Untersuchungen zur Biochemie und Klinik der Milchsäureacidose

Leppla, W; Kumposcht, H.; Keller, H. E.

doi:10.1007/978-3-642-96030-7_71

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“…In the presence of hypoxia hepatic anaerobic glycolysis may occur, resulting in lactate production rather than removal (Berry and Scheuer, 1967). Leppla et al (1964) (Heinz et al, 1968), and, secondly, the subsequent steps in fructose utilization are largely independent of phosphofructokinase, whereas this enzyme regulates the rate of glucose metabolism after initial phosphorylation. As a result of rapid fructose breakdown the end products of glycolysis, lactate and pyruvate, accumulate in the blood (Bergstrom et al, 1968) and the liver may be depleted of enough ATP and inorganic phosphate to reduce protein synthesis to an important extent, thereby impairing the integrity of enzyme systems concerned with lactate removal (Maenpaa et al, 1968).…”

Section: Commentmentioning

confidence: 99%

“…In the presence of hypoxia hepatic anaerobic glycolysis may occur, resulting in lactate production rather than removal (Berry and Scheuer, 1967). Leppla et al (1964) showed that the lactate/pyruvate ratio may be influenced by changes in intracellular H+ concentration as well as by the proportion of NADH to NAD according to the relationship Lactate + NAD ;Z pyruvate + NADH + H+.…”

Section: Commentmentioning

confidence: 99%

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Lactic acidosis complicating liver failure after intravenous fructose.

Craig¹,

Crane²

1971

BMJ

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procedure she complained of the sudden onset of pain in the chest, shortness of breath, and haemoptysis. A lung scan showed lage areas of impaired perfusion in both lung fields typical of pulmonary embolism. There were no physical signs in her legs but testing with the ultrasound flow detector showed an impairment of venous flow in the left popliteal and lower femoral vein. Peripheral ascending phlebography was carried out as an emergency procedure and showed extensive recent, non-adherent thrombus in most of the calf veins, the popliteral vein, and lower femoral vein of the left side (see Fig.).It was considered advisable to protect her against a further and CommentThis case shows that thrombus can propagate along a vein very quickly. Within an hour the risk to this patient of developing a massive, as opposed to a minor, pulmonary embolus was seriously increased, because the potential embolus had doubled in size. Anticoagulants had not been given because of the recent episode of haemorrhage from the cerebral artery aneurysm and it may be that they would have prevented the growth of the thrombus. Normally we find at operation that the thrombus fits the phlebogram perfectly, but most of these patients are already anticoagulated with heparin as the first line of treatment of their pulmonary embolus.If thrombus can grow so quickly then the value of any routine screening procedure, such as ultrasound flow detection or the labelled fibrinogen uptake test, in the prophylaxis of sudden massive embolism is open to doubt.This case emphasises the urgency with which any procedure must be carried out when attempting to prevent recurrent pulmonary embolism.

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Section: Commentmentioning

confidence: 99%

Section: Commentmentioning

confidence: 99%