Estimation of width of narrow molecular-weight distributions by size-exclusion chromatography with concentration and light scattering detection.

A new method for the estimation of the weight-to-number-average molecular-weight ratio, Mw/Mn of polymers with a narrow molecular-weight distribution, approximated by log-normal distribution, is proposed using size-exclusion chromatography (SEC) with concentration and light-scattering detectors. From experimental data, the Mw/Mn ratios are calculated by two procedures: one using the concentration and light-scattering elution curve for the polymer measured, and the other based on the concentration elution curve and calibration line for a wide range of molecular masses. An iteration method has been developed making the two Mw/Mn ratios converge. The method was applied to a series of narrow molecular-weight distribution polystyrene standards.

Congenital fibropapillomatosis in a piglet.

We report a case of congenital fibropapillomatosis in the head and neck of a piglet from a swine breeding farm where sporadic cutaneous papillomas of the prepuce and scrotum had previously occurred in several boars. Histologically, the tumor consisted of multiple exophytic, papillary projections composed of branching, densely cellular, fibrovascular stalks covered by hyperplastic keratizing squamous epithelium. Ultrastructural examination failed to reveal viral particles. Cutaneous papillomatosis is rare in swine. To the best of our knowledge, this is the second report of congenital fibropapillomatosis in pigs.

[Occurrence of struma in cattle in the Czech Republic]. / Strumavorkommen bei Kälbern in der Tschechischen Republik.

In the years 1988 to 1995 among 1355 cattle examined in the frame of iodine deficiency studies in the Czech Republic 404 animals (30%) showed congenital struma. Clinical and postmortal findings are described. A monitoring of iodine content in milk showed lower values in herds with struma prevalence. The insufficient supply of iodine in these animals results from low iodine content of feed or from the goitrogenic influence of nitrate in drinking water or high content of crucifera in feed or other stress factors. An increased iodination of mineral mix in feed is highly recommended.

Double-blind dose-finding study of olsalazine versus sulphasalazine as maintenance therapy for ulcerative colitis.

OBJECTIVE: To determine the therapeutic efficacy and safety of three doses of olsalazine compared with the standard dose of sulphasalazine. DESIGN: Randomized double-blind multicentre 6-month study comparing three doses of olsalazine (0.5, 1.25 and 2.0 g daily) and sulphasalazine 2.0 g daily for maintaining remission in patients with ulcerative colitis. SETTING: Public hospitals and private practices in Germany, Austria and Switzerland. PATIENTS: A total of 162 patients with ulcerative colitis in remission. RESULTS: According to intention-to-treat analysis, the failure rates of the different treatment groups were not significantly different (36, 49 and 24% for 0.5, 1.25 and 2.0 g olsalazine daily and 32% for 2.0 g sulphasalazine daily). Olsalazine and sulphasalazine showed a tendency towards lower failure rates in extended (28%) than in distal disease (44%). The withdrawal rate due to adverse effects was 4%, the most frequent single event being diarrhoea (2.5, 5.2 and 11.7% for 0.5, 1.25 and 2.0 g olsalazine daily and 0% for sulphasalazine daily). CONCLUSION: This study found no significant differences between the therapeutic efficacy or safety of 0.5-2.0 g olsalazine daily. Because of its sulpha-free formulation olsalazine may, however, be preferred to sulphasalazine.

[Effect of pirenzepine on motility of Oddi's sphincter]. / Der Einfluss von Pirenzepin auf die Motilität des Sphincter Oddi.

