Biomedical subjects

S Kahl

Publications and source records attributed to S Kahl.

At least 37 records · Page 2Linked to original sources

PubMed2003

Helicobacter pylori genotypes and expression of gastritis in erosive gastro-oesophageal reflux disease.

BACKGROUND: Epidemiological studies suggest a negative association between Helicobacter pylori and gastro-oesophageal reflux disease (GORD). Moreover, cagA-positive strains are reported to protect from complications of GORD. The aim of this study was to determine virulence factors (cagA, vacA and iceA) of H. pylori strains and the pattern of gastritis in patients with GORD in comparison with patients with duodenal ulcer (DU) or functional dyspepsia (FD). METHODS: H. pylori strains isolated from gastric biopsies of 105 consecutive patients with mild to moderate erosive GORD (n = 35, LA grade A-B), and from sex- and age-matched patients with DU (n = 35) or FD (n = 35 without reflux symptoms) were investigated. CagA, vacA, and iceA genotypes were determined by PCR analysis of the isolates. Gastritis was classified in accordance with the updated Sydney classification. RESULTS: The prevalence of all three H. pylori virulence factors was higher in patients with GORD (cagA+ 80%, vacA s1 77%, iceA1 71%) and DU (cagA+ 83%, vacA s1 80%, iceA1 74%) than in patients with FD (cagA+ 40%, vacA s1 49%, iceA1 46%). Gastritis activity in the antrum and corpus did not differ between the three groups. However, lymphocytic infiltration of the gastric antral mucosa was more pronounced in DU patients than in those with GORD or FD. CONCLUSIONS: H. pylori strains obtained from patients with mild to moderate erosive GORD show a virulence pattern similar to that found in DU patients. The presence of these virulence factors does not appear to protect against erosive lesions in the oesophagus.

Antigens, Bacterial↗

PubMed2003

Estradiol plus progesterone treatment modulates select elements of the proinflammatory cytokine cascade in steers: attenuated nitric oxide and thromboxane B2 production in endotoxemia.

Estradiol plus progesterone (EP) implants have been shown to favorably alter the time course or decrease the severity of many of the clinical manifestations associated with coccidiosis and endotoxemia in calves. This study evaluated the effect of EP treatment on plasma tumor necrosis factor-alpha (TNF), thromboxane (TXB), prostacyclin (PRC), nitrite and nitrate (NO[x]), and cortisol. Holstein steer calves were divided into four groups: control, EP, endotoxin (LPS), and EP + LPS (n = five/group). Estradiol/progesterone pellets (Synovex-S) were implanted subcutaneously when calves reached 20 wk of age. One week after implantation, calves were injected i.v. with endotoxin (i.e., lipopolysaccharide; LPS, 0.6 microgram/kg of BW) or nonpyrogenic saline placebo. Body temperature was measured and blood was collected before injection and at 1, 2, 3, 4, 6, and 8 h thereafter. Plasma concentrations of TNF, cortisol, TXB, PRC, NO[x], were measured. Body temperature increased in both LPS and LPS-EP calves, but had returned to normal by 6 h in the LPS-EP group (P < 0.05). Plasma TNF and cortisol increased after LPS (P < 0.01), but were not differentially affected by EP treatment. Likewise, EP did not affect the magnitude of increase in LPS-induced PRC, but EP decreased the magnitude of increase in TXB (P < 0.05). Plasma NO[x]) levels were increased (P < 0.01) in calves after LPS; treatment with EP attenuated the LPS-associated increase in plasma NO[x] levels. These results suggest that EP exerts specific effects on different components of the proinflammatory cytokine cascade. Although the initiation of responses mediated by TNF, cortisol, and PRC do not seem to be differentially affected by EP, components of the nitric oxide- and TXB-axis responses to LPS are decreased in calves pretreated with EP.

Animal Feed↗

PubMed2002

Combined endoscopic intragastral resection of a posterior stromal gastric tumor using an original technique.

