[Whether or not to perform an early endoscopy following ingestion of potentially caustic agents - a retrospective longterm analysis in a tertiary referral institution].

Background: The optimal clinical management of patients following ingestion of potentially caustic lesions is still undetermined. In particular, the indication for early upper GI endoscopy in this context remains unclear.

Purpose: To draft recommendations regarding the use of early upper GI endoscopy following hospital admissions of patients after ingestion of potentially caustic agents.

The effect of naloxone-3-glucuronide on colonic transit time in healthy men after acute morphine administration: a placebo-controlled double-blinded crossover preclinical volunteer study.

Background: Constipation is a significant side effect of opioid therapy. We have previously demonstrated that naloxone-3-glucuronide (NX3G) antagonizes the motility-lowering-effect of morphine in the rat colon.

Aim: To find out whether oral NX3G is able to reduce the morphine-induced delay in colonic transit time (CTT) without being absorbed and influencing the analgesic effect.

Esophageal strictures in adult eosinophilic esophagitis: dilation is an effective and safe alternative after failure of topical corticosteroids.

Strictures are a frequent complication of eosinophilic esophagitis. The efficacy and safety of topical corticosteroids and of dilation of eosinophilic esophagitis-associated strictures have not yet been thoroughly clarified. We present a retrospective analysis of 10 adult patients with eosinophilic esophagitis who had symptomatic esophageal stenosis that was unresponsive to topical corticosteroids, and who were treated using bougienage.

Effect of naloxone-3-glucuronide and N-methylnaloxone on the motility of the isolated rat colon after morphine.

The effect of the opioid antagonists naloxone-3-glucuronide and N-methylnaloxone on rat colon motility after morphine stimulation was measured. The rat model consisted of the isolated, vascularly perfused colon. The antagonists (10(-4) M, intraluminally) and morphine (10(-4) M, intra-arterially) were administered from 20 to 30 and from 10 to 50 min, respectively.

Differences in yeast intolerance between patients with Crohn's disease and ulcerative colitis.

Purpose: Alimentary factors, especially those modifying the intestinal flora, may influence the course of inflammatory bowel disease. It is known that T and B cells of patients with Crohn's disease can be stimulated with the yeast antigen, mannan. We evaluated the impact of eating habits with special respect to food containing yeast on the course of inflammatory bowel disease.

[The hepato-pulmonary syndrome--where do we stand in the year 2006?].

The hepato-pulmonary syndrome (HPS) is characterized by a combination of liver disease and pulmonary gas exchange abnormalities with arterial hypoxemia, intrapulmonary vasodilatation and arteriovenous shunting in the absence of intrinsic cardiopulmonary disease. The course of the disease is typically progressive. The mortality rate correlates with the pulmonary shunt volume and the degree of hypoxemia at room air.

[Abdominal pain].

Abdominal pain can result from a variety of different intra- and extra-abdominal disorders. Given the wide variety of etiological triggers for this pain, the primary task during the first stage of the diagnostic work-up is to determine as soon as possible the underlying cause and the degree of emergency. The aim of this evaluation is to adapt the therapeutic measures which are necessary for a causal treatment to the individual situation.

Human ileal bile acid transporter gene ASBT (SLC10A2) is transactivated by the glucocorticoid receptor.

Background: Patients with Crohn's disease suffer from intestinal bile acid malabsorption. Intestinal bile acid absorption is mediated by the apical sodium dependent bile acid transporter ASBT/IBAT (SLC10A2). In rats, ASBT is induced by glucocorticoids.

Dysphagia in Crohn's disease: a diagnostic challenge.

Dysphagia is a rare manifestation in a patient with Crohn's disease. We report on the case of a patient with long-standing Crohn's disease who developed progressive dysphagia over 3 years. Endoscopy showed minimal distal oesophagitis with non-specific histological findings.

Influence of naloxone on gastric emptying of solid meals, myoelectrical gastric activity and blood hormone levels in young healthy volunteers.

There is considerable evidence that opioid mechanisms are involved in the mediation of pyloric motor responses that in turn regulate gastric emptying. The purpose of this randomized, placebo-controlled crossover study was to investigate the effect of naloxone on gastric emptying of a solid meal, gastric myoelectrical activity and the postprandial release of gastrointestinal peptides and neuropeptides in 20 healthy volunteers. Naloxone was administered as an intravenous bolus, followed by continuous infusion according to an intravenous dosing nomogram.

Does intravenous ondansetron affect gastric emptying of a solid meal, gastric electrical activity or blood hormone levels in healthy volunteers?

Background: In previous studies, tropisetron has been shown to accelerate gastric emptying of a solid meal. However, it is uncertain whether other specific 5-hydroxytryptamine-3 receptor antagonists, such as ondansetron, also have a gastroprokinetic effect in humans.

Aim: To evaluate the effect of ondansetron on gastric half-emptying time (T1/2) of a solid meal, gastric myoelectrical activity and hormone levels in 14 healthy volunteers.

Acute pancreatitis--ERCP/endoscopic papillotomy (EPT) yes or no?

Until the mid eighties ERCP and EPT were considered to be contraindicated in acute pancreatitis, because of possible aggravation of active pancreatitis or induction of new attacks of pancreatitis. This attitude was revised with the new knowledge obtained from four prospective randomised studies, which compared the effects of endoscopic treatment with conservative management of acute pancreatitis. Although the four studies are not strictly comparable their results indicate that there is no advantage to ERCP +/- EPT over conservative treatment alone in mild biliary pancreatitis.

Impacted papilla minor stone in pancreas divisum causing severe acute pancreatitis: a case for early ERCP in acute pancreatitis of unknown origin.

