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Biomedical subjects

G Adler

Publications and source records attributed to G Adler.

At least 289 records · Page 16Linked to original sources
PubMed1995

Exocrine pancreatic function after recovery from necrotizing pancreatitis.

The aim of the present study was to investigate the exocrine pancreatic function after recovery from necrotizing pancreatitis. The exocrine function was analysed in 53 patients who had recovered from their first attack of necrotizing pancreatitis. In a group of 23 patients (Group A), three follow-up studies were performed between four weeks and 12 months after recovery from acute pancreatitis. A second group of 30 patients (Group B) was submitted to only one function test 18 months after recovery from acute necrotizing pancreatitis. Exocrine pancreatic function was observed after endogenous stimulation using the Lundh test meal. In Group A, after four weeks 74% of the patients had mild-to-moderate insufficiency, while 26% suffered from severe impairment of pancreatic function. Twelve months after recovery, only 16% of the patients showed a normal pancreatic response, while 84% still had pancreatic insufficiency of variable severity. In Group B, 13% of the patients showed a normal pancreatic response, while mild-to-moderate insufficiency was observed in 81%. Severe pancreatic insufficiency was measured only in 6% of these patients. After recovery from necrotizing pancreatitis persistent global or dissociated functional insufficiency is found in 80-85% of the cases. Individual pancreatic enzyme secretion varies quiet considerably during the course of recovery in the follow-up period.

Acute Disease↗
PubMed1995

Low pretreatment gallbladder stone densities at computed tomography predict rapid stone clearance following extracorporeal shock wave lithotripsy.

The importance of routine computer tomographic (CT) stone analysis in optimizing the therapeutic outcome after extracorporeal shock wave lithotripsy (ESWL) remains controversial. The aim of the present prospective study was to seek a correlation between CT findings and stone clearance rates after ESWL in 159 patients. One hundred fifty-nine symptomatic patients (116 females, 43 males) with solitary radiolucent gallbladder stones underwent CT for stone analysis before lithotripsy. In Group I (<50 HU, n=104), stone clearance was achieved in 55.8% of patients within 6.11+/- 6.95 months; in Group II (51-100 HU, n = 28), in 50.0% of patients within 11.2 +/- 10.3 months; in Group III (>100 HU, n = 27) in 29.7% of patients within 9.60 +/- 6.96 months. The mean follow-up period was 17.9 +/- 10.0 months. Patients in Group I showed a significantly higher rate of stone clearance than those in Groups II and III (p < 0.001) as well as a significantly shorter time for the achievement of total stone clearance than either of the other groups (p < 0.001). The authors conclude that CT stone analysis provides a more accurate method of selecting patients suitable for ESWL and may be of importance in predicting the expected length of time for achieving complete stone clearance.

Absorptiometry, Photon↗
PubMed1994

[Liaison psychiatry in an internal medicine clinic. Study of a subgroup of patients with psychogenic reactions and neurotic disorders].

Too little attention is paid to psychiatric consultation activities--and this also applies to the literature. Within the framework of an overall consideration of patients passing through a psychiatric consultation service in 1989 and 1990 at the Medical Department of the University Hospital in Ulm, the largest subgroup of patients with psychogenic reactions and neuroses were examined in detail. Among the psychiatric disorders diagnosed, anxiety disturbances clearly predominated. Among the psychogenic reactions these latter presented in the form of body-related anxiety and among the neurotic patients more often as a diffuse feeling of anxiety. With respect to the acceptance of the diagnoses and the passing-on of the therapeutic recommendations by the internist, certain reservations were observed, in particular involving patients with psychogenic reactions, which in the first instance were induced by the disease and associated diagnostic and therapeutic measures. For this patient group, however, more intensive management with respect to further treatment could be very helpful.

Adolescent↗
PubMed1994

Differential expression of heat shock proteins in pancreatic carcinoma.