Gastric stromal tumors are solitary, usually asymptomatic, lesions that can bleed, become obstructive, or even degenerate into malignant neoplasms. Therefore, their surgical excision is recommended. We report a technique for the successful resection of a stromal tumor of the posterior gastric wall using a transgastric approach. After the creation of a 12 mmHg pneumoperitoneum using a three-trocar technique, a 2-cm gastrostomy was performed; an 18-mm trocar was then positioned in the gastric lumen and secured with a pursestring suture. Next, an intragastric wedge resection of the posterior gastric wall was carried out under endoscopic guidance. Finally, the anterior gastric wall was closed using a linear stapler. Histopathological analysis showed a benign spindle cell tumor, which was excised in toto. Patient recovery was uneventful. This report supports previous data showing the feasibility of a laparoscopic transgastric approach for the resection of stromal tumors of the posterior gastric wall. It also underscores the synergy of laparoscopic and endoscopic procedures in minimally invasive gastric surgery.

Aged↗

PubMed2002

High rate of post-therapeutic resistance after failure of macrolide-nitroimidazole triple therapy to cure Helicobacter pylori infection: impact of two second-line therapies in a randomized study.

BACKGROUND: The optimal second-line treatment after failed Helicobacter pylori therapy has not been established. AIMS: To ascertain whether quadruple therapy or triple therapy with omeprazole, clarithromycin and amoxicillin is the superior re-treatment after triple therapy containing a macrolide and a nitroimidazole, and to determine the impact of microbial in vitro resistance. METHODS: Patients after failed triple therapy were randomly allocated to one of two 1-week second-line treatments: omeprazole, 40 mg, clarithromycin, 500 mg, and amoxicillin, 1 g, all b.d.; or omeprazole, 20 mg b.d., bismuth subsalicylate, 600 mg q.d.s., metronidazole, 400 mg t.d.s., and tetracycline, 500 mg q.d.s. Post-therapeutic Helicobacter pylori status was assessed by 13C-urea breath test at least 4 weeks after treatment. RESULTS: The study was terminated after including 84 patients. H. pylori cure rates differed significantly: omeprazole-clarithromycin-amoxicillin: intention-to-treat, 43%; per protocol, 50%; omeprazole-bismuth subsalicylate-metronidazole-tetracycline: intention-to-treat, 68%; per protocol, 69%. The frequencies of resistance after first-line therapy were: metronidazole, 90%; clarithromycin, 71%; both combined, 68%. For clarithromycin resistance, H. pylori cure with omeprazole-clarithromycin-amoxicillin was 30% vs. 83% for clarithromycin susceptibility. CONCLUSIONS: Omeprazole-bismuth subsalicylate-metron- idazole-tetracycline was superior to omeprazole-clarithromycin-amoxicillin, but both therapies yielded unsatisfactory results. The high rate of post-therapeutic dual resistance has a negative impact on omepraz- ole-clarithromycin-amoxicillin, and probably also on omeprazole-bismuth subsalicylate-metronidazole-tetracycline, and limits the choice for second-line treatment.

Adult↗

PubMed2002

Addition of glucose to a fatty meal delays chylomicrons and suppresses VLDL in healthy subjects.

BACKGROUND: Postprandial lipemia has been shown in a number of studies to be associated with atherosclerosis. However, the test meals used in these studies were heterogeneous particularly in their carbohydrate content, which may be important for the resulting lipemia and which makes comparison between different studies difficult. We studied the effect of 75 g glucose added to a fatty meal on various lipoproteins and on gastric emptying. MATERIALS AND METHODS: Fourteen healthy young volunteers were studied in the fasting state and until 7 h postprandially. In a crossover design, each subject received an oral fat load (1 g fat kg(-1) body weight) with or without 75 g glucose. Triacylglycerol (TG) and free fatty acids (FFA) were then measured in whole blood and lipoproteins were separated off by ultracentrifuging. Gastric emptying was determined by the (13)C breath test. RESULTS: The addition of 75 g glucose to a fatty meal had two different effects. Gastric emptying was delayed by about 2 h and the chylomicron response was consequently postponed. In addition, the postprandial increase in VLDL triacylglycerol was reduced by 40%, which may be due to the pronounced FFA depression during the glucose-induced rise in insulin. CONCLUSIONS: 75 g glucose added to an oral fat load causes a delay of the chylomicron response and a marked suppression of the postprandial increase in VLDL.

