PubMed HealthSearch

Biomedical subjects

H Selmair

Publications and source records attributed to H Selmair.

At least 19 recordsLinked to original sources

[Long-term prognosis of chronic B and C viral hepatitis].

146 patients (62 female, 84 male) with chronic hepatitis B and 80 patients (34 female, 46 male) with chronic hepatitis C were regularly examined in 1 to 2 year intervals with an average follow-up period of 12 years (mean). Each time patients were evaluated by physical examination, routine laboratory data, immunological and serological testing, ultrasonography, and laparoscopy and/or percutaneous liver biopsy. No patient of the study underwent immunosuppressive or antiviral treatment at any time.-The average time data in years are given as the median value (mean). Chronic hepatitis B: Histologic diagnoses and their long-term prognosis: Chronic persistent hepatitis (CPH) on first biopsy: 10% of cases complete recovery after 15 years, 70% progression to chronic active hepatitis (CAH) after 5 years; CAH: 30% advanced remission/complete recovery 8 years after the first diagnosis of CAH, 40% progression to liver cirrhosis after 5 years; liver cirrhosis: 50% advanced remission/recovery 4 years after the first diagnosis of cirrhosis, 5% developed a hepatocellular carcinoma (HCC) 11 years after the first diagnosis of cirrhosis. Natural history: In the 11 years following initial diagnosis of HBV-infection spontaneous recovery was observed in 49% of cases. In 3% of the patients the disease eventually caused death (1 x hemorrhage of oesophageal varices, 3x HCC after 14 to 20 years). Chronic hepatitis C: All patients were anti-HCV- and HCV-RNA-positive.-There was no spontaneous elimination of virus in any patient (maximal follow-up 27 years).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

[Clinico-chemical diagnosis of the cholestasis syndrome].

1. Cholestatic reactions of various etiology are biochemically established by determination of alkaline phosphatase, gamma-glutamyltranspeptidase (and leucinaminopeptidase) activities and of bile acid concentrations in serum. 2. The pathomechanisms of elevated serum activities of AP, gamma-GT and LAP in cholestatic diseases are - an induction of these canalicular membrane bound enzymes, probably due to an intracellular increase of bile acids, - a partial solubilization of canalicular membrane structure (detergent effect of bile acids), - a histochemically and morphologically demonstrable change of liver cell polarity. 3. A discrimination of intra- or extrahepatic cholestasis only by means of biochemical parameters is impossible. 4. Additional serological and immunological parameters often demonstrate the etiology of cholestatic diseases; a short review is given.

Alkaline Phosphatase

[Prognostic validity of biochemical data and immunofluorescence microscopy in acute hepatitis B (author's transl)].

For an early identification of chronic courses of hepatitis virus B infections a statistical prediction model based on simple biochemical parameters and immunofluorescence microscopy for the investigation of virus HBs and HBc antigen expression in liver tissue is established. As early as 3 weeks after maximum liver cell damage it is possible to identify chronic virus B infections and to predict the further course of hepatitis (CPH, CAH).

Alanine Transaminase

[Relevance of immunofluorescence microscopy for diagnosis and prognosis of chronic hepatitis B (author's transl)].

109 patients with hepatitis B infections had 162 biopsies of the liver. The specimens obtained were investigated microscopically; at the same time existence and pattern of distribution of HBs and HBc antigens were looked for by immunofluorescence microscopy. In cases with a histologically established diagnosis of chronic aggressive hepatitis (CAH) the following patterns could be found: (a) focal occurrence of HBc in all cases, (b) pure cytoplasmatic HBs fluorescence (HBs type I), (c) pronounced HBs fluorescence at the cell membrane (HBs type II), or (d) pronounced HBs fluorescence at the cell membrane combined with cytoplasmatic HBs fluorescence in focal areas (HBs type III). The 3 HBs types could be associated with different clinical courses of CAH. A pure cytoplasmatic HBs fluorescence without HBc fluorescence could be found in about two thirds of the cases, which had been diagnosed as chronic persistent hepatitis (CPH) established by the first microscopic examination of the biopsy specimen. All cases deviating from this pattern could be classified at a later date as CAH also by histological criteria. In 25% of the cases the clinical course was protracted, the histological diagnosis having been at first: residual changes after acute hepatitis; in these cases the pattern of distribution of virus antigens in the biopsy specimen did allow already at an early date the diagnosis of CAH or CPH; this diagnosis could be confirmed by control biopsy and conventional microscopic examination in all these cases at a later date.

Adult

[Serum levels of cholylglycine and sulfolitho-cholylglycine in the course of acute hepatitis (author's transl)].

In 20 patients with acute hepatitis B the serum levels of cholylglycine and sulfolitho-cholylglycine were investigated by radioimmunoassay; bile acid concentrations and routine biochemical parameters were determined weekly. The statistical evaluation displayed a close correlation between serum levels of cholylglycine and bilirubin during the course of hepatitis, and between serum levels of sulfolitho-cholylglycine and the enzyme activities of liver cell damage parameters (GOT, GPT, GIDH), respectively. A tentative interpretation on the validity of bile acid assays (CG, SLCG) in hepatobiliary disease is presented.

Acute Disease

[Comparison of endoscopic biopsy and scintiscans in liver diseases (author's transl)].

The diagnostic possibilities of liver scintiscans with indium-113m acetylacetonate were investigated in 314 patients. The results obtained were compared with our own endoscopic biopsy investigations. The scintiscans give information on the stage of the disease, but in contradistinction to the laparoscopic biopsies, not on etiology or activity of the disease. In contrast to the endoscopic biopsies, scintigraphy carries no risk. The advantage of the indium-113m acetylacetonate we used lies in the low radiation exposure.

Biopsy

[Autolymphocytotoxins (CoCoCy) in different forms of hepatitis and cirrhosis (author's transl)].

Sera of altogether 282 patients with different forms of hepatitis and cirrhosis were screened for cold reacting complement dependant auto-lympho-cytotoxins (CoCoCy). These antibodies are 19S-IgM-immunoglobins and have no HLA-antigen-specificity. CoCoCy occurred in 48% of the patients with chronic aggressive hepatitis (CAH), in 14% of the patients with chronic persistent hepatitis (CPH) and in intermediate rates in the sera of patients with acute hepatitis. No correlations was found between CoCoCy and hepatitis B-antigen (HB-Ag). CoCoCy could be demonstrated also in 20% of the sera of a HB-Ag-positive and in 6% of a HB-Ag-negative control group. The serum concentration of CoCoCy is low. CoCoCy seems to be of T-cell-specificity and to reflect the overall-immunoreactivity without relation to the specificity of the antigenic stimulus. Thus demonstration of CoCoCy may be of pathogeneic and pathodynamic rather than of diagnostic interest.

Acute Disease