[Ultrasonic diagnosis of liver diseases]. / Ul'trazvukovaia diagnostika zabolevanii pecheni.

Sonography has become widely used in the diagnosis of liver diseases. Fatty infiltration of the liver (adiposis hepatica), hepatic cirrhosis, cysts, metastases and tumors can be reliably diagnosed. A valid differentiation between benign and malignant new growths, however, can only be obtained by cytologic and histologic techniques. The lowest sensitivity can be expected in chronical benign diffuse diseases. Our results were compared with those in literature. Furthermore, other diagnostic approaches and procedures, e.g. fine needle biopsy and sclerotherapy in cysts, are recorded.

Encapsulation of liver microsomes--a further procedure for detoxication.

Due to their partial permeability and their good mechanical properties, the symplex capsules are technically suited for an application in extracorporal detoxification. By this newly developed procedure the activity of encapsulated enzymes is considerably increased; thus, application for extracorporal detoxification seems to be advisable.

[An improved method for the microencapsulation of liver microsomes for use in extracorporeal detoxication]. / Ein verbessertes Verfahren für die Mikroverkapselung von Lebermikrosomen zur Anwendung in der extrakorporalen Detoxikation.

Rat liver microsomes were microencapsulated in a pure aqueous medium by means of a new technique. The wall of the microcapsules consists of a semipermeable simplex membrane which is stabilized mainly by electrostatic interactions between a polymeric polyanion (sodium cellulose sulphate) and a polymeric polycation (polydimethyldiallylammonium chloride). The metabolic as well as the mechanic parameters of the microcapsules could be markedly improved by separating the metabolic (liver microsomes) from the membrane component (sodium cellulose sulphate) in such a way that two distinct compartments are formed during the preparation of the microcapsules.

[Ultrasound-controlled percutaneous puncture of pancreatic pseudocysts]. / Ultraschallgeleitete perkutane Punktion von Pankreaspseudozysten.

The puncture of pancreatic pseudocysts with the help of ultrasound is an attempt of treatment without putting too much strain on the patient. In a number of cases a definitive emptying of cysts is successful so that a surgical intervention with application of an interior drainage can be avoided. Of 4 male patients of medium age treated 2 were successfully to be treated. The casuistics of one of the patients is reported. Under the point of view that a sonographically assisted intervention increases the security of the puncture therapy the complex of problems is outlined.

[Gastroesophageal reflux--cause of hemorrhaging esophageal varices?]. / Gastroösophagealer Reflux--Ursache der Osophagusvarizenblutung?

The results of the examinations do not depend on the peptic theory of the haemorrhage of the oesophageal varices in patients with liver cirrhosis, since the relative frequency of reflux troubles and of gastrooesophageal reflux in patients with liver cirrhosis and haemorrhage of the oesophageal varices was not found greater than in patients with liver cirrhosis and oesophageal varices without haemorrhage as well as the combination of reflux oesophagitis and oesophageal varices was rarely to be observed in the endoscopic material.

Levamisole therapy in chronic hepatitis--results of a multicentric double blind trial.

The effectiveness of levamisole in the immunmodulatory treatment of chronic hepatitis was assessed in a multicentric double blind trial. Twenty patients received in the first week 50 mg, in the second 100 mg and thereafter 150 mg, levamisole on two days every week for 6 months, 20 others received a placebo. Five patients dropped out (non-compliance 1, pregnancy 1, adverse effects 3). The diagnoses were confirmed by clinical, biochemical immunological and histological data. After 6 months 26 subjects allowed us to take a control liver biopsy. The results showed that the rate of improved, unchanged and impaired cases was not significantly different in the levamisole and placebo groups. No correlation was found between etiology, activity or histological type of chronic hepatitis, skin test reactivity (DNCB, PPD, Streptokinase) and therapeutic effect, respectively. Clinical improvement was not associated with the elimination of HBs antigen. In general levamisole was well tolerated, but we saw one case of severe agranulocytosis.

[A new procedure for the revision and reposition of functionless peritoneal dialysis catheters]. / Ein neues Verfahren zur Revision und Reposition funktionsloser Peritonealdialysekatheter.

