Pancreatic endoscopic sphincterotomy in patients with chronic pancreatitis: a single-center experience in 171 consecutive patients.

Background And Study Aims: In recent years, interest in endoscopic therapy techniques for pancreatic diseases has been constantly increasing. The aim of the present study was to assess the technical success, technique, and complications of endoscopic pancreatic sphincterotomy (EPS) in patients with chronic pancreatitis.

Patients And Methods: A total of 171 patients with chronic pancreatitis and abdominal complaints were identified in whom at least one attempt at EPS was carried out.

ERCP and MRCP--when and why.

Since the introduction of endoscopic retrograde cholangiopancreatography (ERCP) in the 1970s, gastroenterologists have a wide spectrum of diagnostic and therapeutic options in the biliopancreatic ductal system at their disposal. With its arrival in the 1990s, magnetic resonance cholangiopancreatography (MRCP) developed as a potent diagnostic tool in biliopancreatic pathology. Currently, MRCP is widely replacing diagnostic ERCP and thereby avoiding complications related to endoscopic technique.

Neuroendocrine carcinomas of the prostate and urinary bladder: a diagnostic and therapeutic challenge.

This review addresses the various morphological, immunohistochemical and cell kinetic aspects of pure and mixed neuroendocrine carcinomas of the prostate and urinary bladder and of carcinomas with focal neuroendocrine differentiation. It is important that neuroendocrine tumours of the prostate and urinary bladder be clearly distinguished from their nonneuroendocrine counterparts because of differences in treatment and prognosis. In the case of high-grade neuroendocrine carcinomas, early diagnosis and initiation of appropriate chemotherapy may increase survival and potentially induce complete remission in individual cases.

Minilaparoscopy versus conventional laparoscopy in the diagnosis of hepatic diseases.

Background: Minilaparoscopy (ML) is being used increasingly in the diagnosis of liver disease. This is a prospective study of the accuracy and safety of ML compared with conventional laparoscopy (CL) in the diagnostic workup of liver disease.

Methods: One hundred four patients with suspected liver disease were randomized either to undergo CL (n = 50) or ML (n = 54).

Pancreatic cancer detection with magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography: a prospective controlled study.

Background: Magnetic resonance cholangiopancreatography (MRCP) is a non-invasive and increasingly used procedure in cases involving biliary and pancreatic diseases. However, the accuracy of MRCP in differential diagnosis between pancreatic cancer and chronic pancreatitis has never been documented in a large prospective controlled study.

Methods: 124 patients were recruited for the study, selected from 141 consecutive patients with an average age of 55 years (range 19-80) who presented to our department between February, 1996, and January, 1998, with a strong clinical suspicion of pancreatic cancer.

Current role of magnetic resonance cholangiopancreatography in the diagnosis of common bile duct and pancreatic diseases.

Magnetic resonance cholangiopancreatography is a noninvasive procedure that is increasingly used in patients with hepatobiliary and pancreatic diseases. The accuracy of magnetic resonance cholangiopancreatography has dramatically improved during the last few years, and there is no doubt that magnetic resonance cholangiopancreatography will have a major impact on the gastroenterologist's diagnostic work-up of patients. The key for success in dealing with hepatobiliary and pancreatic diseases is the precise knowledge of their course, the indications for treatment, and the therapy available.

Adverse effects of nonsteroidal anti-inflammatory drugs on the small and large bowel.

Nonsteroidal anti-inflammatory drugs (NSAID) account for a large part of prescriptions and self-administered medication worldwide. The adverse effects on the upper gastrointestinal tract are well documented. However, in an increasing number of publications adverse effects in the small and large intestine distal to the duodenum are being reported.

Long term follow up of patients with chronic pancreatitis and pancreatic stones treated with extracorporeal shock wave lithotripsy.

Background: There have been conflicting reports as to whether pancreatic ductal drainage achieved by endoscopy and lithotripsy improves the clinical outcome of patients with chronic pancreatitis.

