Gastroenterology and Hepatology

Exocrine Pancreatic Function Test 13C-Mixed Triglyceride Breath Test

Chronic pancreatitis could be well diagnosed by histopathology, but for clinical purposes, differential diagnostics and patient follow-up we use mainly imaging procedures and non-invasive pancreatic function tests, if available. In this study we report the 4 years experiences with noninvasive test of exocrine pancreatic function - breath test with 13C-mixed triglycerides (MTG-BT). The diagnostic significance has been compared with determination of fecal elastase-1 in relation to new clinically oriented classification of chronic pancreatitis (Buchler and Malfertheiner, Bern 2000). The study group was 180 subjects with suspected chronic pancreatitis (CHP). The diagnosis of CHP was confirmed in 169 patients. MTG-BT test was performed with 250mg of Glyceryl-1,3-dioctadecanoate-2-octanoate-1-13C, 13C:12C ratio was analysed by infrared Isomax 4000 analyser. Cummulative recovery of 13C was calculated by two methods, Body Surface Area and Basal Metabolic Rate. Fecal elastase 1 (FELA) was...

author: Petr Kocna, P. Kocna, Z.Vaníčková, T.Krechler, M.Lukáš, J.Doseděl, P.Kohout | 1.LF UK | discipline: Biochemistry, Chemistry, Gastroenterology and Hepatology | category: E-learning objects archive | keywords: diagnostic techniques, digestive system, pancreatic function tests, pancreatitis, breath tests, Exocrine pancreatic function, Chronic pancreatitis, Breath test, Stable isotope 13C, Mixed triglyceride, Fecal elastase, diagnostic techniques, digestive system, pancreatic function tests, pancreatitis, breath tests | attachment: 1 | viewed: 1172x | published on: 19.2.2007 | last modified on: 25.6.2008

The Role of IgA and IgG Classes of anti-tissue Transglutaminase in Coeliac Screening

In this study we compared different algorithms using four serology markers of CD in a group of 1451 patients. The correlation of two ELISA methods (Genesis, DPC Millenia) of atTG IgA class was high (r = 0.930), correlations of atTG (DPC) and antigliadin (AG) antibodies were significantly higher in the IgA class than IgG class, Spearman’s coeff. were 0.607 and 0.423 respectively. The clinical benefit of IgG atTG antibodies determination could be exhibited by 7 cases highly positive in IgG class but negative in IgA class of atTG, or by 5 cases in the screening strategy positive with IgG atTG from 78 cases negative in all IgA class antibodies (AGA, EmA, atTG). ELISA determination of IgA atTG with human antigen could raise the specificity especially in screening of patients with other autoimmune diseases. ELISA determination of IgG class of atTG could be recommended as additional serology marker of silent coeliac disease especially in IgA deficiency and other cases with negative...

author: Petr Kocna, Kocna Petr, Vaníčková Zdislava, Dvořák Miloš, Perušičová Jindřiška | 1.LF UK | discipline: Biochemistry, Chemistry, Gastroenterology and Hepatology, Immunology, Allergology | category: E-learning objects archive | keywords: celiac disease, immunoglobulin A, immunoglobulin G, transglutaminasy, screening, Coeliac disease, Tissue transglutaminase, IgA, IgG, Antibodies, Screening | attachment: 1 | viewed: 1088x | published on: 1.2.2007 | last modified on: 22.9.2008

Atypical phenotype of Dubin-Johnson syndrome caused by co-inherited defects in two crucial genes of bilirubin excretory pathway: A

Úvod: Dubin-Johnsonův syndrom je autosomálně resesivně dědičná převářně nekonjugovaná hyperbilirubinémie vyvolaná mutacemi v genu ABCC2/MRP2 kódujícím kanalikulární transportér pro konjugovaný bilirubin. Gilbertův syndrom je recesivně dědičná nekonjugovaná hyperbilirubinémie vyvolaná ve většině případů sníženou aktivitou transkripce genu UGT1A1 v důsledku homozygotní mutace A(TA)7TAA v promotoru uvedeného genu. Cílem naší studie bylo najít molekulární příčinu atypické intermitentní převážně nekonjugované hyperbilirubinémie u 3-letého chlapce. Metody: Žlučové cesty byly zobrazeny cholescintigrafií s použitím 99mTc-HIDA. Exprese proteinu ABCC2/MRP2 byla vyšetřena imunohistologicky. Sekvence genů UGT1A1 a ABCC2/MRP2 byla určena přímým sekvenováním z genomové DNA. Přítomnost nalezených mutací byla potvrzena fragmentovou analýzou, sekvenováním klonovaných fragmenů genomové DNA s mutací a PCR-RFLP....

