Search

A 23-year-old woman suffered from chronic abdominal pain, nausea and diarrhea. The clinical symptoms particularly increased after ingestion of several foods. Laboratory investigation revealed a moderate eosinophilia in peripheral blood, elevated serum IgE-level and specific IgE against food allergens in radioallergosorbent testing. The patient exhibited exsudative ascites with eosinophiles. CT scan revealed a thickened wall of the small bowel. There was no evidence of a parasitic or extraintestinal disease. Endoscopically, the gastrointestinal tract appeared normal. Histological examinations of biopsies of the gastrointestinal tract led to the diagnosis of eosinophilic gastroenteritis. Under an elimination diet the patient is symptom-free since 16 months without ascites.

To test in a prospective study whether the non-invasive 13C-acetate test is suitable for measuring gastric emptying time with a liquid/solid test meal. (99m)technetium scintigraphy served as the reference method.18 consecutive type 2 diabetics with symptoms of gastroparesis (nine men, nine women; mean age 64 [45-76] years) were, after a nocturnal fasting period, given a liquid/solid test meal (370 kcal; 100 ml coffee; doubly marked with 75 mg 13C-acetate and 0.5 mCi 99mTc-colloid). At ten-minute intervals breath samples were taken over two hours and examined by mass spectometry for the 13CO2/12CO2 ratio. In parallel scintigraphy was performed for one hour at one-minute intervals. Gastric emptying half-life (t1/2) was calculated and the correlation between the two methods determined. In addition, the 13C-acetate breath test was performed on 20 healthy subjects to assess reproducibility (ten men, ten women; mean age 44.4 [23-77] years).Median t1/2 with the scintigraphy was 93.5 min, with the breath test 55 min, i.e. a significant correlation (r = 0.8; P0.001). Four of five patients with delayed gastric emptying by scintigraphy also showed delay (compared with the control group) in the breath test (median t1/2: 41 min; 95th percentile: 86 min).The 13C-acetate test correlated significantly with the results by scintigraphy. It can therefore be recommended as a non-invasive test for assessing gastric emptying time after a liquid/solid test meal in type 2 diabetics.

Endoscopic band ligation is a newly developed technique that has been proved to be an effective treatment of bleeding esophageal varices. Meanwhile, this technique also has been shown to be a successful method of controlling non-variceal upper gastrointestinal hemorrhage. Moreover, there are scattered reports about endoscopic band ligation for treatment of post-polypectomy hemorrhage. In this report, we describe the successful application of colonoscopic band ligation to control severe post-polypectomy colonic bleeding not responding to standard techniques.

To date, some studies have suggested that short-term therapy may be a promising therapeutic concept for the eradication of Helicobacter pylori. The primary objective of the present study was to elucidate the role of the duration of treatment in the cure of H. pylori infection.Forty consecutive patients with H. pylori-positive peptic ulcer disease were randomly allocated to four study groups. The groups were treated with a 14-day course of 20 mg omeprazole b.i.d. orally combined with 2 g amoxicillin t.i.d. intravenously for 1 day (n = 10; six women, age range 40-84 yr), for 3 days (n = 10; five women, age range 29-74 yr), for 5 days (n = 10; five women, age range 21-82 yr), for 7 days (n = 10); five women, age 42-82 yr), respectively. Initially, a standardized clinical evaluation of symptoms and and upper GI tract endoscopy were performed for assessment of H. pylori infection of the gastric mucosa (biopsy urease test, specific culture, and histology). At least 4 wk after cessation of omeprazole medication, H. pylori eradication was evaluated either as described or with the help of the 13C-urea breath test.H. pylori eradication, defined as negative bacterial findings in urease test, culture, and histology or 13C-urea breath test at least 4 wk after discontinuation of omeprazole therapy, was achieved in one of 10 patients (10%) in the one-day group, none of 10 patients (0%) in the 3- and 5-day groups and six of 10 patients (60%) in the 7-day group.We conclude that short-term therapies with the proton pump inhibitor omeprazole and the antibiotic amoxicillin must be considered completely ineffective if performed as a short-term therapy for up to 5 days. A therapy duration of 7 days seems to mark a turning point in antibiotic effectiveness, with a rapid increase in eradication rates.