Pirenzepine (Gastrozepin) has a proven positive effect in the treatment of peptic ulcers by blocking the so called muscarinic acetylcholine receptors of the gastric glands. Reports of positive results with pirenzepine in the treatment of acute pancreatitis led to new discussions about its biological effects. It is thought that there are three ways by which pirenzepine acts in the pancreas. It decreases enzymatic secretion and it increases the secretion of sodium bicarbonate and water. Furthermore, it is said to have a spasmolytic effect on the sphincter of Oddi. To prove this spasmolytic effect we performed endoscopic manometry at the sphincter of Oddi with intubation of the pancreatic duct in 12 healthy patients. After two minutes of manometric registration of the normal sphincter activity 6 patients received 10 mg pirenzepine i.v. while a control group of 6 patients received 2 ml of 0.9% NaCl i.v. During the next 5 minutes the basal pressure of the sphincter, the amplitude of concentrations, as well as their frequency and duration were monitored. There were no changes noticed in the placebo group. However, pirenzepine caused a considerable decrease of the 4 manometric parameters of the sphincter of Oddi in all patients. Within 5 minutes the basal tonus fell from 14.3 +/- 5.1 mm of mercury to 9.0 +/- 6.0 (p less than 0.01). The frequency of contractions dropped from 5.8 +/- 2.7 per minute to 2.0 +/- 2.1 (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

[Treatment of mild to moderate reflux esophagitis with the H2-blocker famotidine]. / Die Behandlung der leichten bis mittelschweren Refluxösophagitis mit dem H2-Blocker Famotidin.

The efficacy of a single daily dose of 40 mg famotidine was compared with that of the same dose administered twice daily for 4 and 8 weeks respectively, in the treatment of reflux oesophagitis of varying severity (oesophagitis stage I to III). A total of 20 patients took part in the trial; the rate of total recovery was 50%. A significant improvement was recorded in a further 10% of the patients, and no change was observed in 30%. In 5% of cases, a deterioration was seen, that is to say that the treatment was discontinued for 1 patient due to adverse reactions. Following a 4 week course of treatment, the rate of recovery was markedly better in the patient group given 40 mg twice daily, compared to the group receiving 40 mg once daily. After 8 weeks, taking into account the fact that 5 patients were withdrawn from the study, there was no significant difference in the rate of recovery. H2-blocker therapy would thus seem to be, as published, a potentially conservative treatment of mild to moderate forms of reflux oesophagitis. Higher daily dosages initially give better results.

[Dysfunction of the sphincter of Oddi as a cause of so-called postcholecystectomy syndrome]. / Dysfunktion des Sphinkter Oddi als Ursache des sogenannten Postcholezystektomiesyndroms.

In up to 30% of cases of the so-called postcholecystectomy syndrome functional disturbances of the sphincter of Oddi are responsible for the clinical picture. These pathological changes in pressure and motility at the sphincter can be identified by means of endoscopic manometry. We found dysfunction of the sphincter of Oddi in 4 out of 10 patients with so-called postcholecystectomy syndrome. In 2 patients in whom the basal pressure was higher than 40 mmHg endoscopic papillotomy was performed, after which the patients remained symptom-free. In one case tachyoddi was diagnosed and in another case the proportion of retrograde sphincter contractions exceeded 50%. Endoscopic manometry at the sphincter of Oddi enables many of the as yet unclarified postcholecystectomy symptoms to be identified.

Haematopoiesis in a degenerating uterine leiomyoma.

We report the case of a 66-year-old woman who had a hysterectomy because of uterine tumour. Histological examination showed a leiomyoma with degenerative changes and extensive extramedullary haematopoiesis. There was no evidence of any haematological or systemic disease. Extramedullary haematopoiesis in patients without haematological disorders is very rare and has apparently never been described previously in association with a leiomyoma of the uterus.

Combined therapy with cisapride and cimetidine in severe reflux oesophagitis: a double blind controlled trial.

Combined treatment with cimetidine 1 g daily and cisapride 40 mg daily in patients with endoscopically diagnosed severe reflux oesophagitis was compared with single drug therapy (cimetidine and placebo). At the end of the six to 12 weeks treatment, 11 (46%) of the 24 patients under single drug therapy were endoscopically healed and three were improved. In contrast, 16 (70%) of the 23 patients under combined therapy were healed and all of the remainder were improved (p = 0.025). The severity of diurnal and nocturnal heartburn, decreased significantly more (p less than 0.05) on cimetidine + cisapride than on cimetidine + placebo. The combined treatment was well tolerated. These results suggest that combined therapy with cisapride and cimetidine may be useful in patients with severe reflux oesophagitis.

