The long term outcome of thirty eight post-transfusion hepatitis C.

Thirty-eight cases of post-transfustion HCV hepatitis have been followed for 5-24 years. Cirrhosis and hepatocellular carcinoma were found in 44.7 per cent and 13.1 per cent respectively. Cirrhosis was recognised by pathological evidence as early as one and a half years after transfusion and the clinical evidences of decompensated cirrhosis were noted in the fifth year post-transfusion onward. Hepatocellular carcinoma was first recognised in year ten and thereafter. Nine patients died of liver failure or hepatocellular carcinoma during years 8-16 of the follow-up. Therefore, it is of utmost importance to screen out the HCV infected blood donors and to treat the HCV patients as early and as effectively as possible.

Clinical study of 457 cholecystectomy cases in a private hospital.

This is a retrospective study of 457 cases of cholecystectomized patients, who were admitted to Vichaiyut Hospital from 1970 to 1996. The ratio of male to female was 1:1.6 and the most common age range was 51-60 years, 45.3 per cent of patients were older than 60 years. Associated or underlying diseases were highly prevalent (81.6%). Diabetes mellitus, cardiovascular disease and liver disease were the three most common associated diseases. In acute cholecystitis the pathological findings were in accordance with clinical feature in only 46.2 per cent but in chronic or subsided cholecystitis pathology confirmed in 97.5 per cent. Carcinoma of the gallbladder was found in 0.9 per cent. Clinical diagnosis of cholecystitis was incorrect in 1.1 per cent. Multiple gallstones were found in 67.3 per cent, single stone in 23.5 per cent, sand stones in 2.1 per cent and acalculous cholecystitis in 7.1 per cent. Combined gallstones and CBD stones were found in 9.8 per cent. Enteric bacteria were isolated from the bile in 32.5 per cent and in acute cholecystitis similar organisms were isolated from both bile and blood cultures in 12.8 per cent. Morbidity rate of cholecystectomy was 7.6 per cent, the most common complication was perioperative infection in 3.5 per cent. It is interesting to find that atelectasis was recognized only in 2 out of 57 laparoscopic cholecystectomy. Mortality rate was low (0.66%).

Study on pathogenicity and central nervous system migration of the larval stage of Gnathostoma spinigerum in experimental animals.

Studies were conducted on the pathogenicity and the route of migration to the central nervous system by the immature larval stage of G.spinigerum in experimental animals. Five mice and one rat showed signs of nervous tissue damage and CNS involvement. The significant findings were massive haemorrhagic areas and blood clot around large lower nerve trunk and spinal cord invasion by the worm. The possible roles of the immature larval stages of G.spinigerum in human was discussed.