Reduced metabolic efficiency in patients with Crohn's disease.

Malnutrition is frequently seen in patients with inflammatory bowel disease, and parenteral or enteral nutrition is considered essential in this patient group. However, many patients with Crohn's disease have difficulties in gaining weight in response to overfeeding, suggesting reduced energy retention. Substrate utilization and nutrient balances as well as changes in body composition were followed in 10 patients with Crohn's disease immediately in the course of remission on low-dose steroid treatment, during an eight-day period of continuous enteral nutrition at constant (protocol 1:1.

Metabolic responses to lipid infusions in patients with liver cirrhosis.

Energy expenditure, whole body substrate oxidation rates and arterial substrate concentrations were measured in 14 patients with liver cirrhosis and 13 control subjects before and during sequential infusions of a long chain (LCT) or a medium chain triglyceride emulsion (MCT) without and with concomitant insulin plus glucose infusions. Resting energy expenditure, basal substrate oxidation rates and the arterial concentrations of glucose, lactate, triglycerides and ketones were normal, whereas plasma free fatty acids and glycerol were both increased in patients with liver cirrhosis. The arterial plasma triglyceride and free fatty acid concentrations as well as whole body lipid oxidation rate rose in response to LCT in both groups and the maximum lipid oxidation rate was 1.

Resting energy expenditure and the thermic effect of adrenaline in patients with liver cirrhosis.

1. Resting energy expenditure and the metabolic responses to adrenaline (infusion rate: 0.03 micrograms min-1 kg-1 fat-free mass for 1 h) were investigated in 25 patients with liver cirrhosis.

Lipoprotein (a): a risk factor for retinal vascular occlusion.

The protein moiety of lipoprotein (a) consists of apoB-100 and apolipoprotein (a). Lipoprotein (a) is an independent risk factor for premature atherosclerosis. Apolipoprotein (a) and plasminogen are structurally homologous.

[Lipolysis and lipid oxidation of weight stable patients with malignant tumors of the digestive system].

Tumor-caused weight loss is frequently associated with a high rate of lipolysis and fat oxidation. In order to differentiate the effect of weight-loss from the tumour-dependent regulation of fat metabolism, we studied weight-stable and well nourished patients (ideal body weight 109 +/- 4% (+/- SEM), body mass index 25.1 +/- 0.

Energy expenditure and substrate metabolism in ethanol-induced liver cirrhosis.

Energy expenditure and substrate metabolism were investigated in 10 patients with alcoholic liver cirrhosis (EtOH-Ci) and 10 healthy controls (C). Resting metabolic rate (RMR) varied from 1,269 to 2,467 kcal/day in C and from 1,228 to 2,098 kcal/day in EtOH-Ci. RMR was significantly related to fat-free mass (FFM) in both groups, but EtOH-Ci decreased FFM and increased RMR when expressed per kilogram FFM (+33%).

[What is the role of nutrition in Crohn disease? A contribution to the importance of dietary therapy in regional enteritis].

The clinical appearance of Crohn's disease (CD) is especially marked by nutritional deficits and insufficiencies. For a long time the goal of nutritional care was reduced to the readjustment of the nutritional status. The development and clinical use of controlled parenteral nutrition (TPN) and enteral nutritive solutions (EN) did not only emphasize this therapeutical issue, but furthermore showed positive effects on the conservative as well as on the surgical treatment concepts.

[Pathogenesis of alcohol-induced hyperlipidemia: case report of hypertriglyceridemia over 10,000 mg%].

A 53-year old woman developed excessive hypertriglyceridemia (greater than 10,000 mg/dl) with features of toxic liver damage after prolonged ethanol ingestion. Lipoprotein-lipase-activity was not decreased, apolipoprotein-C-II analysis, as shown by gel-electrophoresis, revealed a regular pattern. Treatment with parenteral nutrition and abstinence of ethanol resulted in a complete normalization of plasma triglycerides after transient remnant-hyperlipidemia.

Results of a stimulatory therapy of low bone metabolism in osteoporosis with (1-38)hPTH and diphosphonate EHDP. Protocol of study I, osteoporosis trial Hannover.

In contrast to prevention, the therapy of manifest osteoporosis remains a clinically significant problem. So far all therapeutic attempts have yielded unsatisfying results. For this reason we have tried to achieve a positive bone balance by sequential stimulation and inhibition of the osseous metabolism.

Comparison between simvastatin and bezafibrate in effect on plasma lipoproteins and apolipoproteins in primary hypercholesterolaemia.

The ability of simvastatin, a competitive inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A reductase, to lower lipid levels in 16 patients with primary hypercholesterolaemia was compared with that of bezafibrate in a 16-week, double-blind, parallel, placebo-controlled trial that was continued in an open crossover fashion. Simvastatin was better than bezafibrate at lowering total and low-density lipoprotein (LDL)-cholesterol and apolipoprotein B concentrations (30.4% [p less than 0.

