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Biomedical subjects

M Manns

Publications and source records attributed to M Manns.

At least 163 records · Page 9Linked to original sources
PubMed1986

Is the bile duct diameter a reliable parameter to diagnose extrahepatic cholestasis? Relationship between bile duct diameter and bile duct pressure.

The common bile duct (CBD) pressure was determined in 57 patients before endoscopic retrograde cholangiography (ERC) and related to the diameter of the CBD and the common hepatic duct (CHD). We found that despite a weak overall positive correlation in the individual patient, CBD or CHD diameters do not correlate with CBD pressure. In patients without extrahepatic cholestasis and normal CBD pressure, both CBD and CHD diameters were measured in a wide range between 5 and 32 mm. Extrahepatic cholestasis due to distal CBD obstruction is reflected by a high CBD pressure, but cannot be identified reliably by measuring the CBD diameter which is found within the range of patients not obstructed. In cholecystectomized patients, CBD and CHD are significantly (p less than 0.005) wider than in non-cholecystectomized patients (8.8 +/- 1.0 vs. 13.3 +/- 1.2 and 9.2 +/- 0.9 vs. 14.2 +/- 1.2 mm, respectively). The CBD pressure, however, is nearly identical in both groups. It is concluded that the assessment of CBD and CHD diameter is not a reliable parameter for the diagnosis of extrahepatic cholestasis which--in certain cases--could be proved by endoscopic retrograde manometry.

Cholangiography↗
PubMed1986

[Detection and significance of HBsAg associated receptors for polymerized human serum albumin in acute hepatitis B virus infection].

Receptors for polymerized human serum albumin (R-pHSA) may play a role in the attachment of hepatitis B virus (HBV) to hepatocytes. Therefore, we evaluated the incidence and prognostic value of R-pHSA in acute hepatitis B virus infection. High titers of R-pHSA were found in 12/12 patients with HBeAg positive acute hepatitis B (log2-Titer: 8.5 +/- 1.5). Titers for R-pHSA and HBsAg correlated closely. Furthermore, R-pHSA occurred (log2-titer: 6.5 +/- 1.5) in 10/10 patients with HBeAg positive chronic active hepatitis B (CAH-B). In the course of HBV infection, R-pHSA were eliminated earlier than HBsAg. 4/20 patients which were asymptomatic HBsAg carriers had high titers of R-pHSA in correlation to the histological findings of CAH-B. Asymptomatic HBsAg carriers which were R-pHSA negative had a normal liver histology. R-pHSA were found to be an early prognostic marker in acute hepatitis B infection.

Carrier State↗
PubMed1986

[Acute fatty liver of pregnancy. A case report of the differential diagnosis of pregnancy-associated liver diseases].

Acute fatty liver of pregnancy (AFLP) is a rare, but often fatal disorder in the third trimester of pregnancy. We report on a patient with AFLP complicated by acute hemorrhagic diathesis, who survived after early diagnosis and adequate treatment. On electronmicroscopy, the characteristic microvesicular fatty deposits in the centrolobular hepatocytes could be demonstrated.

Acute Disease↗
PubMed1985

Antiglomerular basement membrane antibodies in human sera: detection by a modified micro-ELISA.

An enzyme-linked immunosorbent assay (ELISA) for detection of antibodies to human glomerular basement membrane has been developed. Special emphasis has been put on the choice of microtiter plates which were coated with a collagenase digest of human glomerular basement membrane. Results differed markedly between the different microtiter plates. Best results were obtained with a flexible polyvinylchloride microtiter plate with flat wells (Dynatec). This plate exhibited the highest positive/negative ratio and the lowest intraassay standard deviation. Optimal conditions for each step in the ELISA have been determined. The assay proved to be specific, sensitive, and reproducible. Circulating antibodies in each of 11 patients with active antiglomerular basement membrane disease were detected by the ELISA, while sera from patients with various renal and nonrenal diseases were negative by the test.

Autoantibodies↗
PubMed1985

[Oral zinc in Wilson disease--an alternative to D-penicillamine].

Recently Brewer et al. reported the possibility of an oral zinc therapy in Wilson's Disease. We treated a 19 years old patient with decompensated liver cirrhosis due to Wilson's disease with zinc-sulphate. D-Penicillamine had to be withdrawn since proteinuria occurred under treatment. After the discontinuation of D-Penicillamine an increase of serum copper almost up to normal range was observed; concomitantly urinary copper elimination decreased. Under oral zinc sulphate therapy (145 mg/day) a drop of serum copper level was achieved and liver function improved: serum albumin, gamma globulins and prothrombin time reached normal values. The patient did not complain any side effects during oral zinc sulphate therapy. Oral zinc therapy in Wilson's Disease may be regarded as an alternative to D-Penicillamine treatment when this drug has to be discontinued because of side effects.

Administration, Oral↗
PubMed1985

Age and sex dependency of bile duct diameter and bile duct pressure--an ERC manometry study.

Using ERC-manometry diameters of the common bile duct (CBD) the common hepatic duct (CHD) as well as CBD pressure before and after opacification were determined in 35 non-cholecystectomized patients without extrahepatic cholestasis. We found a significant rise of both CBD and CHD diameters as well as CBD pressure recorded before the injection of contrast medium with increasing age. (p less than 0.005, less than 0.001 and less than 0.05 respectively). Following the opacification CBD pressure became elevated. Again this increase tended to be more pronounced in older patients although this association was lacking statistical significance. In the presence of comparable age female patients (n = 16) exhibited higher CBD and CHD diameters (n.s.) as well as CBD pressure values (p less than 0.05) than male patients (n = 19). We conclude that in the absence of extrahepatic cholestasis bile duct diameter as well as bile duct pressure rise significantly with increasing age. Furthermore women tend to have higher diameters and pressure values than men.

Adult↗
PubMed1984

A monoclonal antibody directed against an organ-specific liver cell membrane antigen in rabbits.

We generated monoclonal antibodies after immunization of mice with rabbit liver-specific protein (LSP) preparations. One of these antibodies (2D3) showed an organ-specific and species-specific binding pattern as determined by immunohistological and ELISA techniques. Immunoelectron microscopy studies demonstrated that this antibody is bound exclusively to the liver cell membrane except in the region of the bile canaliculi. We further describe a simple ELISA technique for the detection of anti-LSP antibodies. Our study clearly demonstrates the presence of at least 1 organ-specific liver cell membrane antigen in rabbit LSP and shows antigenic differences between areas of the plasma membrane of hepatocytes.

Animals↗
PubMed1984

[Significance of autoantibodies in the diagnosis of non-A, non-B hepatitis].

Various autoantibodies against different components of the hepatocytes have been demonstrated in chronic active hepatitis (CAH) which is an etiologically heterogeneous disease. These antibodies are essentially antinuclear antibodies (ANA), antibodies against liver cell membranes (LMA), antibodies against a microsomal antigen from liver and kidney (LKM), antibodies against soluble liver antigen (SLA) and antimitochondrial antibodies (AMA). These various autoantibodies mentioned could not be demonstrated in 18 patients with clearly established acute and 27 patients with clearly established acute and 27 patients with clearly established chronic hepatitis non-A-non-B. In addition these autoantibodies could not be found in our own cases of clearly established hepatitis non-A-non-B after the acute stage of the disease. Testing for the presence of these antibodies thus helps essentially to differentiate the autoimmunologically caused form of CAH from the CAH non-A-non-B.

Adult↗
PubMed1984

[Detection of autoantibodies to polymerized human serum albumin].

Binding activity of antibodies against polymerized human serum albumin (pHSA) was measured in the serum of 348 patients with various hepatic and non-hepatic diseases and in the serum of 108 control persons. The methods used were passive hemagglutination (PH) with antigen loaded human erythrocytes and radial immunodiffusion (ID). In the PH-method only HBsAg-positive sera reacted. Blocking experiments with pHSA, polymerized bovine serum albumin (pBSA) and monomeric human serum albumin (mHSA) showed, that the PH-method measures HBsAG associated receptors for pHSA. In HBeAG-positive cases titers were significantly higher than in anti-HBe-positive sera. Using the ID-method it could be shown, that 40% of sera of patients with liver diseases (n = 272), 37% of patients with LED (n = 27), 72% of patients with rheumatoid arthritis (n = 32), 6% of patients with glomerulonephritis (n = 17) and 2% of normal persons (n = 108) reacted. These sera reacted in the immunodiffusion assay with pHSA and pBSA but not with mHSA. Autoantibodies against non species specific determinants of pHSA which are not specific for liver diseases and possibly due to disturbed immunoregulation can be demonstrated by immunodiffusion. They may possibly be modulators of the pHSA mediated binding of hepatitis B-virus to hepatocytes.

Adolescent↗
PubMed1984

Detection of liver-kidney microsomal autoantibodies by radioimmunoassay and their relation to anti-mitochondrial antibodies in inflammatory liver diseases.

A radioimmunoassay (RIA) was developed for the detection of liver-kidney microsomal (LKM) autoantibodies. These were detected in four of 62 patients with HBsAg negative chronic active hepatitis (CAH) and in one patient with mixed connective tissue disease (MCTD). LKM antibodies were not detected in other hepatic and non-hepatic diseases. Other autoantibodies, especially anti-mitochondrial ones, do not react in this assay system. Sera positive for LKM antibodies by RIA showed a cytoplasmic staining of hepatocytes and proximal renal tubules by immunofluorescence. The LKM antigen was detected by RIA in microsomes prepared from rat liver, kidney, stomach, heart, lung, and skeletal muscle. It was destroyed after treatment with trypsin and chymotrypsin, but preserved after treatment with RNAase, DNAase and neuraminidase. Upon centrifugation of purified rat liver microsomes in CsCl gradient, LKM reactivity was detected at a density of 1.20 g/ml. In addition, the M2 antigen of the inner mitochondrial membrane specific for primary biliary cirrhosis (PBC) was localized at 1.28 g/ml in these density gradient fractions. The LKM antigen could not be solubilized. The presence of LKM antibodies characterizes a distinct subgroup of HBsAg negative CAH; they do not occur in PBC.

