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Biomedical subjects

A G Redeker

Publications and source records attributed to A G Redeker.

At least 73 records · Page 4Linked to original sources
PubMed1984

Fulminant B viral hepatitis: role of delta agent.

The prevalence of delta-markers among 71 patients with fulminant B viral hepatitis was found to be 33.8%. The majority of the patients with delta-markers showed serologic evidence of simultaneous acute delta-infection and B viral infection. Only 5 of the 24 patients with serologic markers of acute delta-infection in this fulminant group were presumably infected chronically with hepatitis B virus as shown by the absence of immunoglobulin M antibody to hepatitis B core antigen. A study of serologic markers of acute delta-infection among 118 patients with nonfulminant acute B viral hepatitis, in contrast, revealed only 4.2% incidence. This significant difference in the prevalence of simultaneous acute B and delta viral infections between the fulminant and the nonfulminant acute hepatitis groups indicates a higher morbidity rate associated with simultaneous infection. When the fulminant group was divided into acute B viral infection without delta-markers (subgroup 1), simultaneous acute B and delta-infections (subgroup 2), and chronic asymptomatic B with acute delta-infections (subgroup 3), for comparison of survival data, the mortality rate was not significantly different in the first two groups when the patients were age matched.

Acute Disease↗
PubMed1983

Effect of short-term prednisone therapy on aminotransferase levels and hepatitis B virus markers in chronic type B hepatitis.

We have studied the effect of short-term high-dose prednisone therapy on aminotransferase levels and hepatitis B virus markers in 6 patients with chronic type B hepatitis. All showed a decrease in amino transferase levels during treatment. This was followed by a transient increase in aminotransferase levels after prednisone was discontinued. In 5 patients, there was a decrease in hepatitis B virus deoxyribonucleic acid polymerase activity at the time of postprednisone peak of aminotransferase levels. Three of them became transiently deoxyribonucleic acid polymerase negative. All the patients have remained hepatitis B e antigen-positive throughout the period of observation. We have also found transient deoxyribonucleic acid polymerase negativity unrelated to prednisone therapy in 2 patients with chronic type B hepatitis: in one during a superimposed episode of acute type A hepatitis, and in the other during a period of pronounced alanine aminotransferase elevation. We postulate that these periods of deoxyribonucleic acid polymerase negativity are due to a decreased number of hepatitis B virus-infected cells in the liver as a consequence of hepatic necrosis.

Adult↗
PubMed1982

The prevention of hepatitis B with vaccine. Report of the centers for disease control multi-center efficacy trial among homosexual men.

A randomized, double-blind, vaccine/placebo trial of the Merck 20-micrograms hepatitis B virus (HBV) vaccine was done among 1402 homosexual men attending venereal disease clinics in five American cities. Vaccination was followed by only minimal side effects. Two doses of vaccine induced antibody in 80% of vaccine recipients. A booster dose 6 months after the first dose induced antibody in 85% of recipients and markedly increased the proportion of recipients who produced high antibody titers. The incidence of HBV events was markedly less in the vaccine recipients compared to that in the placebo recipients (p = 0.0004). Between month 3 and 15 after the first dose, 56 more significant HBV events (hepatitis, or hepatitis B surface antigen positive, or both) occurred in the placebo group while only 11 occurred in the vaccine group. Ten of the 11 HBV events in the vaccine recipients occurred in hypo- or nonresponders to the vaccine. This vaccine appears to be safe, immunogenic, and efficacious in preventing infection with hepatitis B virus.

Adult↗
PubMed1982

Double-blind, controlled trial of propylthiouracil in patients with severe acute alcoholic hepatitis.

Sixty-seven patients entered a double-blind, controlled trial to evaluate the efficacy of propylthiouracil treatment in severe alcoholic hepatitis. Twenty-three percent (7 of 31) given propylthiouracil and 19% (7 of 36) given placebo died during the 6-wk study. Propylthiouracil treatment did not reduce the frequency and incidence of complications in alcoholic hepatitis, but induced hypothyroidism in 4 patients. Treatment produced no beneficial effect on any of the hepatic biochemical tests. We were unable to show any beneficial effect of propylthiouracil treatment on morbidity and mortality in patients with severe acute alcoholic hepatitis.

