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Biomedical subjects

K Lenz

Publications and source records attributed to K Lenz.

175 records · Page 10Linked to original sources
PubMed1976

Bile acid metabolism and plasma protein turnover in Crohn's disease.

Postprandial duodenal bile acids, intestinal protein loss, and albumin and IgG turnover were studied in 19 non-operated patients with Crohn's disease. A lesion of the terminal ileum was present in 18 of 19 patients, either alone or associated with regional colitis. Identical bile acid studies were made in a control group of 20 patients with chronic diarrhoea of undetermined origin. Duodenal bile acid concentration was decreased in 9 of 19 patients with Crohn's disease, and in 5 of 20 patients with unexplained diarrhoea. The glycine/taurine-ratio was increased in 8 of 17 patients with Crohn's disease, but in only one of the 20 control patients. Abnormal intestinal protein loss was present in 13 of 14 patients with Crohn's disease. The fractional catabolic rate of albumin and IgG was increased in all 17 cases of Crohn's disease studied, except the patient with no protein loss. A statistically significant and positive correlation was observed between glycine/taurine-ratio and fractional catabolic rate of both albumin and IgG. No patient with Crohn's disease harboured an abnormal bacterial flora in the proximal small intestine. It is concluded that, in the absence of abnormal bacterial flora in the proximal jejunum, the glycine/taurine-ratio is more valuable as an indicator of terminal ileopathy than postprandial duodenal bile acid concentration in nonoperated patients with terminal ileitis. Abnormal intestinal protein loss and increased catabolic rate of albumin and IgG are practically always present in active Crohn's disease and are strong evidence of an organic gastrointestinal lesion in patients with normal radiographic findings.

Adolescent↗
PubMed1975

A comparison of stable and 3H- labelled polyethylene glycol 4000 as non-absorbable water phase markers in the human ileum and faeces.

Polyethylene glycol 4000 (PEG plus 3H-PEG) was used as volume indicator during ileal perfusion in man. Faeces, urine, ileal infusates, and aspirates were investigated. Turbidimetrical assay and liquid scintillation counting (in the faeces radioassay was done after conbustion) yielded similar estimates of water absorption and secretion. Tracer amounts of 3H were found in the urine, indicating a minimal absorption. The simplicity of 3H radioassay and the reliability of 3H-PEG as a non-absorbable water phase marker is emphasized.

Crohn Disease↗
PubMed1975

The effect of the site of lesion and extent of resection on duodenal bile acid concentration and vitamin B12 absorption in Crohn's disease.

Duodenal bile acid concentration following a standard meal, glycine/taurine (G/T) ratio, vitamin B12 absorption, and faecal fat were determined in 79 patients with Crohn's disease. Intestinal resection had been made in 50 patients before the study, and no evidence of recurrence was present at the time of the study. Among 46 patients subjected to ileal resection of 10-180 cm, a reduced duodenal bile acid concentration and vitamin B12 malabsorption was almost invariably present when 50 cm or more of ileum had been removed. Patients with smaller resections and unoperated patients did not show a consistent pattern. Vitamin B12 absorption and duodenal bile acids were of equal value as indicators of ileal dysfunction with the exception that, in 10 ileostomy patients, duodenal bile acids were decreased in every case, but vitamin B12 absorption only when 80 cm of ileum or more had been resected. G/T-ratio was related to the extent of ileal resection-being elevated after large resections (80 cm or more)-but not to the presence of an abnormal flora. Faecal fat was much more elevated in ileostomy patients with large ileal resection (80 cm or more) than in unoperated patients and patients without an ileostomy.

Bile Acids and Salts↗
PubMed1975

An evaluation of the 'breath test' in Crohn's disease.

The 1-(14C)-glycine-glycocholic-acid breath test was evaluated in 10 normal subjects and in 38 patients with Crohn's disease. Twelve patients were non-operated and 26 had been subjected to ileal resection (10-180 cm). In addition, coecal resection or right-sided hemicolectomy was performed on 20 patients and subtotal colectomy on six. The 14C-excretion in breath was abnormally elevated in only 16 of the 38 patients with Crohn's disease. Combining 14C-excretion in both breath and faeces, the test was found to be correlated with the activity of the disease in non-operated cases, whereas all resected patients were found to have bile acid malabsorption. It is concluded that the breath test is useless in Crohn's disease without concomitant measurement of the radioactivity in stools. The faecal 14C-excretion was correlated with the extent of ileal resection and with the extent of colonic resection, whereas the 14C-excretion in breath was independent of the type of operation performed. The breath test was found to be a more sensitive assay for ileal dysfunction than the duodenal bile acid concentration and the vitamin B12 absorption. No correlation with an elevated G/T-ratio and an abnormal bacterial growth was found.

Bile Acids and Salts↗
PubMedDate not supplied

Function of the autonomic nervous system in patients with hepatic encephalopathy.

