摘要:

ABSTRACT—The authors report 24 cases of diffuse nodular regenerative hyperplasia of the liver (DNRH) seen in a General Hospital during the last 9 years (prevalence: 3'1/100 000, incidence: 0'34/100 000). DNRH was diagnosed in 0.52% of the liver biopsies and 0.72 of the autopsies. These results suggest that DNHR is probably more frequent than suspected, and 1 DNRH was seen for each 39 biopsied cases of liver cirrhosis. Fourteen patients did not have hepatic symptoms. Portal hypertension was present in 9 cases. The biochemical disturbance most frequently found was a moderate elevation of GGT and APh, associated with slight elevation of SGOT, SGPT and bilirubin levels. Normal liver function tests could be seen (3 cases). Previous exposure to potentially hepatotoxic drugs or chemicals was discovered in 15 cases (62.5%). Diseases associated were circulatory disturbances (6 cases), autoimmune disease (5 cases), hemopathies (5 cases), and visceral carcinomas (4 cases). Two patients were recipients of renal transplant. Nodules distributed through the whole liver tissue were found in 16 cases, while 8 patients showed areas of normal parenchyma in their livers. Impairment of small hepatic vessels was detected in 16 cases. Some uneven cytologic findings were discovered: clusters of small basophilic cells (4 cases), large clear cells (8 cases), and dysplastic hepatocytes (10 cases), which suggests that DNRH could be a preneoplastic conditio

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1989.tb00409.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACT—The HEPAR system is a medical expert system intended as a supportive tool for the diagnosis of disorders of the liver and biliary tract. In the system, the role of information from the medical interview, physical examination, and simple non‐invasive diagnostic methods, such as ultrasonography, is emphasized in order to reduce the number of diagnostic procedures to be applied. Medical diagnosis is modelled in the system using the formalism of if‐then rules. Based on patient data available, the system determines whether the data indicate a hepatocellular or a biliary obstructive disorder, and whether or not benign or malignant features are present. Moreover, the system produces a subset of possible diagnoses out of a set of more than 70 diagnostic categories. The system is still under development. In a preliminary study, the HEPAR system has been evaluated using data from 94 jaundiced patients. Conclusions with respect to the hepatocellular or biliary obstructive nature of the disorder, the benign or malignant nature of the disorder, and the final diagnosis, were reached in 95%, 65%, and 80% of the cases, respectively. These conclusions were correct in 85%, 92%, and 80% of the classified cases, respectively. The system was shown not to be sensitive to incompleteness of inform

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1989.tb00410.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACT—Two cases are reported, a daughter and her mother who both have myotonic dystrophy with abnormalities of liver function tests and an important perisinusoidal cell enlargement without other pathologic features. In both cases, the myotonic dystrophy was clinically obvious and confirmed by electromyography. No other causes of perisinusoidal cell enlargement were found including vitamin A intake, psoriasis, viral disease or alcoholism. These observations suggest a genetic linkage and that serum test abnormalities could be associated with a perisinusoidal cell chang

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1989.tb00411.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACT—Antibodies against thymus epithelial cells (anti‐TEC) and the basal cell layer (BCLA) of squamous epithelia have been described in association with HDV‐related chronic liver disease (CLD). Data are lacking on their presence during nAnB virus infection. Sera from 51 patients with nAnB post‐transfusion hepatitis, including acute and chronic cases diagnosed during a prospective study on candidates for cardiac surgery, and 167 with various forms of CLD were tested for the presence of anti‐TEC and BCLA using indirect immunofluorescence on human thymus and rat forestomach sections. Both antibodies mainly occurred in nAnB, HDV and cryptogenic CLD (anti‐TEC: 51%, 47% and 42%; BCLA: 29%, 38% and 31%, respectively). The prevalence of anti‐TEC in nAnB CLD turned out to be higher than that recorded in alcoholic, HBV‐related, autoimmune, liver and kidney microsomal antibody positive CLD and primary biliary cirrhosis (p ranging from<0.03 to<0.0004). Two monoclonal antibodies (Mabs) to cytokeratins gave a pattern superimposable on that of spontaneous anti‐TEC (both Mabs) and BCLA (only one). Antibodies against epithelial constituents, presumably targeting cytokeratin‐associated antigens, occur not only in HDV CLD, as previously reported, but also in nAnB CLD, where they might represent a diagnostic aid, due to the unavailability of reliable serological markers of nAnB infection. The close similarity of anti‐TEC and BCLA status between nAnB and cryptogenic CLD suggests a nAnB etiology of at least a proportion of chronic liver patients at present

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1989.tb00412.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACT—This paper reports the results of a prospective study carried out to demonstrate the most important advantages of 99mTc‐blood pool single emission computed tomography (SPECT) versus the established method of planar scintigraphy (PS) in the non‐invasive diagnosis of liver hemangiomas. The study group comprised 40 patients in whom positive evidence of 56 hemangiomas, detected incidentally in the course of screening examinations, was established via SPECT and PS. The sensitivity of SPECT was 51/56 (91%), of PS 22/56 (39.3%); for lesions smaller than 30 mm in diameter, the sensitivity of SPECT was 31/38 (81.6%), of PS 6/38 (15.8%). All lesions with diameters of more than 30 mm were detected by both PS and SPECT. However, the SPECT method proved to be clearly superior in the identification of lesions which were smaller than 30 mm and located in unfavourable topographical sites (dorsal or subphrenic). The study proves that SPECT with 99mTc‐labeled erythrocytes is the ideal complement to ultrasonography in the detection of liver hemangionas; its major advantage over TCT (transmission computed tomography) is its safe application in cases with contrast agent intolerance and hyperthyroid patients. Moreover, liver biopsies are dangerous and ill‐suited for the verification of

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1989.tb00413.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACT—It has been reported in human hepatic graft‐versus‐host disease (GVHD) that an attachment of lymphocytes to vascular wall, the feature called “endothelialitis”, is the most important predictive histologic sign of GVHD. However, its precise nature and significance in GVHD are still unknown. We developed experimental mouse GVHD across minor histocompatibility barriers and examined the lesion during a 14‐month period after transplantation. The lesion was transiently found, appearing first at 4 days after transplantation, reaching a maximal level at 2 weeks and disappearing 5 weeks after transplantation. Electron microscopically, an intimate interaction between lymphocyte and endothelial cell was demonstrated. Lymphocytes showed irregular cytoplasmic processes and pseudopods and were in close contact with endothelial cells. Lymphocytes frequently penetrated in between and under the endothehal cells, and migrated into the perivascular spaces. Immunohistochemical analysis revealed that the vast majority of lymphocytes attached to the endothelial cells are helper/inducer T cells, indicating the cardinal role of helper/inducer T cell in lymphocyte‐endothelial cell interactions. These results, together with previous evidence of the presence of Ia antigens and an antigen‐presenting ability of vascular endothelial cells, suggest that the attachment of lymphocytes to the vascular endothelial cells in the early course of GVHD may represent anin situmorphologic representation of antigen presentation by endothelial cells to

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1989.tb00414.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

ABSTRACT—Interleukin‐1 and tumor necrosis factor‐alpha activity byE. colilipopolysaccharide‐triggered monocytes were studied in patients with chronic alcoholic liver disease. Monocytes from cirrhotic patients were shown to have a significant reduction in IL‐1 and TNF‐a activity, compared with that from age‐ and sex‐matched healthy controls. These findings indicate further immunoregulatory disturbances concerning alcoholic

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1989.tb00415.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1989.tb00416.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1989.tb00417.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY