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Biomedical subjects

W Kruis

Publications and source records attributed to W Kruis.

At least 127 records · Page 7Linked to original sources
PubMed1985

Contractile patterns and transit of fluid in canine terminal ileum.

Earlier recordings of intraluminal pressure from the terminal ileum and across the ileocolonic sphincter of dogs revealed, in addition to the usual interdigestive and digestive patterns, pressure waves that appeared to have propulsive potential. One of these, which we designated as a "prolonged propagated contraction" (PPC), was a wave of high amplitude; it had a duration much longer than the ileal slow wave and migrated rapidly through the ileum, often into the proximal colon. The other pattern was one of "discrete clustered contractions" (DCC); these were propagated bursts of rhythmic phasic waves, distinct from phase III of the interdigestive myoelectric complex. These migrated through the ileum more rapidly than did phase III. Our aims were to record the electrical and mechanical equivalents of these pressure events using only extraluminal sensors and to evaluate the capacity of these contractions to propel fluids. PPCs and DCCs were recorded by extraluminal strain gauges, and flow was assessed by recovery of a nonabsorbable marker. Phase III of the migrating motor complex propelled fluid through the ileum, but in addition DCCs and, especially, PPCs were able to empty the ileum. These latter contractions have similarities to the ileal "peristaltic rush" described by others, and we believe these waves are an important force for ileal emptying.

Animals↗
PubMed1985

Determination of the pK values of 5-aminosalicylic acid and N-acetylaminosalicylic acid and comparison of the pH dependent lipid-water partition coefficients of sulphasalazine and its metabolites.

Sulphasalazine (SASP), used in the treatment of inflammatory bowel disease, is split into sulphapyridine (SP) and 5-aminosalicylic acid (5-ASA) in the colon. Lower plasma levels of SASP and 5-ASA as compared to those of SP may be due to different absorption rates from the colon because of different pK values and pH dependent lipid-water partition coefficients. In this study we determined the pK values of 5-ASA and its major metabolite, N-acetyl amino-salicylic acid (AcASA), by 13C-NMR spectroscopy and compared the pH dependent apparent benzene-water partition coefficients (Papp) of SASP, SP and 5-ASA with respect to their different plasma levels. The COOH group of 5-ASA had a pK value of 3.0, the -NH3+ group had 6.0, the -OH group 13.9; the -COOH group of AcASA had 2.7 and the -OH group 12.9; The Papp of SASP (0.042 +/- 0.004) and 5-ASA (0.059 +/- 0.01) were significantly lower than that of SP (0.092 +/- 0.03) (at pH 5.5).

Aminosalicylic Acids↗
PubMed1985

Zinc deficiency as a problem in patients with Crohn's disease and fistula formation.

Zinc deficiency is common in patients with Crohn's disease (CD), especially in those with skin lesions and growth retardation. Patients with fistulas have been considered to be another group with zinc deficiency. We therefore determined serum zinc concentrations of 50 patients with CD. Zinc deficiency was diagnosed in 17 out of 50 patients (34%). Serum zinc concentrations of patients with fistulas were significantly lower than those of patients without fistulas, and zinc deficiency was found in 11/17 (65%) patients. Zinc deficiency may play a role in the formation and clinical course of fistulas. Therefore, in view of possible therapeutic implications, determination of serum zinc concentration in patients with CD and fistulas appears to be of value.

Adolescent↗
PubMed1984

Comparative pharmacokinetics of sulphasalazine and sulphapyridine after rectal and oral administration to patients with ulcerative colitis.

Rectal administration of sulphasalazine to patients with ulcerative colitis has recently been shown to have similar therapeutic activity but fewer side effects than oral treatment. The present study is a comparison of the pharmacokinetics of sulphasalazine (SASP) and its metabolite sulphapyridine (SP) after rectal and oral administration of SASP to 6 patients with ulcerative colitis. The areas under the concentration-time curves (AUC) and the maximum concentrations (Cmax) of SASP and SP were significantly lower after rectal than oral administration of SASP (p less than 0.05). These findings support the view that the lower frequency of side effects after rectal administration of SASP may result from the lower plasma levels of SASP and SP.

Administration, Oral↗
PubMed1984

Circulating lipid A antibodies despite absence of systemic endotoxemia in patients with Crohn's disease.

Lipid A is a component common to endotoxins of gram-negative bacteria. It has been suggested that the gut wall of patients with inflammatory bowel disease is more permeable to luminal bacterial macromolecules which may stimulate the gut-associated lymphoid tissue. We therefore investigated 40 patients with Crohn's disease (CD) and 23 patients with ulcerative colitis (UC) with respect to their lipid A antibody titers and presence of endotoxins (Limulus test). Both tests were performed simultaneously using peripheral venous blood. Systemic endotoxin was demonstrated in only two of the patients. The lipid A antibody titers in the CD patients were significantly higher than either in patients with UC or in 42 healthy controls. Lipid A titers of patients with UC did not differ from those of controls. Titers of lipid A were significantly higher in patients with active Crohn's disease than in patients with inactive disease. It is concluded that systemic endotoxemia occurs rarely in patients with inflammatory bowel disease; however, despite this virtual absence of endotoxins in their peripheral blood, patients with CD show an increase in antibody formation against lipid A. This is suggestive of an altered immunologic reactivity against endotoxins in patients with CD and may be relevant to the pathogenesis of this disease.

Adolescent↗
PubMed1984

A diagnostic score for the irritable bowel syndrome. Its value in the exclusion of organic disease.

