Ablation of Barrett's epithelium by endoscopic argon plasma coagulation in combination with high-dose omeprazole.

Background: Barrett's esophagus is a premalignant condition induced by gastroesophageal reflux. The aim of this prospective study was to assess the efficacy of argon plasma coagulation in combination with high-dose omeprazole therapy to ablate nondysplastic Barrett's epithelium.

Methods: In 73 patients with histologically confirmed Barrett's epithelium, argon plasma coagulation was used in combination with maximal acid suppression (omeprazole 40 mg three times a day).

Successful immunomodulating in AIDS patients with ursodeoxycholic acid--a pilot study.

Based on the positive therapeutic results with ursodeoxycholic acid (UDCA) in patients with primary biliary cirrhosis, in whom we observed a clinical improvement in conjunction with the normalization of the low pretreatment dipeptidyl peptidase (DPIV, CD26) expression of peripheral blood lymphocytes (PBL), we hypothesized that the very low DPIV expression in AIDS patients could be positively influenced by UDCA. Four young male AIDS patients were therefore treated with 750 mg of UDCA for 4 months. The low CD26 expression (2-8% of the PBL versus 18-28% in healthy controls) at the beginning of the study rose to 10-16% after UDCA therapy.

Spontaneous regression of hepatocellular carcinoma confirmed by surgical specimen: report of two cases and review of the literature.

Two cases with spontaneous regression of a histologically confirmed hepatocellular carcinoma (HCC) are presented. This rarely seen phenomenon of a spontaneous tumor involution is discussed and compared with the current literature. The clinical symptoms were very similar to that of a liver abscess.

Very fast ultracentrifugation of serum lipoproteins: influence on lipoprotein separation and composition.

A very short run time and small sample volumes in the separation of lipoproteins by preparative ultracentrifugation are needed for several investigations. Recently, a very fast sequential separation method was described that needs only 100 min for one run in a centrifugal field of 625,000 x g. We studied the influence of centrifugal fields of this dimension on lipoprotein separation and lipoprotein particle integrity using a Beckman Optima TLX ultracentrifuge with a TLA-120.

[Reversible thrombocytopenia due to digitoxin overdose].

A 65-year-old woman, known to have peptic ulcers, developed nausea and retching. Clinical examination demonstrated pain on pressure in the epigastrium with otherwise normative findings for age. Two gastric ulcers and gastritis with erosions were seen at endoscopy.

Immunomodulating effect of ursodeoxycholic acid therapy in patients with primary biliary cirrhosis.

Peripheral blood lymphocytes of 22 patients with primary biliary cirrhosis under ursodeoxycholic acid therapy were examined for selected lymphocyte activation markers. The percentage of dipeptidyl peptidase IV positive Peripheral blood lymphocytes of primary biliary cirrhosis patients by using immune- and enzyme-histochemical staining was found to be low (5-12%), with healthy controls exhibiting a normal range of 18-27%. After pokeweed mitogen stimulation in vitro the interleukin-2 production by peripheral blood lymphocytes in primary biliary cirrhosis patients was significantly decreased (3.

[Dipeptidyl peptidase IV of peripheral blood lymphocytes in patients with primary biliary cirrhosis].

Investigations concerning changes of dipeptidyl-peptidase IV-positive (DP IV+) lymphocytes in the peripheral blood (PBL) were undertaken in 22 patients with primary biliary cirrhosis (PBC) under therapy with ursodeoxycholic acid (750 mg/day). We found that after 4-8 weeks of therapy the number of DP IV+ PBL was raised from an initially low, suppressed level of 5-12% to 18-33% corresponding to the range observed in healthy subjects. Concurrently liver function parameters of the patients were significantly improved.

[Endoscopy in cholestasis].

The spectrum of causes of cholestasis ranges from microscopically recognizable damage to the parenchymal cells of the liver to obstruction of the ductus choledochus und papilla Vateri. Liver biopsy on the one hand and ERCP on the other therefore constitute the morphological methods that come closest to the pathological substrate. Obligatory sonography serves the restriction of diagnosis to a large extent.