Adult↗

PubMed2001

[Changes in bone density of the femur after cement-free implantation of a modular hip prosthesis with a long shaft].

Until now, no reports exist on the existence of femoral bone loss after hip arthroplasty using long-stem cementless prostheses in elderly patients. In a prospective evaluation the amount of bone loss (stress-shielding) after implantation of a long stem hip prosthesis in patients with femoral neck fractures (group A) or pertrochanteric femoral fractures (group B) was examined. Eleven patients (five from group A and six from group B) were treated with a long-stem modular hip prosthesis (MHP). Change of bone mass was evaluated using quantitative computed tomographie (QCT) immediately following and at six months (group A and B) and twelve months (group A) after implantation of the prosthesis. Clinical results, expressed with the modified Harris Hip Score, and relative changes of bone mass were compared with mean periprosthetic bone mass of the femur after operation. After implantation of the MHP, the maximum decrease of mean femoral bone mass was 19.1% at six months and 20.2% at twelve months for group A and 29.5% at six months for group B. Bone loss in the proximal periprosthetic area was higher than in the distal part. There was no correlation between baseline values of bone mass and the amount of stress-shielding or clinical outcome.

Aged↗

PubMed2001

[Basic principles of enteral nutrition, tube techniques, percutaneous endoscopic gastrostomy].

Cachexia of malignancy is a heterogenous and dynamic phenomenon. Thirty to fifty percent of all oncologic patients suffer from malnutrition. Patients with ENT carcinomas, from the clinical view-point, are clearly high-risk patients. Essentially, malnutrition in ENT carcinoma patients is attributable to reduced or even insufficient energy supply and intake of nutrients as a result of pain experienced in swallowing and constrictions of the upper swallowing tract. Malnutrition has turned out to be a factor entailing an unfavourable prognosis and, frequently, limiting a therapy. In a survey conducted by the Endoscopy Working Group of the German Society for Otorhinolaryngology, Head and Throat Surgery, 70% of the university ENT hospitals confirmed that their patients experienced a clinically relevant weight loss in the range from 3 to 10 kg during oncologic causal treatment. Tube feeding with liquid formula diets is the most efficient, least-risk approach to long term use, and should already be adopted prior to therapy irrespective of scheduled oncologic causal therapy. The feeding tube placed by percutaneous endoscopically controlled gastrostomy is increasingly becoming an alternative to a nasogastric tube. Two basic PEG techniques have been employed: 1. the transoral pull technique and 2. direct puncture. In direct puncture, as distinct from the pull technique, iatrogenic dispersal of tumour cells from the primary location of the tumour with subsequent implantation in the gastric or abdominal wall is definitely ruled out. In the ENT Clinic of Magdeburg University, we decided to adopt direct puncture and, since 1991, this technique has been used in interdisciplinary co-operation with the Magdeburg University Clinic of Gastroenterology and successfully employed in 660 patients with advanced carcinomas of the upper swallowing tract. Severe PEG-induced abdominal complications were extremely rare, observed in as little as 0.5% of the cases. For enteral feeding through PEG which maintained or even improved the nutritional status, good compliance was noted in 83% of the patients. Prior to PEG and oncologic causal therapy, 36% of the patients showed malnutrition (BMI < 20 kg/m2). At the stage of anamnesis half of the patients indicated that, for the past six months prior to diagnosis of the tumour, they had experienced a weight loss of more than 10% of the calculated ideal body weight. Prior to therapy, 97% of the patients complained of dysphagia-induced reduced or impaired food intake. The various PEG tube techniques, along with their pros and cons, as well as nutritional aspects in oncology are presented for the Magdeburg patients and discussed.

