PubMed Health⌕ Search

Biomedical subjects

U Baumgartner

Publications and source records attributed to U Baumgartner.

At least 19 recordsLinked to original sources
PubMed2006

Zonation of hepatic bile salt transporters.

Pericentral and periportal hepatocytes differ in their capacity to eliminate and velocity of eliminating bile acids and other organic anions. We wonder whether differences in the distribution of anion transporters (ntcp [M77479], besp [NM_031760], mrp2 [NM_012833], oatp1 [NM_017111], oatp2 [NM_131906]) cause the differences in bile acid excretion. Therefore, we analyzed the distribution of these anion transporters in periportal and pericentral cells by immunohistology, their mRNA by quantitative PCR, and regulating nuclear factors (NF-kappaB, HNF1, HNF3, HNF4, FXR, PXR) by gel shift assay. We did not find any differences in nuclear factors or regarding the proteins that could explain the zonal differences in anion transport.

Animals↗
PubMed2002

[Postoperative fistulas. How to close them].

Postoperative enterocutaneous fistulas are usually the result of an anastomotic leak. The likelihood of a postoperative fistula developing depends on concomitant diseases. An established gastrointestinal fistula is associated with considerable morbidity and mortality. Appreciable losses of fluid, protein and electrolytes often result in malnutrition, which has a negative impact on wound infection and the mental performance of the patient. Conservative treatment must aim to compensate these deficits as early as possible. Adequate amounts of energy (carbohydrates and fats) vitamins and trace elements must be ensured by replacement measures. In addition to appropriate drainage of the intra-abdominal focus and the use of antibiotics, treatment with octreotide (somatostatin analogues) may be considered. For conservative treatment, however, free intestinal transit distal to the fistula must be ensured. If an enterocutaneous fistula fails to heal within two or three months under conservative treatment, surgical management must be applied.

Algorithms↗
PubMed2002

Transrectal Doppler sonography of uterine blood flow in cows during pregnancy.

Transrectal Doppler ultrasound was used for the noninvasive investigation of uterine blood flow in three cows during pregnancy. The uterine arteries ipsi and contralateral to the conceptus were scanned monthly. Blood flow was reflected by the following parameters: resistance index (RI), time-averaged maximum velocity (TAMV), diameter of the vessel (D) and the volume of blood flow (VOL). RI values were negatively correlated to all other blood flow parameters (P < 0.01). Positive correlations occurred between TAMV, D and VOL (P < 0.0001). While blood flow parameters did not differ between cows (P > 0.05), the month of gestation showed a positive effect on RI and negative effects on TAMV, D and VOL (P < 0.0001). The RI was lower and TAMV, D and VOL higher in the uterine artery ipsilateral to the conceptus (P < 0.05). RI values decreased continuously during the first 8 months of gestation and remained from then until birth at a relatively constant level. While TAMV increased especially in two-thirds of pregnancy, a relatively uniform rise of D was noticed. VOL increased exponentially with stage of gestation. The results show that transrectal Doppler sonography is a suitable, noninvasive method for the examination of uterine blood flow during pregnancy in cows. Using this technique it might be possible in the future to determine the role of uterine blood flow in cows at the risk of abortion.

Animals↗
PubMed2002

[Brain concussion: risk factors].

AIM: Identification of risk factors for intracranial bleeding after minor traumatic brain injury. METHOD: The charts of 464 patients treated between January 1976 and December 1997 with the initial diagnosis of minor traumatic brain injury were reviewed. They were analyzed for clinical and diagnostic signs putting the patients at risk for intracranial bleeding. RESULTS: About two thirds of the patients (67.5%) were males, the average age being 36.1 years. Leading causes of accident were sudden falls (27.4%) and bike/autocycle crashes (24.8%). 30.4% of the patients were under the influence of alcohol. At the time of admission to the hospital 17.2% of the patients showed impaired consciousness and 12.5% presented neurologic signs. In ten patients an intracranial bleeding was found. All these bleedings were diagnosed at the primary investigation. DISCUSSION/CONCLUSIONS: Following groups of patients with traumatic brain injury have an increased risk for intracranial bleeding: Age > 60 and < 16 years, sudden falls, tachycardia, Glasgow-Coma-Scale < 15, impairment of consciousness, neurologic signs, fracture of the skull and patients suffering from coagulopathy. Drunk patients are difficult to judge; therefore, they should be handled as being at risk. Patients at increased risk should be observed on an intensive care unit whereas patients without those risk factors can be observed on a normal ward or, alternatively, discharged after reexamination and uneventful course after some hours.

