Acta hepato-gastroenterologica最新文献

alpha 1-Antitrypsin levels were measured in sera of 134 patients with cirrhosis and in 64 with cirrhosis and hepatoma. S-TIC was determined in 105 patients with cirrhosis and in 54 with cirrhosis and hepatoma. The mean alpha 1-at and S-TIC values in patients with cirrhosis were 369.59 +/- 14.072 mg% and 1,808 +/- 0.05 mg/ml respectively. In patients with cirrhosis and hepatoma the mean alpha 1-at level was 406.595 +/- 17.834 mg% and the S-TIC mean values was 2.064 +/- 0.82 mg/ml. Although these values are higher than those found in the healthy controls, the differences are not statistically significant.

Cancer in the resected stomach has a very poor prognosis unless it is detected at the "early gastric cancer" stage. The development of gastric stump carcinoma is probably dependent on the procedure chosen for primary surgery (resection). Local irritation accompanying the execution of anastomosis is also discussed as a possible cause of malignant transformation. Surgical precautions should include the choice of methods avoiding reflux, and the use of resorbable suture material for performing an exact and well-matched anastomosis. Periodic postoperative control is essential; in addition to radiological methods, endoscopy and biopsy are indicated for adequate identification of local abnormalities and mucosal changes. Patients whose high risk was stated in previous examinations, must be re-examined at shorter intervals. Identification of changes at the early cancer stage requires close cooperation of surgeon and pathologist.

Endoscopic retrograde cholangiopancreatography (ERCP) pictures of the pancreatic duct and of the biliary tract are described in the youngest member of a family with hereditary pancreatitis. The endoscopic changes are very similar to those usually observed in patients affected by chronic relapsing pancreatitis. Morphological changes were particularly marked in the body and tail of the pancreas. However, no abnormal changes were observed in the biliary tract.

Mechanical activity of isolated circular muscle strips from the lower oesophageal sphincter (LES), fundus, corpus and antrum of canine stomach was recorded. Nifedipine (10(-6) mol/l) selectively suppressed the phasic components of spontaneous, acetylcholine (ACh)- and noradrenaline (NA)-induced activity of gastric strips. The nifedipine-resistant tonic components of gastric strips were suppressed by nitroprusside sodium (NP) (10(-5) mol/l). LES strips exhibited only weak spontaneous activity. Their ACh-induced activation was nearly completely suppressed by nifedipine. Only NA was able to elicit a strong nifedipine-resistant activation which was, in contrast to the activation of fundus strips, not suppressed by NP.

Twelve patients with Crohn's disease (C.D.), in whom there was no improvement of symptoms and signs under protracted corticosteroid and salicylazosulphapyridine medication, were treated with 1 000 mg metronidazole (M.) daily. Crohn's Disease Activity Index (CDAI) was used as a criterion of therapeutic response. Seven patients showed improvement of symptoms with a concomitant fall of the CDAI from 300 +/- 84 to 56 +/- 32 (mean +/- SD) after 10 to 45 days. In one patient, therapeutic success was judged to be doubtful, a negative result being obtained in 4 patients. During follow-up, which was maximally 21 months, patients failed to relapse while receiving a maintenance dose of 250 and 500 mg of M. per day. -- Judicious attempts at drug withdrawal were undertaken during the first 6 months but were invariably followed by a relapse. -- Metronidazole given over a protracted period did not give rise to side-effects. -- A reduction of anaerobic bacterial invaders of the intestine is suggested to underlie the favourable therapeutic effect of M.

The time-course of plasma lipid alterations and of triglyceride accumulation in the liver was investigated in male and female rats 12, 24 and 48 hours after treatment with 3.48 mmole/kg (0.75 g/kg) D-galactosamine (Ga1N). In the early stages of Ga1N-induced liver injury the concentrations of triglycerides, phospholipids and total cholesterol decreased, while in the later stages these values in the plasma increased above normal, especially in male animals. In contrast, glucose concentrations continually decreased, while free fatty acid (FFA) levels rose to twice those normal in female animals. Male animals had significantly lower FFA-values throughout the experiment. Consistently, the triglyceride accumulation on liver was 75 mg/g in female animals 24 hours after Ga1N administration, while male animals in the average showed only 33 mg/g triglycerides. Similar fatty infiltrations were obtained in female animals with the rather low doses of 1.16 and 2.32 mmol/kg Ga1N. It is concluded that the increase of FFA-influx after Ga1N administration is the main cause for fatty infiltration, the sex differences in the plasma FFA concentrations explaining the net differences in liver triglyceride accumulation. Additional effects in the pathogenesis of fatty liver might stem from disturbed glycosylation reactions and/or an altered secretion and metabolism of lipoproteins after Ga1N-induced liver injury.

The function of organic sphincter systems cannot be described by measuring a static pressure, but only by applying a dynamic procedure of measurement that takes into account the characteristics of smooth muscles. Therefore, the elastance-method has been developed. Experiences with this method and its clinical value are demonstrated when one applies this procedure to measurements in the lower oesophagus, the duodenal papilla and the anal canal.

Five nonalcoholic diabetic women were clinically and histologically verified as having micronodular cirrhosis. In this series all the patients were over 50 years of age, and showed obesity, hyperglycemia, enlarged liver and mild abnormalities of liver function tests. The histological findings differed from hepatitic cirrhosis. In two patients serial biopsies confirmed development of cirrhosis from centrilobular necrosis.

The enzymes of haem biosynthesis have been measured in the peripheral blood of 13 patients with cutaneous hepatic porphyria. The activity of leucocyte delta-aminolaevulinic acid synthase was significantly elevated (p less than 0.001) as was that of erythrocyte porphobilinogen deaminase (p less than 0.05). Leucocyte ferrochelatase activity was depressed (p less than 0.001) and the activity of erythrocyte uroporphyrinogen decarboxylase did not significantly differ from control values. Similar enzyme activities were assayed in 12 chronic alcoholics and 8 patients with liver disease and the results differed markedly from those obtained from the porphyric patients. It is unlikely that the raised leucocyte delta-amino-laevulinic acid synthase activity can be attributed to alcohol ingestion or liver disease. A defect in the activity of uroporphyrinogen decarboxylase may exist in cutaneous hepatic porphyria but this could not be demonstrated in erythrocytes in this study.