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Biomedical subjects

J Metzler

Publications and source records attributed to J Metzler.

15 recordsLinked to original sources

CYP2E1 activity in patients with alcoholic liver disease.

BACKGROUND/AIMS: In addition to the possible toxicological impact of cytochrome P4502E1 (CYP2E1) in alcohol-induced liver damage, its activity can be regarded as a variable for drug action in patients with alcoholic liver disease as CYP2E1 is involved in the metabolism of several drugs, for example, paracetamol and halogenated anesthetics. The purpose of our study was to acquire detailed knowledge of CYP2E1 activity in patients with progressingly severe manifestations of alcoholic liver disease. METHODS: The concentration ratio of 6-hydroxy-chlorzoxazone/chlorzoxazone in plasma 2 h after ingestion of 500 mg chlorzoxazone (so-called metabolic ratio) has been shown to reflect CYP2E1 activity in vivo. We examined CYP2E1 activity in 56 Caucasian inpatients with minor (n=20), more pronounced (n=14) and severe alcoholic liver disease (n=22). Alcohol abusers were compared to healthy teetotallers (n=14). RESULTS: Metabolic ratios were increased 3-fold in actively drinking (ethanol-induced) compared to abstaining (non-induced) patients with alcoholic liver disease (1.19+/-0.84 vs. 0.44+/-0.45, mean+/-SD, (p<0.0001). CYP2E1 activity was significantly lower in non-induced patients with severe alcoholic liver disease (0.19+/-0.10) than in healthy controls (0.50+/-0.28, p<0.01), abstaining alcohol abusers with minor (0.67+/-0.60, p<0.01) and more pronounced alcoholic liver disease (0.53+/-0.31, p<0.01). When non-induced patients with alcoholic liver disease were arranged in progressing order of liver damage (minor, more pronounced, severe alcoholic liver disease), there was a significant decline in CYP2E1 activity (p=0.0008). CONCLUSIONS: In non-induced patients, CYP2E1 activity decreases in line with severity of alcoholic liver disease. CYP2E1-mediated drug metabolism is significantly impaired in severe alcoholic liver disease.

Adult↗

Sonographic observation of pulmonary infarction and early infarctions by pulmonary embolism.

Fifty-eight consecutive patients with clinical symptoms of pulmonary embolism/infarction were examined by ultrasound as the first imaging modality. The diagnosis was confirmed in 35 patients by ventilation-perfusion scintigraphy; 13 underwent pulmonary angiography for verification of clinical diagnosis. Seven patients died, necropsy was performed and the diagnosis of pulmonary embolism was confirmed in six cases; three patients were submitted to transthoracic lung biopsy. Intercostal space and an additional small pleural effusion in 48% of the examined patients served as a sonic window for the 5 MHz sector scanner. In 42 of the 54 cases with a final diagnosis of pulmonary embolism/infarction a total of 69, hypoechoic, lesions with a pleural basis were detected. These were conspicuous, predominantly triangular, of a mean size 4.6 x 3.7 cm (range 9 x 8 to 2 x 1.5). A hyperechoic structure with reverberation artefacts suggestive of air was frequently visible in the centre: a sign of segmental involvement. The ultrasound examination yielded a true positive result in 41 cases. The overall sensitivity was 98% and the specificity 66%. The prevalence of pulmonary embolism was 83% and the diagnostic accuracy 90%. This suggests that chest sonography can be an efficient technique in the detection of pulmonary infarction.

Adult↗

[Sonography in salmonella enterocolitis].

27 patients suffering from salmonella enterocolitis--24 proven by stool cultures, 3 confirmed serologically--were examined for ultrasound findings. In 81% the left side gut wall was concentrically thickened up to 7 mm (5-11). Further sonographic findings were: Less demarcated gut wall layers in 33%, hypoechoic gut wall in 48%, polypoid mucosa thickening in 33%. In individual cases enlarged mesenteric lymph nodes, splenomegaly, and ascites were seen. Sonographic changes correlated well with clinical results in respect of the intensity of the illness.

Adolescent↗

[Lung infarcts detected with ultrasonography].

33 patients with clinical signs of pulmonary infarction were investigated by intercostal chest sonography. 40 preponderant triangular sharply outlined echo-poor lesions were detected with an airdense reflex in the centre of the area as a sign of segmental involvement. Sonomorphology of pulmonary infarction is compared to pneumonias (n = 22) and carcinomas (n = 20). The sensitivity of chest sonography in pulmonary infarction is 96%, whereas the diagnostic accuracy is 82%.

Diagnosis, Differential↗

Evaluation of a latex agglutination test for the detection of Salmonella and Shigella spp. by using broth enrichment.

We evaluated the Bactigen Salmonella-Shigella Latex Agglutination Slide Test (Wampole Laboratories, Div. Carter-Wallace, Inc., Cranbury, N.J.) for detection of Salmonella and Shigella spp. in enrichment broth cultures (gram-negative broth incubated for 24 h) as part of the routine testing of stool samples. A total of 1,128 stool samples were screened by using this test. Of 29 samples culture positive for Salmonella spp., 25 were positive with the Salmonella test (sensitivity, 86.2%; specificity, 96.2%). Of four stool samples culture positive for Shigella spp., two were detected with the Shigella latex reagent. Overall, the Shigella test had a specificity of 99.2%. Testing of enrichment broth cultures after 24 h of incubation was more sensitive than was testing after 6 h of incubation. When used for direct culture identification, both reagents had a specificity of greater than 98.0%. We conclude that the Salmonella test may be useful as an enrichment broth screening test to detect Salmonella spp.; however, we cannot make any conclusions about the Shigella test because of the low number of culture-positive specimens in this study.

Diarrhea↗

Effects of lung inflation on the excitability of dorsal respiratory group neurons.

The effect of lung inflation on the excitability of inspiratory neurons of the dorsal respiratory group was studied in decerebrate, paralyzed, artificially ventilated cats. Variations in the antidromic latency (AL) were used as a measure of the changes in excitability. The antidromic responses of single cells were recorded extracellularly during electrical stimulation (20 Hz) of their spinal axons. Single-breath test inflations were delivered at the onset of inspiration (I) or expiration (E), and then maintained for the duration of that respiratory phase. In the absence of inflation during E, most of the inspiratory cells underwent progressive lengthening of the AL, indicating inhibition or disfacilitation. This effect was stronger in I beta than in I alpha cells but there was considerable overlap. In every cell (21 I alpha, 17 I beta), inflation during E caused a prompt AL shortening (excitation or disinhibition) that was evident in single tests. On average, I beta neurons were more strongly excited by the test inflation during E, but again there was considerable overlap. The excitation was maintained for the duration of the inflation, indicating that pulmonary stretch receptor afferents (PSR) were involved. The response to slow inflations (that preferentially excite PSR) was a progressive shortening of the AL that mirrored the increase in lung volume. The results emphasize the qualitative similarity in the responses of I alpha and I beta neurons to lung inflation and in their excitability changes during normal respiratory cycles.

Adaptation, Physiological↗

Mental rotation of three-dimensional objects.

The time required to recognize that two perspective drawings portray objects of the same three-dimensional shape is found to be (i) a linearly increasing function of the angular difference in the portrayed orientations of the two objects and (ii) no shorter for differences corresponding simply to a rigid rotation of one of the two-dimensional drawings in its own picture plane than for differences corresponding to a rotation of the three-dimensional object in depth.

Computers↗