Pancreatic function tests were performed in 15 patients with advanced renal insufficiency. Pancreatic secretion was stimulated with CCK/PZ and secretin and 60 minutes later with bile given intraduodenally and CCK/PZ and secretin intravenously. The Wilcoxon-test showed that there were significantly higher lipase levels in serum and lower amylase amounts in duodenal juice compared to normal volunteers. No differences could be demonstratd for volume, maximal bicarbonate concentration, lipase and trypsin outputs. It could be shown by nonlinear discriminant analysis that pancreatic secretion might specifically be changed in patients with chronic renal failure. These patients can be definitely differentiated according to the secretion pattern from normal controls and patients with chronic pancreatitis, pancreatic carcinoma, chronic and acute duodenal ulcer.

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Pancreatic function was determined (using the secretin-pancreozymin test) before the use of gluten-free diet in 22 patients with endemic (celiac) sprue. Water and bicarbonate secretion were within normal limits, if anything there was a trend to high-normal values. Remarkable and apparently characteristic for celiac sprue was the only slight contraction of the gallbladder after intravenous injection of submaximal doses of cholecystokinin-pancreozymin (CCK). Secretion of the 3 enzymes amylase, lipase and trypsin was decreased in about one third of cases, the difference relating both to the concentrations and the amount secreted, compared with normal control values was significant (P greater than 0.01). But in no case was the reduced enzyme secretion so marked that one would expect maldigestion. Multivariate non-linear discriminance analysis demonstrated that pancreatic secretion in sprue is quite distinct from that in healthy subjects and those with chronic pancreatitis. It is assumed that there is a pattern of exocrine pancreatic secretion typical for sprue.

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Deut schland eines der wich tigsten Gesundheitsprobleme dar. Dem Risikofakto r "Adipositas" komm t daher auch in der Geburtshilfe steigende Bedeut ung zu. In der vorliegenden Unte rsuchung sollte der Einfluß des mütterlichen Körpergewichts auf den Verlauf von Schwangerschaft. Geburt. Wochenbett und Neugeborenenzustand überprüft we rden. Patlentlnnen und Methodik: Es w urden 6747 Geburten an der Frauenklinik der TU München ausgewe rte t (1987-1993). Nach dem. body mass index" (BMI. Quotient aus mütt erlichem Gewicht und dem Quadrat der Körpergröße) erfolgte die Einteilung in vier BMI-Klassen und zeigte 19,2 % unter-(BMll), 67,8 % normal-(BM I 2) sowie 8,2 % leicht (BM I3) bzw. 4,8 %sta rk (BMI 4) übergewichtig e Frauen. Die statistische Auswertung erfolgte durch Vergleich der Param eter von adipösen mit norm algewichtigen M ütt ern mittels H-Test nach Kruskal und W allis, Mann-Whitney-U-und X 2 •Test. Ergebni sse: Bei Adipositas w aren Hypertonie, Prote inurie. Plazentainsuffizienz und Gestati onsdiabetes häufiger. Übergewichtige Frauen w urden selte ner sponta n entbunden und erlitten gehäuft Geburtsverletzung en. Die Rate sekundärer Sect iones war signifika nt erhöht (BMI 4). M akrosomie. geburtsbedingt e Verletzung en (BMI 3) und Beatmungspflicht (BM I 4) tr aten bei Neugeborenen adipöser Mü tter öfter auf. Schlußfolgerung: Die Bet reuung übergewic ht iger Frauen in der Schwa ngerschaft erfo rdert besondere Aufmerksamkeit. Als präventive M aß nahme ist die Gew icht sredu ktion vor der Konzeptio n zu empfehlen. Obeslty In Pregnancy: A Risk for the Mother and her Offspring: Overw eight is one of th e most formidab le health problems in German y. rher efore. th e risk factor ..obesity" is gaining imp ortanc e in pregna nt wom en. The investigation presented here deals with the influence of maternal weight on the course of pregnancy. deliver y, post parturn period and the condition of th e newborn. 6747 deliveries at the Department of Obstetrics and Gynecology. Technical University of Monich. we re eva luat ed (1987-1993). Four groups we re defin ed according to body mass index (BM I, calculated as m aternal pre-pregnancy weig ht divided by th e sq uare of mat emal length): BMI 1-subnorm al wei ght (19.2 %), BMI 2-normal weight (67.8 %), BM I3obe se (8.2 %) and 8MI4 extre me ly obese wo me n (4.8 %).Statistical evaluation w as perform ed by comparison of the parameters of normal-w eight and adipose w omen w ith the H•test