PubMed Health⌕ Search

Biomedical subjects

J Mössner

Publications and source records attributed to J Mössner.

At least 109 records · Page 6Linked to original sources

Mutations of the cationic trypsinogen in hereditary pancreatitis.

Hereditary pancreatitis (OMIM 167800) is thought to be associated with a mutation of the exon 3 of cationic trypsinogen (Nature Genet (1996): 14:141-145). This paper reports sequence data of two independent families suffering from this disease. PCR amplificates from leukocyte or buccal swab DNA showed no mutation of exon 3 of cationic trypsinogen. Instead, in exon 2, an A-to-T tranversion was found that led to the substitution of Asn by Ile in the sixth amino acid of the active trypsin. In exons 4 and 5, silent mutations were found. In the other expressed trypsinogens, several homozygous alterations not associated to hereditary pancreatitis were identified. As a model of pathogenesis, we hypothesize that mutation of trypsinogen in exon 2 could lead to premature cleavage of the activation peptide of trypsinogen or to altered intracellular transport.

Base Sequence↗

Inability of rat alveolar macrophages to recycle L-citrulline to L-arginine despite induction of argininosuccinate synthetase mRNA and protein, and inhibition of nitric oxide synthesis by exogenous L-citrulline.

In the present study it was tested whether rat alveolar macrophages (AMphi) convert L-citrulline to L-arginine to maintain nitric oxide (NO) synthesis under conditions of limited availability of L-arginine. Rat AMphi (0.5 x 10(6) cells/well, cultured for 20 h in the absence or presence of 1 microg/ml lipopolysaccharides, LPS), were incubated for 6 h in amino acid-free Krebs solution and nitrite accumulation was determined as a measure of NO synthesis. After culture in the absence of LPS, nitrite in the incubation media was at the detection limit, independent of the addition of L-arginine or L-citrulline. AMphi, cultured in the presence of LPS, produced about 4 nmol per 10(6) cells and 6 h nitrite, and L-arginine enhanced nitrite accumulation in a concentration-dependent manner, maximally about threefold (EC50: 55 microM). In LPS-treated AMphi L-citrulline (up to 10 mM) failed to enhance nitrite accumulation, but rather inhibited it by about 50% in the presence of 100 microM L-arginine, i.e. when NO synthesis was enhanced. L-Arginine in the culture medium was 3H-labelled and its metabolism analysed by HPLC. In medium of AMphi exposed to LPS [3H]-L-arginine was reduced by about 60% after a 20-h culture period and this was almost balanced by an almost equal increase in [3H]-L-citrulline and [3H]-L-ornithine, i.e. L-arginine was markedly consumed. When [14C]-L-citrulline was added to the culture medium of AMphi, no significant formation of [14C]-L-arginine could be detected. On the other hand, argininosuccinate synthetase mRNA (by RT-PCR) and protein (by Western blot) was marginally detectable in control AMphi, but clearly induced after exposure to LPS. Finally, L-citrulline was shown to inhibit L-arginine uptake in a concentration dependent manner, by about 50% at 10 mM. In conclusion, although the expression of argininosuccinate synthetase in rat AMphi can be induced by LPS, AMphi appear not to be able to recycle significant amounts of L-citrulline to L-arginine to maintain sustained NO synthesis. On the contrary, at high concentrations L-citrulline can reduce NO synthesis, and this effect appears to be caused by inhibitory effects on L-arginine uptake.

Animals↗

A comparison of lipase and amylase in the diagnosis of acute pancreatitis in patients with abdominal pain.

