摘要:

ABSTRACT—A small double‐blind controlled trial to evaluate the short‐term effects of D‐penicillamine therapy was carried out in 24 patients with primary biliary cirrhosis (PBC). The daily dose of D‐penicillamine was increased monthly by 250 mg until a total of 1 g daily was reached. Two out of 11 patients (18%) were withdrawn because of side‐effects, as also were 4 out of 13 (31%) patients receiving the placebo. Transient improvement in symptoms was observed in 4 of 11 patients on D‐penicillamine, but also in 5 of 13 patients from the placebo group. The proportion of patients showing a fall in serum IgM, IgG and hepatic copper was significantly larger for the D‐penicillamine group than for the placebo group. No improvement in liver tests was observed, but the progression of inflammatory periportal liver cell destruction (piecemeal necrosis) was retarded in patients on D‐penicillamine (p = 0.02). Data analysis within the D‐penicillamine group showed that lowering the dose of D‐penicillamine to 500 mg daily abolished the effect on the serum immunoglobulins and hepatic copper. The beneficial effect of D‐penicillamine therapy appears to be small and dose‐related; side effects should not prevent its use, provided the

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1983.tb00887.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

ABSTRACT—We compared the diagnosis of oesophageal varices obtained by oesophagoscopy and percutaneous transhepatic portography in 78 patients with hepatic cirrhosis who were suspected of having oesophageal varices because of ascites and/or preceding upper gastrointestinal haemorrhage. Portograms were evaluated independently of the clinical and endoscopical findings. Endoscopy showed varices in 59 patients and portography in 54 patients. The two methods agreed on the presence of varices only in 46 patients (59%), on the absence of varices in 11 patients (14%), and disagreed in 21 patients (27%). Among the patients showing varices by endoscopy, portography agreed on the diagnosis in 78%, and among patients without endoscopical varices, portography agreed in 58%. The corresponding rates of agreement expected by chance alone are 69% and 31%, respectively. The free portal pressure was lowest in patients with no varices according to both techniques, highest in patients with varices by both techniques and intermediate in patients in whom there was disagreement on the diagnosis. Modification of the criteria for endoscopical and portographical diagnosis of varices and distinction between patients with and without ascites and preceding haemorrhage had no appreciable effect on the agreement. We conclude that endoscopy and portography show only moderate agreement in the diagnosis of oesophageal varice

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1983.tb00888.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

ABSTRACT—The presence of Fc and C3 receptors was studied on mechanically and enzymatically isolated rabbit, mouse and rat hepatocytes as well as on hepatocytes derived from primary cultures. The same cell preparations were used for studying the uptake of an antibody against nuclear antigens. Mechanically isolated hepatocytes were able to bind AIgG and activate complement. However, the same cells were not able to form rosettes with EA or with EAC. Enzymatically isolated hepatocytes did not bind AIgG or activate complement nor did they form rosettes with EA or with EAC. The mechanically isolated cells and the nonviable fraction of the enzymatically isolated cells showed a nuclear fluorescence when incubated with an antibody against nuclear antigens. We conclude that enzymatically isolated hepatocytes lack Fc and C3 binding sites. Furthermore, the damage to the plasma membrane of the non‐viable cells allows the penetration of antibodies against intracellular antig

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1983.tb00889.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

ABSTRACT—Using a sensitive fluoroimmunoassay, anti‐actin antibodies (AA) of the IgM and IgG classes were measured in 240 patients with various chronic liver diseases and in 211 patients with non‐hepatic autoimmune muscle, heart, malignant and inflammatory bowel diseases. Thirty‐two out of 40 patients (80%) with autoimmune chronic active hepatitis (CAH) had AA only of the IgG class (geom. mean X = 1.78, SEM±0.07) and only three patients (8%) had both IgG and IgM AA, the latter in lower titres. In patients with primary biliary cirrhosis (PBC) and AMA‐positive cholestatic CAH, AA of both IgM and IgG classes were equally represented (60% IgG and 64% IgM AA in PBC, 73% IgG and 51% IgM AA in cholestatic CAH) but the titres were very low (geom. mean IgG AA in PBC 1.035, SEM±0.03, in cholestatic CAH 1.18, SEM±0.02). In contrast to autoimmune (lupoid) CAH, AA were rare in HBsAg positive CAH (9/43, 21%) and only present in low titres. However, in six out of 21 patients with anti‐HBs and anti‐HBc‐positive chronic active hepatitis, high AA of IgG class were found, suggesting the autoimmune type of liver disease. In NANB virus‐induced chronic liver disease after blood transfusion, AA were only occasionally found (IgG antibodies 1/19, IgM antibodies 3/19) and none were found in the eight patients with sporadic NANB hepatitis. They were also rare in 30 patients with alcoholic liver disease (3/30, 10%). Of 211 patients with non‐hepatic disorders, only 13 patients (6%) had AA (geom. mean of positive titres 0.076, SEM±0.01). We conclude therefore that high titre AA of the IgG class are reliable serological markers for the diagnosis of an a

