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Biomedical subjects

K Jacob

Publications and source records attributed to K Jacob.

At least 55 records · Page 3Linked to original sources

Beta 3-adrenergic-receptor allele distributions in children, adolescents and young adults with obesity, underweight or anorexia nervosa.

OBJECTIVE: The missense mutation (64Trp to 64Arg) in the beta 3-adrenergic-receptor has previously been described to confer a genetic predisposition to the development of obesity. DESIGN: To test the hypothesis we evaluated allele frequencies in children, adolescents and young adults who belonged to different weight groups that were delineated with percentiles for the body mass index (BMI; kg/m2). SUBJECTS: 99 underweight probands (BMI < or = 15th percentile). 80 normal weight probands (BMI: 5th-85th percentile). 238 obese children and adolescents (BMI > or = 97th percentile). 84 patients with anorexia nervosa (AN). MEASUREMENTS: The cohorts were screened by polymerase chain reaction with subsequent restriction fragment length polymorphism (PCR-RFLP) analysis. Data were statistically analysed for association. In addition to these case control studies, the transmission disequilibrium test (TDT) was applied to 80 families of obese probands and to 52 families of patients with AN. RESULTS: Both the tests for association and linkage were negative. The Trp64Arg allele frequencies in the three weight groups (obesity: 0.071; normal weight: 0.081; underweight: 0.056) and the AN patients (0.054) were similar. Extremely obese individuals showed no excess of the Trp64Arg allele. No homozygotes for the Trp64Arg allele were detected. CONCLUSION: Heterozygosity for the Trp64Arg allele is not of major importance in regulation of body weight in individuals younger than 35 y. Additionally, the extreme obese subgroup is not enriched for the polymorphism.

Adolescent↗

The effect of dietary alpha-tocopherol on the experimental vasogenic brain edema.

It has become increasingly obvious that free radicals and lipid peroxidation contribute to brain damage from trauma by mediating edema formation and ischemia. It should, therefore, be expected that the actual level of endogenous antioxidants, as for example, vitamin C and E in plasma, has an influence on the extent of free radical-induced injury. In this communication we investigate the effect of dietary changes in the free radical scavenger alpha-tocopherol on posttraumatic cerebral swelling in Sprague-Dawley rats. Low, normal, and high plasma levels of alpha-tocopherol were established by respective diets supplied over 2 weeks. Animals of all groups received the same food without alpha-tocopherol. One group was fed a vitamin E-free diet. The pellet-food for the other animals was supplemented either with 5-mg alpha-tocopherol/100 g or 250-mg alpha-tocopherol/100 g dry mass, respectively. The vitamin E-free diet lowered the alpha-tocopherol level in plasma to 30% of control, whereas supplementation with 250 mg/100 g led to a plasma concentration of 200% of control. The animals were then subjected to a focal cold injury of the left cerebral hemisphere. Twenty-four hours after trauma the brain was removed and the water content of each hemisphere was determined by the wet-dry weight method. Swelling of the traumatized hemisphere was calculated as the difference in weight between the traumatized and contralateral control hemisphere. The 2-week alpha-tocopherol supplementation or -deletion diet, respectively, did not either afford significant reduction or lead to an enhancement of traumatic brain swelling. Likewise, the increase in brain water content of the traumatized hemisphere was not affected. It is concluded that supplementation or depletion of alpha-tocopherol for 2 weeks, resulting in a marked increase or decrease of the vitamin E plasma level, does not influence formation of posttraumatic vasogenic brain edema.

Animals↗

Haem precursors and porphobilinogen deaminase in erythrocytes and lymphocytes of patients with acute intermittent porphyria.

Patients with AIP can be subdivided into three different groups concerning their PBGD activity in erythrocytes: The first of which has lowered, the second overlapping and the third normal PBGD activity. Out of 385 AIP patients 87% had lowered, 8% had overlapping and 5% had normal PBGD activity. Gene carriers of AIP having slight, moderate or high metabolic aberrations of excretion parameters are recognized by analysis of urinary haem precursors and faecal porphyrins. The haem precursor excretion of the groups with lowered, overlapping and normal PBGD activity in erythrocytes compared to each other is not significantly different but differs significantly (p < 0.001) from the normal values. One individual suffering from AIP was detected in a family with normal PBGD. Lymphocytes can be stored in liquid nitrogen for 3 months without loss of PBGD activity. Specific PBGD activity in lymphocytes is 5% from specific PBGD activity in erythrocytes. In AIP patients with lowered specific PBGD activity in erythrocytes specific PBGD activity is lowered to the same extent in their lymphocytes.