In the present study we sought to determine by Northern blot analysis and mRNA in situ hybridization whether gene expression of heat shock proteins (HSPs) (HSP 89 alpha, HSP 89 beta, HSP 70, and ubiquitin) is altered in pancreatic carcinoma, compared to control tissues (normal pancreas and chronic pancreatitis tissue). HSP 89 alpha was selectively overexpressed in pancreatic carcinoma, and tumor cells were shown to contain the largest amount of HSP 89 alpha mRNA. Steady state levels of HSP 70 mRNA were increased in pancreatic carcinoma (tumor and connective tissue cells) and in chronic pancreatitis (connective tissue cells and residues of exocrine acinar cells). HSP 89 beta and ubiquitin B were constitutively expressed at high levels in pancreatic tissue from all three groups; HSP 89 beta mRNA was found in cells of parenchymal and stromal origin. A strong correlation was found between the expression of HSP 70 and the expression of transforming growth factor beta 1. The finding that HSPs are differentially expressed in pancreatic cancer, compared to normal pancreas and chronic pancreatitis tissue, and the cancer specificity of HSP 89 alpha suggest that HSPs play a specific role in the pathogenesis of pancreatic cancer, e.g., by participating in regulatory processes or in tumor immunity, as proposed previously.

Blotting, Northern↗
PubMed1994

Macrophages within the human adrenal gland.

There is increasing evidence for an immune-adrenal interaction in which macrophages may play an important role. However, few data are available with respect to a human intra-adrenal macrophage system. In this study, we have investigated the density, distribution and phenotype of human adrenal macrophages using monoclonal antibodies. Macrophages are localized in all zones of the adrenal gland. These cells exhibit the phenotype of the phagocytotic macrophage compartment (CD11c+, KiM8+). At the ultrastructural level, macrophages are frequently attached to the endothelial wall, but also lie in direct contact with cortical and chromaffin cells. This investigation reveals the cellular basis for the possible role of macrophages in the local immune-neuroendocrine axis.

Adrenal Glands↗
PubMed1994

Rat pancreatitis-associated protein is expressed in relation to severity of experimental pancreatitis.

To study the relation between expression of the pancreatitis-associated protein (PAP) and severity of pancreatitis in rats, different degrees of experimental pancreatitis were induced by a 1-, 3-, or 5-h cerulein infusion (5 micrograms kg-1 h-1). This treatment decreased pancreatic volume secretion to below 10%. Immediately after infusion, the secretion rate increased to approximately 50% of control. Within 1 day, volume and bicarbonate secretion rates were not different from controls. At this point, protein secretion amounted to 30% of control, but only in animals receiving the 3- or 5-h dose. The values increased to 40-60% within 3 days. In all groups, the isoenzyme pattern was not influenced by the cerulein treatment. One day after induction of pancreatitis, the PAP was found in pancreatic juice in concentrations related to the dose of cerulein given. By immunohistochemical techniques, the protein was localized over acinar cells, but was not detectable in interstitial tissue, islets, or in the healthy exocrine pancreas. Pathomorphologic alterations in the pancreas were quantified by a scoring system. One and 2 days after the treatment, a more severe pancreatitis and more elevated levels of PAP were found in animals treated with the higher dose of cerulein. It is concluded that PAP is expressed in the pancreas in relation to the severity of cerulein-induced pancreatitis.

Animals↗
PubMed1994

Enhancement of transforming growth factor beta 1 expression in the rat pancreas during regeneration from caerulein-induced pancreatitis.

