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Biomedical subjects

H Prytz

Publications and source records attributed to H Prytz.

At least 37 records · Page 2Linked to original sources
PubMed1992

Ultrasound, hepatic lymph nodes and primary biliary cirrhosis.

Thirty-five consecutive patients with primary biliary cirrhosis were examined using liver biopsy, laboratory tests and ultrasonography of the hepato-duodenal ligament to investigate the possible correlation between enlarged lymph nodes in the hepato-duodenal ligament and biochemical activity, histologic activity or stage and/or humoral immunoreactivity. We found a positive correlation between the size of the largest lymph node and laboratory values of cholestasis, hepatocellular damage and increased humoral immunoreactivity. On the other hand, we found a negative association between lymph node size and hepatocellular function. When twelve of the patients were reexamined after at least 10 months, in the majority of the patients changes in lymph node size were accompanied by similar changes in markers of cholestasis, hepatocellular damage and immunoreactivity. Prognostic index was also directly associated with lymph node size in most of these patients. No association between lymph node size and histologic stage was observed.

Adult↗
PubMed1992

Prednimustin treatment in primary biliary cirrhosis: a preliminary study.

We observed a decrease in serum bilirubin, alkaline phosphatases (ALP) and IgM in five patients with primary biliary cirrhosis (PBC) treated with Prednimustin (Sterecyt) for 6 months. In contrast to pretreatment findings, C3 activation was undetectable during treatment in three patients where normalization of serum IgM was achieved. After discontinuation of Prednimustin, bilirubin and ALP levels rapidly returned to pretreatment values, although IgM remained normal for up to 6 months in some patients. We conclude that Prednimustin might be of value in patients with symptomatic PBC where liver transplantation is not an option, and that it should be evaluated in a controlled study. However, the rapid reactivation of the disease after conclusion of treatment must be considered.

Aged↗
PubMed1989

Liver biopsy complications monitored by ultrasound.

Ultrasound (US) was performed in 96 patients (on 108 occasions) 2-4 h after diagnostic liver puncture with a modified Menghini needle. Serious complications (major haemorrhages: one intraparenchymal and one into the abdominal cavity) were seen in two patients, while seven presented with minor bleedings though without any registered clinical abnormality (slight pain in one). On 11 occasions (10 patients) slight to moderate pain was observed though in combination with a normal US. Findings on US and clinical observations showed poor correlation and the number of bleeding complications discovered by US examination seems to depend upon when the study is performed. US does not replace the clinical follow-up but may be helpful in the presence of adverse clinical reactions in order to establish the type of lesion: profuse parenchymal haemorrhage versus bleeding into the abdominal cavity. This information may be helpful in the choice between conservative and surgical therapy.

Adult↗
PubMed1989

Does smoking tighten the gut?

There is a low prevalence of smoking in ulcerative colitis. The disease often starts or relapses after stopping smoking. Increased intestinal permeability for harmful substances has been proposed as one causal factor in ulcerative colitis. We therefore wanted to study the relationship between smoking and intestinal permeability in healthy subjects. In 25 smoking and 25 non-smoking healthy persons urine recoveries of two different oral probes, 51Cr-ethylenediaminetetraacetic acid (51Cr-EDTA) and low-molecular-weight polymers of polyethylene glycol (PEG 400), were measured. The smokers had significantly lower 24-h urine recoveries of 51Cr-EDTA than the non-smokers (median, 1.6; range, 0.8-4.2, versus 2.1; range, 1.1-5.8; 2 p less than 0.001). In contrast, 6-h urine recoveries of PEG 400 were not significantly different in smokers and non-smokers. Thus, smoking appears to tighten the gut either by effects on the paracellular junctions in the intestinal epithelium or by decreasing the permeability in the distal small bowel and the colon.

Adult↗
PubMed1988

Underreporting of alcohol-related mortality from cirrhosis is declining in Sweden and Denmark.

Death rates for alcoholic cirrhosis ran parallel to alcohol consumption in Sweden and Denmark from 1961 to 1986, according to official statistics. Reported death rates for alcoholic cirrhosis and for non-alcoholic cirrhosis increased linearly from 1965 to 1976 in Sweden and from 1967 to 1973 in Denmark. This suggests that constant proportions of deaths from real alcoholic cirrhosis are misclassified in official statistics as due to non-alcoholic cirrhosis during these time periods. Assuming that the mortality from real non-alcoholic cirrhosis is constant (c), a statistical model for estimating both c and the misclassification rates for real alcoholic cirrhosis (p) is proposed. In the Sweden population and in Danish males c was about 5 deaths per 100,000 adults annually. The model was not applicable to Danish females because their mortality from non-alcoholic cirrhosis decreased. The misclassification rate p was about 55% in both Swedish and Danish males and 70% in Swedish females during the above time periods. Moreover, during the past decade p has decreased to 30% in Swedish and Danish males.