Adult↗

Measurement of free triiodothyronine in intensive care patients--comparison of two routine methods.

One hundred sera from intensive care patients, and 93 sera from endocrinological outpatients were used for a comparison between two automated assays for free triiodothyronine (Enzymun Test, and Elecsys 2010, both Boehringer Mannheim, Mannheim, Germany). In outpatients a good correlation between both methods was found (r = 0.932). In contrast, comparability between the two assays was poor in intensive care patients (r = 0.75, after exclusion of two outliers); significantly more values in the hypothyroid range were found with the Elecsys 2010 assay (n = 83, compared with n = 33 with the Enzymun Test; chi 2 test p = 0.001). We conclude that routine measurement of free triiodothyronine which has the theoretical advantage of quantifying the biologically active fraction of thyroid hormones may have methodological limitations in severely ill patients.

Aged↗

Characterization of selected strongly and weakly invasive sublines of a primary human melanoma cell line and isolation of subtractive cDNA clones.

Invasion of basement membranes is a key step in systemic spread of tumour cells. To analyze genetic mechanisms involved in this process, we have selected strongly and weakly invasive sublines with stable phenotypes from a primary human melanoma cell line by repeated passage through a reconstituted basement membrane in vitro. The sublines differed approximately 5-fold in their invasive potential. Invasiveness correlated with better attachment and overexpression of the integrin alpha v/beta 3 (vitronectin/laminin-receptor). Treatment with retinoic acid inhibited proliferation in both sublines and invasion in the weakly invasive cells but stimulated invasion in the strongly invasive subline. Northern-blot analyses revealed equal levels of mRNA expression regarding collagenase type-IV and retinoic-acid receptors but enhanced expression of TIMP-2 mRNA in weakly invasive cells. The 2 sublines differed significantly in their respective DNA ploidy when compared to the wild-type Mel Im cell line, suggesting that they represent heterogeneous clones present in the primary tumour. We have started to exploit this in vitro system for tumour heterogeneity to clone genes involved in invasion. By a subtractive cDNA cloning strategy, 12 partial cDNA clones were obtained that are specifically overexpressed in the strongly or weakly invasive subline. These results illustrate that stable genetic alterations lead to heterogeneous subpopulations within primary melanomas which differ in their ability to invade basement membranes and interact with components of the extracellular matrix.

Actins↗

Modulation of the endogenous leukotriene production by fish oil and vitamin E.

We investigated the effects of fish oil and vitamin E on the endogenous leukotriene production. 10 healthy volunteers were supplemented for 1 week with fish oil (containing 40 mg/kg body weight per day of eicosapentaenoic and docosahexaenoic acid), vitamin E (540 mg, i.e., 800 IU of D-alpha-tocopherol per day), or with both agents. Treatment resulted in a significant increase in the eicosapentaenoate concentration in red blood cell membranes and/or in the vitamin E concentration in serum. In addition, nine obese patients were investigated who were on a hypocaloric diet including 10 mg vitamin E/day for 8 weeks. This diet was associated with a significant decrease in serum vitamin E concentration. The urinary concentration of leukotriene E4 plus N-acetylleukotriene E4 served as a measure for the endogenous leukotriene production. Fish oil reduced leukotriene production in eight of the 10 healthy individuals. After vitamin E supplementation, urinary leukotrienes were significantly reduced in all of the healthy volunteers. The combination of vitamin E plus fish oil had no synergistic effect on leukotriene production in the individuals tested. The decrease in serum vitamin E concentration during the hypocaloric, 10 mg vitamin E/day diet was associated with an increase in urinary leukotrienes in 8 of the 9 obese patients. Urinary prostaglandin metabolites, determined as tetranorprostanedioic acid, increased or decreased in parallel with urinary leukotrienes in most individuals; however, changes were less pronounced than those observed with leukotrienes. We conclude that the endogenous leukotriene production can be reduced effectively by high doses of fish oil or vitamin E, whereas vitamin E depletion is associated with an increase in leukotriene generation.

