Ganglioglioma: a clinical and pathological study of 12 cases.

We report the clinico-pathological and immunohistochemical findings of 12 cases of gangliogloma that were diagnosed at Legnano Civil Hospital over a period of 10 years. The patients' age at presentation ranged from 2-69 years with a mean duration of symptoms equal to 52 months. Seizures were the most common presenting symptoms. These tumors, mainly located in the temporal lobe (5/10), displayed in 10 cases a low density appearance at CT scan. Histologically the tumors were composed of neoplastic ganglion cells mixed together with a glial component. All but one of the tumors were surgically treated: complete removal was accomplished in 8 cases and incomplete in 3 cases; 1 case was an incidental autopsy finding. Radiotherapy was administered in the incompletely removed cases. The mean follow-up period was 40.8 months, with 3 patients deceased. Our findings support the notion that ganglioglioma is a slow-growing relatively benign tumor of young adults, ubiquitous in the central nervous system with a non-specific CT scan appearance and varied histological morphology, in which immunochemical stains will confirm the diagnosis and could provide a prognostic marker.

Experiencia en resecciones hepaticas. / Experience in hepatic resections

Se realizaron 20 resecciones hepaticas en 19 pacientes (11 resecciones menores y 9 mayores). Diez por patologia benigna y 10 maligna. La mortalidad fue del 10% y corresponde a 2 resecciones menores

Experiencia en resecciones hepaticas. / Experience in hepatic resections

Se realizaron 20 resecciones hepaticas en 19 pacientes (11 resecciones menores y 9 mayores). Diez por patologia benigna y 10 maligna. La mortalidad fue del 10% y corresponde a 2 resecciones menores

Ruptura de aneurisma de la arteria esplenica. / Rupture of splenic artery aneurysm

Se presenta un caso de ruptura aneurismatica de la arteria esplenica intervenido con buen resultado. Son mas frecuentes en la mujer y pueden desarrollarse durante el embarazo. Sin embargo, una causa frecuente es la arterioesclerosis, como sucedio en el caso presentado. Asintomaticos antes de la ruptura pueden sin embargo causar dolor y ser sospechados por calcificaciones curvilineas en radiografias directas del abdomen o en el curso de otros estudios. La aortografia y la arteriografia del tronco celiaco confirmaran el diagnostico. Aunque la ruptura es infrecuente y en general depende de su tamano, la reposicion sanguinea adecuada y la cirugia de hemostasia o de exeresis podran salvar la vida del paciente

Ruptura de aneurisma de la arteria esplenica. / Rupture of splenic artery aneurysm

Se presenta un caso de ruptura aneurismatica de la arteria esplenica intervenido con buen resultado. Son mas frecuentes en la mujer y pueden desarrollarse durante el embarazo. Sin embargo, una causa frecuente es la arterioesclerosis, como sucedio en el caso presentado. Asintomaticos antes de la ruptura pueden sin embargo causar dolor y ser sospechados por calcificaciones curvilineas en radiografias directas del abdomen o en el curso de otros estudios. La aortografia y la arteriografia del tronco celiaco confirmaran el diagnostico. Aunque la ruptura es infrecuente y en general depende de su tamano, la reposicion sanguinea adecuada y la cirugia de hemostasia o de exeresis podran salvar la vida del paciente

HBV and HAV infection in chronic hepatitis in Argentina.

Sera of 155 chronic hepatitis (CH) patients in Argentina were tested for the presence of HBsAg, anti-HBs, anti-HBc, and anti-HAV. Our purpose was to define the role that both virus A and B might play in the etiology and pathogenesis of this condition. The patients were divided into two groups: group I (57) HBsAg-negative; group II (98) HBsAg-positive. The control group consisted of 1,209 healthy blood donors from Banco Central de Sangre de Rosario; 286/1,209 (24%) had viral markers for HBV. In group I, 38/57 (67%) had anti-HBs and/or anti-HBc, but none had anti-HBs alone. Group II showed a higher percentage of males (P less than 0.05). We found similar incidence of anti-HAV among group I, group II, and the control group.

[Transparieto-hepatic cholangiography with Chiba needle]. / La colangiografía transparieto hepática con aguja de Chiba.

253 percutaneous transhepatic cholangiographies with Chiba needle were performed. In 83% of the cases the biliary tract could be visualized. In the patients with extrahepatic cholestasis 92% success was achieved, while only 48% success in the cases with intra-hepatic cholestasis. Complications were developed in 3,87% of cases (choleperitoneum 4, cholangitis 2, hemorrhage 2, paralytic ileum 1, hemobilia 2). There was no mortality. Patients with dilated biliary tract should be operated upon in no more than 24 hours following the procedure.

[Incidence of HAV and HBc antibodies in patients with chronic hepatitis]. / Incidencia de anti HAV y anti AHc en pacientes con hepatitis crónica.

156 patients with chronic hepatitis were studied in Rosario, Argentina. 98 patients were HBsAg positive (group I) and 58 patients were negative (group II). 209 normal volunteer blood donors served as controls (group III). In all cases the presence of anti-HAV was sought by RIA and was found in 92% of cases in group I, 91% in group II and 82% in group II patients. In groups II and III we also determined the presence of anti-HBcAg by RIA being positive in 65% and 15% respectively (p less than 0.01). There were no differences related to sex, age and type of chronic hepatitis. We conclude, firstly that the percentage of anti-HAV is similar in chronic hepatitis and healthy controls; secondly, that 65% of patients with HBsAg negative chronic hepatitis have evidence of virus B infection demonstrated by the presence of anti-HBcAg; finally we remark the greater sensitivity of RIA over hemmagglutination for the detection of anti-HBcAg.

La colangiografía transparieto hepática con aguja de Chiba / [Transparieto-hepatic cholangiography with Chiba needle]

253 percutaneous transhepatic cholangiographies with Chiba needle were performed. In 83

of the cases the biliary tract could be visualized. In the patients with extrahepatic cholestasis 92

success in the cases with intra-hepatic cholestasis. Complications were developed in 3,87

of cases (choleperitoneum 4, cholangitis 2, hemorrhage 2, paralytic ileum 1, hemobilia 2). There was no mortality. Patients with dilated biliary tract should be operated upon in no more than 24 hours following the procedure.

Incidencia de anti HAV y anti AHc en pacientes con hepatitis crónica / [Incidence of HAV and HBc antibodies in patients with chronic hepatitis]

156 patients with chronic hepatitis were studied in Rosario, Argentina. 98 patients were HBsAg positive (group I) and 58 patients were negative (group II). 209 normal volunteer blood donors served as controls (group III). In all cases the presence of anti-HAV was sought by RIA and was found in 92

of cases in group I, 91

in group II and 82

in group II patients. In groups II and III we also determined the presence of anti-HBcAg by RIA being positive in 65

respectively (p less than 0.01). There were no differences related to sex, age and type of chronic hepatitis. We conclude, firstly that the percentage of anti-HAV is similar in chronic hepatitis and healthy controls; secondly, that 65

of patients with HBsAg negative chronic hepatitis have evidence of virus B infection demonstrated by the presence of anti-HBcAg; finally we remark the greater sensitivity of RIA over hemmagglutination for the detection of anti-HBcAg.

La colangiografía transparieto hepática con aguja de Chiba. / [Transparieto-hepatic cholangiography with Chiba needle]

253 percutaneous transhepatic cholangiographies with Chiba needle were performed. In 83

of the cases the biliary tract could be visualized. In the patients with extrahepatic cholestasis 92

success was achieved, while only 48

success in the cases with intra-hepatic cholestasis. Complications were developed in 3,87

of cases (choleperitoneum 4, cholangitis 2, hemorrhage 2, paralytic ileum 1, hemobilia 2). There was no mortality. Patients with dilated biliary tract should be operated upon in no more than 24 hours following the procedure.

Incidencia de anti HAV y anti AHc en pacientes con hepatitis crónica. / [Incidence of HAV and HBc antibodies in patients with chronic hepatitis]

156 patients with chronic hepatitis were studied in Rosario, Argentina. 98 patients were HBsAg positive (group I) and 58 patients were negative (group II). 209 normal volunteer blood donors served as controls (group III). In all cases the presence of anti-HAV was sought by RIA and was found in 92

of cases in group I, 91

in group II and 82

in group II patients. In groups II and III we also determined the presence of anti-HBcAg by RIA being positive in 65

and 15

respectively (p less than 0.01). There were no differences related to sex, age and type of chronic hepatitis. We conclude, firstly that the percentage of anti-HAV is similar in chronic hepatitis and healthy controls; secondly, that 65

of patients with HBsAg negative chronic hepatitis have evidence of virus B infection demonstrated by the presence of anti-HBcAg; finally we remark the greater sensitivity of RIA over hemmagglutination for the detection of anti-HBcAg.

The role of the hepatitis B virus infection in patients with chronic hepatitis in Argentina.

Over a seven-year period, we monitored 221 patients with chronic hepatitis from two medical centers. By using the counterlectrophoresis (CEP) test to detect the presence of HBsAg and anti-HBc, or both, we established that 87.7% of them had hepatitis B infection. Serum specimens originally found negative for HBsAg by CEP were further tested by reversed passive hemagglutination (RPH), and those originally found negative for anti-HBc by CEP were further tested by radioimmunoassay (RIA). Five patients were anti-HBc-positive and HBs-Ag-negative. No sex predominance was observed, but HBsAg incidence increased with increasing age. The HBeAg antigen was detected in 46.8% of the 161 cases tested for it; the most frequent subtype found was adw (63.7%). The present findings indicate that HBV infection largely contributes to the development of chronic hepatitis in Argentinian patients.

Prognostic implications of the e antigen of hepatitis B virus.

The e antigen HBeAg and its antibody anti-HB, have been said to be predictive of chronicity and resolution, respectively, in viral hepatitis. We found, as have others, a specific association with hepatitis B virus-induced disease. In addition, detectability of HBeAg in the acute phase of type B hepatitis was followed by a sixfold higher incidence of chronic hepatitis. Unfortunately, the prediction was erroneous in 65% of positive cases and 6% of negative cases. In chronic hepatitis, HBeAg did not necessarily disappear in advance of resolution, and its disappearance did not necessarily indicate resolution. Two patients with acute hepatitis progressing to chronicity were anti-HBe-positive in both phases, as were seven (5%) with chronic hepatitis. For individual patients, therefore, HBeAg and anti HBe are not prognostically useful indexes.

LP-X in cholestasis.

Extrahepatic and intrahepatic biliary obstruction of different etiology were studied in 62 patients, who were investigated for the presence of lipoprotein X (Lp-X). It was found present in 19 of 20 cholestasis by lithiasis, in all three primary biliary cirrhosis patients, in 2 of 4 cirrhosis, in 5 of 13 hepatitis, in all three benign recurrent intrahepatic cholestasis and in 1 of 2 recurrent juandice of pregnancy. It was found in a Dubin Johnson. Lp-X disappeared in 4 patients within two weeks after relief of the obstruction. It was found in patients with cholestatic hepatitis during the first week of jaundice. It was found in the first 48 hours in three patients with cholestasis by lithiasis. Lp-X does not help in differential diagnosis between extrahepatic and intrahepatic biliary obstruction, but the time of its appearance could contribute to it in some cases. A word of caution is raised in indicating surgery in a cholestatic patient without the presence of Lp-X.

[The frequency of the e-antigen in acute and chronic hepatitis (author's transl)]. / Das e-Antigen bei akuter und chronischer Hepatitis

Five groups of patients were studied: (a) 88 HBsAg-positive cases of acute viral hepatitis (AVH) who completely cured within 90 days; (b) 75 cases of acute HBsAg-negative hepatitis with early resolution; (c) 15 AVH patients who became chronic; (d) 94 HBsAg-positive cases of chronic hepatitis (CH) and liver cirrhosis; (e) HBsAg-negative cases with CH. The e-antigen was investigated in every patient and was found in 9 of the AVH cases with favorable evolution, and in 8 of the AVH patients evolving to chronicity. Amont the CH and cirrhosis group, 48 of the HBsAg carriers were positive while e-antigen could not be detected in any of the HBsAg-negative ones. The high incidence of e-antigen carriers among patients with chronic hepatitis and liver cirrhosis as well as among those with AVH who later entered the chronic stage of the disease, deserves especial consideration. A possible role of e-antigen in the evolution to chronicity and a prognostic significance is suggested.