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Biomedical subjects

E Roth

Publications and source records attributed to E Roth.

At least 217 records · Page 12Linked to original sources
PubMed1983

[Lack of stimulation of nitrogen retention and plasma protein synthesis due to increased intake of branched-chain amino acids].

In a randomised study the influence of 3 different amino acids (AA) solutions on nitrogen balance, plasma protein synthesis, and plasma and urine AA pattern was investigated in postoperative (p.o.) cancer patients. The patients in group I received a balanced AA solution designed especially for p.o. patients with 10 percent branched chain amino acids (BCAA), those in group II a solution with 60 percent BCAA and those in group III a solution with 67 percent alanine. All patients received the same amount of nitrogen (0.16 g/kg BW/day) and energy (2.p.o. day: 80 kJ/kg BW/day; 3.-5. p.o. day: 160 kJ/kg BW/day) with a 3:1 ratio of carbohydrate to fat calories. No difference was observed between the three groups for mean daily nitrogen balances, however, the cumulative nitrogen balance of group I (-4.5 +/- 3.6 g) was significantly (p less than 0.05) improved compared to group II (-12.2 +/- 4.2 g). The p.o. decreased concentrations of short-life plasma proteins (prealbumin, transferrin, retinol-binding protein) increased until the end of the study period without any statistic differences between the three groups. On the 2nd p.o. day especially the gluconeogenetic AA were decreased in all patients, but were nearly normal in all patients on the 5th p.o. day. In conclusion the increased administration of BCAA neither improved nitrogen retention nor plasma protein synthesis and does not seem advantageous in the postoperative total parenteral nutrition.

Aged↗
PubMed1982

[Malnutrition and postoperative complication rate in cancer patients (author's transl)].

The nutritional status and skin reactivity of 82 cancer patients were determined before surgery and compared with the postoperative complication rate. The nutritional status of 47 patients was evaluated by weight, height, weight-loss, arm muscle circumference, triceps skin-fold measurements, serum albumin, pre-albumin, retinolbinding protein, tranferrin, and cholinesterase. In 35 patients protein catabolism was assessed by the urea production rate (catabolism greater than 15 g/d). Immunity was assessed by the total lymphocyte count and a skin reactivity test. Using these criteria, 55% of the patients were malnourished. Curative operations could only be carried out in 17.4% of the malnourished, but in 50% of the normally nourished patients (P less than 0.0001). Postoperative complications were increased in malnourished patients (47%) when compared with normally nourished patients (20%, P less than 0.05). In anergic and malnourished cancer patients no curative surgical treatment was possible. Due to the increased postoperative complication rate in malnourished cancer patients, nutritional assessment, including the determination of cellular immunity should be performed after admission.

Body Height↗
PubMed1982

Metabolic disorders in severe abdominal sepsis: glutamine deficiency in skeletal muscle.

The metabolic profiles of 14 patients with prolonged abdominal sepsis were analysed on the second day after laparotomy. The profiles of survivors were compared with those of non-survivors who died one to five days after the time of evaluation due to uncontrollable multiple organ failure. In the non-surviving patients plasma glucose and glucagon levels were significantly higher than in surviving patients. The plasma concentrations of phosphoserine, cysteine, valine, phenylalanine, and 3-methylhistidine were found to be significantly increased in non-survivors and their muscle tissue showed significantly decreased concentrations of glutamine, proline and lysine with increases in valine and leucine. A correct classification of non-survivors and survivors could be obtained from the plasma and muscle amino acid concentrations, the highest discriminant power being from muscle glutamine. In severe sepsis metabolic changes correlate with the outcome of the patients, and amino acid metabolism seems to be characterised by low concentrations of muscle glutamine and high levels of the branched chain amino acids possibly indicating an inhibited intracellular glutamine formation in muscle tissue.

Journal Article↗
PubMed1982

[Extracorporeal liver perfusion in the treatment of hepatic coma].

Four patients with fulminant hepatic failure had extracorporal hemoperfusion. In selecting the patients, the following criteria were applied: Potential reversibility of the liver disease, prothrombin time under 10%, neurological coma stage III-IV. In total 11 treatments (9 treatments using baboon and 2 treatments using human livers) were performed lasting from 3 to 60 hours. One patient improved immediately after perfusion. 3 patients died; at post mortem severe oedema of the brain and acute yellow atrophy of the liver without tendency to regeneration was observed in these patients.

Adult↗
PubMed1981

[Alanine as a nitrogen sparing and gluconeogenetic substrate in the postoperative state (author's transl)].

