Low dose alpha interferon treatment in chronic hepatitis B virus infection.

Fifty eight patients with chronic viral hepatitis B (HBV) were randomised in a prospectively controlled trial. Thirty patients were treated with 3 million units (MU) of interferon alfa-2b subcutaneously thrice weekly for four months. Twenty eight controls received no treatment. The follow up period after treatment was six months. Twenty eight treated patients and 27 controls completed the protocol. One woman in the treatment group showed a complete response, and eight other treated patients (32%) showed a partial response. Three patients in the control group (11%) lost hepatitis B e antigen and HBV-DNA spontaneously. This finding is statistically significant (p < 0.05). The elimination of HBV markers from the serum was associated with a return to normal of serum aminotransferase activities. Reactivation of hepatitis was not observed after seroconversion.

[Significant laparoscopy and ultrasound findings in chronic hepatic porphyria]. / Laparoskopische und sonographische Befundauffälligkeiten bei chronischer hepatischer Porphyrie.

In the years from 1983 to 1989 we diagnosed in altogether 69 patients a chronic hepatic porphyria. As a rule the light microscopic and sonographic findings in the liver use to be uncharacteristic. Yet, unexpectedly by sonography in eight patients findings, suspicious for metastases, were stated. Multiple coin lesions with a marginal edge mostly rich in echoes were impressing. The laparoscopy resulted in grey/blue-discoloured depressions in an otherwise even surface of the liver, thus suggesting mass necroses respectively rebuilding processes. Subclinical stages of a chronic hepatic porphyria could have been proved by the partial red-fluorescence of bioptates and a corresponding porphyrin secretion. The histological changes of the liver were--in contrary to the impressing laparoscopic picture--rather insignificant. In case of a successful intervention the pathological porphyrin secretion was done in about eight months. Mostly, more than a year used to pass away till the sonographic findings normalized. The seldom described phenomena use to conceal the danger of a false interpretation and an unnecessary stress for the patient. More over the causes and the development of these peculiar porphyria findings are unclear; they need in an discussion among medical special branches.

[Treatment of chronic hepatitis B with interferon alpha-2b]. / Behandlung der chronischen Hepatitis B mit Interferon alpha-2b.

In a prospective randomized trial 58 patients (46 men, 12 women; mean age 41 [18-65] years) with histologically proven chronic hepatitis B and demonstration of HBs antigen and hepatitis B virus DNA in serum were randomly divided into two groups: 30 patients were treated with recombinant alpha 2b interferon. The interferon was administered subcutaneously, 3 x 10(6) IU, three times weekly for four months. 28 patients served as untreated controls. There was a six-month post-treatment follow-up. Two patients in the treatment group and one in the control group had to be excluded later. In the treatment group one patient responded completely (HBs antigen, HBe antigen and HBV-DNA negative) and eight partially (HBe antigen and HBV-DNA negative). In three patients of the control group, HBe antigen and HBV DNA were no longer demonstrated (P less than 0.05). The loss of HBV features was associated with normalization of serum transaminases activity. Reactivation of liver inflammation after seroconversion was not observed.

[Treatment of chronic hepatitis B with interferon alpha-2b]. / Zur Behandlung der chronischen Hepatitis B mit Interferon alpha-2b.

A total of 58 patients with histologically confirmed chronic viral hepatitis B and presence of HBsAg and HBV-DNA in the serum were randomized in a prospectively controlled trial. 30 patients were treated with 3 megaunits of rIFN a-2b s.c. thrice weekly for 4 months. 28 controls received no treatment. The post-treatment follow-up period consisted of 6 months. 28 patients treated and 27 controls completed the protocol. One female patient of the treatment group showed a complete response (loss of HBsAg, HBeAg and HBV-DNA), 8 other patients (32%) revealed a partial response to therapy (loss of HBeAg and HBV-DNA). Three patients of the control-group (11%) lost HBeAg and HBV-DNA spontaneously. This finding is statistically significant (p less than 0.05). The elimination of HBV-markers from the serum was associated with a normalization of aminotransferase activities in the serum. A reactivation of hepatitis was not observed after seroconversion.

Treatment of chronic hepatitis B with interferon alfa-2b.

A total of 58 patients with histologically confirmed chronic viral hepatitis B and presence of hepatitis B surface antigen and hepatitis B virus DNA (HBV DNA) in the serum were randomized in a prospectively controlled trial. Thirty patients were treated with 3 megaunits of recombinant interferon alfa-2b (INTRON A, R Schering-Plough, Essex Corporation) subcutaneously thrice weekly for 4 months. Twenty-eight controls received no treatment. The post-treatment follow-up period consisted of 6 months. Twenty-eight treated patients and 27 controls completed the protocol. One female patient of the treatment group showed a complete response, and eight other treated patients (32%) showed a partial response to therapy. Three patients in the control group (11%) lost hepatitis B e antigen and HBV DNA spontaneously. This finding is statistically significant (p less than 0.05). The elimination of hepatitis B virus markers from the serum was associated with a normalization of aminotransferase activities in the serum. Reactivation of hepatitis was not observed after seroconversion.

[The internist and general practitioner in ambulatory care--similarities and limits]. / Internist und Allgemeinmediziner in der ambulanten Betreuung--Gemeinsamkeiten und Grenzen.

As a contribution to a self-appreciation of internal medicine which must newly be thought through under the modern conditions of medicine and society is tried to determine limits and communities of this specialty in the ambulatory basic medical care with regard to the general medicine orientating to the activities as a family doctor.

[Management of elderly citizens dependent on outside help from the clinical viewpoint]. / Die Betreuung auf fremde Hilfe angewiesener älterer Bürger aus klinischer Sicht.

The increase of life expectancy has led to a higher percentage of the oldest and requiring help people. The present paper described the possibilities and situation of care for this part of the population on the basis of an analysis of a district of Berlin. It must be stated that the cooperation between social organizations and ambulatory institutions and hospitals can be improved. The hospitalisation of older people requiring help should be an exception and is ethically legitimated only then, when it is performed with the intention of the patient. The willingness for care on the side of the members of the patients' families is analysed and discussed in the sense of improvement.