Comparative LC-MS/MS and HPLC-UV Analyses of Meropenem and Piperacillin in Critically Ill Patients.

Background: Therapeutic drug monitoring (TDM) of beta-lactam antibiotics has become a valuable tool to guide dosing in critically ill patients. The main goal of the study was to compare two routinely used techniques for beta-lactam TDM in intensive care unit (ICU) patient samples, namely isotope dilution liquid chromatography tandem mass spectrometry (ID-LC-MS/MS) and high-performance liquid chromatography combined with ultra-violet detection (HPLC-UV).

Methods: A set of 80 sera/plasma samples from ICU patients receiving therapeutic meropenem or piperacillin dosage was investigated.

Sequence-based prediction of type III secreted proteins.

The type III secretion system (TTSS) is a key mechanism for host cell interaction used by a variety of bacterial pathogens and symbionts of plants and animals including humans. The TTSS represents a molecular syringe with which the bacteria deliver effector proteins directly into the host cell cytosol. Despite the importance of the TTSS for bacterial pathogenesis, recognition and targeting of type III secreted proteins has up until now been poorly understood.

[Valine and branched-chain amino acids in the treatment of hepatic encephalopathy].

We studied the effects of infusion of a liver adapted amino acid solution (Amino-Mel hepa: Group A) versus a liver adapted amino acid solution plus L-valine (Amino-Mel hepa + L-valine: Group B) in 30 patients with decompensated liver cirrhosis with coma. Each 15 patients were randomly allocated to the group A and B, respectively. Both regimens included the infusion of glucose and fat, further supplementation of vitamins and trace elements in addition to the amino acid solution.

Correlations between zinc, amino acids and ammonia in liver cirrhosis.

In view of the universal metabolic importance of zinc in the organism, it was the purpose of the present work to determine the concentrations of zinc in serum, of amino acids and ammonia in plasma of patients with liver cirrhosis, and investigate that correlations might exist between these substances. The study involved 18 patients with decompensated liver cirrhosis without coma and eleven with coma. The subjects with normal livers were used as controls.

[Determination of cellular and humoral parameters of fatty liver].

Cellular and humoral immunological parameters were examined in mononuclear cells from peripheral blood of patients with alcoholic and nonalcoholic steatosis hepatis. The ratio of T4 and T8 positive lymphocytes and the number of monocytes of these patients were in the normal range. The percentage of NK-cells, B-lymphocytes and DR-antigen-positive cells was increased.

Clinical studies on zinc in chronic liver diseases.

Zinc is essential to numerous metabolic processes in the organism, multiform symptoms being found especially in deficiencies. In addition to nutritional factors, diseases such as cirrhosis of the liver. Crohn's disease and chronic renal diseases are relevant in this context.

[Value of ultrasound tomography in the diagnosis and follow-up of fatty liver].

In a prospective study 187 patients with diffuse fatty infiltration of the liver, estimated by ultrasound tomography, were investigated. In any case the history as well as the results of clinical investigation and the lab findings were known to the observer. Liver blind punctions were performed after a short time, on an average of 11 days.

[Initial clinical experience using an interdisciplinary management concept for pregnant patients with liver damage].

Among 6,404 deliveries in 49 cases (0.8%) a liver disease was diagnosed in the course of pregnancy. The onset of the disease happened exclusively in the last trimester of pregnancy.

[T cell subpopulations in peripheral blood and liver tissue in acute HBsAg-negative hepatitis].

By means of monoclonal antibodies against surface antigens of mononuclear cells we examined alterations of T-cell-subpopulations of peripheral blood and liver tissue in the course of acute HBsAg-negative hepatitis. Used methods for determination were the immunofluorescence for blood lymphocytes, respectively the peroxidase-anti-peroxidase-(PAP)-technique for round-cell-infiltrates of the liver based on paraffin fixed sections. The focus of attention was the relation of T4-(helper/inducer) to T8-(suppressor/cytotoxic) cells, the so-called immuno-regulatory quotient.

[Functional muscular abdominal distension--a case report].

The rare clinical picture of the functional muscular distension must be demarcated from organic changes which are connected with an increase of the abdominal volume such as intraabdominal tumours, accumulations of fluid or gatherings of gas or pregnancy. In this symptom a functional disturbance is concerned which appears in patients with vegetative lability or psychic peculiarities and by changes of tension of the musculature surrounding the abdominal space leads to the intermittent or chronic protrusion of the abdomen. By means of an anaesthesia the presence of a functional cause can be made evident: after injection of anaesthetics the protruding abdominal wall is subsiding.

[Pathogenesis, clinical aspects and development of fatty liver].

Anamnestic, clinical, biochemical and bioptic examinations were performed in 127 patients with fatty infiltration of the liver of different degrees of severity. Anamnesis, clinical practice and laboratory findings can only throw the suspicion on the fatty infiltration of the liver. For the verification of the diagnosis and for the gradation first of all the liver biopsy is necessary.

[Behavior of plasma amino acids in alcohol-induced chronic liver diseases].

In chronic liver diseases of alcoholic and non-alcoholic origin there are strikine differences of aspartate, glutamate and prolin. Where as plasma levels of aspartate and prolin are in most cases higher than in non-alcoholics, glutamate shows a contrary behaviour except in hepatic coma. The plasma ratio of alpha-amino-butyric acid to leucin allows no distinction of alcoholic from non-alcoholic liver lesion.

[Hepatological aspects of surgical interventions in the stomach].

By means of quantitative-biochemical and histomorphological methods after vagotomies changes of the liver could be proved to a smaller extent than after resections of the stomach (Billroth II). Among the bionomic operation methods the supra-selective proximal vagotomy without pylorplastics is superior to other methods under the aspect of the change of the liver.

[Gastrectomy patients--a retrospective study].

Of 39 patients with resected stomach the endoscopic and radiological findings as well as the anamnestic and paraclinical data were analysed retrospectively and compared. In contrast to the patients with recidivation ulcer and stump gastritis the patients with a gastric stump carcinoma had an essentially higher average age and, in general, a considerably longer postoperative interval. The endoscopy, including biopsy, achieved a considerably greater diagnostic security in the various groups of disease than the X-ray examination.

[The effectivity of long-term treatment of porphyria cutanea tarda from a hepatological viewpoint].

34 Patients with an ascertained porphyria cutanea tarda who underwent a long-term therapy a comprehensive internal and hepatological diagnosis was made. In these cases for the first time the estimation of the intrahepatic distribution of enzymes and its comparison with the serum enzymes were also performed. The liver histology allowed a division of our patients into three groups, in which cases the reactive hepatitides prevailed and a conspicuously large proportion of normal histological findings were present.

[Peptic ulcer and the liver].

The interorganic relations between liver and stomach are explained from the point of view of the primary diseases of each organ and the higher mechanism is also discussed. The at present well-known and partly hypothetic pathophysiological mechanisms are treated within the subject. On own combined histologo-biochemical examinations of the liver punctate is generally explained the too little regarded role of the peptic ulcer for the induction of so-called latent hepatopathies.