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Biomedical subjects

G L Gitnick

Publications and source records attributed to G L Gitnick.

At least 37 records · Page 2Linked to original sources
PubMed1978

Anticore antibody screening of transfused blood.

Aliquots of 130 HB8Ag negative units of blood which were administered to 26 recipients were tested under code for anti-HBc by a solid phase radioimmunoassay technqiue. 14 of the 26 recipients developed posttransfusion hepatitis (PTH), including 6 cases of hepatitis B. Anti-HBc was detected in 7 or 5.3% of 130 donor units. Of the 14 patients acquiring PTH, 6 received a unit of anti-HBc-positive blood. Type B hepatitis occurred in 4 of the 7 anti-HBc recipients, and non-type B hepatitis in 2. Only 1 of 12 recipients who failed to develop PTH had received a unit containing anti-HBc.

Antibodies, Viral↗
PubMed1978

Non-A, non-B hepatitis transmission in chimpanzees: a project of the transfusion-transmitted viruses study group.

Experimental transmission of non-A, non-B hepatitis was apparently accomplished in 5 chimpanzees following inoculation with presumably infectious human sera. Administration of sera from implicated donors with normal alanine aminotransferase (ALT) values, as well as from those with abnormal ALT levels, resulted in the development of ALT abnormalities in the inoculated chimpanzees. Transmission from donors with normal ALT values implies that healthy carriers of non-A, non-B virus exist. Evidence is presented which indicates that a period of viremia precedes the clinical illness by at least 12 days.

Alanine Transaminase↗
PubMed1978

Viral hepatitis.

Viral hepatitis may be classified into three or more forms including type A hepatitis, type B hepatitis, and a group denoted as non-A non-B hepatitis which may represent viral hepatitis of one or more causes. The differentiation of these forms of hepatitis is primarily serologic. The development of antibody to hepatitis A virus can be detected by radioimmunoassay as well as by other test systems. The serologic diagnosis of type B hepatitis rests on the detection of hepatitis B surface antigen or on the development of antibody to hepatitis B core antigen or hepatitis B surface antigen. The serologic diagnosis of non-A non-B hepatitis is a diagnosis of exclusion for assay systems for this form of disease are not yet available.A prototype hepatitis B vaccine has been prepared and is currently undergoing clinical trials. Gamma globulin is now available that contains high titered antibody against hepatitis B virus. Normal immune globulin contains high titers directed against hepatitis A virus. Therefore, for documented exposure, effective prophylaxis is available for both of these forms of acute liver disease. The past decade has resulted in rapid advances in our understanding of the pathogenesis of acute hepatitis and its extrahepatic manifestations. However, it is clear that specific treatment for acute hepatitis and the accurate description of the etiologic agents of non-A non-B hepatitis require exploration.

Hepatitis B Antigens↗
PubMed1978

Hepatitis B surface antigen carriers--to biopsy or not to biopsy.

In order to assess the frequency of significant liver disease in hepatitis B surface antigen carriers with normal liver tests, 54 such individuals were identified and prospectively followed for 4 to 48 months with monthly liver tests. Upon testing, 4 were found to carry e antigen and 14 carried e antibody (anti-e). During follow-up, only 4 patients, none of whom were e antigen-positive, developed persisting abnormalities in liver tests. Of the 23 patients who underwent percutaneous liver biopsies, normal histologies were found in 2, nonspecific changes (ground glass hepatocytes, focal necrosis, fatty changes, etc.) in 18, and chronic persistent hepatitis (with or without other nonspecific changes) in 3. Chronic active hepatitis and/or cirrhosis, lesions which may carry more serious prognostic implications, were not seen in any biopsies. Two of the 4 e antigen-positive patients consented to biopsy, both of whom had chronic persistent hepatitis. All 6 patients with anti-e who underwent biopsy had ground glass hepatocytes, which were found in only about 50% of the remaining patients. It is concluded that hepatitis B surface antigen carriers should be followed with serial liver tests, and those whom tests remain normal should not be considered for liver biopsy.

Adult↗
PubMed1977

Hepatic pathologic condition in asymptomatic Australia antigen carriers. A light microscopical study of 26 cases and a review of the literature.