Adolescent↗
PubMed2002

[Therapy of the pilonidal sinus--Primary wound closure or open wound after excision].

The postoperative follow up of 177 operations in 162 patients with pilonidal sinus was investigated. After excision of the sinus a primary wound closure was performed in 80 cases; in 83 cases the wound was left open. After primary wound closure 40 % of the patients showed a primary healing of the wound. Although the remaining 60 % of the wounds healed secondarily the patients were not disabled longer and did not demonstrate more frequently recurrences than those with open wound management. As a consequence we recommend a primary wound closure after excision of a pilonidal sinus.

Adolescent↗
PubMed2001

Colchicine inhibits taurodeoxycholate transport in pericentral but not in periportal hepatocytes.

Indirect evidence for a microtubule-dependent vesicular hepatocellular transport of bile acids has accumulated. Since inhibition of this transport by colchicine can be achieved only at high but not at low bile acid infusion rates we were wondering whether this transport pathway shows a hepatic zonation or not. To answer this question we perfused isolated rat livers antegradely or retrogradely, respectively, with unlabeled and labeled taurocholate or taurodeoxycholate. Inhibition of microtubule-dependent bile acid transport was aimed at co-infusion of colchicine. Periportal cells eliminated the likewise hydrophobic taurodeoxycholate as fast as the more hydrophilic taurocholate. In contrast, pericentral cells excreted taurodeoxycholate much slower than taurocholate. Colchicine did not change the biliary taurocholate excretion profile in periportal and pericentral cells. However, colchicine reduced significantly taurodeoxycholate excretion in pericentral but not in periportal cells. It is concluded that a microtubule-dependent vesicular, colchicine-sensitive transport pathway seems to be involved in the translocation of taurodeoxycholate in pericentral but not in periportal cells. Since such a vesicular bile acid transport is regarded to be much slower than transcellular transport by diffusion, this observation may explain the much slower excretion of hydrophobic bile acids like taurodeoxycholate in pericentral than in periportal cells under physiological conditions.

Animals↗
PubMed2001

Pericentral hepatocytes translocate hydrophilic bile acids more rapidly than hydrophobic ones.

The aim of this study was to analyze whether velocity of periportal and pericentral translocation is different for bile acids differing in their physicochemical properties. Isolated livers of male Sprague-Dawley rats were perfused antegradely or retrogradely, in single pass arrangement with labeled taurodehydrocholate, cholate, taurocholate, glycocholate, or taurodeoxycholate (inflow rate: 32 nmol/min/g liver). Bile was collected at 2-min intervals; aliquots were counted in a liquid scintillation spectrophotometer to trace uptake rate and biliary excretion profile. Biliary excretion patterns of all bile acids tested were almost identical in periportal cells; in contrast, it differed greatly in pericentral cells. Pericentral cells excreted taurodehydrocholate as fast as periportal cells, while periportal cells eliminated taurodeoxycholate about four times as fast and cholate, taurocholate and cholate about two times as fast as pericentral cells. It is concluded that, in contrast to periportal translocation, the velocity of pericentral translocation depends upon the hydrophilicity of the respective bile acid. Therefore, different or additional translocation pathways for bile acids may be involved in periportal versus pericentral cells.

Animals↗
PubMed2001

[Surgically relevant comorbidity: ability to cooperate].

The ability to cooperate represents an important prognostic factor for the result of any surgical therapy. Cooperation relies on a trustful relationship between physician and patient and requires active participation of the patient. Surgical procedures requiring long-term follow-up depend on a high degree of cooperation. Cooperation is the result of numerous psycho-social factors. The degree of potential cooperation influences to a large extent the decision process for indication and choice of method. The ability to cooperate does not depend on the patient only but it is result of a therapeutic alliance between patient and physician.

Comorbidity↗
PubMed2000

Transrectal Doppler sonography of uterine blood flow.

