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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 60 (1982), S. 237-242 
    ISSN: 1432-1440
    Keywords: Cholestasis ; Bile salt enzyme interaction ; Enzyme inhibition ; Enzyme alteration ; Cholestase ; Gallensalz-Enzym-Wechselwirkung ; Enzyminhibition ; Enzym-Strukturveränderung
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Wechselwirkungen zwischen Gallensäuren und Zellbestandteilen sind im Zusammenhang mit Untersuchungen zur Cholestase von erheblicher Bedeutung. Schwerpunkte sind dabei die Wirkungen der verschiedenen Gallensäuren auf die Struktur von Lipiden und Proteinen. Die Wechselwirkungen mit Lipiden sind in erster Linie wegen der damit verbundenen Störung der Membranstruktur von Bedeutung, die den Zellstoffwechsel durch Aufhebung der Kompartimentierung in Unordnung bringen kann. Durch Wechselwirkungen mit Proteinen können Konformationsänderungen eintreten, die spezifische Funktionsleistungen in Mitleidenschaft ziehen. Von besonderer Wichtigkeit sind dabei Enzyme, da sie entscheidende Funktionsträger zellulärer Prozesse darstellen. In der vorliegenden Arbeit wurde daher die Wirkung verschiedener Gallensäuren auf die Aktivität von Schlüsselenzymen der Leber untersucht. In kinetischen Tests wurden Enzymaktivitäten geprüft, mit elektrophoretischen Verfahren strukturelle Veränderungen an den Enzymen. Es konnte nachgewiesen werden, daß bereits weit niedrigere Gallensäurekonzentrationen als sie in der Gallenflüssigkeit vorkommen, bei gewissen Enzymen zu einem vollständigen Aktivitätsverlust führen. Es ist auffällig, wie unterschiedlich empfindlich verschiedene Enzyme auf die Anwesenheit von Gallensäuren reagieren. Die verschiedenen Gallensäuren zeigen je nach Hydroxylierungsgrad charakteristische Unterschiede in ihrer Hemmwirkung auf Enzymaktivitäten. Eine Beteiligung der Wechselwirkung zwischen Gallensäuren und Enzymen bei der Ätiologie und Pathogenese der cholestatischen Leberveränderungen erscheint aufgrund der hier ermittelten Resultate möglich
    Notes: Summary Interactions between bile salts and cellular constituents are of considerable significance in studies on cholestasis. The main points of interest are the effects of the various bile salts on lipid and protein structures. Of primary interst are the interactions with lipids since these can cause disorder in cellular metabolism by eliminating compartmentalization. Conformational changes of proteins can occur through interactions with bile salts. They can involve specific functions. Of special importance here are the enzymes, since these are decisive supportive agents in cellular processes. In this paper, the effect of various bile salts on the activity of key hepatic enzymes was studied. In addition to the kinetic tests for enzyme activity, structural changes of the enzymes were studied as well using electrophoretic techniques. It could be shown that even much lower bile salt concentrations than those which occur in bile can lead to a complete inhibition of activity. The varying sensitivities of different enzymes when they react in the presence of bile salts is striking. According to the degree of hydroxylation, the various bile salts show characteristic differences in inhibitory effect on enzymatic activity. On the basis of the results reported here, it is quite possible that the interaction between bile salts and enzymes is a participating factor in the etiology and pathogenesis of cholestatic hepatic changes.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1238
    Keywords: Transthoracic electrical impedance ; Acute respiratory failure ; Pulmonary interstitial edema ; Intrathoracic fluid volume
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The alteration (ΔZ 0 ) of transthoracic electrical impedance (TEI) during extracorporeal hemodialysis (EHD) was investigated in two Groups of patients with acute renal and acute respiratory failure, that differed with respect to the severity of respiratory insufficiency. Group I had moderate respiratory failure (Fi O 2 0.31±0.10, Pa 0 2 84±14 mmHg), and Group II had severe respiratory failure (Fi 0 2 0.75±0.17, Pa O O 77±14 mmHg). There was a significant correlation between increase in TEI (ΔZ0) and decrease in body weight (ΔBW) in each individual patient, but the slope of regression lines was remarkably flattened in Group II. In Group I, ΔTEI was 1.9±0.9 Ω, the calculated TEI for 500 gr decrease in BW (ΔZ0–500 gr) was 0.59±0.21 Ω, and a significant correlation existed between pooled data of ΔZ0 and ΔBW. In Group II TEI increased less significantly, ΔTEI was 0.6±0.3 Ω (P〈0.001), ΔZ0–500 gr was 0.26±0.27 Ω (P〈0.01), and there was no correlation between pooled data of ΔZ0 and ΔBW. Increase of TEI in Group II could be completely attributed to increase in hematocrit. It is concluded that patients of Group I with acute renal failure and moderate respiratory failure lost intrathoracic fluid during EHD, whereas patients of Group II with severe respiratory failure did not. TEI during EHD may serve as a test for detection of fixed fluid within the pulmonary interstitium indicating a poor prognosis of the acute respiratory failure.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Intensive care medicine 7 (1981), S. 77-87 
