PubMed Health⌕ Search

Biomedical subjects

F Klee

Publications and source records attributed to F Klee.

9 recordsLinked to original sources
PubMed2003

Tissue and serum concentrations of levofloxacin 500 mg administered intravenously or orally for antibiotic prophylaxis in biliary surgery.

OBJECTIVES: Levofloxacin is a third-generation fluoroquinolone with a broad spectrum of antibacterial activity, comprising enterobacteria, non-fermenters, Gram-positive cocci and some anaerobic species. Members of these species are common pathogens in acute and chronic cholecystitis. This suggests that levofloxacin may be used as peri-operative prophylaxis in gall-bladder surgery. The purpose of our study was to determine serum and tissue levels of levofloxacin in cholecystectomy patients following pre-operative dosing. PATIENTS AND METHODS: Patients with gall-bladder surgery were given levofloxacin 500 mg as a single dose either intravenously (iv) or orally pre-operatively, at the treating physician's decision. Gall-bladder tissue and serum samples were collected, and drug concentrations were determined by HPLC with fluorescence detection. Additionally, all tissue samples underwent routine microbiological diagnostics. MICs for aerobic isolates were determined using the Etest. RESULTS: A total of 61 patients (48 female, 13 male) were included. The medians of the levofloxacin concentrations in serum were 11.37 mg/L (iv) and 9.65 mg/L (oral), and in gall-bladder tissue they were 15.61 mg/kg (iv) and 17.93 mg/kg (oral). Eleven pathogens were isolated from gall-bladder samples. Post-operative wound infection was observed in two of the 61 patients. CONCLUSION: Our data suggest that levofloxacin may be considered for peri-operative prophylaxis in biliary tract surgery.

Administration, Oral↗
PubMed1996

Validation of endothelin (ET) immunoreactivity in human bile by HPLC. Comparison of biliary ET concentration in liver transplant recipients with values obtained during cholecystectomy.

High endothelin (ET) concentrations were recently detected in human bile after orthotopic liver transplantation (OLT). In the present study we compared biliary ET/big-ET levels measured by radioimmunoassay (RIA) in liver graft recipients (n = 37) with levels measured in non-transplant patients during cholecystectomy (n = 38) to clarify the influence of transplantation on the levels of biliary ET peptides. HPLC elution profiles of biliary ET were analyzed for characterization of ET peptide composition and validation of RIA analysis in bile extracts. Mean ET/big-ET levels in the common bile duct after OLT were significantly elevated (ET, 20.9 +/- 15; big-ET, 39.2 +/- 19 fmol/ml) compared to levels in non-transplant patients (ET, 5.7 +/- 4.9; big-ET, 12 +/- 8 fmol/ml). Highest ET/big-ET levels were measured in the gall bladder during cholecystectomy (ET, 61.7 +/- 41; big-ET, 75 +/- 28 fmol/ml). ET and big-ET levels were correlated by linear regression. HPLC analysis reveals the presence of high levels of ET/big-ET in human bile. Biliary ET mostly represents ET-1. High biliary ET levels after OLT appear to be derived from active endothelial secretion and probably reflect hepatic endothelial stress after preservation/ reperfusion. High biliary ET levels could be involved in the mediation of functional cholestatic syndromes after OLT.

Adult↗
PubMed1996

Alcohol dehydrogenase in the human colon and rectum.

Alcohol dehydrogenase (ADH) activities were measured in rectal biopsies from 55 patients (28 males, 27 females aged 22-81 years), in colonic biopsies from 19 patients (10 males, 9 females aged 21-81 years) and in three surgical specimens. All patients had normal mucosa as determined by light microscopy. The activity of rectal ADH was comparable to gastric ADH activity and did not exhibit any significant gender effect (5.5 +/- 1.1 vs. 6.7 +/- 1.0 nmol/mg protein x min; nonsignificant). No significant correlation was found between age and rectal ADH activity. Compared to ADH activities in other colonic segments, rectal ADH activity was found to be significantly increased (ascending colon: 3.9 +/- 0.7 nmol/mg protein x min; p < 0.05; transversal colon: 3.4 +/- 1.1 nmol/mg protein x min; p < 0.05; descending colon 2.3 +/- 0.4 nmol/mg protein x min; p < 0.001; rectum 6.1 +/- 0.8 nmol/mg protein x min). This higher activity of ADH in the rectum could result in increased acetaldehyde levels after alcohol administration and could therefore play a role, at least in part, in the ethanol-associated rectal cocarcinogenesis.

Adult↗
PubMed1995

General stress response to conventional and laparoscopic cholecystectomy.

