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Seroprevalence of hepatitis B and C in the Dutch population
Miscellaneous
[ C11/09 I
[ C11/11 ]
BILIARY IMAGING USING SPIRAL CT CHOLANGIOGRAPHY. A SINGLE CENTRE EXPERIENCE M. Hcydtmann. A. Sebastian. A. Parnell. M. Ahmed Good Hope Hospital, Rectory Road, Sutton Coldfield B75 7RR. Introduction: CT cholangiography (CTC) employs spiral CT scanning after the administration of biliary contrast medium to generate images of the biliary tract. We reviewed 47 patients who had undergone CTC to determine the clinical utility of this technique.
SEROPREVALENCE OF HEPATITIS B AND C IN THE DUTCH POPULATION M.A.E. Convn-van Svaendonck1. I.K. Veldhuijzon], C.J. van Marrewijk ], J.W. Dorigo-Zetsma2 :Dept. of Infectious Diseases Epidemiology, National Institute of Public Health and the Environment, Bilthoven, The Netherlands. 2Laboratory for Infectious Diseases Diagnostics and Screening, National Institute of Public Health and the Environment, Bilthoven, The Netherlands. Background: In 1991, the World Health Organization (WHO) advised all countries ~ implement general vaccination against hepatitis B. In the Netherlands, ohanging of the vaccination policy from selective vaccination of risk groups to general vaccination is still under discussion. The seroprevalence of hepatitis B and C in the general Dutch population has never been studied before. Objective: To determine the seroprevalence of hepatitis B (HBV) and C (HCV) viral markers in the general Dutch population. Methods: Sera from a semmbank established in 1995-96by means of a crosssectional population-basedstudy were tested for antibodies against hepatitis B core antigen (anti-HBc),hepatitis B surface antigen (HBsAg), and antibodies against hepatitis C virus (anti-HCV). The seroprcvalenccwas calculated and described in relation to variables on demographics and sexual history. Results: A total of 7373 sere of men and women aged 0-79 years were tested. The seroprevalence of current or past infection (anti-HBc) and of I-IBV infectiousness (HBsAg) in the general Dutch population was 2.1% (95°6 CI: 1.6-2.7°6) and 0.2% (95% CI: 0.0-0.3°6) respectively. The anti-HBc prevalence increased with age. A positive association with urbanization was found. Numbers were too sman to show clear relations with several known risk factors for HBV infection, except for allochtonous, especially Turkish individuals, among which HBV infection is more camanon.The seroiacvalence of anti-HCV was 0.98960(95% CI: 0.06-1.8996o). In most of the HCV infected individuals risk factors wore not present. Conehmions: This study provided valid estimates for the seroprevalance of hepatitis B and C in the general Dutch population. The seroprevalencefor both hepatitis B and C is low compared to most West European countries.
Patients and Methods: 47 consecutive patients (16 male, 31 female; median age 57, range 32-82 yrs) had CTC between 4/6/98 and 8/9/99. The results of the CTC were analysed retrospectively to determine technical success rate of the imaging procedure and to correlate imaging diagnosis with results of other diagnostic procedures and with clinical follow-up. Results: Indications for CTC were: gall stone pancreatitis (5), biliary type pain (15), abnormal USS (20), abnormal liver biochemistry / jaundice (6), other (3). In 46 patients (98 %), CTC was technically successful (the 1 failure was in a patient with a bilirubin of 53). An abdominal USS was performed in 42 patients prior to CTC. There was good agreement between the two modalities in terms of biliary duct dilation and presence of duct stones. 10 patients underwent successful ERCP following CTC (with 1 further failed ERCP) - - there was reasonable agreement in terms of bile duct dimension (7/10) and duct stones (8/10) between CTC and ERCP. 19 patients underwent cholecystectomy following CTC with on-table cholangiograms performed in only two cases (both normal, in agreement with CTC). Conclusion: CTC is a robust technique for imaging of the biliary tract and is a valuable addition to the battery of non-invasive biliary investigations.
Cl1/10
]
"SLOW-DOWN" OF THE INTRAHEPATIC BILE DUCT DEVELOPMENT BETWEEN THE 2ND AND THE 3RD TRIMESTER OF GESTATION C. Sergi, S. Adam, P Kahl, H.E Otto Institute of Pathology, University Hospital, INF 220, D-69120 Heidelberg, Germany.
