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V Skar

Publications and source records attributed to V Skar.

30 records · Page 2Linked to original sources
PubMed1990

How reliable are the 14C-urea breath test and specific serology for the detection of gastric Campylobacter?

Detection of gastric Campylobacter by the 14C-urea breath test and serology were correlated to biopsy culture in 25 unselected outpatients referred for gastroscopy. All the 17 culture-positive patients had positive 14C-urea breath test, and 16 had positive serology. Of eight culture-negative patients, six patients had negative breath test and seven negative serology. A high degree of reproducibility was found when two subsequent breath tests were performed in 11 healthy volunteers. The breath test values obtained at 10 min showed a strong correlation (r = 0.97, p less than 0.001) to the accumulated values within 30 min. Breath sampling once, 10 min after intake of 2.5 microCi 14C-urea, seems sufficient for the detection of gastric Campylobacter. The 14C-urea breath test correlates well with biopsy culture and provides a sensitive tool for the detection of gastric Campylobacter. Serology also corresponds well with biopsy culture and should provide a useful tool for epidemiologic studies.

Adult↗
PubMed1989

[Campylobacter pylori. Determination of gastric colonization and its clinical relevance].

While evidence suggesting a statistical association between Campylobacter pylori and chronic active antral gastritis is convincing, the role which the organism may play in the pathogenesis of this condition and in the case of peptic ulcer remains to be elucidated. The development of safe, non-invasive diagnostic tests suitable for population studies greatly facilitates this investigative process. This article presents a brief review of currently available methods of diagnosing C pylori colonization in the stomach and discusses their possible application in the field of clinical gastroenterology.

Campylobacter↗
PubMed1989

Juxtapapillary duodenal diverticula predispose to common bile duct stones.

In an endoscopic study of 107 patients with suspected common bile duct calculi, 26 were found at retrograde cholangiography to have juxtapapillary diverticula (JPD). Over 80% of these patients had common bile duct calculi, compared with only 52% among those without any JPD (p less than 0.01).

Adult↗
PubMed1989

Beta-glucuronidase activity in the bile of gallstone patients both with and without duodenal diverticula.

Patients with juxtapapillary duodenal diverticula have an increased occurrence of calcium bilirubinate gallstones. One possible hypothesis to explain this observation is enzymatic deconjugation of bilirubin conjugates in the bile. Beta-glucuronidase of human or bacterial origin may lead to deconjugation of the bilirubin glucuronides in bile. This, in turn, may increase the amounts of unconjugated, water-insoluble bilirubin which can precipitate as calcium bilirubinate, the main component of brown pigment stones. In this study we compared gallstone patients with and without duodenal diverticula treated with endoscopic papillotomy. Increased occurrence of bacteria producing beta-glucuronidase (p less than 0.01) and increased activity of bacterial beta-glucuronidase (pH 7.0) in the bile itself (p less than 0.01) were found in patients with duodenal diverticula. When the activity of the enzyme at pH 4.5, the optimum of the human enzyme, was measured, no such difference was found. The results support the hypothesis of bacterial glucuronidase as an etiologic factor in pigment gallstone disease in patients with duodenal diverticula. The high activity of bacterial enzyme found in the bile in some patients without diverticula suggests bacteria as an etiologic factor, independent of the presence of diverticula.

Aged↗
PubMed1989

The duodenal bacterial flora in the region of papilla of Vater in patients with and without duodenal diverticula.

Small-intestinal bacterial overgrowth may be one etiologic factor in pigment gallstone disease, previously shown to be prevalent in patients with juxtapapillary duodenal diverticula. In this study the bacterial microflora in the duodenum was examined in 52 patients admitted for endoscopic retrograde cholangiography, 27 with and 25 without duodenal diverticula. Endoscopic sampling was done with a microbiology specimen brush. The reproducibility of the method was good. Presence of gas in the anaerobic cultivation media corresponded closely to growth of Enterobacteriaceae, with a sensitivity of 90% and a specificity of 98%. Gas production in thioglycollate medium with 1% glucose is proposed as a simple criterion of bacterial overgrowth. Patients with diverticula had significantly higher total numbers of bacteria in the duodenum than patients without diverticula (p less than 0.01). Enterobacteriaceae and fecal streptococci dominated the flora in patients with diverticula, and gram-positive cocci were most frequently isolated from patients without diverticula.

Aged↗
PubMed1989

High-performance liquid chromatography of bilirubin conjugates in bile: effect of beta-glucuronidase on the bile pigments.

A simple, specific, and technically easy high-performance liquid chromatography (HPLC) method for the separation and quantification of unconjugated bilirubin, bilirubin monoglucoside-monoglucuronide, bilirubin diglucuronide, and bilirubin monoglucuronide has been developed. The method was used to determine the bilirubin compounds of bile obtained endoscopically from the common bile duct in 43 patients with gallstone disease and in 6 subjects without gallstones or liver disease. The bile samples were also assessed for the presence of beta-glucuronidase-producing bacteria. The amount of unconjugated bilirubin was significantly higher (p less than 0.01) in bile containing bacteria producing beta-glucuronidase than in bile without such bacterial strains. In six 'normal' bile samples the following quantities of bilirubin conjugates and unconjugated bilirubin were found (median and range): bilirubin monoglucoside-monoglucuronide (mixed conjugate), 61 (27-80) mumol/l; bilirubin diglucuronide, 632 (512-861) mumol/l; bilirubin monoglucuronide, 113 (70-175) mumol/l; and unconjugated bilirubin, 3 (1-7) mumol/l. These results are in good agreement with those obtained with other HPLC methods. The concentrations of unconjugated bilirubin were lower than those found when using conventional diazo methods and thin-layer chromatography. HPLC proved to be a useful tool in gallstone pathogenesis studies. Our results support bacterial glucuronidase as a possible pathogenic factor in pigment gallstone disease.

