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Final digestion and absorption of carbohydrates (CHO) occur after intraluminal hydrolysis by pancreatic alpha-amylase at the surface of the mucosal membrane in close relationship between disaccharide hydrolysis and the glucalogue carrier system. In general, Na(+)-dependent transport is the rate-limiting step of CHO absorption. The rate of absorption is determined by mode of ingestion, chemical composition of the meal, gastric emptying, pancreatic digestion, intestinal digestion and absorption, and intestinal motility. A delay of absorption of CHO may be achieved by dietary fibers, alpha-amylase inhibitors, or alpha-glucosidase inhibitors. Final protein digestion is achieved by a dual mechanism: intact peptide absorption with subsequent intracellular hydrolysis to free amino acids (AA) and membrane hydrolysis of peptides followed by absorption of free AA. More complex is the mechanism of lipid absorption: emulsification, lipolysis, micellar formation, membrane translocation, intracellular resynthesis, chylomicron formation, and lymphatic drainage. The most critical steps in lipid digestion are lipolysis and micellar formation.

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OBJECTIVE.The flow pattern in hepatic veins depends on cardiac physiology and liver histology. The aim of our study was to determine the dependence of the flow pattern of he patic and portal veins in relation to histologic features in patients with chronic hepatitis C. SUBJECTS AND METHODS.In 135 patients with chronic hepatitis C, the Doppler sonography spectrum of the right hepatic vein was classified as triphasic, biphasic, or monophasic. The flow of theportalvein wascharacterizedaccordingto theundulation(veloc itYm@min). A liver biopsy was performed during sonography, and biopsy specimens were semiquantitatively evaluatedon a histologicactivity index anda scoreof the hepaticfat con tent. Multiple logistic regression analysis was used to identify the histologic features that might contribute to the type of flow pattern. RESULTS.The hepatocyte fat content was the only variable associated with an indepen dent effect on the type of flow pattern (monophasic versus triphasic; odds ratio, 16.26; 95% confidence interval, 6.38â€"41.45; p < .0001). A pronounced undulation in the portal vein was associated with portal inflammation but not with other parameters of the histologic activity in dex or the intrahepatic fat deposition. The normal triphasic Doppler sonography waveformof hepaticveinsvanesaccordingto changes in the central venous pressure. During atrial and ventricular diastole, two portions of the signal (phase I and phase II) reflect the hepatofugalflow to the heart, while during atrial contraction a third portion (phase ifi) representsa short interval of reversedflow [1,10]. Conflicting data have been reported concerning changes of the flow pattern in rela tion to chronic liver disease. A few studiessug gested that liver fibrosis or cirrhosis and transplant rejection may reduce undulation of the hepatic flow pattern [2][3][4]7]. The possible contribution of inflammatory changes and mtra hepaticfat depositionhasneverbeensystemati cally investigated.To address thesequestions, chronichepatitis C is an attractiveclinical model [11â€"13] be causethe diseasecan causethe completehisto logic spectrum of inflammatory and fibrotic changes[14â€"17] andcan lead to variable intra hepaticfat deposition [3,18]. In the present study, we examined 135 patients with chronic hepatitis C and 75 age-and sex-matched healthy subjectsusing B-mode and duplex

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Despite being on a gluten-free diet German coeliac disease patients suffer from a high burden of general and extra-intestinal symptoms and a reduced HRQOL.

During therapeutic endoscopy, sedation with propofol and midazolam requires a lower total dose of propofol, but otherwise has no superior sedation efficacy and is associated with a slower post-procedure recovery than sedation with propofol alone.