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Biomedical subjects

A G Redeker

Publications and source records attributed to A G Redeker.

At least 91 records · Page 5Linked to original sources
PubMed1977

Prognostic implications of the e antigen of hepatitis B virus.

The e antigen HBeAg and its antibody anti-HB, have been said to be predictive of chronicity and resolution, respectively, in viral hepatitis. We found, as have others, a specific association with hepatitis B virus-induced disease. In addition, detectability of HBeAg in the acute phase of type B hepatitis was followed by a sixfold higher incidence of chronic hepatitis. Unfortunately, the prediction was erroneous in 65% of positive cases and 6% of negative cases. In chronic hepatitis, HBeAg did not necessarily disappear in advance of resolution, and its disappearance did not necessarily indicate resolution. Two patients with acute hepatitis progressing to chronicity were anti-HBe-positive in both phases, as were seven (5%) with chronic hepatitis. For individual patients, therefore, HBeAg and anti HBe are not prognostically useful indexes.

Acute Disease↗
PubMed1977

Multiple hepatitis viruses in multiple attacks of acute viral hepatitis.

We evaluated the causes of 30 episodes of acute viral hepatitis in 13 patients who had multiple attacks. Two (seven per cent) of 30 bouts were caused by hepatitis A virus, and 12 (40%) by hepatitis B virus. No patient, however, had more than one attack with the serologic characteristics of Type A or Type B disease. Thus, there were 16 bouts (53 per cent) not attributable to either of the two recognized hepatitis viruses. None of these "non-A, non-B" episodes, evaluated for infectious mononucleosis and cytomegalovirus infection, could be ascribed to either. From this evidence, therefore, it appears that the clinical syndrome of viral hepatitis is produced not only by the two viruses (hepatitis A virus and hepatitis B virus) recognized since the 1940's but also, in all probability, by two non-A, non-B agents.

Acute Disease↗
PubMed1977

Etiology of sporadic hepatitis B surface antigen-negative hepatitis.

We studied serologically 45 adults who had sporadic acute viral hepatitis that was hepatitis B surface antigen (HBsAg) negative. Two cases were due to hepatitis B virus, as demonstrated by the appearance of antibody to hepatitis B core antigen. In three other patients, the serologic pattern was inconclusive. Of 40 non-B cases, 20 were type A hepatitis and 20 were non-A, non-B hepatitis. Clinically, type A and non-A, non-B hepatitis were indistinguishable; one case of fulminant disease occurred in each group. The type A cases were more frequent in young adults; non-A, non-B disease predominated in women 35 years or older. Epidemiologic backgrounds were generally similar, including illicit self-injection; but four transfusion-associated cases were limited to the non-A, non-B group. We conclude that relatively few HBsG-negative cases are due to hepatitis B virus, and that hepatitis A virus and non-A, non-B viruses are both important in acute non-B disease.

Adolescent↗
PubMed1977

Liver replacement for alpha1-antitrypsin deficiency.

A 16-year-old girl with advanced cirrhosis and severe alpha 1-antitrypsin deficiency of the homozygous Pi ZZ phenotype was treated by orthotopic liver transplantation. After replacement of the liver with a homograft from a donor with the normal Pi MM phenotype, the alpha 1-antitrypsin concentration in the recipient's serum rose to normal; it had the Pi MM phenotype. Two and a third years later, chronic rejection necessitated retransplantation. Insertion of a homograft from a heterozygous Pi MZ donor was followed by the identification of that phenotype in the recipient's serum. Neither liver graft developed the alpha 1-antitrypsin glycoprotein deposits seen with the deficiency state. These observations confirm that this hepatic-based inborn error of metabolism is metabolically cured by liver replacement.

Adolescent↗
PubMed1977

Rapid progression of chronic active type B hepatitis in a patient with hypogammaglobulinemia.

Rapid progression of acute type B hepatitis to chronic active liver disease and cirrhosis in a young male with hypogammaglobulinemia is described. Absent circulating IgA, significantly low IgG, and normal IgM levels were detected during the acute phase of illness. Enumeration of peripheral lymphocytes revealed a decreased number of T cells and normal numbers of B cells. In vitro pokeweed stimulation of Ig synthesis correlated with the in vivo circulating levels of the three immunoglobulins. Cell-mediated immune responses were normal except for lymphocyte stimulation to hepatitis B surface antigen. It was concluded that the defective synthesis of IgG and IgA antibodies to hepatitis B surface antigen contributed to the accelerated progression to chronic active type B hepatitis in this person.

