The uses of small area analysis in community health planning.
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Biomedical subjects
Publications and source records attributed to E Schmidt.
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In 66 patients with chronic active hepatitis and chronic fatty liver hepatitis of predominantly alcoholic aetiology the effect of B vitamins and the anabolic steroid clostebol (Steranabol) was tested during an eight-week period, using 12-biochemical parameters of liver function, histological findings and the activity of 14 enzymes. In chronic active hepatitis there was no demonstrable difference in effect between the treated and untreated subjects. In those with chronic fatty liver hepatitis, the marked greater therapeutic effect among the untreated group during hospitalization is thought to have been due largely to an accompanying reduction of alcohol intake.
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In 50 patients with peptic ulcer (48 duodenal ulcers and 2 pyloric channel ulcers) proximal gastric vagotomy was performed. The diagnosis was confirmed by radiology and endoscopy in all cases. Pentagastrin-stimulated maximal acid output (MAO) was measured preoperatively. At 6-12 months after the operation a pentagastrin test (6 mug/kg) and an insulin test (12 units regular insulin intravenously) were carried out. The results of the insulin tests were assessed by 5 criteria. In patients with 3 or more positive criteria the vagotomy was considered incomplete. 30 patients had "complete" and 20 "incomplete" vagotomy. MAO was reduced by 56%. The mean reduction of MAO was 63% in cases of "complete" vagotomy and 46.5% in "incomplete" vagotomy. The purpose and indication of postoperative studies of gastric secretion are discussed.
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A calcium-rich rachitogenic vitamin-D deficiency and additional doses of calcitonin cause serious changes in cell structure and metabolism, which can be demonstrated by cytophotometry and morphometry. The experiments were made with 9 male juvenile Wistar rats. 6 animals were kept on a vitamin-D deficient diet for 6 weeks and 3 of these animals got injections with salmon-calcitonin S.C. during the last 14 days every second day. The remaining 3 animals, fed with altromin-R standard diet were kept for control purposes only. The morphometric analysis of the liver parenchymal cells was based on the statements by Weibel and the cytophotometric examinations were made according to the Sandritter technique. As a consequence of the altered metabolic condition a great volume reduction of cells and cell nuclei is found in the animals with vitamin-D deficiency, which were treated with calcitonin. In comparison with the control animals the hepatocytes show hardly any tetraploid nuclei, which points to an inhibited polyploidization. The cytoplasm shows an oncocytic transformation with megamitochondria. As reason for this mitochondriopathy an extreme and abnormal growth as well as a mutation of the mitochondrial genom are under discussion. Furthermore the total endoplasmic reticulum (volume and membrane surface), the peroxisomes and the ribosomes are strongly reduced. Due to the serious cell injury the other organelles are also reduced in number and volume, which points to a chronic hypocalcemia.
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Twelve patients with gallstones were treated with chenodeoxycholic acid (CDCA) for 3 to 22 months. Liver function and structure were studied before and during treatment. No signs of hepatotoxicity were observed. Activities of several enzymes, including transaminases, GLDH, and gamma-GT were frequently abnormal in this group of patients. But there was no statistical difference between treatment and pre-treatment levels. Serum bilirubin and protein electrophoresis remained normal throughout the study. The BSP retention test was not significantly altered by CDCA treatment. Light microscopic examination in 8 patients revealed no changes of liver structure during 3 to 19 months of CDCA administration except, however, for a decrease of fatty changes in 3 patients. The ultrastructure of liver cells was found to be normal in 5 patients, in whom electron microscopy was done as well.
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