Showing papers on "Hepatitis published in 1973"
TL;DR: Spherical 27-nanometer particles were visualized in stools obtained from hepatitis A patients in the acute phase of the disease and suggest that it is the etiologic agent of hepatitis A.
Abstract: Spherical 27-nanometer particles were visualized in stools obtained from hepatitis A patients in the acute phase of the disease. The particle was serologically specific for this disease, and every hepatitis A patient tested demonstrated a serologic response to this antigen. The findings suggest that it is the etiologic agent of hepatitis A.
774 citations
TL;DR: In 15 patients, antibodies to core appeared in acute viral hepatitis, type B, twelve to twenty weeks after exposure, usually during antigenaemia and well before the appearance of anti-HBAg, and anti-core antibodies were found in all chronic HBAg carriers tested.
325 citations
TL;DR: Findings suggest a common pathogenetic mechanism, and disordered cellular immune reactions directed primarily against the liver could affect other organs as a result of cross antigenicity.
189 citations
187 citations
TL;DR: Antibody was twice as frequent in health personnel, indicating increased exposure to the antigen; antibody correlated with past hepatitis in personnel, but not in controls, suggesting that overt hepatitis B infection is more common among health personnel.
Abstract: The frequency of hepatitis B antigen and antibody among health-care personnel was compared with that among matched controls with no exposure to patients or blood products. The frequency of the antigen in personnel and controls did not differ significantly. However, the causes may have been different, the antigen correlating with past transfusion in the controls but not in personnel. A history of past hepatitis did not correlate with antigenemia in either population, impugning the validity of hepatitis history as a cause for donor exclusion. Antibody was twice as frequent in health personnel, indicating increased exposure to the antigen; antibody correlated with past hepatitis in personnel, but not in controls, suggesting that overt hepatitis B infection is more common among health personnel. The frequency of hepatitis B antigen among health workers is not currently alarming, but the risk that each antigen-positive health worker represents to his patients remains unknown. (N Engl J Med 289:647–651...
140 citations
TL;DR: It is found thatSinusoidal congestion, parenchymal atrophy, and subintimal fibrous thickening of the central veins are early histologic manifestations of liver injury, whereas dense fibrous occlusion of the vein lumina is a late effect.
Abstract: 1. Irradiation of the entire liver with doses of 2,450 to 2,920 rads given by the moving strip technique caused liver injury in 14 of 65 patients treated.2. The clinical picture of radiation hepatitis may consist of hepatomegaly, ascites, pleural effusion, and alteration in liver function. The response to the injury sustained is variable, and patients may die within a short time (Group I). The chronic form may be a continuation of the acute injury (Group II), or the patient may experience an abrupt onset of symptoms (Group III).3. Sinusoidal congestion, parenchymal atrophy, and subintimal fibrous thickening of the central veins are early histologic manifestations of liver injury, whereas dense fibrous occlusion of the vein lumina is a late effect.4. A safe dose to the entire liver with the moving strip technique has not been determined. Part of the liver is no longer included in the treatment field.
139 citations
TL;DR: The evidence supports the hypothesis that hepatitis B virus can be transmitted nonparenterally and Familial clustering does not appear to be correlated with the presence or absence of liver damage in the asymptomatic donor carrier.
Abstract: In a survey among 449 family contacts of blood donors from 197 households containing carriers of hepatitis B antigen, 6.7 per cent were antigen positive, as compared with 0.8 per cent in control households. The greatest prevalence of B antigen was among siblings (19.7 per cent) and other genetic family contacts (8 per cent). In spouses B antigen was less frequently detected (3.4 per cent). Hepatitis B antibody was detected three times more frequently in the study households than in control households. No differences in prevalence of hepatitis B antibody between specific relatives of antigen carriers were seen. Familial clustering does not appear to be correlated with the presence or absence of liver damage in the asymptomatic donor carrier. Neither venereal nor Maternal-Fetal transmission seems to be of primary importance in the spread of hepatitis B infections in these surveyed families. The evidence supports the hypothesis that hepatitis B virus can be transmitted nonparenterally. (N Engl J Med...
131 citations
TL;DR: The hepatitis B antigen (HBAg) was detected in 17 of 31 infants whose mothers had acute hepatitis B while pregnant or in the first 2 postpartum months and an occasional neonate in whom acute icteric hepatitis B develops may experience rapid healing with prompt loss of antigenemia followed by the development of significant HBAb titers.
129 citations
TL;DR: In this paper, the authors examined the possible mechanisms whereby an abnormal immunological response in liver disease might result in hyperglobulinaemia, and concluded that defective sequestration of a wide variety of antigens by the Kupffer cells of the liver or their abnormal release contribute to the hyperglobalobalobalinemia.
125 citations
TL;DR: The incidence of major malformations following maternal chickenpox, mumps, measles, and viral hepatitis was observed in a controlled, cohort study of offspring followed up until five years of age.
Abstract: The incidence of major malformations following maternal chickenpox, mumps, measles, and viral hepatitis was observed in a controlled, cohort study of offspring followed up until five years of age. Major congenital defects occurred in each viral group, but the malformations were equal in frequency and often similar in type to those observed among comparable controls for the respective viral groups. Consequently, the malformations that occurred could not be attributed directly to the associated diseases under study.
125 citations
TL;DR: In an investigation of the etiology of 21 consecutive cases of active chronic hepatitis presenting for the first time in the last 12 months, 14 cases considered to be drug-induced showed clinical and biochemical improvement after drug withdrawal, and 3 months later the change in their liver function was greater than in cases of unknown etiology.
Abstract: In an investigation of the etiology of 21 consecutive cases of active chronic hepatitis presenting for the first time in the last 12 months, 14 were considered to be drug-induced. Nine cases were associated with ingestion of laxatives containing oxyphenisatin, and 5 followed ingestion of methyldopa (Aldomet®). Cases considered to be drug-induced closely resembled cases of active chronic hepatitis of unknown etiology clinically, biochemically, and histologically. However, of 9 cases associated with laxative ingestion, 8 had submassive necrosis diagnosed on liver biopsy and 1 died in fulminant hepatic failure. Drug-induced cases showed clinical and biochemical improvement after drug withdrawal, and 3 months later the change in their liver function was greater than in cases of unknown etiology. One case associated with Aldomet, and 1 with laxatives containing oxyphenisatin, had severe exacerbations of hepatitis on re-exposure to the drug.
TL;DR: An agent isolated from chickens with lesions of inclusion body hepatitis, anemia, and intramuscular hemorrhages when a liver suspension was inoculated via yolk sac into specific-pathogen-free chicken embryos indicates that the disease is virus-caused.
Abstract: An agent was isolated from chickens with lesions of inclusion body hepatitis, anemia, and intramuscular hemorrhages when a liver suspension was inoculated via yolk sac into specific-pathogen-free (SPF) 4-day-old chicken embryos. Embryos died, generally within 5 to 10 days postinoculation (PI) when given inoculum from subsequent passages. Harvested infective yolk material proved negative for other known or described avian pathogens and passed through a 0.22-/ Millipore filter. Infectivity trials were conducted with chickens of different ages and sources in reproducing the disease syndrome. Parental immunity to the agent interfered in inducing the disease experimentally. Transmission of the agent from dam to progeny was suggested as occurring in 3 experiments. Attempts at characterization of the agent indicate that the disease is virus-caused. It is recommended that the new agent be designated inclusion body hepatitis virus (IBHV).
TL;DR: A radioimmunoassay for detecting the core of the Dane particle and antibody to it was developed and such antibody was found less frequently in patients with evidence of re-exposure to hepatitis B antigen and could not be detected in pooled hepatitis B immune serum globulin.
Abstract: A radioimmunoassay for detecting the core of the Dane particle and antibody to it was developed. The core was detected in concentrates of Dane particles but not in preparations of purified 22-nm forms of hepatitis B antigen. Detergent treatment of Dane particles increased the detectability of the core. Antibody to the core appeared following acute type B hepatitis infection and could be consistently demonstrated in chronic carriers of hepatitis B antigen. Such antibody was found less frequently in patients with evidence of re-exposure to hepatitis B antigen; it could not be detected in pooled hepatitis B immune serum globulin.
TL;DR: Although accidental needle punctures prior to hepatitis were reported by many staff, other types of exposures were common, and nonparenteral transmission probably occurred.
Abstract: Of 65 renal hemodialysis units surveyed prospectively by the Center for Disease Control in the four-year period 1967 to 1970, fifty-three reported 355 cases of viral hepatitis—260 in hemodialysis patients and 95 in hemodialysis unit staff members. The incidence of infection in 1970 for center-based patients and staff was 4.4 cases and 3.4 cases, respectively, per 100 persons at risk. Almost 70% of the hemodialysis patients were anicteric; many of these cases would not have been detected if periodic serologic screening for hepatitis B antigen or liver-function tests had not been performed routinely. On the other hand, 85% of staff members with hepatitis were jaundiced, and 74% required hospitalization. Although accidental needle punctures prior to hepatitis were reported by many staff, other types of exposures were common, and nonparenteral transmission probably occurred.
TL;DR: Level of CEA correlated with degrees of impairment of liver function as judged by bromsulphalein retention and serum levels of alkaline phosphatase and transaminase, and in cancer of the pancreas 94% had levels above 5 ng/ml and 50% above 20 ng/ ml.
Abstract: Carcinoembryonic antigen (CEA) was measured in whole serum and in serum extracted with perchloric acid by microradioimmunoassay in patients with benign and malignant diseases of the liver and pancreas. The level of detectability was 5 ng per ml. This level or greater was present in the serum of 50% of patients with chronic diffuse liver disease, 64% with pancreatitis, 94% with cancer of the digestive system, and 3% of controls. The incidence of levels of CEA of 5 ng/ml or more differed for various categories of chronic liver disease: from 22% in active chronic hepatitis, 46% in primary biliary cirrhosis, 63% in hepatoma, 78% in cryptogenic cirrhosis, and 88% in alcoholic cirrhosis; levels of CEA correlated with degrees of impairment of liver function as judged by bromsulphalein retention and serum levels of alkaline phosphatase and transaminase. In pancreatitis, 64% of cases had levels of CEA ranging from 5 to 20 ng/ml and in cancer of the pancreas 94% had levels above 5 ng/ml and 50% above 20 ng/ml.
TL;DR: On serial liver biopsy a significant increase in hepatocyte volume and clotting factors was only observed in patients who recovered consciousness, and the estimated liver cell mass after regeneration in patientsWho recovered consciousness was ≥45% and <45% in the patients who did not.
Abstract: Liver biopsy was performed in 38 patients with fulminant hepatitis and coma and repeated in 22. Stereological estimation of hepatocyte volume was correlated with levels of clotting factors. Early liver biopsy allowed prognosis in 55% of the cases. All patients with a hepatocyte volume of 10% recovered consciousness (n = 9) or at least showed evidence of marked liver regeneration (n = 2). On serial liver biopsy a significant increase in hepatocyte volume and clotting factors was only observed in patients who recovered consciousness. The estimated liver cell mass after regeneration in patients who recovered consciousness was ≥45% and
TL;DR: In this paper, the etiologic relationship of CR326 hepatitis virus recovered in marmosets to hepatitis A in man was defined and the factors influencing the results were given; the results showed that neutralization was highly effective since marmoset given the neutralized virus remained susceptible to reinfection with the agent.
Abstract: SummaryStudies were conducted to define the etiologic relationship of CR326 hepatitis virus recovered in marmosets to hepatitis A in man. CR326 virus exhibited physical-chemical properties considered characteristic of human hepatitis A virus, viz, small size and heat, ether and acid stability. A serum neutralization test carried out with CR326 virus in S. mystax marmosets is described and the factors influencing the results are given. Tests of paired sera from 8 cases of hepatitis A and 2 cases of hepatitis B were carried out including coded paired sera from 3 human subjects given MS-1 strain hepatitis A and 1 given MS-2 strain hepatitis B virus of human source. All subjects with hepatitis A developed antibody that neutralized CR326 virus; there was no such antibody response in persons with hepatitis B. All of 3 samples of human immune globulin neutralized the CR326 agent. Neutralization was highly effective since marmosets given the neutralized virus remained susceptible to reinfection with the agent; by...
TL;DR: It is concluded that primary antibody responses to HB Ag are common after viral hepatitis, type B, and that protective immunity frequently but not invariably follows early exposure to hepatitis-B virus.
Abstract: Most individuals with viral hepatitis, type B, acquire a serum antigen (hepatitis-B antigen [HB Ag]) 1 at some time during the incubation period or the acute phase of the disease. Serial sera from 88 patients with viral hepatitis, type B, were examined for antibodies against HB Ag (anti-HB Ag) by passive hemagglutination (PHA) and radioimmunoassay (RIA) methods. Seventy individuals (79.5%) were found to develop serum anti-HB Ag at some time after exposure. Overt occurrences of hepatitis were usually followed by primary-type anti-HB Ag responses. However, early- or secondary-type anti-HB Ag responses were seen in 17 individuals who subsequently developed clinical hepatitis. Most individuals who were resistant to infection after parenteral exposure to materials known to transmit hepatitis had secondary antibody responses. We conclude that primary antibody responses to HB Ag are common after viral hepatitis, type B, and that protective immunity frequently but not invariably follows early exposure to hepatitis-B virus.
TL;DR: It appears that the developmental period when exposure occurs, rather than the clinical status of the mother or the subtype, is the most important determinant whether the infant will be chronically infected.
TL;DR: The severity of hepatitis duringregnancy and the effect of hepatitis on pregnancy and the fetus have been evaluated in southern Iran and significantly increased frequency of fulminant hepatitis in pregnancy.
TL;DR: Results provide conclusive evidence on the existence, at the cellular level (hepatocyte), of two immunochemically different specificities of HB Ag, the nuclear and the cytoplasmic.
Abstract: The specificity of fluorescent antibodies to hepatitis B (HB Ab) in the sera of patients with acute viral hepatitis and chronic aggressive hepatitis and precipitating HB Ab of human and animal origin were examined by indirect immunofluorescent technique performed on sections of liver that contained large quantities of hepatitis B antigen (HB Ag) localized in the nuclei and/or cytoplasm of hepatocytes. It was found that HB Ab from sera of patients with acute viral hepatitis and chronic aggressive hepatitis reacted predominantly with nuclear HB Ag. Precipitating HB Ab from man reacted predominantly with cytoplasmic HB Ag and those from hyperimmunized animals, almost exclusively with cytoplasmic HB Ag. These results provide conclusive evidence on the existence, at the cellular level (hepatocyte), of two immunochemically different specificities of HB Ag, the nuclear and the cytoplasmic. Accordingly, antibodies to HB Ag in the sera may be of either nuclear or cytoplasmic specificity, or both.
TL;DR: Before therapeutic experiments with somatostatin are feasible it is necessary to develop a mode of long-term suppressin and if a preparation which can suppress the growth hormone hypersecretion of diabetics in a clinically acceptable way is found it should be used.
Abstract: The results for the nine male diabetics are shown in fig. 2. Sonrtstatin also caused suppresion in this group. This effect was statistically significant 20 and 30 ninutes after beginning exercise (2 P < 0 05 and < 0.025 respectively). The experiments without somatostatin show that fwting growth hormone values were higher and the rise during exercise occurred earlier and was morie pronounced in the diabetics. This is in accordance with earlier findings (Hansen, 1972). It should be emphasized that the metabolic state of the diabetics was similar in the experiments with and without somatostatin (average fasting blood glucose 138 mg/100 ml in control experiments and 130 mg/100 ml in the somatostatin experiments). Before therapeutic experiments with somatostatin are feasible it is necessary to develop a mode of long-term suppressin. One possibility is to produce a delayed absorption compound. Another is to try somtostatin or some modification of the molecule given by mouth. If a preparation which can suppress the growth hormone hypersecretion of diabetics in a clinically acceptable way is found it should be used in con30 -
TL;DR: In the liver biopsies of normal subjects, patients with Gilbert's syndrome, and patients with acute viral hepatitis, UDPG-T was uniformly reduced, unrelated to the serum bilirubin concentration, unaffected by acute changes in caloric intake and not significantly altered by phenobarbital administration.
TL;DR: It is believed that the serum hepatitis virus was transmitted to the surgeons while they were operating, most likely through tissue penetration by contaminated surgical instruments or materials.
Abstract: An epidemic of serum hepatitis (hepatitis-associated antigen [HAA]-positive) among surgical house staff occurred at Albert Merritt Billings Hospital in the winter of 1971. Four surgeons, who had operated on a patient in whom HAA-positive serum hepatitis subsequently developed, were affected. Arthralgia or arthritis and rash were prominent clinical features of this outbreak. Reduced synovial fluid complement level and a synovial fluid that was HAA-positive were found in one of the surgeons. A detailed evaluation of the 75 medical and allied medical personnel who cared for this patient before, during, and after surgery uncovered no additional cases of hepatitis. We believe, therefore, that the serum hepatitis virus was transmitted to the surgeons while they were operating, most likely through tissue penetration by contaminated surgical instruments or materials.
TL;DR: Adenovirus infection in chickens has been associated with a drop in production and problems of egg-shell quality and gross lesions associated with the disease have been tracheitis and hepatitis.
Abstract: SUMMARY Adenovirus infection in chickens has been associated with a drop in production and problems of egg-shell quality. Gross lesions associated with the disease have been tracheitis and hepatitis. The hepatitis was characterized histologically as lymphocytic foci containing a few heterophils early in the disease. Focal fibrinoid necrosis was present, occasionally with a granulomatous response accompanied by fatty infiltration. The lesion progressed to fibrosis and hyperplasia of the bile duct. The tracheitis varied in severity and consisted of a round-cell infiltrate into the lamina propria. In addition to the segmental infiltrate, lymphoid follicle formation was prominent. Susceptible embryos inoculated with the virus were stunted and dwarfed. The gross lesions were those of hepatitis. Histologically, eosinophilic intranuclear inclusion bodies were present in the hepatocytes. A portal inflammatory cell infiltrate composed of heterophils and fibroblastic cells was observed 4 days postinoculation. Chickens 3 days to 8 weeks old were inoculated with the cloned virus. Tracheitis and hepatitis were present at necropsy. The microscopic lesions were identical to those in field cases with one exception: a necrotizing pancreatitis observed occasionally in the experimental chickens is not found in the naturally occurring disease.
TL;DR: Examination of renal tissue by a fluorescent antibody technic suggested that immune complexes containing Australia antigen might be involved in the pathogenesis of the glomerular disease.
Abstract: A patient with chronic active hepatitis and persistent Australia antigenemia developed glomerulonephritis with pathologic features of chronic membranoproliferative glomerulonephritis. Examination of renal tissue by a fluorescent antibody technic suggested that immune complexes containing Australia antigen might be involved in the pathogenesis of the glomerular disease.
TL;DR: The RIA method was compared with other serologic methods and found to be significantly more sensitive than all methods except PHA and approximately equal in sensitivity as judged both by endpoint titrations and tests on the 745 sera for antibodies.
Abstract: . The sera from 385 hemophilia patients and 360 normal voluntary blood donors were tested by a variety of methods for antibodies against the hepatitis- associated or hepatitis B antigen (HB Ag). Anti-HB Ag was detected in 79.8% of the hemophilia sera and 7.5% of the normal blood donor sera by a ‘sandwich’ solid-phase radioimmunoassay (RIA) method. The RIA method was compared with other serologic methods (agar-gel diffusion, counterelectrophoresis, complement fixation and passive hemagglutination [PHA]) and found to be significantly more sensitive than all methods except PHA. The RIA and PHA methods were approximately equal in sensitivity as judged both by endpoint titrations and tests on the 745 sera for antibodies. The RIA method is also applicable to HB Ag detection.
TL;DR: There were no significant differences between HBAg positive and negative patients for clinical manifestations, immunoglobulins, autoantibodies, cell-mediated immunity, or prognosis, and in some cases the progression of tissue damage in this condition may be unrelated to the continued presence of circulating HBAG.