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  • 1
    Electronic Resource
    Electronic Resource
    Serum-cholesterol-lowering effect of metronidazole and possible mechanisms of action (1985)
    Springer
    Journal of molecular medicine 63 (1985), S. 279-281 
    Details
    ISSN: 1432-1440
    Keywords: Metronidazole ; Bile acids ; Cholesterol absorption ; Serum cholesterol
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In five patients with Crohn's disease long-term therapy with metronidazole (400 mg b.i.d.) was followed by a significant reduction of total serum cholesterol from 179 mg/dl to 156 mg/dl, 134 mg/dl, and 143 mg/dl, after 2–4 months, 6 months, and 9–12 months, respectively. Lipoprotein analysis before and after 3 weeks of administration of metronidazol (400 mg/day) to five normolipemic volunteers revealed that LDL-cholesterol was reduced by 21% (P〈0.05), whereas HDL-cholesterol remained unchanged. Biliary secretion of cholesterol and bile acids were reduced by 13% and 20% (P〈0.05), respectively, which might suggest a decreased sterol synthesis. The amount and percentage of intestinal cholesterol absorption were decreased by 33% and 22% (P〈0.05). Thus, a possible decrease in sterol synthesis and a reduction of cholesterol absorption might be responsible for the serum-cholesterol-lowering effect of metronidazole. However, caution should be taken when considering metronidazole for long-term treatment of patients with hypercholesterolemia due to possible side effects.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01731475
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  • 2
    Electronic Resource
    Electronic Resource
    Acrodermatitis enteropathica: Recent findings concerning clinical features, pathogenesis, diagnosis and therapy (1976)
    Springer
    European journal of pediatrics 121 (1976), S. 247-261 
    Details
    ISSN: 1432-1076
    Keywords: Acrodermatitis enteropathica ; Small bowel ; Oxyquinoline ; Metabolism of fatty acids ; Paneth cells ; Zinc deficiency
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Bei 2 Geschwistern, einem Jungen und einem Mädchen, wurde die Diagnose der Acrodermatitis enteropathica (AE) im Alter von 10 bzw. 6 Wochen gestellt. Bis auf eine Blutsverwandtschaft, die 5 Generationen zurückliegt, ist die Familienanamnese anauffällig. Beide Kinder boten bei Diagnosestellung die für AE typischen Hautveränderungen. Symptome von seiten des Magen-Darm-Kanals waren weniger ausgeprägt und traten mit zunehmendem Alter in den Hintergrund. Bei dem jüngeren Patienten konnten während eines Rezidivs eine Erniedrigung des Serumspiegels der Ölsäure (18:1) sowie eine leichte Vermehrung der Linolsäure (18:2) festgestellt werden, während die Arachidonsäure (20:4) vermindert war. Bei beiden Patienten waren die Serumzinkspiegel mit und ohne Oxychinolinbehandlung deutlich erniedrigt. Eine Substitutionstherapie mit Zinkaspertat brachte weder eine klinische Besserung noch einen wesentlichen Anstieg des Serumzinkspiegels. Durch Gabe von Zinksulfat konnten eine völlige Remission der Hautveränderungen sowie eine weitgehende Normalisierung der Serumzinkspiegel erreicht werden. Untersuchungen der Dünndarmschleimhaut zeigten lichtmikroskopisch keine Besonderheiten. Elektronenmikroskopisch fanden sich in den Enterocyte sogenannte multi-vesicular bodies. Die Paneth-Zellen zeigten teilweise unregelmäßig geformte, inhomogene Strukturen im Cytoplasma. Die pleomorphen Sekretgraula wanen plump und groß und wiesen eine ausgeprägte Heteromorphie ihrer Matrix auf. Da bei Ratten unter zinkarmer Ernährung ähliche ultrastrukturelle Veränderungen bekannt sind, muß durch weitere Untersuchungen geklärt werden, ob die Veränderungen in den Paneth-Zellen typisch für die AE sind. Die adäquate Therapie der AE besteht zur Zeit in der Substitution von Zink. Dadurch wurde die mit toxischen Augenschädigungen belastete Therapie mit Oxychinolinen überflüssig.
