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A retrospective study was performed on 1091 acute duodenal ulcers found by endoscopy from 1973-1983. The chi 2-test verified statistically a maximum of ulcers in autumn. The vectorial analysis by means of the Rayleigh-Test showed a maximum of observed ulcers in November for all of the patients as well as for subjects with a duodenal ulcer seen only once, or with one relapse found endoscopically. Patients with three or more successive duodenal ulcers showed an individual pattern with or without seasonal periodicity. In chronic duodenal ulcer disease the individual long-time follow-up might be useful in prophylactic anti-ulcer therapy.

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The history of a 46 years old female patient is reported who suffered from rheumatoid arthritis. During therapy with chlormezanon and paracetamol symptoms of cholestatic liver disease developed. We believe that this was a side-effect of chlormezanon.

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35 out of 57 patients with gastric carcinoma presented with a so called "target" pattern. In cases with distal cancer the more advanced cases with endoscopic types Borrmann III/IV showed this sign more frequently than less advanced forms, i.e. suspected early cancer, Borrmann I or Borrmann II. On the other hand in endoscopically advanced cancers Borrmann III/IV a thickening of the gastric wall was more frequent in distal than in proximal localization of carcinoma. The presence of target sign in abdominal ultrasound did, statistically, not influence gastric resection. Other findings, which were observed exclusively in gastric cancer type Borrmann III/IV, like infiltration to the surrounding (pancreas, liver), liver metastasis, and/or ascites, were decisive. Additional sonography of the abdomen is, therefore, a valuable preoperative diagnostic procedure in gastric cancer beside upper GI endoscopy and biopsy.

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The evaluation of 535 patients with gastric cancer observed in two 5-years periods with low (3%) and high (84%) preoperative endoscopic frequence demonstrated: 1. Change of the diagnostic procedure, mainly on the basis of out-patients examination, 2. a diminished role of preoperative X-ray examination for decisions about the further proceeding. 3. no more unnecessary probatory laparotomies without a lesion requiring surgery, 4. improved preoperative exclusion from surgery of patients supposed to be not operable, resulting in a reduction of explorative laparotomies and a relative increase of gastrectomies, and finally 5. a significant increase in early gastric cancer with a concomitant decrease of stage 2 and 3. The percentage of the largest group of gastric cancer in stage 4 remained constant, however.

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In a nine-year period, 46 patients with early gastric cancer were diagnosed and operated at a county hospital. Fiberscopy of the stomach raised the percentage of early gastric cancer from 1% in a five year pre-endoscopic period to 11.9% with endoscopy. On an average, subjects with early gastric cancer were 8 years younger than all cases with gastric carcinoma, those with the diffuse type according to Laurén significantly younger than those with the intestinal type, too. Postoperative mortality amounted to 6.5%; five more patients of 43 surviving the operation have died in the meanwhile. Besides synchronous and metachronous cancer in the resected stomach and other organs, late distant metastasis must be considered, too, in the follow-up of patients operated from early cancer of the stomach. These complications may endanger the five-years survival rate of 89% observed in the first series of our patients.

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In a double-blind study the influence of Pirenzepin on ulcer healing was studied in 28 in-patients with gastric ulcer under endoscopic control. The ulcer size was reduced by Pirenzepin significantly quicker, and the number of ulcers healed after three weeks treatment with Pirenzepin was significantly higher than under placebo. As to accompanying symptoms appetite stimulation was significantly more frequent with Pirenzepin compared to placebo. No patient complained of dryness of the mouth.

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A retrospective analysis was performed in 332 cases with cancer of the upper gastrointestinal tract. A limit of one month was set for delayed and missed bioptically verified endoscopic diagnosis. Malignant cycle in ulcerated lesions and the size of elevated processes were the probable causes of delayed diagnosis in 7 out of 37 cases with early cancer. In advanced gastric cancer missed diagnosis was probably caused by the indication for endoscopy made too late in an unknown number of cases or patient's refusal to undergo controls. However, failure of the endoscopist to recognize a malignant process must be considered too. The percentage of endoscopist's mistakes was below 2% in our series.

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In 24 000 gastroscopies at 4 medical departments 705 subjects with gastric operations done more than 5 years before had been studied. 39 of 608 patients with Billroth II, 5 of 81 with Billroth I and 4 out of 15 with gastroenterostomy were found to be suffering from carcinoma of the gastric stump. The primary gastric operations were performed at a medium age of 40 years. The interval between surgery and development of carcinoma averaged 24 years and was shorter in patients operated at a higher age. Besides age and interval since operation risk factors were apparently former gastric ulcers or polyps. Indications for endoscopic follow-up studies of gastrectomized patients to improve surgical results with carcinoma of the gastric stump have been suggested.

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Report on a man of 29 years with acute bronchopneumonia, antibodies against Mycoplasma pneumoniae and acute pancreatitis lasting three weeks. In some cases M. p. must be considered to be the cause of acute pancreatitis.

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