| 1. |
- Danbolt, Christina, 1946-, et al.
(författare)
-
Validation and characterization of the computerized laryngeal analyzer (CLA) technique
- 1999
-
Ingår i: Dysphagia (New York. Print). - 0179-051X .- 1432-0460. ; 14:4, s. 191-195
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate the response characteristics of the Computerized Laryngeal Analyzer (CLA) and the validity of the noninvasive CLA method to detect swallowing-induced laryngeal elevation correctly. Two healthy adults and two experimental models were used in the study. The CLA technique identified all swallowing events but was unable to discriminate between swallowing and other movements of the tongue or the neck. The computer program produced a derivated response to a square wave signal. Stepwise bending increments of the sensor displayed a linear amplitude response. The degree of laryngeal elevation could not be estimated with the CLA technique, and it was not possible to draw any reliable conclusions from the recordings as to whether the larynx was moving upward or downward.
|
|
| 2. |
- Franzén, Thomas, 1955-, et al.
(författare)
-
Prospective evaluation of laparoscopic and open 360o fundoplication in mild and severe gastro-oesophageal reflux disease
- 2002
-
Ingår i: European Journal of Surgery. - 1102-4151 .- 1741-9271. ; 168:10, s. 539-545
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:To investigate the relationship between five-year control of reflux and early postoperative oesophageal function after total fundoplication done either laparoscopically or through a laparotomy in severe and mild reflux disease.DESIGN:Prospective open study.SETTING:University hospital, Sweden.PATIENTS:In the group with severe disease 9 patients had a laparotomy and 7 laparoscopy. The corresponding figures for the group with mild disease were 21 and 34 respectively.RESULTS:The increase in lower oesophageal sphincter pressure 6 months after operation in patients with recurrent disease was significantly less than that for patients with good reflux control (p < 0.01). In patients who had laparotomy, including 30% (9/30) with severe reflux disease, good long-term reflux control was found in 93% (27/29). In patients operated on laparoscopically including 17% (7/41) with severe reflux disease good long-term reflux control was found in 90% (35/39).CONCLUSION:The mechanism of recurrence differed between patients with severe disease who had a laparotomy and patients with mild disease operated on laparoscopically. Early postoperative manometry was prognostic for recurrence. Long-term reflux control seems to be similar after laparotomy and laparoscopy. Further randomised studies are needed.
|
|
| 3. |
- Franzén, Thomas, 1955-, et al.
(författare)
-
Prospective study of symptoms and gastro-oesophageal reflux 10 years after posterior partial fundoplication
- 1999
-
Ingår i: British Journal of Surgery. - : Oxford University Press (OUP). - 0007-1323 .- 1365-2168. ; 86:7, s. 956-960
-
Tidskriftsartikel (refereegranskat)abstract
- Background:This was a prospective study of symptoms, and short-term and long-term reflux competence after partial fundoplication.Methods:Some 101 patients were operated consecutively with posterior partial (270°) fundoplication. Indications for surgery were reflux disease without erosive oesophagitis in 25 patients, moderate oesophagitis in 43, severe oesophagitis in 25 and paraoesophageal hernia in eight. Symptom score, manometry and pH tests were performed before operation, 6 months after operation and after 6–14 years.Results:All patients (n = 101) were free from heartburn and regurgitation at early follow-up. There was evidence of clinical recurrence at late follow-up (n = 87) in two of 22 patients without oesophagitis before operation, two of 39 with moderate oesophagitis before operation and three of 19 patients with severe oesophagitis before operation; 92 per cent had good reflux control at late follow-up.ConclusionPosterior partial fundoplication shows excellent reflux control at early follow-up. Ten years later fewer than 10 per cent of patients have recurrence, which is more common in patients who had severe oesophagitis before operation.
|
|
| 4. |
- Franzén, Thomas, 1955-, et al.
(författare)
-
Reliability of 24-hour oesophageal pH monitoring under standardized conditions
- 2002
-
Ingår i: Scandinavian Journal of Gastroenterology. - : Informa UK Limited. - 0036-5521 .- 1502-7708. ; 37:1, s. 6-8
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Twenty-four-hour pH monitoring is an investigation technique that can give both false-positive and false-negative results, depending on patient factors such as diet and different activities. The aim was to study the reproducibility of 24-h oesophageal pH monitoring under as standardized conditions as possible in patients with symptoms of gastro-oesophageal reflux disease.METHODS:Antimony pH electrodes were used in 22 adult patients who were investigated twice, 6 weeks apart, under identical conditions. They were hospitalized and were served a standardized diet which had been tested to contain no lower than pH 5.0. Neither coffee nor smoking was allowed. The patients had to refrain from proton-pump inhibitors for 10 days and H2 blockers for 2 days prior to the investigation. The paired t test was used.RESULTS:There was no significant difference in total reflux time, upright or supine reflux time, or longest reflux periods between the two test occasions. However, there were discordant results in six patients who had normal total reflux time on one test occasion but pathological results on the other.CONCLUSION:Since the biological variability of gastro-oesophageal reflux is not negligible from time to time, a normal 24-h oesophageal pH test should be assessed with caution.
|
|
| 5. |
- Mjönes, Anna-Britta, 1947-, et al.