Electrogastrography (EGG) permits measurements of the gastric electrical activity. However, normal values of electrical activity are poorly defined. In addition, limited data are available on the effect of age and gender. Therefore, in 40 healthy subjects (age range: 19-90 years) normal values for several EGG parameters were assessed after an overnight fast for 1 hr in the fasting and fed state after ingestion of a standardized solid-liquid meal. The electrical signals were captured by a pair of surface electrodes sonographically placed on the skin overlying the gastric antrum. The dominant electrical frequency was predominantly in the defined normal frequency range between 2 and 4 cycles per minute (cpm) (P0.001) and was higher in the postprandial than in the preprandial period (3.1 cpm vs 2.8 cpm, P = 0.02). The instability of the electrical rhythm calculated by a dominant frequency instability coefficient (DFIC) was postprandially lower than in the fasting state (P = 0.04). The electrical power (amplitude) increased postprandially (postprandial to fasting power ratio = 2.4). To evaluate the influence of age and gender on normal values the subjects were divided into four groups (median age: male, 28 and 69 years; female, 25 and 67 years). The most parameters did not differ significantly between the groups. However, DFIC was different between the groups (P0.05), with elderly women revealing lowest DFIC. In conclusion, normal values for several EGG parameters evaluated in this study should be included in the analysis of gastric electrical activity. The magnitude of electrical frequency and power are not influenced by age and gender, whereas the instability of the electrical frequency is influenced by these factors.

Mass lesions of the pancreas can be clearly visualized by endoscopic ultrasonography. For the differentiation of benign from malignant mass lesions, however, cytological examination is still recommended. As transcutaneous fine-needle biopsies have a limited diagnostic value, we have evaluated the efficiency of transmural (trangastral, transduodenal) endosonographically guided fine-needle aspiration (EUS-guided FNA) puncture for cytological confirmation of such pancreatic mass lesions. EUS-guided FNA puncture was performed in 11 patients with focal pancreatic solid lesions. In 4 patients a malignant mass lesion and in 2 patients a benign lesion were correctly identified by EUS-guided FNA puncture, while in 4 patients a false benign diagnosis was established and in 1 patient with a malignant mass lesion a sufficient cytological sample could not be obtained. Histological confirmation or rejection of the cytological diagnosis gained by EUS-guided FNA puncture was obtained in all patients by surgical biopsy or resection. It is concluded that transmural EUS-guided FNA puncture-with the application of a curved-array EUS transducer scanning parallel to the axis of the endoscope-is a new approach to the cytological diagnosis of pancreatic mass lesions. However, the of flexible puncture needles with a short needle tip-destined for multiple use-results in a considerable amount of false-negative diagnoses, as the needle tip frequently can only be advanced into the margin of the lesion. New prototypes of aspiration needles with an extending steel are presently under study for improved transmural EUS-guided FNA puncture.

This study was carried out to evaluate a simplified sonographic technique for the sonographic analysis of antral motility.For this purpose the percentage of visually complete contractions (estimated reduction of the antral area50%)/2 minutes was compared to the mean amplitude (%) and the mean velocity (%/s) of the contractions.The percentage of complete contractions was closely correlated to both the mean amplitude (r = 0.97, p0.0001) and the velocity (r = 0.92, p0.0001) of the antral contractions.Since the simplified technique is regardless to a postprocessing unit, which is not available in many sonolayers, it could be recommended as a valid routine screening method for the detection of antral motility disorders.

A 71-year-old woman with psoriasis-associated rheumatoid arthritis had for 15 months been treated with methotrexate (5 mg/week orally). Four weeks before admission she had developed dyspnoea and cough. On admission her axillary temperature was 38.2 degrees C, the white cell count was normal. Erythrocyte sedimentation rate (50/90 mm), lactate dehydrogenase activity (449 U/l) and the creatinine level (1.33 mg/dl) were all elevated. Blood gas analysis revealed partial respiratory impairment (pO2 52 mm Hg), and the chest X-ray demonstrated bilateral interstitial-alveolar changes. Despite antibiotics the temperature continued to rise, and on the 11th day a blood eosinophilia of 4% was noted. The bronchial mucosa was normal on bronchoscopy, and transbronchial biopsy showed only minor interstitial fibrosis, occasional macrophages and lymphocytes. Cultures of the lavage-fluid were negative. As methotrexate pneumonitis was suspected the drug was discontinued and prednisolone administered (50 mg daily for 3 days, gradually reducing over 7 days). The symptoms quickly improved, and blood gas analysis and the X-rays became normal. The patient was discharged symptom-free after 30 days.

