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Biomedical subjects

S Ritland

Publications and source records attributed to S Ritland.

At least 55 records · Page 3Linked to original sources

Incorporation of precursors into sterols and proteins in liver biopsies from patients with liver disorders.

Incorporation of 14C-acetate into 3-beta-OH sterols and of 3H-leucine into proteins was examined in liver biopsies from patients with liver disorders. Biopsies obtained from patients in whom no liver disease was found served as controls. Reduced 14C-acetate incorporation into sterols was found in biopsies from patients with chronic active hepatitis and primary biliary cirrhosis. Stimulated incorporation of 3H-leucine into proteins was demonstrated in patients with alcoholic liver cirrhosis and in patients with ulcerative colitis associated with liver disease. No correlation could be established between serum proteins and lipids, respectively, on the one hand, and between incorporation of precursors into proteins and sterols, on the other. 'Incorporation parameters' were also inferior to conventional liver tests when used in the differential diagnosis between different liver disorders by discriminant analysis. Our findings may suggest, however, that hepatic sterol synthesis is frequently decreased in patients with chronic active hepatitis and primary biliary cirrhosis.

Adult↗

Stereotactic localization of deep-seated arteriovenous malformations in the functional area.

The authors approached 5 arteriovenous malformations (AVMs) located deep in functional areas of the cortex with major draining veins found in the mesial hemisphere by using the stereotactic method. This procedure is a useful adjunct to total resection of these AVMs. No mortality or significant morbidity was noted after the surgical procedure. The authors believe that direct attack on AVMs in areas of critical function is the procedure of choice in order to preserve neurological function.

Cerebral Angiography↗

Prednisolone pharmacokinetics and protein-binding in patients with portosystemic shunt.

The pharmacokinetics and protein-binding of orally administered prednisolone have been studied in seven patients with chronic liver disease and portosystemic shunts. The peak prednisolone serum concentration and the time of peak prednisolone concentration were similar to those found in normal subjects, indicating that there is no clinically significant first-pass metabolism of prednisolone. The elimination half-time and the extent of bioavailability of total prednisolone tended to be lower in the patients, and the extent of free, unbound prednisolone higher, but the differences were not statistically significant. The patients had a significantly lower serum protein-binding of prednisolone than the controls. Despite the decreased protein-binding in the patients, however, the results indicate that changes occur in the pharmacokinetics of prednisolone that tend to reduce the bioavailability of free, biologically active prednisolone towards that seen in healthy subjects. Reduction of the prednisolone dose is therefore not indicated in patients with portosystemic shunt and chronic liver disease, even in the presence of hypoalbuminemia.

Administration, Oral↗

Improvement of physical capacity after long-term training in patients with chronic active hepatitis.

A training program was started in nine patients with chronic active hepatitis in clinical remission while receiving immunosuppressive therapy. The patients were examined before and after a training period of 4-5 weeks and 10-12 weeks, respectively. The calculated oxygen consumption increased by 19% and 29%, and the estimated work load capacity improved. No change occurred in alanine aminotransferase, aspartate aminotransferase, alkaline phosphatases, gamma-glutamyl-transpeptidase, serum bilirubin, or prealbumin, whereas creatine kinase and lactate dehydrogenase increased significantly. The clinical condition did not worsen in any patient, and most of the patients felt that their physical performance capacity had improved. We conclude that long-term regular physical training is well tolerated by patients with chronic active hepatitis in clinical remission and that training leads to improvement in the oxygen consumption and the estimated work load capacity in such patients.

Adolescent↗

Prevalence of hepatitis A antibodies in a normal population and some selected groups of patients in Norway.

The prevalence of hepatitis A virus antibodies was tested by radioimmunoassay in Norway in healthy blood donors, in patients without clinical signs of liver diseases and in two selected groups of patients. The presence of hepatitis A antibodies was highly age-dependent in 625 normal persons. A major reduction occurred from 50 per cent or more in those born before 1938 to 10 per cent or less among those born after 1943. The decline of hepatitis A antibody prevalence was correlated to the history of infectious hepatitis epidemics in the entire country during World War II. The prevalence was not different from controls in a group of patients with various liver disorders. Hepatitis A antibodies were more prevalent in males than in females in blood donors, patients with chronic liver disorders and their controls. Hepatitis A antibodies were frequently present in prison inmates; their presence was associated with the presence of antibodies against hepatitis B virus and with anamnestic data on drug addiction.

Adult↗

Sclerosing cholangitis in ulcerative colitis. A follow-up study.

In the 5-year period 1974-78, 48 (14%) of 336 patients with ulcerative colitis were found to have hepatobiliary disease. Endoscopic retrograde cholangiography (ERC) was successfully performed in 39 of these 48 patients, and sclerosing cholangitis was demonstrated in 19. One is excluded from this series because Crohn's disease was diagnosed at reclassification of the bowel disease. Two of the 18 patients with ulcerative colitis and sclerosing cholangitis have died, one of cholangiocarcinoma and one of an unrelated cause. The remaining 16 patients have been observed for a median period of 6 years (3-13 years) since the diagnosis of hepatobiliary disease. Ten have remained symptom-free, four have had intermittent or non-progressive symptoms, and two have developed symptoms of advanced chronic liver disease. The bilirubin level, which was initially raised in one of the patients, was elevated in four at the follow-up examination. Otherwise the laboratory values have remained stationary. Evidence of a progression of the hepatobiliary disease was found in most patients by repeated liver biopsy and particularly ERC. It is concluded that sclerosing cholangitis may remain asymptomatic for several years. Since progressive cholangiographic changes were often seen without concomitant worsening of symptoms, laboratory data, and liver biopsy findings, it is concluded that these criteria are of limited use in evaluating the progression of this disease.

