Evaluation of nutritional status in the GDR trial.
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Adult↗
Biomedical subjects
C Metzner
Publications and source records attributed to C Metzner.
[Use of the stable nitrogen isotope 15N in assessing liver metabolism in hormonal contraception].
In 37 women with long-term use of oral contraceptives (average use 13.4 years) and 12 women who had not taken oral contraceptives for at least 5 years we determined the serum enzymes ALAT, ASAT, Gamma-GT and conducted the 15N-ammonium test as a marker of partial metabolic performance of the liver. In addition we studied total protein, protein fractions in the serum and haematologic parameter. 18 out of 37 women showed a morbid result in the 15N-ammonium test. In 4 of these 18 women morphological changes representing hepatic damage caused by contraceptives could be detected. On the average ALAT, Gamma-GT and 15N-ammonium test in both groups are clearly different. Because the enzymic levels are being in the normal range, only the 15N ammonium test enables to give a hepatotoxic evidence. It is possible to conclude that long-term use of oral contraceptives influences the liver metabolism.
Adult↗
[The (15N) ammonium test in clinical research].
By use of the [15N]-ammoniumtest the liver function is investigated under influence of hormonal contraceptives in women and in liver diseases in children. With the described noninvasive nonradioactive isotope test the ammonia detoxification capability and the urea synthesis capacity of the liver is determined by measuring of the 15N-exceretion in ammonia and urea in the urine after oral administering of [15N]-ammonium chloride. The [15N]-ammonium test shows a significant influence of the hormonal contraceptives on the liver function and gives diagnostic evidence for liver diseases in children.
Adolescent↗
[Therapy of severe liver diseases. 2. Therapy of protracted toxic liver damage by means of specific artificial nutrition].
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Animals↗
[Physical exertion and the course of hepatitis].
Twenty-five patients with clinically and histologically verified acute hepatitis were subjected to a submaximal bicycle ergometer exercise during the first week after inpatient admission and afterwards subdivided into two groups. The first group maintained bedrest, and the other group trained for 30 minutes a day over six weeks at an exercise level amounting to 70% of the submaximal performance of the initial ergometry. Histological, clinical and laboratory results did not differ between the groups. It is concluded that immobilization for a short time only is indicated in acute hepatitis.
Acute Disease↗
[Value of various amino acid mixtures for the treatment of chronic liver damage].
A reproducible liver lesion was caused in 28 pigs by intermittent, intraperitoneal administration of thioacetamide. The morphological degree of the liver lesion was checked by histological investigations (material drawn from the liver by biopsy). During a 3-day infusion period a so-called liver solution (Aminofusin hepar) was given to one group of animals, a normal solution (Infesol) to a second group, and only an electrolyte infusion solution under oral nutrition ad libitum to a third one. The solutions were labelled with (15N) glycine. The amounts of total N, total 15N, 15N with single non-protein fractions, a number of enzymes of 15N incorporated into the liver protein were measured in urine, and the following points were established: 1. The catabolic situation of metabolism is eliminated both by the so-called normal solution and the specific amino acid solution. The two mixtures of L-amino acids thus have a nutritive effect. 2. The toxic liver lesion is an indication for parenteral nutrition. Oral nutrition alone is not sufficient. 3. The so-called liver solution influences the liver metabolism of the protracted liver lesion more than the so-called normal solution does, and considerably more than an electrolyte infusion solution under oral nutrition ad libitum.
Amino Acids↗
[Therapy of severe liver diseases. 1. Induction of protracted toxic liver damage].
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Animals↗
[Liver diagnostics].
Prerequisite of a scientific and rational liver diagnostics is the knowledge of the physician of function and structure of the liver. The laboratory demand should always be an accomplishment of the physician and should be performed only upon such a scale that it is also followed by therapeutic consequences and/or consequences concerning the expert's opinion. The biochemical blood analysis gives information about the size of the injury to the parenchyma and about the disturbance of the various partial functions of the liver. In this case is to be taken into consideration that biochemical and histological parameters are no concurrent, but supplementing diagnostic methods. A progress in liver diagnostics is the use of the isoenzymes of the aspartate aminotransferase and the lactate dehydrogenase as well as of the enzymes of the metabolism of the connective tissue. With the entering into selected parameters of the liver diagnostics possibilities to the establishment of the disturbed liver metabolism by means of markers are shown and at the same time recommendations for the praxis of the liver diagnostics are derived.
Clinical Enzyme Tests↗
[Acute viral hepatitis and body loading--a self-excluding therapeutic principle?].
Of 27 patients with acute virus hepatitis 16 patients performed successfully a daily training programme during their stay in hospital. On the basis of both clinical and clinical chemical parameters in comparison to the control group of 10 patients who observed the conventional rest in bed the course of healing did not deteriorate. Also with regard to the late prognosis no higher rate of recidivation or chronification could be proved. Our examinations support the thesis that the demand of strong rest in bed is to be regarded as out of date in the treatment of acute virus hepatitis.
Adult↗
[Bicycle ergometric testing in the acute phase of liver disease with particular reference to changes in serum enzymes].
It is reported on 20 patients (17 women, 3 men) who had undergone a bicycle-ergometric load in the acute phase of virus hepatitis (an average at the 16th day after admission to hospital). Among the significant changes of the activity the slight increase of SGPT 30 minutes after the end of the load as well as the clear decrease of the enzyme activities of SGPT and SGOT below the initial value 48 hours after load are particularly to be emphasized. LDH and CPK exhibited only insignificant changes of activity. It remains open to what extent there exists a connection between the ECG-changes proved in about half the women and the virus hepatitis as a cyclic infectious disease. In the 20 patients examined a clinically recognizable deterioration in the course of the disease by the load examination did not appear.