Cachexia↗

PubMed2001

A novel immunoassay based on monoclonal antibodies for the detection of Helicobacter pylori antigens in human stool.

BACKGROUND AND AIM: With the Premier Platinum HpSA EIAtrade mark a new enzyme immunoassay was developed for diagnosis of H. pylori infection, using polyclonal antibodies against H. pylori antigens in human stool. Here we evaluated FemtoLab H. pyloritrade mark based on the use of monoclonal antibodies in comparison to established reference methods. METHODS: 53 consecutive patients (27male, 26 female, age: 17-85 years) undergoing routine upper gastrointestinal endoscopy were enrolled in this study. The H. pylori status was determined by 4 reference methods: Histology, rapid urease test (HUT), (13)C-urea breath test ((13)C-UBT) and serology. Patients were considered to be infected with H. pylori if at least 2 of the 4 reference tests were positive. Stool samples were aliquoted after reception and stored frozen (-20 degrees C) until tested. The FemtoLab H. pyloritrade mark (Connex GmbH, Germany) and the Premier Platinum HpSA EIAtrade mark (Meridian, Connecticut, Ohio, USA) were performed according to the manufacturers protocols. RESULTS: 26 of the 53 patients were H. pylori infected. 3 were false-negative by the FemtoLab H. pyloritrade mark and one false-positive result was obtained (sensitivity 88,5 %, specificity 96,3 %). The concordance between the 2 stool tests was 94,3 % (50/53 cases). CONCLUSION: The diagnostic quality of the novel FemtoLab H. pyloritrade mark Enzyme Immunoassay is comparable with the established Premier Platinum HpSA EIAtrade mark. The differences between positive and negative results obtained with the FemtoLab H. pyloritrade mark are greater in comparison to the Premier Platinum HpSA EIAtrade mark and therefore this test system allows a better distinction.

Adolescent↗

PubMed2001

[The isolated perfused rat pancreas - an experimental model for investigation the early events in the pathogenesis of acute pancreatitis].

METHODS: External perfusions of the pancreatic glands of Wistar-rats were done, using a modified Krebs-Ringer-Buffer (KRB). We looked for an elevation of amylase, lipase and lactate-dehydrogenase in the effusion fluid (portal outflow fluid). We investigated a normal perfusion (KRB, 60 minutes), a long term perfusion (KRB, 240 minutes) and a perfusion (60 minutes) including an additive of the detergents triton x-100 or the cholecystokinin analogue ceruletid (10(-8) M). RESULTS: An isolated external perfusion of a rat pancreas is possible without inducing any increase of parameters of damage such as amylase, lipase or lactate-dehydrogenase in the outflow medium. The perfusion time should be limited to 80 minutes including a 20 minutes equilibration period. A damage of pancreatic parenchyma is indicated by increased levels of pancreatic enzymes in the perfusion medium. Such damage can be induced by various noxious substances like detergents or cerulein, which has a significance in the pathophysiology of experimental acute pancreatitis. A significant increase (p < 0.01) of lactate-dehydrogenase, lipase and amylase was found 10, 20 and 30 minutes after an application of triton x-100. During a perfusion with the cholecystokinin analogue ceruletid (10(-8) M) we found an increase of lipase (p < 0.05) after 30 minutes and an increase of amylase (p < 0.05) after 50 minutes perfusion. CONCLUSIONS: The isolated perfused rat pancreas is a valuable experimental model to investigate the early phase of pathophysiology in acute pancreatitis.

Acute Disease↗

PubMed2001

Influence of feeding level during postweaning growth on circulating concentrations of thyroid hormones and extrathyroidal 5'-deiodination in steers.