[Dipeptidyl-peptidase IV of human lymphocytes in patients with primary biliary cirrhosis and UDCA therapy].

Investigations concerning changes of dipeptidyl-peptidase IV-positive (DP IV+) lymphocytes in the peripheral blood (PBL) were undertaken in 22 patients with primary biliary cirrhosis (PBC) under therapy with ursodeoxycholic acid (750 mg/day). We found that 4-8 weeks after therapy beginning the number of DP IV+ PBL was raised from a low initial suppressed level of 5-12% into a range of 18-33% corresponding to that of a healthy. Concurrently liver function parameters of the patients were improved significantly.

[The significance of internal medicine intensive care within the complex of intensive medicine. Discussion contribution to the structural and professional classification in adult intensive medicine].

The development and establishment of intensive care units for adult patients requires a far-reaching subdivision into surgical and conservatively oriented intensive care for qualitative and quantitative reasons. Insufficiently substantiated claims to monopolization of intensive care techniques that are polemically asserted have to be strongly contradicted. The present paper is concerned with approved structural concepts of intensive care developed by Deutsche Krankenhausgesellschaft and various medical societies.

[Lipid metabolism disorders in primary biliary cirrhosis (PBC)].

40 women, average age 52.5 years, with varying stages of primary biliary cirrhosis, were observed. One third of them suffered from a mild anaemia, mean plasma concentrations of ALAT were increased four times and those of AP six times.

[Ultrasonography studies on spontaneous and pharmacologically modified gallbladder motility].

The intra- and interindividual variations of gallbladder motility were sonographically studied in 10 healthy subjects. We investigated the following criteria: a) the gallbladder volumes after overnight fasting on 5 consecutive days, b) the spontaneous motility under fasting over 12 or 24h at hourly intervals, c) the emptying rate and time of maximal contraction after stimulation with sorbitol, and d) the emptying rate and time (like c) after premedication with "cholagogic" drugs (Cholecysmon, Divalol), nifedipine, indomethacin or N-butylscopolaminiumbromide. We found a great intrapersonal and interpersonal variability in gallbladder volumes after overnight fasting in consecutive days.

[The effect of various non-ulcer pharmaceuticals on nocturnal gastric pH in healthy subjects].

The effects of 4 non-ulcer drugs and the M1-antagonist pirenzepine on the nocturnal intragastric pH were investigated in 12 healthy volunteers. We tested single doses of pirenzepine (100 mg), Chlorprothixene (30 mg), clonidine (75 micrograms), ketotifen (3 mg) and nifedipine (30 mg) in an randomized, single-blind, cross-over study. The nocturnal intraluminal pH is significantly elevated not only by pirenzepine but also by the other substances.

Prophylactic endoscopic sclerotherapy of esophageal varices--a prospective randomized trial.

Sixty-three patients with degree III or IV esophageal varices and the so-called red color sign, but without previous bleeding were randomly assigned to either prophylactic sclerotherapy (PST) (n = 30) or to a control group (n = 33). In 58 cases the portal hypertension was caused by liver cirrhosis (40% alcoholics). The two groups were comparable with respect to demographic data and endoscopic appearance, causes and severity of liver damage.

[Drug-induced liver damage from the clinical viewpoint].

Extensive drug-induced hepatic injury leading up to jaundice occurs relatively rarely. Generally it is not predictable, independent on dosage and irreproductible in animals. As a rule you find it in less than 0.

[A high rate of surgery of stomach ulcer in long-term follow-up].

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.

[Regression of stomach polyps--spontaneous or induced?].

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.

[Endoscopic sclerotherapy of esophageal varices--studies of the technic and follow-up].

Several prospective studies on the efficiency and technique of endoscopic sclerotherapy (EST) were performed among 300 patients with bleeding esophageal varices, 173 of which had been treated by EST. Contrasted with a comparable control group (n = 80), EST (n = 100) reduced the incidence of rebleedings (40% vs 13.3%; p less than 0.