Adolescent↗
PubMed1983

Detection of mitochondrial antibodies directed against the primary biliary cirrhosis (M2) antigen by an enzyme-linked immunosorbent assay (ELISA).

An enzyme-linked immunosorbent assay (ELISA) was developed for the detection of 1 subtype of mitochondrial antibodies (AMA) specific for chronic cholestatic inflammatory liver diseases. AMA were detected by ELISA in 16 of 16 patients with primary biliary cirrhosis (PBC) and in 2 of 31 patients with chronic active hepatitis. These 18 positive sera were positive for AMA by indirect immunofluorescence (IF) and by radioimmunoassay (RIA). No AMA were detected by ELISA in 2 patients with the pseudolupus erythematosus syndrome, who were positive for AMA by IF, 2 patients with secondary syphilis, positive for cardiolipin antibodies, 1 patient with systemic lupus erythematosus, positive for AMA by IF, 58 further patients with various hepatic and non-hepatic diseases and 10 healthy blood donors. The titers obtained by ELISA, ranging from 1:20 to 1:62,500, correlated well with those obtained by IF and RIA. The ELISA detected an AMA directed against one determinant of a mitochondrial antigen bearing the characteristics of the so-called PBC antigen (M2 antigen). The ELISA described is a sensitive and specific test for the detection of AMA directed against the PBC (M2) antigen and may be used not only as a standard method assaying this clinically important subtype of AMA but also as a tool for further purification and characterization of the PBC (M2) antigen.

Animals↗
PubMed1983

[Chronic active hepatitis: recurrence after long-term immunosuppressive therapy in spite of normal liver histology].

We report the case of a patient with liver-kidney microsomal antibody (LKM) positive chronic active hepatitis (CAH) which was followed-up for 12 years. Besides LKM the patient's serum was positive for thyroid microsomal antibodies, but negative for antinuclear, liver membrane and smooth muscle antibodies as well as hepatitis B virus markers. The patient was HLA B 8 negative. The disease of the 23 year old female patient began as an acute hepatitis which progressed to CAH. Immuno-suppressive therapy with a combination of prednisone and azathioprine led to a long lasting normalization of transaminases, gammaglobulin levels, and finally liver histology. Despite a normal liver histology after more than six years of continuous treatment the discontinuation of therapy was followed by a relapse. The presented case with LKM-positive CAH demonstrates that discontinuation of immuno-suppressive therapy may be followed by a relapse even if normal liver histology has been achieved under treatment.

Adult↗
PubMed1982

Fractionation of the liver membrane lipoprotein (LSP) and characterisation of its antigenic determinants by autoantibodies and a heterologous anti-serum.

Sera from 50 patients with chronic active liver disease were investigated by radioimmunoprecipitation test for autoantibodies against human and rabbit liver membrane lipoprotein (LSP), and a human kidney equivalent protein. Twenty-one of 50 chronic active liver disease sera were positive for autoantibodies against human liver membrane lipoprotein. Eleven of 50 sera reacted with rabbit liver membrane lipoprotein and four of 50 sera with human kidney equivalent protein as well. I order to identify the antigenic determinants of these autoantibodies 125I-labelled human and rabbit liver membrane lipoprotein and human kidney equivalent protein were fractionated by CsCl density gradient centrifugation. Distribution of labelled antigen fractions in density gradients revealed two peaks with maximum radioactivity at 1.34 and 1.11 g/ml. Density gradient fractions were assayed for antigen activity by radioimmunoprecipitation test using autoantibody positive sera of patients with chronic active liver disease. Anti-human and anti-rabbit liver membrane lipoprotein and anti-human kidney equivalent protein positive human sera all localised their corresponding determinants in the low density fractions (1.08-1.10 g/ml). An antiserum against human liver membrane lipoprotein, raised in rabbits after short-term immunisation, recognised the low density 125I-human liver membrane lipoprotein subfraction. This serum had previously been absorbed with human kidney homogenate, plasma, and blood cells. Thus, organ-specific and non-organ specific determinants were both localised in the low density liver membrane lipoprotein subfraction. They could not be separated by the described fractionation procedure. It is to be supposed that organ-specific determinants of a low density membrane protein of hepatocytes are targets circulating autoantibodies in chronic active liver disease.

Autoantibodies↗