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J Henker

Publications and source records attributed to J Henker.

At least 19 recordsLinked to original sources
PubMed2005

[Definitions of celiac disease--statement of an expert group from the German Society for Celiac Disease].

Celiac disease may have different manifestations and the clinical course can be very heterogeneous. Thus, management and treatment of celiac disease can be difficult and therefore requires individual patient care. In this article an expert group from the German Society for Celiac Disease (Deutsche Zöliakie-Gesellschaft) defines the different manifestations of celiac disease. In the past these definitions were often used differently. The consequent usage of these definitions may diminish uncertainties in clinical practice and lead to a more standardized management of the disease which is likely to improve patient care.

Adult↗
PubMed2003

[Prevalence of type 1 diabetes-specific autoantibodies and of certain HLA patterns in celiac disease].

BACKGROUND AND OBJECTIVE: An association between type 1 diabetes mellitus and celiac disease has been known for some time. One in ten type 1 diabetics have immunological markers for celiac disease (CD). But is there, conversely, an increased risk of CD for diabetics? This study was undertaken to answer this question by determining diabetes-associated antibodies and genetic factors in patients with a gluten-sensitive enteropathy (CD). PATIENTS AND METHODS: 68 patients with CD (48 females and 20 males) were investigated by determining the diabetes-associated serological marker GADA (glutamic acid decarboxylase antibodies). 1A-2A (insulinoma-associated protein 2 antibodies), ICA (Islet cell antibodies) and IAA (insulin autoantibodies). Among this cohort were 60 patients up to the age of 25 years and eight adults (average age 41.7 years). In 36 of these patients the HLA was also determined. RESULTS: GADA was found in 6 patients (9%), 1A-2A in eight (12%) and IAA in 21. ICA were not demonstrated in any. Five of the CD patients were positive for several markers. One child, positive for autoantibodies already had manifest diabetes at the time of investigation. None of the patients with autoantibodies had an abnormal glucose metabolism one year later. HLA-DR3, that occurs in both CD and diabetes, was demonstrated in 78% of the patients with CD. The most common constellation, HLA-DR3-DQ2/HLA-DR7-DQ2, was found in 31%. CONCLUSION: This investigation indicates a genetic association between celiac disease and diabetes. Nonetheless, the risk of developing diabetes mellitus is only minimally higher in patients with CD than in the normal population. Therefore, general screening cannot be recommended at present. Further studies will be needed.

Adolescent↗
PubMed2002

[Prevalence of asymptommatic coeliac disease in children and adults in the Dresden region of Germany].

BACKGROUND AND OBJECTIVE: Coeliac disease (CD) can be present without any, only a few, or many symptoms. Since asymptomatic CD can have the same complications and also carries the same risk for malignant disease as clinically typical CD inadequately treated by diet, early diagnosis is essential. The prevalence of asymptomatic CD in the Dresden region was determined by antibody screening. At the same time the sensitivity and specificity of the different antibodies were calculated. MATERIAL AND METHODS: Anti-gliadin and endomysium antibodies and total IgA content were measured in the serum of 3004 children (group A), aged 5-12 years, and of 4313 blood donors (group B), aged 17-64 years. Small-intestine biopsies were recommended if either (1) endomysium antibodies (EmA) or (2) anti-gliadin antibodies (ACA) and clinical symptoms or (3) AGA-IgG in the presence of total IgA deficiency and clinical symptoms had been demonstrated. RESULTS: EmA were demonstrated in 0.17% of group A and in 0.28% of group B. But AGA were found much more frequently (group A: 3.89%, group B: 3.76%). The number of cases of CD confirmed by biopsy indicated a prevalence of asymptomatic CD of 1 in 500 children and 1 in 540 adults. Sensitivity and specificity of EmA were significantly higher than those of AGA. CONCLUSION: Compared with a previous study on the prevalence of clinically typical CD in the same region, the present investigation indicates a four-fold higher prevalence of asymptomatic CD. Coeliac-specific antibodies should, therefore, be measured much more widely in the presence of certain symptoms and risk factors. While in adults the measurement of EmA is sufficient to provide the indication for a small-intestine biopsy, both EmA and AGA should be determined before a biopsy is undertaken in children.

Adolescent↗
PubMed2001

Detection of four human milk groups with respect to Lewis-blood-group-dependent oligosaccharides by serologic and chromatographic analysis.

