Hepatitis B antigen, auto-antibodies and liver disease in a haemodialysis and transplantation unit.

This study concerns hepatitis B antigen and antibody, (HBAg and HBAb) auto-antibodies and liver disease in a renal haemodialysis and transplantation unit between February, 1970 and December, 1972. Fourteen per cent of patients on maintenance haemodialysis, 25% of renal transplant recipients, and 5% of the staff were HBAg positive during this period. Three family members of antigen positive patients developed hepatitis; all were either antigen or antibody positive. Both immuno-electro-osmo-phoresis and radio-immuno-assay were used to detect HBAg. No additional carriers were identified among the dialysis or transplant patients by applying the more sensitive technique, although two persons with hepatitis were positive only by RIA. None of the staff members who developed antigen positive hepatitis died, and no one became a carrier. Dialysis patients who had icteric hepatis also cleared the antigen from the serum. Clinical hepatitis did not occur in immunosuppressed graft recipients who were carriers of the ay subtype of the antigen, nor was there histological evidence of liver disease in 18 of 19 of such carriers studied. Moreover, there was no association between long term carriage of the antigen and the presence of the auto-antibodies characteristic of chronic active hepatitis. Rapid reduction of immunosuppression was followed by acute hepatitis in one carrier, while another, whose antigen was of the ad subtype, developed micro-nodular cirrhosis.

Australia antigen, autoantibodies and cell-mediated immune responses in patients with Down's syndrome.

The prevalence of Au antigen, autoantibodies and impaired cell-mediated immune responses was studied in 66 patients with Down's sydrome and 66 other mentally retarded patients in a South Australian institution. The antigen was detected in three of the former and none of the latter. This unexpectedly low carrier rate in patients with Down's syndrome was thought to be due either to good hygiene and state of nutrition in the institution or to the high age of which the patients had been admitted to hospital (eight to nine years). Because of the incompleteness of the association between impairment of cell-mediated immunity and antigen carriage, it was thought unlikely that the former was the sole reason for the latter.

Primary hepatoma and hepatitis-associated antigen in a young white woman.

A young woman whose serum was positive for hepatitis-associated antigen (H.A.A.) and alpha-fetoprotein developed a malignant hepatoma. Though the light-microscopical appearances of the surrounding liver tissue were normal, electronmicroscope examination of the tumour tissue disclosed both C-virus-like particles and H.A.A. particles. Possibly there was a causal connexion between one of these particles and the hepatoma.

The Effects of External Pneumatic Splint Pressure on Muscle Blood Flow.

The effects of external pneumatic pressure on muscle blood-flow through the calf have been estimated by a Xenon-133 clearance curve technique. Flow was found to be greatly reduced at 40 mm. of mercury external pressure, and it was concluded that for first-aid purposes inflation pressures in excess of 30 mm. of mercury should not be used.