In a prospective study 27 patients (13 women, 14 men; mean age 62 [45-83] years) with Helicobacter (H.) pylori associated disease received over 7 days pantoprazole (40 mg twice daily), clarithromycin (500 mg twice daily) and metronidazole (500 mg twice daily). Six patients had gastric ulcer, 4 duodenal ulcer, 4 erosive gastritis, 6 erosive duodenitis and 7 had H. pylori-positive functional dyspepsia. Pre-treatment oesophago-gastro-duodenoscopy was combined in 4 patients with antral and in 4 others with body-of-stomach biopsies to demonstrate H, pylori (urease test, specific culture and histology). The H. pylori status was checked with the 13C-urea breath test 4 weeks after the end of treatment. In addition, 9 patients with peptic ulcer were examined endoscopically at least 2 weeks after onset of the treatment to check for any healing of the ulcers, 25 of the patients completed the study according to the protocol. The H. pylori eradication rate was 100% (25 of 25 patients), while the "intention to treat" analysis gave a rate of 92.6% (25 of the 27 patients). The peptic ulcers were found to be healed in all 9 patients who had been endoscoped. One woman developed a reversible stomatitis, but the drug treatment did not have to be stopped. -These findings indicate that short-term triple treatment in the described manner is efficacious in curing H. pylori infection and any peptic ulcer. It is thus a highly promising treatment of H. pylori-associated diseases.

The recently developed 13C-octanoic acid breath test allows the measurement of gastric emptying of solids. In this prospective study we wanted to investigate, whether the 13C-octanoic acid breath test using breath samples every half an hour is suitable in assessing gastric emptying in comparison to scintigraphy in diabetics. Furthermore, we examined the intraindividual reproducibility in healthy volunteers. 20 consecutive diabetics with clinical symptoms of gastroparesis received a solid double-labeled standard test meal. The meal consisted of 1 scrambled egg, labeled with 75 mg 13C-octanoic acid and 0.5 mCi 99mTc colloid, 50 g rye bread, 20 g butter, 200 ml orange juice; 280 kcal. Breath samples were taken at half hour intervals for 4 hours and analyzed for 13CO2 by isotope ratio mass spectrometry. Using a regression method gastric emptying half times (t 1/2) were determined and correlations to simultaneous 99mTc-scintigraphy were calculated. There was a moderate significant correlation of 13C-octanoic acid breath test t 1/2 and scintigraphic t 1/2 (R = 0.6; p = 0.008). The 13C-octanoic acid breath test t 1/2 obtained in 20 healthy volunteers measured at two separate days showed a coefficient of variation (VC), that was greater between subjects (VK = 42%) than between two measurements in the same subject (VK = 24%), which reflects a moderate intraindividual reproducibility. Taking breath samples every half an hour the 13C-octanoic acid breath test only reveals a moderate intraindividual reproducibility and a moderate correlation to scintigraphy in diabetics. For detailed assessment of solid gastric emptying in diabetics a 13C-octanoic acid breath test using shorter breath sampling intervals is recommended.

Cutaneous electrogastrography (EGG) allows the measurement of gastric electrical activity. An association of EGG with gastrointestinal motility disorders has been shown. Abnormalities of electrical rate or rhythm are accepted as the most important parameters in EGG. However, the reliability of the magnitude of electrical amplitude in the assessment of motility is discussed controversially. Therefore in a prospective study we investigated the relation between amplitude and antral contractions by means of ultrasonography. 8 healthy volunteers (4 men, 4 women, 24-31 years) ingested 400 ml carbonated mineral water after an overnight fast at two separate study days. Over a period of 10 min preprandial and 10 min postprandial small and intense antral contractions were measured employing sagittal antral planimetry. Simultaneous amplitudes were determined during contractions and at 1 min intervals (average amplitude) by cutaneous electrogastrography. Data were analyzed by Wilcoxon's rank sum test and Spearman rank correlation test. The coefficient of variation of the postprandial/preprandial amplitude ratio was nearly two times greater between subjects than between recordings in the same subject, which reflects a moderate intraindividual reproducibility. We found a significant increase in the average amplitude postprandially (p0.05). Although postprandial contractions (n = 243) predominated preprandial contractions (n = 127) significantly (p = 0.02), no significant correlation between the number of contractions and the average amplitude existed (R = 0.1; p = 0.7). Moreover the average amplitude did not differ from amplitudes during intense and small contractions significantly (p = 0.7; p = 0.1). The magnitude of the amplitude measured by EGG does not correlate with the mechanical gastral activity significantly.(ABSTRACT TRUNCATED AT 250 WORDS)

