Search PubMed⌕ Search

Biomedical subjects

S Ritland

Publications and source records attributed to S Ritland.

At least 73 records · Page 4Linked to original sources

The effect of a standardized work load on 'liver tests' in patients with chronic active hepatitis.

Since opinions differ about the effect of physical activity in chronic liver disease, we performed a submaximal ergometric exercise test in 17 patients with chronic active hepatitis in clinical remission while receiving immunosuppressive therapy and in 5 patients with portacaval shunts. The calculated oxygen consumption was low in most patients. Blood samples were drawn before the exercise and 4 h, 24 h, and 48 h after. No changes occurred in serum ALAT, ASAT, ALP, CK, GT, or prealbumin. The clinical condition was not influenced by the exercise test. We conclude that moderate physical activity, at least of short duration, is well tolerated by patients with chronic active hepatitis.

Adult↗

Cholangiographic findings in ulcerative colitis.

Endoscopic retrograde cholangiography (ERC) was performed in 28 patients with hepatobiliary disease associated with ulcerative colitis. The films were reviewed and correlated with diagnoses at liver biopsy. Thirteen patients with extrahepatic as well as intrahepatic bile duct abnormalities had characteristic cholangiographic findings compatible with sclerosing cholangitis, together with cholangiocarcinoma in one patient. Six patients had intrahepatic bile duct involvement only, and the cholangiographic abnormalities differed from those of sclerosing cholangitis. In 5 of these patients cirrhosis of the liver was found at biopsy or clinically. The result indicates that in patients with hepatobiliary disease suggested in association with ulcerative colitis, ERC gives valuable information.

Adenoma, Bile Duct↗

Synthesis of sterols and proteins in liver biopsies from obese patients subjected to gastric or jejunoileal bypass operations.

Incorporation of 14C-acetate into digitonin-precipitable sterols and of 3H-leucine into proteins was examined in per- or post-operative liver biopsies from morbidly obese patients subjected to either gastric or jejunoileal bypass operations. Biopsies obtained from non-obese patients without liver disease served as controls. Incorporation of precursors into sterols and proteins in peroperative biopsies from obese patients (mean weight, 131 kg) did not differ from that of control subjects (mean weight, 64 kg). However, biopsies obtained from eight patients 11-53 months after jejunoileal bypass (mean weight loss, 32% of initial weight) showed an eightfold increased 14C incorporation into sterols, whereas incorporation of 3H-leucine into proteins did not differ from that of the control group. The results in postoperative biopsies (3-12 months) from 9 patients subjected to gastric bypass (mean weight loss, 25% of initial weight) did not differ significantly from those in 15 controls. The markedly stimulated biosynthesis of sterols in patients with jejunoileal bypass might reflect increased faecal excretion of cholesterol and bile acids, causing reduced feedback control mediated by bile acids and cholesterol.

Adolescent↗

Usefulness of serum nucleotide pyrophosphatase and phosphodiesterase I activities in classifying liver disease.

Nucleotide pyrophosphatase and phosphodiesterase I activities were determined in sera from 126 patients with different types of liver disease and in two additional groups of patients with intra- and extrahepatic cholestasis, respectively. Both activities probably represent the same enzyme, and were positively correlated with alkaline phosphatase, lipoprotein X, and several other tests reflecting cholestasis. Also, we found by discriminant analysis that tests for cholestasis frequently replaced the results of both enzymes. In some groups of liver disease, nucleotide pyrophosphatase and phosphodiesterase I were correlated with the concentrations of prealbumin and albumin. The sensitivity of phosphodiesterase I (and nucleotide phosphatase) is rather low when compared with alkaline phosphatase, and we do not recommend it for use in the clinical routine. Nevertheless, it appears to be of potential value for studies on classification of liver diseases, adding information to a panel of 20 commonly used "liver tests" by appearing in some of the best four test-sets for distinguishing between groups of liver disease by discriminant analysis.

Blood Chemical Analysis↗

Sclerosing cholangitis in ulcerative colitis.

