Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019163 (hepatitis B)
38,309 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Regular 4-weekly follow-up controls of serum lactate dehydrogenase activity in 23 renal transplant recipients revealed a constant rise in serum LDH activity during the early postoperative months. During the first post-transplant month serum LDH activity increased from 150.0 +/- 48.2 mE/ml to 195.5 +/- 84.8 mE/ml, serum enzyme activity being highest (329.1 +/- 143.2 mE/ml) 6 months after surgery. Since serum creatinine levels remained relatively constant, it seems unlikely that renal rejection played a major pathogenic role in the production of increased LDH activity. Since the pattern of lactate dehydrogenase isoenzymes was ithin normal limits, the pathogenesis of increased LDH serum activity following renal transplantation is not yet clear. Possible causes such as liver damage due to hepatitis B, macrocytosis induced by immunosuppressive therapy and myopathy to steroids are discussed.
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PMID:[Serum lactate dehydrogenase activity after renal transplantation (author's transl)]. 33 55

Because of the inhomogeneous prognosis in fulminant hepatic failure, prognostic criteria are required which help to establish the indication for liver transplantation as a successful therapeutic procedure. In our study of 33 patients with fulminant hepatic failure (94% viral hepatitis, 67% hepatitis B), serum bilirubin > 320 or < 160 mumol/L, serum creatinine > 110 mumol/L, prothrombin time < 15% of the normal value and duration of jaundice until onset of encephalopathy > 7 days indicated a fatal outcome. When criteria described by O'Grady et al. were used, only limited predictability was achieved. This, as well as the frequently contradictory results of the few prognostic studies published so far, is probably due to the regional differences in the etiology and the different clinical courses of fulminant hepatic failure.
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PMID:Prognostic indicators in fulminant hepatic failure. 144 4

Since October 1987, 80 patients underwent open-heart surgery without donor-blood transfusion. 50 (Group I) out of these 80 cases were selected to be paired with 50 patients (Group II) who underwent open-heart surgery with homologous blood transfusion in the same period. Twelve cases (Group III) underwent open-heart surgery without homologous blood transfusion but were transfused after surgery. To decrease the homologous blood requirements, ultra-filtration system as well as conservation and autotransfusion of autologous blood was employed. Peripheral blood count, blood chemistry for liver and renal function were analyzed and compared among these three groups. Although hematocrit of Group I was lower than that of Group II until the third postoperative day, there was no difference after the seventh postoperative day. The platelet count was more in Group I than in Group II or III on the first and the seventh postoperative day. The level of lactate dehydrogenase was higher in Group II than in Group I. Total bilirubin was more elevated in Group II than in Group I on the first and the fourteenth postoperative day. Direct bilirubin was also higher in Group II than in Group I till fourteenth postoperative day. Five cases in Group II fulfilled the criteria of the serum hepatitis. Blood urea nitrogen and creatinine were less in Group I than in Group II. The duration of the intra-tracheal intubation was shorter in Group I than in Group II or III. There was no difference in postoperative dosage or duration of catecholamines among three groups.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Open-heart surgery without donor-blood transfusion--a clinical study]. 148 33

The long-term clinical course of patients with primary Type II essential mixed cryoglobulinaemia is unclear as many reports fail to separate this group from patients with Type III disease. We have reviewed 13 patients with Type II essential mixed cryoglobulinaemia who presented to the Hammersmith Hospital between 1976 and 1990. All patients had a cryoglobulin level greater than 0.1 mg/ml (range 0.27-6.50 mg/ml), and characterization of the cryoglobulin in all cases revealed the presence of a monoclonal IgM kappa component with rheumatoid factor activity together with polyclonal IgG. All patients had evidence of activation of the classical pathway of complement with greatly reduced levels of C4, while C3 levels were moderately reduced in three patients. All patients had skin disease and joint symptoms were reported by nine patients, with erosive arthritis in one. Eight patients had peripheral sensorimotor neuropathy. Renal disease was observed in 10 patients, manifesting as raised creatinine level, proteinuria or haematuria. Renal tissue was examined in eight patients: in six the appearances were those of a mesangiocapillary glomerulonephritis Type I while in the other two patients there was a mesangioproliferative glomerulonephritis, in one diffuse and in the other focal and segmental. Glomerular capillary 'hyaline thrombi' were found in six biopsies, extracapillary proliferation was found in three and evidence of vasculitis was found in all eight. Liver biopsy showed macronodular cirrhosis in one patient, while a second with recurrent episodes of jaundice showed only chronic inflammatory changes. No patient was positive for hepatitis B surface antigen; however one patient had low titre anti-hepatitis B surface antibody. Normochromic normocytic anaemia was present in nine patients. Bone marrow examination was carried out in 13 patients at presentation to our unit: 10 showed no evidence of a lymphoproliferative disorder, while three suggested the presence of a non-Hodgkin's lymphoma (some years after original presentation in all three). Unusual clinical features included one patient with retinal vasculitis and one patient with severe pulmonary haemorrhage.
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PMID:Type II essential mixed cryoglobulinaemia: presentation, treatment and outcome in 13 patients. 162 Aug 12