A 67-year-old woman had developed weakness, fatigue and a 10 kg weight loss over the past year. On examination a cylindrical mass was palpated in the right middle abdominal cavity. Erythrocyte sedimentation rate was increased to 87/126 mm, there was an hypochromic anaemia (haemoglobin 9.1 mg/dl) and an hypoalbuminaemia (32 g/l) with an increase in alpha 2-globulins (9.4 g/l), Cholinesterase activity was decreased to 588 U/l. X-ray film of the abdomen revealed a calcified mesenteric lymph-node and coloscopy demonstrated polypoid tumorous changes with ulcerations, extending from the pole of the caecum to the right flexure. Histological examination showed epithelioid-cell granulomas with Langhans giant cells. Culture grew Mycobacterium tuberculosis, confirming the diagnosis of intestinal tuberculosis. She was treated with oral doses of isoniazid (300 mg daily), rifampicin (600 mg daily) and pyrazinamide (2 g daily) for 2 months, followed by isoniazid and rifampicin for a further 4 months. After this the laboratory tests were within normal limits and urine as well as stool samples contained no acid-fast bacilli. As the patient felt so well she declined another coloscopy.

The value of a modified 13C-urea breath test for the detection of Helicobacter pylori was analysed in a prospective study of 50 consecutive patients (28 women, 22 men, aged 20-90 years) with unknown Helicobacter pylori status about to undergo upper intestinal endoscopy. Four biopsies each were obtained in each patient from the antrum and the body of the stomach and examined for Helicobacter pylori infection of the gastric mucosa histologically (haematoxylin-eosin and Giemsa stain), with the rapid urease test and by culture. The patients then underwent a modified 13C-urea breath test. Results were positive histologically and(or) by culture in 29 patients, while the breath test was positive in 28 (sensitivity 96.3%). The breath test was falsely positive in two (specificity 91.3%). The biopsy urease test had a sensitivity of 96.3% with a 100% specificity. These results demonstrate that the modified 13C-urea breath test is a simple and accurate way of demonstrating Helicobacter pylori infection, equal in diagnostic value to the biopsy urease test.

Measurement of gastric emptying of liquids by sagittal antral planimetry is established. Ultrasonic measurement of gastric emptying of solids has not been assessed although gastroparesis often reveals a delayed gastric emptying of solids first. Therefore in this prospective study we used a solid meal (50 g rye bread, 1 egg, 40 g butter, 200 ml orange juice; 280 kcal) to examine intraindividual reproducibility of ultrasound in 20 healthy volunteers. Moreover, in 20 diabetics antral planimetry assessed by ultrasound was compared to scintigraphy. Antral planimetry showed a coefficient of variation, that was nearly three times greater between subjects than between two measurements performed on the same subject. This results reflect a good intraindividual reproducibility. Gastric emptying half-times assessed by ultrasound and scintigraphy did not correlate in diabetics (R = 0.2). However, correlation between sonographic measurement of antral area and scintigraphy at defined times (60, 120, 180, 240 min) was significant (R = 0.7; p0.001). These results imply that ultrasonic antral planimetry is a suitable orientating method for measuring gastric emptying of solids.

Mycoses are common complications of haematological neoplasias. For successful antimycotic treatment, a knowledge of preferential underlying disease, frequency, species and site of the mycosis is of importance.Postmortem material comprising clinical data, autopsy protocols and histological sections obtained between 1976 and 1990 from 1,053 patients with leukaemia and malignant lymphomas following antineoplastic therapy was analysed retrospectively.Autopsy revealed systemic mycoses in 184 patients (17.5%). Between 1976 and 1990, the incidence of fungal infections increased from 12% to 30%, most being found in acute leukaemia (24%). Myeloproliferative syndrome (18%), non-Hodgkin's lymphomas (16%), Hodgkin's disease (10%) and plasmocytoma (2.5%) were less frequently associated with mycoses. With no preference for any particular malignancy in evidence, aspergillosis predominated at histology (85 cases), while candidosis occurred in 75 cases. A combination of two mycoses (aspergillosis and candidosis) (14 patients), zygomycosis (eight patients) and cryptococcosis (two patients) were much less common. While aspergillosis caused mostly pulmonary (81 cases) and cerebral (18 cases) infections, candidosis most frequently affected the GI tract (83 cases). The fungal infection was regarded as the main cause of death in some 76% of the cases. An analysis of bone marrow of patients with mycosis (184 cases) revealed a predominance of hypoplasia (54%) over tumour infiltration (34%) and normal bone marrow (12%). In malignancies with no mycoses (869 cases) in contrast, hypoplasia was significantly less common (19%) than infiltration (59%) or normal bone marrow (22%) (p0.001).The incidence of mycoses in haematological neoplasias in our post mortem series has continued to increase. Bone marrow hypoplasia in particular predisposes to fungal infection. The lungs are the organs of predilection, and aspergillosis is likely to be the infection presenting.