author: Milan Elleder, Dita Cebecauerová, Tomáš Jirásek, Lucie Budišová, Václav Mandys, Vladimír Volf, Zorka Novotná, Iva Subhanová, Martin Hřebíček, Milan Elleder, Milan Jirsa | 1.LF UK | discipline: Biochemistry, Chemistry, Gastroenterology and Hepatology, Genetics, Pathology, Laboratory Medicine and Forensic Medicine, Paediatrics, Neonatology | category: E-learning objects archive | keywords: Dubin-Johnsonův syndrom, Gilbertův syndrom, ABCC2/MRP2, UGT1A1 | attachment: 1 | viewed: 2094x | published on: 2.1.2007 | last modified on: 4.7.2006

Serum bilirubin as a predictor of oxidative stress-mediated diseases

Bilirubin, the principle bile pigment, is the end product of heme catabolism. For many years, bilirubin was thought to have no physiological function other than that of a waste product of heme catabolism – useless at best and toxic at worst. Although hyperbilirubinemia in neonates has been shown to be neurotoxic, studies performed during the past decade have found that bilirubin has a number of new and interesting biochemical and biological properties. In addition, there is now a strong body of evidence suggesting that bilirubin may have a beneficial role in preventing oxidative changes in a number of diseases including atherosclerosis and cancer, as well as a number of inflammatory, autoimmune and degenerative diseases.

THE EFFECT OF ARTIFICIAL BEZOAR (BOVINE GALLSTONE POWDER) ON PROLIFERATION OF HUMAN PANCREATIC CANCER

Bile pigments, including bilirubin and biliverdin, contribute importantly to the defense against oxidative stress. Moreover, recent clinical studies suggest that mildly elevated serum bilirubin levels might protect from certain forms of cancer. Artificial bezoar (powdered bovine gallstones, also known as Niu Huang, or Calculus bovis) is used in traditional Chinese medicine for centuries for its antipyretic and anti-inflammatory properties. In the present experimental study, we investigated the effect of artificial bezoar on proliferation of human pancreatic cancer.

Clinical and Laboratory Aspects of 13C-Breath Test Evaluated by NDIRS Infrared Spectrometry

This study summarizes pre-and post-analytical aspects of the 13C-breath-test(BT) evaluated by means of isotope selective nondispersive infrared spectrometry(NDIRS) -Isomax 4000 (Isodiagnostika). Moreover, the sources of inaccuracy in test results are identified: (a) uncertain baseline 13C abundance, (b) inaccuracy of the spectrometer, and (c) uncertainty in CO2production, which also burden cummulative BT where IR/IRMS measuring instruments are used. Regarding (a), an estimate is presented that is closer to reality than the commonly used PDB standard. To address (b), the accuracy of measurementsis assessed by a statistical analysis and by measuring IRMS calibrated samples every four months. After 14 cycles of checking, the calculated mean bias of the Isomax 4000 equals 5.23 %. Concerning (c), two published estimates of CO2production are used and compared: a BSA-based (Body Surface Area) estimate, and a BMR-based (Basal Metabolic Rate) estimate.To measure gastrointestinal functions,...

author: Petr Kocna, Kocna Petr, Vaníčková Zdislava, Chleboun Jan | 1.LF UK | discipline: Biochemistry, Chemistry, Gastroenterology and Hepatology | category: E-learning objects archive | keywords: breath tests, spectroscopy, near-infrared, diagnostic techniques, digestive system, NDIRS, Infrared spectrometry, Breath test, 13C/12C ratio analysis | attachment: 1 | viewed: 969x | published on: 1.2.2007 | last modified on: 25.6.2008

Hypertext Encyclopedia of Laboratory Methods on the web and CD-ROM

Textbooks, lectures and other educational textsprepared in last years are on-line (mostly in Czech language) available on WWW server of 1st Faculty of Medicine of the Charles University in Prague on URL: http://www.lf1.cuni.cz/ukb/.This presentaion is concerned to our last project of hypertext, multimedia encyclopedia of laboratory methods -GastroLab(URL: http://gelab.zde.cz).This pilot chapter is focused to gastroenterology. There are 47 laboratory methods, described in concise text, supplemented with 38 PowerPoint images, 237 on-line linksto last scientific papers (MEDLINE database) and direct links into National Registry of Laboratory Methods (NCLP = National Reference Table of Laboratory Items) on the server of Ministry of Health of the Czech Republic -URL: http://www.mzcr.cz.The GastroLab is now included into another hypertext project -Encyclopedia of Laboratory Medicine. This CD-ROM publication was issued in December 2002, 2nd updated edition will be ready in June 2003,...