An experiment was conducted with 42 growing Montbéliard steers to study the effect of feed restriction, followed by refeeding, on circulating concentrations of thyroxine (T4) and triiodothyronine (T3) and on hepatic and muscle activities of 5'-deiodinase (5'D). At 9 mo of age, 21 steers were diet-restricted for 3 mo (ADG, 641 g/d), prior to a 4-mo compensatory growth period with ad libitum access to the same diet (ADG, 1,240 g/d). They were compared to 21 control steers continuously gaining 1,100 g/d between 9 and 16 mo of age. Blood samples were collected every 14 d and samples of liver and semitendinosus and triceps brachii (triceps) muscles were obtained at slaughter at the end of the restriction and refeeding periods (12 and 16 mo of age, respectively). Compared to control steers, feed restriction decreased plasma concentrations of T4 after 56 to 83 d of feed restriction (P < 0.05), whereas T3 concentration decreased only after 83 d of feed restriction (P < 0.05). No differences in hepatic and muscle 5'D activities were observed after 87 d of feed restriction and decreased growth rate (12 mo of age). During the refeeding period (compensatory growth), circulating concentrations of T4 and T3 were restored to control levels within 14 d. Moreover, T3 concentration rose above that of control steers after 56 d of refeeding and remained higher for the duration of the experiment (P < 0.05). Hepatic 5'D activity was higher (P = 0.07) in compensated than in control steers at the end of refeeding period (16 mo of age) and higher (P < 0.01) after compensation at 16 mo than during restriction at 12 mo. Activities of 5'D in semitendinosus and triceps muscles were higher (P < 0.001) in 16-mo-old than in 12-mo-old steers, but no differences were observed due to feed restriction or compensatory growth. These results indicate that nutritional status regulates both thyroidal secretion and extrathyroidal T3 production in cattle. The data also suggest that extrathyroidal T3 production may be involved in the mechanism of compensatory growth in cattle.

Adaptation, Physiological↗

PubMed2001

Effect of somatotropin on thyroid hormones and cytokines in lactating dairy cows during ad libitum and restricted feed intake.

Twelve Holsteins in first lactation were used to investigate the relationship between energy balance and effects of bovine somatotropin (bST) on thyroid hormone metabolism and cytokine concentrations in serum. Six cows were fed for ad libitum intake and six cows were feed restricted to induce negative energy balance during two treatment periods of 6 d. During treatment periods, cows were administered vehicle or 40 mg of bST/d according to a crossover design. Between treatment periods was a 15-d recovery period, during which all cows were fed ad libitum. Cows that were fed ad libitum remained in positive energy balance during control and bST treatments, whereas cows that were fed for restricted intake were in negative energy balance during control and bST treatment periods. In both dietary groups, bST decreased energy balance. Milk production and the fat percentage of milk increased during bST treatment in both dietary groups. Fat-corrected milk yield was increased 13% by bST treatment. Serum concentrations of IGF-I did not differ between dietary groups but were greater during bST than control periods. Serum thyroxine concentration was decreased by bST treatment. Serum triiodothyronine and reverse-triiodothyronine were not altered by hormone treatment, but circulating concentrations of thyroid hormones were apparently reduced by dietary restriction. Neither hepatic nor mammary thyroxine 5'-deiodinase was affected by bST treatment. Plasma concentration of tumor necrosis factor-alpha, a potential regulator of thyroxine 5'-deiodinase, was not affected by bST treatment. Short-term treatment with bST did not influence thyroid hormone metabolism in lactating cows in positive or negative energy balance.

Animals↗

PubMed2000

Metalloprotease-mediated shedding of enzymatically active mouse ecto-ADP-ribosyltransferase ART2.2 upon T cell activation.

