Origin and development of exocrine pancreatic insufficiency in experimental renal failure.

Chronic renal failure affects the physiological function of many organ systems. One of them is the exocrine pancreas. Although varying degrees of pancreatic insufficiency are the dominating clinical characteristic of uraemic pancreatic disease, it remains unclear whether this disease should be regarded as a manifestation of chronic pancreatitis, arising from recurring attacks of acute pancreatitis, or represents a distinct entity.

In vitro perfusion and incubation of rat pancreatic lobules in a kinetic system.

The use of pancreatic lobule preparations is one of the well-established approaches to study stimulus-secretion coupling in the exocrine pancreas in vitro. We have developed a kinetic system for the perfusion and intermittent incubation of rat pancreatic lobules. This model allows repeated hormone stimulation for up to 3 h while permitting rapid changes of the cellular environment with no accumulation of secretory or metabolic products.

The information needs and fears of patients with inflammatory bowel disease.

A questionnaire containing a list of 36 questions and nine "fear factors" was sent to 139 patients with inflammatory bowel disease. Patients were asked to select the most and the least important questions and fear factors. Furthermore, the level of information and the source of information were recorded.

[Pancreas divisum as a possible cause of misinterpretation in ERCP, computed tomography, sonography and MDP].

In 488 patients endoscopic retrograde pancreatography (ERP) revealed a pancreas divisum in 21 (4.3%): in 17/21 patients we found a complete, in 4/21 an incomplete separation of the pancreatic ducts. The pancreas divisum is caused by a malfusion of the ductal system.

[Changes in the esophageal wall following sclerotherapy of varices--roentgen morphology and therapy].

Endoscopic sclerotherapy of esophageal varices is a widely used procedure. It reduces the frequency of rebleeding and improves the survival of cirrhotics with portal hypertension. The intravariceal or paravariceal injection of sclerosing agents causes structural changes of the esophageal wall recognisable radiologically.

[Peritoneovenous shunt in ascites therapy. Complications and their treatment].

Complications occurred in 29 of 37 patients after ascites retransfusion (n = 16) or introduction of a peritoneovenous shunt (n = 21). Blood clotting disturbances, that could either be successfully treated with drugs or which led to interruption of the reinfusion, appeared in 38%. Estimation of plasminogen proved to be of reliable prognostic value thus enabling prophylactic measures to be taken.

[Hemorrhage into a liver adenoma associated with long-term use of oral contraceptives].

A 39-year-old woman was evaluated for acute midepigastric pain. The patient was never severely ill; her only medication was an oral contraceptive (OC) which she took regularly over the last 12 years. Abdominal ultrasonography and computed tomography revealed bleeding into a liver tumor.

[Bile duct endoprostheses. Insertion using a combined endoscopic-radiologic technic].

Percutaneous transhepatic biliary drainage is a proven method for treating obstructive jaundice due to malignancy. However, the rate of complications for primary internal drainage is relatively high. Consequently, various types of biliary endoprostheses which can be introduced transhepatically or endoscopically have been developed.

[Endoscopic and biopsy findings in the esophageal, gastric and duodenal mucosa before and after radiotherapy for Hodgkin's disease].

Esophago-gastro-duodenoscopies with multiple mucosa biopsies were performed before and after irradiation of the mantle field or the spleen pedicle in 13 patients with Hodgkin's disease in stage I and II. For the irradiation the photons of a 4 MeV linear accelerator were applied with focal doses of 40 to 44 Gy. Contrast simulator radiographs were made in order to verify the position within the irradiation field of the organs from which biopsies were taken.

Zinc and vitamin A deficiency in patients with Crohn's disease is correlated with activity but not with localization or extent of the disease.

A study of serum zinc and plasma vitamin A concentrations in 54 patients with Crohn's disease was performed. Compared with controls the patients had significantly lowered zinc and vitamin A concentrations. There was a marked correlation between zinc and vitamin A and the activity of the disease, as measured by the Crohn's disease activity index, and a weaker correlation with serum proteins considered to be indicators of disease activity.

[Immunogenetic findings in Crohn disease, ulcerative colitis and gluten sensitive enteropathy].

Immunogenetics explain the influence of genetic dispositions and regulation mechanisms on the defence mechanisms of organisms. In this paper the interrelationship between immunogenetic findings and Crohn's disease, ulcerative colitis and glutensensitive enteropathy are presented. The association with HLA-antigens and the complement factors Bf and C 4 are described.

[Significance of sonographic course controls in acute pancreatitis].

Two patients with complicated acute pancreatitis are demonstrated. Sonographic factors are compared to laboratory and clinical findings. Ultrasound can add relevant information for classification and thereby supply an indication for surgery in patients with acute pancreatitis.

[Extraintestinal complications of Crohn disease, demonstrated in a patient].

A patient with different extraintestinal complications of Crohn's disease is demonstrated. The case allows a discussion of frequency and importance of such complications in Crohn's disease. Vitamin-und trace element deficiency, protein loss and renal complications are the main complications.

[Oral contraceptives and benign tumorous conditions of the liver (author's transl)].

Tumorous lesions of the liver were diagnosed by means of angiography, sonography and laparoscopy in six patients on oral contraceptives for a long time. These lesions were identified as liver cell adenoma (1), focal nodular hyperplasia (4) and cavernous hemangioma (1). The relationship between oral contraceptives and liver disorders is well-known.

[Severe and prognostically unfavourable forms of tick-borne encephalitis (early-summer meningo-encephalitis) in Freiburg (author's transl)].

Eight patients with proven tick-borne encephalitis (early-summer meningo-encephalitis; central European encephalitis) were treated in 1979. The disease ran a severe course in four: one died after six weeks of coma and pneumonia with right-heart failure. Another patient is in coma for more than 40 weeks.