The clinical value of amylase and lipase measurement for the diagnosis of acute pancreatitis was evaluated in 253 patients presenting with acute abdominal pain. Acute pancreatitis was detected in 32 patients by computed tomography or ultrasound. In the serum samples collected on days 0-1 after the onset of symptoms, lipase was elevated in 100% and amylase in 95%. A 95% sensitivity/specificity was reached at a lipase cutoff near twofold above normal. The receiver-operating characteristics (ROC) showed similar curves for both enzymes, lipase being slightly superior to amylase. The ROC curves from days 2-3 demonstrated a much lower sensitivity/specificity of both enzymes. Lipase, however, was notably superior to amylase: at a sensitivity of 85% the specificity of lipase (amylase) was 82% (68%). In samples from days 4-5 the accuracy of the enzyme assays was even worse; at a sensitivity of 60% the specificity did not increase above 70%. The diagnostic value of simultaneous measurement of amylase and lipase was tested at different cutoffs in two groups: the OR group, in which one of the two parameters had to be elevated, and the AND group, in which both parameters had to be above normal. Combination of both parameters mainly improved the specificity of the assay (from 91 to 98% on days 2-3 and from 93 to 97% on day 4-5) but only when, in the OR group, twofold elevated amylase was combined with lipase. We conclude that the simultaneous determination of serum lipase and amylase marginally improved the diagnosis of acute pancreatitis in patients with acute abdominal pain, however, the sensitivity of the assay with samples collected 4-5 days after onset of the disease remained low.

Abdominal Pain↗

Primary amyloidosis of the mesentery and the retroperitoneum presenting with lymphedema.

We report the case of a 57-yr-old woman presenting with moderate weight loss, abdominal distension, and lymphedema of the legs and vulva. Computed tomography of the abdomen revealed massive thickening of the rectal wall, mesentery, and retroperitoneum. Primary amyloidosis was diagnosed by immunohistochemistry from the rectum and duodenum. To our knowledge, lymphedema due to primary amyloidosis has not yet been reported. The diagnosis should be presumed in the case of retroperitoneal thickening and lymphedema and can be established by immunohistochemistry.

Amyloidosis↗

[Therapy and follow-up of injuries after laparoscopic operations].

From May 1993 to September 1997 we treated 22 patients with complications after laparoscopic surgery. We report on 18 patients after laparoscopic cholecystectomy, three patients after diagnostic laparoscopy and one after TAPP. Two patients died (hepatic failure and without any possibility of definitive therapy) and the injuries of the other 20 patients were repaired.

Biliary Fistula↗

[Diagnosis and differential diagnosis of pancreatic carcinoma].

Despite improved imaging procedures for diagnosis, there is no improvement in prognosis of pancreatic carcinoma. This may be explained by the lack of early symptoms and the aggressiveness of the tumor with its tendency of early metastasis. However, in most cases imaging procedures enable an exact preoperative diagnosis and a reliable preoperative staging. Unnecessary laparotomies are avoided since resectability can be correctly predicted in more than 80%. Transabdominal sonography and computed tomography are mandatory in almost all cases. Endoscopic retrograde cholangiopancreatography has not lost its importance due to the possibilities of transpapillary biopsy or brush-cytology. A major role for ERCP is palliative therapy of cholestasis by stenting of malignant bile duct stenosis. At present endosonography can be regarded as most sensitive procedure to detect small pancreatic tumors and as a very reliable method for preoperative T-staging. Detection of mutations of the Ki-ras gene in shedded cells of pancreatic secretions may improve the still difficult differential diagnosis chronic pancreatitis versus pancreatic carcinoma.

Biopsy↗

Expression of a non-MDR2-coded liver phosphatidylcholine membrane transport protein in Xenopus laevis oocytes.

Phosphatidylcholines (PC) are secreted into the bile via a membrane transport protein(s). Recently, evidence for ATP-dependent mdr2-encoded PC transport as well as for carrier-mediated PC transport had been reported. Therefore, we investigated whether mdr2 P-glycoprotein is involved in the transport of a water-soluble short chain phosphatidylcholine analogue L-alpha-dibutyroyl-PC (diC4PC) induced by expression of liver mRNA in Xenopus laevis oocytes. Expression of mouse and rat mdr2 cRNA did not result in diC4PC net uptake in Xenopus laevis oocytes. By contrast oocytes showed a similar carrier-mediated uptake activity for diC4PC after injection of mouse, rat and human liver total mRNA (Km 7.7, 9.6, and 11.6 mM). Antisense inhibition of mdr2 mRNA expression increased diC4PC uptake induced by total liver mRNA from mouse and rat. The present data prove the existence of a specific mRNA for a non-mdr2-coded cell membrane PC carrier in mouse, rat, and human liver which exhibits similar transport affinity for diC4PC as the PC carrier in rat liver canalicular membranes.

