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T Poralla

Publications and source records attributed to T Poralla.

At least 55 records · Page 3Linked to original sources
PubMed1989

[Subcutaneous fat necroses, arthritis and vasculitis of small skin vessels in chronic pancreatitis].

We describe an 42 year old patient suffering from chronic pancreatitis for 7 years who additionally developed subcutaneous fat necrosis, acute arthritis and erythema nodosum--like skin lesions. These symptoms associated with acute or chronic pancreatic disease represent a rare clinical entity. In this case the clinical course was rapidly progressive, resistant to therapy and further complicated by a vasculitic process.

Adult↗
PubMed1988

[Rheumatologic syndrome in gastrointestinal diseases. Clinical and pathogenetic aspects].

Patients with reactive arthritis, sacroiliitis, spondylitis or Reiter's syndrome following intestinal infection from Yersinia, Salmonella, Shigella or Campylobacter organisms have been reported from endemic areas and after epidemic dysenteries. Possession of the antigen HLA B27 affects severity and prognosis of the arthritis and is more often associated with spondylitis and Reiter's syndrome. Articular manifestations are also quite common systemic complications of chronic inflammatory bowel disease. The clinical picture, pathogenetical aspects and treatment of arthritis associated with Crohn's disease, ulcerative colitis and Whipple's disease are reviewed. In only few cases, coeliac disease can be complicated by arthritis. In patients undergoing intestinal bypass surgery systemically absorption of intestinal bacterial antigens and immune complex formation may contribute to the development of bypass-arthropathy and dermatologic manifestations.

Arthritis, Reactive↗
PubMed1987

Liver membrane autoantibodies in chronic active hepatitis. Studies on mechanically and enzymatically isolated rabbit hepatocytes.

Target antigens relevant for immune reactions in inflammatory liver diseases should be expressed on the hepatocellular membrane. Using mechanically or enzymatically isolated rabbit hepatocytes, we evaluated the influence of cell integrity on the detection of membrane-expressed antigens by sera from patients with chronic hepatitis and by murine monoclonal antibodies. Our results provide evidence that target antigens of liver membrane autoantibodies (LMA) as well as liver kidney microsomal antibodies (LKM) are not expressed on the hepatocellular membrane of viable and intact isolated rabbit hepatocytes. However, LMA were detected in the sera of 56% of patients with autoimmune chronic active hepatitis using mechanically isolated hepatocytes. These findings underline the diagnostic relevance of the autoantibodies. It is suggested that LMA are directed against constituents of the cytoskeleton. Therefore, it seems to be unlikely that this antibody is causally involved in the pathogenesis of autoimmune liver diseases.

Animals↗
PubMed1987

Liver cell damage caused by monoclonal antibody against an organ-specific membrane antigen in vivo and in vitro.

Monoclonal antibodies have been raised against different antigenic determinants of normal rabbit hepatocytes. One antibody (2D3) recognized a liver-specific 43 kDa protein displayed exclusively on the basolateral portion of the hepatocellular membrane. Purified monoclonal antibodies were injected intravenously into rabbits. Following the injection of antibody 2D3, a dose-dependent increase of liver enzyme activities in sera was observed. Within 8 h, marked morphological alterations of the hepatocytes, including multiple cell necroses, could be demonstrated by light and electron microscopy. When isolated vital rabbit hepatocytes in culture were used as targets, cytotoxic effects of this antibody could also be observed. This indicates that liver cell damage was not due to antibody-dependent cellular cytotoxicity, but was mediated by the antibody itself. Control antibodies did not show these effects. Thus, our results clearly demonstrate that humoral immune reactions against particular liver membrane antigens may play a role in the development of liver diseases, and provide a useful experimental approach for the investigation of their specificity.

Animals↗
PubMed1987

Analysis of liver-specific protein LSP using murine monoclonal antibodies.

We describe twenty murine monoclonal antibodies directed against different antigenic determinants of human and rabbit liver-specific protein LSP. Among them, nine were directed against liver-specific epitopes as judged from immunohistological studies. Immunoelectronmicroscopy revealed that seven of these monoclonals recognized membrane determinants differing in staining of distinct areas of the hepatocellular surface. Eleven antibodies were directed against intracellular structures. Western blot analysis showed that the epitopes detected were displayed on either single or multiple protein bands with apparent molecular weights between 24,000 and 60,000. Further differences were observed with respect to the species specificity and (among the non-organ-specific antibodies) pattern of tissue cross-reactivity. Our results demonstrate the presence of several liver-specific determinants and membrane components within LSP. There are, however, a very much greater number of non-organ-specific epitopes and numerous determinants displayed on intracellular structures. This emphasizes the remarkable heterogeneity of the antigen preparation named LSP and warrants the use of clearly defined antigens in further studies dealing with auto-immune phenomena in liver diseases.

