[Chronic disseminated histiocytosis X. A case with unusual liver involvement]. / Chronische disseminierte Histiocytosis X. Ein Fall mit ungewöhnlicher Leberbeteiligung.

A chronic disseminated histiocytosis X of a 37-year-old patient is reported on. Besides the classical Hand-Schüller-Christian-trias the involvement of central parts of the liver with jaundice and cholangitis was predominant.

[Cimetidine and ethanol]. / Cimetidin und Ethanol.

Cimetidine inhibits hepatic drug metabolism, but its effect on ethanol elimination is less well established. The influence of cimetidine on the kinetics of ethanol is studied with three standardized drinking experiments. Cimetidine had no influence on the absorption or elimination of ethanol. There were significant differences in distribution of ethanol in consequence of inhibition of vascular histamine receptors after cimetidine application.

[Treatment of cholecystolithiasis from the internal medicine viewpoint]. / Therapie der Cholezystolithiasis aus internistischer Sicht.

There is no better treatment method for the cholecystolithiasis accompanied by symptoms than the cholecystectomy. In the so-called mute gall an expecting attitude is justified. During the last years for selected patients with gallstones and calculi in the common bile duct, respectively, non-surgical therapeutic methods were developed. So it is possible for carriers of gallstones with slight to moderate complaints to undergo a medicamentous trial of litholysis with chenodesoxycholic acid or ursodesoxycholic acid or above all with a combination of these two bile acids. X-ray-negative calculi of less than 1.5 cm with a functioning gallbladder are the prerequisite. The extracorporeal stoss-wave lithotripsy is a new interesting method as well as the percutaneous or retrograde instillation of methyl-butyl ether. In these cases we are at the beginning, the international development should be pursued with attention. In calculi of the bile duct apart from operative methods the papillotomy and the extraction of calculi more than stood the test. The stoss-wave lithotripsy in calculi of the bile duct, which are to be removed neither by instillation of solvents nor endoscopically is a way out of the difficulty in contrast to the operation. As it is evident from the demonstrated facts the cholecystectomy, as the Swiss surgeon Rewbridge remarked already over 50 years ago, is really not the last answer to the problems of the cholelithiasis. Today it is the point to use the method best suited for the patient.

[Vascular anomalies of the gastrointestinal tract--an unusual case of multiple intra-abdominal hemangiomas]. / Gefässanomalien des Gastrointestinaltraktes--ein ungewöhnlicher Fall multipler intraabdomineller Hämangiome.

A case of multiple abdominal haemangiomas (mesentery, intestine, liver) in a 19 year-old patient is described. The anomalies, at first incidentally found during appendectomy, were confirmed by angiographies and vascular surgery. Ascites and bleeding esophageal varices developed in further course. A short review of literature and classifications is given.

[Pregnancy, oral hormonal contraception and lipid bile composition]. / Schwangerschaft, orale hormonale Kontrazeption und Gallenlipidzusammensetzung.

PIP: 67 pregnant women; 46 women using oral hormonal contraceptives; and a control group of 44 women were studied to determine the effect of pregnancy and oral hormonal contraceptive use on the lipid bile composition. The bile specimens were obtained with a duodenal probe and chemically analyzed for bile acid, phospholipid, and cholesterol concentration. A relative cholesterol supersaturation of the bile is associated with pregnancy, especially during the last trimester. A drop in this relative cholesterol supersaturation was observed in 18 women who were examined 2 months postpartum. The bile more frequently showed cholesterol supersaturation among the women who used oral contraceptives than among the control group. A cholesterol supersaturation of the bile is a major factor in the formation of gallstones, so that an increase in the incidence of gallstone formation among women using oral hormonal contraceptives is anticipated.^ieng

[Immunopathological phenomenona in liver diseases]. / Immunpathologische Phlänomene bei Leberkrankheiten

More than 400 patients with acute and chronic liver diseases as well as non-hepatic diseases (control group) were examined for the existence of antibodies against mitochondria, smooth musculature and cytoblasts with the help of the immunofluorescence-serological method. The proof of the hepatitis-B antigen was carried out by means of the transmigration-electrophoresis. Auto-antibodytitres larger than 1 : 160 (limiting titres) could be established only in the chronically aggressive hepatitides and the chronically destructing non-purulent cholangitides. Whilst in the chronically destructing non-purulent cholangitides dominate high mitochondrial antibody-titres, in the chronically aggressive hepatitides the antibodies against smooth musculature and/or cytoblasts are dominating. When the hepatitis-B-antigen was present in all groups of diagnosis auto-antibody titres of 1 : 160 were not transgressed. The kind of the antibody-spectrum and the size of the antibody-titres seem to be suitable for the differential diagnosis. High mitochondrial antibody-titres in women are suspicious of a chronically destructing non-purulent cholangitis. High titres of antinuclear antibodies or such ones against smooth musculature might be a reference to the so-called auto-immune form of the chronically aggressive hepatitis. For a still better differentiation of the chronic liver diseases the determination of these antibodies seems to be valuable.