Biomedical subjects
Publications and source records attributed to K Gyr.
The case of a 30-year-old woman with intra- and extrahepatic biliary dilatations (Caroli's disease) is reported. The features of the disease and its differential diagnosis are discussed. Special reference is given to the diagnostic approach by endoscopic retrograde cholangiography and to treatment with Chenodeoxy-cholicacid.
Formazan cells were less numerous in the peripheral blood of vervet monkeys (Cercopithecus aethiops) receiving a "O" protein-low calorie diet than in animals fed a full or a protein but not calorie deficient diet.
The number of white blood cells and of polymorphonuclear leukocytes remained unchanged in vervet monkeys (Cercopithecus aethiops) receiving a "O" protein diet. The motility of the polymorphonuclear leukocytes and their phagocytic and killing indices with and without leukokinin stimulation decreased in protein-depleted animals. Acid cathepsin decreased, DNA relatively increased, and peroxidase, alkaline phosphatase, acid phenylphosphatase, and lysozyme reached higher levels in the polymorphonuclear leukocytes of animals on a "O" protein diet.
Diagnostic, therapeutic and prognostic aspects are interpreted on the basis of two cases of Echinococcus alveolaris. Both patients had undergone partial hepatectomy and were subsequently treated chemotherapeutically. In one case dehydroemetine and mebendazole (Vermox, Janssen), and in the other case metrifonate (Bilarcil, Bayer A.G.) were used. The diagnosis of alveococcosis of the liver was demonstrated in one case histologically on the occasion of appendectomy, and in the other case by the indirect immunofluorescence test and passive haemagglutination. In case of suspected alveococcosis these serological are imperative, as they are the most reliable methods of demonstrating this disease. The latest trend in theraphy aims at a combination of surgery and chemotherapy. Mebendazole seems to be promising as an anthelmintic agent for the treatment of alveococcosis. Remission of the disease was obtained in either case.
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Exocrine pancreatic function was investigated by means of the Lundh test model in dogs with chronic duodenal and gastric fistulas. The test was standardized and the effect of glucagon on exocrine pancreatic secretion was evaluated. The mean tryptic activity detected in 18 tests in 6 dogs was 32.25 +/- 5.25 muEqH+/minute/ml, which is considerably higher than that observed in man. The administration of glucagon was followed by a significant decrease (30.8%) in the volume of the duodenal contents and a more pronounced depression of the enzyme concentrations (trypsin 59%, chymotrypsin 53.3%). It is concluded that the Lundh test affords a valuable experimental model for the investigation of exocrine pancreatic function in dogs.
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Six Patas monkeys were fed a protein-free diet while 16 animals of the same species receoved a standard monkey diet. The protein-depleted monkeys showed reduced absorption of folic acid but not Dxylose, and 5 out of 6 exhibited depressed exocrine pancreatic function. When challenged with Vibrio cholerae, animals with reduced folic acid absorption and pancreatic enzyme production excreted the micro-organisms for a longer time.
Advantages and disadvantages of various laboratory techniques used for the diagnosis of intestinal protozoa are discussed. The importance of a correct parasitological diagnosis is emphasized. The MIF procedure has been investigated with regard to its reliability and found to be very effective due to its high diagnostic yield and reproducibility in repeated examinations. The incidence rates found in our material agreed well with those in the literature, thus enhancing the value of the MIF procedure. The feces of 1005 persons returning from the tropics during the first 8 months of 1975 have been examined by the MIF technique and assessed for intestinal protozoa. Apathogenic amebae were found four times as often as E. histolytica. The incidence was 52.7/1000 for E. histolytica and 70.6/1000 for Giardia lamblia. Multiple parasitosis is often diagnosed. E. histolytica is very likely to be encountered when two or three apathogenic amebae are present.
One gram N-benzoyl-L-tyrosyl PABA was orally administered to 24 controls, 15 patients with chronic exocrine pancreatic disease, 13 patients after an attack of acute pancreatitis, two patients with gluten-sensitive enteropathy, and 10 patients with biliary tract disease, peptic ulcer, or other pathology of the gastrointestinal tract. In the presence of chymotrypsin, PABA is split from the peptide and excreted in the urine. The amount of PABA excreted serves as a parameter of exocrine pancreatic function. In 51 patients, exocrine pancreatic secretion was also assessed by the Lundh test. In the control group a mean of 59-6 +/- 12-2% (mean +/- 2 SD) of the peptide-PABA was excreted over a period of six hours. PABA excretion in exocrine pancreatic deficiency was significantly less (P less than 0.001) than in controls. With one exception no overlap of data was noted. In the group with exocrine pancreatic deficiency, a significant relationship was shown between the PFT and the Lundh test. Reproducibility in duplicate test was excellent. The present data justify further investigations of this procedure as a possible new oral test of exocrine pancreatic function.
