Biomedical subjects

J Neuberger

Publications and source records attributed to J Neuberger.

At least 109 records · Page 6Linked to original sources

PubMed1981

Improved survival after orthotopic liver grafting.

A total of 108 orthotopic liver transplants have been carried out in the Cambridge/King's College Hospital series. Over 13 years, changes in patient selection, immunosuppression, and surgical and anaesthetic techniques have led to a steady improvement in results. Results obtained in the last 22 patients indicated that over half survive for one year. Although at considerable risk during the operation, patients with non-malignant cirrhotic diseases who survive one year have a good long-term chance of survival

Adolescent↗

PubMed1981

Hepatic damage after exposure to halothane in medical personnel.

Two surgeons, in whom liver damage developed after occupational exposure to sub-anaesthetic doses of halothane, were found to have a circulating antibody which reacted specifically with halothane-altered hepatocyte membrane components. This antibody had been found previously only in those patients in whom severe hepatic necrosis developed after exposure to halothane and in no other form of liver injury. It may provide a specific diagnostic marker in patients in whom there are other possible causes of liver damage and could, therefore, remove the need for a challenge exposure and its attendant risks.

Adult↗

PubMed1981

Oxidative metabolism of halothane in the production of altered hepatocyte membrane antigens in acute halothane-induced hepatic necrosis.

Previous investigations have shown that patients with fulminant hepatic failure after halothane anaesthesia have a circulating antibody which reacts with an antigen present on the surface of halothane-altered hepatocytes. In the present study, it has been shown that the expression of the antigen is associated with the oxidative metabolism of halothane, in contrast with results of other groups which have shown that the reductive route is involved in the direct hepatotoxic reaction attributed to halothane.

Animals↗

PubMed1980

Antibodies to the surface of halothane-altered rabbit hepatocytes in patients with severe halothane-associated hepatitis.

Circulating antibodies reacting specifically with the cell membrane of hepatocytes isolated from halothane-anesthetized rabbits were detected in nine of 11 patients with fulminant hepatic failure after helothane-induced anesthesia. The immunoglobulin deposition, as revealed by immunofluorescence, showed a granular pattern on the hepatocyte surface membrane. Preincubation of halothane-pretreated, but not of control, hepatocytes with serum containing this antibody rendered them susceptible to cytotoxic effects of normal lymphocytes in vitro. Control studies using serum from subjects repeatedly exposed to halothane without the development of liver damage, and from patients with viral and toxic liver injury have confirmed the specificity of these findings to serve halothane-associated liver injury. These results provide further evidence of an immunologic component in this condition.

Adult↗

PubMed1980

Oral-contraceptive-associated liver tumours: occurrence of malignancy and difficulties in diagnosis.

Seven of ten women with oral-contraceptive-associated liver tumours were found to have hepatocellular carcinoma. The diagnosis was often delayed, although hepatomegaly was always present on examination, and liver-function tests and erythrocyte sedimentation-rates were abnormal in most cases. Other investigations, including routine technetium liver scans and biopsy, were sometimes misleading. There were important differences in alpha-fetoprotein concentration, vascularity on angiography, and survival between liver tumours in pill users and non-users.

Adenoma↗

PubMed1980

Long-term ingestion of paracetamol and liver disease.

Of 45 patients with chronic active hepatitis, 17 had taken paracetamol before the onset of symptoms. There were no significant differences, however, between the two groups in abnormalities of liver function tests, nor in ease of control after paracetamol withdrawal and institution of immunosuppressive therapy. The patient who had taken more than 5 g/week was studied in greater detail, but after a challenge dose of 1 g paracetamol there was no rise in serum aminotransferases and the pattern of excretion of paracetamol metabolites was normal. A critical review of the previously published reports failed to uncover any convincing evidence that paracetamol is an initiating factor in the development of chronic active hepatitis, although it may, at therapeutic levels, cause a toxic hepatitis in those individuals at risk.

Acetaminophen↗

PubMed1979

Bilateral sixth cranial nerve palsy in infectious mononucleosis.

A 15-year-old girl who presented with a bilateral sixth nerve palsy caused by infectious mononucleosis is described. The neurological presentation of infectious mononucleosis is discussed.

Abducens Nerve↗

PubMedDate not supplied

The Cambridge and King's College Hospital experience of liver transplantation, 1968-1983.

The postoperative course of 138 transplants performed in 137 patients in the Cambridge and King's College Hospital series between May 2, 1968 and April 1, 1983 is presented. During the last 15 years, criteria for selection of transplant candidates has been improved and types of disease categories, both suitable and unsuitable for liver transplantation, have been defined. The acceptance of the concept of brain death and the use of heart-beating donors in the United Kingdom since 1976 has greatly improved the quality of donor organs. Changes in surgical technique, particularly with regard to biliary tract drainage, have reduced morbidity and mortality from biliary tract complications since 1975. The use of partial cardiopulmonary bypass in selected cases and changes in immunosuppressive drug regimens have not significantly improved our overall results. Despite these changes based on our experience, the perioperative mortality in the Cambridge and King's College Hospital series remains disturbingly high.

Adolescent↗

PubMedDate not supplied

Evidence for expression in human liver of halothane-induced neoantigens recognized by antibodies in sera from patients with halothane hepatitis.

Previous investigations have shown that antibodies in sera from patients with halothane hepatitis recognize neoantigens, expressed in livers of halothane-exposed rabbits and rats, which consist of a halothane metabolite bound covalently to specific microsomal proteins. These studies have suggested that the patients' antibodies may play a role in the pathogenesis of the hepatitis. In the present investigation, human liver biopsy samples were analyzed using an immunoblotting method to seek evidence for expression of halothane-induced neoantigens in humans. Sera from four patients with halothane hepatitis, which recognized halothane-induced rabbit liver neoantigens of 100, 76 and 57 kD, reacted strongly with antigens of very similar molecular weights that were expressed in livers from two patients who had died of cardiac failure following recent anesthesia with halothane. The antigens were not expressed in normal human liver or in livers from three patients who died of cardiac failure following anesthesia with agents other than halothane. The human antigens were not recognized by antibodies present in various control sera. Recognition of the 100- and 76-kD human antigens by the patients' antibodies was greatly reduced by absorption of sera with liver microsomes from halothane-exposed rabbits, but not by absorption of sera with control rabbit microsomes. These results indicate that humans exposed to halothane express liver neoantigens which are analogous to the halothane metabolite-protein neoantigens characterized previously in halothane-exposed animals.

Adult↗

PubMedDate not supplied