This is the first description of severe acute pancreatitis in pancreas divisum caused by a solitary stone impacted in the minor papilla. Recovery was rapid after diagnostic endoscopic retrograde cholangiopancreaticography (ERCP) and endoscopic stone removal. Since other etiological factors accounting for the acute pancreatitis were carefully excluded, it seems that obstruction of the minor papilla by a solitary pancreatic concrement was the most likely cause of acute pancreatitis.

[Lower gastrointestinal hemorrhage: etiologic assessment and surgical concept].

Due to its occurence in patients at higher ages with comorbidities, lower gastrointestinal bleeding remains a challenge in terms of diagnostic and therapeutic strategies. In this series (1994-1997, n = 40) the source of bleeding was in the upper gastrointestinal tract in 38% and in the lower gastrointestinal tract in 62%. The source of bleeding could be localized in 58%.

[Idiopathic dilatation of the large intestine (Ogilvie syndrome--acute pseudo-obstruction)].

Acute colonic pseudo-obstruction (Ogilvie's syndrome) is characterized by abdominal distention and massive colonic dilatation without any mechanical cause of obstruction. We have reviewed the records of 57 patients, 36 men and 21 women (median age 65.4 y), from 1/1992 to 12/1996, with a colonic pseudo-obstruction, defined as dilatation of at least 10 cm on plain abdominal x-ray.

Comparison between esophageal Wallstent and Ultraflex stents in the treatment of malignant stenoses of the esophagus and cardia.

Background And Study Aims: Several published studies have examined various self-expanding metal esophageal stents for use in the palliative treatment of esophageal or cardiac neoplasia, but few have compared different self-expanding metal stents. The aim of this study was to evaluate non-covered Wallstent and Ultraflex prostheses in the treatment of malignancies in the esophagus and the cardiac region.

Materials And Methods: In a retrospective study, the effectiveness of non-covered Wallstents (46 patients) and Ultraflex stents (36 patients) was compared in the treatment of malignancies in the esophageal and cardiac regions.

Self-expanding metal stents in malignant esophageal obstruction: a comparison between two stent types.

Objectives: Self-expanding metal stents are a promising alternative in the palliation of malignant esophageal obstruction, but the relative value of different stent types is not well established.

Methods: During a 3-year enrollment period in four different centers, 82 consecutive patients with malignant dysphagia without tumor recurrence after surgery or esophagorespiratory fistulas received either an uncovered Wallstent (44 patients) or a knitted nitinol stent (38 patients).

Results: Age (median: 79 yr), sex (F:M = 33:67), dysphagia score (median: 3), Karnofsky score (median: 53), body mass index (median: 19), type of pretreatment, tumor stage, stricture length (median: 5.

[15 years of endoscopic therapy in choledocholithiasis].

Introduction: The relevance of endoscopic retrograde cholangiopancreatography (ERCP) in the diagnosis and treatment of common bile duct stones has increased since the introduction of laparoscopic cholecystectomy in 1989-1990.

Methods: The number, indications, success and complication rate of ERCP were analyzed retrospectively in 1121 consecutive patients with bile duct stones treated at Berne University Hospital between 1980 and 1994.

Results: The number of patients undergoing endoscopic stone extraction increased slowly from 1980 to 1990, but has shown a 4-fold increase in the last 5 years parallel to the introduction of laparoscopic cholecystectomy.

[Pancreatic carcinoma: diagnosis].

Early detection, tumor diagnosis with histological proof and tumor-staging are the principle aims of diagnostic approaches in patients suffering from pancreatic cancer. Asymptomatic and small cancers are often missed since they produce no or no typical symptoms and no reliable screening methods are available. Symptomatic pancreatic cancers are often so advanced that only about 20-30% of patients qualify for curative treatment.

Wallstents versus plastic stents in malignant biliary obstruction: effects of stent patency of the first and second stent on patient compliance and survival.

Objectives: In prospective trials in patients with malignant biliary obstruction, it has been reported that Wallstents prolong stent patency, but this does not translate into a significant survival benefit. Compared with prospective trials, however, survival may be different in clinical practice because of differences in patient compliance. We report on a retrospective, long term analysis comparing Wallstents versus plastic stents.

Pre-, intra- and postoperative staging of gastric carcinoma and clinical outcome.

Background: We compared preoperative (combined clinical and radiological staging and endoscopical Borrmann classification), intraoperative (by the surgeon: curative/palliative; R0/R1/R2-resection; intraoperative stage I to IV) and postoperative staging including histological results (pTNM) in respect of resectability and prognosis.

Methods: All patients with adenocarcinoma of the stomach were prospectively and consecutively included in the study protocol and were staged during the hospitalisation by the different specialists. Out of 215 patients with malignant tumors of the stomach, 153 were finally evaluated for the study.

[Clinical manifestations of cholelithiasis and its complications].

Gallbladder stones remain asymptomatic over a long period. The biliary colic is the typical pain caused by these stones. Dyspeptic symptoms seem to be unrelated to the presence of gallstones.

Substance P activates rat colonic motility via excitatory and inhibitory neural pathways and direct action on muscles.

We studied effects of nicotinic, muscarinic, serotoninergic, dopaminergic, adrenergic, vasoactive intestinal peptide (VIP) antagonists, VIP, nitric oxide-synthase inhibitors and stimulators alone and in combination with tetrodotoxin on substance P (SP)-stimulated intraluminal tone of the isolated proximal, middle and distal rat colon. Tetrodotoxin significantly enhanced SP-stimulated intraluminal tonic pressure in the distal, but not in the middle and proximal colon. N omega-nitro-L-arginine methylester enhanced SP stimulation in all colonic segments, whereas L-arginine inhibited it partially and D-arginine did not affect it.