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Biomedical subjects

B Jakober

Publications and source records attributed to B Jakober.

28 records · Page 2Linked to original sources
PubMed1990

[Abscess of the thyroid gland caused by Salmonella enteritidis in immunosuppressive treatment of generalized myasthenia gravis with thymoma].

We report the case of a 69-year old male caucasian patient who developed a lateral neck tumor while under immunosuppression with azathioprine. The tumor was diagnosed finally as an abscess caused by Salmonella enteritidis after isolation of the agent from blood, tumor biopsy and feces. This extremely rare manifestation of an infection by Salmonella enteritidis is considered as a complication of immunosuppressive therapy.

Abscess↗
PubMed1989

Nitrogen absorption in pancreatectomized patients: protein versus protein hydrolysate as substrate.

To investigate nitrogen absorption in the absence of the pancreas, six patients with total pancreatectomy, all in stable nutritional and metabolic condition, underwent two periods of enteral nutrition identical in all respects except for the nitrogen source. Nitrogen source was either lactalbumin or its hydrolysate. The quantity and quality of calories infused simulated the patient's usual diet, which was a high-protein diet (2.0 +/- 0.4 gm/kg body weight). Pancreatic enzyme replacement therapy was discontinued during each period of enteral nutrition. All patients had greater nitrogen absorption during the enteral nutrition with lactalbumin hydrolysate than that with lactalbumin (91% +/- 2% vs 61% +/- 6% of nitrogen intake, p less than 0.02). Despite this difference in absorption, nitrogen balances during the two periods of enteral nutrition were not significantly different. This appeared to be caused by a urea production rate that was greater during the enteral nutrition with lactalbumin hydrolysate than the rate during that with lactalbumin (26 +/- 1 gm/24 hr vs 16 +/- 3 gm/24 hr, p less than 0.05). Plasma concentrations of amino acids and proteins did not differ significantly during the two treatments. In conclusion, the data suggest that (1) the intestine plays a significant role in protein digestion and that (2) enteral feeding with a protein hydrolysate could eliminate the need for a high-protein diet in patients with pancreatic insufficiency.

Absorption↗
PubMed1983

Hormonal and metabolic changes in starving obese patients during exhaustive physical exercise.

Exhaustive graded exercise leads to changes of hormones, carbohydrate, and lipid metabolism in normal controls and obese patients after prolonged starvation. Concomitant with a large increase of plasma catecholamines, insulin concentration is reduced and blood glucose levels slowly increase. More glucose is made available by glycogenolysis and gluconeogenesis than can be oxidized in the mitochondria. Lactate associated metabolic acidosis appears. Starving obese patients in the basal state have reduced blood glucose concentrations, but their initial values for free glycerol, free fatty acids, and ketone bodies are much higher than in normal controls. This is caused by the starvation induced lipolysis. With exhaustive exercise adrenaline, noradrenaline, and free glycerol increase. In contrast, free fatty acids and ketone bodies decrease, because they are consumed as fuel. Prolonged starvation changes basal values of hormones and metabolites, but it does not change the quality of exercise-induced shifts in these values when compared with those of the normal controls.

Carbohydrate Metabolism↗
PubMed1983

Carbohydrate and lipid metabolism in type I diabetics during exhaustive exercise.

During an exhaustive graded bicycle spiroergometer test, several arterial blood samples were taken from six type I diabetics and seven normal controls for determination of catecholamines and parameters of carbohydrate and lipid metabolism. In both groups during exercise, glucose remained unchanged, and lactate associated metabolic acidosis was compensated by respiratory gas exchange. Diabetics showed an impaired exercise-induced response of adrenaline and noradrenaline (62 +/- 8 to 176 +/- 24 and 98 +/- 6 to 612 +/- 175 pg X ml-1), respectively, compared to controls (55 +/- 6 to 1213 +/- 720 and 95 +/- 17 to 1710 +/- 506 pg X ml-1). Free glycerol increased to an equivalent extent in both groups. Simultaneously produced free fatty acids decreased at high work loads in diabetics. In addition to insulin deficiency and impaired catecholamine secretion, diabetics showed high values of growth hormone, ACTH, and cortisol. These may be responsible for the high values of free glycerol and free fatty acids. At maximum the FFA values decreased in both groups, although levels of lactate and pyruvate were high. It is suggested that insulin deficiency is the reason for the disturbed hormonal and metabolic response to exhaustive exercise and reduces physical fitness in diabetics.

Adult↗
PubMed1983

[Effect of diet and stress on fat and carbohydrate metabolism after duodenopancreatectomy].

In 6 male patients, who had duodenopancreatectomy, oral fat respectively carbohydrate tolerance tests were performed. Intake of at least 10 g pancreatine did reduce the ensuing steatorrhea. Increased oral intake of carbohydrates led to increased levels of glucose in blood and urine. In addition, the patients were subjected to excessive exercise tests; in the course of these tests hormones, substrates and metabolites of fat and carbohydrate metabolism were measured. The values were compared to corresponding values from 6 type I diabetes patients and 7 normal persons. In the operated group lactate and free glycerol increased because of reduced hepatic glucose neogenesis, catecholamines increased little, and HGH not at all. Capacity for work was reduced in the operated group. Malassimilation and diabetes may be compensated for by drug therapy after duodenopancreatectomy. However, endocrine as well as metabolic derangements do follow duodenopancreatectomy, and ought to be taken into account preoperatively, since they may reduce the benefit of surgery in patients with chronic pancreatitis.

Adult↗
PubMed1982

[Metabolic studies under ergometric loading of patients with total duodenopancreatectomy].

One year after total duodenopancreatectomy a clinical and laboratory evaluation including exhaustive bicycle ergometry was performed in 6 male patients. The insufficiency of the exocrine pancreas can be compensated by at least 10 g pankreatin per day. During physical exercise patients had higher arterial values of lactate and free glycerol after duodenopancreatectomy than 7 healthy individuals and 6 diabetic patients type I. This metabolic overreaction was due to a deficiency of pancreatic glucagon and resulted in an impaired hepatic gluconeogenesis. There was no detectable increase in growth hormones and only a small one in catecholamines. The physical condition of patients after duodenopancreatectomy was clearly worse.

Adult↗
PubMedDate not supplied

Cognitive and psychomotor function during hypoglycemia: a comparison between porcine and human insulin.

After an overnight euglycemic clamp, blood glucose levels were precisely lowered on two nonconsecutive mornings via a glucose-controlled insulin infusion system (GCIIS, Biostator) using either purified porcine insulin (PPI) or human insulin (HI). Two cognitive and psychomotor tests were significantly different in 8 type-I diabetic subjects and 8 healthy volunteers at four timepoints, when mean blood glucose concentrations (BGCs) were 100, 65, 50, and 40 mg/dl. Also, a significant difference (p = 0.005) could be found between the mean of all reaction time testing (RTT) values under HI as compared with the mean of all RTT values under PPI. Lowering the BGC resulted in a significant increase in the reaction time (p = 0.012). These effects were not dependent on the type of insulin being used nor were they typical of a particular study group.

Adolescent↗