Aims: To determine the clinical outcome in patients with chronic pancreatitis who received extracorporeal shock wave lithotripsy (ESWL), and were followed up for two to eight years.

Methods: Eighty patients with severe chronic pancreatitis and endoscopically unretrievable obstructive stones underwent ESWL with a piezoelectric lithotripter between 1989 and 1996.

Stoma care nurses: good value for money?

Decreasing financial resources in health services often lead to wholesale budget reducing in hospitals. Enterostomal therapists are more and more concerned by this situation. Data on the cost-effectiveness of stoma therapy have not existed, a gap filled by the present study.

Risk factors associated with intraabdominal infections: a prospective multicenter study. Peritonitis Study Group.

Introduction And Methods: A prospective observational multicenter study with 18 hospitals was performed to assess preoperative risk, therapeutic management and outcome of patients with peritonitis. Data collection was carried out according to standardized and recommended definitions. Included in the study were 355 patients with macroscopically confirmed peritonitis.

Prevalence and clinical importance of Helicobacter pylori infection in patients after partial gastric resection for peptic ulcer disease. A prospective evaluation of Helicobacter pylori infection on 50 resected patients compared with matched nonresected controls.

Unlabelled: There have been only a few surveys on the prevalence of persistent Helicobacter pylori (Hp) infection in patients who have undergone surgery for peptic ulceration. The aim of the study was to evaluate the prevalence and clinical importance of Hp infection after partial gastric surgery due to peptic ulcer disease.

Methods: We examined 50 patients who had partial gastric resection for peptic ulcer disease and years later underwent upper gastrointestinal (GI) endoscopy.

Ovarian reserve tests in infertility practice and normal fertile women.

The decline in fecundity with the age of the woman is mainly attributed to the loss of follicles from the ovary and a decrease in oocyte quality. Evaluation of the aging status of the ovary in an individual woman has been hampered by a lack of knowledge with regard to the relative contribution of these two factors. Most if not all so called ovarian reserve tests (ORT) reflect indirectly the remaining follicle pool in the ovary.

Effects of add-back therapy on bone mineral density and pyridinium crosslinks in patients with endometriosis treated with gonadotropin-releasing hormone agonists.

Treatment of endometriosis with gonadotropin-releasing hormone agonists (GnRHa) is limited to 6 months because of possible adverse effects on bone metabolism. We designed a randomized, double-blind, placebo-controlled, prospective study of 27 patients with endometriosis who were given GnRHa with or without hormone add-back therapy (+ 20 microg of ethinyl estradiol with 0.15 mg desogestrel) designed to suppress the adverse effects of hypoestrogenism while preserving the efficacy of GnRHa.

Differential diagnosis of glandular proliferations in the prostate. A conventional and immunohistochemical approach.

A variety of small acinar lesions of the prostate can mimic prostate cancer in punch biopsies and in transurethral resection material. The first part of this review deals with differential diagnostic problems of the central and transition zone, including atypical adenomatous hyperplasia of the prostate, atrophic processes, sclerosing adenosis, basal cell hyperplasia, and low-grade adenocarcinoma. The second part deals with differential diagnostic problems in the peripheral zone: prostatic intraepithelial neoplasia, postatrophic hyperplasia, Cowper's glands, seminal vesicles, and ductal and intraductal carcinoma.

A prospective evaluation of magnetic resonance cholangiopancreatography in patients with suspected bile duct obstruction.

Background: The value of magnetic resonance cholangiopancreatography (MRCP) is under debate.

Aims: To assess the diagnostic accuracy of MRCP and endoscopic retrograde cholangiopancreatography (ERCP) and to determine whether MRCP may help to prevent unnecessary interventional procedures.

Methods: Eighty six patients with suspected common bile duct obstruction who presented between January and December 1996 were enrolled.

Characterization of the thromboxane synthase pathway product 12-oxoheptadeca-5(Z)-8(E)-10(E)-trienoic acid as a thromboxane A2 receptor antagonist with minimal intrinsic activity.

