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  • 1
    Electronic Resource
    Electronic Resource
    Rare association of herpes simplex virus IgM-specific antibodies and Guillain-Barré syndrome successfully treated with plasma exchange and immunosuppression (1985)
    Springer
    Journal of molecular medicine 63 (1985), S. 468-474 
    Details
    ISSN: 1432-1440
    Keywords: Guillain-Barré syndrome (GBS) ; Herpes simplex virus (HSV)-IgM antibodies ; Immunohistology ; Plasma exchange ; Immunosuppression
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Herpes simplex virus (HSV) has been associated with various neurological disorders. In contrast, HSV infection is very rarely found in acute polyneuroradiculitis. In this report, a patient is described with a severe course of Guillain-Barré syndrome (GBS). HSV IgM-specific antibodies and a rise of complement-fixation antibodies were detected. During the acute phase of neurologic syndrome, a nerve biopsy showed myelin damage and IgM deposits on the inner layer of the perineurium. Plasma exchange, in combination with immunosuppression, was successfully applied as a treatment in the relapsing course of GBS. Finally, after recovery, HSV-specific IgM antibodies disappeared.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01731495
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  • 2
    Electronic Resource
    Electronic Resource
    Hepatitis C virus associated primary hepatocellular carcinoma in a noncirrhotic liver (1993)
    Springer
    Journal of molecular medicine 71 (1993), S. 49-53 
    Details
    ISSN: 1432-1440
    Keywords: Hepatocellular carcinoma (HCC) ; Non-cirrhotic liver ; Hepatitis B virus (HBV) ; Hepatitis C virus (HCV) ; Nodular regenerative hyperplasia (NRH)
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The case of a 71-year-old man with a primary hepatocellular carcinoma in a non-cirrhotic liver is reported. There were no risk factors of hepatocellular carcinoma (HCC)-like liver cirrhosis, alcohol drinking, tobacco smoking, exposure to vinyl chloride, thorotrast, aflatoxin or α1-antitrypsin deficiency. Serologically, the patient was positive for antibodies to the hepatitis B virus (anti-HBc, anti-HBs) and for anti-hepatitis C virus (HCV) antibodies. Virologically, positive and negative strands of HCV RNA could be detected in the patient's serum and tumorous liver tissue by reverse transcription polymerase chain reaction as a sign of persistent HCV replication. Histologically, the HCC was completely surrounded by liver tissue which showed the signs of nodular regenerative hyperplasia. Indeed, the mechanism of hepatocarcinogenesis remains to be clarified. However, this case supports the observation that HCC may also develop in patients with HCV infection without preexisting liver cirrhosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00210964
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  • 3
    Electronic Resource
    Electronic Resource
    Sustained elimination of hepatitis B virus from serum induced in a patient with chronic hepatitis B and advanced human immunodeficiency virus infection (1994)
    Springer
    Journal of molecular medicine 72 (1994), S. 1030-1036 
    Details
    ISSN: 1432-1440
    Keywords: Human immunodeficiency virus ; Hepatitis B virus ; Interferon-α ; Corticosteroid
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 48-year-old male patient was admitted with acquired immunodeficiency syndrome (stage III, Centers for Disease Control 1993) and viremic hepatitis B. Blood CD4 count was 15/μl. Discontinuation of prednisolone, previously prescribed by the patient's family practitioner because of elevated liver enzymes, resulted in severe hepatitis (alanine aminotransferase 〉 300U/1). Administration of interferon-α, (9 × 106U s.c. 3 × weekly) was initiated. Serum markers of viral replication disappeared, and aminotransferase levels returned to normal within a few weeks. The patient's serum was found negative for HBsAg after 3 months. Immunohistochemical analysis of liver biopsies before and during interferon therapy showed disappearance of all hepatitis B virus antigens and a marked reduction in inflammatory activity. Hepatitis B virus seroconversion remained stable until the patient died from the syndrome 2 years later. This case shows that in spite of severe HIV-associated immune deficiency with CD4 counts constantly below 100/μl, interferon-α can lead to sustained serological and histological improvement of viremic hepatitis B. Previous administration and discontinuation of cortisone may have helped to reach this effect.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00577750