Data Interpretation, Statistical↗
PubMed1983

Escherichia coli antibodies in alcoholic liver disease. Correlation to alcohol consumption, alcoholic hepatitis, and serum IgA.

In 41 patients with alcoholic liver disease, antibodies to 12 common Escherichia coli O antigens (expressed as number of O antibody reactions with an agglutination titre of greater than or equal to 40) and to immunoglobulins IgG, IgA, and IgM were studied for 8 weeks. In 18 patients (8 with cirrhosis, 10 with fatty liver) who continued drinking during this period no significant changes were found. In 23 patients (11 with cirrhosis, 12 with fatty liver) who stopped or reduced drinking, a significant decrease in the levels of E. coli O antibodies and IgA was found (p less than 0.05 and p less than 0.01, respectively). In these 41 patients and in an additional 43 patients with alcoholic liver disease the amount of E. coli O antibodies was compared with type of histological lesion. The levels of E. coli O antibodies were significantly higher in cirrhosis with alcoholic hepatitis (22 cases) than in cirrhosis without alcoholic hepatitis (17 cases) (p less than 0.05). In these 17 patients antibody levels were significantly higher than in 41 patients with fatty liver without alcoholic hepatitis (p less than 0.02). In all patients a significant correlation between the number of positive reactions to E. coli O antigens and serum IgA concentration was found (p less than 0.01). No microbes were cultured from the liver biopsies, and no E. coli O antigens were demonstrated in the liver tissue by immunohistochemistry. Our results support the hypothesis that the high levels of E. coli O antibodies in alcoholic liver diseases are due to failure of the liver to extract circulating antigens and gut-derived endotoxins.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1982

Metronidazole treatment of bypass-enteropathy after jejunoileal shunt-operation for obesity.

In 5 patients with bypass-enteropathy following jejunoileal shunt-operation for morbid obesity, bacterial overgrowth was demonstrated in the functioning small bowel. The symptoms were effectively relieved during treatment with metronidazole in the 3 patients, who completed the treatment. Bacterial cultures revealed no anaerobic growth during 3 of 4 periods of treatment. Anaerobic overgrowth in the small bowel is probably the cause of bypass-enteropathy following jejunoileal shunt-operation.

Adult↗
PubMed1981

Changing mortality from cirrhosis in Denmark 1965-1978.

The annual consumption of alcohol in Denmark doubled from 6 to 121 per adult inhabitant during the years 1964 to 1976. The impact of this change on the mortality from cirrhosis was studied. Overall cirrhosis mortality increased by 33% during this period. However, when analysed according to sex- and age-specific mortality rates, a threefold increase in mortality among young and middle-aged men was found, whereas the mortality among older women fell to 50% of previous rates. Long-term observation of female mortality demonstrated several significant changes since 1945, the reason for which could not be elucidated. Thus in Denmark mortality from cirrhosis in young men closely paralleled alcohol consumption, whereas in women other factors appeared more important and should be specifically looked for.

Adolescent↗
PubMed1981

Morbidity, Mortality, and incidence of cirrhosis in Denmark 1976-1978.

National and international statistics on the occurrence of cirrhosis are generally based on death rates. In Denmark as elsewhere the morbidity and incidence of cirrhosis is largely unknown. National patient register data from 1976 to 1978 and data from a suburban county hospital register during 1971-1977 form the basis for calculations of hospital-related prevalence of cirrhosis (discharge rates and consumption of bed-days). Furthermore, a measure of incidence was established and calculated for the suburban area. Mortality from cirrhosis was about 10 per 100,000 population during 1976-77. Eight-five per cent of the deaths occurred in hospitals. Data from the national patient register of somatic hospital wards underrated mortality from cirrhosis by 40%. Death certificate data classified about 1/3 of th deaths as due to alcoholic cirrhosis, whereas alcoholic cirrhosis constituted 2/3 of the deaths in the material derived from the national patient register. The discharge rate was about 60, and the expenditure of bed-days in somatic hospital departments was about 900 per 100,000 population during 1976-78. Forty per cent of the patients were women. Seventy per cent of the patients had alcoholic cirrhosis-80% of the male and 55% of the female patients. The annual incidence of cirrhosis during 1976-77 was about 27 per 100,000. Forty-three per cent of the patients were women. Two thirds of the newly diagnosed cases of cirrhosis were alcoholic-80% for men and 50% for women. These extended morbidity data on the occurrence of cirrhosis can easily be incorporated in future data based patient registers and should be applied in evaluation of costs and preventive strategies.

Denmark↗
PubMed1980

Red cell sodium and potassium contents in liver cirrhosis.

