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Biomedical subjects

J Kelleher

Publications and source records attributed to J Kelleher.

At least 91 records · Page 5Linked to original sources
PubMed1983

Vitamin A and its transport proteins in patients with chronic renal failure receiving maintenance haemodialysis and after renal transplantation.

Serum vitamin A, retinol binding protein, prealbumin and transferrin have been studied in chronic renal failure patients receiving maintenance haemodialysis and after renal transplantation. Vitamin A and retinol binding protein were uniformly raised in haemodialysis patients and this was unrelated to the period on dialysis. There was a molar excess of retinol binding protein to both vitamin A and prealbumin as compared with normal individuals. Renal transplantation significantly reduces serum vitamin A and retinol binding protein concentrations but has no effect on prealbumin concentrations. The reduction in vitamin A and retinol binding protein is variable in individual patients and cannot be predicted either by the allograft function or time since transplantation. Several years after transplantation, with normal serum creatinine, both serum vitamin A and retinol binding protein levels may still be greatly increased. Despite the very high vitamin A and retinol binding protein concentrations, the close correlation between the two seen in normal individuals is well maintained. The continuing high vitamin A and retinol binding protein levels in patients with satisfactorily functioning transplants is unexplained.

Creatinine↗
PubMed1983

Zinc, vitamin A and prostatic cancer.

The serum zinc, vitamin A, albumin, copper and retinoid-binding protein content was measured in 27 patients with benign prostatic hyperplasia and 19 patients with carcinoma of the prostate. A significantly lower (P = less than 0.05) level of serum zinc was found in the cancer group as well as a significant zinc/vitamin A correlation (P = less than 0.05). The possible significance of this in relation to the pathogenesis of carcinoma of the prostate is discussed.

Aged↗
PubMed1983

Functional recovery of the exocrine pancreas after acute pancreatitis.

A tubeless pancreatic function test (BTP test) using N-benzoyl-l-tyrosyl-p-aminobenzoic acid was used to assess exocrine function from urinary recovery of p-aminobenzoic acid produced by hydrolysis of the peptide by chymotrypsin. Patients with acute pancreatitis were studied at various time intervals after the acute attack and compared with controls with abdominal pain that was not pancreatic in origin. The initial BTP test carried out in the convalescent period was abnormal in all of 30 patients with acute pancreatitis but normal in 10 patients with non-pancreatic abdominal pain and also in 8 patients who had recovered from an attack of acute pancreatitis 2-6 years previously. Results were improved or normal in 12 of 15 patients re-tested 1 year after the attack of pancreatitis, but 4 out of 6 still had abnormal results 2-6 months after the attack. The data suggest that an attack of acute pancreatitis may impair exocrine pancreatic function for several months.

4-Aminobenzoic Acid↗
PubMed1983

Assessment of a rapid pancreatic isoamylase assay as a screening test for chronic pancreatic disease.

A new, rapid assay for pancreatic isoamylase (PIA) has been evaluated in normal subjects and patients with either proven chronic pancreatic disease or diseases in which chronic pancreatitis commonly enters the differential diagnosis. A wide normal range limited the diagnostic usefulness of the test. In non-pancreatic disease the serum levels of PIA were normal in 107 of 109 patients with non-pancreatic disease, but only 3 of 16 patients with chronic pancreatitis and proven exocrine insufficiency had a low PIA level, and variable levels occurred in pancreatic carcinoma. These results suggest that measurement of serum PIA is of limited value as a screening test for chronic pancreatic disease.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1983

Vitamin status in patients on maintenance haemodialysis.

The vitamin status (vitamins A, E, C, Carotene, B1, B2 and B6) of 18 patients receiving maintenance haemodialysis was assessed. All patients were receiving vitamin B1, B2 and B6 supplements and the effect of stopping these supplements on subsequent vitamin status was further studied. Apart from vitamin A, which was significantly increased in all patients, the mean level of all other vitamins was similar to the control group. Despite these normal group means, individual patients could be identified with low or marginally low vitamin C and B2 levels. When the vitamin B complex supplements were stopped, vitamin B2 and B6 remained normal over the subsequent six months maintenance haemodialysis but there was deterioration in vitamin B2 status. Leucocyte vitamin C levels responded well to oral supplements of 400 mg vitamin C per day. This study suggests that vitamin C and B2 supplements are necessary in patients receiving maintenance haemodialysis, other vitamin supplements being unnecessary.