Long-term manometry of the tubular esophagus was performed in 20 consecutive patients (18 females, 2 males; median age 56.5 years) with progressive systemic sclerosis (PSS) and a control group of 20 healthy subjects (18 females, 2 males; median age 56.5 years). The measurements were performed via a data logger of 1 MByte memory capacity with the help of two pressure sensors placed 8 and 18 cm above the lower esophageal sphincter. Esophageal contractions were analyzed with respect to pressure amplitudes in the esophagus distal and proximal, quotient of pressure amplitudes distal/proximal, number of contraction waves in a 24-h period, and kind of spreading (propulsive, simultaneous). In the PSS group there was a significant decrease in pressure amplitudes in the distal sensor (median 31.5 versus 39.5 mbar in controls, P < 0.02), in the quotient of pressure amplitudes distal/proximal (median 0.885 versus 1.25 in controls, P < 0.001), in the number of waves in 24 h (median 939.5 versus 1656 in controls, P < 0.01), and in the occurrence of propulsive waves (median 34% versus 57% in controls, P < 0.01). Fifteen patients (75%) had hypomotility disorders as compared to the control group, in which the lower limit of normal values was defined by the 5th percentile of descriptive analysis. These first data of long-term manometry in patients with PSS indicate that long-term manometry may be an effective method for identifying esophageal involvement in PSS.

The concepts of a locally presentable category and an accessible category have turned out to be useful in formulating connections between universal algebra, model theory, logic and computer science. The aim of this book is to provide an exposition of both the theory and the applications of these categories at a level accessible to graduate students. Firstly the properties of l-presentable objects, locally l-presentable categories, and l-accessible categories are discussed in detail, and the equivalence of accessible and sketchable categories is proved. The authors go on to study categories of algebras and prove that Freyd's essentially algebraic categories are precisely the locally presentable categories. In the final chapters they treat some topics in model theory and some set theoretical aspects. For researchers in category theory, algebra, computer science, and model theory, this book will be a necessary purchase.

Gastric emptying, antral motility, and gallbladder emptying after a liquid fatty meal were studied by ultrasound in 25 patients with progressive systemic sclerosis and in 25 sex- and age-matched controls. In patients with systemic sclerosis, the possible role of autonomic dysfunction was evaluated by four noninvasive cardiovascular reflex tests. Despite a significant delay of gastric emptying and a significant postprandial antral hypomotility in the patients with systemic sclerosis, the fat-induced gallbladder emptying was only slightly reduced, reaching no significant level when compared to the controls. The prolongation of gastric emptying correlated significantly with the duration of the disease. Although 36% of the patients in the systemic sclerosis group exhibited signs of autonomic cardiac dysfunction, there was no evidence of an association between these signs and gastric motor dysfunction. In conclusion motility disorders of the gallbladder seem to play a minor role in the upper gut involvement of systemic sclerosis, whereas motility disorders of the stomach are frequent and can be easily recognized noninvasively by real-time ultrasound.

Thirty-five consecutive patients (median age: 50 years, 17 men and 18 women) suffering from Helicobacter pylori associated peptic ulcer disease (duodenal ulcer: n = 15, gastric ulcer: n = 13) or severe functional dyspepsia (n = 7) were enrolled in a two-center clinical trial and treated with omeprazole 20 mg bid preprandially and roxithromycin 300 mg bid postprandially over two weeks. After cessation of the study medication, ulcer patients received a full dose H2-blocker treatment up to the final examination four weeks later. All patients completed the trial without contravening the protocol. Side effects were not recorded. The overall proportion of cure of Helicobacter pylori-infection was 29% (10 out of 35 patients) without statistically significant difference between the two participating centers (center I: 7 out of 20 patients [35%], center II: 3 out of 15 patients [20%]; p = 0.33). We conclude from our results that omeprazole plus roxithromycin is an ineffective treatment schedule with regard to cure of H.pylori-infection in patients with peptic ulcer disease or dyspepsia.

