With the aim of establishing suitable follow-up intervals, we examined the probability for the recurrence of relevant adenomas in the colorectum. A total of 592 adenoma patients in whom colonoscopy up to the caecum had reliably excluded relevant findings, were admitted to the study. Relevant findings were considered to be 1) colorectal carcinoma, 2) an adenoma with severe cellular atypia, 3) an adenoma of at least 5 mm in diameter, 4) a histologically unclassified polyp of at least 5 mm in diameter. We were able to show that the use of a dose-effect relationship is statistically justified for the follow-up results of the 592 patients. Thus, the probability for renewed relevant findings at any given time can be computed on the basis of the follow-up results. Renewed relevant findings were presented by 6.0% of patients with single adenomas after 4 years (confidence level 4.8-7.3%), while 5.7% of patients with multiple adenomas had relevant findings after 2 years (confidence level 4.5-7.0%). These follow-up intervals are, thanks to the adequate detection rate, economical and, at the same time, safeguard adenoma patients with a high level of reliability, against cancer of the colorectum.
In 11 juvenile diabetics and 13 control subjects, the secretin-pancreozymin test was performed. Duodenal-volume losses were corrected by use of radioactive vitamin B12 as marker substance. As compared to normal subjects, juvenile diabetics had significantly decreased pancreatic outputs of amylase, trypsin, chymotrypsin, and to a lesser degree, of bicarbonate. Clinical evidence of disease of the exocrine pancreas was missing. There was no discernible relationship between the abnormality of external pancreatic function and the duration of diabetes mellitus or the dose of insulin required. Possible factors that may be responsible for the exocrine deficiency of the pancreas in juvenile diabetics are discussed.
After endoscopic papillotomy, the extraction of large stones is often very difficult. In numerous cases, it proves impossible to remove large concretions using conventional methods. On account of technical problems, electro-hydraulic lithotripsy was unable to fulfill all the hopes placed in it. A possible alternative method is that of mechanical lithotripsy. Initial clinical experience gained in 8 patients with large stones in the common bile duct, has shown that, with the aid of the technically simple procedure, it is possible to extract such large concretions, too.
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