In a 5-year period 48 (14%) of 336 patients with ulcerative colitis were found to have hepatobiliary disease. The bile ducts were examined in 35 of these patients, and optimal visualization of both intra- and extra-hepatic bile ducts was obtained in 26. Duct changes compatible with sclerosing cholangitis were found in 14 patients. This finding of sclerosing cholangitis in 4% of all patients admitted with ulcerative colitis by far exceeds previous estimations on the incidence of sclerosing cholangitis in ulcerative colitis. The entire colon was usually affected, and the symptoms of the bowel disease were most often mild or moderate. The age at the onset of the colitis was usually below 20 years in patients with combined ulcerative colitis and hepatobiliary disease. In most patients the hepatobiliary disease gave no symptoms. Biochemical data and the histological findings in the liver biopsies did not distinguish between patients with hepatobiliary disease with and without sclerosing cholangitis. Our follow-up study has so far shown that most patients with sclerosing cholangitis remain asymptomatic for a considerable period of time.

Adolescent↗

Liver copper content in patients with inflammatory bowel disease and associated liver disorders.

In 45 patients with inflammatory bowel disease (9 with Crohn's disease and 36 with ulcerative colitis) and associated liver disorders, increased liver copper content (above 100 microgram/g dry weight) was found in 14 (31%). These patients represented about 50% of the patients with either biliary cirrhosis or pericholangitis. Four of the patients had levels regarded as compatible with hepatolenticular degeneration (greater than 250 microgram/g dry weight). In patients with chronic active hepatitis or non-specific changes in liver tissue, normal levels were found. The patients with Crohn's disease also had normal levels. Plasma ceruloplasmin was normal or increased in all. Determination of urinary copper output gave little diagnostic information. Alkaline phosphatases were markedly increased in most of the patients with increased liver copper concentration. In patients with ulcerative colitis and enhanced alkaline phosphatases, elevated liver copper content should be suspected and chelation therapy should be considered.

Adult↗

The fortune of a capacious spinal canal.

Injury to the spine may be either osseous, neural, or both. The neurological deficit may or may not be a reflection of the severity of the osseous injury. Patients having wide canals are more likely to have less neurological dysfunction than those having narrow canals.

Adolescent↗

The effect of lipoprotein lipase and hepatic lipase on the electrophoretic mobility of lipoprotein-X.

Lipoprotein-X containing plasma from a patient with familial lecithin:cholesterol acyltransferase (LCAT) deficiency, was used as substrate and incubated with postheparin plasma or partly purified lipases. LP-X could not be demonstrated by agar gel electrophoresis after incubation with postheparin plasma from a healthy subject, from a patient with chronic active hepatitis deficient in hepatic lipase, or with partly purified lipoprotein lipase. After incubation a marked increase in free fatty acids (FFA) was observed. In contrast LP-X was still present after incubation when postheparin plasma deficient in lipoprotein lipase or partly purified hepatic lipase was added to the substrate. Only minor changes in the concentration of FFA occurred. After addition of oleic acid to the substrate LP-X could not be demonstrated by agar gel electrophoresis. However, in the isolated low density lipoproteins, LP-X like particles were still present as viewed by electron microscopy. Our results strongly suggest that the change in electrophoretic mobility of LP-X was induced by the release of FFA. This was achieved by lipoprotein lipase, but not by hepatic lipase.

Adult↗

Oesophageal variceal bleeding in Felty's syndrome associated with nodular regenerative hyperplasia.

Four patients with Felty's syndrome developed massive upper gastrointestinal bleeding due to oesophageal varices. The underlying hepatic pathology in all 4 was nodular regenerative hyperplasia. This appears to be a difficult histological diagnosis to make, having been initially reported as normal on percutaneous biopsy or as fibrosis or cirrhosis on wedge biopsy. This series brings the total number of cases reported in the English literature of this association to 12, suggesting a definite symptom complex. The portal hypertension seems to be due to a combination of increased splenic blood flow and postsinusoidal resistance. The clinical importance of this syndrome is that the appropriate therapy for bleeding oesophageal varices appears to be shunt procedure such as a splenorenal shunt with splenectomy, which should be well tolerated.

Aged↗

Chromogenic substrate assay of plasma prekallikrein. With a note on its site of biosynthesis.

A method for assaying plasma prekallikrein has been developed applying the chromogenic substrate Chromozym PK. Different variables have been investigated, and the final assay system was found to give a reproducible and reliable assay procedure. A normal value of 99.0 +/- 18% was found, the coefficient of variation being 7.9. Studies on material from patients with various liver diseases indicated that the main site of prekallikrein biosynthesis is the liver.

Adult↗