Search PubMed⌕ Search

Biomedical subjects

E H Thaysen

Publications and source records attributed to E H Thaysen.

At least 19 recordsLinked to original sources

Bile acids in health and disease.

Over the last quarter of a century Danish research on bile acids has comprised studies of their physical and chemical properties, their physiology, pathophysiology, metabolism, and kinetics, and their clinical applicability. In the beginning of the period a major contribution was made to the understanding of the factors involved in the solubility of cholesterol in bile. The growing international understanding of the potential importance of the bile acids in health and disease gave raise to a substantial Danish contribution in the 1970s and 1980s in parallel with international achievements. Emphasis was on the possible clinical implications of bile acids. Studies on physiology and pathophysiology were in focus. Patients who have had an intestinal bypass operation for obesity served as a model for obtaining new knowledge on various aspects of the properties of the bile acids. Also the analytical methods were improved. Important physiological research on the mechanisms of hepatic bile flow was conducted. An intestinal perfusion model served as a tool providing information on absorption kinetics and on transmucosal water and electrolyte movements. The gallstone disease, liver diseases, inflammatory bowel disease, fat malabsorption, and other intestinal disorders were studied. The 'idiopathic ileopathy' as a cause for bile acid malabsorption causing diarrhoea was established as a new disorder. Thus, in the time period concerned, substantial Danish contributions emerged on major and minor topics of the bile acid field.

Bile Acids and Salts↗

Evaluation of the applicability of the SeHCAT test in the investigation of patients with diarrhoea.

For the assessment of ileal bile acid conservation the retention of orally administered 75Se-23-selena-25-homotaurocholic acid (SeHCAT), a gamma-ray-emitting radioisotope-labelled synthetic bile acid, was measured by an uncollimated abdominal gamma camera in 89 patients with various gastrointestinal disorders and in 20 persons without gastrointestinal complaints. A significant differences in retention was observed between patients with and without previously detected ileal disease. However, it was not possible by use of the test to differentiate between the various types of diarrhoea. Hence the test is not recommended in the routine investigation of patients with diarrhoea.

Adolescent↗

Idiopathic bile acid diarrhoea reconsidered.

Two new cases of a rare entity provisionally coined 'idiopathic bile acid diarrhoea' are reported and compared with previous cases. The diarrhoeal syndrome has been identified as a cholegenic enteropathy. In the absence of conventional ileopathy the cause of the bile acid loss is obscure, but it is hypothesized that it may be due to a relative deficiency in ileal absorptive sites for bile acid anions. So far the diagnosis has partly been based on measurements of faecal bile acid losses. It is suggested that a carefully conducted therapeutic trial with cholestyramine may be almost equally helpful.

Aged↗

Development of collagenous colitis in sequential biopsy specimens.

The present report describes the morphologic findings in sequential colorectal biopsy specimens obtained from 2 patients who within 1.5-2.5 yr developed collagenous colitis. The initial biopsy specimens revealed an acute nonspecific inflammatory reaction in the colorectal mucosa. An intermediate stage, characterized by edema and slight fibrosis in the subepithelial region of the colorectal mucosa, preceded the final development of collagenous colitis. We suggest that the mechanism that leads to the formation of a thick, bandlike subepithelial collagenous deposit in the colorectal mucosa may be triggered off by some inflammatory or toxic stimulus.

Aged↗

Colorectal spirochetosis: clinical significance of the infestation.

Mucosal biopsy specimens from 300 consecutive patients with symptoms requiring sigmoidoscopy were examined for spirochetosis by light and electron microscopy. Colorectal spirochetosis was detected in 15 of the patients (5%). Apart from the spirochetal infestation, the mucosa appeared normal with no inflammatory reaction. The spirochetes were eliminated upon treatment with neomycin and bacitracin, but the symptoms of the patients remained unchanged. It is concluded that in the present material, colorectal spirochetosis was without clinical significance.

Adolescent↗

Intestinal spirochetosis: morphological characterization and cultivation of the spirochete Brachyspira aalborgi gen. nov., sp. nov.

The ultrastructure of spirochetes obtained from rectal biopsies of patients with intestinal spirochetosis was studied by means of negative staining and ultrathin sectioning. The cells were sigmoidal with tapered ends, 2 to 6 microns long, with a wavelength of 2 microns. Four flagella were inserted at each end of the cells. The maximal cell width was about 0.2 microns. The spirochetes were cultured on tryptose soy blood agar plates. They were anaerobic and grew, although very slowly, at 37 to 38.5 degrees C in an atmosphere of 5% CO2-95% H2. Two types of colonies could be distinguished. The growth characteristics and the morphology of the isolated spirochetes differ from those of previously isolated spirochetal strains. Consequently, it is proposed that the present strains constitute a new genus, Brachyspira, of the family Treponemataceae. The type species is Brachyspira aalborgi, the type strain of which is 513A (NCTC 11492).

Culture Media↗

Assessment of ileal function by abdominal counting of the retention of a gamma emitting bile acid analogue.

In eight patients without gastrointestinal complaints and 30 patients with various gastrointestinal disorders ileal bile acid conservation was assessed by oral administration of 75Se 23-selena-25-homocholic acid (SeHCAT) followed by abdominal gamma counting (SeHCAT-test). The results of the test correlated fairly well with the clinical features and with the [1-14C]-cholylglycine breath test including faecal 14C measurements (breath test). Of the two bile acid absorption tests the new is perhaps the more sensitive and is the one most easily performed.