AimR: To evaluate the progressive remodeling of the human primitive biliary structures, we studied the liver in 57 normal
human fetuses and infants (15-40 weeks of gestation) by both immunohistochemistry and computer-based image-analysis. Methods: Anti-bile duct type cytokeratins (CK 7, CK 19) and pan-cytokeratins (AE 1+3) Mo-Abs and the avidin-biotinperoxidase technique were used. A computer-based imageanalysis system was used for quantitative and morphometric studies. W e used a complex set-up: light microscope, CCD greyscale video camera, BNC cable hook-up, Intel-based personal computer equipped with video frame grabber card, Windows 3.11 operating system, Bioscan Optimas version 5.2 software n m n i n g in interlaced mode, a 2 0 " colour monitor, and a drawing pad equipped with an induction mouse. R e m i t s : The maturation o f bile ducts is a process continuous and active up to term, but a "slow d o w n " o f the mean values of the surface and perimeter o f the portal tracts as well as o f the m e a n values o f the longest external and luminal axis of pcri'pheral ductular structures occurs between the 20 th and the 3 2 " week o f gestation. Conclusion: The intrahepatic bile duct development is accelerated before 21 and after 32 weeks o f gestation.
I C11/12
I
VITRONECTIN INDUCES MIGRATION OF ACTIVATED T LYMPHOCYTES S. Edwards. K. Price, D.H. Adams MRC Centre for Immune Regulation, Queen Elizabeth Hospital, Birmingham B30 2TH. The extracellular matrix glycoprotein vitronectin is a significant component o f hepatic turnout stroma and might play a role in leukocyte recruitment and retention. We examined the ability o f vitronectin to support migration o f activated peripheral blood T lymphocytes (PBL) and turnout infiltrating lymphocytes (TIL) from hepatic colorectal cancer metastases and whether this retention was mediated by ~vJ33. Methods TIL and PBL migration to vitronectin was assessed using an in-vitro chemotaxis assay. Cells were analysed by fluorescence microscopy to determine whether ligation o f the vitronectin receptor resulted in cytoskeletal rearrangement and actin polymerisation. (Zv[33expression on leukocytes was determined by flow cytometry. Results TIL and activated PBL migrated to vitronectin. Optimal PBL migration correlated with ctvJ33 upregulation, although TIL migration was not mediated by (xd33. Vitronectin stimulation induced a change from cortical actin to discrete localisation o f actin filaments. S u m m a r y Vitronectin can trigger haptotaxis and chemotaxis o f activated T lymphocytes. TIL show minimal (Zv[33 dependent migration whereas activated blood T cells respond in an CZv[33dependent manner. Conclusions Vitronectin is a pro-migratory factor for activated T cells and may regulate lymphocyte migration through the extracellular matrix in hepatic turnouts.
225
[ C11/09 I
[ C11/11 ]
BILIARY IMAGING USING SPIRAL CT CHOLANGIOGRAPHY. A SINGLE CENTRE EXPERIENCE M. Hcydtmann. A. Sebastian. A. Parnell. M. Ahmed Good Hope Hospital, Rectory Road, Sutton Coldfield B75 7RR. Introduction: CT cholangiography (CTC) employs spiral CT scanning after the administration of biliary contrast medium to generate images of the biliary tract. We reviewed 47 patients who had undergone CTC to determine the clinical utility of this technique.
SEROPREVALENCE OF HEPATITIS B AND C IN THE DUTCH POPULATION M.A.E. Convn-van Svaendonck1. I.K. Veldhuijzon], C.J. van Marrewijk ], J.W. Dorigo-Zetsma2 :Dept. of Infectious Diseases Epidemiology, National Institute of Public Health and the Environment, Bilthoven, The Netherlands. 2Laboratory for Infectious Diseases Diagnostics and Screening, National Institute of Public Health and the Environment, Bilthoven, The Netherlands. Background: In 1991, the World Health Organization (WHO) advised all countries ~ implement general vaccination against hepatitis B. In the Netherlands, ohanging of the vaccination policy from selective vaccination of risk groups to general vaccination is still under discussion. The seroprevalence of hepatitis B and C in the general Dutch population has never been studied before. Objective: To determine the seroprevalence of hepatitis B (HBV) and C (HCV) viral markers in the general Dutch population. Methods: Sera from a semmbank established in 1995-96by means of a crosssectional population-basedstudy were tested for antibodies against hepatitis B core antigen (anti-HBc),hepatitis B surface antigen (HBsAg), and antibodies against hepatitis C virus (anti-HCV). The seroprcvalenccwas calculated and described in relation to variables on demographics and sexual history. Results: A total of 7373 sere of men and women aged 0-79 years were tested. The seroprevalence of current or past infection (anti-HBc) and of I-IBV infectiousness (HBsAg) in the general Dutch population was 2.1% (95°6 CI: 1.6-2.7°6) and 0.2% (95% CI: 0.0-0.3°6) respectively. The anti-HBc prevalence increased with age. A positive association with urbanization was found. Numbers were too sman to show clear relations with several known risk factors for HBV infection, except for allochtonous, especially Turkish individuals, among which HBV infection is more camanon.The seroiacvalence of anti-HCV was 0.98960(95% CI: 0.06-1.8996o). In most of the HCV infected individuals risk factors wore not present. Conehmions: This study provided valid estimates for the seroprevalance of hepatitis B and C in the general Dutch population. The seroprevalencefor both hepatitis B and C is low compared to most West European countries.
