[Exocrine pancreatic function and gastric mucosa and duodenal mucosa in patients with chronic kidney failure]. / Czynnosc zewnatrzwydzielnicza trzustki i blony sluzowej zoladka i dwunastnicy u chorych na przewlekla niewydolnosc nerek.

Uraemic pancreatopathy is frequently observed in patients with chronic renal failure. The aim of the study was to assess some parameters of exocrine pancreatic function in uraemic patients maintained on intermittent haemodialyses. Elevated serum amylase activity was found in these patients. The most significant finding was the low bicarbonate output in duodenal content after secretin-cerulein stimuli, comparable with that obtained in patients with chronic pancreatitis. It indicates pancreatic exocrine defect in uraemic patients. A fall in protein output and lower amylase activity in duodenal content was also observed in haemodialyzed patients after stimulation. Low basal acid output (BAO) and enhanced maximal (MAO) and peak (PAO) acid outputs were found in uraemic patients after pentagastrin stimulation. Gastritis and duodenitis were frequently diagnosed in endoscopic and histopathological examinations in these patients. In patients with chronic renal failure even without clinical signs of pancreatic, laboratory findings of exocrine pancreatic abnormalities are reported. It may be the cause of uraemic pancreatopathy.

Gastric and pancreatic functions in haemodialyzed patients.

The aim of this work was to assess gastric acid secretion in relation to morphological and histological changes in the gastric mucosa as well as prevalence of Helicobacter pylori in chronically haemodialyzed uraemic patients. Exocrine pancreatic functions after secretin-cerulein test were also studied. In haemodialyzed patients low basal gastric acid output was found, whereas peak output after pentagastrin stimulation did not differ significantly when compared to controls. Endoscopy of gastric and duodenal mucosa revealed inflammatory changes in the majority of patients, described histologically as chronic gastritis with duodenitis. Helicobacter pylori antigen was detected in the serum of 45% of uraemic patients. Serum amylase activity was elevated in haemodialyzed patients relative to controls. Although clinically asymptomatic, haemodialyzed patients exhibited various degrees of gastrointestinal mucosal abnormalities and impairment in exocrine pancreatic functions, mainly low stimulated bicarbonate and protein output as well as low electrolyte concentrations in duodenal content.

[A case of esophageal pemphigus]. / Przypadek pecherzycy przelyku.

A case of oesophageal pemphigus was observed in a man aged 76. Attention is called to the rarity of this disease and resulting diagnostic difficulties.

[Misoprostol and de-nol in the treatment of patients with cimetidine-resistant stomach ulcer]. / Mizoprostol i de-nol w leczeniu chorych z wrzodem zoladka opornym na stosowanie cymetydyny.

Both misoprostol (synthetic PGE1 analog) and De-Nol (factor releasing endogenous prostaglandins in the gastric mucosa) can be useful in the treatment of patients with gastric ulcer resistant to cimetidine according to their gastroprotective properties. 64 patients whose gastric ulcer had not healed after 6 weeks of therapy with cimetidine in daily dose of 1000 mg were treated in a comparative short-term trial to assess the relative efficacy of misoprostol (Cytotec; Searle) in daily dose of 800 micrograms (I group; n = 32) and colloidal bismuth subcitrate (De-Nol; Gist-Brocades), four times a day in dose of 5 ml diluted with 15 ml of water (II group; n = 32). Both groups of patients were comparable according to age, sex, duration of ulcer disease, smoking habits, gastric acid secretion, ulcer size and localization in the stomach. The ulcer healing was controlled endoscopically after 2 and 4 weeks of the treatment. Healing rates after 2 weeks of therapy appeared to be 47% for misoprostol and 34% for De-Nol. After 4 weeks of therapy the healing rates were 72% with misoprostol and 63% with De-Nol. No statistically significant differences in the therapeutic efficacy were observed between two groups of the patients. No correlation was found between the ulcer healing rates and size of ulcer, its localization or smoking habits. The moderate side effects (transient diarrhea) were observed in 22% of patients treated with misoprostol. These findings suggest that misoprostol is as effective as De-Nol in the treatment of gastric ulcers resistant to cimetidine.