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Biomedical subjects

W Uhl

Publications and source records attributed to W Uhl.

121 records · Page 7Linked to original sources
PubMed1989

Serum phospholipase A2 in intensive care patients with peritonitis, multiple injury, and necrotizing pancreatitis.

To study the source and role of circulating phospholipase A2 (PLA2) catalytic activity we monitored the serum from patients with necrotizing pancreatitis (n = 8), diffuse peritonitis (n = 6), and multiple injuries (n = 11). Immunoreactive PLA2 serum protein concentration was analysed using a fluoroimmunoassay based on an antibody against human pancreatic PLA2. Serum PLA2 catalytic activity was analysed using a radiochemical method based on a substrate with tritiated palmitic acid in beta position. In necrotizing pancreatitis immunoreactive PLA2 and PLA2 catalytic activity both increased. Obviously, in necrotizing pancreatitis the major part of serum catalytic activity stems from the pancreas. In patients with diffuse peritonitis and multiple injuries, as a rule, immunoreactive phospholipase A2 serum concentration appears to be within the normal range. In contrast, in these patients we demonstrated high serum catalytic PLA2 activity comparable to that in necrotizing pancreatitis. The source of catalytic PLA2 activity in peritonitis and multiple injuries seems not to be the pancreas. There was a correlation between pulmonary insufficiency and serum PLA2 catalytic activity in patients with necrotizing pancreatitis, peritonitis, and multiple injuries.

Acute Disease↗
PubMed1987

Serum elastase 1 in inflammatory pancreatic and gastrointestinal diseases and in renal insufficiency. A comparison with other serum pancreatic enzymes.

Serum elastase 1 has been evaluated in 115 patients with pancreatic and nonpancreatic gastrointestinal diseases and in 36 healthy controls. Increased serum elastase 1 values were found in all 27 patients with acute pancreatitis. If the diagnostic cutoff was established as the 2-fold increase above the upper normal range, sensitivity of elastase 1 (100%) was superior to pancreatic lipase (90%), immunoreactive trypsin (87%) and pancreatic amylase (78%). Specificity was 96% for elastase 1 at this cutoff. No distinction was possible between edematous and necrotizing acute pancreatitis on the basis of peak serum elastase 1 concentrations. Among 32 patients with chronic pancreatitis increased serum elastase 1 values were found in 22% and decreased values in 16% of patients, showing a striking parallelism to serum values of pancreatic lipase and immunoreactive trypsin. Specificity, established in controls and 49 patients with different gastrointestinal diseases, was 77% for elastase 1, 76% for immunoreactive trypsin, 83% for pancreatic lipase and 91% for pancreatic amylase. In addition, we investigated 21 patients with severe chronic renal diseases. In patients with renal insufficiency elastase was increased in 33%, comparable to the frequency of increased amylase and pancreatic amylase serum levels, whereas immunoreactive trypsin was increased in 95%. Immunoreactive trypsin showed a significant correlation to creatinin serum concentration, whereas the other enzymes did not.

Acute Disease↗
PubMed1986

Diagnostic and prognostic value of serum elastase 1 in acute pancreatitis.

Serum elastase 1 was determined in the serum of 38 patients with acute pancreatitis, using specific radioimmunoassay technique. Serving as controls were 36 healthy people, 33 patients with chronic pancreatitis, 49 patients with various GI-tract diseases, and 6 patients with pancreatic carcinoma. Sensitivity of elastase 1 for the diagnosis "acute pancreatitis" was 97% after admission to the hospital and 100% within 48 h after onset of acute pancreatitis. The determination of elastase 1 is clearly superior to that of trypsin, pancreatic lipase, or pancreatic amylase, if diagnosis has to be made more than 48 h after the onset of the disease. The specificity is restricted, because there are some cases with chronic pancreatitis and GI-diseases with raised values. There is no possibility to estimate the severity of acute pancreatitis by measuring serum elastase 1.

Acute Disease↗
PubMed1986

Sensitivity of antiproteases, complement factors and C-reactive protein in detecting pancreatic necrosis. Results of a prospective clinical study.

Thirty-five patients with acute pancreatitis underwent serum monitoring of alpha-1-protease inhibitor, alpha-2-macroglobulin, complement factors C3 + C4, and C-reactive protein (CRP). Edematous interstitial pancreatitis was shown to be present in 13 patients by contrast-enhanced computed tomography (CT) and laparotomy (n = 3). Necrotizing pancreatitis was confirmed by laparotomy (n = 21) and contrast-enhanced CT. There were significant differences between the serum values of all measured parameters in the two morphologically defined pancreatitis groups. The best discriminating factors were CRP and alpha-2-macroglobulin, showing 95% and 85% overall detection rates for pancreatic necrosis, respectively.

Acute Disease↗
PubMed1986

[Value of biochemical and imaging procedures for the diagnosis and prognosis of acute pancreatitis--results of a prospective clinical study].

For a period of 14 days we carried out measurements for alpha-1-protease inhibitor, alpha-2-macroglobulin, complement C 3, complement C 4, and C-reactive protein in two different groups of patients with acute pancreatitis. Group I consisted of 13 patients with edematous-interstitial pancreatitis and group II of 22 patients with necrotizing pancreatitis. Diagnosis of acute pancreatitis was established by clinical signs and symptoms, by specific pancreatic enzymes determined in the serum, by imaging procedures, and by laparotomy in 24 cases. The overall detection rate for pancreatic necrosis was 90% for the contrast enhanced CT and 33% for ultrasonography respectively. There were significant differences as to all measured serum parameters between the two morphologically defined pancreatitis groups. The necrosis detection rate was 95% for CRP and 85% for alpha-2-macroglobulin. The combined determination of CRP and alpha-2-macroglobulin is recommended in patients with acute pancreatitis to stage the severity of the disease and to probably replace the CT investigation.