OBJECTIVE: In many retrospective and prospective observational studies, laparoscopic cholecystectomy (LC) compares favorably with conventional cholecystectomy (CC), with respect to length of hospital stay, postoperative pain, and pulmonary function, indicating a diminished operative trauma. Comparison of laboratory findings (stress hormones, blood glucose, interleukins) are a possibility to objectify stress and tissue trauma of laparoscopic and conventional cholecystectomy. SUMMARY BACKGROUND DATA: Major body injury, surgical or accidental, evokes reproducible hormonal and immunologic responses. The magnitude of many of these changes essentially is proportional to the extent of the injury. METHODS: In a prospective study, biochemical stress parameters were measured in the blood of patients undergoing elective cholecystectomy because of symptomatic cholecystolithiasis. Patients with acute cholecystitis, pancreatitis, choledocholithiasis, or malignant disease were excluded. Values from 40 patients after LC and from 18 patients after CC were compared. Both groups had similar patient characteristics, baseline values, and perioperative care, except for deeper anesthesia during CC. RESULTS: On postoperative day 1, epinephrine (p = 0,05), norepinephrine (p = 0.02), and glucose (p = 0.02) responses were higher after CC. Two days postoperatively, norepinephrine remained higher after CC (p < 0.01). Interleukin-1 beta responses were higher during (p < 0.01) and 6 hours after CC (p = 0.03). Interleukin-6 responses were higher 6 hours (p = 0.03), 1 day (p = 0.02), and 2 days (p < 0.01) after CC. CONCLUSIONS: The results show significant lower values of intraoperatively and postoperatively measured epinephrine, norepinephrine, interleukin-1 beta, and interleukin-6 in patients with laparoscopic cholecystectomy, indicating a minor stress response and tissue trauma in this group of patients. The results correspond to the favorable results of most other trials evaluating clinical aspects of laparoscopic cholecystectomy.

Adult↗
PubMed1993

[Inflammatory intestinal tumor as a cause of thrombocytopenia].

The acquired thrombocytopenia is part of a large number of diseases caused by a variety of different factors. Besides the classical failure of bone marrow proliferation respectively the replacement of the bone marrow with malignant cells, there are immunological disorders and many substances which may cause thrombocytopenia. The diagnosis of an "idiopathic thrombocytopenia" is sometimes posed even at the end of intensive diagnostic efforts. Possibly a benign neoplasia is also to cause a massive decrease of thrombocytes. We observed preoperatively in one patient with extensive stenosis of the sigma, caused by an inflammatory tumor a thrombocytopenia with a level under 50,000/ml. A normalization in thrombocyte blood counts appeared spontaneously after tumor resection.

Aged↗
PubMed1982

Hepatitis A and B markers and presumable non-A, non-B hepatitis in a psychiatric institution.

The frequencies of hepatitis A and hepatitis B markers were determined in 291 members of the staff and 714 patients of a psychiatric institution for adults. 71.8% of the patients suffered from psychosis, 17.7% from neurosis, and 10.6% from oligophrenia. 84.4% of the patients and 69.2% of the staff were anti-HAV-positive. - 26.8% of the patients and 19.9% of the staff showed at least one HBV marker. The frequency of anti-HBc increased with age but not with hospitalization. Anti-HBc-positive persons did not show transaminase abnormalities more often as reported previously. - 2.6% of the patients were presumable Non-A, Non-B hepatitis cases after excluding IgM-anti-HAV, IgM-anti-CMV or -EBV and possible toxic effects. The rate of presumable Non-A, Non-B hepatitis equaled the frequency of HBsAg-positive persons.

Adult↗
PubMedDate not supplied

Helicobacter pylori infection decreases gastric alcohol dehydrogenase activity and first-pass metabolism of ethanol in man.

BACKGROUND/AIMS: Ethanol is metabolized by alcohol dehydrogenase in the human stomach. This metabolism contributes to the so-called first-pass metabolism of ethanol which is affected by gender, medication, and morphological alterations of the gastric mucosa. Recently, it has been shown that Helicobacter pylori is capable to oxidize ethanol to acetaldehyde in vitro. Since H. pylori also injures gastric mucosa, the present study examines the effect of this bacterium on gastric alcohol dehydrogenase activity and systemic availability of ethanol in vivo. METHODS: Thirteen volunteers (7 men and 6 women, aged 18-52 years) with gastric H. pylori infection diagnosed by a positive CLO test and positive gastric histology received ethanol (0.225 g/kg) either orally or intravenously before and after H. pylori elimination to determine systemic availability of ethanol. In addition, gastric biopsy specimens were taken from all subjects before and after H. pylori elimination for histological assessment of mucosal alterations and determinations of gastric alcohol dehydrogenase activity and phenotype of the enzyme. RESULTS: In the presence of H. pylori the first-pass metabolism of ethanol was found to be significantly reduced (625 +/- 234 vs. 1,155 +/- 114 mg/dl/min, p = 0.046). This reduction of first-pass metabolism of ethanol was associated with a significant decrease in alcohol dehydrogenase activity (4.8 +/- 1.5 vs. 12.1 +/- 2.3 nmol/mg protein x min, p < 0.05) and an increase in the severity of mucosal damage as determined by a histological score (p < 0.05). CONCLUSIONS: H. pylori infection leads to gastric mucosal injury which is associated with a decrease in gastric alcohol dehydrogenase activity and first-pass metabolism of ethanol. Ethanol metabolism by H. pylori does not play an important role in vivo. However, gastric morphology is one important factor determining systemic availability of ethanol in man.

Adolescent↗