This study concerns 105 patients with acute viral hepatitis, apparently contracted abroad. They comprised 27% of all cases of traveller's hepatitis notified in Denmark during 1976 to 1978. 88% were HBsAg-negative, probably type A hepatitis. 85% of the patients were aged 18-45 years. Two-thirds of all patients had been on individual journeys for more than 2 weeks, mainly in Africa or Southern Asia. Areas of risk for tourist group travellers (30 cases) were established to be Northern and Central Africa. The data support the present restricted use of immune serum globulin rather than general prophylaxis to all travellers.

The galactose elimination capacity and the plasma clearance of phenazone were investigated in 24 patients with uncomplicated acute hepatitis and in 8 patients who survived and in 26 who died of fulminant hepatitis. The galactose elimination capacity was 52% of the normal mean value on admission to the hospital in uncomplicated hepatitis, 47% in patients who survived fulminant hepatitis, and 22% in the fatal cases, while the plasma clearance of phenazone was 43%, 22%, and 10%, respectively. Both quantitative liver function tests showed rapid improvement in most cases of uncomplicated acute hepatitis and in the patients who survived fulminant hepatitis. They did not improve in the fatal cases of fulminant hepatitis, among whom the patients with the lowest initial values died first. Both the galactose elimination capacity and the plasma clearance of phenazone were significantly higher in survivors than in non-survivors of fulminant hepatitis. The results indicate that the loss of functioning liver cell mass is about 60-70% in the acute stage of uncomplicated hepatitis and 80-85% in patients who survive fulminant hepatitis, whereas patients who die of fulminant hepatitis have nearly total loss of functioning liver cell mass.

Severe combined immunodeficiency (SCID) was diagnosed in a girl immediately after birth; her older brother had SCID and was successfully reconstituted by bone marrow transplantation from his uncle. She was isolated in a laminar air flow bench and decontaminated. The father differed by one HLA-A antigen but was HLA-Dw2 homozygous like the patient; his lymphocytes showed a slight response to the patient's cells in mixed lymphocyte culture (MLC). At the age of 2 1/2 months and again at 5 months, she was given a bone marrow transplant from the father. During the entire course the patient had no infections, and apart from a transient eosinophilia she had no signs of graft-versus-host reaction. Immunological reconstitution was nearly complete at 9 months of age, when she was recontaminated. One year later plasma immunoglobulin concentrations are in the low normal range (IgG and IgM) or decreased (IgA); tests of cell-mediated immunity are normal. Apart from slight upper respiratory infections, the patient has been healthy. Physical and psychological development have been normal.

In 131 patients on a medical service and 97 patients on a surgical service, in whom a diagnosis of hepatobiliary disease was verified in the hospital, the diagnostic value of routine liver tests performed soon after admission was evaluated by stepwise discriminant analysis. By measurements of alanine aminotransferase, alkaline phosphatases, gamma globulin, prothrombin time, bilirubin, and albumin, half of the medical patients were correctly classified into one of seven diagnostic categories. Aminotransferase contributed most to the classification, being twice as effective as random allocation. Decreasing the number of diagnostic categories to three (hepatitis, fatty liver, and chronic liver disease) increased the frequency of correct allocation to 80%. The allocation of all the patients to seven medical and four surgical diagnostic categories by means of four tests (aminotransferase, alkaline phosphatases, prothrombin time, and bilirubin) was significantly improved by each step with a misclassification rate of 55% when all tests were used. A reduction of the diagnostic groups to five (hepatitis, fatty liver, chronic liver disease, duct obstruction and tumor) increased the frequency of correct allocation to 63%. The analysis demonstrates the limited diagnostic effectiveness of routine liver tests when used alone. The absolute discrimination values depend on the a priori frequencies of the diagnostic groups investigated, and therefore may vary from time to time and from place to place.

