[Pancreatic exocrine secretion in patients with cirrhosis of the liver (author's transl)]. / Die exokrine Pankreassekretion bei Patienten mit Leberzirrhose.

The exocrine function of the pancreas was studied with the aid of the pancreozymin-secretin-test in 30 patients with ethanolic and 10 patients with nonalcoholic cirrhosis of the liver as well as 30 healthy subjects. It was established that the changes of the pancreatic secretion in cirrhosis of the liver are characterized by elevated output of water and bicarbonate, diminished bicarbonate concentration without substantial changes in enzyme secretion. In alcoholic cirrhosis, these changes are more frequent, but they do not differ from those observed in cirrhosis of other etiology.

[Advantages of cytodiagnostics in ascites (author's transl)]. / Möglichkeiten der Zytodiagnostik von Aszitesflüssigkeit.

Investigations were made on 253 patients. In 44 patients with peritoneal carcinosis, cell imprints and histological investigations of tissues from the changes in the peritoneum, taken during laparoscopy have been performed. In 122 out of 151 patients with neoplastically stipulated ascites (80.8 per cent) tumour cells have been found in the ascitic fluid. The false negative results represented 19.8 per cent and the false positive results--2.0 per cent. In all cell imprints from peritoneal tissues tumour cells have been detected even when these were absent in the ascitic fluid. In 2 out of 49 patients (4 per cent) the histological investigation of bioptic material from the peritoneum showed no neoplastic changes. The activity of gamma-glutamyltransferase and alkaline phosphatase in the ascitic fluid of patients with carcinosis was higher than in the remaining patients, whilst the 5'-nucleotidase did not show particular deviations. The cytologic method was well tolerated by the patients and showed higher specificity, sensitiveness, simplicity and realization and in 80.8 per cent solved the diagnostic problems and made useless the application of other labour-consuming, burdensome and more expensive methods of investigation.

The diagnostic value of x-ray methods, endoscopy, oriented gastrobiopsy and brush cytodiagnostics in malignant and benign diseases of the stomach.

Studies in 59 patients with various diseases of the stomach (37 cancerous and 22 non-cancerous ones) are reported and their results commented on. Each of the patients underwent, beside clinical examinations, laboratory tests, and radiography, fibrogastroscopy with oriented gastrobiopsy and brush cytodiagnostics respectively. At the cytologic preparation of the material, three methods have been used: direct smears, smears from sediment as obtained after brush rinsing in alcohol (50%), and paraffine embedding of sediment. Out of 37 patients with carcinoma of the stomach, positive and suspicious data resulted at the clinical examination (chiefly suspected ones) in 27, as against 25 at the X-ray one, and 35 at fibrogastroscopy. Oriented gastrobiopsy yielded positive results in 27 cases, whereas oriented brush cytodiagnostics in 35 out of 37 patients. An evaluation of the various cytologic methods in the diagnostics of cancerous and non-tumorous diseases of the stomach has been made. The complex examination of the patients yields the most accurate diagnosis, contributing to the ascertainment of benign and malignant diseases of the stomach.

[Laparoscopy in the diagnosis and differential diagnosis of ascites]. / Die Laparoskopie bei der Diagnose und Differentialdiagnose des Aszites

Out of 2,500 patients who underwent laparoscopy 772 (30.89%) had ascites; liver cirrhosis underlay it in 57.78%, peritoneal carcinosis in 26.29%, primary and metastatic carcinoma, respectively, in 12.95%, tuberculous peritonitis in 1.42%, more rarely other diseases. Liver cirrhosis, malignant tumours and the other hepatic affections with concomitant ascites in their course can certainly be diagnosed laparoscopically. Laparoscopy with oriented biopsy of peritoneum and liver is of decisive importance in differentiating peritoneal carcinosis from tuberculosis. In peritoneal carcinosis the diagnosis (as based in clinical and laboratory findings) coincided perfectly with the laparoscopic and histologic one in 24.5%, partially in 45.5%. In 30% there was no congruence at all. Laparoscopy and the test methods associated with it contributed to the accurate diagnosis of peritoneal carcinosis in 75.5% of the patients. Ovarian carcinoma (20.9%) and cancer of the stomach (16.3%) underlay peritoneal carcinosis most frequently, other diseases by far more seldom.