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Biomedical subjects

L B Seeff

Publications and source records attributed to L B Seeff.

At least 73 records · Page 4Linked to original sources
PubMed1984

Antibody to the hepatitis B virus-associated delta-agent in immune serum globulins.

Fifty lots of immune serum globulin prepared by four United States manufacturers between 1944 and 1977 were tested for the presence and titer of antibody to the hepatitis B virus-associated delta-agent. Anti-delta was detected in 28 of the 50 lots (56%) of immune serum globulin at titers ranging from 1:10 to 1:400. Anti-delta was present in 75% (6 of 8) of lots produced between 1962 and 1965, in 77% (17 of 21) produced between 1967 and 1970, in 45% (5 of 11) produced between 1971 and 1972 and in none (0 of 9) produced since 1973. A single lot of globulin prepared from plasma that was collected in 1944 from United States Army soldiers also contained detectable anti-delta. These data indicate that delta-infection has been occurring among hepatitis B surface antigen (HBsAg) carriers in the United States since the 1940s. The decrease in prevalence of anti-delta in immune serum globulin lots coincided with the start of routine HBsAg screening of blood and plasma. The elimination of HBsAg-positive units from plasma pools has reduced levels of HBsAg and anti-delta and should have decreased the risk of transmission of both type B hepatitis and delta-hepatitis by plasma products.

Blood Donors↗
PubMed1984

Therapy for chronic active hepatitis.

As is apparent from the foregoing, there is only one etiologic variant of CAH for which specific therapy is available, namely, that associated with Wilson's disease. However, Wilson's disease is responsible for only a minute portion of the total cases of CAH. Drug-induced CAH also seems highly responsive to appropriate management--in this instance, removal of an offending agent rather than administration of a therapeutic drug. However, as stated, it too is an infrequent contributor to the CAH pool. Among the remaining forms of CAH, a reasonably consistent response to treatment can be expected only from patients with autoimmune CAH. This entity is a serious disorder with unequivocally high morbidity and mortality and thus clearly warrants treatment. Despite the considerable side effects that invariably result from the long-term use of corticosteroids--the only available, although nonspecific, form of treatment--corticosteroid use is justified and indeed recommended. Current evidence, derived from the Mayo Clinic data, suggests that the best therapeutic approach is to use both corticosteroids and azathioprine, a combination that offers the highest therapeutic index with the lowest rate of side effects. Using this regimen, complete remission is reported to result in 65% of cases within 2-3 years, although a considerable proportion of these individuals relapse and require retreatment. Much publicity has surrounded the Mayo Clinic and Royal Free Hospital treatment trials; however, it is probable that autoimmune CAH represents far less than 20% of all cases, and that severe disease requiring corticosteroid therapy comprises but a minor fraction of these. Thus, the bulk of cases of CAH in the United States occur in patients with either established or inferred viral-related disease, the group for which clearly effective therapy is not yet available. Most of these persons are asymptomatic, their disease having been detected through routine screening programs or at the time of evaluation of other disorders. Much interest is evoked, at present, by the new experimental forms of treatment, but none has proved to be consistently effective, and for some, toxicity is high. All appear to reduce levels of replicating virus, but none clearly affects HBsAg or disease activity. Research in this area continues, with highest expectations of success for the use of combination therapy.(ABSTRACT TRUNCATED AT 400 WORDS)

Adjuvants, Immunologic↗
PubMed1983

Stability of aspartate aminotransferase and alanine aminotransferase activities.

Because there are conflicting data regarding the effect of different temperatures and durations of storage on the stability of the activities of aspartate aminotransferase (AST) and alanine aminotransferase (ALT), a new study has been conducted to re-examine this important issue. Blood obtained from patients with varying aminotransferase levels was centrifuged, the resultant serum was divided into aliquots, the samples were stored at room, refrigerator, and freezer temperatures, and the aminotransferases measured on days 0, 1, 2, 3, 4, and 30. In all but one circumstance, both AST and ALT activities declined markedly beginning within 24 hr of venipuncture; the temperature of storage did not significantly affect the rate or degree of loss of enzyme activity. The exception was the evidence that ALT activity in samples obtained from individuals with initially normal values showed a rise during the first 3 to 4 days, followed thereafter by a decline to below baseline values. Thus, to ensure accuracy of aminotransferase measurement, testing of samples should be conducted on the day of venipuncture.

