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Biomedical subjects

W Kruis

Publications and source records attributed to W Kruis.

At least 109 records · Page 6Linked to original sources
PubMed1988

Human colonic (Na+ + K+)-ATPase and specific ouabain binding are not influenced by lipoxygenase products or superoxide radicals.

The effects of lipoxygenase products (5-, 12-, 15-HETE, LTB4) and superoxide radicals on human colonic (Na+ + K+)-ATPase and specific ouabain binding were measured. No significant inhibition in concentrations up to 3 x 10(-5) M was observed. The results are discussed with regard to a possible role of lipoxygenase products and radicals in the pathogenesis of water and electrolyte disturbances in various diarrheal states including inflammatory bowel disease.

12-Hydroxy-5,8,10,14-eicosatetraenoic Acid↗
PubMed1988

Inverse relationship between colonic (Na+ + K+)-ATPase activity and degree of mucosal inflammation in inflammatory bowel disease.

In inflammatory bowel disease (IBD), mucosal damage and loss of colonic function are regarded as major consequences of inflammation. Decreased colonic (Na+ + K+)-ATPase activities with diminished reabsorption of sodium and water have been found in active stages of ulcerative colitis. In this study, we report an inverse relationship between colonic (Na+ + K+)-ATPase activity and the degree of mucosal inflammation in 19 patients with IBD of mild to moderate disease activity. Various macroscopic and histologic types of mucosal lesions were differently associated with the (Na+ + K+)-ATPase activities. 5'-nucleotidase activity was not associated with the degree of mucosal inflammation or the kind of macroscopic or histologic lesions. Our findings support the view that, in contrast to 5H-nucleotidase, (Na+ + K+)-ATPase activity may better reflect the severity of mucosal damage and the degree of inflammation in IBD.

5'-Nucleotidase↗
PubMed1988

Crohn's disease is frequently complicated by giardiasis.

Giardiasis is a common infection, and many of its symptoms are similar to those of Crohn's disease. Despite a long discussion on the role of microbiologic agents in Crohn's disease, giardiasis has never been investigated. We studied giardiasis as assessed by the occurrence of cysts in 86 patients with Crohn's disease, in 82 patients with other gastrointestinal disease, and in 52 patients without gastrointestinal disease. In addition, in 20 patients with Crohn's disease the effects of metronidazole on giardiasis and disease activity were studied. Frequency of giardiasis was 61.6% in patients with Crohn's disease, 31.7% in patients with other gastrointestinal disease, and 5.8% in the control group (p less than 0.01). Stool frequency, disease activity, and humoral signs of inflammation in patients with Crohn's disease showed no relationship to giardiasis. All but two patients treated with metronidazole became free of cysts. Crohn's disease activity index decreased in 14 of 20 patients (p less than 0.05). In conclusion, giardiasis is a common finding in patients with Crohn's disease. Treatment of giardiasis can, in individual cases of Crohn's disease, result in a quick recovery from symptoms of high disease activity.

Adult↗
PubMed1988

Olsalazine in the treatment of mild to moderate ulcerative colitis: a randomized, placebo-controlled, double-blind, clinical trial.

Olsalazine, 2 g/day, was compared with placebo in 126 patients with mild or moderate ulcerative colitis. Evaluation after 4 weeks revealed a significant improvement in endoscopic findings in the rectum and sigmoid colon and in the clinical parameters rectal mucus and blood discharge, whereas no significant difference was found between olsalazine and placebo groups in clinical parameters, such as stool frequency and consistency, urge to defecate, abdominal pain and biopsy findings. It is concluded that olsalazine, 2 g/day, is tolerated as well as placebo except that it caused diarrhoea in some patients.

Aminosalicylic Acids↗
PubMed1988

Accuracy of the whole body retention half-life of 75SeHCAT in the diagnosis of ileal dysfunction in patients with Crohn's disease.

The measurement of the whole body retention of the synthetic taurine conjugated trihydroxy bile acid 75SeHCAT has been suggested as a new clinical test for the function of the terminal ileum. Because of the frequent occurrence of ileal dysfunction in Crohn's disease (CD), the accuracy of the SeHCAT test was studied in 64 patients with CD in various clinical conditions. A positive test result (retention half-life less than 1.2 days) was seen in 48.4% of the patients with ileal involvement (true positive tests) whereas a negative test was seen in 33 of the 64 patients. In 21 of the 33 patients (63.6%) the test was false negative since ileal inflammation or resection was confirmed by radiology or endoscopy. In 14 of those 21 patients with false negative test results a stenosis of the intestinal lumen was diagnosed. At a specificity of 100% the sensitivity of the SeHCAT test was 59.6% and the efficiency was 67.2%. If patients with known stenosis were excluded sensitivity improved to 79.4%. In conclusion, calculation of the whole body retention half-life of SeHCAT does not seem to be a valuable screening test for the diagnosis of ileal dysfunction. In CD, a pathologic test result identifies ileal dysfunction with high accuracy.

Adult↗
PubMed1987

Flow across the canine ileocolonic junction: role of the ileocolonic sphincter.