Adult↗
PubMed1981

Results of a 12-year randomized trial of portacaval shunt in patients with alcoholic liver disease and bleeding varices.

During a 7-yr period (1967-1974), 89 patients with alcoholic liver disease and at least one severe upper gastrointestinal hemorrhage thought to be from esophageal varices entered a randomized, controlled trial of medical therapy vs. end-to-side portacaval shunt. Follow-up continued to September, 1979, so that all surviving patients had at least 5 yr observation after randomization. Among 45 patients randomized to surgical therapy, 4 did not receive portacaval shunt, for various reasons. Among shunted patients there were 11 episodes of upper gastrointestinal bleeding, none fatal and none thought to be from esophageal varices. Thirty-seven percent of eligible patients have had moderate or severe hepatic encephalopathy ascribed to the shunt. Of 44 patients randomized to medical therapy, 7 eventually received portacaval shunt after multiple bleeding episodes. Since randomization there have been 190 episodes of bleeding requiring 589 transfusions and resulting in 23 deaths from bleeding or hepatic failure precipitated by bleeding. THere are 12 survivors in the surgically treated group and 8 in the group treated medically. Life-table analysis shows a small increase in survival in the surgically treated group throughout the study, which is not statistically significant. From our data, we could not identify risk factors that would improve the selection of patients for medical or surgical therapy.

Adult↗
PubMed1981

Fine needle transhepatic cholangiography. Current status and critical review of the technic.

Percutaneous fine needle transhepatic cholangiography (FNTC) is a preferred procedure in demonstrating pathology of the biliary tract in jaundice disorders. Aspects in technic such as: 1. roentgenographic anatomy of the needle path and guidelines for its identification; 2. necessary radiologic equipment; 3. the injection technic; 4. aspiration of bile; 5. significance of the number of needle passes and 6. pharmacologic aids must be familiar to anyone using FNTC. Similarly, knowledge of the indications, contraindications, and complications are essential to the operator. The following review presents the authors' experience as well as a critical assessment of the current state of the art of FNTC.

Cholangiography↗
PubMed1980

Hemolytic anemia in Wilson disease: clinical findings and biochemical mechanisms.

Two patients with Wilson disease who presented with severe hemolytic anemia are described. One was noted to have unusually high serum copper levels (369 micrograms/100 ml). A review of similar such patients in the literature suggests that, rather than having a low serum copper, patients with hemolysis accompanying Wilson disease have very high serum copper levels. For this reason, in vitro studies of the toxic effects of copper on erythrocytes were undertaken. It was found that, although copper does not have a major direct inhibitory effect on glycolytic enzymes such as hexokinase, the metal does inhibit hexokinase as a consequence of its interaction with oxyhemoglobin. However, such inhibition does not appear to be a major factor in copper-induced hemolysis. On the other hand, the addition of the lipid antioxidant butylated hydroxyanisole (BHA) suppresses hemolysis in copper-treated cells. These experiments suggest that the primary toxic effect of copper is mediated through its oxidant actions on membrane phospholipids rather than through its potential inhibitory effects on intracellular enzymes.

Adult↗
PubMed1980

Hepatitis B surface antigen in pancreatic and biliary secretions.

Pure pancreatic juice (PPJ) and pure bile (PBJ) were obtained by endoscopic retrograde cannulation of the pancreatic duct and common bile duct in 26 patients with acute (15) and chronic (11) hepatitis B infections and the specimens were tested for HBsAg. HBsAg was detected in PPJ in 8 of 15 patients with acute infections and 3 of 10 with chronic infections. HBsAg was detected in PBJ in 7 of 10 with acute infections and only 2 of 5 with chronic type B infection. Since normal PPJ was shown to be inhibitory to the detection of HBsAg, it is suggested that the HBsAg-positive PPJ represents heavy viral excretion.

