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Biomedical subjects

B Kommerell

Publications and source records attributed to B Kommerell.

At least 37 records · Page 2Linked to original sources
PubMed1991

Prophylaxis of traveler's diarrhea in Egypt: results of a double blind controlled study.

Diarrhea represents the most frequent health problem of Western tourists visiting subtropical and tropical areas. Antibiotic prophylaxis has been suggested by some authors but may not be generally advisable because of adverse drug effects. In the present study we investigated the prophylaxis of traveler's diarrhea using a combination of tannalbuminate and ethacridin-lactate. During a 16-day cruise in Egypt, 77 tourists were assigned to either placebo or prophylactic doses of tannalbuminate (500 mg) and ethacridin-lactate (50 mg), 1 tbl. b.i.d., in a randomized double-blind fashion. The number of bowel movements, consistency of stools, and clinical symptoms like nausea, abdominal cramps, vomiting, and fever were monitored daily. In the placebo group (n = 43) 35 tourists developed diarrhea (81.4%), whereas in the verum group (n = 34) only 18 tourists (52.9%) had diarrhea (p less than 0.0125). In the travelers receiving verum and developing diarrhea the clinical symptoms were less pronounced than in the placebo group. These results demonstrate that the events of traveler's diarrhea may be reduced; moreover, symptoms are attenuated by medical prophylaxis with tannalbuminate and ethacridin-lactate.

Adult↗
PubMed1991

Effect of intraperitoneal recombinant human tumour necrosis factor alpha on malignant ascites.

29 patients with refractory malignant ascites due to metastatic peritoneal spread of adenocarcinomas originating from the ovary, gastrointestinal tract, liver, breast and uterus were treated in a phase I trial of intraperitoneal infusions of recombinant human tumour necrosis factor alpha (rhTNF-alpha). Patients received 40-350 micrograms/m2 rhTNF-alpha intraperitoneally once weekly for 2 months or for a shorter period in case of early resolution of ascites. Systemic side-effects resembled those reported for rhTNF-alpha given intravenously. No dose-limiting toxicities were found and thus a maximum tolerated dose of intraperitoneal rhTNF-alpha was not established. Out of 29 patients, 22 responded with a complete (16) or partial (6) resolution of their ascites. There was a less than 50% reduction in 4, and no increase in ascites in 1. 1 patient showed progressive ascites formation, and another patient was not eligible because of early death unrelated to treatment. Trials in patients with smaller tumour burden are warranted.

Adenocarcinoma↗
PubMed1991

Prevalence of antibodies to hepatitis C virus in hemodialysis patients.

Due to frequent parenteral contact with blood transfusions hemodialysis patients are prone to acquire hepatitis C virus (HCV) infection. To determine the role of HCV infection we investigated the prevalence of antibodies to HCV in 188 hemodialysis patients. The prevalence of antibodies to HCV was 7.4%. As compared to anti-HCV-negative patients, anti-HCV-positive patients had slightly elevated transaminases which were independent of the presence of markers for hepatitis B virus infection. We conclude that HCV infection is common among dialysis patients.

Female↗
PubMed1991

[Thyroxine-binding globulin--not a tumor marker of hepatocellular cancer].

Thyroxin-binding globulin (TBG) is secreted by human hepatoma cell lines and was suggested as a tumor marker of primary hepatocellular carcinoma (HCC). However, the results of several clinical studies are contradictory. Therefore, we decided to investigate whether TBG is a valuable marker for early detection and/or followup of HCC. In 30 patients with HCC we determined TBG, thyroxine (T4), trijodothyronine (T3), alpha-feto-protein, ferritin and the sonographically determined tumor size. Twenty one of these patients had liver cirrhosis. In 19 patients hepatitis B-markers could be detected, 9 of whom with positive HBs antigen. Twenty two patients with liver cirrhosis served as controls. Serum TBG in HCC and liver cirrhosis was not significantly different (21.1 +/- 6.9 vs. 18.7 +/- 5.1 micrograms/ml). T4 (p less than 0.04) and the T4/TBG ratio (p less than 0.0002) were significantly lower in HCC. T3 and ferritin were comparable in both groups. TBG correlated with T4 (r = 0.6), but not with the sonographic tumor size, alpha-fetoprotein or ferritin. In 3 patients alpha-fetoprotein and TBG could be determined 3 to 36 months prior to the primary diagnosis of HCC. In none of these patients an increase of TBG was detected before diagnosis of HCC. In the 4 patients under chemotherapy, TBG decreased after the first course. Three of these patients showed further decreasing TBG values in spite of an increasing tumor size. We conclude that in our patients TBG is no valuable tumor marker for the early diagnosis or follow up of HCC.