(författare)
-
Hoarseness and misdirected swallowing before and after antirefluxsurgery
- 2005
-
Ingår i: Acta Oto-Laryngologica. - : Informa UK Limited. - 0001-6489 .- 1651-2251. ; 125:1, s. 82-85
-
Tidskriftsartikel (refereegranskat)abstract
- Conclusion Patients with hiatus hernia can be relieved from H, MSL and MSN by hiatus hernia repair. Objective It has been hypothesized that respiratory symptoms in patients with gastro-oesophageal reflux disease (GORD) may, in some cases, be due to misdirected swallowing as a consequence of defective opening of the upper oesophageal sphincter. The aim of this study was to investigate whether patients with hiatus hernia are relieved from symptoms of misdirected swallowing to the larynx (MSL) and nose (MSN), as well as hoarseness (H), as a result of hiatus hernia repair. Material and methods A questionnaire concerning symptoms of H, MSL and MSN was administered to 90 patients under investigation for hiatus hernia repair before and after surgery. Results Before surgery, MSL occurred in 30% of patients, MSN in 30% and H in 25%. These symptoms were significantly interrelated (p<0.008). After antireflux surgery, all symptoms were significantly reduced (p<0.001). Symptom reduction was not related to the weight of the patients.
|
|
| 6. |
- Mjönes, Anna-Britta, 1947-
(författare)
-
Svalgproblem och hiatushernia : reflektioner över symptom och fynd
- 2009
-
Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Denna licentiatavhandling består av tre delarbeten. Dessa tre arbeten handlar omsymtom som inte alltid kommer i fråga när det gäller gastroesofageal reflux.I det första arbetet var syftet att undersöka huruvida patienter medmagmunsbråck (hiatushernia) blev förbättrade med avseende på symtom somfelsväljning till larynx (MSL) och till näsan (MSN), samt heshet (H), som ettresultat av hiatusherniaoperation. Nittio patienter, som undersöktes före ochefter hiatusherniaoperation, fyllde i frågeformulär om H, MSL och MSN. Hos30% av patienterna förekom MSL och lika många hade MSN. Heshet fanns hos25% av patienterna före operation. Dessa symtom hade ett signifikant inbördessamband (p<0.008). Alla symtom minskade efter antirefluxkirurgi (p<0.001).Förbättringen var oberoende av patienternas vikt.I det andra arbetet studerades huruvida felsväljning var en extralaryngeal orsaktill heshet och om det var någon skillnad i prevalensen för felsväljning ochheshet mellan patienter med hiatushernia med gastroesofageal refluxsjukdom(GERD) och patienter med hiatushernia utan patologisk gastroesofageal reflux(GER). Patientmaterialet bestod av 198 patienter, som befunnits ha hiatusherniavid undersökning med esofagusmanometri och pH-refluxtest och somkontrollgrupp 262 personer ur normalbefolkningen, vilka inte visade sig hahiatushernia vid endoskopi. Dessa grupper svarade på ett frågeformulärangående symtom på heshet, felsväljning och halsbränna. Jämförelsen mellanpatientgrupp och kontrollgrupp visade H hos 35% respektive 13%, MSL hos35% respektive 5%, MSN hos 22% respektive 1% och halsbränna hos 85%respektive 6% (p<0.001). Båda symtomen MSL och MSN var vanliga(p<0.0001). H och MSL hade inget inbördes förhållande. H och MSL var likavanligt i gruppen med GERD som i gruppen med GER. Slutsatsen blev att detfinns en predisponering för H och MSL hos patienter med hiatushernia, menorsakssambandet är oklart. Heshet verkar inte vara orsakat av GERD.
|
|
| 7. |
- Tibbling Grahn, Lita, et al.
(författare)
-
Gastric bile monitoring : An in vivo and in vitro study of bilitec reliability
- 2002
-
Ingår i: Scandinavian Journal of Gastroenterology. - : Informa UK Limited. - 0036-5521 .- 1502-7708. ; 37:11, s. 1334-1337
-
Tidskriftsartikel (refereegranskat)abstract
- Background: It has been claimed that the combination of bile and hydrochloride acid (HCl) has a noxious effect on intestinal mucosa. The aim was to study the reliability of the Bilitec 2001 method in monitoring the presence of bile in repeated tests and at different pH and water dilutions. Methods: 24-h esophageal pH and gastric Bilitec monitoring were performed twice with an interval of 6 weeks in 23 patients with symptomatic gastroesophageal reflux (GER). In vitro tests of pH and Bilitec recordings were performed with different mixtures of bile, HCl and water. Results: Gastric bile was present in 37% of the recording time, 28% during day time and 47% during nights. No significant difference was found between the two test occasions. The maximum bile concentration in the stomach was significantly lower in patients with severe pathological GER than in those with normal GER. When concentrated bile was diluted with the same volume of HCl, the pH level fell below 4. The maximum absorption limit with Bilitec in concentrated bile was gradually reduced with decreasing pH. The Bilitec technique recorded the presence of bile even at a pH of 1.4, but not if the bile was diluted with water at a ratio of 1:100 or more. Conclusions: Bilitec gastric recordings show the same clinical result when repeated under standardized conditions. The Bilitec technique is not reliable for monitoring the amount and concentration of bile in the stomach. Bile reflux cannot be monitored with the pH recording technique.
|
|
| 8. |
- Tibbling Grahn, Lita
(författare)
-
Longitudinal oesophageal muscle and pharyngo-oesophageal dyshagia - a deductive study.
- 2000
-
Ingår i: Acta Oto-Laryngologica. - 0001-6489 .- 1651-2251. ; 543, s. 239-240
-
Tidskriftsartikel (refereegranskat)abstract
- The hypothesis has been raised that a dysfunction of the longitudinal oesophageal muscle is the common denominator for pharyngeal and oesophageal dysphagia in patients with hiatal hernia, and that contraction of the: longitudinal muscle is a contributing factor for the opening of the upper oesophageal sphincter and for the stiffening: of the oesophageal wall when swallowing. Different studies were used to test the implications of this hypothesis. It was concluded that dysfunction of the longitudinal oesophageal muscle, caused by slipping of the distal end through the hiatal canal, can explain oesophageal dysphagia and inadequate opening of the upper oesophageal sphincter.
|
|