    ISSN: 1432-1238
    Keywords: Burn toxins ; Immunotherapy ; Liver damage
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Modern intensive care combined with current improvements in the specific, systemic and local therapy of burns has delayed the mortal effects of severe burns. Nor has there been any significant improvement in this mortality during the last decade. The occurrence of uncontrollable infection and sepsis due to gram-negative bacteria or fungi as the basic cause of death was not a satisfactory explanation. So, progress should only be expected from a new concept in burn treatment. This new concept should be to view the burn disease as being caused by toxic factors induced by thermal injury to the skin. Electron-microscope studies in mice and rats have revealed similar mitochondrial alterations in hepatocytes after either a sublethal controlled burn injury or an intraperiotoneal application of an equivalent dose, of a cutaneous burn toxin. The intraperitoneal injection of different amounts of the burn toxin indicated, that the extent of the mitochondrial changes correlated directly with the dose of toxin. Investigations of liver metabolism suggested an inhibition of the oxygenation chain. The incubation of isolated liver cells together with the burn toxin demonstrated by scanning electron microscopy a direct cytotoxic effect of the burn toxin. In animal tests the pathogenic effect of the burn toxin could be prevented by treatment with an antitoxic IgG generated in sheep. The fatal sepsis of severely burned patients is the consequence of a decreased host defence against infections, which is caused by a primary and general toxic alteration of the whole organism. One important aspect of treatment should therefore be the elimination of burn toxins. To achieve this management should include primary excision of the burns, local application of nonabsorbable protein-complex-binding substances and specific passive immuno-therapy with an antitoxic IgG.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    European archives of oto-rhino-laryngology and head & neck 235 (1982), S. 681-685 
    ISSN: 1434-4726
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Recently vitamin A has been shown to have an inhibitory effect on the carcinogenic potential of tobacco smoke constituents and vitamin A deficiency has been reported to be capable of reducing the tumor induction time in the respiratory tract of animals treated with polycyclic aromatic hydrocarbons. Prospectives epidemiological investigations have shown an inverse association between vitamin A and risk of lung cancer. We have done therefore histologic and electron microscopic investigations on the influence of a chronic vitamin A deficit diet on the epithelial structures of trachea in rats. Further we measured vitamin A, RBP and zinc in the blood in alcoholics, cancer patients and controls. After 12 week of a vitamin A deficit diet the male rats showed focal metaplasias. Mean levels of vitamin A in patients with alcoholic liver diseases and in patients with head and neck cancer and simultaneous alcoholic liver diseases were deceased compared to healthy controls and patients with head neck cancer without liver diseases. The mean levels for zinc and RBP were in the groups with liver diseases likewise decreased compared with the two others groups. We conclude that the chronic alcoholism leads to a vitamin A deficit in humans and this may be one cause for the higher risk for cancer in chronic alcoholics.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1435-2451
    Keywords: Extensive ascites ; Peritoneo-venous shunt ; Therapieresistenter Ascites ; Peritoneo-venöser Shunt
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Ein therapieresistenter Ascites wird seit einigen Jahren durch Reinfusion über eine begrenzte Zeitdauer oder durch Implantation eines peritoneo-venösen Shunts behandelt. Neben der drohenden Shuntsepsis stehen Hypercoagulabilität und Blutungsneigung im Vordergrund. Endotoxin im Ascites hat sich als auslösender Mechanismus für die Induktion von Palsminogen-Aktivatoren herausgestellt. Vor der Implantation des Shunts müssen folgende Voraussetzungen erfüllt sein: 1. Keimfreiheit im Ascites und im Blut. 2. Nachweis von Plasminogenaktivität im Ascites. Wir haben bei 7 Patienten einen peritoneo-venösen Shunt implantiert. Dabei trat nach Gaben von Fortecortin nie eine generalisierte Blutung auf.