Adult↗

The diagnostic value of fasting serum total bile acid concentration in patients with suspected liver disease. A prospective, consecutive study.

To assess the diagnostic value of fasting serum total bile acids (STBA) in liver disease, STBA together with serum bilirubin (BIL), serum alkaline phosphatase (AP), and serum aspartate aminotransferase (ASAT) were measured in 66 consecutive patients who had a liver biopsy. Twenty-four of the patients who had normal liver histology all had normal STBA values (less than 8 mumol/l). In the remaining 42 patients with abnormal liver histology STBA values were elevated in 21, corresponding to a sensitivity of 0.50. The same figures for BIL, AP, and ASAT were 0.52, 0.76, and 0.79, respectively. The predictive values of elevated (PVpos) and normal (PVneg) STBA for disclosing or excluding liver disease, respectively, were not better than the figures for BIL, AP, and ASAT. None of the tests were suited for distinguishing among various liver diseases. It is concluded that STBA had no diagnostic advantage as compared with the commonly used liver function tests BIL, AP, and ASAT.

Adolescent↗

Collagenous colitis: an ultrastructural study of a case.

A case of so-called collagenous colitis is described. This entity, featured clinically by watery diarrhea, is characterized histologically by a 50-60 micrometer fibrous layer immediately beneath the surface epithelium. Ultrastructural changes in the endothelial cells and the basement membranes of the superficial capillaries of the colonic lamina propria, as well as concentric collagenous encasement of these capillaries, are described.

Capillaries↗

Bone composition and vitamin D after Pólya gastrectomy.

With the aim of evaluating bone phosphorus/hydroxyproline ratio (P/Hypro) as an index of osteomalacia, this bone index and the bone mineral content (BMC) have been investigated together with other indices of calcium metabolism in 27 gastrectomized patients. None of the patients had clinically manifest bone symptoms. The mean values of bone P/Hypro, BMC, plasma calcium and plasma magnesium were subnormal; the mean values of serum parathyroid hormone (iPTH) and plasma alkaline phosphatase were elevated. Mean serum 25-hydroxycholecalciferol (25-OH-D) did not differ from normal. A significant positive correlation was found between bone P/Hypro and serum 25-OH-D, but no significant correlation between bone P/Hypro and BMC. Serum 25-OH-D and bone P/Hypro were significantly lower and serum iPTH was significantly higher in a subgroup of 12 patients with no regular supplementary intake of vitamin D. In conclusion, the gastrectomized patients had blood biochemical evidence of a mild vitamin D insufficiency and the low bone P/Hypro values can be explained by mild osteomalacic changes in bone.

Adult↗

Idiopathic bile acid catharsis.

In the course of extensive routine screening for bile acid malabsorption a few patients were detected in whom chronic diarrhoea was apparently induced by excess bile acid loss which was neither associated with demonstrable conventional ileopathy nor with any other disorder allied to diarrhoea. In three patients subjected to scrutiny the results obtained were in harmony with a concept of idiopathic bile acid catharsis. Ingestion of cholestyramine was followed by immediate relief, but the diarrhoea recurred whenever this treatment was withdrawn. It it suggested that idiopathic bile acid catharsis should be suspected in patients with unexplained chronic diarrhoea and especially in those with a diagnosis of irritable colon with diarrhoea.

Adult↗

The diagnostic value of liver scanning. A retrospective study.

Among 650 consecutive radioisotope liver scans there were selected 180 representing all cases in which a pathoanatomical evaluation of the liver was available. The scanning data, the clinical information, and the pathoanatomical diagnosis were reviewed independently, and the results achieved in each group were classified as evidence of normal liver, focal hepatic disease, or diffuse hepatic disease. Using pathology for verification scanning had a sensitivity of 97% and a specificity of 90% regarding detection of unspecified liver disease, which was significantly better than clinical setting alone. In diffuse hepatic disease scanning had a sensitivity of 100% and a specificity of 81%, whereas in the focal hepatic disease the corresponding figures were 78 and 97%, respectively. Passive hepatic congestion was recognized as a diffuse hepatic disease by scanning, thus representing a source of error in screening for liver disease sensu stricto. It is concluded that scanning, apart from being a rapid and simple procedure without significant inconvenenience to the patient, is a very accurate diagnostic tool that deserves more recognition in clinical departments.

Biopsy, Needle↗

Turnover of plasma cholesterol in patients with cholesterol gallstones.

Following the i.v. injection of about 30 muCi of 1-alpha-2-alpha-3H-cholesterol, the specific activity decay of plasma cholesterol has been analysed in terms of a 2-pool model in eight patients with radiolucent gallstones and two healthy controls. In each subject some kinetic parameters were calculated, including the input into and the size of the rapidly exchangeable cholesterol pool. The results were compared with those in 16 controls from another study. Statistical analysis failed to demonstrate significant differences in any of the parameters between the gallstone patients and the combined controls, indicating that patients with cholesterol gallstones have normal input into and size of the rapidly exchangeable cholesterol mass. The conclusion is discussed in relation to similar studies, and it is speculated that gallstone patients may have decreased absorption of exogenous cholesterol.

Adult↗