[Pyogenic liver abscess. Successful percutaneous ultrasound-controlled drainage]. / Pyogener Leberabszess. Erfolgreiche ultraschallgeleitete perkutane Drainage.

Successful percutaneous drainage of a solitary pyogenic liver abscess guided by ultrasound is the subject of a case report. The technique of catheter insertion and the follow-up are described in detail. The selection criteria for this procedure are discussed.

[3-year long-term therapy of recurrent duodenal ulcer with 400 mg cimetidine nocte]. / Dreijährige Langzeittherapie des rezidivierenden Ulcus duodeni mit 400 mg Cimetidin nocte.

253 patients were treated for 3 years with 400 mg cimetidine at night to prevent relapses of recently healed duodenal ulcers. The efficacy of maintenance treatment was evaluated on a life table basis. In contrast to previous studies not the first but the third symptomatic relapse was taken as the major criterium of treatment failure, an assumption, that better represents the everyday practical situation. Further endpoints for the life table calculation were: the wish of the patient to stop treatment after the first or second recurrence, the failure of a first or second recurrence to heal within 12 weeks and side effects. At 1, 2 and 3 years 5 +/- 2.4%, 16 +/- 4.6% and 20 +/- 5.2% respectively had to be considered as treatment failures. 4 patients presented with a bleeding relapse, none of which necessitated emergency operation. There were no irreversible side effects. This study demonstrates that treatment of recurrent duodenal ulcers with 400 mg cimetidine at night for 3 years is safe and improves considerably the quality of life of the majority of patients. The authors suggest that drug maintenance treatment should be offered before surgery is recommended.

Nizatidine versus ranitidine in the prevention of duodenal ulcer relapse. Six-month interim results of a European multicentre study.

Nizatidine, a new H2-receptor antagonist, was compared with ranitidine in a double-blind, randomized, multicentre trial for the prevention of duodenal ulcer relapse. This is the interim analysis of 197 patients admitted to the study by 1 September 1985, having finished a 6-month treatment period by 1 March 1986. At night, 96 and 101 patients received 150 mg nizatidine and 150 mg ranitidine, respectively. Both groups were well matched for demographic data, duration and severity of ulcer disease. Calculating cumulative relapse rates by the life-table method of Cutler and Ederer, 18% on nizatidine and 13% on ranitidine had experienced a symptomatic or asymptomatic recurrence. The difference is not statistically significant. The symptomatic response was identical in both groups, 3/4 of the patients in both groups being free of any symptom over all 6 months. During maintenance treatment, 24% of the patients on nizatidine and 32% of those on ranitidine reported new symptoms, listed as 'adverse events'. However, none of these events was likely to be drug related. There was no difference between the two groups concerning the percentage change of laboratory variables from baseline to endpoint.

[Results following endoscopic paravasal long-term sclerosing of esophageal varices]. / Ergebnisse nach endoskopischer paravasaler Langzeitsklerosierung von Osophagusvarizen.

Our experiences confirm that with endoscopical paravasal longterm sclerosing of esophageal varices the incidence of recidive bleeding can be clearly reduced and the probability of survival of the patients treated with this method can be improved. Recidive bleeding occurred in 38% of those patients treated with longterm sclerosing, in a conservatively treated group, on the other hand, in 61% of the cases. At the end of the observation period (January 1980 to December 1984) two thirds of the patients treated with sclerosing remained alive, in the control group, however, only one half of 71 patients survived. This favourable result can be attributed to reduced mortality because of bleeding, since the mortality of coma hepaticum and of other rare causes of death is nearly equal in both groups of patients.

