Microliths causing acute pancreatitis--a diagnostic gap.
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Biomedical subjects
Publications and source records attributed to A Eimiller.
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In a 49-year-old patient who was investigated because of abdominal complaints we found a polypoid tumor in duodenum near the papilla of Vater. The histological investigation after endoscopical polypectomy showed the rare case of a gangliocytic paraganglioma. After complete endoscopical removal no further intervention is necessary.
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The clinical value of ranitidine, 75 b. d. versus 175 mg b. d. in 48 patients with endoscopically proven duodenal ulcer was evaluated in a randomised double-blind study. In the two groups of patients there was no significant difference of ulcer healing. After 4 weeks of treatment in each group healing of 79% and after 6 weeks of 92% of the ulcers was observed. After 8 weeks the healing rate was 96% in patients who received 75 mg b. d. and 100% in those receiving 150 mg of ranitidine b. d. Smoking prolonged ulcer healing in both groups. Upon ulcer healing in 34 patients a ranitidine dosis of 75 mg nocte for prophylaxis of ulcer recurrence was compared with a 150 mg dosis nocte. Within 12 months in the two groups recurrence of duodenal ulcer was found by endoscopy in 21% and 20% of the patients. 7 out of 8 patients with ulcer recurrence were smokers. According to the results of these studies it appears that the recommended standard dosis of ranitidine for treatment of duodenal ulcer could be reduced by one half. To confirm our conclusions, further studies with a greater number of duodenal ulcer cases are necessary.
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1. Sexual differentiation of the metabolism of testosterone in liver slices of normally developed, sexually mature mice: Sexual differentiation in the mouse, unlike that in the rat, shows a high degree of uniformity: Where the formation of metabolites with the composition C19O2 is markedly greater in one sex, then this is invariably the male. The formation of C19O3 steroids and 4-androstene-3,17-dione, and the turnover of testosterone show no marked sexual differences, although the sum of the C19O2-type delta4-hydrogenation products of testosterone is significantly greater in the male. This apparent discrepancy is explained by the fact that the sum of the delta4-hydrogenation products represents no more than 10% of testosterone turnover. Thus, sexual differences in the formation of individual delta4-hydrogenation products are not apparent from a consideration of the overall turnover of testosterone. 2. Sexual differentiation of testosterone metabolism studied in genetically male litter mates, carrying the X-chromosome-bound mutation and showing testicular feminization (Tfm): The Tfm mutation (genotype XTfm Blo/Y; Blo = coat colour gene Blotchy) results in a feminization of testosterone metabolism. Where the level of testosterone metabolites is significantly higher in the normal male than in the normal female, the Tfm mutation shows a level that is significantly lower than in the normal male, and which, in most cases, is the same as that in the normal female. The concentration of three metabolites (3alpha- and 3beta-hydroxy-5beta-androstan-17-one, and 5beta-androstane-3,17-dione), which do not show sex-based differences, were significantly increased in the Tfm mutation. The Tfm mutation therefore effects the formation of all ring A hydrogenation products of type C19O2 (with the single exception of 5bets-androstane-3alpha,17beta-diol). It does more than simply equalize sexual differences by feminization. It has no effect on the hydroxylation of testosterone, or on its 17beta-dehydrogenation to 4-androstene-3,17-dione. The consequences of the Tfm mutation for the liver are irreversible: The formation of 5alpha-androstane-3,17-dione, which is a representative parameter for the sexual differentiation of testosterone metabolism, is not influenced by the injection of testosterone (15 mg i.p. 6 days before investigation).
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