[What is accomplished by sonographic studies of the kidneys?]. / Was leistet die Sonographie der Nieren?

Sonography of the kidneys can be regarded not only as supplementary examination to intravenous pyelograms but as first step investigation for evaluation of hypertension, micro-hematuria and other acute processes. Since no contrast medium and no ionizing radiation is used it can be applied to pregnant women and also in cases of acute renal failure. Together with needle biopsy its diagnostic value is immense and it can be repeated as often as wanted even as a bed-side method. Therefore it can be used routinely for follow-ups.

Influence of an antiarrhythmic premedication on the development of premature ventricular contractions during fiberoptic gastroduodenoscopy.

Heart rate, blood pressure and ECG changes during fiberoptic gastroscopy were examined in 128 patients, 60 of whom had been orally premedicated with Mexiletine. 55% of the non-premedicated patients developed occasional, and 22% of this group developed accumulated or frequent, premature ventricular contractions. In the patient group with antiarrhythmic premedication, the respective figures were 25% and 8%, and in this group patients with a normal ECG developed premature ventricular contractions less frequently than patients with pathological changes in the ST segment. The antiarrhythmic premedication had no influence on pulse or blood pressure.

[Clinical evaluation of serum bile acids as a new liver function test (author's transl)]. / Die klinische Bewertung der Serumgallensäuren als neuer Leberfunktionstest.

In a randomized patient material, with various histologically verified hepatobiliary diseases, the serum levels of Cholyl glycine (CG) and Sulfolithocholyl glycine (SLCG) were compared with each other. SLCG levels are a more sensitive parameter and permit a more significant differentiation between fatty and normal livers and between cases with and without portal hypertension in liver cirrhosis. There were poor correlations between the hitherto routinely performed laboratory tests and the SLCG levels, but good correlations between SLCG and defined parenchymal liver diseases. the publication ends with the presentation of a newly developed SLCG-stimulation test, which provides a staging of parenchymal liver diseases without unnecessary requirements of time and material and with minimal stress to the patients.

[On hepatitis in dialysis patients and personnel (author's transl)]. / Zur Hepatitis bei Dialysepatienten und beim Dialysepersonal.

This publication presents data concerning the prevalence of virus hepatitis B in dialysis patients and the dialysis staff of the Medical University Clinic Graz and describes means of controlling this infectious disease.

[Virus hepatitis B in hemodialysis wards: ways of distribution and possibilities of their interruption (author's transl)]. / Virushepatitis B auf Dialysestationen: Verbreitungswege und Möglichkeiten für deren Unterbrechung.

An attempt was made to describe differentiated problems in connection with virus hepatitis B in hemodialysis wards in a form as brief and precise as possible and to present some suggestions as to the elimination of this insidious disease. A through consideration of the hepatitis question yielding to a well established and legally sanctioned prevention concept would not only be of great importance to hemodialysis patients and their family members and the dialyses personnel but it would also play a great role for the protection of the general population. Finally, a statement by Baruch Blumberg (Nobel Price winner in Medicine, 1976) should visualize the universal importance of the hepatitis question once more: "If we succeeded in bringing hepatitis B under control, this would bring about a reduction of the rate of chronic liver diseases and of primary liver carcinoma."

[Complications of acute pancreatitis (author's transl)]. / Komplikationen der akuten Pankreatitis.

On the basis of 35.392 necropsies, 270 cases of acute "tryptic" pancreatitis with severity degrees II and III, are compared with regards to frequency, sex- and age distribution, and etiology. The frequency of complications in our own cases, is compared with current literature. The average survival time was 13 days. With regard to the most favourable time for partial resection of the pancreas (-necrosis), the period during the 5th to 7th day of illness, is suggested. The most common cause of death was, shock and intoxication.

[Social profile and accompanying diseases in acute and chronic pancreatitis (author's transl)]. / Sozialprofil und Begleiterkrankungen der akuten and chronischen Pankreatitis.

200 patients with pancreatitis were examined for various concomitant and previous diseases, and socioeconomic factors, in a retrospective study. This pancreatitis group (PG) was compared with a control group (CG) of 250 patients. Most frequent amongst the etiological factors, were biliary diseases, especially a state after cholecystectomy. Second in rank, was chronic alcoholism. For women, the incidence was highest in the 7th decade; for men, there was a double peak in the 4th and 6th decade, respectively. The incidence was about equal for both sexes. The following factors were found to play no essential role in the PG: type of profession, cigarette consumption, gastric and/or duodenal ulcers, partial gastric resection, renal and cardiac insufficiency, viral hepatitis, liver cirrhosis of hypertriglyceridemia. There is a significant accumulation of mumps in the history of the PG, which had gone along without any clinically detectable affection of the pancreas in childhood, in practically all cases.

[The influence of a beta-adrenolytic premedication on cardiovascular parameters and plasma free fatty acids during esophago-gastro-duodenoscopy (author's transl)]. / Uber den Einfluss einer beta-adrenolytischen Prämedikation auf Herz-Kreislaufparameter und freie Fettsäuren bei der Osophago-Gastro-Bulboskopie.