In 31 patients with cirrhosis of the liver undergoing porta-caval shunt surgery, the prognostic value of some liver function tests was studied. The surgical mortality was not correlated with the test results. Serum concentrations of bilirubin, albumin, and prothrombin were not correlated with postoperative encephalopathy, but the mutually correlated preoperative galactose elimination capacity and age of patients were correlated with encephalopathy development. Incapacitating encephalopathy mainly occurred in patients above 60 years of age, and when the galactose elimination capacity was at or less than an arbitrary limit of 225 mg/min. The liver function decreased significantly following operation.

Albumin and IgG turnover were studied in 12 patients with chronic active liver disease before, and at a variable time interval during, prolonged prednisone treatment. Before treatment, serum albumin concentration was subnormal in 9 and albumin synthetic rate reduced in 6 and low normal in 4. Serum IgG concentration and IgG synthetic rate were increased in all patients. During treatment 8 patients improved or were unchanged, and 4 deteriorated. In the former group the mean serum albumin concentration and albumin synthetic rate increased significantly, in the latter both values decreased. Serum IgG concentration and IgG synthetic rate decreased in all but one during treatment. The changes were more pronounced in the former than in the latter group. The changes in serum concentrations and synthetic rates of albumin and IgG were significantly negatively correlated, both in the whole material, and especially in patients who improved. The synthetic rates of albumin and IgG were not correlated before or during prednisone administration. Corticosteroids probably inhibit antibody production and stimulate albumin synthesis in chronic liver disease by two separate mechanisms.Key-words: Albumincirrhosis of the liverIgGprednisoneprotein turnover

Four patients with active, non-alcoholic cirrhosis and high serum gamma globulin levels were treated with extracorporeal irradiation of the blood (ECI) on the premise that the irradiation-induced lymphocytopenia might suppress the immune processes in the liver and thereby improve liver function. One patient died from a bleeding stomach ulcer. In the surviving patients an increase in galactose elimination capacity and prothrombin concentration was found; other liver function tests showed non-significant changes. Serum immunoglobulin concentrations and IgG turn-over rate were unaffected by the treatment. In 2 patients liver biopsy 3 months after ECI showed no change in lymphocyte and plasma cell infiltration. ECI thus cannot be considered a promising mode of treatment in active cirrhosis.Key-words: Blood, radiation effectsimmunosuppressive agentsliver cirrhosisliver function tests

ArticleLiver function and blood flow at high altitude.K Ramsoe, S Jarnum, R Preisig, J Tauber, N Tygstrup, and H WestergaardK Ramsoe, S Jarnum, R Preisig, J Tauber, N Tygstrup, and H WestergaardPublished Online:01 Jun 1970https://doi.org/10.1152/jappl.1970.28.6.725MoreSectionsPDF (691 KB)Download PDF ToolsExport citationAdd to favoritesGet permissionsTrack citations ShareShare onFacebookTwitterLinkedInWeChat Previous Back to Top Next Download PDF FiguresReferencesRelatedInformation Cited ByEvaluating the Risks of High Altitude Travel in Chronic Liver Disease PatientsHigh Altitude Medicine & Biology, Vol. 16, No. 2Liver Function in Rats Acclimatized to a Simulated Altitude of 5500 mHigh Altitude Medicine & Biology, Vol. 14, No. 4Cytochrome P450 enzyme-mediated drug metabolism at exposure to acute hypoxia (corresponding to an altitude of 4,500�m)4 February 2005 | European Journal of Clinical Pharmacology, Vol. 61, No. 1Maternal electrolyte and liver function changes during pregnancy at high altitudeClinica Chimica Acta, Vol. 328, No. 1-2Glucose Metabolism in Pregnancy at High AltitudeDiabetes Care, Vol. 24, No. 5Biochemical adaptations to moderately high altitude livingJournal of Wilderness Medicine, Vol. 2, No. 4Vascular responsiveness in obstructed gutDiseases of the Colon & Rectum, Vol. 34, No. 3Human cardiovascular adjustments to acute hypoxaemiaClinical Physiology, Vol. 7, No. 5Hypoxia and the HeartAcute and chronic hypoxia in rats. 1. Effect on organismic respiration, mitochondrial protein mass in liver and succinic dehydrogenase activity in liver, kidney and heartJournal of Experimental Zoology, Vol. 210, No. 1Intestinal function in infants with severe congenital heart diseaseThe Journal of Pediatrics, Vol. 92, No. 4Bilirubinemia and intravascular hemolysis during acclimatization to high altitudeInternational Journal of Biometeorology, Vol. 21, No. 2Regional blood flow responses to hypoxia and exercise in altitude-adapted ratsEuropean Journal of Applied Physiology and Occupational Physiology, Vol. 33, No. 2Adaptation to High AltitudeNew England Journal of Medicine, Vol. 284, No. 23 More from this issue > Volume 28Issue 6June 1970Pages 725-7 https://doi.org/10.1152/jappl.1970.28.6.725PubMed5419492History Published online 1 June 1970 Published in print 1 June 1970 Metrics

