[Significance of the antigen and the anti-e antibody in patients with surface antigen of hepatitis B virus].
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Biomedical subjects
Publications and source records attributed to R Bacardi.
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The histological lesions found in patients with hepatic disease and positive anti-mitochondrial antibodies (AMA) by immunofluorescence were compared with those in 10 subjects of the same age and sex with negative AMA. The majority of the patients with positive AMA were suffering from primary biliary cirrhosis, the diagnosis being based upon the histological appearance (Stage 1 of Scheuer's classification: 40%) or the presence of clinical signs of cholestasis with a compatible histological appearance (40%). None of the remaining patients (20%) with positive AMA nor the 10 individuals with negative AMA showed histological signs suggestive of primary biliary cirrhosis. The absence of certain clinico-biological factors, with the exception of Stage 1 histology, gives a high degree of value to a high level of AMA in the diagnostic of PBC.
The in vitro effect of post-heparin and post-heparin plus post-protamine normal serum on serum lipoprotein X (LP-X) is described. Serum LP-X is cleared after incubation with post-heparin normal serum, and serum LP-X remain unmodified when it is incubated with post-heparin plus post-protamine normal serum. The action of phospholipase A from snake venom on serum LP-X is also studied. A very small quantity of phospholipase is necessary to degrade LP-X and to transform lecithin into lysolecithin. It is concluded that phospholipase seems to be the enzyme that most likely induces the LP-X changes after heparin administration.
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Two patients with alpha heavy chain disease are described. In the first patient, treatment with cyclophosphamide, prednisone and doxycycline was associated with a 28 month-long remission and the disappearance of the paraprotein and lymphoplasmocytic infiltration of the intestine. Shortly afterwards, a retroperitoneal immunoblastic lymphoma was found associated with an immunoglobulin G-kappa-paraproteinemia, and gamma heavy and kappa-light chains in the urine; the intestinal biopsy specimen was normal. In the other patient, the alpha chain only appeared two years after the malabsorption syndrome. The fact that in the first, apparently cured patient, a tumor of different anatomic site and secretory capacity appeared, suggests the existence of a B-cell neoplasia of different clone from that which gave rise tothe original disease. In the second patient, it is probable that only the increase in the mass of neoplastic cells led to the detection of the protein abnormality, or alternatively the antigenic-oncogenic stimulus led to the abnormal secretion only after two years.
The effect of heparin on the proportion of cholesterol esters, lecithin/lysolecithin ratio, and lecithin: cholesterol acyltransferase (LCAT) activity was studied in twelve patients with cholestasis. A good correlation was observed between a decreased LCAT activity and the proportion of cholesterol esters, and no consistent variation was noted after heparin. The lecithin/lysolecithin ratio was increased in 7 patients and became normal after heparin in 6 cases. The clearance of lipoprotein-X after heparin seems to be not related to LCAT activity. These results demonstrate that heparin does not modify the LCAT activity, and suggest that heparin induces an increase of phospholipase activity in some patients with cholestasis.
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Serum lipoprotein-X was investigated in 12 patients with cholestasis in basal conditions and 20 minutes after intravenous heparin. In all cases, lipoprotein-X was positive in the first sample and became negative after heparin. A decrease in triglycerides was observed in all patients after heparin with an increase in free fatty acids and mobilization of prebetalipoproteins, and a transformation of lecithin into lysoleithin in 4 cases after heparin. These facts suggest that heparin plays an important role in the mobilization of serum lipoprotein-X.