Red cell sodium and potassium contents were investigated in 57 patients with histologically proven liver cirrhosis and were compared with 13 controls without clinical evidence of liver disease. Patients with normal serum electrolytes (and without digoxin treatment) had normal red cell sodium content indicating no influence of the cirrhosis per se on the sodium-potassium pump or membrane permeability for sodium. Red cell potassium content was elevated, possibly as a consequence of subclinical hemolysis and a relatively young cell population. Hypokalemia was correlated to increased red cell sodium. Hyponatremia was correlated to low red cell sodium indicating reduced influx due to a decreased concentration gradient. According to the concept of the "sick cell syndrome," membrane failure and cellular gain of sodium and loss of potassium can lead to hyponatremia. Our findings of normal or low red cell sodium contents provide evidence against this mechanism as explanation for the often sever hyponatremia in terminal liver failure. The abnormalities found in the red cells could be attributed to secondary complications to the cirrhosis.

Acid-Base Equilibrium↗
PubMed1977

Correlation between hepatic morphology and immunoglobulins and antibodies to Escherichia coli in cirrhosis.

Increased antibody production and hypergammaglobulinaemia in cirrhosis are probably to a large extent due to decreased hepatic extraction of antigens. The deceased extraction is presumably related to changed microcirculation caused by damaged anatomical structure of the liver. It is therefore to be expected that immunoglobulin and antibody levels in serum in cirrhotic patients are related to the degree of certain morphological changes of the liver. This hypothesis has been tested. In 50 patients with cirrhosis, 28 alcoholics and 22 non-alcoholics, the degree of architectural destruction, the degree of fibrosis, the degree of fatty infiltration, and the degree of "activity" were compared with immunoglobulins G, A, and M and E. coli O antibody levels. The comparison was carried out within each of the aetiological groups. Identical relationships were found in both groups. Patients with completely destroyed lobular architecture had higher levels of E. coli O antibodies than patients with partly destroyed architecture. Patients with severe fibrosis had higher IgA and E. coli O antibody levels than patients with moderate or slight fibrosis. Patients with moderate and severe steatosis and patients with no or slight steatosis had the same immunoglobulin and E. coli O antibody levels. Patients with active cirrhosis had higher IgG levels than patients with inactive cirrhosis. When architectural destruction and fibrosis were combined significantly higher IgG, IgA, IgM, and E. coli antibodies were found in the group with the most severe changes. These findings support the hypothesis that immunoglobulin and antibody levels are related to the degree of morphological changes in the liver--namely, destruction of lobular architecture, fibrosis, and "activity".

Adult↗
PubMed1976

Acid-base status in liver cirrhosis. Disturbances in stable, terminal and portal-caval shunted patients.

Acid-base status was determined in 86 patients with cirrhosis of the liver. Group I comprised 55 patients living more than 3 months after examination (stable). Another 18 stable patients with a surgical porta-caval shunt (p.c.a.) formed group II. Group III consisted of 12 terminal patients without p.c.a. examined within the last week of life. With respect to liver function group II was intermediate between I and III. The most common acid-base disturbance in group I was compensated respiratory alkalosis (20%) followed by compensated metabolic alkalosis (15%). 50% of group II presented compensated respiratory alkalosis. 85% of group III showed metabolic acidosis, which was compensated in only half of the patients. Respiratory alkalosis seemed more related to impairment of liver function than to portasystemic shunting. The genesis of the terminal metabolic acidosis was complex. Renal function was reduced in 92% of group III, and lactic acidosis was found in 36%. In this group hepatic function was most severely impaired, and 60% were hypotensive. These disturbances were not related to aetiology or treatment of the liver disease.

Acid-Base Equilibrium↗
PubMed1976

Portal venous and systemic endotoxaemia in patients without liver disease and systemic endotoxaemia in patients with cirrhosis.

Systemic endotoxaemia without evidence of gram-negative bacterial infection occurs in liver diseases in man. The endotoxaemia is probably due to impaired hepatic clearance of endotoxin absorbed from the gastrointestinal tract, but portal venous endotoxaemia has never been reported in man. By means of the limulus gelation test, portal venous blood from 21 patients without parenchymal liver disease and arterial blood from 21 patients without parenchymal liver disease and 31 patients with cirrhosis was examined for endotoxin. Portal venous endotoxaemia was found in 9 of 21 samples and systemic endotoxaemia was found in 2 of 21 samples from patients without liver disease. Systemic endotoxaemia in cirrhosis occurred with a frequency of 15/31. No relationship to gram-negative bacteraemia was found. Leucocytosis was only seen in endotoxin-positive patients with cirrhosis. In cirrhosis higher levels of E. coli O antibodies were found in endotoxin-positive than in endotoxin-negative patients, supporting the view that the limulus gelation test specifically detects endotoxin (i.e. E. coli O antigen). The study suggests that endotoxin is a normal constituent of portal venous blood in man. The normal human liver clears endotoxin from the portal venous blood. This effect is diminished in cirrhosis, most probably owing to decreased phagocytic function of the liver. The increased humoral immune response in cirrhosis may be related to spillover of endotoxin from the liver.

Antibodies, Bacterial↗