    Notes: Abstract Acrodermatitis enteropathica (AE) was diagnosed in 2 siblings, boy and girl, at the age of 10 and 6 weeks. The family history is unremarkable except for consanguinity 5 generations previously. The clinical symptoms of the 2 patients conformed to the known features of AE, the gastrointestinal involvement loosing its significance with increasing age. In one patient in a stage of exacerbation the serum level of oleic acid (18:1) was lowered and of linoleic (18:2) acid slightly increased while that of arachidonic acid was decreased (Fig. 4). In both patients the serum zinc levels were significantly lowered. Under substitution with ZnSO4 the clinical condition improved and the serum zinc levels returned to normal. Histologically the small bowel mucosa was practically normal. Ultrastructural examination of jejunal biopsies revealed rather unspecific changes in the enterocytes in the form of numerous multivesicular bodies. The Paneth cells sometimes contained irregularly formed inhomogeneous structures within their cytoplasm. In addition the secretory granules varied in size and displayed a granular heteromorphic matrix. Frequently they were confluent and formed giant granules.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00443018
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  • 3
    Electronic Resource
    Electronic Resource
    Acrodermatitis enteropathica (1977)
    Springer
    European journal of pediatrics 125 (1977), S. 153-162 
    Details
    ISSN: 1432-1076
    Keywords: Acrodermatitis enteropathica therapy ; Small bowel ; Zinc malabsorption ; Zinc deficiency ; Paneth cells
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Als Ursache der klinischen Erscheinungen bei der Akrodermatitis enteropathica (A.E.) muß ein Zinkmangel als Folge einer Zinkmalabsorption angesehen werden. Durch orale Substitution mit Zink lassen sich die Krankheitserscheinungen beseitigen. Es wird über 2 Geschwister mit A.E. berichtet, die lange Zeit mit Oxychinolinpräparaten mit wechselndem Erfolg vorbehandelt waren. Durch orale Substitution mit Zinksulfat in der Dosis von 110–220 mg täglich wurde eine vollständige und anhaltende Remission erzielt. Gleichzeitig normalisierten sich die vorher stark erniedrigten Serumzinkspiegel. Keine so strenge Korrelation bestand zwischen dem Zinkgehalt der Haare und der Art Der Zinksubstitution. — Wie wir in unserer 1. Mitteilung zeigten, lassen die Paneth-Zellen der Dünndarmmukosa bei A.E. ultrastrukturelle Veränderungen in Form von inhomogenen Strukturen des Zytoplasmas, der Bildung von Riesengranula und Einschlüssen erkennen. Unter der Zinksubstitution kommt es zu einer vollkommenen Normalisierung des ultrastrukturellen Bildes der Paneth-Zellen. Die Veränderungen an den Paneth-Zellen können daher nur die Folge, jedoch nicht die Ursache des Zinkmangels bzw. der Zinkmalabsorption sein.
    Notes: Abstract The basic defect in acrodermatitis enteropathica (A.E.) is zinc deficiency caused by zinc malabsorption. The clinical symptoms disappear and serum zinc levels normalize after oral treatment with zinc. A report is given on two siblings suffering from A.E., both treated with oxyquinolines for a long period with changing clinical success. A permanent clinical remission could be achieved by treatment with zinc-sulphate at doses of 110–220 mg daily. The serum zinc levels normalized. The correlation between the zinc concentration of the hair and the kind of therapy was not very close. As we have shown in our first communication, the Paneth cells of the intestinal mucosa display ultrastructural changes in form of an unhomogeneous structure of the cytoplasm, formation of giant granules, and inclusion bodies. The zinc-therapy led to a complete normalization of the pathological changes in the Paneth cells. Thus, the changes in the Paneth cells in A.E. are the result and not the cause of zinc deficiency.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00489988
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  • 4
    Electronic Resource
    Electronic Resource
    Biliary lipid metabolism in children with chronic intrahepatic cholestasis (1984)
    Springer
    European journal of pediatrics 143 (1984), S. 35-40 
    Details
    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
    URL: http://dx.doi.org/10.1007/BF00442745
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  • 5
    Electronic Resource
    Electronic Resource
    Effects of phenobarbital on biliary lipid metabolism in children with chronic intrahepatic cholestasis (1984)
    Springer
    European journal of pediatrics 143 (1984), S. 41-44 
    Details
    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
    URL: http://dx.doi.org/10.1007/BF00442746
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