T cells proteolytically shed the ectodomains of several cell surface proteins and, thereby, can alter their responsiveness and can release soluble intercellular regulators. ART2.2 is a GPI-anchored ecto-ADP-ribosyltransferase (ART) related to ADP-ribosylating bacterial toxins. ART2.2 is expressed exclusively by mature T cells. Here we show that ART2.2 is shed from the cell surface in enzymatically active form upon activation of T cells. Shedding of ART2.2 resembles that of L-selectin (CD62L) in dose response, kinetics of release, and sensitivity to the metalloprotease inhibitor Immunex Compound 3, suggesting that ART2.2, like CD62L, is cleaved by TNF-alpha-converting enzyme or by another metalloprotease. ART2.2 shed from activated T cells migrates slightly faster in SDS-PAGE analyses than does ART2.2 released upon cleavage of the GPI anchor. This indicates that shedding of ART2.2 is mediated by proteolytic cleavage close to its membrane anchor. Shed ART2.2 is enzymatically active and ADP-ribosylates several substrates in vitro. Thus, shedding of ART2.2 releases a potential intercellular regulator. Finally, using a new FACS assay for monitoring ADP-ribosylation of cell surface proteins, we demonstrate that shedding of ART2.2 correlates with a reduced sensitivity of T cell surface proteins to ADP-ribosylation. Our findings suggest that by shedding ART2.2 the activated T cell not only releases a potential intercellular regulator but also may alter its responsiveness to immune regulation by ART2.2-mediated ADP-ribosylation of cell surface proteins.

ADP Ribose Transferases↗

PubMed2000

Thoracoscopic enucleation of benign tumors of the esophagus under simultaneous flexible esophagoscopy.

BACKGROUND: Benign tumors of the esophagus are very rare, accounting for only 0.1-2% of all esophageal tumors. Conventional treatment consists of thoracotomy adapted to the location of the tumor, followed by enucleation of the lesion. This approach, however, involves major surgery. Minimally invasive surgery represents a viable therapeutic alternative, in particular for benign tumors. METHODS: In four patients with a benign tumor of the esophagus, we carried out thoracoscopic enucleation under simultaneous esophagoscopy. RESULTS: Using this combination of endoscopic procedures, the tumors were removed reliably and safely. Two of the lesions were intramural leiomyomas, and two were intramural myxoid cysts. CONCLUSION: This combination of endoscopic procedures represents a minimally invasive approach with correspondingly minor surgical trauma. Using simultaneous esophagoscopy and transillumination (diaphanoscopy) of the esophageal wall, the safety and accuracy of the dissection is increased, and the risk of mucosal perforation minimized.

Esophageal Neoplasms↗

PubMed2000

Modulation of growth performance in disease: reactive nitrogen compounds and their impact on cell proteins.

During life, all animals encounter situations that challenge their capability for optimal growth. In reacting to immune challenges in the form of disease, homeostatic mechanisms attempt to overcome disharmony of the body's internal environment, or simply put, stress. The overall impact of stress revolves around a dynamic relationship between the level of challenge imparted on physiological systems and the degree of host response that is mounted in the process of detecting and reacting to the stress. In growing animals, the majority of milder stress encounters are manifest in terms of energetic inefficiencies and periods of reduced anabolism. In contrast, severe stress is often characterized by frank catabolism and tissue wasting. In some instances a level of stress (that might be termed a "stress breakpoint") is reached at which time the host response itself contributes to the cascade of negative effectors that further cause illness. These "breakpoint" responses are characterized by more intense acute responses to stress or a much more protracted duration of the response than would be expected given the nature of the stress. Key to understanding how growth in the young animal responds to infectious stresses is the recognition that (a) when immune responses that normally maintain health go awry, the reporters and effectors of the immune system (cytokines and the nitric oxide cascade) can contribute to stress disease processes and (b) reactive nitrogen compounds derived from the nitric oxide, as well as super oxide anion can modify intracellular proteins and block otherwise normal biochemical processes that regulate cell function. A key example of this is the loss of regulation of IGF-I by GH. As animals react more severely to disease stress, IGF-I concentrations in plasma decline progressively. Recent data derived from (LPS) challenges performed on young calves suggest that the prolonged decline in IGF-I is associated with the development of hepatic cytotoxicity localized to regions of protein nitration as identified by immunohistochemistry. Identifying biochemical criteria for disease processes provides needed guidance for the further development of intervention strategies to limit the impact of disease on growth.