Exploration work had been done within today area of Czech Republic tilt 1970 mainly in the Vienna Basin and less in the Carpathian Foredeep and in the Carpathian Flysh Units. In Vienna Basin the most explored areas had been namely fields Hrugky, Poddvorov, Lednice, Týnec. In the Hrusky field during end of fiftieths was discovered one of the biggest industrial deposits with moge than 1.5 milion tons of recoverable oil and 1.500 milion m³ of natural gas.

The aim of the present study was to examine the effect of the application route of the antibiotic amoxicillin in Helicobacter pylori eradication, using omeprazole/amoxicillin.In a prospective medium-term study, 31 patients with H. pylori-positive gastroduodenal ulcer disease were treated with a 14-day course of 20 mg omeprazole bid orally, combined with either 1 g amoxicillin tid intravenously (n = 15) or 500 mg amoxicillin six times daily orally (n = 16).H. pylori eradication, defined as negative bacterial findings in urease test, culture, and histology at least 4 wk after cessation of study medication, was achieved in 93% (14/15) of the patients in the first group and in 91% (11/12) of the patients in the second group. To obtain medium-term results, patients in whom H. pylori had been successfully eradicated were investigated with a 13C-urea breath test at least 6 months later. Medium-term eradication rates of 91% (10/11 patients) in the first and 100% (10/10 patients) in the second group were observed.In view of the equally high eradication rates obtained by a 14-day course of intravenously administered amoxicillin and an oral therapy of the same length and dosage, during the necessary induction of luminal hypoacidity by the proton pump inhibitor omeprazole, we conclude that the route of administration of amoxicillin does not play a decisive role in bacterial eradication.

The results of a cardiologic work-up in patients with retrosternal pain are negative in about 20-30% of cases. Overall one half of these patients exhibit an esophageal dysfunction. In order to diagnose esophageal dysfunction long-term pH-metry, transit scintigraphy and standard manometry are used as well as provocation tests. New diagnostic procedures such as long-term manometry and combined long-term pH-metry and manometry have recently been developed and are increasingly used. Long-term pH-metry is a valid, uncomplicated and sensitive procedure used to diagnose acid gastroesophageal reflux. The differential diagnosis of hypermotility esophageal dysfunction is, however, considerably more difficult. Scintigraphy appears unsuitable. The value of standard manometry is hindered by the short examination time and the rare possibility to correlate pain episodes and motility disorders. It is therefore recommended that a provocation test should be carried out after standard manometry. Preliminary results for long-term manometry are now available. These show that it is not only possible to correlate pain episodes and motility disorders but also to differentiate pathological manometry profile. This applies also to combined pH-metry and manometry reducing patients discomfort to one examination.

Central nervous system vasculitis in Crohn's disease. A 36-years old man was referred to the hospital because of severe headache, vertigo and right sided combined motor-sensory hemiparesis. There was a history of Crohn's disease with an acute exacerbation only two months ago. Magnetic resonance imaging detected a vascular lesion of the left brainstem and serologic investigations revealed circulating immunocomplexes and p-antineutrophil cytoplasmic autoantibodies (p-ANCA). Further investigations care no evidence of arteriosclerotic cerebrovascular disease. These findings therefore suggest that cerebral vasculitis secondary to Crohn's disease was the underlying cause of this focal neurologic deficit.

Ion sensitive probes serve to measure the ion temperature in magnetized plasma. Such a probe typically consists of a collector submerged inside a hollow tube, which is oriented perpendicularly to the magnetic field. The principle of the probe is based on geometrical shielding of the ion collector from plasma electrons. According to the basic theory, when the collector is retracted in the tube, electrons with their small Larmor radii should not be able to reach it and the collector becomes sensitive to ions. However, experimental results show that the electron shielding is in general inefficient, it only works in the case when the potential of the collector is the same as the potential of the inside surface of the tube.This problem is investigated using a full 3D particle-in-cell Cartesian code with a fast multigrid Poisson solver. We simulate the plasma behaviour in the vicinity of a model of the ion sensitive probe. A positive potential structure is formed at the entrance of the tube due to the space charge of ions that gyrate inside. This structure produces E × B drifts, which push electrons into the shielded space. A stream of electrons hitting the collector is observed for various potentials of the collector. Simulations revealed that electrons can penetrate inside the geometrical shadow in all studied cases; however, they do not reach the collector when the potential of the collector is equal to the potential of the tube.

