ISSN:0277-2116    

出版商:OVID    

年代:1989

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:1989

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The effect of short-term immunosuppressive treatment on the percentage of circulating DR-bearing T cells was investigated in 16 children with HBsAg-positive chronic active hepatitis. DR-positive T cells, thought to represent activated T cells, were significantly increased in all patients as compared to 10 age-matched controls [14.5 ± 4.2% (mean ± SD) vs. 0.4 ± 0.1%,p< 0.001]. Fifty-six percent of patients showed a decrease in the percentage of DR-positive T cells after 72 h of prednisone therapy. A response did not correlate with the presence of HBeAg, anti-HBeAg, or anti-delta antibodies. There was an inverse relationship (r= −0.56;p< 0.05) between the decrease of the percent of DR-positive T cells during immunosuppression and pretreatment alanine aminotransferase levels. The persistence of high levels of circulating DR-bearing T cells during therapy may represent the immunological counterpart of more severe disease, and of nonresponsiveness to corticosteroids.

ISSN:0277-2116    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

We evaluated [99mTc]diisopropylphenyl-carbamoylmethylimidodiacetic acid ([99mTc]DISIDA) cholescintigraphy with measurement of duodenal fluid radioactivity collected by the string test in patients with neonatal cholestasis. Twenty-six infants with prolonged jaundice and acholic stools were studied prospectively. Twelve patients had neonatal hepatitis, 12 biliary atresia, and one each Alagille syndrome and α1-antitrypsin deficiency liver disease. All infants except the biliary atresia patients and four of the neonatal hepatitis patients revealed bowel activity on scan 6 h after tracer administration. At 24 h, three of these latter patients with neonatal hepatitis and two of the patients with biliary atresia revealed bowel activity. String radioactive counts for neonatal hepatitis ranged from 99,574 to 967,205 cpm (374,504 ± 232,210 cpm; mean ± SD) and for biliary atresia from 8,342 to 370,346 cpm (117,149 ± 98,698 cpm; mean ± SD). While neither test alone was capable of correctly differentiating among all patients, those patients with biliary atresia had either a negative hepatobiliary scan at 24 h or string radioactive count below 197,007 cpm. Disparity between the hepatobiliary scan and the string radioactive counts mandates further diagnostic investigation. These data suggest that simultaneous administration of the string test with hepatobiliary scintigraphy is advantageous in the evaluation of infants with chole-static jaundice.

ISSN:0277-2116    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

To test the hypothesis that bacterial infections are the main cause of acute cholestasis in short-term intravenously fed newborns, two groups were studied. Group I consisted of 152 newborn infants who were fed intravenously for at least 7 days and in whom severe bacterial infections developed. Group II was formed of 92 newborn infants who were matched to the group I cases with respect to the year of birth, birth weight and gestational age, Apgar scores, and duration of parenteral nutrition but who did not have infections. Bacterial infections were diagnosed on the basis of impaired microcirculation with prolonged capillary filling time, a shift to the left in the white cell differential, and a positive blood culture. Cholestasis was diagnosed when the total serum bilirubin level was >4 mg/dl and the conjugated fraction made up more than 40% of the total. The results were that all 40 cases of cholestasis were found in the first group of infected infants. All of the other factors were distributed equally between both groups and could not be attributed as a major factor in the etiology of idiopathic neonatal cholestasis. The conclusion was that bacterial infections are the main cause of acute cholestasis in intravenously fed newborn infants.

ISSN:0277-2116    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

It is not known to what extent humans store vitamin K in liver. We measured hepatic concentrations of vitamin K1(phylloquinone) and K2(menaquinones) in 11 human livers (eight infants and three adults). Relatively small amounts of vitamin K were found in the liver at any age compared to other fat soluble vitamins. Vitamin K1was the predominant form with much smaller concentrations of vitamin K2. Long-chain menaquinones (vitamin K2) were readily identified in most liver specimens. Hepatic vitamin K2concentrations also increased with increasing age. These observations have implications for vitamin K supplementation in infants.

