Electron microscopy and x-ray scanning microanalysis of needle biopsy material from human liver.
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A study has been made of the fine structure of hepatic parenchymal cells of human biopsy material in a case of pancreatic tumor with obstructive jaundice. Dense particles about 60 A in diameter have been found in the cytoplasm, which are considered to be ferritin molecules by electron microscopy. They are encountered throughout the cytoplasmic matrix and are often aggregated in electron-transparent areas, most of which are enclosed by an apparently single-layered membrane. Identification of the elemental iron has been pursued by the application of the x-ray scanning microanalyser which reveals a quantitative value within 1.0 per cent of the pure iron sample. The use of x-ray scanning microanalysis enables one to obtain accurate data from extremely small and precisely defined volumes of biological specimens. (+info)
POST-NECROTIC CIRRHOSIS WITH CHRONIC CHOLESTASIS.
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Features of biliary obstruction were seen in 57 of 300 cases of post-necrotic cirrhosis but gave rise to real diagnostic difficulty in only 11 cases. The paper deals with the recognition and possible pathogenesis of this syndrome. (+info)
SERUM LACTIC DEHYDROGENASE, LEUCINE AMINOPEPTIDASE AND 5-NUCLEOTIDASE ACTIVITIES: OBSERVATION IN PATIENTS WITH CARCINOMA OF THE PANCREAS AND HEPATOBILIARY DISEASE.
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Serum lactic dehydrogenase, leucine aminopeptidase, 5-nucleotidase and alkaline phosphatase activities were investigated in a number of diseases involving the hepatobiliary system.Leucine aminopeptidase was found to be a sensitive indicator of biliary obstruction, serum 5-nucleotidase slightly less sensitive, and alkaline phosphatase appreciably less sensitive. Leucine aminopeptidase and 5-nucleotidase activities were often increased by malignant infiltration of the liver and primary hepatic disease even in the absence of jaundice.Serum lactic dehydrogenase was frequently increased in primary hepatic disease and malignant disorders but was not apparently affected by bile duct obstruction per se. Thirty-five of 45 patients with proved malignancy had increased lactic dehydrogenase levels.The highest leucine aminopeptidase levels were encountered in carcinoma of the head of the pancreas. The frequent increase in both serum lactic dehydrogenase and leucine aminopeptidase activities in patients with carcinoma of the head of the pancreas suggests that these combined estimations are useful laboratory procedures in the diagnosis of malignant extrahepatic obstruction. (+info)
THE VALUE OF JIRGL'S FLOCCULATION TEST IN THE DIAGNOSIS OF JAUNDICE.
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Jirgl's serum flocculation reaction was examined in a series of 121 patients with varying types of liver disease. Positive results were found in 90% of patients with proven extrahepatic obstructive jaundice. Strongly positive reactions were also obtained in primary biliary cirrhosis and chlorpromazine jaundice. One out of three cases of ;cholestatic' hepatitis gave a weakly positive reaction and the test may be of value in the diagnosis of this condition and in the rare recurrent conjugated hyperbilirubinaemia in which it is also negative.Eighty-four per cent of cases of portal cirrhosis were negative and the finding of a positive result in this condition may indicate the presence of a hepatoma.No correlation could be found either in intra- or extrahepatic obstructive jaundice between the degree of flocculation present and the severity of the obstruction as judged by serum bilirubin and alkaline phosphatase levels. (+info)
TRANSHEPATIC CHOLANGIOGRAPHY.
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Percutaneous transhepatic cholangiography is a method of visualizing the biliary tree by the injection of radio-opaque medium through the abdominal wall and liver into an intrahepatic bile duct. The procedure is indicated in the immediate preoperative evaluation of patients with obstructive jaundice of unknown etiology and is usually diagnostic in these cases. It may also be of value in avoiding operation in poor-risk patients with obstructive jaundice. Biliary leak resulting in chemical peritonitis is a complication in about 5% of these procedures. Intraperitoneal hemorrhage is a complication in less than 1%. Death results from the procedure in less than 0.5% of cases. Transhepatic cholangiography during surgical operation is of value in demonstrating obstructive lesions of the bile ducts. However, preoperative percutaneous transhepatic cholangiography is preferred, since it makes possible adequate preparation for technically difficult repairs and resections. (+info)
PRURITUS AND JAUNDICE.
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The records of 147 patients who had pruritus and jaundice (11% of a series of 1262 patients with jaundice) were reviewed in an effort to delineate more clearly the etiology of jaundice associated with pruritus.Fifty-two had obstructive jaundice caused by neoplasm, 51 had obstructive jaundice not caused by neoplasm, 42 had pruritus associated with hepatogenous jaundice, and two had jaundice and pruritus associated with a lymphoma.Pruritus occurred in 17% of all patients with non-neoplastic obstructive jaundice and in 45% of patients with neoplastic obstructive jaundice. Hepatogenous jaundice was the cause of pruritus in almost one-third of the patients in this series-occurring in 20% of patients with infectious hepatitis and in 7% of patients with cirrhosis.This large series confirms the clinical impression that pruritus occurs most often in association with extrahepatic biliary obstruction, and as well re-emphasizes the common association of pruritus with hepatogenous jaundice. (+info)
ASSOCIATION OF INTRAVENOUS ALBUMIN WITH ALKALINE PHOSPHATASE ACTIVITY.
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After albumin transfusion levels of alkaline phosphatase are raised. These levels were studied in selected groups of patients and in albumin prepared for transfusion using a heat sensitivity test, and by this means the significance of raised levels of alkaline phosphatase may be interpreted correctly. (+info)
The antithrombin activity of glucuronic esters of bilirubin.
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The plasma of patients with pronounced jaundice as well as that of cats with experimental obstructive jaundice inhibits the clotting of normal plasma with thrombin. The influence of different bile constituents-bilirubin, bilirubin glucuronides, sodium salts of bile acid-on the clotting of plasma or fibrinogen with thrombin was examined. Bilirubin glucuronides in concentrations above 8 mg.% showed antithrombic activity but other substances were inactive. Glucuronic acid and phenolphthalein glucuronide in concentrations up to 100 mg.% did not have any influence on the thrombin time. (+info)