Deutsche Zeitschrift fur Verdauungs- und Stoffwechselkrankheiten最新文献

Our investigations in 134 patients showed corresponding to literature porphyria cutanea tarda (PCT) diagnosed by biochemical methods not to be a paraneoplastic dermatosis (but one possible exception acquainted). Relations between PCT and extrahepatic non-porphyrin producing tumours are improbable. Nevertheless but extremely seldom an irregular urinary porphyrin excretion associated with cutaneous changes of hepatic porphyria should lead to the presumption of a porphyrin producing hepatoma. PCT lasting for decades apparently presents a higher frequency of hepatocellular carcinoma in patients suffering from liver cirrhosis than in cirrhotics without PCT. It is supposed that this possible progredience of liver disease in PCT into hepatocellular carcinoma may be prevented by chloroquine phosphate therapy.

In 22 men with chronic duodenal ulcer and 15 healthy men effect of a single intravenous injection of 2 mg of naloxone on basis and pentagastrin-stimulated acid output was determined. Naloxone was found to induce a significant decrease in BAO in chronic duodenal ulcer patients; a decrease in BAO in healthy men was insignificant. MAO was not affected by naloxone in both groups. Gastric secretions of potassium, sodium, chloride and mucoprotein were proportional to changes in the volume of the gastric juice. It seems that opioid agonists may play some role in the pathogenesis of duodenal ulcers.

The efficacy of pirenzepin--of anticholinergic effect--and the H2-receptor blocking cimetidine has been studied in duodenal ulcer with random, double blind fashion. Recurrence examinations were carried out 6 and 12 months following the treatment. 50 patients were given pirenzepin and 50 cimetidine. The average age of the patients was 44.5 and 43.8 years respectively. Of them 60 (24 + 36) were men and 40 (26 + 14) women. At the start, 6 weeks following the start 6 and 12 months after the finishing of the treatment gastroscopy was performed. In the course of the six-week-long treatment 38 (76%) of the pirenzepin taking patients and 36 (72%) of the cimetidine taking patients recovered. No significant difference was found between the efficacy of the both treatments. In the respect of the half and one year recurrence, no significant difference was observed between the two patient groups. Ten of the patients taking pirenzepin and 4 of those taking cimetidine complained of side effects. Dryness of mouth, visual disturbance in the former group and constipation in the latter one. On the basis of the examinations both secretion inhibitors were found equally suitable for the therapy of duodenal ulcer.

The tolerability of the compound AWD 26-06 (which is to classify as a M1-antagonist in consequence of the pharmacological investigations) was investigated in 11 healthy male persons with increasing dosage from 5 to 150 mg. Dryness of the mouth and scratch in the throat were observed by a dosage of 50 mg onwards, a diminuation of the flow of saliva and the accommodation were observed by a dosage of 100 and 150 mg, respectively. The frequency of the heart, but not the blood pressure, is increased by 150 mg of AWD 26-06. The influence on the secretion of the gastric juice was investigated in normal conditions and after stimulation by Pentagastrin with a dosage of AWD 26-06 of 25 mg in comparison with a placebo on 7 healthy male persons. The volume of gastric juice was diminished by 35% in all fractions, but the secretion of HCl, measured as basal acid output and peak acid output, was diminished in 5 of the 7 persons by 20%. A further investigation in order to check the therapeutic effect in patients with ulcus ventriculi and ulcus duodeni, respectively, is necessary and useful.

Two cases are described, which revealed the picture of a dihydralazine-induced chronic aggressive hepatitis bioptically. One case was laparotomized under the clinical diagnosis of obstruction jaundice, the other exhibited no symptoms and was detected by elevated transaminases only. The time of exposure was 2-3 years. After withdrawal of dihydralazine the patients recovered within 2-3 months. Elevated transaminases (more than 1 mumol) should given occasion for withdrawing the drug or for performing of liver biopsy. In a total of 6,581 liver biopsies within five years an acute dihydralazine-hepatitis was seen more frequent than a chronic one (ratio 77:2).

In a review of the literature it is considered a possible relation between duodenogastric reflux and chronic gastritis. Doubtless bile acids are able to break down mucosal barrier in an acute action. But it is not proven, that bile acids cause chronic gastritis in chronic action. Furthermore duodenogastric bile reflux is a frequent and physiological event. Therefore we can not accept the duodenogastric reflux as the cause of simple chronic gastritis. The expression "reflux gastritis" is not correct for each kind of chronic gastritis that is no auto-immune gastritis.

The elimination of caffeine from the plasma and the excretion of the major metabolites of metamizol (AnalginR) in the urine was studied in 25 women on long-term oral steroid contraceptives. Both tests allowed to draw conclusions about metabolic liver function. A steroid-induced delay of the elimination of caffeine in clinically healthy women with/without serologic elevation of aminotransferase activities was demonstrated. --We regard this as the consequence of an inhibition of the cytochrome P-450-dependent poly-functional oxidases of the P-450MC type, which was produced by oral contraceptives. The differences in the elimination of metamizol were not significant.

In 217 patients after gastric biopsies from corpus and antrum we looked for statistic correlations with lipids in serum, blood pressure, and gallstones. In patients with hypercholesterolemia we more often observed atrophic gastritis in antrum whereas in patients with hypertriglyceridemia or hypertension we more frequent found atrophic gastritis in corpus (significance on 5 per cent level). These results allow us to discuss the possibility, that arterial diseases may play a role in pathogenesis of atrophic gastritis. - In agreement with literature in cholelithiasis we found more often atrophic gastritis, but the difference was not statistically significant.

The present study was performed in male Wistar rats. They underwent a 75% removal of the middle part of the small intestine and various procedures to delay the passage time in order to manage short bowel syndrome. Comparisons were made between the following groups: animals with subtotal resection of the small intestine and counterpositioning of a segment of the small intestine, myotomy, isoperistaltic segment, and animals with removal of the small intestine without delayed passage time, and a group of healthy non-operated controls. One year after surgery the following examinations were carried out: gross measurement of length and width of the intestine, eye microscopy, calculations of the intestinal surface, and morphometric investigations in histologic specimens of the intestinal mucosa. The most extensive increase of the residual lumen was observed in animals with antiperistaltic segment interposition. The inhibition of the passage due to the antiperistaltic segment has remained effective during the entire test period despite extreme loading and despite the morphological changes described in the article.

Liver specimen morphology and clinical course of a case of cholesterol ester storage disease are presented. In a 16-year-old boy on the first biopsy a massive storage of neutral fats was found light microscopically and of cholesterol ester micropolariscopically. Advanced portal field fibrosis and severe reactive hepatitis indicate the danger of progression up to metaplasia. Typical membrane-surrounded lipid inclusions were found electron microscopically in hepatic cells, stellate cells and also in bile duct epithelium.