Adult↗
PubMed1979

Liver allograft. Its use in chronic active hepatitis with macronodular cirrhosis, hepatitis B surface antigen.

A patient suffering from chronic active hepatitis with macronodular cirrhosis, positive for hepatitis B surface antigen (HBsAg), was treated with an orthotopic liver allograft. The HBs antigenemia, as measured with several precipitation tests and by complement fixation, became negative after transplantation and remained so for about 2 1/2 months. During the interval, very low titers of the antigen were detectable by radioimmunoassay. At about three months after transplantation, she had an attack of acute hepatitis, at which time HBsAg became detectable by all tests. She recovered, but progressive liver disease developed during the remaining 1 1/2 years of her life. She died of disseminated nocardiosis and candidiasis with deteriorating hepatic function. The homograft at autopsy showed no evidence of rejection, but was the site of chronic active liver disease, although of a different pathologic pattern than that affecting her native liver. The differences in histology may reflect the influence of chronic immunosuppression on the features of chronic active hepatitis.

Adult↗
PubMed1979

Differences in intrahepatic portal-systemic shunting in alcoholic and nonalcoholic liver disease as assessed by liver scan, portal pressure, and E. coli antibodies.

The interrelationship among portal vein pressure, 99mTc sulfur colloid liver/spleen scan abnormality, and serum E. coli antibody titers has been examined in 33 patients with alcoholic liver disease (ALD) and compared with 24 patients with liver disease not related to alcohol (non-ALD). A correlation between portal vein pressure and liver scan abnormality is seen in both groups, but for a given degree of portal hypertension there is a much greater redistribution of sulfur colloid in the ALD group (P less than 0.01). E. coli antibody titers are significantly higher in the ALD patients compared with the non-ALD patients (P less than 0.02), and they show a positive correlation with scan abnormality but not with portal vein pressure. It is suggested that the differences in scan appearance and E. coli antibody titers in these two groups of liver disease patients may be related to differences in intrahepatic shunting.

Alcoholism↗
PubMed1979

A comparative study of hepatitis B viral markers in the family members of Asian and non-Asian patients with hepatitis B surface antigen-positive hepatocellular carcinoma and with chronic hepatitis B infection.

Serologic tests for evidence of hepatitis B virus (HBV) infection were performed on family members of Asian and non-Asian patients with either hepatitis B surface antigen (HBsAg)-positive hepatocellular carcinoma or chronic HBV infection. Asian family members had a significant increase of HBsAg (34% higher) and of antibody to HBsAg or of antibody to hepatitis B core antigen (50% higher) when they were compared with non-Asian family members. In the Asian group, viral markers were detected more frequently in blood relatives than in nonblood relatives of the index cases. Within this group, birthplace did not influence the frequency of antigenemia, since HBsAg was positive in 55 (44%) of 125 Asians born in Asia and in 36 (38%) of the 94 Asians who were born in the United States. Also, HBsAg positivity frequently was seen in offspring from HBsAg-positive carrier mothers as well as from HBsAg-positive carrier fathers whose spouses were either HBsAg-negative or who had antibody. The e antigen was found more often in individuals 30 years of age or younger than in older individuals. This study indicates that intrafamilial spread of HBsAg in Asian families plays an important role in the perpetuation of HBV infection and in the eventual development of chronic liver disease in this ethnic group.

Adolescent↗
PubMed1979

Chronic liver disease after acute non-A, non-B viral hepatitis.

We have analyzed the frequency of chronicity and its distribution according to epidemiologic background following acute non-A, non-B hepatitis. Eighteen of 45 cases (40%) developed chronic liver disease. The incidence of chronicity was significantly higher following transfusion and among drug addicts (54% and 58%) than among patients without obvious source of infection (20%). Chronic active hepatitis developed in 4 of 13 patients (31%) with posttransfusion hepatitis. This lesion was not observed among the addicts or the patients without obvious source for the acute hepatitis.

Adult↗