ISSN:0277-2116    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Lipid composition of gallbladder bile was determined in 20 patients with cystic fibrosis (CF) (9 females and 11 males, ranging in age from 3 to 18 years). The results were compared with 47 normal subjects matched for age, sex, and pubertal stage. In patients with CF, bile was undersaturated with cholesterol before puberty in both sexes and no differences with normal controls could be observed. After puberty, a similar increase in cholesterol saturation was noted in females with CF (85 ± 15% vs. 130 ± 38%,p< 0.01) and normal controls (82 ± 11% vs. 138 ± 31%,p< 0.01). No change in cholesterol saturation could be observed in male patients and controls after puberty. Molar percentage of chenodeoxy-cholic acid (CDCA) was lower (p< 0.05) in postpubertal females (31 ± 9%) and males (36 ± 7%) with CF compared to controls (42 ± 8% and 40 ± 5%, respectively), while cholic acid (CA) was higher in all patients with CF. In females with CF, lithocholic acid (LCA) increased after puberty (2.2 ± 0.8% vs. 5.3 ± 2.6%,p< 0.05) and was higher compared to controls (2.2 ± 0.8%,p< 0.001). An increase was also noted for deoxycholic acid (DCA) in postpubertal females with CF (1.7 ± 2.6% vs. 10.8 ± 7%,p< 0.05), but it was lower in both sexes after puberty than in respective controls. The present results suggest that cholesterol saturation of bile in patients with CF is not different from respective controls. Thus, the higher incidence of gallstone disease in patients with CF reported in the literature might be related to other hepato-biliary disorders known in this disease.

ISSN:0277-2116    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Concentrated proteins in pancreatic juice could precipitate and plug pancreatic ducts, initiating pancreatic disease. In cystic fibrosis (CF), pancreatic fluid secretion is impaired due to defective anion transport and proteins are hyperconcentrated. To determine whether proteins in pancreatic secretions precipitate selectively or nonspecifically, duodenal secretions were obtained from subjects with and without cystic fibrosis, during pancreatic stimulation with cholecystokinin (CCK) and secretin, dialyzed against phosphate-buffered saline (PBS), and concentrated in stages by ultrafiltration. Precipitates obtained by centrifugation at 15,600gfor 10 min at 4°C were analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The only protein band regularly enriched in precipitates from 10 CF and 9 non-CF samples had anMrof approximately 14,000. Monoclonal antibodies, raised independently in two laboratories against either pancreatic stone protein (PSP) or pancreatic thread protein (PTP), reacted with theMr14,000 protein(s). Differential extraction of PTP and PSP by 0.1N HC1 and 10% sodium citrate producedMr14,000 products that reacted equally with each monoclonal antibody (MAB). Two-dimensional gel electrophoresis demonstrated twoMr14,000 spots in each extract with pI's of 5.8 and 6.0. Each spot reacted equivalently with the MABs for PSP and PTP. PSP/PTP type proteins are sparingly soluble in pancreatic secretions and could contribute to protein plugging in pancreatic disease.

ISSN:0277-2116    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Ten young adult cystic fibrosis (CF) patients over 16 years of age (average 21.4 years) began nighttime enteral feedings as a method of nutritional rehabilitation to regain and maintain body weight. Patients received nighttime feedings of 1,000 kcal/M2of a low- (Pulmocare), medium- (Ensure Plus), or high-carbohydrate (Vivonex) formula for at least 2 nights each with pancreatic enzyme therapy. Five of ten young adult CF patients developed nocturnal hyperglycemia (serum glucose >300 mg/dl) and glucosuria (1–3% glucose) with varying degrees of polyuria during enteral feedings. No patient developed ketonuria despite serum glucoses at times >600 mg %. There was no difference between the hyperglycemic and nor-moglycemic groups in median age, percent of ideal body weight, NIH score, Brasfield scores, pulmonary function tests, or family history of diabetes. All normoglycemic and four of five hyperglycemic patients had normal fasting blood sugars. The percent hemoglobin A1cwas greater in the glucose intolerant group than the normoglycemic patients (11.2 ± 0.8% vs. 6.8 ± 1.1%, mean ± SE, p < 0.005). Twelve to 15 units of NPH insulin prior to initiation of feedings provided adequate therapy in most hyperglycemic patients. There was no apparent difference in the elevation of early morning serum glucoses with the low- medium- and high-carbohydrate formulas. We concluded that hyperglycemia requiring insulin therapy was common in young adult CF patients using nighttime enteral feedings. A hemoglobin A1cappeared to be a useful screening test before initiating such therapy.

ISSN:0277-2116    

出版商:OVID    

年代:1989

数据来源: OVID