UNLABELLED: An alanine infusion (90 mg/kg/h) for eight hours was administered to seven patients after cholecystectomy in order to investigate the influence of elevated plasma alanine levels on the postoperative metabolism. The following metabolites and hormone concentrations were analysed in plasma: glucose, urea, free fatty acids, ketone bodies, amino acids, insulin and glucagon. Compared to the pre-infusion values on the 1. postoperative day after an overnight fasting, the following changes were monitored. The plasma glucose concentrations reached a maximum after four hours of infusion (p less than 0.05). Of the amino acids, significant elevated levels were found for alanine (300%, p less than 0.001), glutamine (36%, p less than 0.05), and alpha-aminobutyrate (61%, p less than 0.01). The free fatty acids and ketone bodies concentrations decreased immediately after the onset of the infusion of alanine (p less than 0.05), the increased again during the last four hours of infusion. The secretion of insulin and also the secretion of glucagon were stimulated by the increased alanine levels. The stimulation of insulin reached a maximum after only five minutes, but the glucagon levels increased continuously until the end of the infusion. During the administration of alanine a nitrogen homeostasis was achieved, which was a significant improvement (p less than 0.001) when compared to saline infusions before and after the alanine infusion. CONCLUSIONS: (1) Postoperative increased plasma levels of alanine stimulate gluconeogenesis and reduce the plasma levels of lipolytic metabolites. The induced stimulation of insulin and glucagon is dependent on the duration of the alanine infusion for during extended infusion of alanine the insulin stimulation diminishes while the glucagon secretion continuously increases. (2) Alanine is a potent anabolic substrate in the immediate postoperative situation.

Alanine↗
PubMed1981

[Reduced levels of free amino acids in plasma and muscle tissue of patients with acute hemorrhagic necrotising pancreatitis (author's transl)].

Levels of free amino acids were analysed in plasma and muscle tissue of nine patients with acute hemorrhagic necrotising pancreatitis and compared with date from healthy volunteers. In the patient group the concentrations of threonine, serine, glutamine (p less than 0.001) and tyrosine (p less than 0.01) in plasma were found to be significantly lower than in the volunteers group, while increased plasma levels were found for 3-met-histidine (p less than 0.05). In muscle tissue the cytoplasmatic levels of glutamate, glutamine and histidine (p less than 0.001) and also of lysine, ornithine and arginine (p less than 0.,01) showed decreased concentrations. However tyrosine and phenylalanine had increased intracellular concentrations (p less than 0.05). It is concluded that (1) the patients in this study had a severely disturbed amino acid metabolism with extremely reduced levels of free glutamine in muscle tissue and (2) that the disturbed amino acid metabolism results from an acute catabolic situation of the patients, in which the reduced levels of free amino acids may indicate an impaired nutritional state.

Acute Disease↗
PubMed1981

[Comparative follow-up survey of psychiatric invalids].

Within a five-years-period data about 200 psychic disabled patients (100 from the canton of Basel-country, and 100 from the canton of Basel-town) were collected in respect to their person as well as to the progress of their illness. These patients differed from the general population in the following important points: More single people (unmarried and divorced persons) are found that in the general population of the same age (p less than 0.01). Foreigners are underrepresented (p less than 0.01). Subdivided into social classes (Bolte) it was striking that 71% of the patients belong to the lower class, whereas the upper class is not represented. 10.5% of all patients were not able to finish their professional education because of their illness. Schizophrenia was the most mentioned diagnosis (46.5%), followed by the diagnosis "abnormal psychic development" (inclusively neuroses: 34.5%). The progress of illness shows that 7% of all patients did not need the invalidity-pension any more after five years. Half of them are patients who fell ill already in the late puberty. Patients who were taken ill on abnormal psychic development after their 40th year show unfavourable progress of illness: Except for one foreign patient and two of nine patients who returned to their home-country and who were not included in this study, no tendency of recovery has been noticed. The number of patients who died during the five years of observation (21 deceased on 200 living) is very high. This figure of mortality is 7.4 times (canton of Basel-country) and 8.1 times (canton of Basel-town) higher than the mortality of the same age group of the general population. It is also higher in comparison with the average of the respective illness groups as stated by Ciompi and Müller. The cause of death is suicide in 48%. In another 24%, suicidal impulses could have been inherent. Also the number of hospitalisations is very high: Only 22% of the patients were never in a hospital. In comparison 12% were once and 66% more than once or longer than one year in a hospital.

Adolescent↗
PubMed1980

[Biochemical methods for the determination of a clinical protein catabolism].