Transrectal Doppler ultrasound was used for the noninvasive investigation of uterine blood flow in cows. Both the left and right Aa. uterinae were scanned to obtain blood flow velocity waveforms over 2 consecutive estrous cycles. Blood flow was reflected by the resistance index (RI) and the time-averaged maximum velocity (TAMV). Intra-observer reproducibility of Doppler measurements was evaluated. The intra-class correlation coefficient (Intra-CC) was 0.97 for the RI and 0.95 for TAMV. While RI values did not differ between the left and right A. uterina (P > 0.05), differences in TAMV occurred between both vessels in 2 cows. These differences were not related to the ovary bearing the dominant follicle or to the corpus luteum (P < 0.001). As in all cows, changes of RI and TAMV values between the left and right artery during the estrous cycle were correlated (correlation coefficient r > 0.72; P < 0.0001); the mean values of both sides were used for subsequent analyses. Variance component estimates for the effect of cow on RI and TAMV were 8 and 13% and for the influence of day of estrous cycle they were 70 and 47%, respectively (P <0.0001). Between estrous cycles no significant differences could be measured within cows (P > 0.05). The highest RI and lowest TAMV values occurred on Day 0 (= day of ovulation) and Day 1, while the lowest RI and highest TAMV values were measured between Days -3 and -1 of the estrous cycle, respectively. There was a positive correlation between TAMV and estrogen concentrations and a negative correlation between RI and plasma estrogen levels. Plasma progesterone levels and TAMV were negatively correlated, but no correlation could be measured (P > 0.05) between RI values and plasma progesterone concentrations. While there were no differences in plasma concentrations of estrogens and progesterone between estrous cycles within cows, the levels of these hormones differed between cows. The results show that transrectal Doppler sonography is a useful, noninvasive method for examining uterine blood flows in cows. If there is an influence of uterine perfusion on fertility in cows its role needs further investigation.

Animals↗
PubMed1999

Functional analysis of the Zn(2)Cys(6) transcription factors Oaf1p and Pip2p. Different roles in fatty acid induction of beta-oxidation in Saccharomyces cerevisiae.

Fatty acid induction of the peroxisomal beta-oxidation machinery in Saccharomyces cerevisiae involves transcriptional control of genes regulated by the oleate response element (ORE). Glucose as the preferred carbon source antagonizes this effect. Induction is dependent on the Zn(2)Cys(6) family members Oaf1p and Pip2p, which bind to this element as a heterodimer. We show here by ectopically expressing both components and LexA fusion derivatives that this transcription factor complex is only active in the presence of oleate. In contrast to Pip2p, Oaf1p is responsive to oleate activation in the absence of the other component of the heterodimer. Therefore, it is the exclusive receptor of the oleate signal. Pip2p is active also under noninducing conditions but is effectively inhibited when complexed with Oaf1p in the absence of inducer. It contributes to the trans-activation properties of the Oaf1p-Pip2p heterodimer and is required for efficient binding of Oaf1p to OREs in vivo. Repression of ORE-dependent transcription by glucose occurs via both Oaf1p and Pip2p. By dissecting functional domains of both proteins, we identified a region required for regulated activity of the C-terminal activation domain. These findings allow us to postulate a model for carbon source-regulated transcription of peroxisomal protein genes.

Cysteine↗
PubMed1997

The influence of ischemic bowel wall damage on translocation, inflammatory response, and clinical course.

BACKGROUND: While vascular patency and overall viability of the gut can be evaluated perioperatively, damage to the mucosal barrier can hardly be judged in the perioperative setting and, moreover, will probably determine the clinical course. METHODS: In 19 consecutive cases with intestinal ischemia, the clinical course was correlated to the severity of the disease (APACHE II; Septic Severity Score, SSS), the intraabdominal and systemic inflammatory response, and the translocation of bacteria and endotoxin. RESULTS: The comparison of the 10 survivors with the nonsurviving group revealed no differences as to the length of history, serum lactate levels, white blood cell counts, body temperature, markers of the inflammatory response, or quantity and macroscopic quality of the exudate. Differences were found in intraperitoneal bacteriology (prevalence 0.37, negative predictive value for lethal outcome 0.8), endotoxin concentrations in the exudate (P = 0.02) and in the plasma (P = 0.015), fibrinopeptide A levels (exudate P = 0.036; plasma P = 0.015), PGE2 plasma concentration (P = 0.0357), and APACHE II (P = 0.0034) and SSS (P = 0.0027) values. CONCLUSION: The clinical course of ischemic bowel wall necrosis seems to depend on the severity of the disease at admission and on the integrity of the mucosal barrier rather than on inflammatory response, therapeutic measures, or supportive treatment.

