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Asymptomatic blood donors with persistent HBs antigenaemia have a variety of histological lesions in the liver, and serial biopsies indicate that, in some, these lesions may progress. The immunoperoxidase technique was found to be a sensitive method for the histological demonstration of HBsAg and HBcAg. Livers showing minor histological changes contained more HBsAg than those with active lesions and there appears to be an inverse relationship between the amount of HBsAg in the liver and the severity of the histological damage. In the carriers who had more than one biopsy, the presence of stainable HBsAg, irrespective of the initial histological diagnosis, was associated with a greater likelihood of progression of the histological lesion. HBcAg was found only in the hepatocyte nuclei of carriers with chronic aggressive and chronic persistent hepatitis. [ABSTRACT FROM PUBLISHER]

The degree of inflammation in the trachea, bronchi, and lungs of 139 cot deaths has been analysed and each case allocated to one of four groups. In group I the changes were considered to be serious enough to have caused death, while group II cases showed similar abnormalities but of a less severe nature, and in this group there was some doubt as to whether they were a significant cause of death. Group III lesions were very minor in type and were not considered to be serious enough to have resulted in the death of the child. There was a good correlation between the degree of inflammation in the respiratory tract, and whether or not bacteria of any type were grown. The great majority of the bacterial pathogens were isolated from the first two groups. Respiratory viruses were isolated from three of the four cases of acute bronchiolitis included in group I, and also from a group II case which showed considerable bronchiolar inflammation. One-third of the cases with minor inflammation in the lung parenchyma (group III) showed some evidence of recent virus infection. [ABSTRACT FROM PUBLISHER]

Liver biopsies from 97 hepatitis B antigen (HBsAG)-positive patients were stained by a modified orcein method described by Shikata et al (1974) in order to detect the antigen in liver tissue. The results were consitently negative in acute hepatitis, but positive in nearly two-thirds of biopsies from 53 patients with chronic liver disease. The distribution of positive staining was frequently irregular so that there is a problem of sampling error in needle biopsies. The deposits were seen in the cytoplasm of liver cells and occasionally in Kupffer cells, but never in nuclei. There was an inverse relationship between staining and parenchymal necrosis. Biopsies from asymptomatic HB(s)Ag carriers were often strongly positive, as were "ground-glass" hepatocytes in carriers and patients with chronic liver disease. The mechanism of staining is unclear but may be related to the presence of disulphide bonds in (HBsAG. The technique is simple and of use both in fresh and stored material. [ABSTRACT FROM PUBLISHER]

Thirty-four healthy blood donors, found to be persistent HBAg carriers, have been investigated by means of serial liver function tests, bromsulphthalein (BSP) retention, and liver biopsy. Thirty-one of the donors had histological abnormalities including one with cirrhosis, three with chronic aggressive hepatitis, and 11 with chronic persistent hepatitis. In 13 biopsies there were focal areas of necrosis in the liver parenchyma. Serial liver function tests revealed abnormalities in each of the donors with cirrhosis or with chronic aggressive hepatitis, in seven of the 11 donors with chronic persistent hepatitis, and in seven of the 13 with focal parenchymal necrosis. The degree of BSP retention was greatest (>11%) in the donors with chronic aggressive hepatitis. The severity of the histological changes was related neither to the titre of the antigen in the serum nor to the presence of autoantibodies. [ABSTRACT FROM PUBLISHER]

Three patients were found at necropsy to have Zahn's `infarcts' of the liver. In one of these cases the `infarct' merely showed severe centrilobular congestion. In the other two cases there was centrilobular necrosis, and in one of these early fibrosis was seen. Portal vein occlusion was present in all three cases and this had followed splenectomy in two of them. There was no evidence of hepatic artery or vein occlusion. Circulatory failure is considered to have played a part in the pathogenesis of the lesions. [ABSTRACT FROM PUBLISHER]

Initial liver biopsies from asymptomatic HBs antigen positive blood donors showed a range of histological abnormalities ranging from minor parenchymal lesions to cirrhosis. Twenty of these have now been followed up for periods of up to four years and during that time have had at least two liver biopsies. Throughout the period of study all the donors have remained carriers of HBs Ag, and there was no significant variation in the titers of antigen or the electron microscopic appearances of the serum in individual donors. The histological appearances of subsequent liver biopsies were not always the same as those seen initially, and while there appeared to be some improvement in three cases, there were nine in which the histological appearances were worse. [ABSTRACT FROM PUBLISHER]

The sera of 36 blood donors who are established HBsAg carriers were examined with the electron microscope. The findings were correlated with the histological and electronoptic appearances of the liver and the titre and subtype of the antigen. Antigen-antibody complexes could not be detected. Dane particles constituted 2 percent or more of the total particle count in five of the 36 sera, including three sera from five carriers with chronic aggressive hepatitis and two sera from 11 carriers with chronic persistent hepatitis. In sera from carriers with normal histology or the minimal histological lesion of focal parenchymal necrosis they were detected very infrequently or not at all. Three biopsies revealed intranuclear inclusions when examined electronoptically and the corresponding sera all contained greater than 2 percent Dane particles. Where greater than 2 percent Dane particles were seen the antigen titre tended to be high. The predominant subtype was ad. There was no correlation between the number of Dane particles and the antigen subtype nor between subtype and histology. [ABSTRACT FROM PUBLISHER]

An unusual tumour of the urinary bladder is described. It consists of two distinct nodules each with a quite different histological appearance, one being mucus-secreting adenocarcinoma, the other transitional cell carcinoma. Where the nodules are in contact there is little intermingling of the two histological patterns and it is suggested that the findings are probably due to the collision of two separate neoplasms. Metaplastic changes are present in the bladder mucosa adjacent to the tumour. The significance of these changes in the pathogenesis of adanocarcinoma is discussed. [ABSTRACT FROM PUBLISHER]

Three patients were found at necropsy to have Zahn's ;infarcts' of the liver. In one of these cases the ;infarct' merely showed severe centrilobular congestion. In the other two cases there was centrilobular necrosis, and in one of these early fibrosis was seen. Portal vein occlusion was present in all three cases and this had followed splenectomy in two of them. There was no evidence of hepatic artery or vein occlusion. Circulatory failure is considered to have played a part in the pathogenesis of the lesions.