[Investigation of the deputizing service for general practitioners. II. Misuse of the service. Assessment of the necessity of the calls].
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Biomedical subjects
Publications and source records attributed to T Christiansen.
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Estrogenic chemicals are known to have marked effects on the reproductive system of male fish. Finding useful markers of reproductive effects are therefore of great importance and interest. gamma-Glutamyl transpeptidase (gamma-GTP) is a possible marker of Sertoli cells in testes of fish. In the present study we have examined the relationship between the activity of gamma-GTP and the histological structure of the Sertoli cells in testes of five fish species (guppy, Poecilia reticulata; platyfish, Xiphophorus maculatus; eelpout, Zoarces viviparus; rainbow trout, Oncorhynchus mykiss; flounder, Platichthys flesus). In general we found that the more distinct the Sertoli cells the higher the activity of gamma-GTP.
Consecutive magnetic resonance images were obtained in pregnant animals and their respective controls, and changes in kidney, cortex, medulla, and pelvis volumes were calculated. In non-diabetic pregnant animals, a marked increase in kidney and cortex volumes was observed within the first 15 days of pregnancy (29 and 20%, respectively), while no significant changes were seen in medulla or pelvic volumes. Five days later (near term) and after delivery, kidney and cortex volumes had decreased to values before pregnancy. In pregnant diabetic animals, a 26% increase in renal volume was seen over the first 15 days of pregnancy when compared to the increase seen in non-diabetic pregnant animals. Pregnant diabetic animals had a parallel increase in cortex and medulla volumes, but still no changes in the pelvis volume. In contrast to non-diabetic pregnant animals a non-heterogeneous pattern in renal volume was seen post partum, as not all animals normalized their renal volume.
A prospective investigation on gastro-oesophageal reflux in 97 consecutive patients has been carried out by means of a barium examination employing the conventional method and after food stimulation. Gastro-oesophageal reflux was observed in 38 patients with and 15 patients without oesophageal symptoms. Gastro-oesophageal reflux was induced by two mechanisms, an active component after food stimulation and a passive component after the conventional method including respiratory manoeuvres and leg raising. In 32 patients, only the active component could be demonstrated and in 6 patients only the passive component. In the remaining 15 patients both active and passive components occurred. The clinical significance of the active and passive components in gastro-oesophageal reflux needs further investigation.
In a prospective study a barium examination combined with food stimulation was compared with the acid reflux test in 30 consecutive patients with symptoms of gastro-oesophageal reflux. Both methods were further compared with endoscopy and histology. Gastro-oesophageal reflux could be demonstrated by the radiologic examination in 22 patients and by the acid reflux test in 23 patients. By combining the two methods gastro-oesophageal reflux could be demonstrated in 27 patients. Comparing the two methods with symptoms, endoscopy, and histology they seemed to be of equal value. Accordingly, a food-stimulated barium examination is recommended as the first method for demonstrating gastro-oesophageal reflux because it is simple and well-tolerated by the patient.
An investigation for biliary tract calculi and food-stimulated gastro-oesophageal reflux was carried out in 37 patients with duodenal diverticula demonstrated by barium examination. Sixty per cent of the diverticula were located in the descending part of the duodenum. Biliary tract calculi were demonstrated in 38 per cent and food-stimulated gastro-oesophageal reflux in 81 per cent of the patients. The detection of a duodenal diverticulum should result in a supplementary investigation for gallstones and gastro-oesophageal reflux and its sequelae.
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In a prospective study, 26 patients with symptoms of reflux oesophagitis underwent a barium examination for gastro-oesophageal reflux after food stimulation, and endoscopy with biopsy from different levels of the oesophagus. Radiologic grading of the gastro-oesophageal reflux depending on the height of the reflux into the oesophagus was performed, and this was correlated to the microscopic appearance at different levels in the oesophagus. Complete agreement between the radiologic grading and the histology was found in 69 per cent of the cases, and when gastro-oesophageal reflux was demonstrated the agreement was 75 per cent. Accordingly, the results showed a good accordance between the two variants, indicating that the height of the reflux during the food stimulated test may be truly indicative of the reflux height under non-test conditions.