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Biomedical subjects

G Metz

Publications and source records attributed to G Metz.

At least 73 records · Page 4Linked to original sources

[Extracrural manifestation of necrobiosis lipoidica. Isolated involvement of the head].

Necrobiosis lipoidica confined to the face and scalp is very rare. The clinical diagnosis is complicated by the granuloma anulare like aspect and in particular by the lack of typical localization of the extremities. Histologically prominent granulomatous dermal proliferation and less marked vascular changes can often be found in the involved areas of the scalp and/or in the absence of diabetes mellitus. For the microscopic classification the large variability of necrobiosis lipoidica must be considered. In our case with an exclusive localization in the face and capillitium, diabetes mellitus was excluded. The necrobiotic type of the necrobiosis lipoidica was predominant. The identity between necrobiosis lipoidica with other chronic granulomatous diseases and the possible treatment of this benign but long-term process is briefly discussed.

Aged↗

Yeast aminopeptidase I. Chemical composition and catalytic properties.

An aminopeptidase (alpha-aminoacyl L-peptide hydrolase, EC 3.4.11.1) was purified to homogeneity from autolysates of brewer's yeast. The enzyme which is responsible for most of the yeast cell's aminopeptidase activity is a glycoprotein containing about 12% of conjugated carbohydrate and 0.02% Zn2+ and having a complex quaternary structure. The active species has a molecular weight of approx. 600000 and an isoelectric point of 4.7. The enzyme is remarkably stable, even in dilute solutions. All types of L-amino acid and peptide derivatives containing a free amino terminus are attacked, including amino acid amides and esters. As to its substrate specificity, the enzyme belongs to the so called leucine-aminopeptidases. It is strongly and specifically activated by Zn2+ and Cl- (or Br-) and inactivated by metal-chelating agents. The activation by Zn2+ seems to be mediated by a conformational transition which affects exclusively V and leads to a form of the enzyme which enhanced stability against heat. Halide anions, on the other hand, are acting as positive allosteric effectors, modulating both V and Km.

Amino Acids↗

Breath-hydrogen test for small-intestinal bacterial colonisation.

Breath-hydrogen production after oral glucose administration was examined in patients suspected of having small-intestinal colonisation and compared with the 14C-glycine-cholate breath test (14C-G.C.) and with bacteriological examination of the small intestine. Of 17 patients, 12 had bacteriological evidence of small-intestinal colonisation. Each breath test showed 8 of the 12 patients to be colonised, but only 5 patients gave positive results with both tests. Nevertheless, using both tests only 1 patients out of 12 with small-intestinal colonisation would have been missed. There were no false-positive results in the 5 bacteriologically normal patients when the breath-hydrogen test was used. It is concluded that simultaneous use of these two relatively simple breath tests may improve the indirect diagnosis of small-intestinal colonisation.

Bacteria↗

Breath hydrogen in hyposucrasia.

A simple and reliable test for the diagnosis of hyposucrasia is required, since this may be an unsuspected cause of long-standing gastrointestinal disorder. Furthermore little has been done to define the epidemiology of this condition, possibly because of the limitations of multiple blood-sampling. Breath hydrogen (H2) production after lactose ingestion is a reliable test for hypolactasia, and has now been measured after sucrose ingestion in eleven patients with various gastrointestinal symptoms. Six who had normal sucrase activity on jejunal biopsy produced no H2 after taking 50 g of sucrose. No H2 was produced in three patients with borderline hyposucrasia, either after 50 g sucrose or when retested using 100 g sucrose (two patients). However, the two patients with low jejunal sucrase activity showed rises of breath H2, after only 25 g glucose. Breath H2 measurement is a simple, accurate, and non-invasive test for diagnosing gastrointestinal symptoms due to hyposucrasia.

Breath Tests↗

A simple method of measuring breath hydrogen in carbohydrate malabsorption by end-expiratory sampling.

1. A simple method is described for measuring the hydrogen concentration in alveolar air by end-expiratory sampling, by using a modified Haldane-Priestley tube and gas chromatography. Hydrogen was generated in vivo by ingestion of the non-absorbable sugar lactulose. 2. Alveolar hydrogen concentration showed a highly significant correlation with hydrogen production measured either by a rebreathing technique or by a total collection procedure. 3. The coefficient of variation of the end-expiratory method, assessed by comparing sixty-one paired results, was 11-6%. The coefficient of variation in ten measurements in one subject at 1 min intervals was 17-6%.

Carbohydrate Metabolism↗

The relation of impaired vitamin A and E tolerance to fat absorption in biliary diversion.

Eleven patients have been studied after cholecystectomy with exploration of the common bile duct (CBD) and insertion of a T tube for free biliary drainage. Prior to clamping the T tube no significant rise was seen above fasting serum vitamin A and E, or serum triglyceride levels after 6 of the patients had been given these substances in a liquid test meal. In addition no rise in fasting vitamin E levels was seen after 3 subjects had been loaded for 4 days with 0.5 g DL alpha-tocopherol acetate/day. Faecal fat collections performed on 9 subjects indicated that over 70% of the ingested fat was absorbed. All these findings returned to normal when the T tube was clamped and the intraluminal flow of bile re-established. We conclude that deficiency of bile may allow the absorption of fat in the absence of fat soluble vitamins.