Synthesis of extracellular matrix components is enhanced in the rat pancreas during regeneration from caerulein-induced pancreatitis. To study the involvement of transforming growth factor beta 1 (TGF beta 1), one of the most potent modulators of the extracellular matrix, in the process of pancreatic regeneration we examined the expression of this gene on the transcript and protein level. Pancreatic RNA was extracted from rats killed 0 h, 12 h, 24 h, 2, 3 and 7 days after induction of caerulein pancreatitis. Transcript levels for TGF beta 1 were measured by slot-blot analysis and mRNA in situ hybridization. Total amount of TGF beta 1-protein was measured using a radioligand binding assay. TGF beta 1 protein was increased twofold after 24 h and 48 h and returned to control values 7 days after induction of pancreatitis, TGF beta 1-mRNA reached maximal values (3-fold over controls) after 2 days. The largest amount of TGF beta 1-mRNA was found in pancreatic acinar cells and in stromal cells. In summary, expression of TGF beta 1 in acinar and stromal cells of the rat pancreas is enhanced during regeneration from caerulein-induced pancreatitis, which may indicate an involvement of TGF beta 1 in the regulation of extracellular matrix regeneration in the rat pancreas after caerulein-induced pancreatitis.

Animals↗
PubMed1994

Pancreatic outflow obstruction as the critical event for human gall stone induced pancreatitis.

Opie suggested in 1901 that a common channel between the pancreatic duct and the common bile duct is created when a gall stone becomes impacted at the duodenal papilla. He proposed that bile would regurgitate into the pancreas and trigger pancreatitis. The case is reported of a 22 year old woman with an impacted stone at the duodenal papilla creating a common channel. The patient suffered from acute pancreatitis. Three days before the onset of pancreatitis, however, a T drain had been inserted into the common bile duct from which bile had been flowing freely and continuously. Moreover, amylase activity in fluid from the T drain was 49,000 U/l at the onset of pancreatitis pointing to reflux of pancreatic juice into the biliary tract. The amylase activity in bile decreased rapidly after endoscopic papillotomy and retrieval of the stone. The events participating in the development of acute gall stone induced pancreatitis in this patient with a common channel situation permitted reflux of pancreatic juice into the biliary tract rather than bile into the pancreas. Impairment of pancreatic outflow by a gall stone was probably the primary triggering event, rather than the regurgitation of bile into the pancreas. Preventive or therapeutic treatment in gall stone pancreatitis should be aimed at the urgent restoration of pancreatic flow rather than at the prevention of a hypothetical bile reflux.

Acute Disease↗
PubMed1994

Sympathoadrenal regulation of adrenal androstenedione release.

The effects of epinephrine and of splanchnic nerve activation on adrenocortical androstenedione release were studied in intact isolated perfused pig adrenals with preserved nerve supply. In addition, long-term effects of epinephrine were characterized in bovine adrenocortical cells in primary culture. To investigate the contact zones of the androgen-producing cells of the zona reticularis with the catecholamine producing cells of the adrenal medulla, cortical cells were immunostained for cytochrome P450 side chain cleavage (P450SCC). Perfusion of the isolated adrenals with epinephrine (10(-7) to 10(-5) M) stimulated androstenedione release in a dose-dependent manner. At a concentration of 10(-6) M, epinephrine provoked an increase to 179.11 +/- 16.14% of basal secretion (p < 0.05). Electrical stimulation of the splanchnic nerves led to an increase to 151.5 +/- 9.24% of basal values (p < 0.05). Epinephrine (10(-6) M) reached 40% and activation of the splanchnic nerves 26% of the stimulatory effect of ACTH at a physiological concentration (10(-10) M). The alpha-agonist phenylephrine had no effect on androstenedione release. In cell cultures, epinephrine stimulated the release of androstenedione in a dose-dependent manner with an ED50 of 0.75 x 10(-6) M. The maximal effect was reached at 10(-5) M with 8.92 +/- 0.66 pmol androstenedione/dish/24 h; the basal secretion was 1.44 +/- 0.54 pmol/dish/24 h. The epinephrine-stimulated androstenedione release was abolished by the beta-adrenergic antagonist propranolol while the alpha-adrenergic antagonist phentolamine had no effect. Immunohistochemical staining of paraffin sections of bovine and porcine adrenals for P450SCC revealed that zona reticularis and zona medullaris are closely interwoven.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenal Glands↗
PubMed1994

Intimate contact of chromaffin and cortical cells within the human adrenal gland forms the cellular basis for important intraadrenal interactions.

