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331 dogs, suffering from different intestinal diseases with diarrhea, were classified into the groups of "acute noninfectious", "infectious", "chronic" and "secondary enteropathies". The serum enzymes ALT, AST, GLDH, AP and GGT were determined. In all groups increases of enzyme activities were to be found. The highest and most frequent increases have been observed in acute noninfectious and in secondary enteropathies. The enzyme pattern in acute noninfectious enteropathies indicate a secondary liver disturbance in consequence of the intestinal disease, whereas the liver participation in secondary enteropathies is the effect of the primary disease other than intestinal disturbances. In comparison to this the height and number of increases of liver enzyme activities were low in acute infectious and in chronic enteropathies.

Objective: To determine the effect of a pure glucose and of different glucose/fat regimens as nonprotein energy source on substrate metabolism, nitrogen balance, lipoprotein pattern and liver enzymes. Long-chain and mixed long-/medium-chain triglyceride emulsions as 10 and 20% solutions were infused., Design: Prospective randomized study., Setting: General ward of a university hospital., Patients: 29 patients in five groups after colorectal surgery., Interventions: According to Harris-Benedict an amount of 150% of the calculated daily calorie intake was infused. Besides nitrogen balance and routine laboratory tests the lipoprotein pattern was examined., Results: No difference was observed in protein balance, while a pathological rise of liver enzymes was mainly seen with glucose 20% and long-chain fat emulsions in a concentration of 10%. Physiological lipoprotein balance could only be achieved with a 20% solution of long-chain and medium-chain emulsions., Conclusions: The results demonstrate a fast metabolism of the MCT/LCT 20% solution with physiological lipoprotein pattern and no change in liver enzymes. High-dose glucose infusions and long-chain fat emulsions may cause a fatty degeneration of the liver, and 10% MCT/LCT emulsions may cause a rise of phospholipids and a generation of lipoprotein X.

Lysozyme levels were determined in the mucosa of gut in 80 children with chronic inflammatory bowel disease, malabsorption and acrodermatitis enteropathica.l Levels of lysozyme in the mucosa of colon were found to be significantly higher in cases with chronic inflammatory bowel disease, whereas in children with malabsorption (celiac disease) concentration of lysozyme in the mucosa of small intestine were significantly lower compared to a control group. In a 4 months old boy with acrodermatitis enteropathica there was a low level of lysozyme in the mucosa of the small intestine. After therapy with zinc for one year concentration of lysozyme was normalized.

Investigations for the proof of isoenzymes of the alkaline phosphatase and the alpha-amylase in stool were carried out. The measurements of the faecal enzyme activities were performed in 96 patients with intestinal diseases. The disc electrophoresis in the polyacrylamide gel served for the separation of isoenzymes. The separated enzyme bands of the extracts of stool were compared with those ones of serum duodenal juice and extracts of the mucous membrane of the duodenum, the jujunum, the ileum as well as of the colon. Hereby up to 4 very much anodically wandering bands were present, which might be subunits or fission products of the alkaline phosphatase. In the alpha-amylase up to 5 bands could be proved, which were compared with those ones of the serum, the duodenal juice and the urine. A coordination of these isoenzymes concerning their origin is not possible. The faecal activities of enzymes correlate with the weights of stool. In exocrine pancreatic insufficiency and ulcerous colitis increased faecal activities of enzymes are found, the genesis of which is discussed.

In comparison to normal controls (n = 71) the activity of intestinal alkaline phosphatase in feces is reduced in chronic bowel disease using an immunoprecipitation method: patients with Crohns disease (n = 40) or inactive ulcerative colitis (n = 29) demonstrate small changes of fecal intestinal alkaline phosphate activity in comparison to normal controls. Intestinal alkaline phosphatase is reduced in patients with active ulcerative colitis (n = 11) to 50%, in patients with uraemic enteropathy (n = 18) to 30% and in patients with coeliac disease (n = 14) to 20% of the activity observed in normal controls. During cytostatic treatment of malignant tumors, fecal intestinal alkaline phosphatase activity increases as a sign of toxic damage of the intestinal mucosa.

Intestinal disaccharidase activities were determined in 294 jejunal biopsies obtained from 254 children with various disorders of the small bowel, and alkaline phosphatase activity was measured in 251 biopsies. In normal mucosa a broad range of enzyme activity was found corresponding with the data in the literature. A primary disaccharidase deficiency was observed in 5 children with congenital sucrase-isomaltase deficiency and in a 12-year-old Egyptian boy with acquired lactase deficiency. A secondary generalized depression of disaccharidase activity and a diminution of alkaline phosphatase activity existed chiefly in patients who had severe or moderate mucosal damage, also in active coeliac disease and during gluten loading, in protracted diarrhoea of infancy, chronic malabsorption of unknown origin and agammaglobulinemia. During remissions enzyme activities recovered together with mucosal improvement. Low levels of enzyme activities were also seen in some cases of protracted diarrhoea of infancy and chronic malabsorption of unknown origin although only mild mucosal lesions were demonstrated.

In 63 infants and children with a histological normal mucosa of the duodenum, without an isolated defect of enzyme and with a normal increase of xylose and glucose in serum after a combined xylose-lactose loading test the activities of disaccharidases were log normal distributed. The asymmetric distributions were transformed into symmetric ones and the geometric mean (x) as well as the range (+/- 2 s) of maltase, saccharase, isomaltase, lactase and trehalase were calculated. Only the activity of lactase shows a significant dependency on age. In the first year of age the lower limit (x -- 2 s) of this enzyme is much higher than later.

Activities of lactase, sucrase, and maltase were determined in small intestinal biopsies of 125 children with coeliac disease, cow's milk protein intolerance, transient gluten intolerance, nonspecific enteropathies, and controls. Four cases of primary disaccharidase deficiencies could be identified. In the enteropathies, morphometric data were more closely correlated to the degree of the mucosal lesion (r = -0.92 for crypt depth) than were disaccharidase activities (r = 0.61 for lactase). In a stepwise discriminant analysis of the patient groups, based upon immunological, morphometric, and biochemical variables, lactase activity was a valuable secondary criterion, ranking third among the variables used.