Hauptthema: Neue Infektionskrankheiten

Die Ulcuskrankheit entsteht aus einer Imbalanz mucosaschadigender und mucosaschutzender Prinzipien. Dennoch dominiert der Faktor Saure mit Recht seit Dekaden die pathophysiologischen Konzepte und therapeutischen Strategien. So ist Saure einerseits die einzig bislang bekannte unabdingbare Voraussetzung fur die Entstehung jedes Ulcus, zum anderen heilen praktisch alle Ulcera unter einer sauresekretionshemmenden oder -neutralisierenden Behandlung ab. Da aber bis heute die Atiologie und Pathogenese der Ulcuskrankheit, mit Ausnahme beim Zollinger-Ellison-Syndrom und den durch nichtsteroidale Antirheumatika bedingten Ulcera, weitgehend ungeklart ist und ihr Spontanverlauf durch medikamentose Inte…

Treatment of advanced pancreatic cancer with 5-fluorouracil, folinic acid and interferon alpha-2A: results of a phase II trial.

Interferon alpha-2a (IFN-alpha) and folinic acid (FA) have been shown to modulate the cytotoxic effects of 5-fluorouracil (5-FU) in the treatment of cancer. A phase II study was initiated to evaluate the effect of a combination of 5-FU/FA/IFN-alpha in patients with advanced pancreatic cancer. Sixty previously untreated patients with advanced adenocarcinoma of the pancreas were treated with 500 mg m-2 FU via an intravenous bolus 1 h after the initiation of a 2 h infusion of 500 mg m-2 FA. Before starting the FA infusion, 6 million units (MU) of IFN-alpha was administered subcutaneously. The treatment was repeated once a week. Of 57 evaluable patients, eight (14%) had a partial response (PR),…

Investigation of the Effect of Duodenoscopy on Sphincter of Oddi Manometry

To investigate whether endoscopy affects sphincter of Oddi (SO) manometry, three patients who had undergone previous cholecystectomy and had a T-tube in situ for drainage were studied. Manometry was performed using a perfused triple lumen manometry catheter (diameter 1.7 mm), which was advanced into the SO lumen through the T-tube. SO motility, baseline pressure, common bile duct pressure and duodenal pressure were monitored before and during endoscopy while the tip of the endoscope was in the mouth, esophagus (upper third, precardial), stomach and duodenum. Endoscopy and even a moderate insufflation of air necessary to pass the pylorus and inspect the papilla of Vater did not affect the pa…

Elevated Pressure in the Dorsal Part of Pancreas Divisum

Summary In 6 patients with upper abdominal pain of unknown origin presenting with pancreas divisum, the pressure in the pancreatic duct was measured via the minor papilla into which in these patients the main part of the pancreatic duct system drains. For comparison intraductal manometry via the major papilla (papilla of Vater) was performed in 8 patients with normal pancreatic duct system. The pressure in the pancreatic duct of the control group was 10.5 ± 0.9 mm Hg. whereas in the patients with pancreas divisum it was 23.7 ± 1.3 mm Hg. The results demonstrate that in patients with pancreas divisum, intraductal pressure may be largely increased even in the fasting state.

Safety and Feasibility of a New Minimally Invasive Diagnostic Laparoscopy Technique

Background and Study Aims: Laparoscopy combined with guided liver biopsy offers many advantages in the diagnosis and staging of chronic liver diseases and is superior to other diagnostic procedures. We developed a new minilaparoscopic technique and evaluated the utility of this minimally invasive laparoscopic system in the first 320 patients who underwent diagnostic assessment for liver disease or peritoneal carcinosis. Patients and Methods: Between July 1996 and February 1998, minilaparoscopy, with analgesia and sedation was carried out in 320 patients. It was done using a 1.9-mm optical instrument, which was inserted through the same 2.75-mm trocar as the Veress needle used for inflating …

Autoimmune Hepatitis and Hepatitis C Virus Infection