In this study we investigated the function of the obstructed small bowel of the rat, the behaviour of the mucosal enzymes, the metabolic changes of the small bowel wall and the morphology of the mucosa. We found a decrease of passive transport of 3H-Antipyrine which was equal after 24 and 48 hrs. The active transport of 14C-Glucose was found to be progressively inhibited after occlusion. The metabolic enzymes SDH, G-6-PDH, and GOT remained unchanged, LDH was increased after 48 hrs, which can be explained by enzyme induction. The lactate-pyruvate ratio in the tissue of the obstructed bowel was 3 times as high as in the controls. The brush-border enzymes maltase and especially the alkaline phosphatase are decreased with progressive obstruction, which probably is caused by diffusion into the lumen. By electron-microscopy there are no changes in the brush-border membrane but a swelling of mitochondria which is caused by hypoxia.

No abstract

Severe rectal bleeding in a 6-year-old boy with haemophilia A and factor VIII inhibitors could not be stopped with factor VIII concentrates. But a good effect was achieved with activated prothrombin complex concentrates (fraction FEIBA), given over eight days. Amaurosis occurred as a complication after injection of the first dose, but disappeared completely within several minutes. Tests revealed accelerated intravascular coagulation with increased fibrin monomers and fibrin/fibrinogen degradation products.

Two children with fl-cell nesidioblastosis are described. The importance of early diagnosis is stressed and the extent of the pancreatectomy with preservation of the spleen is pointed out. It is suggested that the first operation should be subtotal pancreatectomy because otherwise the endocrine activity of the pancreas is too high.