Animals↗
PubMed1987

Spontaneous and antibody-dependent cellular immune reactions to ethanol-altered hepatoma cells.

Spontaneous cell-mediated cytotoxicity (SCMC), antibody-dependent cellular cytotoxicity (ADCC) and proliferative lymphocyte stimulation in alcoholic liver disease (ALD) were investigated. Peripheral blood lymphocytes (PBL) from eight patients with advanced ALD and nine normal controls were tested against hepatoma cells (PLC/PRF/5) as targets. Target cells were grown in either normal culture medium or medium supplemented with 1 and 5% ethanol, respectively, for 24 to 48 h. Ethanol-exposed hepatoma cells exhibited profound and characteristic morphological alterations. Ethanol preincubation, however, proved to be without effect on immune reactions. Provided that hepatoma cells are an appropriate model, we assume that the proposed immune reactions in ALD are based on metabolic interactions operative only in vivo but do not parallel morphological alterations of liver cells directly induced by ethanol.

Adult↗
PubMed1986

[Neurocysticercosis. Diagnostic and therapeutic advances].

A 42-year-old man of Croatian birth, with long-standing neurological symptoms, was found to have neurocysticercosis (a rare disease in Central Europe), as proven by positive antibody titres in serum and CSF and typical foci by computed tomography (CT). Ventriculo-cisternal drainage (after Torkildsen) controlled the acute symptoms of raised intracranial pressure. Postoperatively the CT revealed new low-density intracerebral foci, which responded to praziquantel.

Adult↗
PubMed1986

A case of Sjögren's syndrome with severe anemia due to myelitis.

An unusual case of Sjögren's syndrome presenting with severe anemia as the predominant clinical feature is described. Histological examination of a bone marrow biopsy specimen demonstrated that the patient's anemia was caused by myelitis and vasculitis of the small intraosseous vessels. Our report might stimulate a more thorough investigation of bone marrow in patients with connective tissue diseases and anemia.

Anemia↗
PubMed1986

Effect of modern analgesic drugs (tramadol, pentazocine, and buprenorphine) on the bile duct sphincter in man.

Modern narcotic analgesic drugs, such as tramadol, pentazocine, and buprenorphine share similarities of molecular structure with morphine which is widely believed to cause spasm of the bile duct sphincter and so impede bile flow. This study assessed the effects of intravenously administered analgesics on bile duct sphincter motor activity measured by ERCP manometry. Ten minutes after pentazocine injection the duration of contractions and baseline pressure of the bile duct sphincter rose from 6.2 +/- 0.2 to 8.2 +/- 0.27 s and from 5.1 +/- 0.6 to 8.8 +/- 0.4 mmHg respectively. Tramadol, buprenorphine and saline showed no such effect. These data indicated that the effects of such drugs on bile duct sphincter function can be safely assessed by ERCP manometry and that pentazocine adversely affects the bile duct sphincter, whilst tramadol and buprenorphine do not. We consider therefore that pentazocine is not the premedication of first choice for endoscopic procedures involving the sphincter of Oddi and should also be avoided in patients with pancreatic and biliary disorders.

Adult↗
PubMed1986

HBsAg clearance in patients with long-standing chronic active hepatitis B and hepatitis B virus-induced liver cirrhosis.

During a period of 3 years we observed 5 patients with chronic active hepatitis B and 2 with hepatitis B virus-induced liver cirrhosis who cleared HBsAg from their sera after 2-14 years of HBsAg carriership. 4 of them developed anti-HBs. After HBsAg clearance there was no evidence of persisting inflammatory activity within their livers. 5 of the 7 patients had been treated for 1-39 months with prednisolone, sometimes in combination with azathioprine. This therapy, however, had been stopped more than 3 years before these patients terminated their HBsAg carriership. Our observations indicate that even after long-standing chronic active hepatitis B or hepatitis B virus-induced liver cirrhosis HBsAg may be eliminated in a considerable number of patients.

Adult↗
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↗
PubMed1985

Endoscopic removal of common bile duct stones through the intact papilla after medical sphincter dilation.

Recently, glyceryl trinitrate was shown to effectively dilate the smooth muscle of the sphincter of Oddi. This information was applied to endoscopic therapy of bile duct stones. In 21 patients a total of 32 common bile duct stones, 6-12 mm (means = 8.7 mm) in diameter, were removed through the intact sphincter after its medical dilation by administration of 1.2-3.6 mg glyceryl trinitrate. Thirty of 32 stones could be extracted without difficulty. The remaining two concrements had to be crushed by endoscopic mechanical lithotripsy before removal. No complications were observed during or after the procedure. Follow-up manometric examinations showed the papillary function to be well preserved. We therefore consider this new, safe, and easy method to be the treatment of choice for the removal of small- and medium-sized bile duct stones.

Ampulla of Vater↗