Adult↗
PubMed1977

Direct transhepatic measurement of portal vein pressure using a thin needle. Comparison with wedged hepatic vein pressure.

A technique for the direct measurement of portal vein pressure in fully conscious patients is described. This uses a percutaneous transhepatic approach with a thin Chiba needle and is shown to be simple and safe. The technique has been applied to 123 patients with a variety of liver disorders and the pressure measurements have been compared with those obtained by the indirect technique of wedge hepatic vein catheterization. Close agreement was found between portal vein pressure and wedged hepatic vein pressure in quiescent alcoholic liver disease and alcoholic hepatitis. In chronic active hepatitis, portal vein pressure tended to be higher than wedged hepatic vein pressure, indicating a presinusoidal component to the portal hypertension. This technique is shown to be useful in assessing idiopathic protal hypertension and in demonstrating hepatofugal flow.

Alcoholism↗
PubMed1975

Hepatitis B immune globulin as a prophylactic measure for spouses exposed to acute type B hepatitis.

Because the value of usual immune globulin preparations in preventing Type B hepatitis is doubtful, we carried out a double-blind comparison of a control human immune globulin preparation with one--identified as HBIG--that had a high concentration (442 mug per milliliter) of antibodies to surface components of hepatitis B virus. Effectiveness was tested in spouses of patients with acute Type B hepatitis. Within 150 days after injection, nine of 33 spouses in the control group had symptomatic Type B hepatitis, compared with one of 25 spouses receiving HBIG. One non-B case also occurred in the HBIG group. Five control globulin recipients had evidence of subclinical hepatitis B infection, compared with one HBIG recipient. Thus, HBIG appeared effective in suppressing not only disease, but also infection itself. Prophylactic value has been demonstrated in persons who should now be recognized as being at exceptionally high risk.

Acute Disease↗
PubMed1975

Hepatitis B virus infection in dentists.

To evaluate viral hepatitis as a hazard in general dentistry, we surveyed participants in an annual health-screening program at the 1972 American Dental Association session. Of 1245 practitioners, 0.9 per cent were positive for hepatitis B surface antigen, and 12.7 per cent were antibody positive. Of those who had had clinical hepatitis while studying or practicing dentistry, 43 per cent were seropositive. The frequency of evidence for prior infection with hepatitis B virus increased uniformly with increasing years of professional experience. The proportion of seropositive dentists did not vary with geographic region of the United States, or size of community. Only 10.5 per cent recognized illicit self-injection among patients, and their infection rate was not increased. These data indicate an increased frequency of infection with hepatitis B virus among general dentists, and are compatible with relatively uniform endemicity of subtype/ad strans of that agent in the general population for several decades.

Adult↗
PubMed1975

Serologic characterization of patients with two episodes of acute viral hepatitis.

Since testing for serologic markers of hepatitis B virus (HBV) became routine, we have observed in our hospital 28 patients with two distinct episodes of illnesses, each of which was compatible with acute viral hepatitis. We found no distinctions between the first and second bouts with respect to clinical characteristics, abnormalities of liver function or epidemiologic background. Testing of specimens obtained during each of the two acute episodes, the interval between the two episodes and the period subsequent to the second by sensitive procedures for hepatitis B surface antigens (HBsAg) and their corresponding antibodies (anti-HBs) permitted the following classification: 13 of 28 patients experienced first bouts serologically classifiable as due to HBV; 11 patients had second bouts serologically classifiable as due to HBV; 2 patients had two episodes both which were serologically indeterminate; and 2 patients had two bouts neither of which appeared compatible with HBV infection by present criteria. No patient had a second episode for which the HB2Ag and anti-HBs data suggested HBV recurrence or reinfection. This evidence does not favor the speculation that HBV can account for repeated episodes of acute icteric hepatitis.

Acute Disease↗
PubMed1975

Chronic hepatitis.

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Alanine Transaminase↗