Liver biopsies were performed on 26 Australia antigen carriers who were asymptomatic with normal liver function tests. The carriers are part of a prospective and long-term study designed to analyze the clinical and pathological consequences of persistent, though asymptomatic antigenemia. The liver abnormalities that were indicated on biopsy included fifteen specimens with "inflammatory changes" that were characterized by intralobular foci of mononuclear cells and/or portal tract infiltrates. Fifteen biopsy specimens demonstrated "ground-glass" cells. Nine biopsy specimens showed fatty change, and three specimens were normal. The results of our study in conjunction with cases that were reviewed in the literature indicate a narrow and mild spectrum of liver biopsy specimen abnormalities in the asymptomatic carrier with normal liver function tests. Prognostic inference from this liver biopsy data is premature and clinical follow-up of carriers is advocated.

Adult↗
PubMed1977

Vigorous medical management of acute fulminant hepatitis.

Twenty patients with acute fulminant hepatic failure and stage II, III, or IV hepatic encephalopathy attributable to viral hepatitis were studied to assess the risk factors, as well as the affects of vigorous medical management. These patients were treated according to a protocol that directed aggressive medical management of fluid balance with electrolyte solutions, plasma, and blood; acid-base balance; coagulation defects with fresh frozen plasma; blood replacement as needed; dietary protein elimination; and orally administered neomycin sulfate. Among the 20 patients there were eight survivors (40%). Seven of the 13 patients who were positive for the hepatitis B surface antigen (HB-Ag) survived (54%), while one of the seven patients whoe were negative for HB-Ag survived (14%). The stage of encephalopathy on admission did not correlate with survival. Patients under the age of 40 years had a 43% survival rate, while those over 40 years had a 33% survival rate. Conservative but vigorous medical management may improve survival in fulminant hepatic failure.

Acid-Base Equilibrium↗
PubMed1976

Cultivation of viral agents from Crohn's disease. A new sensitive system.

The isolation and animal transmission of a viral agent from Crohn's disease patients stimulated studies aimed at the development of improved tissue culture techniques. The need for an effective tissue-culture system led to a comparison of African green monkey tissue-culture cells (A.G.M.K.), human diploid lung cells (WI-38), and a new tissue-culture line--continuous rabbit ileum (C.R.I.). Homogenates prepared from ileal specimens from four Crohn's disease patients and from four control patients without inflammatory bowel disease were filtered through a 0-2mu 'Millipore' filter. After confluence, groups of six tissue-culture flasks were inoculated with 0-3 ml of Crohn's disease or control filtrates. No cytopathic agents were isolated from A.G.M.K. tissue-culture. Cytopathic agents were isolated in WI-38 and C.R.I. tissue-cultures from each of the four Crohn's disease specimens but from none of the control specimens. A comparison of C.R.I. and WI-38 demonstrated that cytopathogenic change (C.P.E.) developed in C.R.I. earlier than in WI-38. C.P.E. was complete in a shorter period of time in C.R.I. but was irregular in WI-38. The sensitivity of WI-38 varied with the passage level and age of the monolayer. C.R.I. was found to be free of cytopathic adventitial agents upon inoculation of standard tissue-culture systems and weanling mice. Therefore C.R.I. is a sensitive and superior tissue-culture system for the cultivation of viral agents from Crohn's disease filtrates. The reproducible isolation of a viral agent from the ileum of patient's with Crohn's disease is confirmed by these studies.

Animals↗
PubMed1976

Electron microscopic studies of viral agents in Crohn's disease.

Viral agents isolated from ileal filtrates of patients with Crohn's disease have been successfully cultivated in continuous rabbit ileum tissue-culture and grown to titres sufficient to allow electron microscopic characterisation. Electron microscopic studies showed clusters of viral particles only in tissue-cultures inoculated with cultivated viruses originally obtained from tissues from patients with Crohn's disease. Control cultures showed no evidence of viral agents. The mean virus-particle diameter was 30 nm. An electron-dense central core was present and a spiculated coat was demonstrated. The physical chemical properties of this agent, as previously described, together with the electron microscopic appearance are consistent with the appearance of a picornavirus.

Cell Line↗
PubMed1976

Behaviour of e antigen and antibody during chronic active liver disease. Relation to HB antigen-antibody system and prognosis.

Serial determinations of e antigen and e antibody were made in 20 patients with chronic active liver disease and hepatitis-B surface antigen (HBsAg) or antibody (anti-HBs). The presence of e antigen was associated with failure to clear HBsAg, produce anti-HBs, or respond to treatment with steroids. It is proposed that the presence of the e antigen is associated with impaired host immune responses to hepatitis-B virus infection and a poor prognosis.