Accuracy and reproducibility of a quantitative electrophoresis of plasma lipoproteins: interlaboratory comparison and verification by ultracentrifugation.

Fifty-three samples of sera from normal subjects and from patients with type IIa, IIb and IV hyperlipoproteinemia were shipped from Hannover to the collaborative laboratories in Vienna and Mannheim, which participated in the quantification of their lipoprotein fractions based on polyanion precipitation of electrophoretically separated lipoproteins followed by densitometric measurement of alpha-, prebeta- and beta-lipoproteins. Total serum cholesterol and cholesterol calculated from quantified lipoprotein fractions were highly correlated, the correlation coefficients ranged between r = 0.93-0.

[Digestive function of the residual pancreas after partial duodenopancreatectomy for chronic pancreatitis (author's transl)].

Forty-eight patients with chronic recurrent pancreatitis treated by resection of the head of the pancreas were restudied more than a year post-operatively. In addition to general features such as symptoms, alcohol consumption and work ability, faecal weight, its fat content, fat and fatty acid balance and faecal chymotrypsin were measured. According to the patients' own estimate, late results were good or very good in 70-90%.

[Drug therapy of hypercholesterinemias (author's transl)].

Every permanent substantiated primary hypercholesterolemia which does not respond adequately to diet must be treated with drugs. For monotherapy first of all fenofibrate, bezafibrate and nicotinic acid derivatives are suitable for the treatment of adult patients. For supportive therapy colestyramine and colestipol come into consideration as well as beta-sitosterol.

Lowering effect of fenofibrate (procetofene) on lipoproteins in different types of hyperlipoproteinemias.

The effect of 300 mg Fenofibrate daily on serum lipoprotein concentrations was studied for 6 month in 32 subjects with primary familial hyperlipoproteinemias. In summary Fenofibrate lowered already after one month of therapy the mean cholesterol serum concentrations by 20-25% and serum triglyceride concentrations by 40-45%, when compared with placebo therapy. The greatest effectiveness in the lowering of atherogenic lipoproteins was recorded in type IIa and type III, while good effectiveness was experienced in type IV, though with a limitation of an increase of LDL2 at the upper limit of the normal range.

[Function of the residual pancreas following partial duodeno-pancreatectomy].

After Whipple operations, follow-up examinations were conducted under hospital conditions in order to investigate the function of the remainder of the pancreas and the extent to which general health was adversely affected. General parameters such as vocational rehabilitation, history of pain, and weight were analyzed, as well as chemistry related to the severity of pancreatic malassimilation, e.g.

Polymorphism of apolipoprotein E. II. Genetics of hyperlipoproteinemia type III.

Apolipoprotein E from human serum shows a genetic polymorphism determined by two autosomal codominant alleles, Apo En and Apo Ed. Homozygosity for the gene Apo Ed (phenotype Apo E-D) results in primary dysbetalipoproteinemia, but only some individuals with this phenotype develop gross hyperlipidemia (hyperlipoproteinemia type III). Vertical transmission of dysbetalipoproteinemia represents pseudodominance due to the high frequency of the gene Apo Ed.

[Surgical and dietetic problems of subtotal resection of the small intestine in adults (author's transl)].

The human body badly tolerates the extensive loss of the small intestine by resection. Malabsorption of various substances is followed by severe deficiency symptoms. In recent years a longer survival with a satisfactory general condition was achieved by intensive postoperative care and adequate diet--in our own cases even in adults and in old age.

[Results of treating the acute stage of Crohn's disease by a dietary regimen (author's transl)].

23 consecutive patients (13 women, 10 men; mean age 31 years) with acute exacerbation of Crohn's disease were treated by a dietary regimen based on "resting" the bowel by parenteral nutrition or a balanced synthetic diet (Vivasorb), followed by stepwide introduction of a low-residue diet. Cardinal symptoms such as severe abdominal pain, diarrhoea, incomplete ileus or weight loss responded favourably to treatment in each case. Postoperative fistulae closed in two of three patients.

Studies on the metabolic defect in Broad-beta disease (hyperlipoproteinaemia type III).

The apoprotein composition of the main lipoprotein fractions (VLDL, LDL-1, LDL-2 and HDL) was studied initially in 15 patients with Broad-beta disease. Analytical isoelectric focusing of urea-soluble apo-VLDL and apo LSL-1 demonstrated a variant pattern of the polymorphic Apoprotein E with a deficient Apo E-III band in all patients. The Apo E-III deficiency pattern was seen in only six out of 304 hyperlipidaemic controls.