Oligosaccharides from human milk samples obtained from individual donors were analyzed using high-pH anion-exchange chromatography. Three patterns of neutral oligosaccharides were detected corresponding to milk groups already described. These oligosaccharide groups correspond to the Lewis blood types Le(a-b+), Le(a+b-), and Le(a-b-). A new carbohydrate pattern was detected in a milk sample from a Le(a-b-) person in which only nonfucosylated oligosaccharides and compounds bearing alpha1,3-linked fucosyl residues were found. This finding led to the hypothesis that there exist 4 different oligosaccharide milk groups that fit well to the genetic basis of the Lewis blood group system.

Anions↗
PubMed2001

Successful treatment of gut-caused halitosis with a suspension of living non-pathogenic Escherichia coli bacteria--a case report.

UNLABELLED: In up to 90% of cases, severe halitosis is a result of gastrointestinal or orolaryngeal problems. This case study reports on a girl with bad breath caused by increased formation of malodorous intestinal gases (halitosis), which could be successfully treated with a suspension of living non-pathogenic bacteria Escherichia coli. CONCLUSION: in unclear cases of bad breath, an increased formation of intestinal gases should also be considered.

Breath Tests↗
PubMed2001

Pancreatic elastase 1 in feces of preterm and term infants.

BACKGROUND: Determination of fecal pancreatic elastase 1 (E1) is a reliable and noninvasive test of exocrine pancreatic function. Adult reference values of greater than 200 microg E1/g feces do not seem to be applicable to early infancy because of immature pancreatic function. Because reference values for infants do not exist, the current study was aimed to define reference values for preterm and term infants up to 12 months of age. METHODS: The authors measured pancreatic E1 concentration in feces of 148 infants up to 12 months of age. Infants with known bowel or pancreatic disorders were excluded from the study. RESULTS: The authors found that 96.8% of all children had E1 concentrations greater than an adult lower limit after 2 weeks of life, independent of gestational age. Up to 48 hours after birth, none of the preterm infants had an E1 concentration of greater than 30 microg/g meconium, whereas 43% of the term infants had normal adult values. CONCLUSIONS: The adult reference value for pancreatic E1 of greater than 200 microg/g feces can be applied to infants older than 2 weeks, independent of gestational age, birth weight, and the type of nutrition.

Age Factors↗
PubMed1997

Detection of four human milk groups with respect to Lewis blood group dependent oligosaccharides.

Neutral oligosaccharides in human milk samples from approximately 50 women were analysed applying a recently developed high-pH anion-exchange chromatographic method. Three different oligosaccharide patterns could be detected in accordance with milk groups that had been already described. These oligosaccharide groups correspond to the Lewis blood types Le(a-b+), Le(a+b-) and Le(a-b-). In addition to these oligosaccharide patterns, a new carbohydrate pattern was detected in a milk sample from a Le(a-b-) individual. Here, only nonfucosylated oligosaccharides and compounds bearing alpha1,3 linked fucosyl residues were found, whereas structures with alpha1,2 and alpha1,4 fucosyl linkages were missing. This finding led to the hypothesis that there are four different oligosaccharide milk groups that fit well to the genetic basis of the Lewis blood group system.

Animals↗
PubMed1997

Sensitivity and specificity of quantitative determination of pancreatic elastase 1 in feces of children.

BACKGROUND: The secretin-pancreozymin test has been accepted as the gold standard for testing exocrine pancreatic function. However, this test is invasive, time-consuming, and expensive. Therefore, in daily practice, more simple, indirect methods are proposed. METHODS: The fecal concentration of human pancreatic elastase (E1) has been assessed for diagnostic sensitivity and specificity. For sensitivity, fecal E1 determination in 23 healthy children were studied. RESULTS: Sensitivity to detect pancreatic insufficiency was 100% and specificity 96%. CONCLUSIONS: Fecal E1 concentration appears to be a more sensitive and specific test of pancreatic function than other tests.

Adolescent↗
PubMed1997

Simultaneous determination of fecal fat, nitrogen, and water by near-infrared reflectance spectroscopy.