The role of the canine ileocolonic sphincter (ICS) in influencing transit of fluids and absorption of water in the ileum was assessed in loops with or without the ICS. Two sets of four dogs each were equipped with isolated ileal loops 40 cm long, attached to the intact bowel through a neuromuscular bridge. In one set, the loop included the ICS and it terminated in an end colostomy; in the other, the loop ended immediately proximal to the ICS, as an ileostomy. Electrical and mechanical signals were recorded from serosal electrodes and strain gauges, respectively, during perfusion of loops with an isotonic solution at rates from 0.7 to 10.0 ml/min. Loops without an ICS propelled fluid by steady, continuous flow at all rates of perfusion; loops with the ICS in place moved fluids in this way only at 10 ml/min. At greater rates of perfusion, fasting cycles of motility were inhibited in all loops and a random pattern of motility developed; this presumably facilitated more steady flow of fluids. At the slowest rate of perfusion, transit times were longer when the ICS was present, but at faster rates both loops showed similar transit times. Presence of the ICS was associated with increased volumes of fluid in the loop and increased absorption of water, especially when loops were perfused slowly. The canine ICS influences flow of saline and absorption in the terminal ileum, but only when flow rates are low.

Animals↗
PubMed1987

[Hepatobiliary diseases in Crohn disease and ulcerative colitis].

Hepatobiliary diseases are certainly not very frequent extraintestinal complications of chronic intestinal inflammatory diseases, however, they are an important prognostic factor. 2% of patients with ulcerative colitis develop liver cirrhosis but 10% of those die as a direct result of liver failure. Other associated severe hepatobiliary diseases include primary sclerosing cholangitis, carcinoma of the bile duct and amyloidosis. The present review attempts to divide the associated hepatobiliary diseases into three groups. 1. those that are the result of therapy. 2. those that are the result of the pathophysiological mechanisms of the underlying disease and 3. those of unknown etiological origin. This division might serve not only for a better understanding of the various mechanisms but should have some impact on therapeutic regimens.

Amyloidosis↗
PubMed1987

Circulating lipid A antibodies and their relationship to different clinical conditions of patients with Crohn's disease.

Endotoxins have been suggested to be a factor in the pathophysiology of Crohn's disease (CD). We determined circulating antibodies against lipid A, a component common to endotoxins of gram-negative bacteria. Lipid A antibody titers in 91 patients with CD were significantly higher than in 56 patients with ulcerative colitis and 68 healthy subjects. In active CD lipid A antibodies were higher than in quiescent CD and markedly elevated titers of lipid A antibodies were associated with a severe course of CD. Duration, extent and localisation of CD showed no relationship to antibody titers against lipid A. Patients with prior bowel resection had a tendency towards lower antibody titers in comparison with non-operated patients. After total removal of inflamed bowel tissue, lipid A antibodies frequently disappeared. Medical therapy had different effects: prednisone and sulfasalazine did not influence antibody formation against lipid A, whereas antibody titers dropped significantly after therapy with ampicillin. These results confirm elevated circulating lipid A antibodies in patients with CD. Although it remains unclear whether lipid A antibodies are only an epiphenomenon in CD, on the basis of this clinical study further evidence is provided for the involvement of lipid A in the pathophysiology of CD.

Adolescent↗
PubMed1986

Inhibition of human colonic (Na+ + K+)-ATPase by arachidonic and linoleic acid.

The sodium pump, (Na+ + K+)-ATPase, which is involved in the transport of cations and water movement by the colonic mucosa, may be decreased in various diarrhoeal states. In this study, we have measured 3H-ouabain binding and (Na+ + K+)-ATPase activity in human colonic biopsy homogenates and the influence of various inflammatory and antiinflammatory compounds on these parameters. 3H-ouabain binds to one site of high affinity (KD 1.9 +/- 0.2 X 10(-9) mol/l) with a maximal binding capacity of 7.5 +/- 0.8 X 10(14) binding sites/g protein. Both arachidonic and linoleic acid inhibited (Na+ + K+)-ATPase activity (IC50 arachidonic acid: 7.5 X 10(-5) mol/l, linoleic acid: 6.5 X 10(-5) mol/l) and Mg2+-ATPase activity (IC50 arachidonic acid: 9 X 10(-5) mol/l, linoleic acid: 4 X 10(-5) mol/l). Arachidonic acid inhibited 3H-ouabain binding, (IC50 3.2 X 10(-5) mol/l). The following antiinflammatory compounds, at concentrations up to 1 X 10(-3) mol/l, did not influence ATPase activity directly nor reverse the arachidonic acid-induced inhibition: indomethacin (cyclooxygenase inhibitor), nordihydroguaiaretic acid (lipoxygenase inhibitor), sulphasalazine and its metabolites: 5-aminosalicylic acid, N-acetylaminosalicylic acid and sulphapyridine. These results indicate that human colonic (Na+ + K+)-ATPase is inhibited by the prostanoid precursors, arachidonic and linoleic acid. From a therapeutic point of view (effect on colonic (Na+ + K+)-ATPase and perhaps diarrhoea), the suppression of the production of these prostanoid precursors by drugs may, therefore, be beneficial in the treatment of inflammatory bowel disease.

