Ultraschallgezielte Feinnadelaspirationsbiopsie raumfordernder Leber- und Pankreasprozesse und perkutane Abszeß-Drainage

Die sonographisch gezielte Feinnadel-Aspirations-Punktion als einfach durchfuhrbares und risikoarmes Verfahren erlaubte die cytologische Diagnose bei 54 von 57 Patienten mit Lebertumor (94,7%) und bei 25 von 30 Patienten (83,3%) mit sonographisch lokalisierten Raumforderungen des Pankreas. Bei 22 Patienten lag ein Pakreas-Karzinom vor, dreimal ein malignes Lymphom mit Infiltration der Pankreasloge. Falsch negative Ergebnisse fanden sich in 1,8% bzw. 6,7%, falsch positive cytologische Befunde wurden nicht erhoben. Die ultraschallgesteuerte Feinnadel-Punktion stellt somit ein zuverlassiges Verfahren zur Sicherung eines Tumorbefalls von Leber und Pankreas dar. In 41 Fallen wurden Zysten oder A…

IgM-Antikörper gegen Hepatitis B core-Antigen (anti-HBc IgM) bei “gesunden” HBsAg-Trägern. Eine Verlaufsstudie bei 75 Fällen

In 75 healthy HBsAg carriers with normal liver tissue who were followed over a four years period, anti-HBc IgM was determined by ELISA. 61 HBsAg carriers (81%) were positive for anti-HBc IgM at first investigation. 54 individuals demonstrated persistence of anti-HBc IgM, 7 became anti-HBc IgM-negative within the observation period. 12 persons were persistent anti-HBc IgM-negative, and 2 developed anti-HBc IgM of low quantities. 3 of 4 individuals with HBsAg clearance demonstrated a considerable decrease of anti-HBc IgM concentration. Although signs of liver damage or development of chronic liver diseases were not observed at the time of control biopsy the existence of anti-HBcIgM indicates …

Changes in gallbladder motor function during the female cycle — a risk factor leading to gallstone formation?

The gallbladder volume of eight women with stable cycles was determined by sonography. Furthermore, gallbladder contraction — following an orally administered fatty meal and the spontaneous refilling of the empty gallbladder — was quantitatively examined. The formula of a rotation ellipsoid, which has been proven to be adequately accurate in in vitro studies, was used for calculating the gallbladder volume. In the gestagen phase (21st or 22nd day) the intraindividual studies showed greater fasting volumes, higher residual volumes after contraction, slower gallbladder emptying, and retarded refilling of the empty gallbladder as compared to the estrogen phase (12th or 13th day). The hormonall…

NITROGLYCERINE DILATATION OF SPHINCTER OF ODDI FOR ENDOSCOPIC REMOVAL OF BILEDUCT STONES

Detection of hepatitis B virus markers in sera of asymptomatic hepatitis B surface antigen carriers with special emphasis to pre-S-encoded proteins.

Sera of asymptomatic hepatitis B surface antigen (HBsAg) carriers were analyzed for the presence of pre-S-encoded proteins. Four individuals with biopsy-proven chronic hepatitis uniformly expressed pre-S1- and pre-S2-encoded proteins. Individuals who had histologically normal or largely normal livers were heterogeneous with respect to expression of pre-S-encoded proteins. This heterogeneous expression of pre-S-encoded proteins occurred most likely due to difference in serum HBsAg concentration. Alternatively differences in pre-S gene expression need to be considered. Clinically the study indicates that expression of pre-S domains in serum is unrelated to viremia or chronic liver disease.

Active hepatitis B vaccination of dialysis patients and medical staff

AbstractActive hepatitis B vaccination of dialysis patients and medical staff. One hundred six patients with terminal renal insufficiency and 29 medical personnel were given three doses of hepatitis B vaccine at an interval of 0, 1, and 6 months (Merck, Sharp and Dohme, West Point, Pennsylvania, part of a joint study no. 649). Chronic hemodialysis patients (N = 99) received 40 µg vaccine (V) i.m. Uremic patients, who were just about to start chronic dialysis treatment (N = 7), were given 40 µg V, and at the first vaccination 3ml hyperimmune globulin (HBIG) in addition. The medical personnel was alternately vaccinated with 20 µg V (N = 8), 40 µg (N = 11), 40 µg V, and 3ml HBIG at the first v…

Spread of hepatitis B virus infection among family contacts of asymptomatic HBsAg carriers

Family members of 34 asymptomatic HBsAg carriers were tested for different hepatitis B virus (HBV) markers. Among 67 family members tested 24 (36%) presented signs of a past or ongoing HBV-infection. Spread of HBV-infection was particularly high in those families in which the HBsAg carrier was positive for HBeAg and Dane particle-associated DNA polymerase activity. Non-parenteral “horizontal” transmission of HBV among spouses and brothers and sisters and probably parenteral vertical transmission of HBV from carrier mothers to their infants occurred in approximately the same frequency. Fathers transmitted HBV unfrequently to their offsprings. The results show that the risk to acquire a HBV-i…

Hepatitis B virus markers among family contacts of asymptomatic HBsAg carriers.

A study was undertaken to establish the risk of family contacts of HBsAg carriers acquiring a hepatitis B virus (HBV) infection. About one-third of all household contacts of asymptomatic HBsAg carriers had signs of past or ongoing HBV infection. Family contacts of HBsAg carriers with high numbers of circulating Dane particles were shown to have a higher risk of developing HBV infection than family contacts of HBsAg carriers without serological evidence of HBV synthesis. The probability of acquiring HBV infection was not different between spouses, parents, children, and brothers and sisters, respectively of asymptomatic HBsAg carriers.