BACKGROUND: Determinations of fecal fat and nitrogen reveal evidence of malabsorption and assist in estimating the efficacy of pancreatic enzyme treatment. Seventy-two-hour stool collection, with chemical analysis of fecal fat, and Kjeldahl's method for measurement of fecal nitrogen are generally accepted as standard methods for making these determinations. However, these traditional methods are expensive, time-consuming, and cumbersome. This study evaluated the efficiency and validity of an alternative method, using near-infrared reflectance spectroscopy (NIRS) and compared results with those of the standard methods. METHODS: Near-infrared reflectance spectroscopy is a secondary method: The instrument first has to be calibrated with samples analyzed by the standard method. Sixty-three stool samples with known fat content (range 4.79-292.5 mg/g), 24 samples with known nitrogen content (range 5.36-19.38 mg/g), and 24 samples with known water concentration (range 60.1-82.22%) served for calibration. A further 69 samples were analyzed to validate the procedure. RESULTS: There was a satisfactory correlation between the measurements produced by near-infrared reflectance spectroscopy and those produced by standard methods: fat r = 0.97; nitrogen r = 0.94; water r = 0.96. CONCLUSIONS: Near-infrared reflectance spectroscopy appears to be a reliable, simple, and rapid method of measuring different fecal components-as precise and accurate as the standard methods. Stool samples should be analyzed immediately after collecting or stored only a few days before analyzing.

Adolescent↗
PubMed1997

Gastrointestinal lymphonodular hyperplasia and lymphoid polyps of the rectum--a rare coincidence.

Lymphoid polyps of the rectum are rare lesions. We report on an 8 1/2-year-old boy, who presented with hematochezia and abdominal pain. Flexible endoscopy revealed large sessile polyps of the rectum and lymphonodular hyperplasia of the duodenum, terminal ileum und descending colon. One rectal polyp was excised in toto, microscopically it revealed the typical features of a lymphoid polyp. Based on the distinct follicular architecture, the cytomorphology and the immunohistochemical findings of the lymphatic infiltrate we were able to distinguish this lesion from malignant lymphoma. The coincidence of lymphoid polyps and gastrointestinal lymphonodular hyperplasia gives evidence that both entities are different variations of the same benign lymphoproliferative process. Lymphoid polyps of the rectum should be treated by local excision for diagnostic purposes. Immunohistochemical staining of fresh, nonfixed tissue is a useful ancillary technique in distinguishing these benign lesions from lymphoma of mucosa associated lymphoid tissue (MALT-lymphoma).

Biopsy↗
PubMed1996

Indirect parameters of pancreatic function in cystic fibrosis (CF) during a controlled double-blind trial of pancreatic supplementation.

During two treatment periods (4 weeks each), serum immunoreactive trypsin (IRT), immunoreactive human lipase in stool (IRL), and chymotrypsin (CT) activity in stool were determined in 16 cystic fibrosis patients and compared with fecal fat excretion (72-h sampling). Fecal fat estimation revealed mild to severe steatorrhea in all 16 patients (X = 13.7 +/- 9.0 g/24 h) in at least one study period. Stool fat excretion was highest in underweight adolescents and adults. Comparison of IRT and IRL with stool fat values showed no significant statistical correlation. IRT values revealed an inverse exponential correlation with age, with a steep decline at the age of 5 years. CT levels were very high in 14 of our 16 patients during supplementation therapy, whereas 2 patients showed subnormal CT values. We conclude that since indirect parameters of pancreatic function do not correlate with stool fat excretion, stool fat remains the best indirect parameter for the assessment of pancreatic insufficiency in cystic fibrosis. Leaving pancreatic enzyme supplementation in cystic fibrosis patients on the basis of normal serum trypsin or fecal lipase values does not appear to be adequate.

Adolescent↗
PubMed1993

[Long-term treatment of mucoviscidosis. Results with a microencapsulated pancreatic enzyme preparation].

METHODS: In 30 children suffering from cystic fibrosis, the long-term effect (2 years) of treatment with an acid-protected micro-encapsulated pancreatin preparation was investigated in comparison with prior enzyme replacement with a conventional pancreatin preparation given over a period of years. Assessment criteria was the development of body length and body weight, lung function (vital capacity, FEF1) and the Shwachman-Kulczycki score. RESULTS: The therapeutic efficacy of the acid-protected micro-encapsulated preparation is considered to be higher than that of conventional preparations, since the same effect was achieved with only one-quarter to one-third of the pancreatin dose of the conventional preparation (average: 6.5 +/- 2.9 g pancreatin/d, as compared with 1.6 +/- 0.6 g pancreatin in the case of the acid-protected micro-encapsulated preparation). However, none of the clinical parameters investigated revealed any significant changes during the course of the observation period. The results indicate that, if the general state of health and nutritional status of patients with cystic fibrosis is to be improved further, in addition to a special diet, attempts must be made to achieve further optimization of the intraluminal digestion.

