective assessment must be taken out intraurethral pressure measurements. In this measurements it gives some problems due to the influence of physiological functions.

Determination of the urethral stress profile with the aid of perfused catheters.

To make manometric studies of urethral function and obtain exact recordings of the so-called stress profile requires a pressure rise rate which exceeds that of the pressure complex due to coughing. The syringe perfusion pump commonly used in urodynamics limits the pressure rise rate. The rate ist also reduced by catheters with high compliance. A suitable recording accuracy necessitates values greater than 150 kPa/s. This can be achieved with the aid of an improved pneumatic-hydraulic infusion system and low-compliance catheters. We describe the improvement of a recording system and demonstrate the importance of a suitable pressure rise rate.

[Selective proximal vagotomy and truncular vagotomy - comparison based on animal models]. / Die selektiv-proximale Vagotomie und trunkuläre Vagotomie - Vergleich im Tiermodell.

After high-selective vagotomy without pyloroplasty and after transthoracic truncular vagotomy in combination with pyloroplasty serum gastrin and gastric acid secretion were checked in short time intervals. The stimulation was produced by a standard test meal and by insulin induced hypoglycemia before and after vagotomy. The changes observed in serum gastrin levels before and after both kinds of vagotomy indicate a temporary influence on the emptying of the stomach. The decrease in gastric acid output following selective or truncular vagotomy demonstrates a delay of therapeutic effect.

[Effect of potassium concentration of the perfusion solution on organ resistance of the perfused dog pancreas]. / Der Einfluss der Kaliumkonzentration in der Perfusionslösung auf den Organwiderstand des perfundierten Hundepankreas.

The influence of different potassium concentrations in the perfusate on the perfusion pressure of isolated dog pancreas is reported. A potassium concentration above 30 mmol/l leads both under hypothermic and normothermic conditions to an increase of the vascular resistance, That's why organs with a small blood flow should be perfused with solutions poor in potassium also in the initial perfusion.

[Serum gastrin and gastric acid level following vagotomy without pyloroplasty and partial gastrectomy (BI) (author's transl)]. / Das Verhalten des Serumgastrins und der Magensäure nach selektiv proximaler Vagotomie ohne Pyloroplastik und nach Magenresektion (Billroth I).

The course of gastric acid secretion and serum gastrin level before and after operation was studied in 41 patients suffering from a gastroscopically determined ulcer disease. In 15 patients suffering from duodenal ulcer, a highly selective vagotomy without pyloroplasty was performed and in 26 patients suffering from peptic ulcer (duodenal or gastric ulcer) a partial gastrectomy (Billroth I). After a highly selective vagotomy without pyloroplasty a reduction in the secretory response to pentagastrin and a significant rise of the basic and postprandial gastrin concentration could be observed. Both methods are suitable to determine the completeness of vagotomy. The estimation of the course of serum gastrin level after vagotomy only reveals a temporary disorder of the antrum-pylorus mechanism. In our opinion a pyloroplasty is not necessary.