To obtain further pathophysiological details concerning the development of cardiovascular disturbances in severe liver disease, the state of the autonomic nervous system, the function of the baroreceptor reflex pathway and the responsiveness of the cardiovascular system to noradrenaline, angiotensin II and isoprenaline were investigated in 11 patients with hepatic encephalopathy and in 10 healthy control subjects. Increased plasma levels of noradrenaline and adrenaline and an attenuated increase in heart rate in response to atropine were found in patients with hepatic encephalopathy. These changes and the hemodynamic disturbances tended to be more pronounced in patients with hepatic encephalopathy Grades III-IV as compared to hepatic encephalopathy Grades I-II. The increase in systolic blood pressure induced by infusion of noradrenaline (400 ng per kg per min) and angiotensin II (20 ng per kg per min) was higher in the patients than in healthy control subjects (hepatic encephalopathy Grades I-II: p less than 0.001; hepatic encephalopathy Grades III-IV: p less than 0.02). The changes in mean and diastolic blood pressure in response to angiotensin II were more pronounced in hepatic encephalopathy grades I-II than in hepatic encephalopathy Grades III-IV (p less than 0.02). The decrease of heart rate in response to blood pressure increase in patients with hepatic encephalopathy was not different from control subjects except a smaller decrease during angiotensin II infusion in hepatic encephalopathy grades III-IV (p less than 0.05). The responsiveness to isoprenaline was diminished (p less than 0.001). The present results indicate that the increased activity of the sympathetic nervous system in hepatic encephalopathy is associated with decreased parasympathetic tone.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Papillary thyroid carcinoma: occurrence and types of lymph node metastases.

Fifty-seven (35.6%) of 160 patients with papillary thyroid carcinoma had lymph node metastases at the primary treatment. Children and adolescents were most frequently affected (69.2%), followed by the age group of 21-40-year olds (38.8%). Those older than 40 had the lowest incidence of lymph node metastases (29.6%; p less than 0.05). One fifth of all patients had lymph node metastases as first indication of papillary thyroid carcinoma. Two thirds of these patients were 40 years old or younger. Lymph node involvement affected the jugular vein in nearly all cases (78.8%) and the upper mediastinum as well in just under 15%. Women predominated (67.5 vs. 35.3%; p less than 0.05) if there was intrathyroidal tumor growth with lymph node metastases which occurred most frequently in the age group of 21-40-year olds. On the other hand, men had the highest incidence (67.7 vs. 32.5%; p less than 0.05) of lymph node metastases in connection with tumor growth outside the organ. Fixed lymph node metastases occurred more often in men, particularly in those older than 40 years of age. A pT4 stage (tumor growth outside the organ, 66.7%) was often present at the same time. Especially young patients had a high incidence of lymph node metastases in connection with multifocal intrathyroidal tumor growth, the lymph node metastases often being substantially larger than the mostly occult foci of thyroid carcinomas. Cystic degenerations were occasionally mistaken for cervical cysts.

Adult↗
PubMedDate not supplied

Effect of prostaglandin E1 on extravascular lung water in patients with severe heart failure.

Prostaglandin E ( 1 ) (PGE ( 1 ) ) is a naturally occurring paracrine hormone that is used pharmacologically for treatment of peripheral occlusive arterial disease and to maintain ductus-arteriosus patency in neonates with congenital heart disease until the primary condition is operable. PGE ( 1 ) treatment also has been associated with reduction in pulmonary arterial pressure and increase in cardiac output in patients with left ventricular failure. In contrast, in isolated cases, patients with heart failure reportedly have developed pulmonary edema while receiving PGE ( 1 ). Therefore, to better define the effect of PGE ( 1 ) in heart failure, this double-blind study investigated the effect of PGE ( 1 ) on extravascular lung water in intensive-care patients with severe heart failure (New York Heart Association [NYHA] classes III and IV) and slightly above-normal extravascular lung water. Intravenous infusion of 60 microg PGE ( 1 ) (Prostavasin; Schwarz Pharma, Monheim, Germany) over a period of 2 hours caused no significant change in lung water relative to the baseline values (9.8 +/- 4.3 mL/kg before the infusion, 9.3 +/- 3.2 mL/kg after 1 hour, and 9.4 +/- 3.5 mL/kg after 2 hours) or to values observed in placebo-treated patients (6.5 +/- 3.3 mL/kg before the infusion, 7.1 +/- 2.7 mL/kg after 1 hour, and 7.0 +/- 3.2 mL/kg after 2 hours). Thus, administration of PGE ( 1 ) is unlikely to cause or worsen pulmonary edema in patients with severe heart failure (NYHA classes III and IV).

Adult↗
PubMedDate not supplied

[What is concealed behind nonspecific emotional disorders (F93.8/9)--a diagnostic comparison with reference to 4 diagnostic codes of ICD-10].

Psychiatric diagnoses of three patient groups attending a clinical service in 1992 and 1993 were compared: children with rather inspecific diagnoses F93.8 and F93.9, children with specific diagnoses (f93.0 to F93.3 and children without psychiatric disorders. Data were gathered by the clinical documentation based on WHO recommendation. Result was a difference between the specific group and the inspecific group due to the psychopathological evidence. Further the variables of the fifth axis of MAS were analysed.

Adolescent↗