Adult↗
PubMed1990

Biliary excretion of iron in healthy man and in patients with alcoholic cirrhosis of the liver.

We measured the biliary excretion of iron in 11 patients with alcoholic cirrhosis of the liver and in 10 healthy controls using an intestinal perfusion technique. In the patients with cirrhosis increased amounts of iron in liver tissue were present. The concentrations of iron in the bile samples were determined by atomic absorption spectrometry. The biliary excretion of iron in the healthy controls was 0.32 +/- 0.09 mumol/h and in the patients with cirrhosis it was 0.45 +/- 0.14 mumol/h. The biliary excretion of iron in the patients with cirrhosis was not reduced, indicating that other mechanisms than a reduced biliary excretion of iron must be responsible for the accumulation of iron in liver tissue in alcoholic cirrhosis.

Adult↗
PubMed1990

[Guillain-Barré polyneuropathy in Wegener's granulomatosis with pulmonary-renal syndrome].

A 49-year-old female patient suffering from severe necrotising respiratory granulomatosis (Wegener's granulomatosis) had acute renal failure, nearly uncontrollable haemoptyses and severe deterioration of pulmonary function. Haemodialysis had to be performed; immuno-suppressive therapy was effected by administration of high doses of methylprednisolone (100-500 mg/d) and cyclophosphamide (initially with single doses of 500-1000 mg) and plasmaphereses. Artificial ventilation by positive-negative pressure breathing became necessary because pulmonary function became consistently poorer. Glucocorticoid therapy led to the development of several duodenal ulcers resulting in profuse gastrointestinal bleedings requiring transfusions; on the whole, 20 erythrocyte concentrates had to be substituted. These transfusions, in turn, caused a non-A, non-B hepatitis. In the further course of the illness, a Guillain-Barré polyneuropathy developed. Biopsy and electrophysiological tests excluded granulomatous involvement of the nerves as a cause of the latter. But it is likely that there was a pathogenetic connection between the hepatitis and the polyneuropathy.

Acute Kidney Injury↗
PubMed1990

Prostanoid release in experimental liver transplantation.

Prostanoids are biologically active mediators of inflammation and tissue injury. To investigate the role of prostanoids in orthotopic liver transplantation we used a porcine model and determined prostaglandin E2, 6-keto-prostaglandin F1 alpha, and thromboxane B2 in arterial, portal, and hepatic venous blood during organ harvesting, the recipient operation, and the early postoperative period. There were no significantly increased serum levels during the donor operation or at the end of cold storage. As early as 1 or 5 min after initiation of reperfusion of the transplanted organ, prostanoids in hepatovenous blood increased dramatically (100-500-fold). Changes in arterial and portal blood (10-50-fold) were less pronounced but still statistically significant. In surviving animals these values returned to normal within 24 hr. The hepatic release of metabolites of the arachidonic acid cascade after liver grafting indicates that the synthesis of prostanoids might contribute to morphological and functional alterations of the transplanted graft. In addition, the increased arterial values of circulating prostanoids may potentially participate in severe cardiovascular, hemostatic, and immunological alterations known to occur after liver transplantation.

6-Ketoprostaglandin F1 alpha↗
PubMed1990

[Alpha tumor necrosis factor in the serum of patients with sarcoidosis, tuberculosis or bronchial cancer].

