Caffeine elimination in cirrhotic and non-cirrhotic liver disease of different etiology.

Caffeine elimination was studied in 419 patients with cirrhotic and noncirrhotic liver disease of different etiology (hepatitis B virus infection n = 79; hepatitis NANB virus infection n = 74; ethanol-induced liver damage n = 143; primary biliary cirrhosis I-IV n = 63; cryptogenic liver cirrhosis n = 60) following oral administration of 366 mg caffeine. Caffeine clearance in the control group was 69 +/- 33 ml/min (age-matched healthy volunteers and patients without liver disease). Caffeine clearance in acute hepatitis B (70 +/- 60 ml/min) chronic persistent hepatitis B (81 +/- 56 ml/min), chronic aggressive hepatitis B (107 +/- 66 ml/min), posthepatitic liver cirrhosis B (84 +/- 62 ml/min), acute hepatitis NANB (94 +/- 69 ml/min), chronic persistent hepatitis NANB (122 +/- 60 ml/min), chronic aggressive hepatitis NANB (87 +/- 52 ml/min) and posthepatitic cirrhosis NANB (59 +/- 26 ml/min) is not reduced in comparison with controls.

A new method of identifying tumors of the papilla of Vater.

A new method, combining duodenoscopy and computed tomography, is described. This method is used to identify the irradiation area of tumors of the papilla of Vater with steel clips.

Diagnostic problems in upper gastrointestinal bleeding.

In this editorial problems of different diagnostic procedures, the time of endoscopy, i.e. emergency endoscopy procedures, and its complications, are discussed.