Acute Disease↗
[The problem of hypertension and ovulation inhibitors].
It is reported on a 46-year-old woman who died of a haemorrhage of the cerebral matter in renally fixed hypertension and severe arteriosclerosis of the arteries of the basis of the brain. The possible connection between hypertension, arteriolosclerosis of the kidneys and arterioclerosis of the arteries of the brain basis and an intake of ovulation inhibitors lasting 10 years is critically discussed.
Cerebral Hemorrhage↗
[Hepatitis B and chronic lymphadenosis].
It is reported on a 79-year-old female patient who died from coma hepaticum. As evoking cause an immunesuppressive treatment with cyclophosphamide or prednisolone, respectively, on account of chronic lymphadenosis with excessive thrombocytopenia is discussed. An accessible preliminary lesion of the liver after an infectious jaundice with persistence of the HBs-antigen from which the patient formerly suffered is probable. It is referred to the combination of the chronic aggressive hepatitis with malignant systemic diseases and immunopathy, taking into consideration the decision of therapy.
Aged↗
[Cholestatic hepatosis caused by Talinolol (Cordanum)?].
It is reported on a 38-year-old female patient who was treated for 18 days with 150 mg cordanum (talinolol) each and then fell ill with a dyspeptic clinical picture and signs of cholestase. The result of a liver biopsy was the picture of a cholestatic hepatosis. According to the results of the lymphocyte transformation test and the monocyte test as well as to the reexposition with following clinical recidivation the talinolol medication is to be regarded as cause. Pathogenetically is referred to the structural relations of talinolol to substances with paragroups as well as to a possible summation of different loads of the liver function.
Adrenergic beta-Antagonists↗
[Proposals for the explanation of diagnostic procedures in gastroenterology].
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Biopsy↗
[Does abdoman cause ileus?].
On account of its favourable pharmacological properties Abdoman has proved in the treatment of patients with uncomplicated duodenal ulcer. On the basis of its pronounced motility inhibiting effect on the gastrointestinal canal it may be additionally used for the treatment of diarrhoea. It is reported on 5 patients in which under Abdoman therapy a paralytic ileus developed as severe complication, so that it must be warned of an uncontrolled prescription of abdoman concerning this indication. Abdoman should be used above all in juvenile patients, in which case particular attention must be paid to obstipation as most frequent side-effect.
Aged↗
[Physical capacity of patients with liver diseases as well as its significance for therapy and evaluation].
In 50 patients with different liver diseases (20 with subsided viral hepatitis and 30 with degenerative liver damages) the serum enzyme course of SGOT, SGPT, LDH and CPK was investigated after ergometer load. The enzymes were estimated before as well as 1/2, 2, 4, 24, and 48 hours after load. 48 hours after load additionally the liver biopsy after Menghini was carried out. According to the histological findings the 20 patients with viral hepatitis were subdivided into 13 with still active and 7 with residual hepatitis as well as the 30 patients with degenerative liver damages into 15 with toxical hepatosis, 6 with fatty degeneration of the liver cells and 9 with signs of metabolic activation. Since the significant increases of enzymes could not be proved in any of the fours enzymes 1/2 to 48 hours after load we are of the opinion that the liver, independent on the kind of the lesion, better tolerates physical work. Moreover, it seems that load investigations under ergometry with estimation of the course of the serum enzymes are unsuited for the judgment of the degree of activity and the degree of cure of liver diseases, respectively.
Adult↗
[Incidence of toxic liver lesions due to Gravistat].
In 200 women who on the average 5.6 years took ovosiston and/or non-ovlon, and in 40 women who during the last three months had not taken an oral contraceptive we determined the GOT, the GPT, and LP-X and the cholesterol in the serum before and after a three weeks intake of gravistat. After a three weeks intake of gravistat of the two groups ca. one fourth showed pathological transaminases. 30 women with pathological transaminases and/or positive LP-X were hepatologically investigated including liver biopsy after an on an average 7.3 weeks exposition of gravistat. In ca. one third of the cases histologically provable changes of the liver (toxic hepatosis, fatty liver, infectious hepatitis) and in ca. two thirds of the cases the picture of the metabolic activation were found. Morphologically no signs of an intrahepatic cholostasis could be proved, so that it does not seem to be the leading parameter of the toxic liver damage.
Chemical and Drug Induced Liver Injury↗
[Toxic hepatoses due to Gravistat].
With the help of 5 cases with toxic hepatosis by administration of Gravistat the problems concerning ovulation inhibitor and toxic hepatosis were explained. The clinical, paraclinical and histological findings may be pronounced differently. Anamnestically in prescribing ovulation inhibitors particularly a jaundice during pregnancy or a pronounced pruritus in the 3rd trimester of the pregnancy must be taken into consideration. Toxic liver damage may appear not only when the ovulation inhibitor is given the first time, but also after changing it. For this reasons idiopathic jaundice during pregnancy and condition after toxic hepatosis by ovulation inhibitor in every case must be regarded as contraindications for the application of oral contraceptives. In order to establish subclinical courses a control of transaminases in the first three cycles of using the remedies is to be demanded.
Adult↗