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Biomedical subjects

C Löser

Publications and source records attributed to C Löser.

At least 37 records · Page 2Linked to original sources

Aerobic 4-nitrophenol degradation by microorganisms fixed in a continuously working aerated solid-bed reactor.

Studies of microbial purification of a model waste water containing 4-nitrophenol were carried out in a continuously working aerobic solid-bed reactor. The main emphasis was on the dynamic behaviour of the system after a sudden change in cultivation conditions and on the steady state performance of the reactor as a function of the pollution load. A change from ammonium-free to ammonium-containing medium hardly influenced the nitrophenol degradation. The reactor responded differently to an increase in pollutant load, which was brought about by increasing either the 4-nitrophenol content or the flow of the waste water. Up to a load of 270 mg l-1 h-1 the pollutant was stably and almost completely degraded. At a higher load, only a partial 4-nitrophenol degradation took place. A mathematical model was derived to describe the processes that occurred in the reactor. By segregation into two compartments--the aqueous phase and the biofilm--account was taken of the fact that the pollutant is carried into the biofilm by diffusion and is degraded there. The observed relations between the pollutant load, the pollutant concentration in the outlet of the reactor and the reactor performance agreed with the simulated process behaviour. As the model simulation showed, the incomplete pollutant degradation at a higher reactor load was caused by oxygen limitation.

Aerobiosis↗

A double-blind, randomized, multicentre, crossover study to prove equivalence of pancreatin minimicrospheres versus microspheres in exocrine pancreatic insufficiency.

BACKGROUND: Modern pancreatin preparations consist of enteric-coated microspheres to protect the enzymes from gastric acid. There are, however, no clinical trials comparing different sizes of pancreatin microspheres with regard to fat excretion and fat intake. AIM: To prove both equivalent efficacy and safety of conventional pancreatin microspheres and smaller pancreatin minimicrospheres in patients with exocrine insufficiency due to chronic pancreatitis. METHODS: In this prospective, randomized, double-blind, multicentre, crossover trial, patients with a stool fat excretion of > 7.5 g/day during a placebo period were randomly assigned either to the minimicrosphere/microsphere treatment sequence or vice versa. The primary end-point was the coefficient of fat absorption, which was calculated from fat excretion and fat intake during the course of a standardized diet. Stool weight, clinical symptoms and the safety of the preparations were also evaluated. RESULTS: Thirty-seven patients entered the study, of whom 23 fulfilled the criteria for the crossover period. In the per protocol analysis (n=18), the 90% confidence intervals for the coefficient of fat absorption of both crossover periods lay entirely within the equivalence range (P=0.02). The intention-to-treat analysis revealed similar results, but the equivalence range was slightly missed (P=0.07). Similar results were obtained for the secondary parameters and the reported adverse events. CONCLUSIONS: Pancreatin minimicrospheres have been shown to be equally effective as microspheres in improving the coefficient of fat absorption in patients with exocrine insufficiency due to chronic pancreatitis.

Adult↗

Dietary polyamines are essential luminal growth factors for small intestinal and colonic mucosal growth and development.

BACKGROUND: Polyamines are essential for cell growth. Dietary and probably gut bacterial derived polyamines contribute significantly to the polyamine body pool. AIMS: To evaluate the influence of dietary, luminal polyamines on growth and development of different gastrointestinal organs in normally growing rats. METHODS: Male suckling Wistar rats were randomly allocated to four treatment groups: polyamine deficient diet (PDD); PDD plus antibiotics (neomycin 2 g/kg and metronidazole 34 mg/kg); PDD plus polyamine supplementation at normal concentrations; or normal standard laboratory chow. After a six month feeding period 7-10 animals/group were sacrificed. RESULTS: No differences in body weight gain, food consumption, or general behaviour could be observed between the four groups of animals. Feeding of PDD alone or PDD plus antibiotics resulted in a highly significant decrease in organ weight, protein content, and DNA content in small intestinal and colonic mucosa whereas no alterations were found in the liver. CONCLUSIONS: Long term feeding of polyamine deficient diets resulted in a significant hypoplasia of small intestinal and colonic mucosa. Dietary, luminal polyamines are important local factors for growth and the development of small intestinal and colonic mucosa.

Animal Nutritional Physiological Phenomena↗

[Diagnosis of chronic pancreatitis].