ATP Binding Cassette Transporter, Subfamily B↗

Evidence for secretory coupling of phosphatidylcholine molecular species to cholesterol in rat bile.

BACKGROUND/AIMS: Hepatocytes secrete cholesterol into bile within lipid vesicles of selected phosphatidylcholines, mainly palmitoyl-linoleoyl-phosphatidylcholines, palmitoleoyl-oleoyl-phosphatidylcholines and palmitoleoyl-arachidonyl-phosphatidylcholines, which could in part determine the secreted amount of cholesterol. AIMS: To study whether increased secretion of cholesterol, as caused by manipulation of cholesterol synthesis rate, changes the composition of phosphatidylcholines secreted in bile. METHODS: Livers from control rats (Control), rats fed pravastatin for 7 days (Pravastatin) and livers isolated 5-7 or 8-11 hours after pravastatin had been withdrawn (Rebound5-7h; Rebound8-11h) were isolated perfused during infusion of taurocholic acid (400 nmol/min/100 g rat), to study biliary secretion of bile salts, cholesterol and phosphatidylcholine molecular species. RESULTS: Bile salt secretion rate was similar in all four groups, secretion of cholesterol and phosphatidylcholines was similar in Control and Pravastatin. With duration of pravastatin withdrawal the secretion rates of phosphatidylcholine and cholesterol progressively increased by +38% and +122% in Rebound5-7h and by +70% and +300% in Rebound8-11h (vs Control), respectively. In parallel, the secretion rates of palmitoleoyl-oleoyl- and palmitoleoyl-arachidonyl-phosphatidylcholines rose up to sixfold and twofold, respectively, while the secretion rate of palmitoyl-linoleoylphospatidylcholines remained constant. The secretion rate of cholesterol was correlated (p < 0.01) with the secretion rates of palmitoleoyl-oleoyl-phosphatidylcholines (r = 0.83) and palmitoleoyl-arachidonyl-phosphatidylcholines (r = 0.81). Bilirubin ditaurate or taurodehydrocholate reduced (p < 0.05) biliary secretion of phosphatidylcholines (-33%; -72%) without changes in cholesterol/phosphatidylcholine secretory ratio or phosphatidylcholine species. CONCLUSIONS: The secretion of the major molecular species of phosphatidylcholine in bile could be coregulated with the amount of cholesterol destined for biliary secretion.

Animals↗

One-year prophylactic efficacy and safety of pantoprazole in controlling gastro-oesophageal reflux symptoms in patients with healed reflux oesophagitis.

BACKGROUND: Pantoprazole is a benzimidazole derivative which selectively inhibits the proton pump H+. K+-ATPase necessary for the final step in gastric acid secretion. AIM: To investigate the tolerability and the prophylactic effect of pantoprazole 40 mg once daily on relapse in patients whose reflux oesophagitis had been healed. METHODS: The safety of pantoprazole 40 mg once daily was assessed in an open 1-year trial on 222 patients whose reflux oesophagitis had been healed with omeprazole or pantoprazole. Relapse was defined as endoscopically-confirmed reflux oesophagitis (at least Grade I), with endoscopies being performed for patients experiencing 3 consecutive days of disease-specific symptoms. RESULTS: Kaplan-Meier survival analysis at 6 and 12 months gave estimated treatment failure rates of 2% and 6% from confirmed relapses (per-protocol), and of 9% and 30% for a worst-case group (all withdrawals counted as failures). The only population shift in laboratory variables was a doubling of the median serum gastrin level over the first 6 months; thereafter it stabilized. Fifty-four (24%) patients experienced adverse events; 15 of these withdrew. Serious adverse events were reported for 12 patients. CONCLUSIONS: Pantoprazole appears to be highly effective and to have a good safety profile for long-term prophylaxis of reflux oesophagitis.

2-Pyridinylmethylsulfinylbenzimidazoles↗

[Primary amyloidosis of the gastrointestinal tract and liver--two case reports].

