[Laboratory diagnosis of acute pancreatitis].
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Acute Disease↗
Biomedical subjects
C Bode
Publications and source records attributed to C Bode.
Percutaneous endoscopic duodenostomy (PED). Case report.
Surgeons are increasingly using endoscopy to place transabdominal feeding tubes for enteral nutrition or gastric decompression. A possible extension for the application of this new technique is the direct placement of the feeding tube into the duodenal bulb. Two patients are presented in whom percutaneous endoscopic duodenostomy was successfully performed, although percutaneous endoscopic gastrostomy was not possible. It shows that this new method is technically possible. In both patients the positive influence of this technique on the patient's quality of life could be shown using the Spitzer Quality of Life Index and the Karnofsky Performance Status. Enteral nutrition was maintained for more than 6 weeks.
Aged↗
Palmitate uptake in calcium tolerant, adult rat myocardial single cells--evidence for an albumin mediated transport across sarcolemma.
The dependence of (1-14C)-palmitate uptake in adult rat heart single cells on albumin was investigated. The apparent initial rate of palmitate uptake vs total palmitate concentration exhibited saturation kinetics, provided the concentration ratio of palmitate vs albumin was kept constant. However, if total palmitate was increased at constant albumin concentrations, the dependence of the initial rate on palmitate concentration was linear. Within the concentration range of total palmitate investigated in this study, the concentration of free palmitate remained almost constant. These results favour the hypothesis, that palmitate uptake in rat myocardium may be mediated by an albumin dependent sarcolemmal transport system.
Albumins↗
Thrombolysis by a fibrin-specific antibody Fab'-urokinase conjugate.
The unidirectional crosslinking agent N-succinimidyl 3-(2-pyridyldithio)propionate (SPDP) was used to covalently couple fibrin-specific antibody Fab' to low-molecular-weight urokinase by means of the sulfhydryl groups of the inter-heavy-chain disulfide bonds. At enzymatic activities equal with respect to the substrate pyroglutamyl-glycyl-arginyl-p-nitroanilide-hydrochloride, the Fab'-urokinase conjugate lysed fibrin monomer linked to sepharose with a potency 95 times that of urokinase (which is essentially identical to the potency previously reported for an intact antibody-urokinase conjugate). The Fab'-urokinase conjugate also lysed human thrombi in fresh citrated plasma with a maximal potency 4.4 times that of uncoupled urokinase. These findings indicate that univalent antibody binding is sufficient to enhance fibrinolysis and that the increased potency of antifibrin-urokinase conjugates can also be demonstrated when cross-linked thrombi are used as substrate in the presence of plasma.
Antibodies↗
Endotoxemia in patients with alcoholic and non-alcoholic cirrhosis and in subjects with no evidence of chronic liver disease following acute alcohol excess.
The presence of endotoxemia in peripheral venous blood was evaluated in 88 patients with alcoholic cirrhosis (AC) and in 42 patients with non-alcoholic cirrhosis (NAC). The two groups did not differ significantly with respect to mean age, liver function tests, and incidence of esophageal varices or ascites. In addition, a group of 24 patients with no evidence of chronic liver disease but with acute exposure to large quantities of alcoholic beverages was investigated. Endotoxin was determined by using the Limulus lysate test. The assays were carried out in the plasma samples by both the dilution technique and the chloroform extraction method. Endotoxemia was found more frequently in patients with AC (67.3%) than in patients with NAC (45.5%, P less than 0.025). The prevalence of endotoxemia was not significantly higher in cirrhotics with ascites or esophageal varices when compared to the subgroup without ascites or esophageal varices. Of the 24 patients with no evidence of chronic liver disease investigated because of acute alcohol excess immediately before admission 11 (45.7%) were found to have endotoxin in the peripheral venous blood. In 7 of these patients a second blood sample was tested 5-8 days later and no endotoxin could be detected. The latter results suggest that heavy alcohol abuse leads to transient endotoxemia even in patients with no signs of chronic liver disease. The findings support the hypothesis that gut-derived endotoxins might play a role in the initiation and aggravation of alcohol-induced liver disease.