The complement fragment Ba is a 33 kD activation product of factor B which suppresses human B-lymphocyte functions in vitro. We report that plasma levels of Ba are highly elevated in patients with chronic renal failure (4.84 +/- 3.58 micrograms/ml) and in patients with end-stage renal disease undergoing regular hemodialysis (16.1 +/- 6.1 micrograms/ml) as compared to normals (1.01 +/- 0.30 micrograms/ml). Ba levels were strictly correlated with the creatinine clearance. The urinary excretion of Ba was 165-fold higher in patients with tubular proteinuria than in normals. These results indicate that the kidney is the major catabolic site for Ba. In addition, direct evidence was obtained for an enhanced turnover of the alternative pathway of complement in renal failure that, although it appears to be less important than the renal retention of Ba, contributes to elevated Ba plasma levels in these patients. Ba concentrations in dialysis patients who responded to hepatitis B vaccination were significantly lower than in non-responders. Furthermore, the in vitro IgM synthesis by purified mononuclear cells was negatively correlated with Ba concentrations determined in the plasma of these patients. These results suggest that the accumulation of Ba contributes to the defective immune response in patients with renal failure.
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PMID:Elevated plasma levels of the immunosuppressive complement fragment Ba in renal failure. 183 62

Criteria for the classification of polyarteritis nodosa were developed by comparing 118 patients who had this disease with 689 control patients who had other forms of vasculitis. For the traditional format classification, 10 criteria were selected: weight loss greater than or equal to 4 kg, livedo reticularis, testicular pain or tenderness, myalgias, mononeuropathy or polyneuropathy, diastolic blood pressure greater than 90 mm Hg, elevated blood urea nitrogen or serum creatinine levels, presence of hepatitis B reactants in serum, arteriographic abnormality, and presence of granulocyte or mixed leukocyte infiltrate in an arterial wall on biopsy. The presence of 3 or more of these 10 criteria was associated with a sensitivity of 82.2% and specificity of 86.6%. A classification tree was also constructed, with 6 criteria being selected. Three of these, angiographic abnormality, biopsy-proven granulocyte or mixed leukocyte infiltrate in arterial wall, and neuropathy, were criteria used in the traditional format. The other 3 criteria used in the tree format included the patient's sex, weight loss greater than 6.5 kg, and elevated serum aspartate aminotransferase or alanine aminotransferase levels above the range of normal. The classification tree yielded a sensitivity of 87.3% and a specificity of 89.3%.
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PMID:The American College of Rheumatology 1990 criteria for the classification of polyarteritis nodosa. 197 74

The purpose of this study is to clarify the clinical and pathological features of glomerulonephritis associated with hepatitis B virus infection (HBV-GN) in adults. Of the 47 adult cases with HBV-GN, 7 cases were diagnosed as minor glomerular abnormalities, 19 as mesangial proliferative GN (mild 13, moderate 4, severe 2), 11 as membranous GN, 10 as membranoproliferative GN (type I 2, type III 8). Indirect immunoperoxidase method using monoclonal antibody raised against HBV related antigens (HBsAg and HBeAg) revealed glomerular deposition of only HBsAg in 10 cases, only HBeAg in 2, and both antigens in 10. Deposition of HBeAg was observed dominantly along the capillary walls in comparison with that of HBsAg (p less than 0.01). Additionally, in 4 cases diagnosed as the IgA-GN because of the IgA dominant mesangial deposition and normal liver function, HBV related antigens were detected in the mesangial areas. Aggravation of renal function with respect to serum creatinine level, only 0.6-0.8 mg/dl increased, was demonstrated in 4 of 27 cases followed up for more than a year. These results suggest that the high incidence of membranous GN and membrano-proliferative GN was observed in HBV-GN in adults. HBsAg as well as HBeAg may contribute to the pathogenesis of this glomerulonephritis, and then HBsAg may play in capillary walls and mesangial areas, whereas HBeAg in capillary walls mainly. And the possibility exists that HBV related antigens are the responsible antigenic agents in some cases of IgA-GN.
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PMID:[The clinico-pathological studies of hepatitis B virus nephropathy in adults]. 206 11

