Gastroenterologisches Journal : Organ der Gesellschaft fur Gastroenterologie der DDR最新文献

In 1983, 685 out of 1,284 patients having suffered from a gastroscopically identified gastric ulcer in the period from 1972 to 1980 answered a questionnaire. Males prevailed in a proportion of 1,7:1. They showed an earlier onset of the disease and a higher operational rate. As much as 44.2% of them reported complications (mostly haemorrhage), 44.8% a gastric operation. A review of the operation reports showed an incidence of 1% of gastric carcinoma 1-3 years after gastroscopy. In order to demonstrate a better prognosis of gastric ulcer non-selected prospective long-term studies should be performed.

The activity of 7-ethoxycoumarin O-deethylase (ECOD) was determined in the human liver bioptate of 53 patients with chronic liver diseases. Remarkable are the lower values of ECOD in the hepatoses, chronic hepatitis and cirrhosis as compared to patients with normal histology or residual hepatitis. The decline in the activity of ECOD in the patients with chronic hepatitis and cirrhosis has to be seen in connection with parenchymatous necrosis, nodular liver transformation and intracinar fibrosis. For the time being it is not possible to give a satisfactory explanation of the decrease in the ECOD activity of the hepatoses.

In 12 patients with primary idiopathic haemochromatosis absorption and biotransformation were measured by model substances. Aim of the investigation was the correlation of the biotransformation of the liver with the degree of liver injury and the clinical picture. We determined in patients and compared with control group: elimination of metamizol in urine, absorption and elimination of caffeine in serum, serum concentrations and elimination of sulfamethazin in urine, absorption of xylose, - In patients with haemochromatosis accompanied with slight liver damage only demethylation of metamizol was slackened. In patients with higher degree of liver damage the elimination of metamizol as well as of caffeine was decreased. Because of the high percentage of slow acetylators in the patient group metabolism of sulfamethazine is decreased. - There was no correlation between iron loading of the organism, absorption of xylose and biotransformation of the model substances.

The pathophysiologic mechanism by which gallstone migration through the sphincter of Oddi may produce acute pancreatitis is a controversial issue. According to one concept, biliopancreatic reflux following concrement obstruction of the common biliopancreatic channel results in contact of bile with pancreatic parenchyma which is known to produce acute pancreatitis. However, the entrance of bile into pancreatic tissue is usually prevented by the pancreatic duct sphincter, by the pancreatic exocrine secretion pressure and by the pancreatic duct mucosal barrier. A breakdown of these protective mechanisms is an essential prerequisite for the validity of this concept. Relevant clinical and experimental data concerning this possibility are reviewed.

There are different signs after extended small bowel resection. The length of the resected small intestine (size of resection), the location of the removed part (type of resection), the time after operation (stage of adaption) and the age of the patient define the severity and nature of complaints following small bowel resections. We examined the dynamics of glucose- and insulin level after oral and intravenous glucose administration to recognize the relation to the size of resection. We found a decreased basal insulin concentration and a diminished response of insulin after intravenous glucose load in patients with extensive small bowel resection. This reduced response after parenteral administration of glucose load we did not find in the ileum-resected group compared to control group. We can conclude, it is possible to get information about the size of small bowel resections by the intravenous glucose tolerance test.

Acute pancreatitis associated with the passage of gallstones through the sphincter of Oddi might be caused by obstruction of pancreatic exocrine secretion or by duodenopancreatic reflux. Possible complicating factors are discussed, which are necessary in order to turn the interstitial edematous inflammation caused by pancreatic duct obstruction into hemorrhagic necrotizing pancreatitis. Furthermore, clinical and experimental data are reviewed concerning a possible collapse of the protective mechanisms which usually prevent contact of duodenal contents and pancreatic tissue.

In 1980 in the GDR 641 primary liver carcinomas (380 male, incidence 3.8, 261 female, 1.4) and 1834 biliary tract carcinomas (414 male, 3.7 and 1420 female, 7.0) had been registered by the National Cancer Registry. An analysis of stage, age-distribution. Operability and resectability had been performed. For all stages of liver carcinomas the 5-year-survival-rate was 3.5% (male) and 1.0% (female), for the biliary tract carcinomas 3.4 and 4.9% respectively. At present a significant improvement of treatment results cannot be expected.

In an endoscopic follow-up study of gastric polyps we examined their spontaneous disappearance, and the reaction of the rest of polyps after polypectomy. We found spontaneous disappearance in 28 (12.4%) out of 226 patients with gastric polyps. 19 patients showed complete absence of polyps in the later follow-up. Spontaneous disappearance was found in a great number of cases without biopsy of the polyps themselves (16 patients). In the cases of known histology there were predominantly inflammatory, benign polyps (16 out of 18 patients). From among 206 endoscopic polypectomies evident residual tissue was left behind in 19 (9.2%) cases. However, only one premalignant and one malignant residual part of polyp could be diagnosed. In the case of malignant degeneration (early cancer) there was successful treatment by means of 4/5 gastric resection.

A survey of different methods for the production of experimental gastric ulcer in rats is given. 20 male Wistarrats got a chronic gastric ulcer after the injection of 0.05 ml acetic acid (30%) under the serosa. We documented the developing of the ulcer in phases by means of histology. In contrast to other models the Acetic Acid Injection Ulcer (by Takagi et al. 1969) shows similar histology and chronicity to human histology and chronicity.

In 17 patients who more than 1 year ago had suffered from a dihydralazine induced hepatitis the biotransformation velocity was investigated and compared with a healthy control group. 15 out of the 17 patients and 5 out of the 10 volunteers are slow acetylators. All slow acetylators eliminate sulfamethazine more slowly than rapid acetylators.--The elimination of caffeine and metamizol--test substances for oxidative biotransformation reactions--was retarded in patients after dihydralazine induced hepatitis in comparison to control persons. Slow acetylators have to be controlled carefully because of their higher risk of dihydralazine induced drug hepatitis.