4th UEGWBerlin 1995 A121 In 48 patients with negative histology, UBT results matched in 39 patients, In our patients only 8% tested positive for anti-HCV and the frequency while 9 had a positive UBT test. When subsequent re-gastroscopies were of autoantibodies was low. In Italy the high frequency of SMA, Anti-LKM and performed in these 9 patients and multiple antral biopsies were taken, all of Anti-GOR may be the result of the high frequency of associated HCV infection. them showed positive histology results. These results indicate that these autoantibodies can not be considered to be Thus, discontinuous H.P colonization as correctly diagnosed by UBT was linked to the pathogenesis of PCT in Germany. responsible for all false negative histology results in the first gastroscopy. In 10 H.P positive and 10 H.P negative patients, non-fasting conditions were tested and were found to compromise the UBT result. Food intake induced 110771 Serum Ferritin in Chloroquine-Treated Patients with 2 false positive and 1 false negative UBT result. Porphyria Cutanea Tarda 13C-UBT response 88%* U. Stolzel, E. Kostler, E. Frohburg, D. Schuppan, M.O. Doss, E.O. Riecken. 80 Dept. of Gastroenterol. Free Univ Berlin, FRG; Klinikum Benjamin Franklin, a 80 of of 60 t~~~~~ Dept Dermatol., Dresden-Friedrichstadt, FRG; Dept Clinical Biochemistry, Univ Marburg, FRG 40 60~~~~~ 4~~~~~~ Because iron overload is common in PCT and chloroquine-treatment has been 20 found to remove iron deposited in the liver comparable to venesection, we investigated serum-ferritin in 46 patients with different clinical stages of PCT. 4 Results: Serum-ferritin PCT overt PCT in remission* p-Value 2 nora (,ug/l) n = 20 n = 26 'o B:o Mean ± SD 676 ± 526 312 ± 259 p < 0.01 0- fasting after lunch Normal value: ferritin < 440 jsg,1; *remission after "chloroquine" treatment (125-250 mg twice weekly) Conclusion: The 13C-urea breath test is the gold standard in H.P diagno- sis. It correlates with the H.P colonization density. Specificity is 100% and laboratory Serum-ferritin Serum-ferritin p-Value sensitivity is 96%. False negative results were due to a very low H.P coloniza- characteristics > normal (n = 19) normal (n = 27) elimination of H.P or to obstruction. Strict tion during spontaneous pyloric Urinary porphyrinsa 1531 ± 1591 655 ± 927 p < 0.05 fasting conditions are necessary for a reliable test result. ASTa 31±21 16±6 p<0.01 ALTa 47±48 21±13 p<0.05 Inducible Nitric Oxide Synthase is a Local Defence aMean ± SD, normal values: AST<17 U/1. ALT<23 U/I. urinary porphyrins <200 gg/24 h Mechanism in H. pylori-associated Gastritis These results indicate that ferritin serum levels as markers of hepatic G. Rieder, R.A. Hatz, M. Stolte 1, G. Enders2. Dept. of Surgery, Germany; iron deposition were normalised in chloroquine-treated patients with PCT in 2 Institute for Surgical Research, LMU Munich, Germany; 1 Institute of remission. Moreover, diminished levels of ALT/AST and urinary porphyrins Pathology, Klinikum Bayreuth, Germany were observed that correlated with serum-ferritin. Therefore, the potential of choloroquine to remove iron in the liver, merits further studies. Infection of human gastric mucosa with H. pylori results in a local immune response leading to an increase in mucosal production of lgG and IgA anti- bodies. Beyond this, a characteristic feature of inflammation is the marked infiltration with neutrophiles. These cells produce and release defensins as 11079 Serum Markers of Collagen Synthesis and Breakdown a further defence against bacterial infection. The aim of our study was to Suggest an Antifibrotic Effect of Ursodeoxycholic Acid confirm the above defence mechanisms against H. pylori and to investigate in Patients with PBC Stage l-IV further inflammatory mechanisms such as the expression of the inducible C. Oesterling, T. Aksu, R. Somasundaram, U. Stolzel, P Libuda, E.O. Riecken. nitric oxide synthase (iNOS). D. Schuppan. Dept. of Gastroenterology, Klinikum B. Franklin, Free Methods: Antral biopsies were taken endoscopically from H. pylori- University of Berlin, FRG associated gastritis and non-gastritis patients. Defensins were analysed im- Aims: The question if ursodeoxycholic acid (URSO) has an anti-fibrotic effect munohistochemically and RNA was extracted from homogenized biopsies by in patients with PBC remains controversial. Therefore, we used a presumed means of a silica-based membrane technique. PCR was performed on syn- serum marker of collagen synthesis (PIIINP) and a recently established serum thesized cDNA using specific primers for iNOS and the housekeeping gene marker of collagen breakdown (collagen VI, CVI) to follow the course of 23 superoxide dismutase (Cu, Zn-SOD). patients with PBC (12 stage I-Il, 9 stage III-IV) treated over 2-4 years with Results: An equal concentration of cDNA was assured by the amplification oral URSO at 10-15 mg/kg b.w. of Cu, Zn-SOD. iNOS mRNA amplification was only obtained in gastritis pa- Methods: Each patient underwent initial liver biopsy, and serum levels of tients but not in negative control individuals. The amount of mRNA coding for PIIINP (RlAgnost) and CVI (inhibition-ELISA) were determined at regular in- the enzyme iNOS was strictly correlated with the degree of gastritis. Further- tervals. The means of year 1 (2-5 values, group 11) and year 2-4 (2-6 values, more, we could show a local increase of defensins in submucosal gastritis group 111) after initiation of URSO-treatment were compared to each other tissues. and to pretreatment levels (group I) by using linear regression analysis and Conclusions: NO, a cytotoxic substance, is produced by the enzyme NOS. the Mann-Whitney U-test. Therefore, the increased amount of mRNA for iNOS in tissues of active gastri- Results: In all patients both PIIINP and CVI in groups I-l1l were higher than tis may reveal a further local defence mechanism against H. pylori infection. in controls < 0.01 or < There was no radicals (p p 0.05). correlation to conventional Furthermore, it is assumed that NO and other oxygen produced by laboratory parameters except for ALP vs. PIIINP (p < 0.05). Whereas PIIINP chronic inflammatory processes may initiate or enhance carcinogenesis in remained in / vs. II vs CVI increased a mean of 128 + 51 H. infection. unchanged 111, from humans like gastric cancer due to chronic pylori (1 SD) ,ugA (group I) to 156 + 57 .g/1 (II) to 212 + 101 ,tg/1 (IIl) (p < 0.01 for I vs. Ill, p < 0.05 for 11 vs. Ill)]. Subgroup analysis showed a significant in Cutanea Tarda in decrease of PIIINP for PBC stage III-IV (1.47 + 0.31 U/1 (I), 1.20 + 0.47 U/1 Autoantibodies Porphyria (II), 1.1 1 + 0.28 U/1 (Ill), p < 0.05 for I vs. Ill), accompanied by a significant in- Germany crease over time for CVI, both in PBC stage I-Il and III-IV (p < 0.05). The ratio U. Stolzel, E. Kostler, E. Frohburg, M.O. Doss, E.O. Riecken, D. Schuppan, of CVI over PIIINP, supposedly reflecting the balance of collagen breakdown M. Manns. Dept's. of Gastroenterol., Free Univ Berlin, Klinikum Benjamin over collagen synthesis in the liver, further improved the discrimination be- Franklin, Med. Hochschule Hannover, Dept. of Clinical Biochemistry, Univ tween groups. However, individual patients (3 each with stage I-Il and III-IV) Marburg, Dept. of Dermatol., Dresden-Friedrichstadt, FRG displayed an unfavourable evolution of these markers. an- Recently, a high frequency of autoantibodies and hepatitis C infection were Conclusion: Serum markers of fibrogenesis and fibrolysis suggest an reported as main pathogenetic factors in Italian patients with PCT. Therefore, tifibrotic effect of URSO in most but not all patients with PBC. we investigated these markers in 100 German patients with PCT. Results: 11080 Autonomous Neuropathy in Achalasia: Postprandial Antibodies Italy' (n = 23) Germany(n = 100) p-Values Decrease of Pulsatility Index (PI) Is Augmented and ANA > 1:40 17% 16% NS Increase of Peak Flow Velocity is Impaired in Superior SMA > 1:40 78% 20% p < 0.0001 Mesenteric Artery PCA > 1 :40 ND 4% A. von Herbay, T. Heyer, P Auer, T. Frieling, D. of Anti-LKM 4% 0 p < 0.05 Haussinger. Dept. Anti-SLA ND 0 Gastroenterology, Hepatology and Infectiology Heinrich-Heine University of AMA ND 3% Dusseldorf, Germany Anti-GOR 57% 4% p < 0.0001 It that achalasia is Anti-HCV 91% 8% p < 0.0001 has been suggested associated with extraesophageal sym- pathetic and parasympathetic dysfunction. Methods: In a prospective study, 'Data from Italy reported by Ferri et al. 1993; ND, not determined we investigated basal and postprandial gall bladder volume and peak systolic A122 4th UEGWBerlin 1995 velocity of superior mesenteric artery and portal vein in 9 patients with acha- tem. These included faulty implantation, system kinking and ascites leakage. lasia (5 men) and 10 healthy controls (4 men). Gall bladder volume was mea- Disease-related complications such as thrombopathy, cachexia and hepatic sured by ultrasound and peak systolic velocity by duplex-Doppler-sonography and renal insufficiency determine the long-term survival rate. (Toshiba duplex Doppler ultrasound machine with a 3.75 MHz transducer). In each measurement, flow velocity was corrected by evaluation of the doppler angle. PI was calculated as (v max - v min)/v mean. Decrease of PI is a param- 11086 The 13C-Caffeine-Breath-Test as an In-Vivo Probe to eter of a decrease in the distal peripheral vascular resistance. Triple measure- Assess the Activity of Cytochrome P4501A2 ments were obtained at basal state, 15, 30, 60 and 90 minutes postprandially. G. Schumacher, H. Brosicke, A. Pfundstein, H. Helge. Department of The meal consisted of 300 ml liquid formula diet (Fresubin, 300 kcal, 11.4 g Pediatrics, University Clinic Rudolf Virchow, Free University of Berlin, protein, 10.2 g lipid, 41.1 g carbohydrate): Results: At basal state, gallbladder volume, peak systolic velocity and PI were not significantly different between Germany both groups.