Biomedical subjects
Publications and source records attributed to E Henkel.
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1. When giving 100 mg allopurinol and 20 mg benzbromarone in a fixed combination we found that the oxipurinol levels differed at 0 and after 4 h from those after administration of 100 mg allopurinol; the oxipurinol clearance is increased; benzbromarone increased the glomerular filtration rate as well as the urine volume. 2. The urate serum levels are decreased under additional administration of benzbromarone, the urate clearance is increased; urate levels in serum dropped slower than under monotherapy with alloprinol and increased again within the last 12 h.
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Activity of pseudocholinesterase (acylcholine-acyl-hydrolase) elevated up to four times has been detected in sera of members of two German families. The catalytic concentrations of the pseudocholinesterase of the afflicted members of both families (male and female) varied between 4800 U/l and 10 200 U/o (acetylthiocholine iodide substrate). The pseudocholinesterase of the propositi exhibits isoenzyme separation patterns in polyacrylamide electrophoresis as well as in electrofocussing which are different from those of pseudocholinesterase from normal persons. No differences could be seen as regards the Km of substrates or the inhibition by dibucaine, fluoride or succinyldiocholine.
The protein-sparing effect of different programs of peripheral-venous parenteral feeding was studied in 31 patients following abdominal surgery. 10 patients (group II) received 1 g amino acids/kgBW/day, 11 patients (group III) 1 g amino acids and 2 g carbohydrates/kgBW/day and 10 patients (group I, control) were infused only with water and electrolytes. Patients with simultaneous addition of amino acids and carbohydrates had significantly better nitrogen balances than patients given amino acids alone. The normalisation of amino acids metabolised and delivered predominantly by muscle, just as the significant improvement in serum levels of transport and acute-phase proteins demonstrated that the utilisation of added amino acids took place not only in peripheral but also in visceral tissues. Comparable positive effects could not be seen with sole amino acid infusion. Our study indicates that this program, being effective in the state of keto-adapted starvation, is of no use in the early postoperative period, because of lacking corresponding metabolic conditions.
Following limited abdominal surgery peripheral-venous parenteral feeding was performed in 30 patients: 15 patients (group II) received 0.8 g amino acids and 4 g carbohydrates/kg BW; and 15 patients (group III) 1 g amino acids and 5 g carbohydrates/kg BW. As a control group (I) 10 patients were infused only with water, electrolytes and vitamins. A significant improvement of nitrogen balances was noticed in both groups of patients with parenteral nutrition, and about 90% of the infused amino acids was retained as nitrogen. However, the serum levels of various proteins--albumin, transferrin, pre-albumin and retinol-binding protein--presented no significant changes. There was no evidence that peripheral parenteral nutrition improved postoperative metabolism of plasma proteins. It is assumed that the administered amino acids are probably utilised in peripheral tissues (e.g. muscle, wound-repair) and are, therefore, not or only in low measures available for synthesis of plasma proteins in liver.
The author reports a modification of the UV method UltraZyme Plus alpha-Amyl Harleco and the adaptation to the Eppendorf Enzymautomat 5010. alpha-amylase acts on an oligosaccharide mixture yielding maltose, which is hydrolysed by alpha-glucosidase. The liberated glucose is determined specifically by the hexokinase/glucose-6-phosphate dehydrogenase (NAD+-dependent) method+ by addition of pyruvate, lactate dehydrogenase and ATP. Thereafter the lactate dehydrogenase reaction is stopped by addition of oxamate and the alpha-amylase activity is measured.
Alpha-amylase has been measured in 57 patients' sera with normal to highly elevated amylase activities. The results obtained with four enzymatic-kinetic test-kits have been compared with those from five conventional marketed procedures. The results are evaluated by regression analysis. The specificity of the methods was analysed with amylase samples from human pancreas, human saliva and pig pancreas. The susceptibility of the kinetic procedures to interferences is smaller. The problems of conversion of activity units and reference ranges are discussed. The UltraZyme and the Monamyl neu-methods have been found superior to the other procedures because of their good practicability, precision and broad linear range; their specificity for diagnostic purposes in pancreatic diseases is less favourable compared with that of conventional procedures.