Anti-Inflammatory Agents↗
PubMed1986

Chenodeoxycholic and ursodeoxycholic acids alter motility and fluid transit in the canine ileum.

We examined the effects of chenodeoxycholic acid (CDCA) and ursodeoxycholic acid (UDCA) on fasting motility patterns and transit in ileocolonic loops of 5 dogs. Animals were prepared with isolated loops (40 cm ileum and 5 cm colon) which maintained neuromuscular continuity with the intact bowel through a bridge of tunica muscularis. Myoelectrical activity was recorded from multiple serosal, monopolar electrodes and muscle contractions recorded from serosal strain gauges; fluid transit was assessed by continuous perfusion (1.4 ml min-1) of solutions containing polyethylene glycol 4000 marker, with or without bile acids. Saline perfusion did not disturb the fasting cycle of motility and mean cycle length in unperfused (106 +/- 7 min) loop was the same as during perfusion of saline (108 +/- 9 min). Bile acids abolished interdigestive cycles in 11 of 12 experiments, fasting patterns returned 64-106 min after bile acid perfusion was stopped. The fasting pattern continued to cycle normally in the proximal small bowel during bile acid perfusion. CDCA (15 mM) stimulated the occurrence of propulsive contractions of long duration. Bile acids shortened transit time through the loops and altered the pattern of flow towards a more continuous, steady stream. These effects of bile acids on ileal motility, like those described previously in the colon, could play a role in bile acid diarrhea.

Animals↗
PubMed1986

Comparison of the therapeutic effect of wheat bran, mebeverine and placebo in patients with the irritable bowel syndrome.

There is no generally accepted treatment in the irritable bowel syndrome (IBS), probably because of a lack of convincing therapeutic trials. In the present study, 120 outpatients with IBS participated in a prospective randomized therapeutic trial. According to a double-blind design, 40 patients received 400 mg/day mebeverine and 40 patients received a placebo. In an open branch of the trial, 40 patients were treated with 15 g/day wheat bran. The effects of treatment on symptoms were noted after 4, 8, 12 and 16 weeks of therapy. A significantly superior symptomatic effect of bran in comparison to mebeverine and placebo was demonstrated after 12 weeks, but could not be confirmed at the end of the study. There was no significant difference between the symptomatic effect of mebeverine and placebo. The compliance with the therapy was about 80% for 4 weeks, but dropped to about 50% at the end of the trial. This points to a particular difficulty in the management of patients with IBS. The results of this trial suggest that bran and mebeverine are no ideal therapy for patients with IBS but they support the therapeutic use of bran in patients with IBS.

Adult↗
PubMed1986

Comparison of 75SeHCAT retention half-life and fecal content of individual bile acids in patients with chronic diarrheal disorders.

Measurement of the retention of 23-75Se-25-homotaurocholic acid (SeHCAT) has been suggested as a new test for ileal function. We investigated 31 patients with chronic diarrhea, 10 with ileal Crohn's disease and 21 with diarrhea but without ileal disease. The whole-body retention half-life of 1 mu Ci SeHCAT was determined and compared to the fecal content of total and individual bile acids. Patients with ileal disease had increased primary fecal bile acids (chenodeoxycholic acid: mean 6.95 mg/g dry weight, range 3.15-10.6 mg/g; cholic acid: mean 18.15 mg/g, range 10.3-33.9 mg/g) and a short SeHCAT retention (mean 11.9 h, range 2-24 h), whereas patients with intact ileum had normal fecal bile acids and a SeHCAT retention of 85.9 h (range 28-216 h). SeHCAT retention half-life differentiated well between patients with ileal disease and patients with normal ileum, thus indicating the SeHCAT test as a valid investigation method for detection of primary bile acid malabsorption in patients with chronic diarrhea and ileal dysfunction.

Adolescent↗
PubMed1986

Altered fecal bile acid pattern in patients with inflammatory bowel disease.

Alterations of the enterohepatic circulation of bile acids in patients with Crohn's disease (CD) and ulcerative colitis (UC) are known, but fecal bile acid patterns are less well defined. In this study total and individual fecal bile acids of 10 patients with CD (8 patients without bowel resection) 6 patients with UC and 5 healthy volunteers (HV) were determined by capillary gas chromatography. In comparison to HV (782 + 82 mg) the daily fecal excretion rate of bile acids was increased in CD (2,739 +/- 877 mg) and decreased in UC (409 +/- 55 mg). CD (80 +/- 19%) and UC (83 +/- 7%) had mainly primary bile acids, while secondary bile acids were predominant (80 +/- 4%) in HV. Bacterial conversion from primary to secondary bile acids is likely to be altered by rapid mouth-anus transit time (52 +/- 21 min) in UC and in CD by acidic stool pH (5.2 +/- 0.5). This lack of intestinal secondary bile acids may have pathophysiologic significance.

Adult↗