Chronic pancreatitis is typically characterized by clinical (abdominal pain, steatorrhea, loss of body weight), morphological (calcifications, dilated ductus pancreaticus) as well as functional (maldigestion, diabetes mellitus) parameters. Since the diagnosis of chronic pancreatitis is hampered by the inavailability of early histological confirmation, it is therefore based on morphological (ultrasound, ERP, EUS, CT) and functional (faecal elastase) criteria. Due to the poor correlation between morphological and functional parameters in the early phase of the disease, both are complementary at this stage. While the diagnosis of severe cases of chronic pancreatitis with steatorrhea is hardly a challenge in clinical practice, the differential diagnostic evaluation of mild and moderate cases remains a major clinical problem. ERP remains to be the most sensitive morphological procedure, while determination of faecal elastase is the most sensitive and specific "tubeless" pancreatic function test available today and in the future prove to be rapid, easy to handle and highly practicable in clinical routine.

Chronic Disease↗

Enteral long-term nutrition via percutaneous endoscopic gastrostomy (PEG) in 210 patients: a four-year prospective study.

After PEG placement at the Medical Department of the University Hospital in Kiel, 210 patients (mean age 61.3 years; 137 men, 73 women) were prospectively followed-up for 133+/-181 days. Close-meshed evaluations of the development of nutritional status, long-term outcome, complications, subjective acceptability, patient care after discharge from the hospital, survival, and nutritional long-term problems were performed. The PEG procedure (duration 13.3+/-4.2 min) was carried out for neurological (42%), ear-nose-throat (28%), and internal medical (30%) indications. Procedure-related mortality was 0%, while altogether 3.8% severe and 20.0% mild complications were observed. Body weight decreased by a mean of 11.4+/-1.5 kg in the three months before and increased by 3.5+/-1.7 kg one year after PEG placement with no significant differences between malignant or benign underlying diseases. Individual subjective acceptability was excellent in 83%, sufficient in 15%, and poor in 2% of patients only. One-year survival rate was 34.3%. The various results of the present prospective study demonstrate that long-term enteral feeding via PEG is a safe, effective, easy-to-practice, and highly acceptable method with excellent long-term results and distinct improvement of nutritional status. Individual decisions for PEG placement should be considered much earlier and more frequently in appropriate patients.

Adult↗

Comparative clinical evaluation of the 13C-mixed triglyceride breath test as an indirect pancreatic function test.

BACKGROUND: Breath tests using stable isotopes of carbon or hydrogen are increasingly becoming established for the evaluation of various gastrointestinal functions, including measurement of exocrine pancreatic insufficiency. We wanted to evaluate the clinical relevance of the non-invasive, non-radioactive 13C-mixed triglyceride breath test in comparison with the secretin-caerulein test as the 'gold standard' of pancreatic function testing and with faecal chymotrypsin and elastase 1 in patients with mild and severe exocrine pancreatic insufficiency. METHODS: The secretin-caerulein test, faecal fat analysis, 13C-mixed triglyceride breath test, faecal elastase 1, and chymotrypsin and various morphologic investigations were done in 26 patients with mild (n = 13) or severe (n = 13) exocrine pancreatic insufficiency and 25 patients with gastrointestinal diseases of non-pancreatic origin. Twenty-seven healthy volunteers served as normal controls. After a 12-h fast 200 mg mixed triglyceride (1,3-distearyl,2(carboxyl-13C)octanoyl glycerol) were orally administered with a test meal, and breath samples were taken before and at 30-min intervals for 5 h thereafter, and the increase in 13C/12C isotopic ratio in breath was analysed by mass spectrometry. Various modifications of the test procedure were investigated. RESULTS: Specificity for impaired pancreatic function was higher for faecal elastase (90%) and equal for faecal chymotrypsin (82%) as compared with the various variables of the 13C-mixed triglyceride breath test (69-85%). The sensitivity of the 13C-mixed triglyceride breath test for total and separately for mild and severe exocrine pancreatic insufficiency was higher (total, 69-81%) than that of faecal chymotrypsin (total, 56%) but lower than faecal elastase (total, 92%). CONCLUSION: The 13C-mixed triglyceride breath test very sensitively reflects severe exocrine pancreatic insufficiency (steatorrhoea) but has limited sensitivity for the detection of mild cases. With regard to the higher sensitivity and specificity, the higher practicability, and the much lower cost, determination of faecal elastase 1 concentrations is superior to the 13C-mixed triglyceride breath test and therefore remains the most reliable indirect pancreatic function test available today.

Adult↗

Uptake of extracellular, dietary putrescine is an important regulatory mechanism of intracellular polyamine metabolism during camostate-induced pancreatic growth in rats.