Only 50 to 60% of dialysis patients develop anti-HBs antibodies following hepatitis B vaccination. The nonresponder state correlates with impaired monocyte function, decreased interleukin-2 (IL-2) production of T cells, and an upregulation of the IL-2 receptor system. In the present study we examined anti-HBs production after hepatitis B vaccination and the in vitro expression of IL-2 receptors in nondialyzed patients with various degrees of chronic renal failure. Forty-four patients with impaired renal function were immunized with 2 micrograms recombinant hepatitis B vaccine and boostered after one and six months. Prior to the first injection IL-2 receptor expression of activated T cells was studied by an in vitro proliferation assay. Sixty-four healthy subjects served as controls. After completion of the third vaccination 55.0% of the patients acquired antibody titers greater than 10 U/liter. The seroconversion rate did not differ between patients with lower (less than 3.5 mg/dl) and higher (greater than 3.5 mg/dl) creatinine levels. In nonresponders IL-2 receptor expression (stimulation index, SI = 10.09 +/- 1.80) was elevated compared to healthy controls (SI = 4.62 +/- 0.35, P less than 0.002) or patients who responded with a high antibody titer (greater than 50 U/liter, SI = 3.12 +/- 0.43, P less than 0.001). Patients who produced low antibody titers (less than 50 U/liter) also presented with enhanced IL-2 receptor expression. These data show that an impaired antibody production following hepatitis B vaccination and an enhanced IL-2 receptor expression of T cells may already be present in early stages of chronic renal failure.
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PMID:Hepatitis B vaccination and interleukin 2 receptor expression in chronic renal failure. 215 86

From 1980 to 1985, we performed biopsies on 87 adults with nephrotic syndrome (NS). The patients were tested for whether serologic studies obtained routinely at biopsy added to clinical diagnostic accuracy. Using history, physical examination, complete blood cell count (CBC), chemistry panel, urinalysis, and urine creatinine and protein, four nephrologists each predicted whether the patient had primary NS (PNS) or secondary NS (SNS), and the most likely histopathologic entity. Six months later, each nephrologist used this information, with results of tests of sera for fluorescent antinuclear antibody (FANA), rheumatoid factor (RF), complement components, hepatitis B surface antigen (HBsAg), venereal disease research laboratory serology (VDRI), cryoglobulins and protein electrophoresis (SPEP), with an erythrocyte sedimentation rate (ESR) and protein electrophoresis of the urine (UPEP), to make identical predictions. Histopathology was established by renal biopsy. We analyzed the concordance between nephrologists' choices and biopsy results both before and after serologic tests were available with a kappa statistic. Preserology concordance was moderate (kappa = 0.52), and identical to postserology concordance (kappa = 0.51) for both PNS versus SNS and actual histopathology. Serologies were rarely abnormal without clinical suspicion. These results suggest routine serologic testing does not improve diagnostic accuracy in adult NS.
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PMID:Routine serologic tests in the differential diagnosis of the adult nephrotic syndrome. 229 30

The response rate and HBsAG antibody concentrations were examined after hepatitis B vaccination in 78 hemodialysis patients aged between 29 and 79 years. The values were related to age, duration of hemodialysis, body weight, creatinine, urea nitrogen, serum concentrations of beta 2-microglobulin and soluble interleukin-2 receptor (IL-2R). Patients with low anti-HBsAG antibody concentrations (10-100 mU/ml) had significantly higher IL-2R serum concentrations than those with high anti-HBsAG antibody concentrations (greater than 3,000 mU/ml; p less than 0.05). Discriminant multivariate analysis (p = 0.032) revealed the influence (62%) of IL-2R on the response rate while other factors were similar in all patient groups. It is concluded that preactivation of T cells with an increased release of IL-2R may contribute to impaired immune response after hepatitis B vaccination.
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PMID:Factors influencing the response to hepatitis B vaccination of hemodialysis patients. 252 77


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