Avitaminosis↗
PubMed1982

Comparison of the diagnostic value of serum pancreatic isoamylase and immunoreactive trypsin measurement in patients with cystic fibrosis.

We have measured serum immunoreactive trypsin (IRT) and serum pancreatic isoamylase (PIA) activities using commercially available kits in 37 cystic fibrosis (CF) patients and 46 hospital controls of similar age range. Immunoreactive trypsin was more often abnormal than PIA (26/37 v 18/37 abnormal respectively); IRT will be particularly useful as an additional diagnostic test in older children, in whom interpretation of the sweat test may be difficult, as 14/15 CF patients aged over 10 years had abnormal IRT results. Less than half of our patients who were aged between one and nine years had abnormal IRT activity, limiting the value of the test, though a low activity would still support the diagnosis of CF. Comparison with faecal fat estimations in 31 patients suggests that neither IRT nor PIA can be used as a non-invasive test of pancreatic function in order to identify those few CF patients who do not require pancreatic enzyme supplements.

Adolescent↗
PubMed1981

Clinical value of serum immunoreactive trypsin concentration.

The clinical value of estimation of serum concentrations of immunoreactive trypsin was evaluated by studying 46 healthy controls, 23 controls in hospital, 44 patients with chronic pancreatic disease, and 184 patients with non-pancreatic conditions in which pancreatic disease commonly enters into the differential diagnosis. Serum trypsin concentration had a log normal distribution in the controls, and the calculated normal range was considerably wider than that previously reported. The concentration was abnormal in only 13 out of 27 patients with chronic pancreatitis and was extremely variable in patients with pancreatic cancer. Abnormal results occurred in 11% of the patients with non-pancreatic disease. Eighteen patients had a subnormal trypsin concentration, of whom six did not have pancreatic disease and 12 had either chronic pancreatitis or pancreatic cancer. There was no correlation between serum trypsin concentration and mean tryptic activity as measured by the Lundh test. Of 11 patients with pancreatic steatorrhoea, only seven had subnormal trypsin concentrations. There results suggest that the serum concentrations of immunoreactive trypsin has a low specificity and sensitivity for pancreatic disease and does no reflect the degree exocrine insufficiency in patients with proved chronic pancreatitis.

Celiac Disease↗
PubMed1981

Preliminary evaluation of a single-day tubeless test of pancreatic function.

The test for pancreatic exocrine function using N-benzoyl-L-tyrosyl-p-aminobenzoic acid (BTP test) does not require duodenal intubation, but misleadingly abnormal results often occur in patients with liver or bowel disease because the p-aminobenzoic acid (PABA) released by chymotrypsin hydrolysis of the peptide either is not conjugated or is malabsorbed. This study evaluated a modified BTP test, using a tracer dose of 14C-PABA to eliminate misleading results, to assess exocrine function from a single six-hour collection of urine. The test clearly distinguished all patients with pancreatic steatorrhoea from normal subjects and identified patients with less severe pancreatitis as often as did the Lundh test. Furthermore, in patients with bowel or liver disease the misleadingly abnormal results of the unmodified BTP test were eliminated by the modified test in all but one case. These findings suggest that the modified BTP test provides a practical alternative to conventional tests of pancreatic function that entail duodenal intubation.

4-Aminobenzoic Acid↗
PubMed1981

Benign carotenaemia in children.

Six children presented with yellow pigmentation of the skin as a result of carotenaemia, and 5 were aged less than 1 year when this was first noted. Serum carotene levels depend on carotene intake, and absorption is promoted if food is of a fine texture. Five of the children were fed a partly homogenised diet. Pigmentation resolved when the carotene intake was reduced. This condition should be suspected, especially in young children, if the skin is yellow while the sclera remains a normal colour.

Carotenoids↗
PubMed1981

Vitamin status in treated patients with cystic fibrosis.