Thromboxane synthase forms thromboxane (TX) A2 and 12(S)-hydroxyheptadeca-5(Z)-8(E)-10(E)-trienoic acid (HHT) at equimolar amounts. Twelve-oxoheptadeca-5(Z)-8(E)-10(E)-trienoic acid (Oxo-HT) is the primary metabolite of HHT and has been described to be an inhibitor of platelet aggregation. Functional studies, Schild analysis and competitive binding studies were performed to clarify its mode of action.

Antithrombin-III substitution in preterm infants--effect on intracranial hemorrhage and coagulation parameters.

In preterm infants the activity of antithrombin III (AT-III), the main inhibitor of thrombin, is reduced depending on gestational age and complications such as sepsis or respiratory distress syndrome. Babies with low levels of AT-III have been shown to have a higher mortality and an increased incidence of intracranial hemorrhage. In our study we tried to show the effect of early AT-III substitution on coagulation parameters and the incidence of intraventricular hemorrhage (IVH).

GnRH agonists and uterine leiomyomas.

Gonadotrophin-releasing hormone (GnRH) agonists are widely used in the treatment of women with symptomatic leiomyomas. The effectiveness of this treatment, as far as symptoms are concerned, is well established, and in recent years many studies have contributed to defining the optimal role for GnRH agonists. Side-effects and health risks prohibit the long-term use of these compounds.

Photodynamic therapy: a promising new modality for the treatment of cancer.

The first reports on photodynamic therapy (PDT) date back to the 1970s. Since then, several thousands of patients, both with early stage and advanced stage solid tumours, have been treated with PDT and many claims have been made regarding its efficacy. Nevertheless, the therapy has not yet found general acceptance by oncologists.

Doppler sonographic diagnostics and treatment control of symptomatic first-degree hemorrhoids. Preliminary report and results.

Endoscopic Doppler sonography is a relatively new technique in the diagnostics of intestinal hemorrhage. It has been used mainly for gastroduodenal ulcer bleeding, but is also utilized in the lower digestive tract. For the first time, the effectiveness of Doppler ultrasound was studied in hemorrhoidal disease.

Do perceived parental rearing patterns influence social behaviour dimensions and disease severity in schizophrenia?

In an explorative study, a clinical sample of 53 schizophrenic patients was examined. The EMBU inventory was used for measuring perceived parental rearing practices, the AfS for rating the quality of relationship to key relatives and the U-Scale for assessing social anxiety. The findings obtained were intercorrelated and compared with 3 selected parameters of disease severity: age at first hospitalization, number of treated episodes and length of hospital stay.

A stage Ia vulvar carcinoma with an inguinal lymph node recurrence after local excision. A case report and literature review.

A patient with a stage Ia vulvar squamous cell carcinoma (< 1 mm invasion) is reported in which an inguinal recurrence one and a half years after partial radical vulvectomy and superficial inguinal lymph node sampling was noted. After the initial biopsy showing a tumor invading 0.3 mm into the stroma, residual tumor could not be shown in the vulvectomy specimen nor in the superficial lymph nodes.

Liquorpheresis (CSF-filtration): an effective treatment in acute and chronic severe autoimmune polyradiculoneuritis (Guillain-Barré syndrome).

In recent years, plasmapheresis has become a well established treatment of acute and chronic polyradiculoneuritis (Guillain-Barré syndrome, GBS). Nevertheless, there are still non-responders and there are particular risks associated with this treatment. Despite all efforts, the duration of severe forms of Guillain-Barré syndrome is still considerable.

High-speed photographic evaluation of endoscopic lithotripsy devices.

Shock-wave generation and bubble formation occurring during endoscopic lithotripsy were studied using high-speed photography for various devices: a pulsed-dye laser, a Q-switched Nd:YAG laser and an electrohydraulic (EHL) apparatus. The three devices investigated generated gas bubbles that rapidly expanded and decayed. The maximal size of these bubbles was 5-8 mm for the pulsed-dye laser, 6 mm for the Q-switched Nd:YAG laser and up to 14 mm for the EHL device.