[Tuberculous colitis--Crohn disease--a clinico-radiologic-endoscopic approach]. / Colitis tuberculosa--M. Crohn--Eine klinisch-radiologisch-endoskopische Aufgabe.

The authors report on a case of multifocal stenosing tuberculosis of the stomach, pointing out the difficulties in differential diagnosis especially against Crohn's disease. The importance of x-ray examination is discussed.

[The effect of pirenzepine on lipase levels after endoscopic retrograde cholangio-pancreaticography]. / Einfluss von Pirenzepin auf die Lipase-Spiegel nach endoskopisch-retrograder Cholangio-Pankreatikographie.

In a random examination including 40 patients with previous endoscopic retrograde cholangio- pancreaticography (ERCP) the influence of pirenzepine on the lipase elevation through filling of the pancreatic duct with a contrast medium was studied. The result of this study is that, compared with a control group, pirenzepine reduces significantly ERCP-caused hyperlipasemias. Therefore we can recommend the prophylactic application of pirenzepine before ERCP.

[Electrophysiologic findings in lacunar infarcts]. / Elektrophysiologische Befunde bei lakunären Infarkten.

Lacunar lesions are small infarctions in the territory of small penetrating arteries of the brain. Because of their small size these lesions can only in part be detected by CT. Clinical symptoms do not always correspond with the lesions visible in the CT. We studied the somatosensory evoked potentials (SEP), the visual evoked potentials (VEP) and the electrically elicited blink reflex in 50 patients with lacunes to determine if there are any other lesions which are not detectable by clinical examination or CT alone. While VEP and the blink reflex showed pathological results in only a few of these patients the SEP were pathological in about 75%. The multiplicity of the lesions may be documented by means of these investigations.

[Therapy of duodenal ulcer and pyloric ulcer with 800 mg cimetidine nightly]. / Therapie des Ulcus duodeni und Ulcus ad pylorum mit Cimetidin 800 mg nocte.

The efficacy of cimetidine 400 mg b.i.d. as compared with a single evening dose 800 mg was evaluated in a single-blind multicentre trial involving 86 patients with endoscopically proven duodenal or pyloric ulcer. After four weeks of treatment the healing rates were 64.4% (29/45) with 400 mg cimetidine twice daily and 78% (32/41) with 800 mg nocte; after eight weeks the corresponding rates were 77.7% (35/45) and 85.3% (35/41). Administration of 800 mg cimetidine every evening is, consequently, at least as effective as a twice-daily regimen. In the second half of the treatment period it was significantly more effective in reducing pain and antacid consumption. The single noctural dose takes the pathogenetic importance of overnight gastric acidity into consideration, entails a simplification of therapy and may improve patient compliance. It should, therefore, take preference over the conventional twice-daily regimen.

The value of colonoscopy and ultrasonography in the diagnosis of chronic intussusception in childhood.

Ultrasonography and colonoscopy were diagnostic for chronic intussusception in a 6-year-old girl. After an episode of acute gastroenteritis the child developed non-specific recurrent abdominal symptoms, which were considered to be functional. While the ultrasonographic pattern alone was too unspecific to establish the correct diagnosis, the colonoscopic findings were diagnostic of intussusception. This case report demonstrates that ultrasonography and colonoscopy are complementary, radiation-independent but reliable diagnostic procedures for detecting organic bowel disorders in children presenting with recurrent abdominal symptoms.

[Endoscopic palliative drainage of the bile ducts]. / Endoskopische palliative Gallengangsdrainage.

Initial results of palliative endoscopic retrograde drainage of the common bile duct are reported. In 12 out of 19 patients the treatment was successful (63% cases). In every case the serum bilirubin level quickly decreased to normal values. The life span of the endoprostheses lasted on average for 3 months. No fatal complications occurred in connexion with prosthesis implantation. Endoscopic drainage of the common bile duct in patients with an inoperable tumour of the biliary tract represents an alternative procedure to palliative surgery in the management of malignant occlusion icterus.