Three groups of patients with different premedications were examined for changes of blood pressure, heart rate, ECG and plasma free fatty acid levels during esophago-gastro-duodenoscopy: Group A was premedicated with Bunitrolol, group B was premedicated with Hyoscin-N-butyl-bromide and diazepam, group C was endoscopied without premedication. The pulse rate rose significantly less in group A than in groups A and C; the same phenomenon was observed with regard to the systolic blood pressure. Premature beats occurred in all 3 groups: 32 per cent of the patients in group A, 43 per cent in group B and 60 per cent in group C had at least occasional premature beats; an accumulation of premature beats however occurred significantly less frequently in group A than in groups B or C. A drop of the ST-part of the ECG occurred with about the same frequency in each group. An increase of the plasma free fatty acids, which was noted in groups B and C, could be observed in Group A. A pre-endoscopic medication of beta blocking agents could be a useful measure in patients with labile arterial hypertension, vegatative dysregulation and a hyperkinetic heart syndrome.

[Esophageal intramural pseudodiverticulosis (author's transl)]. / Die oesophageal intramurale Pseudodivertikulose.

Esophageal Intramural Pseudodiverticulosis (EIP) is a very rare disease, which may affect patients of all age. EIP is characterized by dilatation of the esophageal submucosal glandular elements. The characteristic radiographic appearance supported by endoscopy makes the diagnosis. Stenosis and motility disturbance caused by secondary chronic esophagitis due to EIP were found in most patients. The etiology of EIP is unknown.

[Early diagnosis of cancer of colorectal carcinoma by rectosigmoidoscopy (author's transl)]. / Die diagnostische und therapeutische Bedeutung der Rektosigmoidoskopie bei der Früherfassung des Rektum-Kolonkarzinoms.

The colorectal cancers in greater part grow out of polyps, which can be looked upon as optional precancerosis. Own results together with literature-reports show a distinct increase of the frequency of polyps beyond the age of fortyfive. The only digital palpation of the rectum is insufficient; it leads to the diagnosis of a rectum polyp only in 15.5%, to the diagnosis of a cancer in 13% of cases. With the rectosigmoidoscopy however the diagnosis is successful in 70% of cases. The percentage of precancerous polypous alterations detected by rectosigmoidoscopy is approximately the same in medical check-up as in directed examinations of patients with anorectal discomfort. A restriction of rectosigmoidoscopy to the last-named group of persons is not any longer justified. The polypectomy in the rectum is a real cancer-prevention.

[The clinical significance of radioimmunologically determined serum bile acids as a new liver function test and the development of a new intravenous sulfolithoglycocholic acid (SLGC) stimulation test]. / Die klinische Bedeutung radioimmunologisch bestimmter Serumgallensäuren als neuer Leberfunktionstest und die Entwicklung eines neuen intravenösen Sulfolithoglykocholsäure-(SLCG-) Stimulationstests.

Cholylglycin (CG-) and SLCG levels were measured in patients with various biopsy-confirmed liver and bile disease. SLCG values were found to be more sensitive, and to distinguish clearly between steatosis hepatis and normals, as well as between cirrhosis hepatis, with and without, portal hypertension. Correlations between the common liver tests and the SLCG levels were poor, but a clear distinction was possible between the various histologically defined liver diseases. The paper concludes with a description of a new method of stimulating the SLCG values, intravenously. Using this method, it is possible to keep consumption of material and time and incommodities inflicted to the patient, as low as possible. Nevertheless staging of parenchymatous liver diseases, is feasible.

[Examination of cardiovascular parameters and plasma free fatty acids during esophago-gastro-duodenoscopy (author's transl)]. / Untersuchungen von Herz-Kreislauf-Parametern und freien Fettsäuren bei dur Osophago-Gastro-Duodenoskopie.

53 patients were examined for changes of blood pressure, heart rate, ECG and plasma free fatty acids during esophago-gastro-duodenoscopy. In 23 cases there were premature contractions, occuring in small numbers only in most of the cases. Only in 5 cases there was an accumulation of premature contractions and in one case ventricular bigeminism occurred. The maximum of premature beats was observed when the primarily sitting patient was put into supine position. In 7 patients there was a lowering of the ST-segment in the ECG by at least 0.1 mV, mostly in patients who already had an abnormal ST-segment before endoscopy. The pulse rate went up by an average of 50.1 per cent, the systolic blood pressure by 14 and the diastolic blood pressure by 17 per cent. The increase of plasma free fatty acids in the total patient material was not statistically significant, but patients with a deterioration of ECG-findings endoscopy had a significantly higher increase of plasma free fatty acids. There was a tendency towards a positive correlation between the number of premature beats and the increase of plasma free fatty acids. It cannot be decided from our study whether the mobilization of free fatty acids is causing the above observed increase of premature beats or whether both phenomena are merely a result of sympathetic nervous stimulation. Gastric fiberoscopy may be applied to elderly patients with decreased cardiac function. The endoscopic procedure should not be started on the sitting patient but primarily in left supine position.

[Growth hormone determination in a combined adenohypophyseal stimulation test (author's transl)]. / Die Wachstumshormonbestimmung mit einem kombinierten Stimulationstest der Adenohypophyse.

The authors sought the simplest but still reliable method for evaluation of the functional reserve of the anterior lobe of the pituitary gland. The proposed test is stimulation of those various functions by injection of insulin, gonadotropin releasing hormone (LH-RH = GnRH) and thyrotropin releasing hormone (TRH). The test fulfils the clinical requirements. Furthermore it forms a valuable first step for the classification of more scientific problems.