Animals↗

PubMed2000

Effect of endotoxin challenge on hepatic 5'-deiodinase activity in cattle.

Thyroid status is compromised in a variety of acute and chronic infections and toxin-mediated disease states. Conversion of thyroxine (T4) into the metabolically active hormone, triiodothyronine (T3), is catalyzed by 5'-deiodinase (5'D). Our objective was to determine the effect of endotoxin (LPS) challenge with and without L-arginine (Arg) infusion on hepatic activity of 5'D and plasma concentrations of T4 and T3. In a 2 x 2 factorial, beef heifers (275-310 kg b.wt.) were fed low (8% CP; 6.5 kg/d) or high (14% CP; 7.2 kg/d) isocaloric protein diets (1.96 Mcal/kg DM) for 10 d before LPS challenge. L-Arginine in saline (0.5 g/kg b.wt.) or saline alone was infused i.v. throughout an 8 hr period starting 2 hr before bolus LPS injection (Escherichia coli, 055: B5; 0.2 microg/kg; i.v.). Blood samples were collected at -2, 0, 3, 6, 12, and 24 hr relative to LPS injection. Liver samples were obtained 20 hr before, and then 6 and 24 hr after LPS challenge using a biopsy needle. Plasma T4 and T3 concentrations were not affected by dietary CP or Arg. Compared with levels at 0 hr, LPS challenge decreased plasma T4 (P < 0.01) and T3 (P < 0.001), respectively, 8.4% and 28.9% at 6 hr and 19.7% and 31.3% at 24 hr. Consistent with these changes, the T3:T4 ratio was lower than that at 0 hr (P < 0.001) 22.0% at 6 hr and 13.5% at 24 hr. Hepatic 5'D activities 20 hr before LPS injection were 2.80 +/- 0.11 nmol I- x hr(-1) x mg protein(-1) and decreased 24 hr after LPS, respectively, 45.4% (P < 0.01) and 17.6% (P < 0.05) in saline- and Arg-infused heifers. The results indicate that mild LPS challenge in cattle inhibits hepatic generation of T3 and decreases plasma concentrations of thyroid hormones. The data also suggest that the impact of LPS on 5'D activity in liver can be altered by Arg supplementation.

Animals↗

PubMed2000

Anti-inflammatory effects of ergotamine in steers.

The objective of this experiment was to investigate whether the ergot alkaloid, ergotamine (ET), an alkaloid used to model fescue toxicosis in cattle, modifies the response of cattle to endotoxin (LPS) challenge. Steers (n = 16) were divided into the following treatment groups: control (C), ergotamine (ET), endotoxin (LPS), and ET + LPS. ET and ET + LPS groups received a single bolus intravenous injection of ET (40 microg. kg. body wt(-1)), whereas C and LPS steers received a single bolus injection of sterile vehicle. Thirty minutes after ET/vehicle administration, a single bolus intravenous injection of LPS (0.2 microg. kg. body wt(-1)) was given. Blood was collected at various time points for 48 hr post. Endotoxin increased rectal temperature (RT) and the circulating levels of tumor necrosis factor-alpha (TNF-alpha), cortisol, haptoglobin (Hp), thromboxane B(2) (TXB(2)). The circulating Hp, TNF-alpha, and TXB(2) increases were blunted by pretreatment with ET compared with ET + LPS. Ergotamine by itself increased circulating cortisol and RT, whereas it decreased serum prolactin (PRL). Therefore, whereas administration of LPS at 0.2 microg/kg to steers resulted in an expected response, the combination of ET + LPS attenuated major effects of LPS alone. Thus, acute administration of ET appeared to be anti-inflammatory as it decreased the inflammatory response to LPS, an effect likely driven at least in part by the ET-caused cortisol increase.

Animal Feed↗

PubMed2000

Clinical and finite element analysis of a modular femoral prosthesis consisting of a head and stem component in the treatment of pertrochanteric fractures.