A new role for the adrenal medulla as a regulator of adrenocortical function has been postulated. However, there has been no idea as to how such a cellular interaction within the human adrenal gland could take place. In this study we were able to demonstrate with the help of specific immunostaining of cortical and chromaffin cells, respectively, that the two endocrine systems are interwoven with each other to an astonishing degree. Protrusions, clusters, islets, and single cortical cells were made visible by immunostaining with an antibody against 17 alpha-hydroxylase cytochrome P450 enzyme. They occurred diffusely within the entire adrenal medulla, providing ample contact zones for paracrine interactions. Specific immunostaining for the neuroendocrine protein chromogranin-A identified the occurrence of chromaffin cells within all three zones of the human adrenal cortex, including the zona glomerulosa. In an ultrastructural analysis, cortical and chromaffin cells were found in all zones in direct apposition, providing the possibility for direct intercellular exchange. The close morphological colocalization of cortical and chromaffin cells revealed in this study may constitute the basis for the growing evidence of relevant intraadrenal paracrine mechanisms within the human adrenal gland.

Adrenal Cortex↗
PubMed1994

Incidental presence of antibodies against gangliosides in Graves' disease.

In Graves' disease an increased immunological activity against glycoconjugate antigens is observed. Since gangliosides seem to be important for thyroid stimulation we searched for the presence of antiganglioside antibodies in Graves' patients sera by the immunoenzymatic method. Antibodies against some of 12 different gangliosides used in this study were found in 22% of the patients. However, in most cases the titer of antiganglioside antibodies was very low. Only the serum from one patient reacted with FucGM1 ganglioside at the dilution up to 1:1300. Anti-FucGM1 antibodies were present in serum samples of this patient taken before and during the treatment when she was hyper-hypo- and euthyroid. The lack of relation of the anti-FucGM1 antibody titer to the thyroid status of this patient, and the very low titer of antiganglioside antibodies in sera of some other patients, suggest that the presence of these antibodies has no close connection to the thyroid disease.

Autoantibodies↗
PubMed1994

Temporal stability of auditory evoked potentials at different stimulation rates.

1. We determined the temporal stability of the N1 and P2 waves of the auditory evoked potentials (AEP) for twelve healthy subjects who were tested in two sessions separated by 2 to 63 days (mean = 25 days). AEP were obtained at two different stimulation rates (1/s and 0.3/s). In addition to wave amplitude and latency, the latency difference and the amplitude ratio between the two stimulation rates were calculated. 2. Mean amplitudes, latencies, latency differences and amplitude ratios were not significantly different between the two sessions. Pearson's correlation was significant only for N1 latency at the 1/s stimulation rate (r = 0.64, P = 0.02). 3. Factors such as arousal and other subjective states of the subjects, personality traits, as well as technical aspects of the examinations, may have influenced the temporal stability of the AEP.

Acoustic Stimulation↗
PubMed1994

Liposome mediated in vivo gene transfer into different tissues of the gastrointestinal tract.

The possibility to transfer and express genetic material in mammalian cells represents a new approach to the treatment of genetic and acquired disorders. So far, most studies use in vitro techniques to introduce foreign DNA into cultured cells, followed by reintroduction of these genetically altered cells into living organisms. In the present study we demonstrate that the LacZ marker gene can be selectively delivered, by in vivo techniques, to various locations of the gastrointestinal tract. Genetic material was targeted to the stomach, the colon, the liver and the pancreas using cationic liposomes. For transfer into the stomach and colon an intraluminal application, in the liver a portal access and in the pancreas an intraductal infusion was chosen. 48 hours after administration, the LacZ gene product beta-galactosidase could be localized in these tissues by cytochemistry. These experiments suggest a new approach to study gastrointestinal physiology and may offer novel aspects for the treatment of gastrointestinal diseases.

Animals↗