Budd Chiari syndrome and pericaval filariasis.

A young girl presented with Budd-Chiari syndrome (BCS) with narrowing of the retrohepatic segment of inferior vena cava (VC). Dorsal cavoatrial bypass (DCAB) was unsuccessful due to thrombotic occlusion of the graft. A limited autopsy revealed occlusion of the retrohepatic segment of IVC and the terminal parts of the three major hepatic veins. Caval occlusion was just above the level of the superior hepatic veins, and caused by a transverse fibrous shelf. An adult filarial worm was found amidst pericaval fibrosis. Filariasis should be included as a possible aetiological factor in chronic BCS.

Duck hepatitis B virus (DHBV) infection in Indian domestic ducks: a pilot study.

One hundred and two apparently healthy Indian domestic ducks from the Poultry Research Station, Madras were screened for duck hepatitis B virus (DHBV) infection by; 1. screening for the duck hepatitis B virus surface antigen (DHBsAg) in their sera using hepatitis B virus (HBV) reagents, 2. screening for DHBsAg using specific duck hepatitis B virus (DHBV) reagents and 3. demonstration of DHBV DNA using DHBV DNA probe by dot blot hybridisation. While 5 ducks (4.9%) were consistently positive with HBV reagents, use of DHBV reagents showed a total of 4 ducks (including 3 of the above 5) to be positive for DHBsAg. DNA hybridisation showed 6 ducks to be positive for DHBV DNA. On clinical examination, 5 out of these 6 ducks did not reveal abnormalities, the other one showed hepatomegaly and ascites. Post-mortem studies showed the presence of nodules on the surface of the liver in all 5 which were positive with HBV reagents including the one with hepatomegaly. On histopathological evaluation, they were found to be hepatocellular carcinoma with or without bile duct carcinoma. The present study is a pilot report on the occurrence of DHBV infection in Indian domestic ducks and the possibility of antigenic cross reactivity between human HBV and duck hepatitis B virus antigens.

Serum and tissue positivity for hepatitis B virus markers in histopathologically proven glomerulonephropathies.

To assess the pathogenic significance of hepatitis B virus (HBV) in glomerulonephritis (GN), 98 patients with histopathologically proven glomerulonephropathies were screened for HBV markers, complement components and levels of circulating immune complexes (CICs); and renal biopsies from 31 of them were examined for the presence of hepatitis B surface antigen (HBsAg), and its location, by immunoperoxidase staining. The HBsAg positive rate in the patients (who came from a population with 10% HBsAg positivity) ranged from 51.9% in minimum change nephrotic syndrome (MCNS) to 81.8% in patients with proliferative glomerulonephritis (PGN). Whereas 24.5% of the cases were positive for HBsAg only, 10.2% had anti-HBcIgM with HBsAg, 13.3% had HBeAg with HBsAg and 9.2% had HBsAg, HBeAg and anti-HBcIgM. Complement component C3 levels were decreased in all groups of GN studied, but C4 levels varied. CIC levels were significantly increased (p less than 0.01) only in HBsAg-positive MCNS, focal glomerulosclerosis (FGS) and membranous glomerulonephritis (MGN). Of the 31 renal biopsies examined for the deposition of HBsAg, 4 (12.9%) were found to be positive for HBsAg in situ; 64.5% of biopsied patients were seropositive for HBsAg and 77.4% had CICs. All the four in-situ HBsAg-positive cases were seropositive for HBsAg, HBeAg and anti-HBcIgM with significantly high CIC levels (p less than 0.01). HBsAg deposition was intracytoplasmic in the mesangial cells of the glomeruli, in the glomerular basement membrane or in the tubules, or in a combination of these sites.

Antifertility effect in male rats of oleanolic acid, a triterpene from Eugenia jambolana flowers.

The antifertility activity of oleanolic acid (C30H48O3), isolated from the flowers of Eugenia jambolana, was evaluated in male albino rats. The administration of the compound for 60 days decreased the fertilizing capacity of the animals without any significant changes in body weight or reproductive organ weights. The compound produced arrest of spermatogenesis but did not cause any abnormality to spermatogenic cells, Leydig interstitial cells and Sertoli cells. Oleanolic acid may prove to be a promising antifertility agent devoid of undesirable side effects.

Acute viral hepatitis with bridging necrosis. Collaborative study on chronic hepatitis.

Bridging necrosis was recorded in 14% of 361 patients with acute viral hepatitis on examination of the liver biopsy. The clinical and biochemical features of acute viral hepatitis with bridging necrosis were compared with acute viral hepatitis with no bridging necrosis (NBN). It was noted that fever of more than 8 days' duration in the preicteric phase, the presence of mild ascites and pedal edema during the icteric phase, increasing or persistently high levels of serum bilirubin even 4 weeks after the onset of the icteric phase and positive hepatitis-B surface antigen were significantly more common in acute viral hepatitis with bridging necrosis. Hepatitis-B surface antigen clearance was slow in this group. The long-term complication of chronic hepatitis was more frequent in patients with acute viral hepatitis with bridging necrosis.

Duration of hepatitis B surface antigenaemia and its correlation with the histopathological and clinical outcome in acute and chronic hepatitis.

The persistence of Hepatitis B surface antigen (HBsAg) in 156 patients with histopathologically proven acute viral hepatitis and 27 patients with chronic active hepatitis was assessed and correlated with their clinical and histopathological outcome; 1387 sequential serum samples were tested for HBsAg and its antibody (anti HBs). In the group with acute viral hepatitis, 86% of the patients who recovered, 67% of the patients who deteriorated histopathologically and 67% of the fatal cases carried HBsAg for up to 8 weeks only. While 56% of patients with chronic active hepatitis harboured HBsAg for 13-80 weeks, only 10% of the group with acute viral hepatitis did so. Of patients with chronic active hepatitis 37% deteriorated to cirrhosis and 11% died. Diverse anti-HBs-response patterns are reported and may have clinical significance.

Correlated clinical, histopathological, HBV and AFP studies of primary carcinoma liver.

This paper presents the clinical and histopathological features of 221 Primary Carcinoma Liver studied over the last eight years. HBsAg studies were carried out in 93, AFP studies in 87 and both HBsAg and AFP in the same serum samples in 78. HBsAg positivity rate by CIEP was 29% and AFP positivity was 52%. There appears to be greater AFP posivity in HBsAg positive group compared to HBsAg negative group. Correlation of cell type with AFP positivity reveals significant greater positivity in clear type. The need for indepth studies to use morphological appearances of cancer cells as simple marker of altered function is suggested. Anti e was positive in 40% of HBsAg positive cases studied for e system, while e antigen was positive in 32%. A very unusual finding of e antigen and Anti e present at the same time in a patient with primary liver carcinoma is documented.

Antigenic subtypes of HBsAg: their distribution and pattern of occurence among blood donors and patients with liver diseases and leprosy in Tamilnadu, India.

One hundred and seventy hepatitis B Surface antigen positive sera derived from blood donors, patients with liver diseases and leprosy were antigenically subtyped by Rheophoresis and 107 of them by agar-gel diffusion. For the first time in India HBsAg/adr as a predominant subtype (64.0%) is documented. Of the two methods adopted, Rheophoresis showed a greater sensitivity of typing, namely 82.3% in contrast to 39.2% only by agar-gel diffusion (p less than 0.001). Analysis of the Hepatitis Be antigen and antibody (anti HBe) positive sera for subtype predeliction revealed the same pattern as in HBe system negative sera.