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Biomedical subjects

E Krag

Publications and source records attributed to E Krag.

At least 73 records · Page 4Linked to original sources
PubMed1976

Bile acid metabolism after jejunoileal bypass operation for obesity.

Bile acid metabolism and duodenal bacterial flora were studied in 12 obese patients before and 1-2 months after jejunoileal bypass operation, either including 37.5 cm jejunum and 12.5 cm ileum (Type I) or 12.5 cm jejunum and 37.5 cm ileum (Type III). The cholic acid pool size was unchanged after type I, but decreased after type III, bypass. The daily fractional turn-over of cholic acid increased about five times after both types of operation. The synthesis rate of cholic acid increased after both types of bypass, but more after type I than after type III. In duodenal bile the ratios of cholic to taurine conjugates increased after type I, but were unchanged after type III bypass, whereas the ratio of cholic to chenodeoxycholic acid was unchanged after both types of bypass. The bacterial flora and the occurrence of free bile acids in the fasting duodenal contents did not change after either of the two types of bypass operation. It is concluded that jejunoileal bypass results in marked disturbances in the bile acid metabolism. Surprisingly, these are most severe after bypass including the longest ileum, possibly because of insufficient stimulation of the bile acid synthesis in this type of operation.

Bile Acids and Salts↗
PubMed1976

Congenital chloridorrhoea. A question of reversed brush border transport processes and varying junctional tightness.

The surprising results of intestinal perfusion studies in an 8-month-old child with congenital chloridorrhoea offered a unique opportunity not only to elucidate the underlying defect, but also to test the adequacy of proposed models for normal intestinal transport. In ileum Na, K and Cl as well as water were secreted and HCO3 absorbed. Lumen was 91 mV negative to blood. Only Cl was transported against both electrical and chemical gradients, but discrepancies between observed and predicted Na flux ratios suggested the presence of a Na-absorbing mechanism as well. Mucosa was impermeable to Cl from the lumen side. 2.5 mM glycochenodeoxycholic acid (GCDC) mediated Na and water absorption and abolished any transport of Cl. PD was -95 mV. In colon a similar pattern was observed and mucosa to serosa fluxes of Cl were abnormally low. Rectal PD was -116 mV. GCDC made the epithelium more absorptive in function, but contrary to ileum the effect was due to an increase of Na and Cl fluxes from mucosa to serosa. The patient was at that time in severe electrolyte imbalance. He was reinvestigated three months later when he was in a good clinical condition with normal serum electrolytes. Net transfer of electrolytes and water and bidirectional fluxes of Cl and K were unchanged while bidirectional Na fluxes had increased considerably and PD decreased to -18 mV. Rectal PD was -45 mV. In jejunum water and electrolyte transport were normal and PD -3 mV. It is tentatively concluded that the abnormal transport in ileum is due to an inversion of the brush border transport processes, which also satisfies the paradoxical effects of GCDC. Furthermore, Na and Cl seem to migrate through separate pathways. A varying degree of junctional tightness, which is almost completely cationic, may be responsible for the functional differences observed in resonse to improvement of the general electrolyte status.

Biological Transport, Active↗
PubMed1976

Regional ileitis (Crohn's disease). I. Kinetics of bile acid absorption in the perfused ileum.

Bile acid absorption was studied by steady state perfusion technique in the ileum of 11 patients with regional ileitis (Crohn's disease). By computerizing absorption kinetics the presence of an active transport of glycochenodeoxycholic acid (GCDC) was rendered probable by finding a saturable transport system and a competitive absorption between conjugated bile acids. At the time of investigation 5 patients had no diarrhoea, whereas 6 patients had diarrhoea as defined from the amount of faecal output. In the former group the faecal bile acid excretion was low, the ileal absorption of GCDC high, and judged from the xylose absorption the ileal absorption surface large compared to the latter group, in which the faecal bile acid excretion was high, the ileal absorption of GCDC low, and the ileal absorptive surface small. It is concluded that malabsorption of bile acids in the ileum may be of significant physiological importance in the pathogenesis of diarrhoea in patients with regional ileitis.

Adult↗
PubMed1976

Regional ileitis (Crohn's disease). II. Electrolyte and water movement in the ileum during perfusion with bile acids.

