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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 143 (1984), S. 35-40 
    ISSN: 1432-1076
    Keywords: Chronic intrahepatic cholestasis ; Biliary lipid composition ; Bile acids ; Gallstones
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Biliary lipid composition, standard liver function tests, serum lipids and faecal fat excretion were studied in 15 children with chronic intrahepatic cholestasis (severe intrahepatic cholestasis, n=6; paucity of intralobular bile ducts, n=4; benign recurrent cholestasis, n=5) and compared to 15 children without gastrointestinal diseases. Severe and benign intrahepatic cholestasis were associated with normal or moderately elevated serum lipids. Biliary lipid concentrations were extremely reduced, bile acid concentrations were below the critical micellar concentration. This may account for the high incidence of gallstone formation in these patients. Remission periods in patients with benign recurrent cholestasis were not followed by complete normalisation of biliary lipid concentrations, indicating a primary defect in hepatic excretory function. Children with paucity of intralobular bile ducts showed markedly increased serum lipids, but only a two-fold reduction in biliary lipid concentrations. Cholic acid was the predominant bile acid in bile of all cholestatic children even during remission. Neither increased levels of monohydroxy bile acids nor unusual bile acids could be identified in notable amounts.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 143 (1984), S. 41-44 
    ISSN: 1432-1076
    Keywords: Chronic intrahepatic cholestasis ; Biliary lipid composition ; Bile acids ; Phenobarbital
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The effects of phenobarbital (5.4–7.5 mg/kg body weight) for 14 days were studied in four children with severe intrahepatic cholestasis (group I) and in four with a syndromatic type of paucity of intralobular bile ducts (group II). Phenobarbital administration resulted in a moderate improvement of pruritus in all patients. There was a significant decrease of bilirubin in serum (group I: from 4.8 to 2.7 mg/dl; group II: from 6.1 to 2.1 mg/dl); total bile acids (group I: from 416 to 337 μmol/l; group II: from 156 to 123 μmol/l) and cholesterol (group I: from 248 to 207 mg/dl; group II: from 351 to 292 mg/dl). Alkaline phosphatase activity increased from 929 to 1126 U/l in group I and from 1751 to 2360 U/l in group II. SGOT and SGPT activities remained unchanged in both groups. In group I total biliary lipid concentration and bile acid output increased from 0.09 to 0.17 g/dl and from 3.9 to 7.2 μmol/kg per 30 min, respectively. Molar percentages of cholesterol, phospholipids and bile acids in bile remained unchanged. In group II total lipid concentrations and bile acid output increased from 1.62 to 2.0 g/dl and from 27.8 to 39.1 μmol/kg per 30 min, respectively. The molar percentage of cholesterol decreased from 5.6 to 3.5 mol%. The present results indicate that short term administration of phenobarbital has only minimal effects on biliary lipid metabolism in children with chronic intrahepatic cholestasis.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 134 (1980), S. 217-225 
    ISSN: 1432-1076
    Keywords: Pancreatic and biliary secretion ; Secretin ; Cholecystokinin ; cAMP ; Chronic intrahepatic cholestasis ; Cystic fibrosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The intracellular transmitter cAMP enters the extracellular space and can be found in the duodenal fluid. The role of this messenger was investigated in response to secretin and CCK in children with secretory insufficiency, i.e. 7 with chronic intrahepatic cholestasis, 7 with cystic fibrosis, and 6 controls. Duodenal juice was collected in 10 min aliquots before and after stimulation with 2 U/kg secretin and subsequently 2 U/kg CCK. cAMP, bicarbonate, Ca++, Na+, K+, bilirubin, protein, amylase, trypsin and lipase were determined. Controls. After the injection of secretin the cAMP concentration increased 2.5-fold, the output 6-fold. Compared to cAMP, the time-concentration curve of bicarbonate and Na+, as well as volume output, were slightly delayed after secretin, whereas Ca++ and bilirubin concentrations decreased. CCK stimulation resulted in an increase of volume, bicarbonate-Na+, Ca++-, bilirubin-, protein- and hydrolase concentration. cAMP concentration increased 1.7-fold and the output was doubled. Chronic Intrahepatic Cholestasis. Following secretin the cAMP concentration hardly differed from the control values; the output of cAMP, bicarbonate and Na+ was enhanced. Compared to the controls CCK was less effective—the concentration and output of cAMP, bilirubin, K+ and Ca++ were diminished. Cystic Fibrosis. After both hormones high concentrations of cAMP, Na+, K+, Ca++ and bilirubin were found. Due to the reduced secretion volume the output of these parameters were significantly decreased. The Results Indicate that essentially more cAMP is found in the duodenal juice after secretin stimulation than after CCK. cAMP in response to secretin seems to be mainly of pancreatic origin, that after CCK of hepatic origin. One of the first steps of stimulus-secretion coupling—the activation of the membrane bound adenylate cyclase system by secretin and CCK —seems to be intact in cystic fibrosis. The defect of this disease is probably beyond this mechanism.
    Type of Medium: Electronic Resource
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