The most important requirement for satisfactory transperitoneal dialysis is faultless functioning of the Tenckhoff catheter. Suddenly occurring functional disturbances are often caused by wrong positioning and by envelopment of the catheter by tissue, which require surgical correction. A technique for successfully locating and replacing a transperitoneal catheter by means of an operation laparoscope is described.

[Behaviour of ujoviridin exposure test (ICG) in conjunction with application of hormonal contraceptives (author's transl)]. / Das Verhalten des Ujoviridin-(ICG)-Belastungstests unter der Applikation hormonaler Kontrazeptiva.

The effects of Ovosiston, Non-Ovlon, Anacyclin, Eugynon, and Deposiston, all oral hormonal contraceptives, on 75 women in fertile age and on the half-life of Ujoviridin (ICG - indocyanine green) were studied prior to treatment as well as late in the second, sixth, and twelfth cycles of treatment. ICG half-life was found to be extended in the adaptation phase only in response to Deposiston. ICG is recommended for time-related diagnosis of liver changes in women on hormonal contraceptives.

The analysis of stain loading tests for the assessment of the liver function.

Stain loading curves are analysed by discriminant analysis. In this multivariate statistical method, the stain concentrations measured in the blood at defined intervals after injection are regarded as measurement vectors.

Consumptive coagulopathy during the Bromsulphalein test--indocyanine green as an alternative.

Liver function tests involving the use of Bromsulphalein can lead to hemolysis and consequent DIC. Latent forms can be detected by means of fibrinolytic degradation products and reduction in the number of leukocytes containing acid mucopolysaccharides of the heparin type, together with an increase in the total leukocyte count as a sign of stress. In comparisons between the bromsulphalein and indocyanine green tests, these parameters have sho4n that liver function tests using indocyanine green are harmless.

Studies on liver function under the influence of oral contraceptives.

The effects of two sequential therapies using mestranol as an estrogen and chlormadinone acetate and norethisterone acetate, respectively, as a gestagen on the aminotransferase (GOT and GPT), alkaline phosphatase and alpha-amylase activities, the cholesterol, total bilirubin and total protein contents and the indocyanine green (Ujoviridin, VEB Chemiekombinat Bitterfeld) half-life were studied in two groups, each comprising 12 women of fertile age. The serum protein was separated by paper electrophoresis and both the thymol turbidity and zinc sulphate tests were performed during the first treatment cycle. An estrogen-induced rise in alanine aminotransferase (GPT) activity from 6.31 U/liter to 12.14 U/liter was observed during application of the mestranol/chlormadinone acetate therapy. The value dropped to 5.34 U/liter when chlormadinone acetate was administered as a gestagen in addition to the estrogen. No significant changes were noted in the other biochemical parameters. Sequential therapy involving application of mestranol and norethisterone acetate produced only statistically secured rises in the alpha 1-globulin content and the GPT activity. All other changes in the different parameters remained within the normal range and were statistically insignificant.

[Liver function studies under the influence of hormonal contraceptives (sequential preparations)]. / Leberfunktionsuntersuchungen unter dem Einfluss hormonaler Kontrazeptiva (Sequenzpräparate).

20 fertile women who were treated with mestranol as oestrogen and both gestagenes chlormadinonacetate and norethisteronacetate were investigated. Alkaline phosphatase, ASAT, ALAT, alpha-amylase, cholesterol, bilirubin, serumproteins, indocyanine green half time, paper electrophoresis of serumproteins, thymol and zinc sulfate turbidity tests were examined during the first therapy cycle. Elevation of ALAT activity (6,3 I U/l to 12,14 u/l) was found during treatment with mestranol/chlormadinonacetate. A depression of ALAT (up to 5,34 u/l) was observed under additional therapy with gestagene chlormadinonacetate. Statistical significance was noted only for ALAT and alpha 1 globuline under sequential therapy with mestranol/norethisteronacetate.