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  • 4
    Electronic Resource
    Electronic Resource
    Regulation of cytochrome P450 IID by acute phase mediators in C3HHeJ mice
    Amsterdam : Elsevier
    Biochemical and Biophysical Research Communications 182 (1992), S. 617-623 
    Details
    ISSN: 0006-291X
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Biology , Chemistry and Pharmacology , Physics
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1016/0006-291X(92)91777-N
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  • 5
    Electronic Resource
    Electronic Resource
    The safety of pegylated interferon alpha-2b in the treatment of chronic hepatitis B: predictive factors for dose reduction and treatment discontinuation (2005)
    Oxford, UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 21 (2005), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background : Treatment with interferon-alpha has been shown to be effective in one-third of hepatitis B e antigen-positive chronic hepatitis B patients, but is clinically associated with relevant adverse events.Aim : To investigate the safety of pegylated interferon alpha-2b in 300 hepatitis B e antigen-positive patients with compensated liver disease.Methods : Patients were treated with pegylated interferon alpha-2b for 52 weeks combined with either lamivudine 100 mg/day or placebo. Pegylated interferon alpha-2b was administered for 100 μg once a week for 32 weeks; thereafter, the dose was reduced to 50 μg once a week. Adverse events and their effect on study medication were reported at monthly visits in a standardized way.Results : The most frequently reported side-effects were flu-like syndrome (68%), headache (40%), fatigue (39%), myalgia (29%) and local reaction at the injection site (29%). These symptoms typically occurred within the first month of therapy and subsided during the course of therapy. Neutropenia and thrombocytopenia induced by pegylated interferon alpha-2b increased the risk of infections and bleeding complications, but these complications were rare and mild. The frequency of all side-effects was not different between patients treated with pegylated interferon alpha-2b combined with lamivudine or placebo. In 69 (22%) patients the dose of pegylated interferon alpha-2b was reduced prematurely. Of these dose reductions, 36 (52%) were because of neutropenia. Therapy was discontinued in 28 (8%) patients. The most frequent reasons for early discontinuation were psychiatric side-effects (depression, psychosis) and flu-like symptoms. Multivariate Cox regression analysis showed that low neutrophil count at baseline and cirrhosis were independent predictors of dose reduction or therapy discontinuation.Conclusion : We conclude that in patients with chronic hepatitis B and compensated liver disease prolonged pegylated interferon alpha-2b therapy is safe, and that pre-existent cirrhosis and neutropenia are the most important predictors of dose reduction or early treatment discontinuation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2036.2005.02453.x
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  • 6
    Electronic Resource
    Electronic Resource
    Akuter Hinterwandinfarkt als Folge eines dissezierenden Aortenaneurysmas bei bikuspider Aortenklappe (1999)
    Springer
    Intensivmedizin und Notfallmedizin 36 (1999), S. 304-308 
    Details
    ISSN: 1435-1420
    Keywords: Key words Myocardial infarction ; dissection ; bicuspidal aortic valve ; dissection of the coronary artery ; Schlüsselwörter Myokardinfarkt ; Dissektion ; bikuspide Aortenklappe ; Dissektion der Koronararterie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Eine 57jährige Patientin wurde mit den klinischen Zeichen eines akuten Hinterwandinfarktes stationär aufgenommen. In der Koronarangiographie zeigte sich eine Dissektion der rechten Koronararterie. Diese konnte durch Implantation zweier Stents erfolgreich rekanalisiert werden. Im Rahmen der weiteren Diagnostik zeigte sich in der transoesophagealen Echokardiographie ein dissezierendes Aortenaneurysma, unmittelbar an der Aortenklappe beginnend (Stanford Typ A) und bis in den Arcus aortae reichend. Das „falsche“ Lumen war proximal bereits vollständig thrombosiert, nur im distalen Abschnitt konnte noch geringer Fluß nachgewiesen werden. Die Aortenklappe war bikuspide angelegt. Ein Zusammenhang zwischen bikuspider Aortenklappe, Aortenaneurysma und Auftreten einer Aortendissektion ist seit langem bekannt, jedoch ist das Übergreifen einer Aortendissektion auf die Koronararterien mit einem in Folge auftretenden akuten Hinterwandinfarkt ein seltenes Ereignis.