Adult↗
Alcohol-induced liver injury after jejunoileal bypass operation in rats.
The objective of this study was to investigate whether alcohol administration exerts a synergistic effect on jejunoileal bypass-induced liver dysfunction in rats. Male Wistar rats were subjected to 90% jejunoileal bypass or sham operation. For 10 weeks, subgroups were pair-fed either an alcohol-containing (36% of total calories) liquid diet or a liquid diet where alcohol was replaced isocalorically by starch. Alcohol feeding in rats with jejunoileal bypass increased hepatic triglyceride content about 6-fold as compared with bypassed rats receiving control diet. Neither jejunoileal bypass nor alcohol feeding led to significant changes in hepatic DNA and protein contents. Alcohol feeding increased cytochrome P-450 levels both in operated and in sham-operated rats. The administration of alcohol-containing diet decreased the activity of succinic dehydrogenase, the decrease being distinctly more pronounced in rats with jejunoileal bypass than in the sham-operated controls. Light microscopy revealed no significant morphological alterations in liver sections of rats fed the control diet after jejunoileal bypass or of rats receiving either the alcohol-containing diet or the control diet after sham operation. Alcohol feeding in bypassed rats, however, produced marked diffuse accumulation of fat, and regularly led to other histological abnormalities in the liver. These abnormalities included ballooning of hepatocytes and disarray of the trabecular structure of the liver lobule, hyalin inclusions resembling megamitochondria, single-cell necrosis and focal clustering of necrosis, increased number of mitotic figures, and infiltrates with inflammatory cells. The histological lesions of the liver of bypassed rats receiving alcohol exhibited no obvious zonal distribution. The results demonstrate that alcohol feeding to rats subjected to jejunoileal bypass leads to marked liver injury which mimics, at least in part, that of alcohol-induced liver disease in man. Rats subjected to jejunoileal bypass may, therefore, provide a new model for the study of alcoholic liver disease.
Animals↗
Antibody-enhanced thrombolysis: targeting of tissue plasminogen activator in vivo.
Tissue plasminogen activator (tPA) was modified by the unidirectional crosslinking reagent N-succinimidyl 3-(2-pyridyldithio)propionate and coupled to iminothiolane-modified anti-fibrin antibody 59D8 by the formation of disulfide bonds at neutral pH. Purification by two affinity-chromatography steps yielded tPA-anti-fibrin antibody conjugate (tPA-59D8) possessing both tPA and anti-fibrin antibody activities. In a quantitative rabbit thrombolysis model, the activity of the purified conjugate was compared with that of tPA alone and that of a conjugate between tPA and a digoxin-specific monoclonal antibody. After correction for spontaneous lysis (10.9 +/- 2.5%), tPA-59D8 was shown to be 2.8-9.6 times more potent than tPA alone. Unconjugated tPA and tPA-digoxin were equipotent. At equivalent thrombolytic concentrations, tPA-59D8 degraded less fibrinogen and consumed less alpha 2-antiplasmin than did tPA alone. This suggests that tPA can be efficiently directed to the site of a thrombus by conjugation to an anti-fibrin monoclonal antibody, resulting in both more potent and more selective thrombolysis.
Animals↗
Antibody-enhanced thrombolysis: capture of tissue plasminogen activator by a bispecific antibody and direct targeting by an antifibrin-tissue plasminogen activator conjugate in vivo.
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Antigen-Antibody Complex↗
Effect of acute and chronic ethanol administration in rats on PGE2 formation in microsomes from stomach and small intestine.
Prostaglandin E2 formation and content has been measured in the stomach and small intestine of rats after acute and chronic ethanol ingestion. Chronic ethanol administration for 6 and 12 weeks inhibits PGE2 synthesis and reduces PGE2 content (12 weeks) in all parts of the upper gastrointestinal tract, while after ethanol ingestion up to 1 week PGE2 synthesis is decreased only in the stomach.
