Macroaspartate aminotransferase: unusual cause of increased serum aspartate aminotransferase activity.
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Biomedical subjects
Publications and source records attributed to C Buffet.
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This clinical and biological study was undertaken to assess the prevalence of infection by HIV, HBV and HDV in male drug abusers entering a prison. One hundred and thirteen drug users accepted to be tested: 14 (12 p. 100) were homosexual; 12 (11 p. 100) consumed more than 80 g per day of alcohol. The mean duration of drug addiction was 5 +/- 2.9 years; 50 (44 p. 100) declared having used a personal syringe while 63 (56 p. 100) usually shared their syringe. Serum activity of transaminases higher than twice the normal value was noted in 36 cases (32 p. 100). One hundred and two (90 p. 100) drug abusers had a HBV marker, 17 (15 p. 100) were HBs Ag carriers, 9 had anti-HBc antibody alone. The prevalence of antibodies to the HDV was 23 p. 100 and was higher among the HBs Ag carriers (65 p. 100). There were no cases of AIDS. Clinical examination showed lymphadenopathy in 49 cases (43 p. 100), a weight loss of more than 10 p. 100 in 47 cases (42 p. 100), and in 69 cases (61 p. 100), HIV positive serology, confirmed by Western blot. The duration of drug addiction was longer in the 102 drug users with HBV markers. Long duration of drug abuse and the use of a shared syringe increased the risk of HIV infection. No relation was noted between the presence of HBV markers and HIV positive serology. In this population the prevalence of HIV, HDV markers and HIV infection was high, but no relation with the duration of previous incarceration or homosexuality was found.(ABSTRACT TRUNCATED AT 250 WORDS)
We report 3 cases of mediastinal pseudotumours in cirrhotic patients. In the 3 cases, plain chest X-ray showed regular homogeneous radiolucency superposed on cardiac shadow. Computerized tomography bolus injection, performed in 2 cases, was poorly contributive in one case. On the other hand, magnetic resonance imaging ensured the diagnosis in all 3 patients showing significant dilatation of the azygos vein and prominent esophageal varices connected with spontaneous abdominal portacaval shunts. These vascular mediastinal structures were well documented by frontal and sagittal spin echoes. Knowledge of such neovascular mediastinal pseudotumours may prevent the use of invasive investigations such as direct puncture or thoracotomy.
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We report the findings in two sisters with active cirrhosis and an anti-liver-kidney microsomal antibody (anti-LKM) of the autoimmune type. This unusual disease is characterized by the presence of high levels of antibodies that react with the smooth and rough endoplasmic reticulum of the liver and other tissues. Our patients had the usual features of chronic hepatitis associated with presence of antibodies: they were young girls, they had anti-LKM antibodies of autoimmune type persisting at a high titer during the whole course of the disease, but with no smooth muscle antibodies; one had a low level of IgA. The occurrence of two cases in the same family has not yet been reported and is probably not coincidental because of the rare occurrence of this disease.
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Prevalences of serum markers of hepatitis B virus and alphafetoprotein levels were investigated in 96 patients with hepatocellular carcinoma. Serum HBs Ag was present in 17 patients (17.5 p. 100), anti-HBc antibody alone in 10 patients (10.5 p. 100), and anti-HBs antibody with or without associated anti-HBc antibody in 32 patients (33.5 p. 100). Serum alphafetoprotein levels were increased (greater than 20 ng/ml) in 71 patients (74 p. 100). Serum alphafetoprotein levels were significantly higher in patients with than in patients without serum HBs Ag. Serum alphafetoprotein levels above 1,000 ng/ml were more frequently found in patients with serum HBs Ag or anti-HBc antibody than in other patients. These results suggest the presence of a link between HBs Ag and alphafetoprotein in hepatocellular carcinoma.
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Currently published studies indicate that the prevalence of serological evidence of hepatitis B viral infection is two to five times higher among health workers than in the general population. Repeated contact with blood specimens is essential for the transmission of hepatitis B to health workers. In particular, accidental wounds produced by used needles, especially needles contaminated with blood from Ag H be positive individuals, are frequently followed by clinical or serological evidence of viral hepatitis. The prevalence of serological evidence of hepatitis B infection increases in proportion to the duration of occupational exposure, the age of the health worker and the size of the city in which he is employed. In contrast, frequent patient contacts not involving exposure to blood products are not a major risk factor. Although unusual, the transmission of hepatitis B virus from chronically infected health workers to their patients has been described.