Adult↗

[Endoscopic and extracorporeal shock wave lithotripsy of salivary calculi].

Shock wave lithotripsy of salivary gland stones has become more and more efficient in the treatment of sialolithiasis during the last years. We use two different methods in our hospital: Extracorporeal shock wave lithotripsy (ESWL) and endoscopically intracorporeal lithotripsy (EISL). The results of both therapies are compatible; 60-70% could be successfully treated. The indication is different due to the localisation of the salivary gland stone. Stones that are located in the glandula or very proximal in the duct should be fragmented by extracorporeal lithotripsy. Stones located in the duct and multiple intraductal stones should be treated by the intracorporeal method. Clinical experiments showed that some salivary stones do not fragment easily. The reason is still unknown. We examined the ability of fragmentation in relation to the physicochemical analysis of the stone. The stones were examined by infrared spectroscopy. This study revealed that pure carbonate apatite stones are more difficult to destroy than stones containing some protein.

Combined Modality Therapy↗

Variations of steroid hormone metabolites in serum and urine in polycystic ovary syndrome after nafarelin stimulation: evidence for an altered corticoid excretion.

To evaluate the clinical relevance of testing pituitary-ovarian responses in patients suffering from polycystic ovary syndrome (PCOS) with the GnRH agonist nafarelin, a 1.2-mg dose of nafarelin was given intranasally to 19 women with PCOS and 15 healthy premenopausal women. The subsequent analysis of steroids in both serum and urine during the test was carried out at several time points for up to 24 h. Serum levels of 17 alpha-hydroxyprogesterone were elevated at all time points of the test in PCOS patients vs. controls [at baseline, 3.5 +/- 0.2 vs. 1.8 +/- 0.1 nmol/L (P < 0.001); at 24 h, 9.9 +/- 0.9 vs. 4.9 +/- 0.3 nmol/L (P < 0.001)]. Basal levels of androstenedione were higher in the patient group, but there was no significant change during the test in either group. Serum testosterone levels were also found to differ in PCOS patients compared with the control values at baseline (2.2 +/- 0.2 vs. 1.5 +/- 0.1 nmol/L; P < 0.05) and after nafarelin treatment (at 24 h, 3.2 +/- 0.4 vs. 1.8 +/- 0.2 nmol/L; P < 0.05). Serum estradiol levels rose significantly in both groups during the test; the posttest levels were significantly higher in PCOS than in controls. The PCOS patients displayed a significant increase in androgen and gestagen metabolites as well as in glucocorticoid metabolites excreted in the urine during the 24 h. In the control subjects, except for 17 alpha-hydroxypregnanolone, which rose significantly, none of the urinary steroids investigated showed relevant changes during the nafarelin test. The posttest excretion of allo-tetrahydrocortisol (1.4 +/- 0.2 vs. 0.3 +/- 0.1 mumol/g creatinine; P < 0.001) and the increase in 17 alpha-hydroxypregnanolone excretion (1.4 +/- 0.2 vs. 0.3 +/- 0.1 mumol/g creatinine; P < 0.001) were distinctly higher in PCOS patients than in the controls; the diagnostic sensitivity of the combination of both parameters was 89% at a 93% specificity. Thus, measurements of 17 alpha-hydroxyprogesterone levels in serum and of urinary allo-tetrahydrocortisol and 17 alpha-hydroxypregnanolone after nafarelin treatment make this stimulation test a valuable diagnostic tool for identifying PCOS patients. The significant changes in the excretion of urinary androgen and gestagen metabolites, unmasked by GnRH agonist stimulation, suggest a functional alteration of the pituitary-ovarian axis. The reason for the increased excretion of glucocorticoid metabolites after nafarelin stimulation remains to be clarified.

Administration, Intranasal↗

Excretion pattern of faecal coproporphyrin isomers I-IV in human porphyrias.

The relative proportions of the four coproporphyrin isomers I-IV were analysed in faeces of 20 healthy subjects and 60 patients suffering from one of the seven common types of hepatic or erythropoietic hereditary porphyrias. A newly developed, reliable method for sample preparation was applied, using reversed-phase thin layer chromatography for the isolation of naturally occurring coproporphyrin free carboxylic acids. Accurate separation and quantitation of the individual isomers I-IV were achieved with the help of ion-pair high-performance liquid chromatography. The four coproporphyrin isomers I-IV were positively identified by on-line scanning of their fluorescence spectra in the emission and excitation modes. Recovery rates with this new analytical procedure were between 90 and 100%, and coefficients of variation varied between 0.8 and 5.7% (N = 7). Diagnostically important findings were greatly increased proportions of isomer I and decreased proportions of isomers III, II and IV in erythropoietic porphyrias, such as congenital erythropoietic porphyria and protoporphyria. Significantly increased proportions of isomers III, II and IV, on the other hand, were observed in acute hepatic porphyrias, e.g. acute intermittent porphyria and porphobilinogen synthase deficiency porphyria, as compared with porphyria cutanea tarda (p < 0.005 and p < 0.03, respectively). Inversion of the faecal coproporphyrin III to I ratios and markedly elevated percentages of the atypical isomers II and IV were important diagnostic markers for variegate porphyria and hereditary coproporphyria. The highest proportions of isomer III were found in hereditary coproporphyria, where the amount of the isomers II and IV exceeded that of isomer I. Asymptomatic carriers of the relevant gene defect in families with hereditary coproporphyria could be detected by an increased faecal coproporphyrin III to I ratio. Our results clearly demonstrate the potential of faecal coproporphyrin I-IV isomer ratios for the diagnosis and differential diagnosis of hereditary porphyrias.

Adult↗

The production of porphyrins from delta-aminolaevulinic acid by Haemophilus parainfluenzae.

Porphyrin production by the haemin-independent Haemophilus parainfluenzae in the diagnostic porphyrin test, which determines the X-factor requirement in Haemophilus spp., was analysed quantitatively by applying modern high-performance liquid chromatographic (HPLC) methods. Ion-pair reversed-phase HPLC enabled the simultaneous separation of all porphyrin intermediates and their isomers of haem biosynthesis produced by the bacteria. The pH-dependence of porphyrin production and the respective composition of the porphyrins within the bacterial cells and in the supernate were investigated. A pH optimum of 6.9-8.0 for the production of porphyrins was found and there were marked differences in the porphyrin profiles at different pH values.

Aminolevulinic Acid↗

Composition of urinary coproporphyrin isomers I-IV in human porphyrias.

The urinary distribution and relative proportions of the four coproporphyrin isomers I-IV were investigated in 50 patients suffering from hepatic and erythropoietic types of hereditary porphyrias. A highly efficient sample preparation method was applied to isolate urinary coproporphyrins, the isomer ratios of which were quantitated by isocratic ion-pair high-performance liquid chromatography. Results showed a significant decrease (p < 0.001) of the proportion of coproporphyrin I in acute hepatic porphyria (acute intermittent porphyria, hereditary coproporphyria, variegate porphyria, porphobilinogen synthase deficiency porphyria) as compared with chronic hepatic porphyria (porphyria cutanea tarda, chronic hepatic porphyria type B and C) (13.2 +/- 5.3%, mean +/- S.D., vs. 31.4 +/- 11.5%). Conversely, the proportion of isomer III was significantly higher (p < 0.001) in acute hepatic porphyria than in chronic hepatic porphyria (80.9 +/- 5.2% vs. 62.2 +/- 10.9%). As expected, the highest level of coproporphyrin I (90.0 +/- 1.9%) was found in congenital erythropoietic porphyria. The atypical coproporphyrins II and IV were detected in all types of porphyria analysed and ranged from 0.2 to 9.0%; no significant differences were seen between acute and chronic hepatic porphyrias. The diagnostic importance of the isomer ratios of coproporphyrins I and III has been confirmed in our study, while the significance of the atypical coproporphyrin isomers II and IV is still unclear at present.

Adult↗

Application of ion-pair high-performance liquid chromatography to detection of the atypical coproporphyrin isomers II and IV in human faeces.

A highly selective and sensitive method has been developed for the detection of small amounts of the atypical isomers II and IV of coproporphyrin in human faeces. This method combines liquid-liquid extraction and solid-phase sampling techniques using talc and C18-modified silica gel as the sorbents. Simultaneous separation of the four coproporphyrin isomers I-IV was achieved by isocratic ion-pair high-performance liquid chromatography. Stool samples of healthy subjects (n = 12) contained 1.1 +/- 0.4% (mean +/- S.D.) isomer II and 2.2 +/- 0.9% isomer IV of total coproporphyrins. A somewhat higher content of isomer II (2.7%) and isomer IV (5.4%) was found in faeces of a patient suffering from porphyria variegata.

Chromatography, High Pressure Liquid↗

Application of ion pair high performance liquid chromatography to the analysis of porphyrins in clinical samples.

Reversed phase ion pair chromatography is a highly selective separation technique for the determination of free porphyrin carboxylic acids from human materials. Isocratic and gradient elution methods can be used to analyse porphyrin isomers and to establish porphyrin profiles for the biochemical diagnosis of porphyrias. Ion pair high performance liquid chromatography led to the discovery of the atypical isomers II and IV of uroporphyrin and coproporphyrin in human urine. Advantages and limitations of the ion pair technique are discussed.

Chromatography, High Pressure Liquid↗

The isomer ratios of urinary coproporphyrins I--IV are pH-dependent.

The percentage of porphyrinogens as related to total porphyrin excretion was determined in the urine of healthy subjects. Acidic urines (pH 5.0 to 5.9) contained 62.9 +/- 10.7% (means +/- s, N = 11) porphyrinogens, whereas in neutral urines (pH 6.0 to 7.2) a somewhat lower percentage (51.2 +/- 15.3%, N = 11) was detected. However, there was no significant difference between the mean porphyrinogen contents of acidic and neutral urines. Evidence was found for a previously unreported pH-dependent influence on the isomer ratios of urinary coproporphyrins I and III. Acidic urines (N = 18) from healthy subjects showed significantly higher percentages of isomer I (27.1 +/- 6.4%), isomer II (2.7 +/- 1.1%), and isomer IV (5.0 +/- 1.3%) as compared to respective values from neutral urines (22.2 +/- 5.1% isomer I, 0.6 +/- 0.6% isomer II, and 1.5 +/- 1.3% isomer IV; N = 16, p less than 0.001). Conversely, the percentage of isomer III was markedly lower in acidic urines than in neutral urines (65.1 +/- 7.9% vs. 75.9 +/- 5.4%; p less than 0.001). The same relationship was confirmed in an individual subject by analysis of a series of urines (N = 13) with pH values ranging from 5.4 to 7.3. These results point to the possibility that the atypical coproporphyrin isomers II and IV are predominantly formed by an increased isomerization rate of coproporphyrinogens under acidic intravesical conditions.

Chromatography, High Pressure Liquid↗

[2 year interferon therapy of metastatic carcinoid tumor].

A 39 year old male patient was treated with daily 5 X 10(6) IU interferon alpha 2b s.c. for 22 months because of advanced carcinoid tumor. Objective response was achieved with greater than 50% reduction of 5-HIAA-excretion. Multiple metastases (liver, lung, bones, thyroid gland) were not progressing in size. An unintentional omission of treatment resulted in a rapid biochemical and morphological tumor progression. Reversibility was achieved with reinstitution of effective interferon therapy. Thus, interferon therapy of advanced carcinoid tumor is able to induce a long-term objective response. It seems to be superior to conventional chemotherapy.

Adult↗

Isocratic ion-pair high-performance liquid chromatographic methods for the determination of uroporphyrin and coproporphyrin type II and IV isomers in human urine.

Urinary porphyrins of porphyric patients were isolated as their methyl esters by using a simple, modified thin-layer chromatographic system. Existing methods for the isocratic ion-pair high-performance liquid chromatographic separation of uroporphyrin and coproporphyrin isomers were decisively improved by elevating the column temperatures, changing the types of columns used and modifying the eluent compositions. These techniques were applied to the determination of the isomeric distribution of uroporphyrins and coproporphyrins isolated from urines of patients in the acute or latent phase of acute intermittent porphyria. In these urines relatively high contents of the atypical uroporphyrins II (2-5%) and IV (13-19%) were found. The coproporphyrin fractions contained significantly smaller amounts of the atypical isomers II (1-2%) and IV (2-5%), the presence of which was demonstrated for the first time in such urines. Several mechanisms for the formation of the atypical coproporphyrin isomers are discussed. The isocratic ion-pair separation method served also to control the isomeric purity of uroporphyrin specimens of both natural and synthetic origin.

Chromatography, High Pressure Liquid↗