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1983.tb00890.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

ABSTRACT—We studied liver biopsies performed between January 1972 and June 1980 in 111 patients receiving regular dialysis treatment. Biopsies were performed either because of suspected liver disease (61 patients) or routinely during abdominal surgery or kidney transplantation (50 patients). Repeat biopsies were done in 14 cases. Hepatitis B virus markers, assayed every 3 months during the observation period, were detected at some time in 71 patients (64%); 51 remained persistently positive. Histological examination showed normal liver in 39 cases, lobular hepatitis in 15, chronic persistent hepatitis in 36 and chronic active hepatitis in 21. All patients with chronic active hepatitis were chronic HBsAg carriers, and repeated biopsies showed aggravation only in these patients. The course was remarkably asymptomatic, with lesions leading to fibrosis despite the lack of histopathological patterns of severe necrosis and/or inflammation, which were conspicuously absent in this serie

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1983.tb00891.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

ABSTRACT—We present the case of an elderly female patient who developed acute and severe hepatitis with two distinct peaks following blood transfusion. The serological markers and histopathology during the first attack were characteristic for hepatitis non‐A, non‐B (NANBH), whereas the second peak was due to hepatitis B virus (HBV) infection. Electron microscopy revealed morphologic equivalents for both hepatitis a

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1983.tb00892.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

ABSTRACT—Delta antigen, a transmissible agent associated with hepatitis B virus, has been detected primarily in Italian patients. The preservation of δ‐antigen in formalin‐fixed, paraffin‐embedded liver tissue enabled us to study the prevalence of this agent in our material. Using the peroxidase‐antiperoxidase method, δ‐antigen was found in 2 of 65 consecutive biopsy specimens of patients with HBsAg‐positive liver disease. In addition, δ‐antigen was demonstrated in 2 of 14 autopsy specimens from HBsAg‐positive patients. Of the δ‐antigen‐positive patients, one was Italian, one was a polytransfused American‐born Italian and two were American homosexuals. All four δ‐Ag‐positive patients had chronic active hepatitis. In one patient, the agent persisted for 5 years while chronic active hepatitis reverted to chronic persistent hepatitis during prednisone therapy. These findings suggest that transmission of δ‐antigen follows that of hepatitis B virus infection, although it is r

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1983.tb00893.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

ABSTRACT—The prevalence of serological markers of hepatitis B virus (HBV) infection was investigated in 75 patients with histologically confirmed hepatocellular carcinoma (HCC). Hepatitis Bs‐antigen (HBs‐Ag) was found in 30.8% and evidence of present or past infection in 61.5%. In a control group of 115 patients with liver cirrhosis of various etiologies in whom evidence of a coexistent HCC was lacking, the corresponding numbers were significantly lower (16.5% and 41.7% resp., p<0.05). Below the age of 65 years, markers of present or past HBV‐infection were significantly more frequent than in patients above 65 years of age (p<0.025). All patients positive for HBs‐Ag had an underlying cirrhosis; in seven cases, HCC was found in a non‐cirrhotic liver. Alpha‐fetoprotein measurements failed to identify patients with HCC in up to 43.6% of the HBs‐Ag negative cases. It is concluded that HBV‐infection does represent a cofactor in the malignant transformation of the liver, even in areas of lower incidence. Alpha‐fetoprotein measurements need to be complemented by other investigations if early recognition of HCC is to lead

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1983.tb00894.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

ABSTRACT—Hepatic vitamin A (VA) is concentrated in lipocytes (fat‐storing cells) but the actual concentration in various cell types has not been measured. In this study hepatocytes from normal and VA‐pre‐treated rats were isolated and the VA content was measured. Because most lipocytes were lysed in the procedure, VA content within lipocytes was estimated indirectly by subtracting total hepatic VA from hepatocellular VA. Hepatocytes contained 10.9% of the total hepatic VA (7.2% in VA‐treated rats). The volume density of lipocytes in whole liver was 0.23% as determined morphometrically (1.45% in VA‐treated rats). From these results it is estimated that the VA concentration in lipocytes is 39 mg/ml (3015 times that in hepatocytes) in normal rats and 69 mg/ml in VA‐treated rats. Lipocyte lipid droplets are estimated to be 26% retinyl palmitate (by volume) in normal rats and 31% in VA

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1983.tb00895.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

ABSTRACT—Bile ducts of rats with 3‐month‐old portacaval shunt were shown by light microscopy to present hypertrophy of the biliary epithelium. This hypertrophy could be linked to the increased hepatic arterial flow following portacaval

ISSN:0106-9543    

DOI:10.1111/j.1600-0676.1983.tb00896.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY