摘要:

ABSTRACTThe prevalence of antibody to hepatitis C virus (HCV) was determined in 139 patients with chronic liver disease (CLD) and 42 patients with hepatocellular carcinoma (HCC) during one year at the Riyadh Military Hospital, Saudi Arabia. The anti‐HCV was detected in 36 of 96 (37.5%) HBsAg‐negative patients with chronic liver disease and six of 43 (13.9%) HBsAg‐positive patients with chronic liver disease. In addition, 11 (42.3%) HBsAg‐negative hepatocellular carcinoma patients and two of 16 (12.5%) HBsAg‐positive hepatocellular patients had antibody to HCV. The anti‐HCV prevalence was 1.5% in 4818 healthy blood donors and 1% in 385 antenatal patients. The overall HCV seropositivity of 30.4% in 181 liver disease patients (CLD and HCC) in Saudi Arabia is lower than that reported from Europea

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1992.tb00970.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

ABSTRACTIt has been widely accepted that there is an ascending route of bacterial infection of the biliary tract but there is a lack of direct evidence. This hypothesis was tested in an animal experiment using the cat as an animal model. The implantation of biliary stents and surgical sphincterotomy were performed in these animals, with sham controls. Stents bypassing the sphincter of Oddi with the tip in the duodenal lumen were colonized by duodenal micro‐organisms and the biliary tract was heavily contaminated. Blockage of these stents resulted in biliary obstruction. Stents implanted within the common bile duct, proximal to the sphincter were largely unaffected by biofilm formation. After surgical sphincterotomy the biliary tract was also contaminated but, in the absence of obstruction, the animals did not develop any symptoms. It was concluded that ascending infection by duodenal biliary reflux, via the sphincter of Oddi, is an important route of infection in the biliary syste

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1992.tb00971.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

ABSTRACTAnti‐hepatitis C virus (HCV) immunoglobulin M antibody titres were measured by an enzyme‐linked immuno‐sorbent assay method in 16 patients with non‐A, non‐B acute hepatitis (NANB AH), 13 with non‐A, non‐B fulminant hepatitis (NANB FH) and nine with type C chronic hepatitis. Anti‐HCV IgM was positive in one of the 16 patients with NANB AH, six of the 13 with NANB FH, and five of the nine with type C chronic hepatitis. Anti‐HCV IgG was positive in eight of the 16 patients with NANB AH and eight of the 13 with NANB FH. Either anti‐HCV IgM or anti‐HCV IgG were positive in 10 of the 13 patients with NANB FH. All of the five anti‐HCV IgM positive patients with type C chronic hepatitis were undergoing an exacerbation of the diseases, while all of the anti‐HCV IgM negative patients were in a remission stage which had lasted for more than 6 months.The findings of this study suggest that anti‐HCV IgM is useful for the early diagnosis of type C FH and may be a useful marker of diseases activity

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1992.tb00972.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

ABSTRACTVasopressin has been found to impair hepatic function in patients with cirrhosis. The aim of this study was to investigate whether oxygen inhalation could improve hepatic function during vasopressin infusion. Vasopressin (0.3iu/min) was infused into eight patients with cirrhosis for 50min. During the first 30min they were ventilated by room air and for the following 20min by oxygen (approximate 50% of FiO2). The extra oxygen inhalation caused a typical increase in arterial (+ 7%,P0.01), portal venous (+8%,P0.05), and hepatic venous (+9%,P0.01) oxygen content. No effect was noted in arterio‐hepatic venous and portal venous‐hepatic venous oxygen content difference in comparison with the values after vasopressin alone. The hepatic perfusion remained unchanged. These results suggest that the extra oxygen did not increase hepatic oxygen uptake. Similarly, intrinsic clearance of indocyanine green did not improve. It is concluded that oxygen supplement in this setting has no hepatic benefit in patients with cirrho

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1992.tb00973.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

ABSTRACTTo investigate the selectivity of serum immunoreactive prolyl 4‐hydroxylase (S‐IRPH) as a marker for hepatic necrosis, sera were taken from patients with hepatic inflammation and hepatic necrosis. The concentration of immunoreactive prolyl 4‐hydroxylase in the sera was determined by radio‐immunoassay, and S‐IRPH and alanine aminotransferase (ALT) data were plotted. Patients with hepatic necrosis showed mainly prolyl 4‐hydroxylase elevation while patients with inflammation had both prolyl 4‐hydroxylase and alanine aminotransferase elevations. The addition of serum immunoreactive prolyl 4‐hydroxylase to current serum markers would be useful in investigating the pathophysiology of hepatocellular damage, particularly in differentiating between hepatic necrosis a

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1992.tb00974.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

ABSTRACTImmunosuppressive regimens are usually required for patients receiving organ transplants. The development of a post‐transplant lymphoproliferative disorder is an infrequent complication of such therapy. FK 506 is a new immunosuppres‐sant agent that has recently been used in patients receiving organ transplantation. This report describes a 20 month old Saudi child who developed post‐transplant lymphoproliferative disorder while receiving FK 506 following liver transplantation. Such a complication has been recognized with cyclosporine but has not been well addressed as yet with FK 506. The child also developed progressive renal complications. There was also a difficulty in interpreting the results for IgM antibodies to different viruses. The overall features of progressive renal toxicity and those of lymphadenopathy, hepatosplenomegaly, fever, neutropenia and thrombocytopenia reversed following discontinuation of FK 506 therapy. It is concluded that all the above complications, though reversible, may well be linked to the new immunosuppressant agent F

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1992.tb00975.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

ABSTRACTThe specificity and sensitivity of α‐fetoprotein (AFP) binding to Concanavalin‐A (Con‐A) andLens culinarisagglutinin (LCA) in 26 South African blacks with advanced symptomatic hepatocellular carcinoma (HCC) but only slightly raised serum AFP concentrations (20–500 ng/mL) was compared with that in patients with similar serum AFP levels from diseases that might be mistaken clinically for HCC (seven ‘benign’ liver disease [BLD] patients and six with metastatic liver disease [MLD]from gastrointestinal tumours). Con‐A–Sepharose‐4B affinity chromatography did not differentiate between the different groups: fucosylation rations for the HCC patients were 0.81 ± 0.60, compared with 0.63 ± 0.27 and 0.54 ± 0.32 in patients with BLD and MLD, respectively. Electrophoresis of AFP serum and fractions in the presence or absence of Con‐A and LCA showed an increase in the AFP C2 band. Rank correlation analysis of the AFP L2 and L3 bands combined could distinguish between patients with HCC and other he

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1992.tb00976.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

ABSTRACTTwo hundred and sixty‐seven susceptible hospital personnel who had been randomly divided into three groups to receive different doses (5 μg, 2 μg or 1 μg) of a plasma‐derived hepatitis B vaccine on a four‐dose schedule were investigated annually for 4 years. Of them, 251 were vaccine responders. The percentages of persistence of antibody to hepatitis B surface antigen (anti‐HBs) in these 3 groups were 95.5% (84/88), 92.3% (72/78) and 95.3% (81/85), respectively (P>0.05). During the follow‐up period, 12 of 21 (57.1%) responders with low anti‐HBs titres (10–100 miu/mL) and 3 of 48 (6.3%) responders with medium anti‐HBs titres (101–1000 miu/mL) were found to be anti‐HBs seronegative, while none of the 182 candidates with high anti‐HBs levels (>1000 miu/mL) lost their anti‐HBs. The 4 year cumulative rate of natural booster in the responders was 11.6% (29/251). None of the candidates became HBsAg positive during the follow‐up period. This study revealed that low dose hepatitis B vaccine can provide satisfactory immunogenic response and long‐term efficacy in Chinese adults and that the persistence of immunogenicity is not related to the vaccine dose but to the candidate's

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1992.tb00977.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

ABSTRACTThe aetiology of idiopathic portal hypertension or hepatoportal sclerosis is unknown. In view of the indirect evidence for underlying immunologic abnormalities 14 patients (all middle‐aged females) were studied. Various auto‐antibodies were demonstrated in seven patients and high levels of serum immunoglobulins, either IgG, IgM or IgA were present in ten patients.T cell responsiveness to stimulation with either autologous or allogeneic non‐T cells was examined in nine of 14 idiopathic portal hypertension patients and compared with responsiveness in patients with posthepatitic cirrhosis and splenomegaly, and healthy controls. Patients with cirrhosis had levels of T cell responsiveness which were not significantly different from those in healthy controls in both autologous and allogeneic mixed lymphocyte reactions. A distinctly reduced autologous mixed lymphocyte reaction was observed in all idiopathic portal hypertension patients.These data indicate that, like many other autoimmune diseases, abnormal serological features and impaired autoreactive T cell responsiveness exist in patients with idiopathic portal hyperte

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1992.tb00978.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

ABSTRACTSurvival rates were calculated for 251 patients with cirrhosis of the liver but without hepatocellular carcinoma, primary biliary cirrhosis, or autoimmune cirrhosis who underwent laparoscopy during the past 21 years at the authors’ hospital. The survival rates were calculated by the Kaplan‐Meier method. Stored serum was assayed for hepatitis B surface antigen (HBsAg) and antibodies to the hepatitis C virus (HCV). Patients with alcoholic cirrhosis had significantly better survival rates than patients with HBsAg, HCV, or both. Differences in survival rates between patients with hepatitis B and C were insignificant. In both groups, habitual drinkers had a significantly lower survival rate. The results suggested that alcohol accelerates liver damage in subjects with viral hepati

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1992.tb00979.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY