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Biomedical subjects

S Sherlock

Publications and source records attributed to S Sherlock.

493 records · Page 28Linked to original sources
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Chronic hepatitis and cirrhosis.

Chronic hepatitis is defined as diffuse chronic liver disease existing for at least 6 months. Cirrhosis is a sequel. It is of multiple etiology. Liver biopsy is essential for diagnosis and prognosis. Hepatitis B-related chronic hepatitis is slowly progressive. Corticosteroid therapy is disappointing. Current antiviral therapy converts the hepatitis B e antigen-positive patient to anti-HBe in about 50%. Non-A, non-B virus hepatitis-related chronic hepatitis suffers from lack of a diagnostic marker. No current therapy is of proven benefit. Autoimmune lupoid chronic active hepatitis presents a very active biochemical and immunological picture. Prednisolone therapy prolongs life but does not prevent the development of cirrhosis. Drug-related liver disease is recognized by its associations. Recovery follows withdrawal of the drug. Deaths often follow continuation of the drug. Indications of progression to a terminal state with likelihood of less than a 6-month survival are detailed. These are helpful in deciding on hepatic transplantation before the patient becomes moribund.

Adolescent↗
PubMedDate not supplied

Transferrin metabolism in alcoholic liver disease.

The metabolism of transferrin was studied using purified 125I-labeled transferrin in 11 alcoholic patients; six with fatty liver and five with cirrhosis. Six healthy subjects whose alcohol intake was les than 40 gm daily were studied as a control group. There were no significant differences in the mean fractional catabolic rate and plasma volume in the alcoholic groups when compared with control subjects. A significantly decreased mean serum transferrin concentration was found in the alcoholic cirrhotic patients (1.8 +/- 0.3 gm per liter vs. 2.9 +/- 0.2; p less than 0.01), resulting from diminished total body synthesis (0.9 +/- 0.2 mg per kg per hr vs. 1.8 +/- 0.2; p less than 0.01). In contrast, in the patients with alcoholic fatty liver, the mean total body transferrin synthesis (2.4 +/- 0.3 mg per kg per hr) was significantly increased when compared with controls (p less than 0.05). For all the alcoholic patients, the serum transferrin correlated with transferrin synthesis (r = + 0.70; p less than 0.01) but the serum iron did not. These results suggest that, in alcoholic cirrhosis, transferrin synthesis is decreased, probably reflecting diminished synthetic capacity by the liver. In contrast, in patients with alcoholic fatty liver, transferrin turnover is accelerated.

Adult↗
PubMedDate not supplied

A randomized study of the effects of adenine arabinoside 5'-monophosphate (short or long courses) and lymphoblastoid interferon on hepatitis B virus replication.

A previous randomized controlled study has shown a 30% rate of HBe antigen/antibody seroconversion within 1 year of a month course of adenine arabinoside-5'-monophosphate; no seroconversion occurred in the control group. In this study of patients derived from the same population, 45 hepatitis B virus carriers with chronic liver disease were randomized to receive either a short (4-week) course of adenine arabinoside-5'-monophosphate, a long (7 to 8-week) course of adenine arabinoside-5'-monophosphate or a 12-week course of lymphoblastoid interferon. Long-lasting suppression of hepatitis B virus replication with disappearance of serum hepatitis B virus DNA and clearance of HBeAg occurred within 12 months of treatment in four patients who received the short course of adenine arabinoside-5'-monophosphate and in five who received interferon. Of the nine responders, four also lost HBsAg. A response to antiviral therapy was accompanied by clinical and biochemical evidence of improvement in liver disease. None of the patients who received a long course of adenine arabinoside-5'-monophosphate responded. Peripheral neuropathy and myalgia were the most serious adverse effect affecting three recipients of the short course of adenine arabinoside-5'-monophosphate and eight recipients of the long course. Thrice weekly administration of interferon was well-tolerated. Further studies to identify the characteristics of the "responder patients" and large-scale controlled trials of antiviral therapy in these subgroups are indicated.

Adult↗
PubMedDate not supplied

Biotechnologies and liver diseases.

Viral hepatitis is surveyed as a European problem. The economic implications of including vaccines against hepatitis A and B in infant and adolescent immunisation programmes are discussed. The urgent need for vaccine against hepatitis C is stressed. Antiviral therapy for hepatitis B and C infections remains unsatisfactory. Costs of widespread implementation, particularly for hepatitis C, would be enormous and the selection of candidates for therapy is still under discussion. Increasing use of liver transplantation is prevented by donor shortage. Methods of artificial liver support must attract more research support.

Adolescent↗
PubMedDate not supplied

Serum angiotensin--converting enzyme (SACE) in sarcoidosis and other granulomatous disorders.

Serum angiotensin-converting enzyme (SACE) activity was significantly higher in 90 patients with sarcoidosis (55 +/- [S.D.] 23 nmol min-1 ml-1) than in 80 healthy controls (34 +/- 9 nmol min-1 ml-1). Steroid therapy modified SACE activity; 60 sarcoidosis patients who were not being treated with steroids had significantly higher enzyme activities (58 +/- 24 nmol min-1 ml-1) than 30 steroid-treated sarcoidosis patients (40 +/- 19 nmol min-1 ml-1). In 50% of the non-steroid treated sarcoidosis patients SACE activity was more than than 2 S.D. above the mean value for the controls. SACE activity was measured in 22 tuberculous patients (38 +/- 14 nmol min-1 ml-1), 20 leprosy patients (34 +/- 9 nmol min-1 ml-1), 31 with primary biliary cirrhosis (44 +/- 20 nmol min-1 ml-1), 26 with inflammatory bowel disease (31 +/- 9 nmol min-1 ml-1), eight with hepatic granulomatous disease, five with Hodgkin's disease, and two with schistosomiasis. The combined false-positive rate for these non-sarcoidosis patients was 10%. Serial SACE assays provide useful information on the course of sarcoidosis and response to steroid treatment.

Adolescent↗