[Endoscopic implantation of endoprostheses in incurable esophageal and cardia cancer]. / Endoskopische Implantation von Endoprothesen beim inkurablen Osophagus- und Kadiakarzinom.

The palliative treatment of tumorous stenosis of the esophagus and cardio-esophageal region by intubation with an endoprosthesis leads to an improved quality of life. The used endoscopic positioning provides better results than the surgical procedure. This method is easy in handling and has only few complications. The endoscopic positioning of endoprosthesis is also a really alternative of alimentary fistula. The positioning of plastic prosthesis under endoscopic control should be given preference in the palliative treatment of obstructing cardio-esophageal malignancy.

[Duodenal bile acid output in gastroenterologic diseases]. / Duodenaler Gallensäurenoutput bei gastroenterologischen Erkrankungen.

The biliary secretion of bile acids was measured with the modified secretin-pancreozymin test in 50 patients with various gastroenterological diseases and in a control group. In the control group the highest bile acid output and the lowest G/T quotient was estimated. In comparison to the control group, the bile acid output in the patients with gastroenterological disorders was reduced significantly to a varying degree. Except in postcholecystectomy patients, it was proved that the G/T quotient was significantly increased compared to that in the control group. The estimation of bile acid output and the G/T quotient presented here shows an easier extension of the validity of the secretin-pancreozymin test which does not indice any additional burden to the patients.

[Pancreatico-biliary secretion in enteral hyperoxaluria]. / Die pankreatobiliäre Sekretion bei enteraler Hyperoxalurie.

The increased oxalic acid absorption is a well documented finding in gastroenterological diseases. The malabsorption of bile acids and fat is important in the pathogenesis of the hyperoxaluria. The enteric absorption of 14C-labelled oxalic acid was measured in 49 patients with different diseases. The dihydroxy-trihydroxy-ratio of bile acids is significantly decreased in patients with hyperoxaluria over 20% of the ingested dosage. We didn't find any correlation between the excretion of oxalic acid and the intraduodenal pancreatic lipase activity.

[Oxalic acid resorption in patients with resection of the small intestine, jejunoileal bypass, Crohn disease and chronic pancreatitis]. / Oxalsäureresorption bei Patienten mit Dünndarmresektion, jejunoilealem Bypass, Morbus Crohn und chronischer Pankreatitis.

The enteric absorption of oxalic acid with 14C-labelled oxalic acid was determined in patients with small bowel resection, jejunoileal bypass, Crohn's disease and chronic pancreatitis in comparison to the control group. Extreme hyperoxaluria were found in small bowel resections above 100 cm, after bypass operations and in ileocolitis Crohn with signs of clinical activity. Small bowel resections and relapses of Crohn's disease increase the absorption of oxalic acid. The significance of 14C-oxalic acid absorption test is the recognition of enteric hyperoxaluria.

[Percutaneous antegrade pyelography with a fine needle]. / Perkutane antegrade Pyelographie mit dünner Nadel.

In 15 patients the percutaneous antegrade pyelography with thin needle was performed for the clarification of a mute kidney and a urinary stasis kidney. The two groups of diseases could not be clarified by means of the methods of the conventional urography. The retrograde pyelography was intentionally given up. By means of the percutaneous antegrade pyelography we could clarify a mute kidney in 8 cases and in 4 cases a urinary stasis kidney. In 3 cases with mute kidney we did not succeed in the demonstration of the renal calyces. No complications appeared. In strong indication the percutaneous antegrade pyelography is an evident diagnostic measure by great security, little stress for the patient and little cost. Despite modern investigation methods including sonography and computer tomography is referred to the fields of application of the percutaneous antegrade pyelography.

[Emergency endoscopy in acute upper gastrointestinal hemorrhage: Does the effectiveness justify the effort?]. / Notfallendoskopie bei akuter oberer Gastrointestinalblutung: Rechtfertigt der Nutzen den Aufwand?

On the basis of a common care of patients with acute upper gastrointestinal haemorrhage by internists, surgeons, and anaesthetists lasting several years advantages and disadvantages of emergency endoscopy are analysed from the standpoint of effectivity. High diagnostic ability, help in the decision concerning operative or conservative activity, the influence of the operative-tactic approach and the furthering influence on the close cooperation of the specialities are to be emphasized. Criteria of effectivity, such as mortality rates, duration of the stay in the hospital and frequency of relapsing haemorrhages underlie many factors of influence. They express results of therapy, to which emergency endoscopy may at present contribute only limitedly. The basic decision to medical activity -- active striving for a rapid, exact diagnosis or waiting when the diagnosis is uncertain -- does not inessentially influence the standpoint in the controversy about the emergency endoscopy.

[Fine needle percutaneous transhepatic cholangiography (PTC)]. / Perkutane transhepatische Cholangiographie (PTC) mit dünner Nadel.

The percutaneous transhepatic cholangiography with thin needle was performed in 40 patients for the diagnostic clarification of epigastric complaints after cholecystectomy and of a cholestasis syndrome. A successful demonstration of the duct was achieved altogether in 80%, in an extrahepatic obstruction in 93.3%. The only complication was a choleresis into the free abdominal cavity, which could be operatively treated without any sequels. By the percutaneous transhepatic cholangiography in the majority of patients pathologic changes were diagnosed, which remained latent when up to now usual methods were performed and which had therapeutic consequences. The high exactness, the slight load of the patient, minimum cost and unproblematic sterilisation are essential advantages of the percutaneous transhepatic cholangiography which justify a broader use. The complication rate may be kept low by the slight calibre of the needle and by suitable investigation technique.

[The behavior of albumin in acute and chronic liver damage. III. Intrahepatic and serum albumin concentrations in human liver diseases]. / Untersuchungen zum Verhalten von Albumin bei akuten und chronischen Leberschäden III. Intrahepatische und Serumalbuminkonzentrationen bei Lebererkrankungen des Menschen.

In 305 patients examined by liver biopsy albumin and the entire soluble protein in the liver puncture as well as albumin in the serum were estimated quantitatively. A significant decrease of the serum albumin level in active cirrhoses and biliary liver damages confirmed the importance of the hypalbuminaemia as facultative symptom of a liver damage. The lacking specifity was emphasized by the low albumin serum concentrations in malignomas and after the intake of contraceptive hormones. The hypalbuminaemia and the increased content of soluble liver protein in the bioptic material might enrich the diagnostics of the activity in cirrhoses. The diagnostic value of the decrease of the relative proportion of albumin is low, since of all liver diseases examined the active cirrhosis alone was accompanied by a significant decrease. The estimation of the albumin content in the bioptically got liver tissue had in contrast to the animal experiment no diagnostic value for liver diseases.

[Diagnostic value of bulboscopy]. / Diagnostische Aussagefähigkeit der Bulboskopie

Bulboscopy is a proved routine examination in radiological suspicion of changes in the duodenum, in duodenal ulcers, haemorrhages from the superior gastrointestinal tract, also as emergency endoscopy, and in unclear epigastric complaints. The endoscopy of the duodenal bulb is better than the radiological examination, especially when a cicatricial bulb is present. Flat ulcers often cannot be proved by radiological examination. Nevertheless the radiological examination should always be carried out, as also endoscopically in the cicatricial bulb ulcers may be overseen. Endoscopically the florid duodenal ulcer can be differentiated in several groups. Some a prognostic importance is ascribed.

[Chronic liver diseases with negative laboratory findings]. / Chronische Lebererkrankungen mit negativen Laboratoriumsbefunden

Chronic liver diseases may be overlooked, when regular laboratory-chemical findings are overvalued. This is important especially for those which coincide with a particupation of the bile ducts. Even in insignificant clinical references laparoscopy and biopsy under direct vision are necessary. The blind biopsy of the liver is not always sufficient as it does not regularly deliver characteristic tissue.