Animals↗
Effect of acute and chronic alcohol feeding on prostaglandin E2 biosynthesis in the small intestine of the rat.
The effect of acute and chronic alcohol ingestion on the PGE2 synthesis and PGE2 content in the duodenum and ileum was studied in rats. Following a single oral load of 20% alcohol (v/v; 4 g/kg body weight) the synthesis of PGE2 in isolated microsomes from both parts of the small intestine did not differ from that in control rats during the first 8 hours, but was increased significantly after 24 hours. Feeding a liquid diet containing alcohol (37% of total calories) for 1 week led to enhanced PGE2 synthesis in the duodenum. After feeding the diet for 6 and 12 weeks the rate of PGE2 synthesis was significantly reduced in the duodenum (-73% and -55%) and ileum (-34% and -45%) as compared with the control group. The PGE2 content of the tissue was not significantly changed 24 hours after the single alcohol load and after 1 week of feeding the alcohol-containing diet. However, after 6 and 12 weeks' feeding, the PGE2 content was reduced in both parts of the small intestine. The results suggest a biphasic response to alcohol of PGE2 synthesis in the small intestine. The increased rate of PGE2 synthesis in the initial phase might reflect an adaptive response to the injurious effect of alcohol which cannot be maintained after long-term ingestion of alcohol.
Alcohol Drinking↗
Effect of short- and long-term alcohol feeding in rats on pancreatic enzyme content and enzyme secretion in isolated pancreatic lobules in vitro.
The effect of short- and long-term ethanol intake on digestive enzyme secretion was determined in isolated pancreatic lobules of rats. Groups of male Wistar rats were fed a modified Lieber-DeCarli diet containing either 5% (w/v) of ethanol, isocaloric amounts of a liquid diet in which ethanol was substituted by starch, or solid rat chow; for 3 days, 1, 2, 4, 8 and 12 weeks. Basal and caerulein-stimulated secretion of lipase, amylase, chymotrypsin and trypsin and the enzyme content in the tissue were studied. Feeding the liquid control diet decreased the tissue content of the four enzymes as compared with the values obtained in the group receiving solid rat chow. While basal and stimulated amylase secretion was markedly reduced in the former group, the secretion pattern of the other enzymes exhibited only transient changes. Caerulein-stimulated secretion of lipase and the proteases was increased by ethanol, the effect being more pronounced during the initial phase of the experiment. Alcohol feeding stimulated the basal secretion of these enzymes only in weeks 1-4. In contrast to the other enzymes, basal and stimulated amylase secretion was not enhanced by ethanol feeding. The results suggest that the enzyme secretion of the rat pancreas is distinctly altered by chronic ethanol feeding. However, the response of the pancreatic enzymes is non-parallel, and changes with the duration of alcohol intake.
Amylases↗
Usefulness of a simple photometric determination of chymotrypsin activity in stools--results of a multicentre study.
The usefulness of a new photometric test for the determination of chymotrypsin activity in stools was evaluated in a multicentre study. By release of the enzyme from stool particles with a cationic detergent solution after, in most cases, 3 min of homogenization, a photometric measurement of the enzyme activity is possible both in the clear supernatant after centrifugation and in the diluted stool homogenate. The precision of the activity measurement in stool samples with pathologically lowered and normal chymotrypsin activity is good both for in-series (CV = 2.6%, scatter 0.6-5.7%) and for day-to-day determinations (CV = 7.2%, scatter 3.9-13.9%). The results obtained by the photometric determination also exhibit a close correlation with the values measured by pH-stat titrimetry (r = 0.901). The sample-preparation system with a sample-metering chamber is easy to use and gives good agreement with determinations in which the sample metering was done by weighing out the stool (r = 0.961). The photometric test for detection of exocrine pancreatic insufficiency is easy to perform, inexpensive and does not place any undue stress on the patient.
Chymotrypsin↗
Varix of the external jugular vein.
A case of varix involving the left external jugular vein is presented. The pathogenesis of the unusual condition is discussed and the attention of practising physicians drawn to the new differential diagnosis of swelling in the neck.
