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

In the clinical praxis there are many seriously ill patients who are unwilling, unable or not allowed to eat. These patients must be fed either parenterally or enterally via permanent nasoenteral gavage. A third method for artificial feeding is the percutaneous endoscopic gastrostomy. In the last time this method was established and different modifications are given. They can be divided into two main techniques: 1. the transoral pull-string method 2. the "Introducer" technique Advantages and disadvantages of the methods used will be discussed and an own modification is presented. By this new modification it is possible to introduce macroluminal Pezzercatheters as gastrostomy. The macroluminal gastric fistula allows the usage of viscous or crushed food. Special or imported instruments or sets are unnecessary.

In 13 men with chronic duodenal ulcer disease effects of somatostatin and naloxone on basic gastric secretion were determined. Following intravenous somatostatin infusion a significant increase in basic gastric secretion was observed. Somatostatin also induced a significant increase in sodium concentration and a decrease in chloride concentration in the gastric juice. Total electrolyte and mucoprotein secretions changed proportionally to alterations in the gastric juice volume. Somatostatin-induced gastric secretion was unaffected by a single intravenous naloxone administration. In patients with chronic duodenal ulcer disease somatostatin and naloxone affect gastric secretion independently of each other.

This short review deals with actions of prostaglandins (PG) and leukotrienes (LT) in liver injury. According to experimental data PGs of the E- and I-series seem to play an important role as metabolic, cytoprotective, antifibrogenic, immunomodulating and hemodynamic regulatory factors having interest in human pathology. In human cirrhosis with portal hypertension elevated PGI levels promote the formation of a collateral circulation. Some studies suggest that renal PGs could be involved in the regulation of renal hemodynamics in cirrhosis and have probably pathogenetic value in the development of the hepatorenal syndrome. LTs act as mediators of inflammatory liver reactions. Conclusively, one can predict that eicosanoid research will lead to some progress in clinical hepatology.

The authors examined the possibilities of the endoscopic treatment of acute gallstone pancreatitis on the basis of the results of retrospective investigation of 19 middle-european endoscopic centers. There were altogether 11,830 EST in these centers; in 261 out of them the indication of EST was acute gallstone pancreatitis. They consider the exact and early diagnosis very important that can be based on the typical clinical and laboratory signs and ultrasonography. The ERCP reassures the final diagnosis and at the same time the therapeutic solution--EST--can also be realized. This took place within the first 48 hours. The results were favourable, in 90.4%, the complaints decreased significantly within 24 hours. The complication rate was 4.9%, and the mortality rate was 1.9%. These results are better than those of the conservative therapy.

Unlabelled: 400 women in continuous care of a family planning clinic were examined for gallbladder stones by standard ultrasound technique. Gallstones (GS) are found infrequently in nulliparous women (3.1 percent). The prevalence of GS increases with number of births and with age: 11 percent of female under 25 years of age, who have ever born, have GS; women aged 45 years and older who have born two or more children have GS in 35 percent. Duration of use of HC increases with rising age and with number of births. There is no regular relationship between duration of use of HC or total dose respectively and prevalence of gallbladder stones.

Conclusion: Intake of HC has no or only a marginal influence on prevalence of gallbladder stones.

Liver abnormalities are common complications in patients with immunosuppressed state iatrogenic or infectious induced. They are caused by infections due to hepatotropic viruses or by other infectious complications, drug induced or caused by rejections in patients after transplantation. Hepatic neoplasms have been associated with liver abnormalities, too. Problems in evaluation of liver abnormalities in these patients are discussed.

Introductory the anatomical particularities of the small and large bowel in their connection to absorption and secretion are represented. According to that the paper of pathophysiological processes by the hand of typical examples of the different kinds of diarrhoea (osmotic-, secretoric-, motility induced diarrhoea, diarrhoea by morphological changes of the small- and/or large bowel, diarrhoea by disturbances of the active ionic transport) has been taken place.

Investigations of pancreatic juice revealed new insights into the pathogenesis of chronic pancreatitis (cP). But many results are contradictory. In this paper pure human pancreatic juice from patients with cP (n = 14) was compared with results obtained from normal subjects (n = 22). The pancreatic juice was obtained endoscopically recording the absorption (280 nm) simultaneously. By means of this special technique 4 fractions could be exactly distinguished: 1. wash-out-period, 2. phase of secretin action, 3. phase of pancreozymin (CCK) action, and 4. post-CCK-phase. Total protein, trypsinogen, zinc sodium, and potassium were determined. In fraction 1 (wash-out-period) mean values of protein, trypsinogen and zinc are lower in patients with cP compared with control subjects. In case of zinc the difference is statistically significant. In fraction 2 (secretin-phase) no differences could be detected between cP and control subjects. In contrast in fraction 3 (CCK-phase) mean values of protein and trypsinogen are lower in control subjects than in patients with cP. But the standard deviations are so high that all differences are not statistically significant. The results indicate that under fasting conditions the pancreatic juice content of protein, trypsinogen and zinc is lower in patients with cP. But patients with cP can be stimulated much better with CCK than control subjects. Till now such a different behaviour during wash-out-period and CCK-stimulation is not reported in the literature.