OBJECTIVE: To determine the biomechanical characteristics and potential clinical efficacy of a cementless modular femoral prosthesis consisting of a variable head (50 to 80 millimeters) and stem (length 120 to 280 millimeters, diameter 10 to 20 millimeters) component in patients with pertrochanteric femoral fracture. DESIGN: Finite element analysis (FEA) of different lengths and diameters of prosthesis components and first clinical prospective study in pertrochanteric femoral fracture. METHOD: Using a 3D-CAD program, a model of femoral cortical bone with a pertrochanteric fracture was created and combined with a model of the prosthesis. This model was transferred into an FEA program. After applying a torsion-bending load of 2,000 N (25 degrees, 45 degrees) on the prosthesis, stress distribution in the cortical bone was determined for different lengths (160 to 240 millimeters) and diameters (10 and 12 millimeters) of stem. PATIENTS: Twenty-eight patients with pertrochanteric fractures (very unstable or osteoarthritis) were treated with a modular hip arthroplasty. Complications, fracture healing, and results at first follow-up (average 13 months) were determined. RESULTS: FEA analysis indicated that reduction in stress was less when a prosthesis with a short stem was used. Shear stress in the interface bone/prosthesis was not affected by stem length. Prostheses with thin stems produced higher sheer stresses than those with thick stems. Results of FEA were used as the basis for clinical application of the device. None of the patients died, and all patients were able to walk, although some needed a cane or walker after surgery. There was no increase in thigh pain compared with reported pretrauma levels. Radiographs showed subsidence of up to 5 millimeters in 20 percent of patients. However, all but one prosthesis was stable at follow-up. Fracture healing was achieved in all patients. CONCLUSIONS: If proximal fixation of a femoral uncemented stem cannot be achieved, stem diameter should provide maximum cortical contact to reduce sheer stress. Longer stems do not necessarily provide additional stability. By using this prosthesis and selection method, a good outcome at first follow-up was observed.

Activities of Daily Living↗

PubMed2000

Comparison of two tubeless function tests in the assessment of mild-to-moderate exocrine pancreatic insufficiency.

BACKGROUND: Faecal elastase 1 (FE1) and the pancreolauryl test (PLT) are widely used for the non-invasive diagnosis of exocrine pancreatic insufficiency (EPI). Whether one of these two tests is superior for the detection of mild-to-moderate EPI is the subject of controversy. The aim of this study was to compare the diagnostic performance of the PLT and FE1 for the detection of EPI in patients with chronic pancreatitis. METHODS: Forty consecutive patients (27 males, 13 females, 23-72 years) with chronic pancreatitis based on imaging procedures (computed tomography, endoscopic retrograde pancreatography and endoscopic ultrasound) were admitted to the study. A secretin-caerulein test (SCT) was performed after an overnight fast by giving secretin (1 U/kg/h) and caerulein (100 ng/kg/h) intravenously over 90 min. Duodenal contents were aspirated at 15 min intervals and analysed for pH, bicarbonate, amylase, lipase and elastase. EPI was graded on the basis of the results of the SCT as absent, mild, moderate or severe. A serum PLT was performed in accordance with a modified protocol previously described. A commercial ELISA was used for determination of FE1. The cut-off values were > or = 4.5 mg/l for PLT and > or = 200 microg/g for FE1. and 13 severe) on the basis of the results of the SCT. The sensitivity of the PLT for diagnosing EPI of all degrees of severity was 82% (27/33), compared with 50% for FE1 (16/ 33). In patients with severe EPI, the PLT was abnormal in 100% (13/13) and FE1 was abnormal in 85% (11/13) of the cases. The sensitivity decreases for both tests in the group of mild/moderate EPI (PLT 70% (14/20), FE1 35% (7/20)). In all seven patients with normal exocrine pancreatic function, both PLT and FE1 were also normal. CONCLUSIONS: The PLT is more sensitive than FE1 for the diagnosis of mild-to-moderate EPI, and is therefore more appropriate for completing the staging of chronic pancreatitis.

Adult↗