Adolescent↗
PubMed1993

Variations of neutral oligosaccharides and lactose in human milk during the feeding.

There exist only few data concerning the variation of oligosaccharides in human milk. In this study the variations of neutral oligosaccharides and of lactose in human milk during the feeding were determined from five women at day 8 and at day 57 post partum. The milk of the investigated feedings was divided in four parts of equal volumes during sampling; the concentrations of neutral oligosaccharide fractions were determined by gel permeation chromatography on Fractogel TSK HW 40 (S) columns. No significant differences in the concentrations of the neutral oligosaccharide groups monofucosyllactoses, difucosyllactose, lacto-N-tetraoses, monofucosyllacto-N-tetraoses and difucosyllacto-N-tetraoses and of lactose were found in the four milk parts. The results of this study favor the use of so-called mid-feed samples, a simple and convenient sampling method for analytical studies of human milk. Mid-feed samples are representative of the whole feeding as concerned for neutral oligosaccharides.

Adult↗
PubMed1993

[Epidemiologic studies of celiac disease in childhood in the Dresden district].

The incidence and prevalence of celiac disease in children aged 0-16 years during the years 1970-1986 have been studied prospectively in a geographic defined area of Germany. The celiac disease has been diagnosed due to the criteria of ESPGAN. During the mentioned time period, 170 patients with confirmed celiac disease and 399,477 live births were registered. This corresponds to an incidence of 1:2060. In December 1986 384,840 children in the age between 0 and 16 years were living in the region of Dresden. This corresponds to a prevalence of 44/100,000 inhabitants. Girls were more often affected than boys (1.8:1).

Adolescent↗
PubMed1991

[Results of mycologic studies of donated breast milk].

From 1968 to 1989 altogether 37,000 specimens of donated and collected mother's milk were mycologically examined by means of a liquid medium (twofold concentrated Raulin solution). The yearly incidence of Candida albicans varied between 8.5 and 5.2%. 25% respectively 14.8% of the donors (n = 60 respectively 813) had delivered milk to the human milk bank which was contaminated by Candida albicans. The mother's milk was primarily contaminated by the donor's own suckling baby. 92.3% of these infants were infected with Candida albicans in the mouth and/or rectum and/or on the skin. Candida albicans was also detected in 46.2% on the nipples of the mothers. It is recommended to transport donated mother's milk at temperatures of 4-8 degrees C and to store the milk at -20 degrees C until the mycological examination is finished to exclude samples contaminated by Candida albicans. Judging our experience donated human milk to be fed in raw state should be regularly controlled mycologically. If the donated milk contains Candida albicans, the donation of milk should be interrupted and an antifungal treatment of the donor and her baby should be performed.

Candida albicans↗
PubMed1990

[Pancreatic enzyme substitution in patients with mucoviscidosis].

In CF-patients physical development is an important prognostic factor. Therefore, maldigestion in consequence of an exocrine pancreatic insufficiency must be payed special attention to. Only the acid-protected microsphere pancreatin preparations should be used for enzyme substitution. In estimating of effectiveness both subjective (pains, tolerance) and particularly objective parameters (balance investigations, stool-weight and -frequency, physical development) should be considered. Referring to this the determination of fecal chymotrypsin-concentration is unsuitable. There are further possibilities for increasing the enzyme efficiency, which could soon become applicable.

Cystic Fibrosis↗
PubMed1990

[Some new treatment strategies for lung involvement in patients with mucoviscidosis].

Autogenic drainage, PEP mask breathing as well as physical exercise are now well established in the treatment of pulmonary disease in cystic fibrosis, but there are different opinions about oxygen therapy over a long period as well as corticosteroid treatment. First reports on amiloride inhalations seem to be hopeful, but there is no experience with cystic fibrosis children till now, therefore clinical use can not be recommended. Heart lung transplants are not to consider as an alternative treatment for all cystic fibrosis patients, in special cases it may be successful.

Child↗