Electrolyte and water movement was studied by steady state perfusion technique in the ileum of 11 patients with regional ileitis (Crohn's disease). Six patients who at the time of investigation had diarrhoea showed a constant secretion of salts and fluid during perfusion with control perfusate. Per 24 hours, the ileal effluents to colon would exceed the normal amount by 1-2 litres. In the 5 patients without diarrhoea the absorption patterns were normal. Electrolytes and water moved in parallel. Dihydroxy bile acids enhanced secretion or decreased absorption respectively, in the two groups of patients. It is concluded that functional disturbances of salt and water absorption in the inflamed ileum may be of significant physiological importance in the pathogenesis of diarrhoea observed in patients with regional ileitis.

Adult↗
PubMed1976

Fat digestion after jejunoileal bypass operation for obesity.

Fat digestion in the upper jejunum was studied in 12 obese patients treated by jejunoileal bypass including either 37.5 cm jejunum and 12.5 cm ileum or 12.5 cm jejunum and 37.5 cm ileum. Jejunum was intubated and a test meal ingested before and 1-2 months after operation. Jejunal aspirates were heated immediately to destroy lipase, pooled and assayed for dilution marker, bile acids and total fat. Lipolytic products were determined by thin-layer chromatography and densitometry. The micellar phase was achieved by ultracentrifugation and analysed for total fat. Results. Bile acid concentration and lipolysis decreased after both bypass operations. In accordance with this, micellar solubilization of fat was impaired after operation. Bile acid concentration and micellar solubilization were lower after bypass with a long, than after bypass with a short, ileal loop. Absorption of fat in the duodenum and upper jejunum did not change significantly after any of the operations. Conclusions. Jejunoileal bypass impairs fat digestion, but this does nto contribute significantly to the fat malabsorption after operation.

Adult↗
PubMed1975

Quantification of carcinoembryonic antigen-like activities in normal, human gastrointestinal secretions.

The secretion of carcinoembryonic antigen-like (CEA-like) material into the gastrointestinal tract of 28 fasting normal men was quantified by using intestinal perfusion techniques. CEA-like material was recovered from all levels of the gastrointestinal tract. The highest secretory rate was in the colon (mean +/- SE, 2.41 +/- 2.0 mug/minute per colon), followed by pancreatobiliary secretion and pancreatic secretion. The secretory rate from the stomach, duodenum, jejunum, and ileum was less than 20 ng/minute. After perchloric acid extraction, the CEA-like material from the colon had the same chromatographic and radioimmunologic properties as [125I] CEA. These data suggest that the CEA-like material is normally secreted into the gastrointestinal tract and particularly into the colon.

Adult↗
PubMed1975

A comparison of stable and 3H- labelled polyethylene glycol 4000 as non-absorbable water phase markers in the human ileum and faeces.

Polyethylene glycol 4000 (PEG plus 3H-PEG) was used as volume indicator during ileal perfusion in man. Faeces, urine, ileal infusates, and aspirates were investigated. Turbidimetrical assay and liquid scintillation counting (in the faeces radioassay was done after conbustion) yielded similar estimates of water absorption and secretion. Tracer amounts of 3H were found in the urine, indicating a minimal absorption. The simplicity of 3H radioassay and the reliability of 3H-PEG as a non-absorbable water phase marker is emphasized.

Crohn Disease↗
PubMed1974

Active and passive bile acid absorption in man. Perfusion studies of the ileum and jejunum.

Absorption of the major human bile acids was studied in 12 healthy volunteers by steady state perfusion of the ileum in 112 experiments and of the jejunum in 48 experiments. Use of a randomized order of four perfusions on 1 day of study and use of up to 4 consecutive days of study in a subject allowed important comparisons of data from the same individuals. That there is active ileal absorption of chenodeoxycholic, glycochenodeoxycholic, and taurocholic acids in man was supported by the finding of saturation kinetics and of competition for absorption among conjugated bile acids. Values for apparent kinetic constants (apparent maximal transport velocity [(*)V(max)] and apparent Michaelis constant) in man are similar to those in other species. The ileum absorbed chenodeoxycholic acid more rapidly than its glycine conjugate, due mainly to a ninefold greater permeability for the free acid. Taurocholate had the highest (*)V(max) and was absorbed more rapidly than glycochenodeoxycholate. Passive permeability of the jejunum to bile acids was twice that of the ileum, and the permeabilities to free and glycine-conjugated chenodeoxycholate were in the same ratio as in the ileum (9: 1). Jejunal permeability to chenodeoxycholic acid was three times that to cholic acid. Variation of intraluminal pH by up to 1.4 units did not influence jejunal uptake of free bile acids. These results, which are comparable with those from animal experiments, provide a basis for estimation of intestinal reabsorption of bile acids in intact man.

Adult↗