    Notes: Summary A 57 year old female patient was admitted with acute myocardial infarction of the posterior wall. In the angiography of the coronary arteries, a dissection of the right coronary artery was found. The vessel was successfully recanalized by implantation of two stents. Further diagnostics showed a dissected aneurysm of the aorta ascendens (Stanford type A) and a bicuspid aortic valve.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003900050243
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  • 7
    Electronic Resource
    Electronic Resource
    Heparin-induced thrombocytopenia (2000)
    Springer
    Intensivmedizin und Notfallmedizin 37 (2000), S. S099 
    Details
    ISSN: 1435-1420
    Keywords: Key words Thrombocytopenia – heparin – thromboembolism – anticoagulants – hirudin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  Heparin-induced thrombocytopenia (HIT), next to bleeding complications, is the most important side-effect of heparin therapy in cardiac patients and the most frequently found thrombocytopenia induced by medication. Two types of HIT are distinguished on the basis of both severity of disease, and pathophysiology: type I HIT is an early, transient, clinically harmless form of thrombocytopenia, due to direct heparin-induced platelet aggregation. Thromboembolic complications are usually not seen. No treatment is required. A normalization of platelet count even if heparin is continued is a usual observation. Type II HIT is more severe than type I HIT and is frequently complicated by extension of preexisting venous thromboembolism or new arterial thrombosis. The thrombocytopenia is caused by a pathogenic heparin-dependent IgG antibody (HIT-IgG) that recognizes as its target antigen a complex consisting of heparin and platelet factor IV. Type II HIT should be suspected when the platelet count falls to less than 100,000 per cubic millimeter or less than 50% of the base line value 5 to 15 days after heparin therapy is begun, or sooner in a patient who received heparin in the recent past. The clinical diagnosis of type II HIT can be confirmed by several sensitive assays. In cases of type II HIT, heparin must be stopped immediately. However, if the patient requires continued anticoagulant therapy for an acute event such as deep venous thrombosis, substitution of an alternative rapid-acting anticoagulant drug is often needed. In the authors experience Danaparoid sodium, a low-sulfated heparinoid with a low cross-reactivity (10%) to heparin, can be regarded as an effective anticoagulant in patients with type II HIT. Preliminary experiences with intravenous recombinant hirudin are also encouraging and suggest that this direct thrombin inhibitor will emerge as a valuable alternative treatment for patients who suffer from HIT.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003900070012
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  • 8
    Electronic Resource
    Electronic Resource
    Chirurgie bei Hepatitis (1998)
    Springer
    Der Chirurg 69 (1998), S. 522-529 
    Details
    ISSN: 1433-0385
    Keywords: Key words: Viral hepatitis ; Liver function ; Liver cirrhosis ; Immunprophylaxis ; Treatment of viral hepatitis. ; Schlüsselwörter: Virushepatitis ; Leberfunktion ; Lebercirrhose ; Immunprophylaxe ; Behandlung der Virushepatitis.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung. Virushepatitiden gehören weltweit zu den wichtigsten Infektionskrankheiten. Allein über 300 Millionen chronische HBsAg-Träger und etwa die gleiche Anzahl chronischer Hepatitis-C-Virusträger werden geschätzt. Nach der Tuberkulose steht die Virushepatitis in der Statistik der infektiös bedingten Berufskrankheiten an zweiter Stelle. Insbesondere Teile Asiens, Afrikas, Lateinamerikas sowie der Mittelmeerraum und der Nahe Osten werden zu den Hochendemiegebieten der Virushepatitis gezählt. Aufgrund der immunologischen und molekularen Differenzierung sind heute die Virushepatitiden von A bis E einschließlich G weitgehend charakterisiert. Während die enteral übertragene Hepatitis A und E nur akute und in seltenen Fällen fulminante Verläufe induzieren, sind die Hepatitis B, ihre Koinfektion und Superinfektion mit Hepatitis Delta und die Hepatitis C insbesondere durch chronische Verläufe von großer medizinischer Bedeutung. Diese Erkrankungen können als Spätfolge in eine Lebercirrhose mit all ihren Komplikationen, einschließlich des primären Leberzellcarcinoms übergehen. Die für die Chirurgie besonderen Aspekte der Virushepatitis sollen diskutiert werden.