Endoscopic ultrasonography with high-frequency ultrasonic beams allows detailed study of the gastrointestinal wall structures and the surrounding Tissues. Moreover most echoendoscopes carry a biopsy channel for biopsy or cytologic puncture guided by endoscopic ultrasonography. We present a patient with a tumor in the posterior mediastinum in whom conventional diagnostic techniques failed to obtain speciments for cytologic evaluation. Transesophageal fine needle aspiration guided by endoscopic ultrasonography confirmed the diagnosis of lung cancer consisting of adeno and small cells in this patient. Transesophageal fine needle puncture guided by endoscopic ultrasonography might become a valuable aid for the diagnosis of tumor masses in the posterior mediastinum.

Patients with H.pylori positive peptic ulcer disease were treated with a two weeks regimen consisting of 20 mg omeprazole twice daily and 500 mg amoxicillin six times daily. Subsequently, an H2-receptor antagonist was started (300 mg ranitidine) at night time for four weeks. Before and one month after completion of antibiotic therapy an upper GI-tract endoscopy was performed for determination of H.pylori infection [biopsy urease test (BUT), specific culture and histologic demonstration]. A total of 12 patients completed the study protocol. H.pylori eradication, defined as a negative result in BUT, culture and histology) four weeks after completion of the combined omeprazole/amoxicillin treatment regimen was achieved in 91.6% (11 of 12 patients). Complete ulcer healing was confirmed in all patients. A stomatitis was observed in one female patient as a possible side effect of antibiotic treatment, but this did not necessitate discontinuation of therapy. Only complicated drug regimen with many side effects have been available so far for successful eradication of H.pylori. Thus, the present drug combination might prove as an effective therapeutic option in the future. These data, however, await confirmation in larger study population.

A case of splenic rupture after an uneventful diagnostic colonoscopy in a 68-year old man is reported. Conservative management of this complication was successful. Splenic rupture is a unique and severe complication of colonoscopy, which can rarely be managed conservatively.

Delayed cutaneous hypersensitivity was assessed in 120 patients (among them 109 HBsAg positive), with chronic persistent hepatitis, chronic active hepatitis, and compensated as well as decompensated liver cirrhosis by simultaneous application of seven standardized antigens and negative control ("Multitest CMI"). In 21 patients, after 12-24 months the tests were repeated. The sum of indurations of all positive responses ("score") were calculated. Responsiveness measured as results below a normal values was related to the advancing of liver disease (from 13% in chronic persistent hepatitis up to 77% in compensated and 61% in decompensated liver cirrhosis). A comparative analysis (t-Student test) of the arithmetical means of the "scores" revealed statistically significant differences between results obtained in diagnostic groups. It was also dependent from the severity of liver disease. Patients with chronic persistent hepatitis (without specific treatment) and patients with chronic active hepatitis (treated using thymus extract, TFX - "Polfa") has showed an increased "score" values. In contrast to this group, all persons with liver cirrhosis without skin-responsiveness in the first and second tests (anergy) died at the period of 18 months. "Multitest CMI" can be of value in assessing of results of immunotherapy, as well as prognosis of the course of advanced liver disease.

Understanding of underlying physics in the edge plasma of tokamaks requires knowledge of the plasma density, potential, electron and ion temperature, ion flows and their fluctuations with a high spatial and temporal resolution. A family of electric probes, which have been designed and tested for this purpose in the CASTOR tokamak, is reviewed and examples of their performance are given. In particular, we focus on description of the 1D and 2D arrays of Langmuir probes for spatially resolved measurements of the edge turbulence, the Ball pen and emissive probes for direct measurements of the plasma potential, the optimized Gundestrup probe for measurements of parallel and perpendicular ion flow, and the tunnel probe for fast measurement of electron and ion temperatures. Additional information on individual diagnostics is available in the listed references. PACS 52.70.Ds

certain the status of the partner. It had spiral bacteria that could not be cultured and was morphologically Helicobacter heilmannii (or similar large spiral organisms). The monkeys negative for any spiral bacteria had essentially normal gastric histology. Conclusion: The results of this study indicate that helicobacters are rare in wild monkeys and casts doubt on the hypothesis that H. pylori has had a long association with primates other than Homo sapiens.