Irritable bowel syndrome is a very common clinical problem for which there are no established diagnostic criteria. The two aims of the present study were first, to create a scoring system for the diagnosis of irritable bowel syndrome incorporating features from the case history, physical examination, and some basic investigations including erythrocyte sedimentation rate and blood count; and second, to estimate the diagnostic accuracy of this scoring system in terms of its sensitivity and specificity, and of its predictive value in patients diagnosed as having irritable bowel syndrome by conventional methods. A group of 479 consecutive outpatients referred to a gastrointestinal clinic was studied by the usual extensive routine workup practiced at the clinic, including numerous laboratory tests, endoscopy of upper and lower gastrointestinal tract, and ultrasound. In 209 patients, symptoms were related to an underlying organic disease and in 108 patients irritable bowel syndrome was diagnosed without any recognizable organic disease. As a separate exercise, a scoring system including the answers of a questionnaire and the results of eight basic investigations was established. After completion of the study, the score was weighted by means of a logistic regression analysis. Using the weighted score, at a sensitivity of 64%, the specificity for the diagnosis of irritable bowel syndrome was 99%, and at a sensitivity of 83%, the specificity was 97%. Patients with organic diseases such as malignant tumor or inflammatory bowel disease were well discriminated by the score. It is concluded that a detailed history, physical examination, and basic laboratory tests are sufficient in most patients for the positive diagnosis of irritable bowel syndrome and the exclusion of any underlying organic diseases.

Colonic Diseases, Functional↗
PubMed1983

Human chorionic gonadotropin and alpha chain of glycoprotein hormones in patients with inflammatory bowel disease.

In twenty patients with Crohn's disease and ten patients with ulcerative colitis serum levels of human chorionic gonadotropin and the common alpha-subunit of glycoprotein hormones were determined by radioimmunoassay. In contrast to published data, all serum samples except one revealed levels within the normal range of 148 controls (human chorionic gonadotropin levels up to 3.9 IU/l, alpha-subunit up to 3.8 micrograms/l). Neither the serum levels of human chorionic gonadotropin nor of the alpha-subunit differed significantly between patients with Crohn's disease (median/maximum: 0.9/4.4 IU/l; 0.7/3.6 micrograms/l) and ulcerative colitis (1.0/3.4 IU/l; 0.8/2.2 micrograms/l). Furthermore, the serum levels studied in patients with active (0.9/3.0 IU/l; 0.7/3.5 micrograms/l) and inactive (0.9/4.4 IU/l; 0.8/3.6 micrograms/l) Crohn's disease and in patients with active (1.1/3.4 IU/l; 0.9/2.2 micrograms/l) and inactive (0.9/2.9 IU/l; 0.8/1.3 micrograms/l) ulcerative colitis were not significantly different. There was no relationship of the duration of the disease or a bowel resection to the serum levels of human chorionic gonadotropin or the alpha-subunit. It is concluded that both parameters are not useful as markers in patients with Crohn's disease or ulcerative colitis. The normal serum levels found in patients with inflammatory bowel diseases indicate human chorionic gonadotropin as a highly specific marker for malignant diseases.

Adolescent↗
PubMed1982

Studies on the in vitro binding of D-penicillamine to cholestyramine.

Adsorption of D-penicillamine to cholestyramine depends on the amount of the resin, the pH and the presence of other compounds such as bile salts. In the usual drug to resin ratio (150 mg D-penicillamine and 4-8 g cholestyramine per single dose) the percentage of D-penicillamine adsorbed to cholestyramine was about 10% of the applied dose; Bile salts (10 mmoles/l) inhibited this small adsorption by 87%.

Adsorption↗
PubMed1982

Retrograde colonic spread of sulphasalazine enemas.

In five patients with inflammatory bowel disease and in two healthy control subjects retrograde spread and colonic distribution of rectally introduced sulphasalazine (SASP) enema were investigated. The SASP enema was labeled with 99mTc and imaged by a gamma camera. In all patients the SASP enema reached the inflamed portion of the colon. From 73% to 84% of the total SASP enema were fairly homogeneously distributed beyond the patients' rectum. The results suggest that patients with inflammatory bowel disease may benefit from SASP enemas even if the total colon is involved.

Adult↗
PubMed1982

Whipple's disease demonstrated by double contrast small bowel enema with barium and methylcellulose.

The radiologic findings on small bowel enema examination using barium and methylcellulose (SBE + Ba + MC) in a patient with Whipple's disease before and after treatment are described. The changes on SBE + Ba + MC corresponded well to the clinical and morphologic picture. The advantages of this double contrast technique compared to the enteroclysis with barium alone are demonstrated. The SBE + Ba + MC is a good method to demonstrate the manifestations of Whipple's disease involving the small bowel and the mesentery.

Barium Sulfate↗
PubMed1981

[Serum immunoglobulin concentrations in Crohn's disease. Clinical relevance and comparison with lipid-A-antibody titers (author's transl)].

The results of previously published studies on serum immunoglobulin concentrations in patients with Crohn's disease are controversial. Therefore a long term study of serum immunoglobulin concentrations comparing 31 patients with Crohn's disease was carried out. The serum IgM concentrations of patients with active disease was significantly lower than the serum IgM concentration in patients with inactive disease. 7/25 patients who were all treated with steroids had an elevated serum IgE concentrations. It could not be demonstrated that serum immunoglobulin concentrations are influenced by steroids, by bowel resection or by the activity of the disease. As no characteristic change of serum immunoglobulin concentration in patients with Crohn's disease could be found the determination of serum immunoglobulins seems to be of no clinical value. Furthermore a possible connection between serum immunoglobulin concentrations and antibody titers against the lipid A component of endotoxins was investigated: Serum IgM concentrations were significantly higher in patients with elevated lipid-A-antibody titers than in patients with normal lipid-A-antibody titers. Thus indicates a specific antibody formation to endotoxins and lipid A, respectively.

Adrenal Cortex Hormones↗