PIP: 2 different sequence preparations were administered to 2 groups of 20 women, 17-41 years of age. Several biochemical parameters, including Ujoviridin ICG tests, were taken 2 days before o.c. use, on the day that the gestagen component was begun, and on the final day of sequential preparation use. In the group takine .08 mg mestranol and 2 mg chlormadinon acetate, a significant increase of the GPT values was observed during the first phase of the sequential preparation. After the gestagen component was introduced, the GPT fell significantly to below initial levels. In the group taking .08 mg mestranol and 1 mg norethisterone acetate, significant increases in the chi-one-globulin levels and the GPT were observed during the first phase of treatment. All other values remained within normal levels, and no significant difference was found between the results obtained from the 2 preparations.

Studies on liver functions under the effect of sequence drugs.

PIP: The effects of sequential therapy (mestranol alone, and combined with norethisteron acetate and chlormadinon acetate) on liver functions were studied in 2 groups of healthy females (16-32 years of age): the first group consisted of 15 subjects who were given 0.08 mg/day mestranol from the 5th to the 24th day of the cycle and 1 mg/day norethisterone acetate from the 15th to the 24th day of the cycle; the second group of 15 subjects were given 0.08 mg per day mestranol from the 5th to the 24th day of the cycle and 2 mg/day chlormadinon acetate from the 15th to the 24th day of the cycle. Blood samples were collected and Ujoviridine tests (indocyanine green tests) were done 3 times under standarized conditions in both groups during the 1st treatment cycle. Comparison of the 2 forms of sequential treatment using simple variance analysis showed no significant differences between the 2 gestagen phases (norethisteron acetate and chlormadinon acetate) or between the alkaline phosphatase and aminotransferases (the values for these 2 parameters however dropped after norethisterone acetate and rose after chlormadinon acetate). This was attributed to the observation that the 10-day estrogen phase followed by an estrogen-gestagen phase of identical length closely approximate the physiological cycle. The enzymatic results and the ICG half-life indicate that both sequential treatments have no serious toxic effects on the liver functions of healthy fertile women.^ieng

[Liver function studies under the effect of 4 sequential hormonal contraceptives]. / Leberfunktionsuntersuchungen unter dem Einfluss von 4 Sequenzpräparaten zur hormonalen Kontrazeption.

During the first cycle of treatment the influence of four forms of sequence therapy with mestranol and ethinyl estradiol as estrogen and the two gestagens chlormadinone acetate and norethisteron acetate in women at fertile age was examined for the aminotransferases (GOT and GPT), the activity of alkaline phosphatase and alpha-amylase, for the cholesterol, total bilirubin and total protein content of the serum and for the half-life period of indocyanine green. Under the application of mestranol/chlormadinon acetate an estrogen-induced increase of the activity of the alanine aminotransferase (GPT) from 6.38 units/l to 12.14 units/l may be established, after addition of the gestagen chlormadinon acetate a decrease to 5.34 units/l was to be established. Under the sequence therapy with mestranol/norethisteron acetate only an increase of the alpha1-globulin proportion was to be ascertained. All the other changes of the tested parameters including the half-life period of indocyanine green were not essential.

[Assessment of liver function using indocyanine green (Ujoviridin) during normal pregnancy, during labor and in puerperium]. / Beurteilung der Leberfunktion mit Indocyaningün (Ujoviridin) während der normalen Schwangerschaft, unter der Geburt und im Wochenbett.

Indocyaningreen (ICG) was given for the characterize of the excretion function of the liver during the course of normal pregnancy, sub partu and post partum. Studies were performed in 168 primi- and multigravidas with normal medical and obstetric histories (mean age of 23,5 years). 0,5 mg ICG/kg body mass were injected intravenously as a bolus. 18 healthy nonpregnant women served as controls (mean age of 24,2 years). In the I. and II. trimester of pregnancy the elimination of ICG was not decreased in comparison to the controls (3,64 +/- 0,86). The increased retention of ICG in the 40th week of pregnancy (4,67 +/- 0,41) and during labor (7,02 +/- 2,32) are caused through the physiological alterations of pregnancy. No placental transfer of the dye could be detected by simultaneous measurement of ICG in the maternal and fetal cord blood. During the post partum period the elimination of ICG will be normal. ICG is recommend instead of Bromsulfaleine (BSP) for the estimation of excretion function of the liver during pregnancy and childbed.