Alanine Transaminase↗
PubMed1981

Measurement of lactate in ascitic fluid: an aid in the diagnosis of peritonitis with particular relevance to spontaneous bacterial peritonitis of the cirrhotic.

Lactate concentrations were measured in the ascitic fluid of patients using the Monotest Lactate Kit, an inexpensive, reliable bedside test that gives results within 15 min. The values were significantly higher in 24 patients with proven bacterial peritonitis, eight of them with spontaneous bacterial peritonitis, than in 53 patients with uninfected ascites of various other etiologies. In only two patients from the latter group, both with hepatic carcinoma and peritoneal metastases, were the values in the range found in bacterial peritonitis. Lactate determination was at least as sensitive as measurement of WBC levels for diagnosing peritonitis. Serial determinations in two patients with peritonitis showed declining values as the disease responded to treatment. The test has particular relevance for patients with spontaneous bacterial peritonitis, because this disease, which is potentially life-threatening although frequently asymptomatic, requires immediate treatment, yet currently depends on time-consuming culture procedures for diagnosis.

Adolescent↗
PubMed1981

Immunoprophylaxis and treatment of viral hepatitis B.

It is evident that new vistas have been opened with the advent of antiviral and other novel drugs. Most of the studies performed to date, however, have involved too few patients, have not been double-blinded, or have been entirely uncontrolled. In essence, these represent phase II studies. Because the HBsAg-carrier state is dynamic in that viral markers are generally in a state of flux, and because it is important to determine risk as well as benefit, no conclusions can be reached without an adequately designed double-blind, controlled study. At present, the most promising therapy seems to be the antiviral drugs, particularly interferon and Ara-A (or Ara-AMP). Still to be determined are the appropriate dose, appropriate duration of treatment, the extent of toxicity, and the validity of combination therapy. Also important is the development of simpler and less expensive ways of producing interferon. A potentially exciting and productive era appears about to open.

Adjuvants, Immunologic↗
PubMed1981

Seroconversion from hepatitis B e antigen to antibody in chronic type B hepatitis.

Twenty-five patients with chronic type B hepatitis documented by liver biopsy were followed for 1 to 6 years with serial measurements of aminotransferase levels, hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg) and antibody (anti-HBe), and hepatitis B virus DNA polymerase. Initially, all were positive for HBsAg and HBeAg and had elevations in serum aminotransferases. In follow-up, only one lost HBsAg reactivity. In 13, however, elevated aminotransferase levels spontaneously fell to normal and have remained normal. These 13 also had a seroconversion from HBeAg to anti-HBe, and all became negative for serum DNA polymerase. Most had a fall in HBsAg titer. This seroconversion occurred concurrently with or several months before the fall in aminotransferase levels. In contrast, the 12 persons who remained HBeAg positive continued to have elevated aminotransferase levels. All 10 of these patients who were initially positive for DNA polymerase remained positive. These data suggest that many patients with chronic type B hepatitis eventually have a spontaneous remission in clinical and biochemical evidence of active disease, usually heralded or accompanied by the disappearance of HBeAg and DNA polymerase.

Adult↗
PubMed1981

Allopurinol hepatotoxicity. Report of two cases and review of the literature.

Allopurinol hepatotoxicity occurred in two patients. Data from the literature suggest that allopurinol can occasionally cause liver injury, particularly in persons receiving diuretic drugs or with compromised renal function. Clinical and laboratory findings are consistent with hepatocellular injury mediated by a hypersensitivity reaction. Most patients recover when the drug is withdrawn; the possible benefits of corticosteroid treatment remain to be established.