APACHE↗
PubMed1996

Different protective effects of tauroursodeoxycholate, ursodeoxycholate, and 23-methyl-ursodeoxycholate against taurolithocholate-induced cholestasis.

The coinfusion of tauroursodeoxycholate (TUDC) prevents taurolithocholate (TLC) -induced cholestasis. 23-Methyl-ursodeoxycholate (MUDC) is a side-chain derivative of ursodeoxycholate (UDC). If conjugation with taurine is important for the protective effect of UDC, the MUDC may not be as able as TUDC to prevent TLC-induced cholestasis since it is poorly amidated by the liver. To answer this question, isolated livers of adult Sprague-Dawley rats were coinfused with MUDC (UDC, TUDC) and TLC. After 15 min, inflow rates of the bile acids were doubled. In further experiments taurine in excess was added to the coinfused bile acids. The uptake of bile acids was >90% in all groups, irrespective of whether they were perfused alone or in combination. Single perfusion of TLC caused a rapid decrease in bile flow. UDC and MUDC were hypercholeretic; TUDC moderately choleretic. During coinfusion experiments, TUDC not only completely abolished cholestasis but in addition increased bile flow and biliary bile acid secretion. UDC did prevent TLC cholestasis at the lower inflow rates. At high inflow rates, bile flow decreased significantly. Addition of taurine to this bile acid combination did not significantly improve the anticholestatic effect of UDC. At low and high infusion rates of MUDC, cholestasis induced by TLC was reduced very little. Cumulative bile flow over 30 min fell by approximately 70% as compared to that of singly perfused MUDC. Addition of taurine to the coinfused MUDC/TLC slightly, but less significantly, improved the anticholestatic effect of MUDC. Since MUDC is by far less protective than UDC (and TUDC) despite similar physiochemical properties, it is concluded that taurine conjugation of UDC seems to be a prerequisite to prevent TLC-induced cholestasis. The results imply that treatment of cholestatic liver diseases with taurine-conjugated UDC might be more appropriate than with unconjugated UDC in cases where taurine conjugation is defective or where taurine depletion has occurred.

Animals↗
PubMed1996

[Diagnosis and therapy of diaphragmatic rupture after blunt thoracic and abdominal trauma].

Diagnosis of diaphragmatic rupture is often missed after blunt thoracic and abdominal injuries because diaphragmatic injury does not play an important role beside severe injuries of intrabdominal and/or thoracic organs. Between 1976 and 1993, 141 patients were treated for traumatic injury of the diaphragm. In 42 patients with penetrating injuries following stab or shot wounds diaphragmatic lesions were diagnosed by the emergent surgical therapy. 99 had diaphragmatic tears from blunt thoracic or abdominal trauma by accidents. 14 of 99 patients sustained isolated diaphragmatic rupture, in 85 the rupture was combined with other injuries, 24 had fractures of the pelvic ring. Preoperatively the following diagnostic procedures were performed: chest radiograph in 99 patients, abdomen radiograph in 75, contrast radiographs in 34, angiography in 9, sonography in 74 and computed tomography in 48. Sensitivity and specificity of these diagnostic methods depend on the dimension of intrathoracic prolaps of abdominal organs. The sensitivity of contrast radiographs ranged from 72-78%. With the additional experience of ultrasonography since 1985 the sensitivity came up to 82%. In 11 patients additional diaphragmatic rupture was diagnosed by laparotomy indicated by liver and/or splenic rupture. Therapy of diaphragmatic injury was performed in 83 patients within 4 days, in 9 within 4 months and in 7 later than one year. For diaphragmatic repair 87 patients underwent laparotomy and 12 thoracotomy. Local complications were found in 13 patients (13.1%). 19 patients (19.2%) died postoperatively due to accompanying injuries.

Abdominal Injuries↗
PubMed1995

Change of zonal bile acid processing after partial hepatectomy in the rat.