Aim of the present study was to evaluate the role of cellular uptake of dietary [3H]putrescine for the regulation of pancreatic, hepatic, and small intestinal polyamine metabolism during normal and camostate-induced pancreatic growth in rats in vivo. Initially dose-response and time-course studies of [3H]putrescine uptake were performed. Male Wistar rats were either treated with the synthetic trypsin inhibitor camostate (200 mg/kg body wt orally twice daily), camostate plus the ornithine decarboxylase inhibitor alpha-difluoromethylornithine (DFMO) (2% in drinking water plus 3 x 300 mg/kg body wt intraperitoneally during daytime) or saline as controls. After 4, 8, 12, 24, 36, 48, or 120 hr, five to seven animals per group were killed, respectively. Orally fed [3H]putrescine (10 nmol/kg body wt. 2 hr prior to death) is rapidly taken up and further metabolized to spermidine in normal growing pancreas, liver, and small intestine. Feeding of camostate significantly enhanced dietary [3H]putrescine uptake, while simultaneous inhibition of de novo synthesis of intracellular polyamines by DFMO resulted in a highly significant further increase in cellular uptake of orally fed [3H]putrescine, which is immediately metabolized to spermidine. The present in vivo data confirm the important role of dietary putrescine uptake for the maintenance of intracellular polyamine pool in normal and stimulated pancreatic growth. Furthermore, dietary putrescine uptake is an important regulatory mechanism to maintain the normal and growth-stimulated cellular polyamine pool in the pancreas after potent simultaneous inhibition of intracellular de novo polyamine synthesis.

Animals↗

Importance of intracellular S-adenosylmethionine decarboxylase activity for the regulation of camostate-induced pancreatic polyamine metabolism and growth: in vivo effect of two novel S-adenosylmethionine decarboxylase inhibitors.

The present study was designed to investigate the inhibitory potency of the two novel S-adenosylmethionine decarboxylase (SAM-DC) inhibitors MDL 73811 and CGP 48664 on the camostate-induced pancreatic polyamine metabolism and especially intracellular spermidine accumulation as well as pancreatic growth in vivo. Male Wistar rats (180 g) were either treated with (1) the synthetic trypsin inhibitor camostate (200 mg/kg b.w. orally twice daily), (2) camostate+MDL 73811 (100 mg/kg b.w. i.p. twice daily), (3) camostate+CGP 48664 (5 mg/kg b.w. i.p. once daily) or (4) saline as controls. Animals (5-9 per group) were sacrificed after 1, 2 and 5 days of treatment. MDL 73811 caused a long-lasting (> 95%; p < 0.005) inhibition of SAM-DC followed by a significant (p < 0.005) increase in ornithine decarboxylase and putrescine, while spermine was decreased (p < 0.005). In contrast to MDL 73811, CGP 48664 had little effect in vivo. Despite potent inhibition of SAM-DC camostate-stimulated intracellular spermidine accumulation was not prevented by the simultaneous administration of MDL 73811. Consequently organ growth was not affected either. Since de novo synthesis of spermidine was effectively inhibited by MDL 73811, counterregulatory mechanisms (i.e. interconversion pathway, extracellular uptake) had to step in to maintain the intracellular balance of spermidine. The present data support the general concept of the importance of intracellular spermidine accumulation for the maintenance of pancreatic growth in vivo.

Adenosylmethionine Decarboxylase↗

13C-starch breath test--comparative clinical evaluation of an indirect pancreatic function test.

The clinical relevance of the 13C-starch breath test was evaluated in comparison to the secretin-caerulein test as the "gold standard" of pancreatic function testing, fecal elastase concentration, and fecal chymotrypsin activity in 30 patients with mild (n = 15) or severe (n = 15) exocrine pancreatic insufficiency. 23 patients with gastrointestinal diseases of non-pancreatic origin and 31 healthy volunteers served as controls. 50 g of natural starch of maize were orally administered after a 12-h fast and breath samples were taken before and in 30 min intervals for five hours after oral ingestion and the increase of 13C/12C-isotopic ratio was analyzed by mass spectrometry. Specificity of fecal elastase (93%) and fecal chymotrypsin (93%) for impaired pancreatic function were much higher compared to the various parameters of the 13C-starch breath test (69-74%). Sensitivities of the 13C-starch breath test for all and separately for mild and severe exocrine pancreatic insufficiency were higher (total 70-77%) compared to fecal chymotrypsin (total 60%), but lower compared to fecal elastase (total 93%). With regard to the higher sensitivity and specificity, the higher practicability, and the lower costs determination of fecal elastase concentrations is superior to the 13C-starch breath test and therefore remains to be the most reliable indirect pancreatic function test available today.

Adult↗

Self-expanding metallic coil stents for palliation of esophageal carcinoma: two cases of decisive stent dysfunction.

Two cases of different dysfunctions of self-expanding nickel-titanium coil stents are described here. In the first case, a metallic coil stent was placed in a 8-cm circular rigid stenosis of the mid-esophagus caused by a squamous-cell carcinoma (T3 N1 M1), and seven weeks later, the stent lumen was completely occluded by massive tumor ingrowth through inadequtely adapted single coil wires. In the second case, the caudal and cranial ends of the stent became increasingly invaginated after initially adequate stent expansion, resulting in a shortening of the stent to about two-thirds of its intended size, with subsequent complete luminal obstruction at both ends of the stent due to tumor overgrowth. These two examples of different stent dysfunction correspond to similar observations by other investigators. Further investigations in a large series of stent insertions have to be performed before general conclusion can be drawn as to the clinical efficacy of metallic coil stents for endoscopic palliation of esophageal carcinoma.

Aged↗

Faecal elastase 1: a novel, highly sensitive, and specific tubeless pancreatic function test.

BACKGROUND: Indirect pancreatic function tests available today are unreliable for clinical practice in early chronic pancreatitis due to their low sensitivity in mild and moderate exocrine pancreatic insufficiency. AIM: To evaluate the sensitivity, specificity, and practicability of faecal elastase 1 determination in patients with mild, moderate, and severe exocrine pancreatic insufficiency categorised according to the secretin-caerulein test as "gold standard'. PATIENTS AND METHODS: Faecal and duodenal elastase 1 concentration (commercial enzyme linked immunosorbent assay (ELISA)), faecal chymotrypsin activity, faecal fat analysis, and the secretin-caerulein test were performed on 44 patients with mild (n = 8), moderate (n = 14), and severe (n = 22) exocrine pancreatic insufficiency and 35 patients with gastrointestinal diseases of non-pancreatic origin. Fifty healthy volunteers were studied as normal controls. Morphological examinations were carried out to definitely confirm or exclude chronic pancreatitis. RESULTS: With a cut off of 200 micrograms elastase 1/g stool the sensitivity was 63% for mild, 100% for moderate, 100% for severe, and 93% for all patients with exocrine pancreatic insufficiency, and specificity was 93%. Values for chymotrypsin were 64% (sensitivity) and 89% (specificity). Significant (p < 0.001) correlations were found for faecal and duodenal elastase with duodenal lipase, amylase, trypsin, volume, and bicarbonate output. Individual day to day variations of faecal elastase 1 concentrations were very low (mean CV = 15%) and sample storage at room temperature is possible for at least one week. CONCLUSIONS: Faecal elastase 1 determination proved to be a highly sensitive and specific tubeless pancreatic function test.

Adult↗

Dissimilar activation patterns of the carcinogen dimethylhydrazine (DMH) on intracellular polyamine metabolism in various organs.

Weekly administrations of the potent carcinogen 1,2-dimethylhydrazine (DMH) predominantly induce carcinoma of the colon by nearly 100% after six months' treatment in rats. Polyamines, and especially the key enzyme of polyamine de novo synthesis ornithine decarboxylase (ODC) are well-known to play an important role in cell growth and tumor carcinogenesis. Male Wistar rats were s. c.-injected with a single dose of 20 mg DMH/kg b. wt. and five to eight animals were sacrificed 4, 8, 12, 24, 72, 120, 168, and 240 hours after injection of DMH or the basic solution, respectively. Additionally, seven animals were simultaneously treated with the ODC inhibitor alpha-difluoromethylornithine (DFMO) and sacrificed seven days after a single DMH injection. A single s. c.-dosage of the colon carcinogen DMH resulted in dissimilar activation patterns of polyamine metabolism in the various organs studied: in distal and less pronounced in proximal colonic mucosa ODC and putrescine are significantly increased seven days after application of DMH and DNA polymerase after ten days; in small intestinal mucosa ODC activity is significantly elevated after seven days and especially S-adenosylmethionine decarboxylase activity is significantly and prolonged increased between twelve and 72 hours after DMH injection; while spermidine/spermine N1-acetyltransferase activity is significantly elevated in liver after 168 and 240 hours, no changes compared to controls are found in the pancreas. DFMO treatment completely prevents DMH-induced activation of polyamine de novo synthesis and DNA polymerase in colon and small intestine. These data prove completely different and -interestingly-late appearing activation patterns of DMH on intracellular polyamine metabolism in various organ systems and further elucidate the complex metabolic changes following carcinogen treatment.

1,2-Dimethylhydrazine↗