SUMMARY In order to investigate further the reported beneficial effect ofdeglycyrrhizinated liquorice in gastric ulcer, a trial with a double-blind, cross-over design was performed. The patients were treated during two consecutive periods of four weeks each with either liquorice extract during the first period and placebo during the second or placebo during the first period and liquorice during the second. Only patients with chronic ulcer disease were accepted for the trial. The dosage of the liquorice extract was 760 mg three times daily. During the first period 38 patients with 47 ulcers in the ventricle and during the second period 30 patients with 36 ulcers took part in the trial. The patients' sex, age, site of the ulcer in the ventricle, and ulcer size in the groups treated with liquorice and placebo during periods I and II were similar. Nor could any difference be shown between the groups treated with liquorice and placebo with respect to heredity, duration of ulcer disease, alcohol consumption, smoking, or the use of drugs.There was no tendency to quicker healing in either group as regards change of ulcer area or complete healing. Small ulcers healed more quickly than big ones. Ulcers at the angulus healed very poorly. No side effects of treatment were observed.Our study was not able to demonstrate any healing effect of the liquorice extract (Caved-S) on gastric ulcer.
In 12 non-icteric patients, changes in the pancreatic duct indicative of carcinoma were found during endoscopic retrograde cholangio-pancreatography (ERCP). Percutaneous fine-needle biopsy was positive for cancer in six cases. Nine of the 12 patients were later proved to have carcinoma of the pancreas. There was one falsely negative biopsy but no false positives. In two cases no pancreatic cells were found in the smear. It seems that percutaneous fine-needle aspiration biopsy during ERCP is a feasible procedure and can be recommended in ductal changes indicative of carcinoma.
A widely used classification of pancreatitis is the one proposed in Marseilles in 1963, which distinguishes among acute, acute relapsing, chronic relapsing, and chronic pancreatitis. The diagnostic criteria in chronic pancreatitis are permanent damage of morphology and/or function of the pancreas after clinical symptoms of pancreatitis. In clinical practice, however, it can be difficult to find the suitable and comparable diagnosis in accordance with the Marseilles classification. In the present study the exocrine and endocrine function and the morphology of the pancreas have been thoroughly investigated in 54 patients who have been treated for various diagnoses of pancreatitis. The results show that the above diagnostic criteria often are difficult to interpret. We consider that the prevailing classification of pancreatitis needs to be revised in the light of progress in investigative techniques. A proposal for a modified classification is presented.
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