Adolescent↗
PubMed1976

Contrasting features and responses to treatment of severe chronic active liver disease with and without hepatitis BS antigen.

To determine the clinical implications of HBSAg in severe chronic active liver disease (CALD), patients with HBSAg positive CALD were compared with those chosen by identical clinical, functional, and morphological criteria in whom this test and anti-HBS were negative. HBSAg positive patients were predominantly males over 40 years of age and more frequently failed to respond to conventional treatment programmes with prednisone. HBSAg negative patients were more often female and younger, had a higher incidence of associated immunopathic disease and immunoserological markers in high titre, and more often responded to treatment with full remission of their disease. HBSAg positive patients failing treatment with conventional doses of prednisone often improved with higher doses, but did not reach full remission of their disease. The benefit-risk ratio of both conventional and high doses of prednisone in HBSAg positive severe CALD needs further clarification.

Adult↗
PubMed1976

The liver and the antigens of hepatitis B.

A decade ago an antigen was identified by immunodiffusion and subsequently proved to be closely associated with hepatitis B virus. Further studies showed that hepatitis B virus circulates as a large particle containing a protein coat and a DNA core, and that excess coat particles are produced and circulate freely. Immunization with surface protein produced protective antibodies, and this led to the development of a prototype vaccine. Patients with hepatitis may develop a variety of extrahepatic manifestations, including polyarteritis, vasculitis, and glomerulonephritis. These associated symptoms may be due to immune complexes consisting of hepatitis B surface antigen and its antibody. The role of cellular immunity in hepatitis B is unknown. The relation between type B virus and the liver is both destructive (leading to severe acute hepatic disease and eventually to cirrhosis) and symbiotic (existing among carriers who have neither liver disease nor symptoms). If the factors that cause these divergent courses were delineated and understood, the results may lead to the prevention and cure of hepatitis B and its sequelae.

Antibodies, Viral↗
PubMed1976

CEA levels in fluids bathing gastrointestinal tumors.

A controlled prospective study was undertaken to determine if fluids which bathe malignancies may contain carcinoembryonic antigen (CEA) earlier in the course of gastrointestinal cancer than does plasma of the same patient and may offer a better means for diagnosis. CEA titers were normal (less than 2.5 ng per ml) in the plasma of 42 healthy volunteers. Normal CEA levels were also found in the plasma and in the colonic mucus of 14, the gastric juice of 18, duodenal drainage of 10, and bile of 11 normal control subjects. The colonic mucus of 3 patients with ulcerative colitis, gastric secretions of 5 benign gastric ulcer patients, bile specimens from 11 normal control subjects and from 5 gallstone patients contained CEA at concentrations below 2.5 ng per ml. Positive CEA titers were found in the fluids bathing tumors of all 23 patients with colonic carcinoma, 9 of 17 patients with gastric carcinoma, and all 6 patients with pancreatic carcinoma. In contrast, positive CEA titers were found in the plasma of only 16 of 23 patients with colon carcinoma, 6 of 17 patients with gastric carcinoma, and 4 of 6 patients with pancreatic carcinoma. Among 46 patients with gastrointestinal malignancies, CEA was detected in significant concentrations in the plasma of 26 patients and in fluids bathing tumors of 38 patients. These results indicate a significant association of adenocarcinoma of the colon with CEA-positive colonic mucus (P less than 0.01) and suggest the usefulness of assaying CEA in fluids bathing tumors for the detection of gastrointestinal malignancies.

Bile↗
PubMed1976

Post-transfusion hepatitis: the role of hepatitis B antibody.

Aliquots from units of blood previously transfused as part of a prospective post-transfusion hepatitis (PTH) study were rescreened for the presence of hepatitis B antibody (anti-HBS) to determine the effect of transfusion of such material. Anti-HBS was more commin in commercial blood. Infusion of anti-HBS was not associated with an increased or decreased risk of PTH, hepatitis B, or hepatitis B (HB) exposure. Receipt of anti-HBS did not modify the hepatitis which occurred. Receipt of large amounts of anti-HBS may be associated with an increased incidence of HB events. Preexisting anti-HBS was not only not protective against PTH, but more PTH (67% versus 40%) and hepatitis B (47% versus 12%) were seen in those patients with it.

Antibodies↗