Kinking deformities in collagen (author's transl)

The affect of stretch on collagen was investigated. Alterations of mechanical dimensions and thermostability of fibrils were measured and changes in fine structure determined by x-ray diffraction and electronmicroscopy. Collagen underwent changes both in tensile strength and fine structure following stretch beyond the physiological range. The severity of these changes depended both on the degree of stretch and the cross-link density of the collagen Fibrils either became split into bundles consisting of subfibrillar units or showed circumscribed kinking deformities. The mechanism producing kinking was investigated. It is possible that a connection exists between fibrillar kinking and tendon rupture.     

Abscess of the liver (author's transl)

A case of liver abscess is analysed in the light of recent data from the literature. The attention is drawn on the increase in frequency of this disease over the last 10 years. The diagnosis is difficult to set on clinical and biological grounds but can be established with certainty by means of scintigraphy and hepatic angiography. Identification of the micro-organism is difficult and impossible in more than half of the cases. Treatment which is essentially surgical, in association with antibiotherapy specific of the anaerobic and gram negative micro-organisms, can reduce total mortality to 10%.     

Swelling of collagen fibers in neutral salt solutions (author's transl)

When applying various concentrations of NaC104 (0.15-7 M) to tendon fibres from rat tails, we found denaturation beginning at 2M, and with increasing concentration a linear increase of the maximal contraction tension and an expoential shortening of the contraction time down to a minimal value of 7.5 min. In a second group of experiments we investigated the weight changes of tendons of old (26-30 months) and young (8 months) rats treated with 5M NaC104 and compared the weight curves and the tension curves. We found an increase in weight up to 900% as the tension decreased. This indicates a connection between the swelling and the relaxation of collagen fibres. Other solutions of neutral salts (5M NaC103, NaC1; 0.15 M NaC104, NaC103, NaC1) tested on young and old tendons did not produce any tension nor other visible changes. The weight curves show an immediate increase up to about 200% which remains constant and which is low compaired with the effect of 5M NaC104. The reason for the contraction of tendon fivres seems to be the denaturation caused by the increased lipophilia of the aqueous salt solutions, while the relaxation is merely the result of the subsequent swelling of the collagen fibre.     

The therapeutic management of consumption coagulopathy in progressive liver cirrhosis: low-dosage heparin therapy (author's transl)

The high incidence of consumption coagulopathy in active liver cirrhosis prompted us to introduce low-dosage heparin therapy (LDHT) in the management of this condition. An investigation was carried out on 109 patients with clinical and biochemical evidence of progressive liver cirrhosis, which was designed to evaluate whether in addition to basic LDHT, the administration of either vitamin K1, human fibrinogen or partial prothrombin complex (Prothromplex 500) enhanced the results obtained with LDHT alone. The normotest, PTT, thrombin coagulase activity, fibrinogen and platelet count were determined at regular intervals. A significant increase in fibrinogen and platelet count was obtained within 14 days of LDHT in about 75% of the patients and the consumption coagulopathy was halted. Additional treatment with vitamin K1 did not bring about any further increase in the prothrombin complex. Substitution therapy with factors II, IX, X and fibrinogen combined with LDHT brought the expected results. The results reported in the literature and the aims of, and indications for LDHT are discussed.     

Intracellular localisation of urea-cycle enzymes in liver (author's transl)

Enzymes of the Krebs-Henseleit urea-cycle were localized by means of differential centrifugation and fractional tissue extraction in rat liver and in human liver. Argininosuccinatlyase (ASAL) and Argininosuccinatsynthetase (ASAS) represent enzymes of the soluble cytoplasmic fraction. Ornithine-ketoacid-transaminase(OKT), carbamyl-phosphate-synthetase (CPS) and ornithine-carbamyl-transferase (OCT) are localized in the mitochondrial and nuclei fractions of the liver cell. Most of the arginase activity is bound to subcellular structures (probably to nuclei). A small portion of arginase-activity was found in the soluble cytoplasmatic fraction. The enzymes of the Krebs-Henseleit urea-cycle are equally distributed in rat liver and in human liver. Differences in the subcellular localisation of (mitochondrial) enzymes in human liver could be attributed to mitochondrial breakage during tissue preparation and do not represent in-vivo conditions.     

Biomechanical investigations of the liver capsule (author's transl)

The strain properties of geometrically defined specimens of human, pig, and bovine liver capsule were analysed in vitro by applying histomechanical procedures. The dynamic relaxation correlates with the static relaxation under sinus shaped strain process after previous additional predetermined increase in length. If such a process occurs in the linear region of the stress-strain curve, the relaxation process continues on a new level even if the amplitude of the sinus length-time input function is augmented. The same experiment causes in the lower non-linear region of the stress-strain relation the so-called asymmetric amplitude phenomenon. Further histomechanical features of the liver capsule obtained after defined length-time input functions such as relaxation, static isorheological line, dynamic isorheological curve, increase of the vertices of the dynamic force-time function after static relaxation and dynamic force recovery curve are shown. The phase shift between force and lenth is pointed out. The significance of the biomechanical properties of the liver capsule under physiological and pathological conditions is discussed.     

Influence of ornithin-alpha-ketoglutaric acid on fatmetabolism in patients with cirrhosis of the liver (author's transl)]

Formation of endogenous toxins through protein metabolism and detoxification through liver are described. In chronic hepatic insufficiency (cirrhosis of the liver), with failure of liver metabolism, levels of endogenous toxins in plasma and tissue, i.e. ammonia, phenol-derivatives and free fatty acids, rise. Plasma levels of ammonia and free fatty acids are both dependent on the Krebs cycle. This interaction and mutual dependance was examined clinically through application of amino acids that lower plasma ammonia level. Di-L(+)ornithin-alpha-ketoglutaric acid was able to lower ammonia levels in patients with liver cirrhosis. The difference between pre- and postinfusion levels of ammonia was significant, this corresponds to the observations of other authors. In addition we found a fall in levels of free fatty acids, triglycerides, and cholesterol. This effect on fatmetabolism was also observed in patients with no evidence of incipient or manifest hepatic insufficiency. The biochemical basis and the clinical implications of these findings are discussed.     

Dumping-prophylaxis (author's transl)

The dumping syndrome is due to a vigorous reflex distension of the jejunum, caused by the stomach violently evacuating its contents. The aim of treatment is to overcome the drastic evacuation by restoring the rhythmic peristalsis of the stomach (eukinetics). This can be achieved by a special diet. Every meal should begin with well chewed solids (pulp) and avoid all fluids. With a well organised medical staff a complete success can be achieved. Surgical measures in Dumping can be avoided.