Adrenal Cortex Hormones↗
PubMed1980

Transmission of human non-A, non-B hepatitis to chimpanzees following failure to transmit GB agent hepatitis.

Two colony-born infant chimpanzees were inoculated with documented infectious serum containing the GB agent. Serum aminotransferase levels remained within normal limits in weekly serum samples, and no abnormalities were detected in weekly liver biopsy specimens. Each of these chimpanzees was subsequently inoculated with serum containing an agent of human non-A, non-B hepatitis. Each developed non-A, non-B hepatitis characterized by elevation of serum aminotransferase levels and histopathologic changes in liver biopsy specimens. Thus, the chimpanzee appears not to be susceptible to the GB agent, and prior inoculation with this agent does not appear to confer immunity to subsequent infection with human non-A, non-B hepatitis.

Alanine Transaminase↗
PubMed1980

Lack of transmission of type B hepatitis by fiberoptic upper endoscopy.

We prospectively investigated the possibility that type B hepatitis might be transmitted during fiberoptic endoscopy from hepatitis B surface antigen (HBsAg)-positive patients to others subsequently endoscoped. All 186 patients having upper gastrointestinal endoscopy during a 6-month period at the Washington, D.C., Veterans Administration Medical Center had a blood sample obtained at the time of the procedure. Three patients were found to be HBsAG-positive and 45 others to have either antibody to HBsAg (anti-HBs) or antibody to hepatitis B core antigen (anti-HBc). Follow-up evaluation for evidence of type B hepatitis and hepatitis B virus infection was possible in only 76% of patients. One patient developed type B hepatitis. This patient's endoscopy did not follow endoscopy of any known HBsAg-positive individual, but he had received five units of blood 5 months before hepatitis developed. No other patient showed clinical, biochemical, or serologic evidence of hepatitis during the follow-up period. These data suggest that transmission of type B hepatitis during fiberoptic endoscopy is rare, if it occurs at all, and support the current policy of not sterilizing the fiberoptic endoscope between procedures and of not routinely screening patients for HBsAg.

Adult↗
PubMed1979

Acquired immunity to human non-A, non-B hepatitis: cross-challenge of chimpanzees with three infectious human sera.

Chimpanzees that had recovered from non-A, non-B hepatitis transmitted by inoculation of serum from each of three chronically infected humans were challenged by inoculation with a second of the three infectious sera to determine whether recovery from infection caused by one serum afforded protection against later infection by another. None of the challenge inoculations caused recognizable non-A, non-B hepatitis in any of the chimpanzees, a finding suggesting that either one agent or several agents sharing a common or similar antigen were responsible for the original non-A, non-B hepatitis in fections in these chimpanzees. Although circumstantial evidence in the literature suggests the existence of more than one agent of non-A, non-B hepatitis, the fact that the three inocula were obtained from humans residing in different geographic areas of the eastern United States suggests that one agent or a group of related agents may be the cause of many cases of non-A, non-B hepatitis in the United States.

Alanine Transaminase↗
PubMed1979

Lack of susceptibility of marmosets to human non-A, non-B hepatitis.

Infectious sera from three humans with chronic non-A, non-B hepatitis, whose blood or serum had transmitted non-A, non-B hepatitis both to other humans and to experimentally inoculated chimpanzees, were inoculated into five marmosets. A sixth uninoculated marmoset served as a control. No elevations in levels of serum alanine aminotransferase or isocitric dehydrogenase occurred in serum samples obtained weekly from any of the marmosets during three months following inoculation. This study indicates that certain species of marmoset, which are susceptible to and provide well-documented animal models for hepatitis A and GB-agent hepatitis, do not appear to be susceptible to the agent(s) of human non-A, non-B hepatitis. In addition, this study suggests that the agent(s) of human non-A, non-B hepatitis and the GB agent are probably different.

Alanine Transaminase↗