author: Petr Kocna, Kocna Petr | 1.LF UK | discipline: Biochemistry, Chemistry, Gastroenterology and Hepatology, Medical Informatics | category: E-learning objects archive | keywords: hypermedia, encyclopedias, medical informatics, laboratory techniques and procedures, gastroenterology, Hypertext, Encyclopedy, Laboratory methods, CD-ROM, WWW, Internet on-line, Medical informatics | attachment: 1 | viewed: 1006x | published on: 18.1.2007 | last modified on: 4.7.2006

Diagnostic and predictive indexes in patients with fulminant and chronic decompensated Wilson’d disease

Úvod: Fulminantní Wilsonova choroba (WD) je zatížena téměř absolutní letalitou a je indikací k transplantaci jater, narozdíl od dekompensované chronické WD, která zpravidla dobře odpovídá na chelatační léčbu. Cílem studie byla validace dvou diagnostických indexů pro časnou diagnózu fulminantní WD a validace tří prognostických systémů predikujících úspěšnost chelatační terapie u pacientů s dekompensovanou chronickou WD. Metodika: Přesnost dvou publikovaných indexů pro časnou diagnózu fulminantní WD, indexu ALP (IU/L)/bilirubin (mg/dL) < 2 a indexu AST/ALT > 4, vyjádřená plochou pod křivkou operační charakteristiky modelu (ROC) s 95% konfidenčním intervalem (CI 95%), byla vypočtena ve skupině 21 pacientů s fulminantní WD, medián věku 18 let (skupina 1), a ve skupině 19 pacientů s fulminantním jaterním selháním jiné etiologie, medián věku 44 let (skupina 2). Diagnostickým standardem WD byla zvýšená exkrece...

author: Julius Špičák, Jan Petrášek, Pavel Trunečka, Milanj Jirsa, Jan Šperl, Pavel Drastich, Libor Kozák, Julius Špičák | 1.LF UK | discipline: Emergency medicine, Physiology and Pathophysiology, Gastroenterology and Hepatology | category: E-learning objects archive | keywords: Wilsonova choroba, fulminantní jaterní selhání, transplantace jater, prediktivní index | attachment: 1 | viewed: 1811x | published on: 2.1.2007 | last modified on: 25.5.2009

Polymorphisms in interleukin-1 gene cluster are associated with increased risk of alcoholic liver cirrhosis

Účel studie: V patogenezi alkoholické jaterní cirhózy (ALC) hrají významnou úlohu zánětlivé cytokiny tumor necrosis factor alfa (TNF-?) a interleukin 1-beta (IL-1?). Haplotyp [-511C; -31T] promotoru genu IL-1B a variabilní počet tandemových repetic délky 86-bp ve 2. intronu genu pro receptorového antagonistu IL-1 (IL-1RN) zvyšují transkripci genu pro IL-1B. Cílem studie bylo ověřit, zda tyto polymorfismy v genovém clusteru IL-1 ovlivní riziko ALC.Metody: Frekvence alel uvedených polymorfismů byly stanoveny u 100 pacientů s etylickou cirhózou a u 180 neabstinujících zdravých dobrovolníků se srovnatelným zastoupením věku a pohlaví.Výsledky: Žádná z alel IL-1B -31T a IL1-RN *2 nebyla samostatně asociována s ALC. Riziko ALC však bylo zvýšené u homozygotů pro alelu IL-1RN*2, kteří byli současně nosiči alely IL-1B -31T (relativní riziko 8,3, 95% konfidenční interval 1,7 - 40,7).Závěr: Naše výsledky prokazují zvýšené riziko...

author: Milan Jirsa, Petrasek J, Reznakova S, Hubacek JA, Sperl J, Trunecka P, Spicak J, Jirsa M | 1.LF UK | discipline: Gastroenterology and Hepatology, Genetics | category: E-learning objects archive | keywords: alkoholická jaterní cirhóza, genetický polymorfismus, tumor necrosis factor¨-alfa, interleukin-1 beta, neutrofilní granulocyty | attachment: 1 | viewed: 989x | published on: 11.12.2006 | last modified on: 4.7.2006