Biomedical subjects
Publications and source records attributed to J D Fengler.
The follow-up of serum immunoglobulin levels in patients with acute viral hepatitis B demonstrated a significant decrease of the IgG and IgM concentrations during the first 6-10 weeks of the illness in a group of 29 patients who resolved the disease. In contrary, similar changes could not be observed in 8 patients developing a chronic course of the disease with persistence of the HBsAg.
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The progression of acute viral hepatitis non-A, non-B in a group of young female patients with well defined disease was evaluated retrospectively over a period of 21/2 years. The histologically proved chronification rate was 39 per cent. It was looked for a correlation between some parameters in the acute phase of the disease, the distribution of HLA antigens, and the progression to chronicity. There were no statistically ensured differences of HLA antigens between patients with chronic hepatitis non-A, non-B, patients with healed acute one, patients with chronic hepatitis type B, and the normal population. The level of transaminases within the acute phase of the illness did not allow to draw any conclusion for the further progression of the disease. But icteric patients seemed to develop chronic disease more seldom. In this time, the reason of the high chronification rate after infection by hepatitis virus(es) non-A, non-B is not yet clear.
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By anamnestic inquiry and investigation for HBsAg and anti-HBs (RIA) of 120 staff members from 18 endoscopic centers, we found reference to remarkable spread of hepatitis B. Its incidence in endoscopic staff is unambiguously higher than in personal of internal wards. So, 8.3 per cent of endoscopic workers were positive for HBsAg, and anti-HBs was found in 29.7 per cent of them. This study accentuates the high danger by gastro-enterologic patients, who not rarely are HBsAg-positive and infectious. Preventive measures are recommended.
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Colicky pain in the gallbladder region, hematemesis, melena and jaundice are symptoms of hemobilia. The underlying cause can be an arterio-biliary or a porto-biliary fistula, resulting in hemorrhage into the duodenum. Shunting may be intra- or extrahepatic and may originate from trauma, or from biliary, pancreatic or vascular lesions. Since 1976 liver biopsies were done in 2221 patients; in 3 of these hemobilia occurred. In one case the artery involved could be obturated by transarterial placement of Ivalon particles; the two other cases recovered without special treatment. A review is given of 23 cases of hemobilia after liver biopsy, and treatment is discussed.
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At present there is not yet a causal therapy of hepatitis. The modern state of knowledge on the mode of transfer, on the persistence of the causative organisms and the immunological reactions evoked by the causative organisms gives the possibility for new ways in prevention. The HBs Ag-carriers are a reservoir of causative organisms in the sense of chronic carriers. In a particular degree they endanger the personnel of public health. A supplementation of the general hygienic preventive measures by the immunoprophylaxis is desirable.
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