Contribution of sensitivity, volume and tone to visceral perception in the upper gastrointestinal tract in man: emphasis on testing

Abstract  Upper gastrointestinal (GI) symptoms occur frequently in the general population, making them among the most common indications responsible for patients consulting the healthcare system. Consequently, understanding and characterization of the upper GI symptoms is important for the diagnosis and assessment of organ dysfunction. In practice, assessment of clinical symptoms is difficult and it is still to a large extent unclear how sensitivity, volume and tone contribute to visceral perception in the upper GI tract. The goal of advanced research in upper GI symptoms is to obtain a better understanding of the mechanisms involved in transduction, transmission, and perception under normal and pathophysiological conditions. An important step towards this goal is understanding the information provided by and the inherent limitations of the currently available measuring techniques. This article focuses on the sensory testing of the oesophagus, and methods and concepts used to assess the relation between gastric volumes or tone and upper GI symptoms. It also summarizes the contributions of these techniques towards identifying the components responsible for the generation of upper GI symptoms.     

Intrastromal keratorhexis with the Nd:YAG laser--a possible method of refractive surgery?

A new method of refractive corneal surgery is presented. With the q-switched Nd:YAG-laser Visulas (Zeiss-Oberkochen) we succeed in altering the optical power of the cornea of rabbits, pigs and humans. The number of applied laser spots and the distribution pattern influence the way and the amount of change of refraction. The method, clinical and histological features, complications and prospects of the Nd: YAG laser keratorhexis are described.     

Ombudskommissionen vor neuen Hürden

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Epidemiologie, Diagnostik und Prävention

Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide. Its diagnosis is based on clinical examination, including ultrasound, laboratory analyses, as well as determination of the tumour marker alpha-fetoprotein (AFP). If evidence for HCC is present, further imaging techniques (CT, MRI), and, if required, histopathological examination are necessary. The most important risk factors are chronic hepatitis B, C, and D, metabolic liver diseases, especially hereditary hemochromatosis, toxins (alcohol, aflatoxin) and states of insulin resistance. This knowledge provides us with strategies for HCC prevention that are of great clinical significance, in particular because, in spite of recent advances, the current therapeutic options for most patients remain very limited.