摘要:

AbstractThe intra‐operative measurements of serum gastrin levels and an intra‐operative secretin test were carried out as the rapid evaluation of curative operation in a case of Zollinger‐Ellison syndrome (ZES). In this case, pre‐operative investigations suggested that the tumours were located in the head of the pancreas and the duodenal wall. The surgeon planned a pan‐creato‐duodenectomy. Serum gastrin levels were reduced after the resection of the head of the pancreas and duodenum, and the secretin test after resection was negative. The surgeon ensured that gastrinomas were resected completely during the operation. The secretin test carried out 1 month post operatively was also negative. The patient has experienced no further complications, to date. This case suggests that intra‐operative secretin test is useful for the rapid evaluation of curative operation i

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1988.tb00225.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

AbstractThe chemotactic migrationin vitroof intestinal macrophages and peripheral blood monocytes has been assessed in patients with Crohn's disease, ulcerative colitis, and miscellaneous intestinal diseases. In all groups, the chemotaxis of peripheral blood monocytes was similar to that of healthy subjects. Intestinal macrophages migrated similarly to autologous monocytes in patients with ulcerative colitis and in the miscellaneous group. In contrast, intestinal macrophages from patients with Crohn's disease exhibited a wide range of chemotaxis from markedly suppressed to normal. This variation was independent of drug treatment and the degree of inflammation present. However, patients in whom granulomata were not present exhibited a significant depression of chemotaxis compared with those with granulomata, with disease controls (ulcerative colitis patients), and with the miscellaneous group. Such a difference was not reflected in monocytes from autologous peripheral blood. These findings indicate the presence of local mucosal suppressive factors in some patients with Crohn's disease and could suggest that the diminished ability of macrophages to accumulate in a focus of inflammation may be an underlying mechanism for the failure to form granulomata in these patients.

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1988.tb00226.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

AbstractA randomized comparison between diazepam in aqueous form and in fatty emulsion was performed in Chinese patients undergoing upper gastrointestinal endoscopy. One hundred and eighty‐four patients completed the study. The sedative effect is similar with both preparations. Aqueous diazepam caused significantly more pain on injection (75%) and more late venous complication (41%) than the emulsified form (13% and 9% respectively). Thrombosis and thrombophlebitis frequently extended beyond the site of injection. Diazepam in emulsion form caused significantly less venous complications and is therefore superior to the aqueous form for intravenous us

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1988.tb00227.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

AbstractImportant factors in drug metabolite‐induced hepatocellular injury are the production of toxic intermediaries by biotransformation processes and the protective capacity of hepatic detoxification systems. In the present study, the hepatic total glutathione (reduced glutathione plus oxidized glutathione), and γ‐glutamyl transferase (γGT) levels, which are important components of a hepatic detoxification system, were measured in pigs before, during, and after bile‐duct occlusion (BDO). The hepatic reduced glutathione (GSH) level fell significantly in the group with BDO compared with a sham operated control group. However, there were no significant changes in the hepatic oxidized glutathione (GSSG) and γGT levels in the two groups. It was also demonstrated that the hepatic GSH level returned to normal 1 week after the BDO was

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1988.tb00228.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

AbstractThe presence of HBeAg‐ and HBV‐specific DNA‐polymerase (DNA‐P) activity—regarded as markers of HBV multiplication—were studied in 40 patients with fulminant hepatitis B within 1‐5 days of the onset of hepatic encephalopathy. HBeAg and DNA‐P were detected in three (7 %) and 21 (51%) of the patients respectively. Only three (7%) were positive for anti‐HBs. DNA‐P activity was present in 38.1 % even 10 days after the appearance of icterus. Present findings confirm an ongoing HBV multiplication in about half of the patients of fu

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1988.tb00229.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

AbstractIn the present study, aiming at the evaluation of the effects of antiviral therapy on hepatitis B e antigen (HBeAg) levels, serum HBeAg concentration was determined serially by a quantitative assay in 44 patients with chronic hepatitis B who received a total of 73 courses of antiviral treatment. The posttreatment HBeAg levels were significantly lower than pretreatment baseline in all treated groups, not only at the end of treatment but also 6 months after the completion of therapy. The proportional decrease in treated patients was significantly greater than in 15 untreated controls. Six months after the completion of treatment, serum HBeAg became negative in seven out of 25 treatments with interferon, seven out of 28 with adenine arabinoside, and five out of 20 with adenine arabinoside 5'‐monophosphate. All patients who became negative for HBeAg had normalization of alanine aminotransferase as well. A progressive decrease in HBeAg in patients treated with multiple courses of drug was observed, and the frequency of negative tests increased, paralleling the number of courses of treatment.These results suggest that antiviral therapy may alleviate inflammatory changes in the liver by promoting clearance of HBeAg from the serum, and may eventually shorten the natural course of hepatitis associated with chronic hepatitis B virus infectio

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1988.tb00230.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

AbstractThe presence of HBV infection has been retrospectively assessed using monoclonal radioimmunoassay (M‐RIA) in the sera of 269 alcoholics. There were three subjects with normal liver, 92 had steatosis, 32 had fibrosis, 15 had acute alcoholic steatosis and 127 had cirrhosis. The HBsAg M‐RIA was performed by the sandwich method using high affinity IgG and IgM monoclonal antibodies. The M‐RIA was more sensitive for detection of HBV when compared with conventional RIA, the former detecting 15 out of 269, the latter detecting five out of 269 (5.6% and 1.9% respectively;P= 0.02). Among the 264 patients negative for conventional RIA, the prevalence of a positive M‐RIA test was no different between patients who lacked HBV related antibodies (seven out of 196; 3.6%) compared with patients with at least one antibody (three out of 68; 4.4%). The prevalence of HBsAg detected by M‐RIA was higher in alcoholic patients with cirrhosis (9.4%) compared with patients without cirrhosis (2.1%;P<0.01). These results suggest that all alcoholic patients could have a low production, or an abnormal expression, of HBV or could be infected by an hepatitis B variant virus. HBV or an hepatitis B variant virus could have in some cases a causative role in the pathogenesis of

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1988.tb00231.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

AbstractIn the present investigation, a radioimmunoassay for carboxy terminal peptide of human type I procollagen (type 1 C‐peptide) was developed. Its clinical implication for serodiagnosis of hepatic fibrosis in 85 patients with viral hepatitis, 45 patients with post‐hepatitic liver cirrhosis and 37 patients with alcoholic liver diseases was evaluated in comparison with that of the previously established amino terminal peptide (type III N‐peptide) assay. Anti‐sera against type I procollagen was obtained by immunization of rabbit with purified type I procollagen from culture medium of IMR‐90.The serum level of type I C‐peptide in normal subjects was found to be 42 ng/ml (s.d. = 19). Type I C‐peptide levels in patients with acute hepatitis were within normal range, while in chronic hepatitis, the mean type I C‐peptide level increased as the grade of fibrosis advanced from grade I to III. However, there was no statistically significant difference between the mean type I C‐peptide level of grade III and that of liver cirrhosis. Increments of type I C‐peptide levels were also observed in alcoholic liver fibrosis (fatty liver with fibrosis and liver cirrhosis).On the other hand, type III N‐peptide assay appeared to reflect not only the degree of hepatic fibrosis, but also the degree of hepatic inflammation, giving the high levels in acute viral hepatitis.Collectively, the results indicate the usefulness of type I C‐peptide assay for monitoring hepatic fibrosis in viral hepatitis as well as in

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1988.tb00232.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

AbstractKnowledge of auto‐immune chronic active hepatitis (AI‐CAH) has developed since the 1940s. Using the analogy of the seven veils, the lifting of the first six could be represented by the finding of: hypergammaglobulinaemia; recognition of the clinical syndrome; the hepatic histopathology; the auto‐immune serological markers; the response to corticosteroid/immuno‐suppressive drugs; and the immunogenetic association with HLA B8; DR3. The lifting of the seventh veil, the ultimate understanding of AI‐CAH, will require the following: consensus on criteria for specifying auto‐immune hepatitis as an entity; identification of a liver‐specific auto‐antigen (or hepatocellular neo‐antigen) as target of the immune attack; the nature of the immune effector process which causes hepatocellular destruction; the basis of the deranged immunoregulatory processes expressed as decreased immune suppressor activity; and processes by which ‘anti‐immune’ drugs exert their ameliorative effects. Auto‐immune hepatitis is not unique in the paucity o

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1988.tb00233.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

AbstractChronic active hepatitis (CAH) is a clinically and histologically defined syndrome which is aetiologically heterogeneous. Immune reactions are involved in almost all types of chronic inflammatory liver diseases. The host's immune system is thought to contribute significantly to the degree of liver cell destruction in chronic hepatitis B—HBcAg is regarded as a major target antigen. Auto‐immune type CAH is a syndrome of unknown aetiology, a loss of tolerance against self antigens is thought to be a principal pathogenetic mechanism. At least three different subgroups of auto‐immune type CAH can be distinguished by circulating auto‐antibodies: antinuclear antibodies (ANA), smooth muscle antibodies (SMA), liver membrane auto‐antibodies (LMA); liver‐kidney‐microsomal antibodies (LKM); and antibodies to a soluble liver antigen (SLA). The identification of auto‐immune type CAH has clinical relevance since only auto‐immune type CAH seems to profit from immunosuppressive therapy. A suppressor T cell defect was demonstrated in chronic hepatitis B and auto‐immune type CAH. However, this defect could only be reversed by the addition of prednisonein vitroin auto‐immune type CAH. Present research concentrates on the evaluation of the precise cellular mechanisms leading to liver cell destruction.In vitrocytotoxicity assays including autologous target cell systems have several drawbacks due to the use of peripheral blood lymphocytes and the questionable viability of the hepatocytes isolated from liver biopsies. Immunohistological studies using monoclonal antibodies revealed that T8positive T lymphocytes account for the majority of the inflammatory cell infiltrate. In addition, T cell clones derived from liver biopsies are mainly T8positive and show cytotoxic functionin vitro.At present, little is known about the antigen specificity of these liver

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1988.tb00234.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY