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Patients with esophageal achalasia, treated by pneumocardiodilatation with "Esophageal balloon dilatation" of the firm "Cook"--Denmark with a size of 22 mm in an inflamed state, were followed up for a period of 8 years. The result of the first course of pneumocardiodilatation treatment was unsatisfactory in 13.9% of the patients and they were recommended a surgical treatment. In the remaining patients the duration of the treatment effect lasted from 10 months up to 8 years. In 16.1% of the patients repeated redilatations were needed at intervals of 10 to 22 months. For this group of patients a decision should be made how to proceed further--with repeated pneumocardiodilatations or with surgical treatment.

99 patients with ascites (60 patients with liver cirrhosis and 39 patients with peritoneal carcinosis) were examined by ultrasound tomography of the gall bladder. In most of the cirrhotic patients a thick gall bladder wall was found (7.7 +/- 3.4 mm) often with a three-layer structure. The gall bladder wall of the patients with peritoneal carcinosis was most often not thickened (2.5 +/- 1.6 mm). The difference is statistically significant (p less than 0.1). Thickening of the gall bladder wall was found in both groups of patients by a decreased serum albumin level. The ultrasound tomography of the gall bladder could help in the differentiation of cirrhotic from malignant ascites, especially in combination with determination of the serum albumin level.

The causes of gastrointestinal bleedings was assessed by fiber gastroscopy, rectoromanoscopy and fiber colonoscopy. The most frequent causes of bleedings from the upper gastrointestinal tract are gastric and duodenal ulcers, erosive hemorrhagic gastritis, gastric cancer, liver cirrhosis with bleeding from varicose veins, polyps, diverticuli, Mallory-Weiss syndrome, etc. The most frequent causes of bleedings from the lower gastrointestinal tract are hemorrhoids, anal fissures, colonic polyps, chronic ulcerohemorrhagic colitis, rectal carcinoma, etc. The diagnostic importance of urgent endoscopic examinations is pointed out.

12 patients with mesangial C3-glomerulonephritis, 7 women and 5 men, aged 16-42, mean age 29.7 years, were followed up for 1-18 years, mean time 5.7 years. The disease was manifested most often by macroscopic hematuria or low degree proteinuria. Single patients had arterial hypertension. In only one patient there was a nephrotic syndrome. For the period of observation, impairment of the renal function was found in none of the patients.

30 patients with primary hyperlipoproteinemia (type II and IV according to Fredrickson) were treated with Gemfibrosil (Gevinon--film tablets of 450 mg of "Parke-Davis Company") for a period of 45 days with a daily dose of two tablets taken with the evening meal. The results of the treatment were a decrease of the total cholesterol (with 16.34%), of triglycerides (with 34.50%), of low density lipoproteins (with 10.76%) and of very low density lipoproteins (with 49.21%) and an increase of the high density lipoproteins (with 2.34%). Gevilon was well tolerated. No side effects requiring discontinuing of the treatment were registered.

Infusion manometry of the esophagus and the stomach after the permanent dynamic method of Winans [correction of Wynas] and Harris was carried out on 52 patients (30 women and 22 men) with hiatal hernia, volvulus of the stomach or peptic ulcer disease. Altogether 75 examinations were performed--35 preoperative and 40--postoperative. The mean preoperative pressure of the inferior esophageal sphincter was 9.1 (from 0 to 15) mmHg and the mean postoperative pressure was 18 (from 12 to 211 mmHg). The mean preoperative length of the inferior esophageal sphincter was 1.4 (from 0 to 4) cm and the mean postoperative length was 2.5 (from 1 to 6) cm. In 12 patients motor disturbances of the tubular esophagus were found: symmetric, hyperpersistaltic waves (Richter's nutcracker symptom)--in 3 patients, hypomotility--in 5 patients, diffuse esophageal spasm--in 4 patients. Esophageal manometry is a valuable noninvasive method for the functional diagnostic of the reflux disease and the motor esophageal disturbances as well as for the assessment of the postoperative function of the inferior esophageal sphincter.

The beta-cell secretion was studied in 7 healthy volunteers (women) by a venous glucagon (1 mg) test. First the test was carried out without smoking and then repeated one week later on the background of continuous smoking (4 cigarettes at intervals of 15 min). The C-peptide was examined at the 0, 10, and 60, min. The mean age of the volunteers was 44.5 +/- 5.1 years and the mean body mass index was 24.22 +/- 1.9 kg/m2. The area of the stimulated insulin secretion under the C-peptide curve in the test on the background of smoking was significantly smaller than in the test without smoking (F = 5.09, p less than 0.05). The conclusion is that smoking exerts an unfavourable influence on the beta-cell secretion.

A case is presented of shock and acute renal failure due to dehydration in a woman with a psychic disease who had not taken food and fluids for a long time. The post mortem examination revealed the pathomorphologic pattern of shock with microthrombi in the inner organs, brain and leptomeninges.

In 33 patients with autosomal dominant renal polycystosis the urine excretion of the electrolytes sodium and potassium was examined and analyzed in relation to the renal function and the arterial pressure. The clearances, the urine ratio and the excreted fractions of both electrolytes were calculated. It was established that by normal renal function and without arterial hypertension there were no significant differences in the parameters studied between the patients and the healthy controls. In the patients with arterial hypertension and preserved renal function the sodium clearance and urine excretion were lower, but the differences with the normotensive patients were not statistically significant. In the patients with chronic renal failure (when diuretic was applied) higher mean values of the excreted fractions of sodium and potassium were established. The results support the thesis that hypertension in renal polycystosis is of volumetric character.