Patients and Methods: 47 consecutive patients (16 male, 31 female; median age 57, range 32-82 yrs) had CTC between 4/6/98 and 8/9/99. The results of the CTC were analysed retrospectively to determine technical success rate of the imaging procedure and to correlate imaging diagnosis with results of other diagnostic procedures and with clinical follow-up. Results: Indications for CTC were: gall stone pancreatitis (5), biliary type pain (15), abnormal USS (20), abnormal liver biochemistry / jaundice (6), other (3). In 46 patients (98 %), CTC was technically successful (the 1 failure was in a patient with a bilirubin of 53). An abdominal USS was performed in 42 patients prior to CTC. There was good agreement between the two modalities in terms of biliary duct dilation and presence of duct stones. 10 patients underwent successful ERCP following CTC (with 1 further failed ERCP) - - there was reasonable agreement in terms of bile duct dimension (7/10) and duct stones (8/10) between CTC and ERCP. 19 patients underwent cholecystectomy following CTC with on-table cholangiograms performed in only two cases (both normal, in agreement with CTC). Conclusion: CTC is a robust technique for imaging of the biliary tract and is a valuable addition to the battery of non-invasive biliary investigations.
Cl1/10
]
"SLOW-DOWN" OF THE INTRAHEPATIC BILE DUCT DEVELOPMENT BETWEEN THE 2ND AND THE 3RD TRIMESTER OF GESTATION C. Sergi, S. Adam, P Kahl, H.E Otto Institute of Pathology, University Hospital, INF 220, D-69120 Heidelberg, Germany.
AimR: To evaluate the progressive remodeling of the human primitive biliary structures, we studied the liver in 57 normal
human fetuses and infants (15-40 weeks of gestation) by both immunohistochemistry and computer-based image-analysis. Methods: Anti-bile duct type cytokeratins (CK 7, CK 19) and pan-cytokeratins (AE 1+3) Mo-Abs and the avidin-biotinperoxidase technique were used. A computer-based imageanalysis system was used for quantitative and morphometric studies. W e used a complex set-up: light microscope, CCD greyscale video camera, BNC cable hook-up, Intel-based personal computer equipped with video frame grabber card, Windows 3.11 operating system, Bioscan Optimas version 5.2 software n m n i n g in interlaced mode, a 2 0 " colour monitor, and a drawing pad equipped with an induction mouse. R e m i t s : The maturation o f bile ducts is a process continuous and active up to term, but a "slow d o w n " o f the mean values of the surface and perimeter o f the portal tracts as well as o f the m e a n values o f the longest external and luminal axis of pcri'pheral ductular structures occurs between the 20 th and the 3 2 " week o f gestation. Conclusion: The intrahepatic bile duct development is accelerated before 21 and after 32 weeks o f gestation.
I C11/12
I
VITRONECTIN INDUCES MIGRATION OF ACTIVATED T LYMPHOCYTES S. Edwards. K. Price, D.H. Adams MRC Centre for Immune Regulation, Queen Elizabeth Hospital, Birmingham B30 2TH. The extracellular matrix glycoprotein vitronectin is a significant component o f hepatic turnout stroma and might play a role in leukocyte recruitment and retention. We examined the ability o f vitronectin to support migration o f activated peripheral blood T lymphocytes (PBL) and turnout infiltrating lymphocytes (TIL) from hepatic colorectal cancer metastases and whether this retention was mediated by ~vJ33. Methods TIL and PBL migration to vitronectin was assessed using an in-vitro chemotaxis assay. Cells were analysed by fluorescence microscopy to determine whether ligation o f the vitronectin receptor resulted in cytoskeletal rearrangement and actin polymerisation. (Zv[33expression on leukocytes was determined by flow cytometry. Results TIL and activated PBL migrated to vitronectin. Optimal PBL migration correlated with ctvJ33 upregulation, although TIL migration was not mediated by (xd33. Vitronectin stimulation induced a change from cortical actin to discrete localisation o f actin filaments. S u m m a r y Vitronectin can trigger haptotaxis and chemotaxis o f activated T lymphocytes. TIL show minimal (Zv[33 dependent migration whereas activated blood T cells respond in an CZv[33dependent manner. Conclusions Vitronectin is a pro-migratory factor for activated T cells and may regulate lymphocyte migration through the extracellular matrix in hepatic turnouts.
225