Adult↗
PubMed1988

Juxtapapillary duodenal diverticula.

This paper presents a review of the clinical significance of juxtapapillary duodenal diverticula in man. The incidence of such diverticula varies considerably in the literature, and possibly depends on the methods of investigation used. Studies show that the incidence of biliary calculi is significantly higher in patients with juxtapapillary diverticula as compared with patients without such diverticula. The assumed higher rate of diverticula in patients with pancreatitis is probably due to the presence of biliary calculi in these patients. Studies have shown that there is an insufficient choledochoduodenal sphincter in patients with diverticula, and also a higher rate of bacterial contamination of the duodenum and bile ducts in these patients. Fecal type flora has been found in most patients with juxtapapillary duodenal diverticula. Further, pigment gallstones have been found in most patients with diverticula, and analyses of these calculi showed that calcium bilirubinate was the main component. Further studies in our laboratory have shown that bacterial cultures produced beta-glucuronidase, a fact which may be connected with the increased frequency of pigment gallstones. Other studies have shown that there is a higher rate of diverticula in patients with recurrent biliary calculi who had undergone cholecystectomy. Recent data have also shown that there is a higher rate of common bile duct calculi in patients with diverticula, than in those without diverticula and without prior cholecystectomy--a fact supporting the theory on the pathogenesis of biliary calculi in patients with juxtapapillary diverticula. Other, and rare complications due to such diverticula are also mentioned.

Adult↗
PubMed1988

Beta-glucuronidase activity related to bacterial growth in common bile duct bile in gallstone patients.

Beta-glucuronidase activity in the bile may be of importance in the etiology of pigment gallstones. This enzyme is of hepatic or bacterial origin. We have described a method to measure the activity of bacterial beta-glucuronidase in human bile, using 4-nitrophenyl-beta-D-glucopyranosiduronic acid as substrate. The method was used to measure the beta-glucuronidase activity in the bile from 51 patients with gallstone disease. This activity was related to the presence of beta-glucuronidase-producing bacteria in the bile. Escherichia coli, Bacteroides species, and Clostridium perfringens were the only species found to produce beta-glucuronidase. Patients with beta-glucuronidase-producing bacteria had on an average significantly higher enzyme activity in the bile than patients without such bacteria (p less than 0.01). The limitations of using artificial substrates in this type of studies are discussed.

Aged↗
PubMed1986

Bacterial growth in the duodenum and in the bile of patients with gallstone disease treated with endoscopic papillotomy (EPT).

Bacterial growth in the duodenum and in the bile was studied in 30 patients treated by endoscopic papillotomy (EPT) for stones in the common bile duct. Duodenal sampling was done endoscopically with a microbiology specimen brush, and bile was collected from the common bile duct using a catheter designed to avoid contamination from other sources. The same type of fecal flora was found in the duodenum and in the bile. The majority of patients had more than one strain in the duodenum as well as in the bile. Strains belonging to the Enterobacteriaceae and fecal streptococci dominated. Anaerobes were found in the duodenum in 27.7% of the patients, and in the bile in 16.7%. The heavy bacterial infestation of the common bile duct in our patients did not give rise to clinical symptoms.

Adult↗
PubMed1986

Beta-glucuronidase-producing bacteria in bile from the common bile duct in patients treated with endoscopic papillotomy for gallstone disease.

This paper reports the occurrence of beta-glucuronidase-producing bacteria in the bile in gallstone patients treated with endoscopic papillotomy (EPT). The study included 36 patients--18 women and 18 men, aged 43-87 years, with a median of 72.5 years. Bile sampling was done with an endoscopic technique. All bacterial strains were tested for beta-glucuronidase activity with a rapid chromogenic tablet test, using 4-nitrophenyl-beta-D-glucuronic acid as substrate. Bacterial growth was found in the bile in 35 patients. Of 103 strains isolated, 30 produced beta-glucuronidase. Twenty-five of the patients had at least one beta-glucuronidase-producing strain in the bile. All 26 strains of Escherichia coli were producing the enzyme. Both strains in the Bacteroides fragilis group and one out of two strains of Clostridium perfringens were producing beta-glucuronidase. The activity of the bacterial beta-glucuronidase was found within the pH range of the bile in these patients. A relationship between the presence of beta-glucuronidase-producing bacteria in the bile and pigment gallstone is suggested.

Adult↗
PubMed1985

The 1-g 14C-D-xylose breath test in gallstone patients with and without duodenal diverticula.

To assess whether gallstone patients with duodenal diverticula have bacterial overgrowth in the proximal small bowel, the results of the 1-g 14C-D-xylose breath test were compared in 24 patients with duodenal diverticula and in 24 without diverticula. All patients had been treated with endoscopic papillotomy (EPT) for stones in the common bile duct before the study, and cholecystectomy had previously been performed in 20 patients. No significant differences between the groups were found concerning age, sex, and body weight. Cumulative 14CO2 expired in 3 h in percentage of administered dose of 14C-D-xylose was 8.55% (7.58-9.57%) and 7.38% (6.32-8.96%) in patients with and without diverticula, respectively (p = 0.06), indicating a higher bacterial activity in the small bowel in patients with duodenal diverticula than in those without diverticula. The results appeared to be influenced by cholecystectomy.

Adult↗