Acute Disease↗
PubMed1983

On the conformation of 5-substituted uridines as studied by proton magnetic resonance.

The proton magnetic resonance (pmr) spectra of 10 basemodified uridine derivatives x5Urd have been measured at 3 degrees, 30 degrees, and 60 degrees C in order to correlate the electronic effects of different substituents with the molecular conformation of the respective nucleosides. The results presented demonstrate the close relation between conformational parameters and the electron-affinity of the substituents as reflected by their Hammett constants. Going from electron-donating to electron-accepting groups, the portion of N-conformer in the ribose N in equilibrium S equilibrium increases from 44% to about 90%. In addition the percentage of gauche-gauche rotamer as measured for the exocyclic groups changes from about 30% in nh52Urd to more than 80% in no52Urd.

Magnetic Resonance Spectroscopy↗
PubMed1983

[Metabolism of parenterally administered amino acids in chronic kidney failure in childhood].

Twenty children (8 months to 17 years old) with chronic renal insufficiency were infused with a 10% L-amino acid solution (1 ml/kg B.W. over 3-5 min). Amino acid blood concentrations were measured in the basal state and repeatedly after the end of infusion. The elimination constant, half-life, clearance, corrected transfer and pool size were calculated for the individual amino acids. The results were analyzed for gender specific and age-related differences. The control group consisted of 19 healthy children. (1) Almost all basal free amino acid concentrations in the chronic renal patients showed abnormalities typical for this disease. (2) Calculation of the pharmacokinetic data demonstrated differences between chronic renal patients with predominantly glomerular and those with predominantly tubular disease. (3) The half-lives and elimination constants did not differ from normal. Evaluation of age-related changes demonstrated no abnormalities for these 2 parameters in renal patients. (4) On the average, the clearance value for the group with primarily glomerular disease was 57% of normal; that of the group with predominantly tubular disease was 115% of normal. (5) Analogously, the average corrected transfer was 56% and 113% of normal; the pool size was 67% and 139% of normal. (6) No gender specific differences were found. (7) The clearance values for lysine, threonine, glycine and proline in infants and toddlers exceeded those found in older children. (8) The corrected transfer values for threonine, arginine, histidine, glycine, alanine and serine in children 8 to 31 months of age were significantly higher than those found in the rest of the children. (9) No significant age-related differences in pool size were found.

Adolescent↗
PubMedDate not supplied

Study of a primary gastrinoma in the common hepatic duct - a case report.

Primary endocrine neoplasms of the biliary tract are exceedingly rare. We report on a 60-year-old man with diarrhea, vomiting and gastroesophageal reflux disease, with a primary gastrinoma of the common hepatic duct. The tumor was positive for a variety of immunohistochemical markers. Postoperatively the patient's symptoms disappeared and in the follow-up the patient was symptom free. To our knowledge, this is the first case in the literature of a primary gastrinoma in the common hepatic duct. The fact that the common hepatic duct is not located within the gastrinoma triangle made the diagnosis difficult and the distinct localization made the surgical treatment demanding.

Biomarkers, Tumor↗
PubMedDate not supplied

Hyperlipidemia in acute pancreatitis. Relationship with etiology, onset, and severity of the disease.

Serum lipid (triglycerides and cholesterol) concentrations were studied in 49 patients with acute pancreatitis (AP). The aims of the study were to investigate the prevalence of hyperlipidemia (HL) in patients with AP according to etiology and to evaluate whether HL precedes or is a consequence of AP. Moreover, we analyzed the relationship between HL and the development of pancreatic necrosis. At admission, 23 patients (47%) had HL: 9 of 19 patients with alcoholic pancreatitis, 5 of 18 patients with biliary pancreatitis, and 9 of 12 patients with AP of miscellaneous etiologies (p less than 0.05). Severe HL (serum triglycerides greater than 20 mmol/L) was observed in five patients. Serum lipid levels in patients with AP and HL decreased markedly during the first 72 h of evolution, but remained slightly above the upper normal limit in most of them after 15 d. The prevalence of HL was similar in edematous and necrotizing pancreatitis. Necrotizing pancreatitis was significantly associated with the presence of hypertriglyceridemia in conjunction with hypercholesterolemia (p less than 0.05). The observations that a) hyperlipidemia is an early event in acute pancreatitis, (b) serum lipid values decrease during the acute phase of the disease, (c) hyperlipidemia has a different prevalence in different etiologies, and (d) high serum lipid levels are not always associated to pancreatic necrosis suggest that HL is a preexistent metabolic abnormality with respect to AP. On the other hand, HL may play a role in aggravating AP.

Acute Disease↗
PubMedDate not supplied

Enzymun-Test TG: results from external evaluation.

A new non isotopic assay for determination of thyroglobulin has been developed by Boehringer Mannheim. This assay uses a new international reference material for calibration, that is thought to replace the current manufacturer specific standardization. Several aspects of the technical performance of this assay have been evaluated in a multicenter evaluation, including precision profile, lower detection limit, recovery testing and method comparison. Additionally reference ranges were established. The presented assay fulfils clinical and analytical needs and offers for the first time a calibration according to a new international certified reference material.

Calibration↗