Adolescent↗
[Percutaneous endoscopic gastrostomy].
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Catheters, Indwelling↗
Antibody-directed urokinase: a specific fibrinolytic agent.
A specific fibrinolytic agent was synthesized by covalently coupling urokinase to a monoclonal antibody that was fibrin-specific and did not cross-react with fibrinogen. The antibody was raised against a synthetic peptide representing the seven amino-terminal residues of the beta chain of human fibrin. The urokinase-antifibrin conjugate retained the original binding specificity of the antibody and showed 100-fold increased fibrinolysis in vitro when compared to unmodified urokinase. The presence of human fibrinogen at plasma concentration did not influence these properties.
Antibodies, Monoclonal↗
Effect of ammonia on plasma and cerebrospinal fluid amino acids in dogs with and without portacaval anastomoses.
To elucidate the possible connection between ammonia-induced changes of plasma and cerebrospinal fluid (CSF) amino acid levels and the development of hepatic encephalopathy in dogs, beagle dogs were given an ammonium acetate infusion both before and following portacaval shunt (PCS). During ammonia-induced coma and after recovery in the dogs prior to PCS the plasma and CSF concentrations of most amino acids were decreased. Following PCS the plasma and CSF concentrations of the aromatic amino acids (AAA), phenylalanine and tyrosine, increased and the levels of the branched chain amino acids (BCAA), valine, leucine, and isoleucine, decreased during ammonia-induced coma. The CSF/plasma molar ratio for the AAA exhibited a marked increase after recovery as compared to the value during coma in the Eck-fistula dogs. With respect to the AAA, no correlation was observed between signs of neurologic impairment in the animals and the following parameters: glutamine and methionine levels of CSF, and the plasma molar ratio (Formula: see text). The data obtained do not support the hypothesis that high concentrations of phenylalanine and tyrosine in the brain may be primarily responsible for altered neurotransmission leading to the development of hepatic encephalopathy.
Amino Acids↗
Specific phosphorylation of a protein in calcium accumulating endoplasmic reticulum from rat parotid glands following stimulation by agonists involving cAMP as second messenger.
Stimulation of secretion in exocrine cells by agonists involving cAMP as second messenger is associated with the phosphorylation of a specific membrane-associated 22.4-kDa protein (protein III) (Jahn et al.). Here it is shown by subcellular fractionation of rat parotid gland lobules that protein III is associated with the endoplasmic reticulum. The submicrosomal fractions containing protein III, also contain the ATP-dependent microsomal calcium pump activity. Protein III in microsomal subfractions can be phosphorylated in vitro with catalytic subunit from cAMP-dependent protein kinase. Phosphorylated protein III contains exclusively P-serine. Protein III can be removed from ER-membranes with acid chloroform-methanol or Triton X-114, but not by high salt wash indicating that it is tightly associated with the membranes. Protein III is smaller than phospholamban and, in contrast to phospholamban, resistant to heating in SDS. A relationship between phosphorylation of protein III and microsomal calcium sequestration is discussed.
Animals↗
The effect of cimetidine treatment on ethanol formation in the human stomach.
Ethanol concentrations were determined in the gastric juice of 53 patients treated with a nasogastric tube. Significant ethanol concentrations ranging from 1 to 27 mmol/l were found in a subgroup of 29 patients receiving cimetidine (n = 22) or antacids (n = 7). The mean ethanol concentration in these patients was higher 1-2 h after a liquid meal (means +/- SEM, 6.95 +/- 2.6) than in the fasting state (3.44 +/- 2.1; p less than 0.05). In the second subgroup of 24 patients, who were not treated with cimetidine or antacids, ethanol concentrations in gastric juice of more than 1 mmol/l were found in 6 cases, with maximal ethanol values of 2.2 mmol/l. The alcohol concentration correlated significantly with the pH of the gastric juice. It is assumed that an increase in the yeast and/or bacterial population in the stomach due to the reduction of gastric acidity induced by cimetidine or antacids is responsible for the enhanced production of ethanol.
Antacids↗