In primary amyloidosis the gastrointestinal tract and the liver are commonly involved, but clinical features and prognosis are mainly determined by the extent of cardiac and renal involvement. We review two cases with primary amyloidosis of the gastrointestinal tract and the liver. The predominant symptoms were malabsorption and hepatomegaly with cholestasis. The clinical aspects, diagnosis, treatment and prognosis of primary amyloidosis of the gastrointestinal tract and the liver are discussed in the context of the current literature.

Amyloidosis↗

[Tumor suppressor gene p53--function and significance in gastroenterology].

The p53 gene is a tumor suppressor gene. The encoded p53 protein directly induces the expression of genes that are involved in cell cycle regulation. p53 was named "guardian of the genome" for its prevention of an otherwise fatal outcome under DNA damaging conditions. Under these conditions p53 inhibits cell cycle progression or induces apoptosis. The p53 protein has been structurally and functionally divided into four domains, two of which are of crucial importance: The sequence specific DNA-binding domain and the aminoterminal transactivation domain. They are both required to trigger the downstream processes following p53 expression. Mutations and inactivation of p53 by oncogenes are frequent events in the development of human neoplasia. That includes gastrointestinal tumors with their mutational spectra reflecting tissue-specific influences of endogenous and exogenous factors in carcinogenesis. Despite considerable progress in molecular biology, clinical applicability of p53 in both diagnostic and therapeutic strategies has not yet been validated.

Apoptosis↗

Polyclonal pancreatic elastase assay is superior to monoclonal assay for diagnosis of acute pancreatitis.

We compared the clinical values for diagnosis of acute pancreatitis of two commercial assays for pancreatic elastase: an ELISA procedure with monoclonal antibodies and a RIA technique with polyclonal antibodies. In 14 patients with acute pancreatitis, serum concentrations of elastase determined by ELISA (ELISA-elastase) decreased much faster (half-life 0.4 days) than those of elastase determined by RIA (RIA-elastase) (2.2 days), amylase (0.8 days), or lipase (0.9 days). Serum samples from 253 additional patients with abdominal pain (32 of these with acute pancreatitis) were analyzed. In sera collected up to 48 h after the onset of disease, the ROC curves showed a slightly higher diagnostic value of RIA-elastase. In samples taken later, at a sensitivity of 90% the specificity of RIA-elastase was 95% (ELISA-elastase 40%). We conclude that serum ELISA-elastase is of much lower clinical value than RIA-elastase for diagnosis of acute pancreatitis.

Abdomen, Acute↗

Role of hypertriglyceridemia in the pathogenesis of experimental acute pancreatitis in rats.

CONCLUSION: The pancreatic damage initiated via different pathogenetic pathways can be increased by triglycerides. Thus, triglycerides seem to play an important role in the pathogenesis of acute pancreatitis. BACKGROUND: Lipolytic enzymes and their substrates may play a role in the pathogenesis of acute necrotizing pancreatitis. We investigated, therefore, whether triglycerides alter the course of acute pancreatitis in three experimental models of rats. METHODS: 1. Edematous acute pancreatitis induced by repeated sc injections of cerulein; 2. Necrotizing acute pancreatitis by retrograde duct injection of sodium taurocholate; and 3. Pancreatic edema by ligation of: a. The bile duct at the liver hilus; b. The common bile/pancreatic duct close to the duodenal wall; or c. A combination of a. and b. Six hours later, rats were sacrificed and the isolated perfused pancreas prepared. The pancreases were perfused with either HEPES/Ringer/HAES alone or in combination with various concentrations of triglycerides (1-5% wt/vol). The activities of lipase and amylase in the portal venous effluents were regarded as a marker of pancreatic injury. In addition, the pancreases were evaluated by light microscopy. RESULTS: In both cerulein and taurocholate acute pancreatitis, amylase/lipase activities were significantly higher compared to controls during 45 min of perfusion. In both models, addition of triglycerides caused a dose-dependent marked elevation of enzymes. Ligation (a) did not cause any rise in enzymes in the venous effluent; triglycerides had no effect. Ligation (b) or (c) caused a significant increase of pancreatic enzymes, which was further increased by triglycerides. Histology showed various degrees of severity of tissue damage depending on the model used. The additional damaging effect of a 45-min perfusion with triglycerides, however, could not be detected by histology.

Acute Disease↗