    Notes: Summary. Viral hepatitis belongs to the most important infectious diseases worldwide. More than 300 million chronic HBsAg carriers and chronic HCV carriers exist, respectively. High endemic areas of viral hepatitis are Asia, Africa, Latin America and the Near, Middle and Far East. Viral hepatitis is also very important in health care workers. Today viral hepatitis can be differentiated from type A to type E (G) based on immunological and molecular assays. While enterally transmitted hepatitis type A and type E only induce acute and rare fulminant disease, hepatitis type B, C and D often induce chronic progressive disease including liver cirrhosis with typical complications due to the portal hypertension and with a high rate of association with the development of primary liver cancer (HCC). This review focusses on viral hepatitis-related surgical problems, including liver transplantation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001040050449
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  • 9
    Electronic Resource
    Electronic Resource
    Quantification and genotyping of serum HCV-RNA in patients with chronic hepatitis C undergoing interferon treatment (1997)
    Springer
    Archives of virology 142 (1997), S. 459-464 
    Details
    ISSN: 1432-8798
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary.  Quantification of serum HCV-RNA and HCV genotyping was studied in 27 patients with chronic hepatitis C undergoing interferon treatment. Pretreatment serum HCV-RNA levels were quantified using competitive RT-PCR and compared to a quantitative RT-PCR assay based on co-amplification of HCV-RNA with a synthetic RNA standard. HCV genotyping was performed using a line probe reversed hybridisation assay or direct solid-phase sequencing. This study shows the feasibility of performing HCV-RNA quantification. RT-PCR based on co-amplification HCV-RNA titer less than 6× 104 genome equivalents/ml serum did correlate with a complete sustained response to α interferon in chronic hepatitis C. HCV genotype 1b was α predominantly associated with a high non-responder rate. Future prospective trials will be required to evaluate quantitative HCV-RNA levels and HCV genotyping as response predicting parameters for interferon-treatment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007050050092
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  • 10
    Electronic Resource
    Electronic Resource
    Receptor-mediated entry of hepatitis B virus particles into liver cells (1997)
    Springer
    Archives of virology 142 (1997), S. 493-498 
    Details
    ISSN: 1432-8798
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary.  In previous reports several receptors for either natural hepatitis B virus (HBV) particles or genetically engineered virus have been described, whereby endocytosis represents a putative uptake mechanism for HBV particles. We have found that HBV-particles from viremic carriers could bind to the human asialoglycoprotein receptor (ASGPR), which mediates glycoprotein uptake into liver cells. The HBV-ASGPR interaction was studied in a cell culture system using hepatoma HepG2 and HuH7 cells compared to COS cells as controls. About 50% of HBsAg-secretion into the cell culture supernatant after HBV-inoculation as a function of HBV-uptake could be inhibited by the specific ASGPR-ligand asialofetuin. COS-cells did not show HBsAg-secretion. If the cells were grown as clones, 15% of HepG2-cells demonstrated HBsAg-secretion but only 5% in the presence of asialofetuin. HBV-particle uptake was further confirmed by HBV-DNA analysis using PCR. HBV-ASGPR interaction was studied with purified, biotin-conjugated human ASGPR. Quantitative inhibition with asialofetuin indicated a high-affinity binding of HBV-particles to purified ASGPR. After denaturing polyacrylamid gel electrophoresis and transblotting of isolated HBV-particles a receptor-blotting system was established which identified distinct binding sites for biotinylated receptors. These results suggest that the ASGPR is capable of specifically binding HBV-particles and, moreover, to mediate their hepatic endocytosis which ultimately could be responsible for the HBV-infection of liver cells.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007050050095
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