The water-soluble (B1, B2, B6, C, folic acid) and fat-soluble vitamin (A, carotene, E, and D) status of 36 patients with cystic fibrosis was assessed and compared with a control group of 21 age-matched normal children. Twenty-seven of the patients were receiving vitamin supplements (except folic acid and vitamin E) at the time of investigation. Vitamin B1, B2, and B6 status was adequate in all patients, and there was little evidence of folic acid deficiency. Vitamin C stores might not have been adequate in some of these patients, despite daily supplements with 50 mg of the vitamin. Steatorrhoea, often severe, was present in most of them. Serum carotene and vitamin E concentrations were low in over 90% of patients and were related to the severity of steatorrhoea. Vitamin A was low in over 40% of the patients despite daily vitamin supplements of 4000 IU and correlated with the serum retinol-binding protein level. Serum 25-OH cholecalciferol was low in some patients whether or not they were receiving a daily supplement of 400 IU vitamin D. In a short-term supplementation trial with water-miscible preparations of vitamin A and E in 14 patients, the serum levels of both vitamins responded well to 2 weeks of treatment with 50 mg vitamin E and 4000 IU vitamin A. Except for serum vitamin A, which was lowest in patients with the poorest clinical grading, the other vitamins were not influenced by the clinical grade of the patients.

Adolescent↗
PubMed1979

The effect of wheat bran and pectin on paracetamol absorption in the rat.

1. The absorption of an oral dose of paracetamol was measured in rats given either a basal fibre-free diet, or the basal diet with either pectin or bran added. 2. Urinary excretion of the oral dose was significantly greater during the first 8 h in the pectin-fed rats compared with those on basal diet, though cumulative excretion after 72 h was the same. 3. Free paracetamol levels in the plasma were significantly higher in the pectin-fed rats compared with those on basal diet at 30, 60, 90 and 120 min after the oral dose. 4. The plasma half-life of intravenously-injected paracetamol was shorter in the pectin-fed rats than in those on basal diet alone, but the antipyrine half-lives were not significantly different. 5. Pectin feeding had no effect on either the apparent volume of distribution of paracetamol and antipyrine, or on the rate of gastric empyting. 6. Perfusion of the whole length of the small bowel showed a significantly greater capacity for paracetamol absorption in the pectin-fed rats. 7. Bran had no effect on paracetamol absorption. 8. It was concluded that dietary fibre intake affects drug absorption and that the effect varies with the type of fibre. Unexpectedly pectin accelerates rather than retards absorption of paracetamol, though the mechansim of this effect is unknown.

Acetaminophen↗
PubMed1979

The effect of pectin on the structure and function of the rat small intestine.

1. The effect of pectin on the structure and function of the rat small intestine was compared with that of a standard pellet diet and of a fibre-free basal diet. 2. The length and wet weight of the small bowel was significantly greater inpect in-fed rats than in either pellet- or basal-diet-fed rats. 3. Histological measurements of longitudinal sections from the small bowel showed a significantly greater crypt depth and muscle layer thickness in the mid-jejunum and ileum of the pectin fed rats. Villous height showed less variation. 4. The specific activity of alkaline phosphatase (EC 3.1.3.1) and leucyl-beta-naphthylamidase (EC 3.4.11.1) in mucosal scrapings was significantly lower in the upper jejunum of pectin-fed rats compared with either of the other dietary groups. The differences were not so marked in mid-jejunum or ileum. 5. Glucose absorption measured in vivo from jejunal and ileal loops was similar in all three dietary groups. 6. With two minor exceptions there were no significant differences in any of these measurements between the pellet- and basal-diet-fed rats. 7. These findings could be explained by increased epithelial cell turnover caused by pectin. The possible mechanisms of this are discussed. 8. The effect of pectin on the human small bowel requires study before it can be widely prescribed in man.

Alkaline Phosphatase↗
PubMed1979

The gastrointestinal absorption of paracetamol in the rat.

The absorption of [3H]paracetamol by rat small intestine, colon and stomach was studied in vivo and in vitro. Small intestinal in vivo studies, using a wide range of drug concentrations, showed that absorption was efficient and uniform throughout the small bowel, no site showing preferential absorption. Double reciprocal and direct plots indicated first order kinetics. The pattern was not observed when uptake was occurring from high concentrations of paracetamol in suspension. Gastric and colonic in vivo studies showed that there was appreciable absorption of [3H]paracetamol from these sites. In vitro studies using everted intestinal sacs showed no effect on paracetamol transfer when the incubation temperature was lowered to 10 degrees C or when iodoacetate (5 X 10(-2)M) and 2.4 dinitrophenol (5 X 10(-4)M) was added to the incubation medium. There was, however, a significant reduction in transfer of paracetamol against a concentration gradient of 10:1 applied across the mucosa. These data suggest that the uptake of paracetamol is by a passive transport process and confirm the efficiency of paracetamol absorption observed indirectly by others.

Acetaminophen↗