Bile↗

[Pathomorphogenesis of blistering in epidermolysis bullosa acquisita and epidermolysis bullosa dystrophica (author's transl)].

Electronmicroscopical examination on skin lesions of epidermolysis bullosa dystrophica recessiva (E.b.d.r.) and epidermolysis bullosa acquisita (E.b.a.) associated with Crohn's disease have demonstrated that blistering occurs between epidermis and dermis beneath the basal lamina. The structural defect concerns the anchoring fibrils only which are missing in the junctional zone of the involved skin. All other junctional structures are intact. Beneath the basal lamina a band-like zone of a moderate electrondense, amorphous material is seen in the skin-lesions of epidermolysis bullosa acquisita, less marked in epidermolysis bullosa dystrophica. Direct immunofluorescent investigation of involved skin of E.b.a. shows a pemphigoid-like fluorescent pattern at the basal lamina with antihuman IgG-, -IgM-, beta1c/beta1a and antihuman C1q-component. In epidermolysis bullosa dystrophica, however, a fluorescent pattern at the basal lamina was found only with anti-human IgG and Anti-C3. The pathogenetic importance of the immunoglobuline-deposits at the basal lamina is discussed in regard of the loss of anchoring fibrils and the subsequent vesication in these types of epidermolytic diseases.

Animals↗

[Ultrastructure of the epidermis in seborrhoic dermatitis (author's transl)].

Electronmicroscopical investigation on 12 cutaneous biopsies of different localisation showed that the seborrhoic dermatitis is not comparable to a psoriatic tissue-reaction. Both, the cyto-morphological feature and the demonstrated localisation of the acid phosphatase are distinctly different from that of the psoriatic epidermis. The described changes are clearly more similar to the well known ultrastructural pictures of eczemateous reactions. In spite of the "eczema-like" ultrastructural picture seborrhoic dermatitis apparently can be separated from the allergic and irritant contact-dermatitis. Nevertheless, the epidermal alterations are also similar to chronic nummular eczema. They therefore are unspecific and do not allow any conclusion regarding the etiopathogenesis or nosological classification of this skin disease.

Acid Phosphatase↗

Breath hydrogen as a diagnostic method for hypolactasia.

Breath hydrogen (H2), collected by end-expiratory sampling, was measured in twenty-five patients with abdominal symptoms or diarrhoea after ingesting 50 g. of lactose. This was compared with established tests of hypolactasia. Fifteen patients with a blood-glucose rise of more than 20 mg. per 100 ml. had less than 4 parts per million (p.p.m.) rise in breath H2 at 2 hours. In contrast, ten patients with blood-glucose rises of less than 20 mg. per 100 ml. had more than a 20 p.p.m. H2 rise (mean 85.8 p.p.m. plus or minus s.d. 44.3) at 2 hours. Similarly, two patients with normal jejunal lactase activity had no significant H2 production, whereas six patients with hypolactasia had more than a 20 p.p.m. rise in H2. Symptoms related to milk or lactose ingestion were found to be unreliable. End-expiratory sampling of breath H2 would seem to be a simple, non-invasive, and accurate method of diagnosing hypolactasia, which is also very acceptable to patients. This should make it a valuable tool both in diagnostic gastroenterology and in epidemiological surveys.

Biopsy↗

[Acquired epidermolysis bullosa in Crohn's disease].

A case of epidermolysis bullosa acquisita associated with colitis granulomatosa (Crohn's disease) is reported. Although the cutaneous lesions of this unusual disease resemble in their clinical, histological and ultrastructural features to those of the hereditary epidermolysis bullosa dystrophica, the epidermolysis bullosa acquisita has to be regarded as a separate entity among the blistering epidermolysis because of its late manifestation in adults without evidence of hereditary disorders. The deposits of immunoglobulins in the involved skin of the acral areas demonstrated fluorescentmicroscopically are discussed in regard of a possible etiopathogenic relation with the primary irritated intestinal disease.

Adult↗

Hypolipemic activity of clofibrate-related compounds.

Ethyl-2(p-chlorophenoxy)-2-methylpropionate (clofibrate) related compounds were synthesized from substituted aryloxy acetic acids (III) either by esterification with selected alcohols (3,3,5-trimethylcyclohexanol and oxyalkyltheophyllines), by introduction into heterocyclic ring system (triazine type) or by amidation (aminotriazines and p-aminobenzoates). Lipid lowering effect was tested in normolipemic and hyperlipemic rats against clofibrate as reference. Some of these derivatives show high activity at low dosage, even under hyperlipemic conditions, whereas clofibrate is only slightly effective. From pharmacological results it can be suggested that the nature of acid group substituent is the main factor for efficacy, while the role of alpha-substituent is important for differentiation of activity against cholesterol and/or triglyceride.

Animals↗