Biomedical subjects
Publications and source records attributed to C Chalybäus.
We report on a 55 year old female patient suffering from weight loss. On endoscopy we found an Esophageal Intramural Pseudodiverticulosis (EIP) with Candidiasis. This case report wants to discuss this rare benign disease and its diagnostic and therapeutic approach.
The results of a study from 25 centers (= Series I: 1974-1980) covering 9041 endoscopic sphincterotomies (EST) were compared with those of a second study from 20 centers (= Series II: 1981-1986) covering 10177 cases. A change was seen in the indications during the past 5 years: While choledocholithiasis after cholecystectomy remained the main indication, EST is performed with increasing frequency in patients with common bile duct stones having their gallbladder in situ as a definitive method with low complications (only 0.61% emergency cholecystectomies): Circumscript papillary stenosis became quite a rare indication. The success rate of EST because of choledocholithiasis was not improved in spite of new techniques (stone-free common bile ducts in I: 84.06%, in II: 83.97%). The complication rate decreased from 7.55% to 5.04%. Types of complications did not change. Only perforations decreased, the rates of bleeding, cholangitis and pancreatitis remained the same. The mortality diminished from 1.12% to 0.60% (the figures remained twice as high in papillary stenosis than in choledocholithiasis). There was no change in the results of EST during the past 5 years. Follow-up studies using radiological methods show worse results (recurrent stones in II: 21.2%, in I: 5.8%, stenosis of EST in II: 6.1%, in I: 3.1%): Late results of EST because of papillary stenosis are still worse compared to those of choledocholithiasis. Therefore, in spite of increasing experience and introduction of new techniques the method became safer, but the therapeutic results did not appreciably improve.
The isolated rat liver was perfused with a haemoglobin-free, albumin containing salt solution at 28 degrees and 37 degrees C, respectively, with [4-14C]oestrone as substrate. During perfusion, the functional state of the liver was checked by continuously measuring the oxygen pressure and hydrogen ion concentration in the perfusion medium, flow rate, oxygen tension at various areas of the liver surface, and oxygen consumption; in addition, the following biochemical parameters were determined: ATP, ADP, lactate and pyruvate in liver tissue, and lactate and pyruvate in the perfusion medium. After 30 min of perfusion, free steroids, steroid glucuronides, steroid sulphates and the remaining water-soluble metabolites, present in liver tissue, perfusion medium and bile, were separated from each other and characterised by thin-layer and paper chromatography. It was found that, during perfusion at 37 degrees C, less hydroxylated metabolites were formed than at 28 degrees C. In contrast, metabolites whose formation is not directly oxygen-dependent, such as glucuronides and sulphates, arose in higher amounts at 37 degrees C than at 28 degrees C. It may be concluded that the relative shortage of oxygen at 37 degrees C leads to a selective impairment of metabolic pathways requiring a sufficient supply of molecular oxygen. Since oxidative processes play an important role in the biogenesis and metabolism of steroid hormones, it is evident that results, obtained in perfusion experiments with haemoglobin-free media at 37 degrees C, must be treated with reserve.