Multivariate discriminant analysis was applied to 9 laboratory tests, per formed in 17 patients with cirrhosis and 19 control subjects. Bromsulfalein transport maximum was the most effective test in discriminating between the two groups. The combination of all 9 tests could not be shown to discriminate significantly better than the combination of bromsulfalein transport maximum and gamma-globulin. These 2 tests, however, could be replaced by the remaining 7 tests without a significant loss of discriminative information. The result of the discriminant analysis is greatly dependent on the size and selection of the materials. In larger materials more tests with significant contribution to the discrimination may be found.Key Words: A priori probabilitydiscriminant analysislaboratory diagnosisliver cirrhosisliver function tests

ArticleDegradation of albumin and IgG at high altitude.H Westergaard, S Jarnum, R Preisig, K Ramsoe, J Tauber, and N TygstrupH Westergaard, S Jarnum, R Preisig, K Ramsoe, J Tauber, and N TygstrupPublished Online:01 Jun 1970https://doi.org/10.1152/jappl.1970.28.6.728MoreSectionsPDF (1 MB)Download PDF ToolsExport citationAdd to favoritesGet permissionsTrack citations ShareShare onFacebookTwitterLinkedInWeChat Previous Back to Top Next Download PDF FiguresReferencesRelatedInformation Cited ByThe scales of coevolution: comparative phylogeography and genetic demography of a locally adapted venomous predator and its prey21 December 2020 | Biological Journal of the Linnean Society, Vol. 132, No. 2Regulation of plasma volume in male lowlanders during 4 days of exposure to hypobaric hypoxia equivalent to 3500 m altitude16 November 2020 | The Journal of Physiology, Vol. 65Variability in human plasma volume responses during high‐altitude sojourn28 March 2019 | Physiological Reports, Vol. 7, No. 6Hemoglobin mass and intravascular volume kinetics during and after exposure to 3,454-m altitudeC. Siebenmann, A. Cathomen, M. Hug, S. Keiser, A. K. Lundby, M. P. Hilty, J. P. Goetze, P. Rasmussen, and C. Lundby15 November 2015 | Journal of Applied Physiology, Vol. 119, No. 10Enhanced synthesis of albumin and fibrinogen at high altitudeReinhard Imoberdorf, Peter J. Garlick, Margaret A. McNurlan, George A. Casella, Edgar Peheim, Meral Turgay, Peter Bärtsch, and Peter E. Ballmer1 February 2001 | Journal of Applied Physiology, Vol. 90, No. 2Plasma Protein MetabolismActa Anaesthesiologica Scandinavica, Vol. 18The Effect of Hypoxia and Carbon Monoxide Exposure on Plasma Volume and Capillary Permeability to Albumin8 July 2009 | Scandinavian Journal of Clinical and Laboratory Investigation, Vol. 30, No. 1 More from this issue > Volume 28Issue 6June 1970Pages 728-32 https://doi.org/10.1152/jappl.1970.28.6.728PubMed5419493History Published online 1 June 1970 Published in print 1 June 1970 Metrics