[Artificial liver support 1985].

Many techniques have been developed to support liver function in patients with hepatic failure. Only two of these methods are suited to be used in adequately equipped hospitals under appropriate safety conditions. Exchange of toxin-rich patient plasma against fresh frozen plasma will decrease plasma toxin levels and substitute coagulation factors and proteins.

Adsorption and desorption characteristics of nucleotide based coenzymes on agarose encapsulated resins for long term cofactor supply of enzymatic reactions.

In order to find optimal long term cofactor supply for continuous enzymatic detoxification processes, different resins of varying surface, dipole moment, pore size, and chemical structure were investigated for their adsorptive capacity as well as their desorption behaviour towards various nucleotide based coenzymes. UDPGA, NADPGH, NADH, and SAM were gently shaken with agarose coated resins XAD-12, XAD-8, XAD-7, XAD-4, XAD-2, Dowex 1 X 2 (50-100; 200-400), Dowex 1 X 4 (20-50; 200-400), Dowex 2 X 8, and charcoal until all nucleotide was adsorbed or a saturation of the resins was achieved. High adsorption capacity was not always found to correlate with a steady release of cofactor in desorption experiments.

Enzymatic detoxification using lipophilic hollow-fiber membranes: II. Sulfation reactions.

A lipophilic hollow-fiber technique was used in the enzymatic sulfation of lipophilic toxins. Endogenous and exogenous toxins, for which glucuronidation reactions already were demonstrated with this technique, were submitted to sulfate transferase reaction as an alternative phase-II detoxification route. Native enzyme was circulated on the external side of a lipophilic hollow-fiber membrane while the toxin-containing media (serum or aqueous solution) were circulated inside the hollow fiber.

[Progress on the way to an "artificial liver"].

Recently lipophilic fluid membrane hollow fiber modules have been developed, which allow continuous extracorporal enzymatic detoxification by elimination of endogenous toxins out of the blood in vivo without loss of enzymatic activity and without immunological risks. The clearance for phenol glucuronisation is 6.8 nMol/min/mg enzyme protein/cm2 hollow fiber surface the hydroxylation rate for dodecanic acid using the cytochrome - P-450 system is 0.

Separation of plasma membrane proteins of cultured human fibroblasts by affinity chromatography on bonded microparticulate silicas.

Adsorbents for high-performance affinity chromatography were prepared by bonding proteins and reactive Procion triazine dyes to 3-isothiocyanatopropyl- and 3-aminopropylsilicas. The materials prepared were used successfully in the separation of hydrophobic plasma membrane proteins of cultured human fibroblasts. The data obtained show that the reaction of 3-isothiocyanatopropyltriethoxysilane (ITCPS) with the surface hydroxyl groups of silica yields a new and convenient route to preparing an "activated carrier" that is capable of coupling with potential affinity ligands containing amino functional groups.

[Incidence of peptic ulcer in an inpatient angiologic patient sample].

Incidence of peptic ulcers in hospitalized patients with arterial occlusive disease without history or clinical symptoms of ulcer disease was 32% and four times higher than in patients with acute phlebothrombosis. Possible etiological factors could be: decreased blood perfusion of gastric or duodenal mucosa because of generalized arteriosclerosis, intake of ulcerogenic drugs, chronic abuse of nicotine, and stress due to the underlying arterial occlusive disease. Patients with inflammatory vascular disease are affected as often as are patients with arteriosclerotic disease.

Enzymatic detoxification using lipophilic hollow-fiber membranes: I. Glucuronidation reactions.

A lipophilic hollow-fiber membrane preparation was used in the enzymatic detoxification of lipophilic toxins. Native enzymes were circulated on one side of the lipophilic membrane, while the toxin-containing media (blood, serum, waste fluids, etc.) were circulated inside the hollow fiber.

[Ranitidine and cimetidine in the prevention of stress: ulcer hemorrhage a prospective comparative multicenter study].

In a multicentre single-blind study, ranitidine was compared to cimetidine as prophylactic treatment against stress-induced upper gastrointestinal bleeding in seriously ill patients in the intensive care unit (ICU). 380 patients entered the study. 192 patients were treated with ranitidine 50 mg q.

[Electrophysiologic studies in neuropathies].

The value of the electrophysiological investigations can be summarized as follows: Differentiation of different types of polyneuropathies. Detection of subclinical neuropathies. Approach to etiopathogenical aspects.

[Long-term EEG recording in comparison with sleep deprivation and other provocation methods in epilepsy patients].

37 epileptics with routine records without paroxysms were subject to 24 hours mobile long-term EEG registration and independently 24 hours sleep deprivation EEG including hyperventilation and photic stimulation. The anticonvulsive treatment was not changed. In 14 cases we could prove epileptiform discharges (= positive finding) by using both methods, in 13 after sleep derivation (10 at rest, 3 only during hyperventilation) in 7 in the long-term record and in 6 of them both after sleep deprivation and in long-term record.

Imitation of contact inhibition by substrate-bound plasma membrane glycoproteins and lectins in serum-free hormone-supplemented cultures of GH3 cells.

N-Acetylneuraminic acid-bearing glycoproteins and lectins isolated from the plasma membrane of GH3 cells are coupled covalently to glass dishes and are used as substrates for cell culture. Under serum-free, hormone-supplemented culture conditions these coupled molecules inhibit the growth rate of GH3 cells. This inhibition is non-toxic and is concentration-and time-dependent.

Encephalopathic effect of phenol in rats.

The coma-inducing effect of phenol was studied in normal 300 +/- 50 gm Sprague-Dawley rats. Dose-response curves were developed which showed that one-half the animals became deeply comatose with 540 mumol of intraperitoneal phenol and 100% with 600 mumol. Five stages of encephalopathy were readily distinguished.

Removal of excess inorganic phosphate by haemoperfusion with composite beads.

New composite beads, made by encapsulating hydrous zirconium oxide powder in agarose, are evaluated in vitro and in vivo for the removal of inorganic phosphate from the blood. Phosphate adsorption is rather good and calcium removal can be controlled. Thus, a 250 to 300 ml column is capable of reducing phosphate plasma level by some 5 mg per cent, thus making it attractive for the treatment of acute renal failure.

Solubilization characteristics of pig liver S-methyltransferase.

S-methyltransferase was solubilized from pig liver microsomes by five different types of detergents: Triton X-100, zetyltrimethyl-ammonium bromide, sodium cholate, Zwittergent, and sodium dodecylsulfate. As regards enzyme activity, stability, and critical detergent concentration, Zwittergent proved superior to the four other detergents utilized. A striking difference was found in the catalytic activity relative to the chain length of homologous substrates between the microsomal and the solubilized enzyme.

Immobilization of S-methyltransferase.

S-methyltransferase was solubilized from pig liver microsomes by treatment with N-dodecyl-N,N-dimethyl-3-ammonio-1-sulfonate (Zwittergent). The soluble enzyme was immobilized by covalent binding to agarose and by copolymerization with acrylamide. The specific activity for the agarose-bound enzyme towards the substrate ethane thiol was 0.

Effect of sucralfate on peptic ulcer recurrence: a controlled double-blind multicenter study.

We entered 174 patients with healed duodenal ulcer and 77 with healed gastric ulcer into a double-blind, placebo-controlled, 6-month trial to investigate the efficacy of 1 g sucralfate twice daily in preventing ulcer recurrence. Endoscopy was performed after 6 months or earlier for symptoms compatible with ulcer disease. The relapse rate in the 126 patients with duodenal ulcer who could be evaluated for efficacy was 14/66 (21.

[Treatment of bleeding oesophageal varices. Results of combined medical and endoscopically selective intravascular sclerotherapy].

Combining careful medical preparation with subsequent selective intravascular sclerotherapy, one-year survival rate of patients with bleeding oesophageal varices was increased to 90%. Of 41 patients with bleeding oesophageal varices, class Child A-C, none died of bleeding from the varices within the first year after sclerotherapy. Four patients died within the first year, two from liver failure due to severe alcohol abuse, one from liver failure with terminal primary biliary cirrhosis and one from an undiagnosed bleeding duodenal ulcer.

[Acute liver failure--therapeutic aspects 1982].

Fulminant hepatic failure is a relatively rare disease. It develops in approximately 400 patients per year in the Federal Republic of Germany after viral hepatitis, toxic hepatitis or hypoxia of the liver. The mortality ranges between 80 - 90%.

[Cerebral metastases as the first clinical manifestation of cancer].

A review of the case histories over the 10-year period 1969 to 1978 revealed 80 patients with cerebral metastases. Group 1 comprised 41 patients (43.9% carcinoma of the breast, 12.

Contracting striated muscle fibres differentiated from primary rat pituitary cultures.

Whole pituitaries or adenohypophyses alone of adult female Wistar/Furth rats were dissociated into single cells by means of two different enzymic disintegration methods. The single-cell suspension was then seeded out and cultured for up to 8 months in tissue culture dishes with untreated and polylysine-coated surfaces. The cells were cultured in different sera (horse serum, newborn-calf serum, fetal-calf serum, mixtures of horse and newborn-calf serum, and isogenic rat serum) and also in a serum-free, hormone-supplemented medium.

Differential specificity of substrate-attached lectins stimulating spreading of GH3-cells under serum-free, hormone-supplemented culture conditions.

Most mammalian cells are capable of growth in culture only when they are supplied with an appropriate substrate to which they can adhere and spread. To prepare suitable substrates different lectins were attached onto polystyrene tissue-culture dishes after coating with polylysine. GH3-cells (a pituitary-tumor-cell line) were seeded into the culture dishes containing serum-free, hormone-supplemented medium.