Five groups of eight vervet monkeys (Cercopithecus aethiops) were fed regular monkey chow, low protein (LP), low B-vitamin complex (LBV), low protein - low B-vitamin complex (LB-LBV), or protein - low calorie (LP-LC) diet, respectively, for eight weeks. Hematocrit values, hemoglobin, BUN, total protein, albumin, riboflavin and body weight decreased, the ratio of dispensable/indispensable amino acids increased in all animals receiving a deficient diet. Total globulin, IgG and IgM remained unchanged in vervets on LBV diet; panthotenic acid and cyanocobalamin in animals receiving LBV, LP or LP-LC chow; and pyridoxal on the LP or LP-LC diet.
Five groups of vervet monkeys (Cercopithecus aethiops) were fed regular monkey chow, low protein (LP), low B-vitamin complex (LBV), LP-LBV, or low protein- low calorie (LP-LC) diets, respectively. After eight weeks the animals were infected with cholera vibrios. IgG, IgA and IgM increased in the sera of all animals after the challenge but the avidity of the immunoglobulins was lower in vervets on LP diets. Diarrhea and excretion of vibrios lasted longer in animals consuming less protein.
A 36-year-old woman was admitted to hospital with a first attack of acute intermittent porphyria. At the same time increased serum levels of amylase and lipase as well as an increased amylase clearance to creatinine clearance ratio were observed, permitting the diagnosis of acute pancreatitis. The etiology of the latter could not be determined. In addition, elevation of indirect bilirubin without evidence of hemolysis was observed Gilbert's syndrome was suspected. 40 weeks after the first episode, a second attack of identical abdominal pain was noted, with elevation of pancreatic enzymes in the serum. There is evidence that acute intermittent porphyria and acute relapsing pancreatitis may have some etiological connection in this patient.
1 g of N--benzoyl-L-tyrosyl-PABA was administered orally to 50 test persons, i.e. controls and patients with known pancreatic disease. In the presence of chymotrypsin, paraaminobenzoic acid (PABA) is split from the peptide and excreted in the urine. The amount of PABA excreted serves as parameter of exocrine pancreatic function. In the control group a mean of 59.2 +/- 6.2% of the peptide PABA was excreted over a period of 6 h. PABA excretion in exocrine pancreatic deficiency was significantly less (p less than 0.001) than in controls. No overlap of data was noted. Gastric emptying rate - estimated by using indium-113m microcolloid - did not appear to influence urinary PABA excretion.
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The Lundh test for exocrine pancreatic function was performed on 376 patients. An increased trypsin concentration in duodenal secretion (greater than 28.9 IU/ml) was measured in eight. Seven of them had symptoms of pancreatic disease, six of them with acute episodes. Eight further cases have been reported in the literature, at least two of them definitely having pancreatic disease. Both in the reported cases and in the authors' study the proportion of patients with abnormally raised enzyme concentrations among the group of patients with acute or subacute pancreatitis was significantly greater than in a control group. It is possible that abnormally raised enzyme concentration is due to subacute pancreatic disease and may at times be the only finding. An abnormally raised enzyme concentration in the Lundh test should therefore simply be classified as such and not be taken as the expression of normal or even "excellent" pancreatic function.
Exocrine pancreatic function in 19 patients with pancreatic disease and in 14 of 16 controls was measured by secretin stimulation and by the Lundh test on two different occasions. Peak bicarbonate concentration in the Lundh test emerged as the most reliable parameters. No additional diagnostic value was obtained by measuring enzymes after secretin injection. In 6 patients with chronic and in 8 of 13 patients with acute pancreatitis, both tests gave results that agreed with each other. The remaining 5 patients showed either an abnormal secretin value or an abnormal Lundh test. This is consistent with the wide variation seen in acute pancreatitis. It is concluded that the Lundh test as well as the secretin test were of value in the assessment of chronic pancreatic disease. The secretin test may be slightly more sensitive to mild and acute pancreatic damage than is the Lundh test. However stimulation of the pancreas by a test meal is easier to perform and more economic.
Six patas monkeys (Erythrocebus patas) were fed a protein-free diet. Sixteen animals of the same species received a standard monkey diet. The protein-depleted patas showed reduced absorption of folic acid but not D-xylose, and 5 out of 6 had a decrease in the exocrine pancreatic function. Animals with reduced folic acid absorption and pancreatic enzyme production developed a longer lasting diarrhoea and excreted the microorganisms for a longer time when challenged with Vibrio cholerae.