摘要:

Patients with chronic viral hepatitis commonly have immunologic manifestations, including autoantibodies and concurrent immune diseases. These immunologic findings may resemble those of autoimmune hepatitis and they are not disease specific. High titer autoantibodies (titers ≧ 1:320) are uncommon in chronic viral hepatitis as are multiple concurrent autoantibodies. These findings reflect an autoimmune-predominant disorder in which the viral infection may be coincidental or facilitative. Concurrent immunologic disorders may be viral antigen-driven and associated with immune complex deposition (cryoglobulinemia, glomerulonephritis, cutaneous vasculitis, and polyarteritis) or autoantigen-driven (autoimmune thyroiditis and Sjögren’s syndrome) and associated with host- rather than virus-specific factors. Genetic predispositions influence immunologic expression. Seropositivity for antinuclear antibodies is associated with HLA A1-B8-DR3, and concurrent immunologic diseases are associated with the DR4 allele. Interferon therapy is appropriate for patients with viral antigen-driven processes that depend on immune complex deposition and for patients with mild background autoimmune expressions. Corticosteroid therapy should be considered for those unusual patients with predominant autoantigen-driven processes since interferon treatment may exacerbate immune-mediated diseases. Patients with chronic hepatitis B and C can have similar immune features, but patients with chronic hepatitis C more commonly have autoantigen-driven proce

ISSN:0257-2753    

DOI:10.1159/000171594

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Eicosanoids are metabolites of arachidonic acid and include, among other compounds, the prostaglandins and leukotrienes. These metabolites are known to play important roles in the health and disease of many gastrointestinal tissues. Less attention, however, has been given to their functions in the esophagus. The present study, therefore, aims both to review the current knowledge about eîcosanoids in healthy and diseased esophagi, and to critically assess the data pertaining to their role in the pathophysiology of gastroesophageal reflux disease

ISSN:0257-2753    

DOI:10.1159/000171595

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

The systemic amyloidoses are serious and potentially fatal disorders caused by deposition of autologous proteins in an abnormal fibrilllar from. The clinical features are highly variable but gut involvement is common and random gastrointestinal biopsies are diagnostic in 80% of patients. Presentations include macroglossia, motility disorders, hemorrhage and pseudo-tumors, although amyloid can mimic almost any other gut pathology. Nonspecific mucosal abnormalities are common both radiologically and at endoscopy. Scintigraphy with serum amyloid P component demonstrates and quantifies the systemic amyloid deposits. Therapy that reduces the supply of the amyloid fibril precursor protein can markedly improve prognosis. Intensive nutritional support for malnourished patients, motility-enhancing drugs and octretide for motility disorders, and correction of clotting disorders in bleeding patients are important adjunctive treatments.

ISSN:0257-2753    

DOI:10.1159/000171596

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Ileal pouch-anal anastomosis (IPAA) has become well established as the ideal surgical option for the majority of patients with chronic ulcerative colitis. Improvements and simplifications in operative technique over recent years mean that such patients need no longer live with the fear of a permanent ileostomy with its associated physical, sexual and sometimes psychological problems. Most patients who have undergone IPAA achieve a good quality of life. There are, however, a number of questions with regard to the ileal pouch that remain unanswered. The purpose of this review is to summarize the advantages and disadvantages of the various designs of pouch which have been described, to discuss the function of the normal pouch and manifestations of dysfunctional pouches.

ISSN:0257-2753    

DOI:10.1159/000171597

出版商:S. Karger AG    

年代:1997

数据来源: Karger