[Behavior of heparinocytes and fibrinolytic degradation products under sulfobromophthalein or indocyanine green in patients with liver diseases or persons with healthy liver]. / Verhalten des Heparinozyten und der fibrinolytischen Spaltprodukte unter Bromsulfalein oder undozyaningrün bei leberkranken und lebergesunden Patienten

Due to a slight haemooysis after the application of bromsulphalein an intravasal coagulation with reduction of the number of heparinocytes and an increase of fibrinolytic split products develops. These changes are to be observed in the vast majority of tests, also in such cases where no clinical signs of an incompatibility appear. Indocyanine-green does not cause these severe disturbances of coagulation. Slight changes are traced back to the examination technique. Patients with chronic liver disease already show increased values of fibrinolytic split products. In increased initial values of fibrinolytic split products bromsulphalein does not cause a further increase.

[Correlations between chronic liver diseases and periodontal diseases with special reference to animal experiments]. / Korrclationen zwischen chronischen Hepatopathien und Parodontopathien unter besonderer Berücksichtigung tierexperimenteller Untersuchungen

The purpose of the present paper was to investigate possible relationships between chronic liver diseases and marginal periodontal diseases, using clinical and radiographic methods as well as animal experiments. The periodontal conditions of 100 patients with histologically confirmed chronic hepatopathies were compared with those in a control group of same size. The results of these studies testify unequivocally to unfavourable conditions in the group of hepatopaths. This finding is corroborated and complemented by subsequent animal experiments. The difference in the extent and intensity of the periodontal alterations between a group of Wistar rats with experimentally induced hepatopathies and a control group was statistically significant. These results permit the conclusion that an aetiologic relation between chronic hepatopathies and marginal periodontal diseases may be assumed.

[Liver function tests under the influence of sequential treatment using ethinyl estradiol-norethisterone acetate and ethinyl estradiol-chlormadinone acetate]. / Leberfunktionsuntersuchungen unter dem Einfluss von Sequentialtherapien mit Athinylöstradiol-Noräthisteronazetat und Athinylöstradiol-Chlormadinonazetat

30 young healthy women were investigated during the first therapy cycle with ethinyl-estradiol-norethisterone acetate and ethinyl-estradiol-chlormadinone acetate as a sequential regime. The following laboratory data were achieved by each of the investigated group of young women: serum aminotransferase (GOT and GPT), serum alkaline phosphatase and alpha-amylase-activity in serum, serum proteins, serum cholesterol, serum bilirubin, serum ZST, serum TTT and the indocyaningreen-clearance of the liver. The serum protein pattern was determined by the paper electrophoretic method. A significant decrease of the aminotransferase GPT was viable during the sequential therapy with ethinyl-estradiol and norethisterone acetate. This viable decrease of the GPT was induced through the application of norethisterone acetate to estrogen. The alkaline phosphatase was significant lightly lower and the beta-globuline lightly elevated at the end of the therapy cycle. The sequential therapy with ethinyl-estradiol and chlormadinone acetate induced only a significant increase of the ZST in serum.

PIP: Sequential therapy to regulate menstruation was administered to 30 women to determine if liver functions are disturbed by contraceptive use. 15 women aged 16-22, used a sequential preparation consisting of ethinyl estradiol and norethisterone acetate. These patients showed significant decreases in aminotransferase GPT and alkaline phosphatase in the last (gestagen) stage of treatment, and slight increases in alpha-amylase and beta-globulin throughout the therapy. In the 15 women aged 17-34 who used ethinyl estradiol and chlormadinone acetate, the ZST showed a significant increase during the therapy. No significant changes in the liver function could be shown by these tests. These preparations are recommended for treatment of disturbances of menstrual cycles; tests of liver functions during treatment are unnecessary. The length of the estrogen and estrogen-gestagen phases of the treatment should be equal to prevent hormonal imbalance.