1. 20 patients before surgery received enteral nutrition for three days (12 g nitrogen, 1800 Kcal). Nitrogen and urea excretions in urine during the second and third day were determined. Eleven patients had a negative nitrogen balance (-2,7 and -2,4 g/day). In these patients urea production rates were 21,1 and 20,1 g/day. An urea production rate exceeding 15 g urea/day is probable an indication for a protein catabolism. The reason for this catabolic state seems to be a decreased protein utilisation (49 and 47 percent) as the result of a metabolic stress situation. This metabolic stress was determined according the stress index (Bistrian). The patients were in a stress situation comparable to postoperative stress (+3,7 and +3,9). The determination of urea production rate and catabolic index seems a suitable tool for defining a catabolic state. 2. 3-met-histidine excretion in urine were measured in seven patients postoperatively. In different periods saline or aminoacids solutions (5% alanine) were infused. During alanine administration protein (+49%)--and 3-met-histidine excretions (+50%) increased. It is not possible to state a catabolic situation out of the 3-met-histidine excretion, because an increased excretion may result from a stimulated protein synthesis in muscle tissue or from an increased muscleprotein wasting. 3. Free amino acid pools in plasma and muscle tissue were analysed in patients with severe illness of liver and pancreas. The free amino acid pattern differed from healthy volunteers. In patients with liver disease significantly increased concentrations of phenylalanine, tyrosine and methionine were found. In patients with acute pancreatitis highly abnormal pattern of intracellular amino acids occurred with decreased concentrations of glutamine, cysteine, histidine, lysine, arginine and ornithine. The highly significant decreased concentrations of glutamine (p less than 0,01) indicate a catabolic situation of these patients. A quantification of the severity of the catabolic state out of amino acid concentrations is not possible.

Alanine↗
PubMed1980

[Changes in glucose, fat and hormone balance induced by the postoperative administration of alanine solution].

Seven patients undergoing cholcystektomy received a 5 pevcent solution of alanine (90 mg/kg/h) during a period of 8 hours on the 1. postoperative day. Stimulation of gluconeogenesis was observed with increase of glucose from 5,9 +/- 0,2 to 6,3 +/- 0,2 mmol/l. Initially the level of ketone bodies decreased (acetoacetate 70 +/- 23 to 17 +/- 6 mumol/l) but again increased to start values during infusion of alanine. Insulin increased twofold from 7,6 +/- 1,4 microU/ml to 14,6 +/- 4,0, and had a constant level during infusion as did glucagon, which increased from 561 +/- 70 to 608 +/- 74 pg/ml. Nitrogen balance during infusionsperiod was almost zero (0,04 +/- 0,09 g/h minus) showing a significant difference to balances calculated from periods before and after infusion of alanine (0,57 +/- 0,07 and 0,53 +/- 0,06 g/h deficit respectively). Direct influence on peripheral glucose alanine cycle and increased gluconeogenetic substrate seem to be responsible for the nitrogen sparing effect of alanine.

Alanine↗
PubMed1980

[The definition of clinical catabolism by the urea production rate and its correlation with cellular immunity].

In 38 preoperative patients the production of urea was estimated and the cell-mediated immunity was measured. 10 patients were catabolic and had negative skin tests, all of them were inoperable. 15 patients were catabolic and had positive skin tests five patients were inoperable. 12 patients were not catabolic and had positive skin tests, two were inoperable. One female patient was not catabolic and had negative skin tests, but was operable. The catabolic state can be assessed by the urea production rate and you can give prognostic and therapeutical references in correlation with the delayed hypersensitivity.

Body Weight↗
PubMed1980

[Urea production and cell-mediated immunity as indicators of preoperative catabolism (author's transl)].

In 38 preoperative patients the production of urea was estimated and cell-mediated immunity was measured. Ten patients were catabolic and had negative skin tests, all of them were inoperable. Fifteen patients were catabolic and had positive skin tests, five patients were inoperable. Twelve patients were not catabolic and had positive skin tests, two were inoperable. One female patient was not catabolic and had negative skin tests, but was operable. The catabolic state can be assessed by the urea production rate and one can give prognostic and trophotherapeutical indications in correlation with the degree of cellular immunity.

Energy Metabolism↗
PubMed1979

Hydergine and vincamine derivative LD 4298 exhibit no anti-sickling properties in vitro.

Amongst the treatments proposed for Sickle Cell disease Ergot derivatives and extracts from Pervinca have been proposed. We have studied in vitro the effect of Hydergine and LD 4298 on Sickle Cells and Sickle Hemoglobin according to the following four parameters: percentage of sickling, potassium leak, minimum gelation concentration and speed of gelation. In these studies no anti-sickling effect was detected. Moreover Hydergine at 50 microgram/ml increased spontaneous potassium loss without any anti-sickling effect. One can conclude that these two drugs have no effect on sickling.

Anemia, Sickle Cell↗