Tumor-necrosis-factor-alpha (TNF-alpha), which is secreted by cells of the macrophage/phagocytic system, interact in a variety of different ways with other cytokines and immunologically active substances. To investigate a possible role of TNF-alpha in granulomatous lung diseases and to determine whether sarcoidosis can be differentiated from tuberculosis on the basis of serum TNF-alpha levels, we studied sera from patients with sarcoidosis and active tuberculosis. Ninety-one percent of the patients with sarcoidosis and 83% of the patients with tuberculosis exhibited significantly elevated TNF-alpha levels as compered with controls. Since these levels remained elevated irrespective of clinical stage and even under therapy, it is believed that patients with sarcoidosis and tuberculosis experience continuous activation of TNF-2-alpha-producing cells of the myelomonocytic system. In addition, determination of serum TNF-alpha levels does not permit differentiation between sarcoidosis, tuberculosis or malignant disease.

Adult↗
PubMed1990

[Dilatation treatment of esophageal stenoses in young patients with recessive epidermolysis bullosa dystrophica].

Recessive dystrophic epidermolysis bullosa is a hereditary disorder affecting both skin and esophageal mucosa. The esophagus is frequently affected resulting in almost complete obstruction. We report here the use of inflatable dilatator balloons as a new treatment of esophageal stenosis in three young patients. Dilatation therapy was tolerated well in all three cases and lead to a long standing success. The patients lived without complaints and they did eat normally up to 2.5 years following dilatation.

Adolescent↗
PubMed1989

Taurine and glycine conjugation and sulfation of lithocholate in primary hepatocyte cultures.

Rat primary liver cells were used to study taurine and glycine conjugation and sulfation of lithocholate. After addition of [14C]lithocholate to the tissue culture medium, synthesis and excretion of amidated and/or sulfated products were investigated for up to 24 h. After incubation for 1 h, more than 83% of the labeled bile salt was amidated but not sulfated and between 5 and 11% was sulfated, with more than 80% of the sulfated bile salts being also amidated. After 24 h, the proportion of sulfated lithocholate had increased to about 23% and more than 99% of the lithocholate sulfate was additionally conjugated with glycine or taurine. Both sulfates and non-sulfates were preferably amidated with taurine. We conclude that in primary rat hepatocytes, (1) lithocholate is rapidly and almost completely conjugated with glycine or taurine (amidated), whereas sulfation of lithocholate (and its amidates) proceeds slowly and even after 24 h represents only a small proportion of the total lithocholate metabolites, and (2) sulfated and unsulfated bile salts are both preferably amidated with taurine.

Amides↗
PubMed1989

Similarities in maximal biliary bilirubin output in the normal rat after administration of unconjugated bilirubin or bilirubin diglucuronide.

The rate-limiting step in the overall plasma-to-bile transport of a saturating load of bilirubin is still a matter of controversy. We reassessed the apparent maximal biliary bilirubin excretion following i.v. infusion of unconjugated bilirubin and--for the first time--of highly purified bilirubin diglucuronide in the rat. The bilirubin diglucuronide preparation could be kept in a stable form at -20 degrees C for at least 2 months after addition of 3 mM sodium ascorbate. The biliary bilirubin excretion rates in animals with and without bile depletion in order to induce different flow rates were comparable after infusion of unconjugated bilirubin and of bilirubin diglucuronide. No significant hydrolysis of bilirubin diglucuronide seemed to occur during the hepatic transport of the pigment. Injection of bilirubin diglucuronide into rats which were already being infused with saturating doses of unconjugated bilirubin did not result in increased biliary bilirubin excretion. In contrast, a reversible inhibition of bilirubin output and bile acid-dependent bile flow was observed. If unconjugated and diglucuronidated bilirubin follow the same intracellular routes, the present results would suggest that conjugation did not restrict maximal biliary excretion. However, if exogenously administered diglucuronide utilizes a separate pathway, as was recently proposed, the biliary secretion of this exogenous conjugate might be restricted, presumably due to a toxic effect of the high local concentration of diglucuronide. The pathways utilized by the unconjugated pigment, on the other hand, could be primarily determined by the conjugating capacity.

Animals↗