Biomedical subjects
Publications and source records attributed to H J Graubaum.
A new colorimetric test for kinetic determination of beta-N-acetylglucosaminidase activity in urine is evaluated according to the diagnostic usefulness in patients after kidney transplantation and in workers exposed to cadmium. The new test is suited to monitor renal parenchymal alterations.
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.
Average and specific individual courses of the following parameters are reported in this paper, with reference being made to eight of eleven clinical heart transplantations so far performed at the authors' department: lactate, pyruvate, myoglobin, ASAT, ALAT, GGT, CK, CK-MB, LDH, LDH-1, and glycogen phosphorylase. Glycogen phosphorylase was found to deviate most strongly from normal, with the enzyme exhibiting two initial maxima. The enzyme activity in the serum vanished not later than twelve days from transplantation. The curve of myoglobin was largely parallel to that of phosphorylase. Phosphorylase seemed to be of particular suitability for assessment of ischaemic damage in the wake of transplantation. The individual courses seemed to suggest that none of the investigated parameters exhibited sufficiently sensitive correlations with pathomorphological signs of rejection.
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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.
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.
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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.
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.
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By the determination of the aldolase, GOT and LDH isoenzymes in the plasma the stage of the acute and chronic hepatitis can be well established. The suitable use of modern statistic methods (multivariate analysis) allows the characterisation, recognition and separation of the groups of disease acute, chronic persisting, chronic aggressive hepatitis and liver cirrhosis as well as the proof of transition forms and severe courses. In acute hepatitides with protracted course under prednisolone therapy in contrast to histology already after a short time changes of the isoenzymes in the hepatic tissue and in the plasma are shown. Apparently the isoenzymes are sensitive indicators of intracellular metabolic processes.
100 patients who got over a virus hepatitis underwent a bicycle ergometry. At the beginning and at the end of the experiment as well as 24 hours after this the isoenzymes of aldolase, GOT and LDH in the plasma were determined by means of kinetic methods. On the basis of the activities of the isoenzymes for the test persons (children and adults of either sex) an arrangement in the groups pathologic--suspicious--normal can be carried out which is compared with the physiologic parameters and the clinic. The results of bicycle ergometry much differ. High effects without pathological changes of the activities of isoenzymes are an objective criterion of the quick, riskless rehabilitation of the test persons.
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In 260 normal students, 20-25 years old, the variation in the activities of serum alkaline phosphatase and its isoenzymes with sex, ABO blood groups, and protein intake were studied. The values are on the whole higher in males than in females. The activity of the intestinal isoenzyme was higher in subjects taking protein-rich diet than in those taking protein poor diet.
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