The aim of this study was to analyze whether partial hepatectomy alters functional liver heterogeneity with respect to bile acid processing. One, 5 and 21 days after liver resection (approximately 80% of liver mass) in male Sprague-Dawley rats (300-400 g), isolated livers were perfused in either the antegrade or the retrograde direction, respectively, with 32 nmol cholate/min per g liver. Uptake, metabolism and biliary secretion kinetics were determined by bolus injection of 14C-cholate. Uptake and biliary recovery (within 30 min) of cholate were > 90% in all groups. One day postresection, liver mass had already doubled and it regenerated to over 80% 5 days after resection. Serum bile acid concentration increased rapidly, peaking 6 h after resection (176.7 +/- 28.5 mumol/l) (mean +/- SEM). Twenty-one days after resection it fell to control values (23.2 +/- 3.8 mumol/l). T25 (T50), the time (min) necessary to excrete 25% (50) of the bile acid load into bile, was strikingly different between periportal and pericentral cells of controls (1.8 vs 5.7 and 3.4 vs 8.1). Five days after resection this difference became smaller (1.4 vs 2.9 and 2.8 vs 5.5) due to accelerated biliary cholate secretion in pericentral cells. Pericentral cells of controls metabolized cholate more extensively to taurocholate (approximately 83%) and glycocholate (approximately 13%) than periportal cells of controls (65%, 10%), leading to a 5-fold higher proportion of unmetabolized cholate in periportal than pericentral cells (25% vs 5%). Five days after resection the percentage of taurocholate decreased significantly at the expense of an increased formation of glycocholate.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1995

Pattern of bile acid regurgitation and metabolism during perfusion of the bile duct obstructed rat liver.

Bile acid processing in the long-term, bile duct obstructed rat liver was studied ex vivo. Twenty four and 72 h, respectively, after bile duct obstruction the isolated liver was perfused with taurodeoxycholate (16 nmol/min per g liver) the bile duct still being closed. Uptake, metabolism and regurgitation profile were traced by bolus injection of tritium-labeled bile acid; in addition, concurrent histological changes were examined by light- and electron microscopy. Ligation caused dilatation of the intrahepatic ductular branches and increased the serum bile acid concentration to 740 +/- 75 microM (controls: 16 +/- 2.12), reaching its maximum within 24 h. At 16 nmol/min per g liver uptake rate was > 96% in controls and in bile duct obstructed rats. Maximal uptake rates (assessed separately) differed between controls and bile duct obstructed rats (700 nmol/min per g liver vs. 460). Controls excreted more than 80% of labeled bile acid in bile within 10 min after bolus injection. Biliary recovery of label was virtually completed after 30 min. In bile duct obstructed rats excretion of label back to the perfusate effluent (regurgitation) started quantitatively 5 min after bolus application and peaked between 10 and 40 min; after 80 min, effluent recovery was incomplete (about 60% of bolus injected). Biliary bile acids of controls consisted of about 20% taurodeoxycholate-metabolites; bile acids in the perfusate effluent of bile duct obstructed rats of about 55%. The major metabolite in all animal groups was taurocholate; minor metabolites were tauroursocholate, tauro-3 alpha,7 = 0,12 alpha-cholanoic acid and 3-sulfo-taurodeoxycholate. Histologically, inflammation and periportal edema were present after 1 day of bile duct obstruction. After 3 days, marked proliferation of bile ductules was the dominant histological feature. It is concluded that during initial bile duct obstruction, bile acid processing is not altered, although ultrastructural alterations occur early.

Animals↗
PubMed1995

Hepatoid adenocarcinoma of the stomach: a case report.

A case of primarily inoperable hepatoid adenocarcinoma of the stomach is reported, which, after chemotherapy with farmorubicin, 5-fluorouracil and leucovorin, showed an impressive regression resulting in an improvement of the overall condition of the patient and a decrease of the serum AFP level from initially 79.120 ng/ml to 3.728 ng/ml. In a second operation the tumor was removed and intraoperative radiation therapy was applied to the head of the pancreas and intraabdominal lymph nodes. Furthermore, we discuss the main pathologic features of this rare tumor entity and give a short review of the literature.

Adenocarcinoma↗
PubMed1994

[Intestine saving surgery in Crohn disease--results of limited resection and stricture-plasty].

In order to evaluate functional results and outcome of "limited surgery" in Crohn's disease we reviewed the data of 161 operations performed in 65 patients. In our series most of the patients had repeated operations. Nevertheless we saw no short bowel syndrome, no death occurred. Correlation was high between number of operations and length of resected bowel (r = 0.8) whereas no correlation was found between resected bowel and duration of disease nor between duration and number of operations. In conclusion strictly admitted principles of limited surgery seem to preserve good functional results. Risk of complications or short bowel syndrome seems not to be increased.

Abscess↗