The excretion of Piracetam was monitored by measuring the concentrations in maternal and fetal substrates during labor in nine volunteers. Piracetam was tolerated without side-effects and injected in the maternal cubital vein. Consecutively, maternal plasma and urine samples as well as amniotic fluid portions were collected during labor. at delivery, fetal blood from placenta and the first fetal urines were collected. Biostatistical methods showed that approximately 50% of Piracetam were eliminated 80 minutes after the injection of the drug. In amniotic fluid a continuous rise of Piracetam concentrations was monitored until delivery. In fetal plasma and urines the substance could be detected. The rapid excretion of Piracetam during labor was obviously typical for the situation sub partu; reasons are discussed.
Hemostasiologic effects of intravenous application of Reptilase were investigated in a randomized double blind study in the course of normal abdominal and vaginal hysterectomies. Coagulation factors and thrombocytes were checked before, after, 40 minutes after as well as 24 hours after the operation. Significant shortening of the clot observation time resulted 40 minutes after the injection of 1 ml Reptilase. A small but highly significant decrease of thrombocytes was observed 40 minutes after the end of the operation when Reptilase was injected. Further coagulation screening tests: Quick test, PTT and thrombin time were without statistically differences in both patients groups from the beginning till 24 hours after the operation. A significant decrease in Factor V concentrations resulted 40 minutes after the injection of Reptilase, whereas no changes were seen in the placebo patient group. Too, Factor XIII values and Antithrombin 3 concentrations decreased after the administration of Reptilase. There was no abnormal raise of fibrin-monomers in both groups. Enhanced fibrinolysis with elevated FDP-levels were measured in none of the cases. The administration of Reptilase induced a short lasting augmentation of blood coagulation but without any signs of disseminated intravascular coagulation.
This study demonstrates that uric acid serum levels are of importance in the prognosis of pregnancy complicated by hypertension. In early pregnancy the uric acid level probably is the most sensitive parameter to select the risk-prone pregnancies with EPH-gestosis to conduct the further course of pregnancy under medical care. Pregnant hypertensives with high uric acid levels develop more often retardation of the fetus, the incidence of eclampsia increases. In case of hypertension in pregnancy complicated by high uric acid levels careful monitoring and normalizing high blood pressure under medical observation improves the prognosis for fetus and mother.
PIRACETAM concentrations in fetal and maternal blood were measured during the first and second stage of labor and the elimination in maternal and fetal blood was studied. Fetal heart-rate, pH- and base-excess of the maternal and fetal blood were investigated to evaluate the influence of PIRACETAM on the acid-base-status of mother and child. PIRACETAM was administered intravenously to 43 patients in a dosage 2 g, 4 g and 6 g. The concentration in the maternal and fetal plasma was measured by gaschromatography. Before and after the injection of PIRACETAM and at delivery, blood was sampled from the mother's earlobe and the umbilical artery and vein, respectively. The results were compared with a control group. There was an exponential fall of PIRACETAM concentration in maternal and fetal blood. Maternal and fetal elimination half-life of PIRACETAM was about 112-98 minutes and 200 minutes, respectively. A fairly good correlation between the concentration of PIRACETAM in maternal and fetal blood was found. The fetal PIRACETAM concentration was about 50% below the maternal values. Fetal heart-rate, maternal and fetal pH- and base-excess-values were not significantly altered following PIRACETAM infusion. It may be concluded, that there exists a transfer of PIRACETAM across the placental barrier. However, the cytoprotective effect of PIRACETAM, as described in animal observations and by investigations in human, could not be verified by the methods and technology used in this study.
40 patients, who underwent abdominal surgical procedures, received 3 different types of peripheral-venous postoperative infusions. Two groups had peripheral parenteral nutrition with different amounts of amino acid substitution, whereas a comparable group only received carbohydrates and electrolytes with same energy content. Regarding plasma proteins there was no evident difference among the various groups. In all patients, however, we found a significant decrease of protein-levels in the early postoperative period indicating a malnutrition at this time. Supply of amino acids had a significant positive effect on nitrogen balance. Utilisation of added protein theoretically came up to 65-70%. Therefore postoperative peripheral parenteral nutrition should be preferred.
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