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A case of a 62-years-old woman with mobile tumor in the upper abdomen is reported. With the contemporary methods of examination, including percutaneous thin needle biopsy, the diagnosis of epithelioid leiomyoma of the stomach was established. The patient was successfully treated surgically. The frequency of these benign gastric tumors, their clinical course, diagnosis and treatment are discussed.

82 patients-10 p. with uncomplicated cholelithiasis, 8 p. with chronic calculous cholecystitis, 34 p. with choledocholithiasis with stenosing papillo-odditis--and 30 healthy controls were examined, with monoclonal antibodies of the firm "Becton-Dickinson". The following immunocompetent cellular clones and subclones were examined: CD3+, CD16+, CD4+, CD8+, CD19+ CD4/CD8, HLA-DR+, CD3+. The results were read with analyzer for fluorescently marked activated cell clones "FACS-TAR". The serum IgA, IgM, IgG, C3-C4 complement fractions and circulating immune complexes were also examined. The analysis of the results shows that in the complicated cases of cholelithiasis with an inflammatory process in the biliary ducts several humoral and cellular immune factors take part.

Extracorporal lithotripsy is a new, modern method of treatment of gallstone disease. The effect of the treatment was evaluated as follows: full--fragments up to 2 mm in size (in 60.5% of the patients), partial--fragments between 2 and 5 mm in size (in 30.1% of the patients) and no effect--fragments larger than 5 mm or lack of fragmentation (in 9.4% of the patients). Complications during the manipulation and after it were very rare--allergic in 1.7% and obstructive in 6.7% of the patients. In only 3 patients on operation had to be done. 84 patients were followed up for 270 or more days. In 10.4% of the patients a full clearance of the fragments was found, and in 28.2% of the patients there was only a reduction of their number. Extracorporal lithotripsy followed by litholytic therapy is a perspective method for gallstone disease treatment. It has wide indications, few contraindications, is well tolerated and is with a low complication rate.

Seven women, mean age 47.7 years, with primary biliary cirrhosis (6 patients in the II-III stage and I patient in IV stage of the disease) were treated in the course of 16 months with ursodeoxycholic acid (Ursofalk) 500 mg daily. At the end of the 3-d month of treatment the itching had passed in 3 of the patients and in the remaining 4 patients it had substantially decreased. In all patients the subjective complaints, dyspeptic syndrome, appetite and sleep improved. The serum concentrations of bilirubin, copper and cholesterol started to decrease and the serum activity of the enzymes alkaline phosphatase, ALAT and ASAT also decreased. In one patient the treatment was discontinued in the 6-th month because of allergic reaction. After 16 month treatment in the 6 patients who completed the treatment the itching passed and the working capacity improved. The serum concentrations of bilirubin, cholesterol, copper and IgG significantly fell (p less than 0.01), the serum activity of alkaline phosphatase, gamma glutamyl transpeptidase, ALAT and ASAT fell near the upper normal range. The hepatomegaly, splenomegaly, McLagan's flocculation test, serum concentration of IgM and the titer of the specific antimitochondrial antibodies (M2) did not change in spite of the treatment. The results show the ursodeoxycholic acid as a perspective therapeutic means for primary biliary cirrhosis which lowers or overcomes the syndrome of intrahepatic cholestasis and limits the activity of the cirrhotic process in the liver. Ursodeoxycholic acid is well tolerated.

The presence and degree of manifestation of Campylobacter (Helicobacter) pylori in gastroduodenal mucosa were studied in 100 patients (56 men, mean age 51.4 years, and 44 women, mean age 46.5 years) with endoscopically proved chronic erosive gastritis (52 patients), erosive duodenitis (36 patients) and erosive gastroduodenitis (12 patients). The examinations revealed the presence of Campylobacter (Helicobacter) pylori in mean 77% of the patients with erosive gastritis, duodenitis and gastroduodenitis. Campylobacter (Helicobacter) pylori was found most often in patients with chronic erosive duodenitis--83.3%, whereas in the patients with erosive gastritis it was found in 73.07%. In 83.33% of the patients with chronic erosive gastritis, duodenitis and gastroduodenitis the campylobacter infection was well manifested--(++) according to Le Bodie et al (1987). The results allow the conclusion that one of the important pathogenetic factors of erosive gastritis, duodenitis and gastroduodenitis is the Campylobacter (Helicobacter) pylori infection of gastroduodenal mucosa.

"Sump" syndrome is a rare complication of choledochoduodenoanastomosis (ChDA). 15 patients are discussed, 13 women and 2 men, mean age 47.7 years (32 to 67 years). The clinical picture is classified into two groups: I. with symptoms mainly from pancreas involvement (recurrent pancreatitis and other lesions of the pancreas) and functioning ChDA--10 patients; 2. with symptoms arising from simultaneous impairment of the biliary ducts and pancreas and a tendency toward obliteration of ChDA--5 patients. All patients had been cholecystectomized at various times in the past. To all 15 patients endoscopic papillosphincterotomy was performed which led to restoration of pancreatic drainage in the patients with functioning ChDA and of bile drainage in the patients with obliterated ChDA. The conclusion is that papillosphincterotomy is a reliable, cheap and less risky method than surgical intervention for treatment of "sump" syndrome in patients without suprapapillary stenosis of the biliary duct.