Adult↗

HLA antigens and immunoregulatory T cells in ulcerative colitis associated with hepatobiliary disease.

Serologic HLA typing was carried out in 20 patients with ulcerative colitis (UC) combined with hepatobiliary disease, in 34 UC patients without hepatobiliary disease, and in control subjects. Association with HLA-B8 and -DR3 was found in both groups of patients. HLA-B8 was found in 80% of patients with combined disease (p less than 0.0005 vs. controls; relative risk (RR), 12.0), whereas 32% of the patients with UC without hepatobiliary disease were HLA-B8-positive (not significant vs. controls). Concomitantly, HLA-DR3 was found in 70% of patients with combined UC and hepatobiliary disease (p less than 0.0005 vs. controls; RR 9.95) and in 35% of UC patients without hepatobiliary disease (p less than 0.05 vs. controls; RR, 2.33). HLA-B8 was found more frequently in UC patients with than without hepatobiliary disease (p less than 0.001; RR, 8.36), as was the case with HLA-DR3 (p less than 0.025; RR, 4.28). No indications of defects in immunoregulatory lymphocytes (T gamma and T mu cells) which could explain hyperactivity in the immune system were observed in the patients with combined UC and hepatobiliary disease. The present study gives support to the theory that UC and, particularly, UC combined with hepatobiliary lesion may be autoimmune diseases with a genetic predisposition.

Adult↗

Liver attenuation values at computed tomography related to liver copper content.

Forty-three patients were examined with computed tomography of the liver and liver biopsies with measurement of hepatic copper content. All recorded liver attenuation values were within normal range, even in patients with markedly elevated hepatic copper content. No statistically significant correlation between the liver attenuation values and the copper concentrations in liver tissue was demonstrated. At present, therefore, computed tomography has no place in monitoring the development of copper accumulation.

Adolescent↗

Physical activity in liver disease and liver function in sportsmen.

Patients with liver disease are often incorrectly restricted in their physical activity. Several studies have shown that physical activity is not detrimental to acute viral hepatitis but it is customary to advise rest in the initial phase of nausea, abdominal pain and fatigue. As soon as these symptoms decline the patient can take part in physical activity. As regards chronic hepatitis and cirrhosis there are divergent views. No restrictions are placed upon patients with chronic active hepatitis in remission. This is also true for the early stage of cirrhosis, while muscle atrophy in more prolonged cases will set a natural limit to the patient's performance. The effect of physical activity on patients with a porto-caval shunt has not been studied. In well trained sportsmen there is no evidence that physical activity within the limits of human performance has an unfavourable effect on liver function.

Adolescent↗

Diagnostic and prognostic value of laboratory tests assessed in a follow-up study of 200 patients with liver disease.

Two hundred patients with liver disease were re-studied after six to eight years. The initial routine diagnosis (mainly based on morphological criteria) was confirmed in almost 80% of cases of chronic liver disease. In chronic active hepatitis, agreement was found in 86%. An alternative classification based on cluster analysis of clinical chemical results from the first admission was also to a great extent confirmed by the follow-up study. Discriminant analysis of clinical chemical data correctly allocated 94% of patients with alcoholic cirrhosis (who had low haptoglobin and albumin) into groups with different prognosis. Clinical chemical results differed between verified and non-verified cases of primary biliary cirrhosis. By retrospective examination , we found that 15 of 16 patients with this disease or chronic active hepatitis who were initially misclassified by biopsy findings could be correctly diagnosed by discriminant analysis of clinical chemical results.

Biopsy↗

A long-term follow-up study of the hepatic copper and serum ceruloplasmin concentrations in patients with chronic liver disease.

Hepatic copper content, measured by neutron activation analysis, has been studied in 70 patients during a median observation period of 3 years. In 15 patients with chronic active hepatitis the median hepatic copper content was 39 micrograms/g dry weight at the start and 28 micrograms/g dry weight at the end of the observation period, during which the clinical condition was improved in most patients. The hepatic copper content did not change significantly (41 versus 54 micrograms/g dry weight) in 28 patients with hepatobiliary disorders associated with inflammatory bowel disease. In 27 patients with primary biliary cirrhosis the median hepatic copper concentration was initially 176 micrograms/g dry weight, and at the follow up 186 micrograms/g dry weight. Serum ceruloplasmin was elevated in most of the patients with hepatobiliary disorders associated with inflammatory bowel disease and in all the patients with primary biliary cirrhosis and remained at high levels throughout the observation period. In primary biliary cirrhosis the hepatic copper content was correlated with bilirubin and alkaline phosphatases but not with ceruloplasmin, coagulation factors, or aminotransferases. Ceruloplasmin was not significantly correlated with other "liver tests". We conclude that the hepatic copper content and serum ceruloplasmin were remarkably constant during 3 years of observation in various liver disorders. Our study gave no evidence of a hepatotoxic effect of copper, since no relation between the initial hepatic copper concentration and the clinical course could be detected.

Ceruloplasmin↗