    Notes: Summary Extensive ascites can be treated by reinfusion or implantation of peritoneo-venous shunt. However, the results vary. Besides sepsis, hypercoagulability and bleeding are the main complications. Endotoxin in the ascites is the release mechanism for the induction of plasminogen activator. Before the shunt is implanted the following conditions must be fulfilled: (1) no germs in the ascites or blood; (2) plasminogen activity must be measured in ascites. We implanted peritoneo-venous shunts in seven patients. Generalized bleeding was not noted.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1435-2451
    Keywords: Isolated rat hepatocytes ; Burnt skin ; Toxic effect of a burn toxin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die Existenz von bei der Verbrennung in der Haut entstehenden toxischen Substanzen und deren Bedeutung für die Pathogenese der Verbrennungskrankheit wird heute weithin als wahrscheinlich angesehen. In der vorliegenden Arbeit wurde der Stoffwechsel isolierter Hepatocyten sowie deren Ultrastruktur unter dem direkten Einfluß sowie nach systemischer Applikation eines aus verbrannter Menschen- und Mäusehaut isolierten hochgereinigten toxischen Faktors untersucht. Unbehandelte Zellen sowie solche, die mit der physiologischen, nicht toxischen Vorstufe des Toxins behandelt wurden, dienten als Kontrolle. Direkt mit dem Toxin inkubierte Zellen wiesen keine Veränderung der Gluconeogenese, eine deutliche Verringerung der Harnstoffsynthese und eine noch deutlichere Reduktion der Glykogenbildung aus den meisten der angebotenen Prekursoren auf. Rasterelektronenmikroskopisch fanden sich deutliche Schädigungen der Zelloberfläche. Zellen von zuvor mit Toxin behandelten Tieren zeigten Einschränkungen aller Syntheseleistungen und wesentlich geringere Membranschäden. Ein direkter zelltoxischer Effekt des Toxins konnte somit gezeigt werden.
    Notes: Summary The existence of a burn toxin which could be responsible for the late burn disease has become increasingly accepted. The present study investigates both metabolism and ultrastructure of isolated rat hepatocytes both under the influence of a burn toxin isolated from burnt mouse and human skin and of its native nontoxic precursor. Cells from rats treated with toxin systematically were also investigated. The cells directly incubated with toxin showed no alterations of gluconeogenesis, but a reduced urea — and glycogensynthesis from most precursors used. Cells of pretreated rats were reduced in all functions and showed more distinct ultrastructural damage, while those incubated directly were significantly more altered. The results prove a direct toxic effect of a burn toxin on isolated liver cells.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 364 (1984), S. 51-60 
    ISSN: 1435-2451
    Keywords: Functional capacity ; Indication for surgical procedure ; Operability ; Belastbarkeit ; Funktionsreserven ; Operationsindikation ; Operabilität
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die somatische Belastbarkeit läßt sich als organbezogene Funktionsreserve definieren. Statistische Untersuchungen haben perioperative Risiken erkennen lassen, die sich in reziprokem Verhältnis zur Belastbarkeit befinden. Zu deren Erfassung wird ein Stufenprogramm von Untersuchungen vor allem der kardialen und pulmonalen Funktion vorgeschlagen, das sich nach dem geschätzten Risiko orientiert. Indikation und Operabilität werden aber besonders in der Tumor- und Alterschirurgie nicht allein von der somatischen Belastbarkeit bestimmt, sondern sind vielfach konditioniert.
    Notes: Summary The somatic functional capacity can be defined as an organ-specific functional reserve. Statistical studies have shown perioperative risks in reciprocal relationship to this limit. A stepwise (graduated) approach for the assessment of cardiac and pulmonary function is suggested, which depends on the estimated risk. Indications for surgical therapy and operability, especially in the treatment of tumors and for geriatric patients, are not only determined by the somatic functional capacity but also by multiple other conditions.
    Type of Medium: Electronic Resource
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