The Japan Red Cross started screening donated blood for anti-HCV in Nov. 1989. Approximately 0.9% of donors were found to be positive by the 1st generation antibody test. The authors started a carrier clinic for the medical care of apparently healthy HCV carriers. Donors whose antibodies were strongly positive both by 1st EIA and 2nd PHA were informed, and were confirmed by RIBA 2 and RT-PCR. A total of 262 carriers (150 males and 112 females) with mean age of 46.8 +/- 11.2 yrs have visited the clinic. Of these carriers 149 were diagnosed to be asymptomatic clinically, biochemically and echographically. Eighty-seven carriers had received blood transfusions 22.7 +/- 10.9 yrs previously, while 106 had had acupuncture. Sixty had a family history of liver disease. Fifty-four had a history of heavy alcohol intake. Tattoos and/or iv drug abuse were found in 11, and nosocomial needle accidents in 4. HBV antibodies were found in 145 cases (55%). In conclusion, approximately 60% of HCV carriers found at the time of blood donation were apparently asymptomatic, suggesting the need of longer follow-up. Main routes of infection were estimated to be blood transfusion (33%), other parenteral exposure routes (6%), household (10% or less), and acupuncture (20% or less), considering duplication and priority.
We describe a subcapsular hematoma of the liver and pylethrombosis in a patient who developed cholestasis 4 days after severe burn injury. On the 44th hospital day, severe anemia suddenly appeared with no determinable cause. This was the initial manifestation of hepatic hematoma. Cholestatic liver injury of unknown cause lasted throughout the clinical course. The patient subsequently died of hepatic failure 27 months after the burn injury. An autopsy confirmed pylephlebitis and pylethrombosis, which were considered to have contributed to the hepatic failure. This was a rare case of hepatic hematoma and pylephlebitis and pylethrombosis that developed after burn injury.
A case of hepatocellular carcinoma with metastasis to the duodenum is reported on together with a review of the literature. A 61‐year‐old male was admitted with hematemesis and melena. An endoscopic examination revealed a large hemorrhagic ulcer at the duodenal bulbi. A biopsied specimen taken from the bottom of the ulcer revealed an infiltrating hepatocellular carcinoma. The postmortem examination revealed a hepatocellular carcinoma with metastasis in the duodenum. This is the third report of hepatocellular carcinoma with metastasis in the duodenum.
Antibodies to the preS2 antigen (anti-preS2) of the hepatitis B virus (HBV), including IgA, IgM and IgG classes, were observed in patients with acute and persistent HBV infection. In acute HBV infection, rapid and marked serum IgM and IgA anti-preS2 responses were observed. Antibodies reached a peak of serum activity at about 1–2 months after the onset of clinical symptoms, and both antibodies disappeared from serum at 4 months after. IgG anti-preS2 was detected in the early phase of the illness, then the level of IgG anti-preS2 gradually rose during the recovery phase. In persistent HBV infection, IgG and IgM anti-preS2 were detected in sera where the preS2 antigen was present, and IgM anti-preS2 was significantly higher (p < 0.05) in HBeAg-positive than in HBeAg-negative patients. These results indicate that an adequate humoral immune response to the preS2 antigen is induced during acute and persistent HBV infection.
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