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Intracecal endotoxin and lactate during the onset of equine laminitis: a preliminary report.

Cecal fluid from two adult horses was assayed by the limulus amebocyte lysate system for endotoxin before and after carbohydrate overload of the gastrointestinal tract. There were increases in cecal fluid endotoxin concentrations at the 3-, 6-, and 12-hour samplings when compared with base-line values. Concomitant cecal fluid lactate concentrations and pH values increased and decreased, respectively. Both horses subsequently developed clinical signs of acute laminitis.

Animals↗

[Serum endotoxin level in the course of open peritonitis treatment].

In 27 patients with severe diffuse purulent or fecal peritonitis planned relaparotomies with peritoneal lavage or continuous dorsoventral lavage with open abdomen were performed after surgical treatment of the primary infection. During the course of the lavage treatment serum endotoxin was measured daily. The endotoxin-induced liberation of lysosomal proteases was studied by determining the elastase from polymorphonuclear leucocytes. 16 surviving patients showed decreasing endotoxin levels and decreasing elastase concentrations during the course of abdominal lavages. Planned peritoneal lavage and continuous dorso-ventral lavage seem to have the same potency in eliminating endotoxin from the infected peritoneal cavity. In letal courses endotoxinemia either persisted at high levels or even progressed inspite of lavage treatment.

Adolescent↗

[Endotoxin in diffuse suppurative peritonitis].

Endotoxin has been measured in the blood and peritoneal fluid from 28 patients with diffuse peritonitis after intestinal perforation, intestinal obstruction or mesenteric infarction. Phenol-Water-Extraction for plasma preparation has been used. Endotoxin in correlated with the clinical state in these patients.

Adolescent↗

Optimalization of a chromogenic assay for endotoxin in blood.

Early detection of Gram-negative septicemia or endotoxemia may become feasible with sensitive and reliable endotoxin (LPS) measurements. We recently published an assay for LPS in blood, based upon the LPS dependent activation of Limulus amebocyte lysate (LAL) and the subsequent chromogenic measurement of the activated enzyme(s). Inhibitors and activated clotting factors potentially interfering in the assay were removed by dilution and heating. In the present study we describe the further improvement of the assay. Optimal conditions include: blood anticoagulated with 30 I.U./ml heparin; dilution of the platelet-rich plasma (PRP) in water; 5 min. heating at 75 degrees C; 15 mM Mg2+, 1.5 mM Ca2+, 125 mM Na+, 50 mM TRIS, pH 8.5 in the LAL activation step; substrate step without extra addition of Ca2+, Mg2+, or Na+, but in the presence of 50 mM TRIS at pH = 9.5. Under those optimal conditions less than 10 pg LPS per ml blood (PRP) can easily be detected. Prospective clinical trials are presently envisaged to investigate the clinical usefulness of this extremely sensitive LPS assay.

Chromogenic Compounds↗

The importance of intestinal endotoxins in liver disease.

The development and wider use of the Limulus amoebocyte lysate assay (LAL) for the detection of endotoxin, has led to renewed interest in the link between gut-derived endotoxin, liver injury and the extra-hepatic manifestations of clinical liver disease. The concept that endotoxemia may occur and be harmful in clinical states without the concomitant presence of Gram-negative bacteria is a relatively recent one and has been most intensively studied in the context of liver injury. Since the liver stands between the gut and the systemic circulation, it has been postulated that failure to detoxify endotoxins absorbed into the portal circulation after hepatic injury might lead to further liver damage and escape of this toxic material into the general circulation. The present review will update the status of this hypothesis, discuss mechanisms proposed for the damage and present evidence for the association in animal models. Finally, studies both positive and negative, will be cited that have used the LAL to detect endotoxemia and its consequences in human liver disease.

Absorption↗