Differential diagnosis, laboratory tests and histology in 245 patients with cholestasis.

In the course of 4 years, among 11,738 admissions there were 245 (2.08%) patients with cholestasis (106 women and 139 men). Intrahepatic cholestasis (i.c.) was detected in 46.5%, and extrahepatic (e.c.) in 53.5%. The most frequent cause of i.c. were alcoholic and nonalcoholic chr. liver disease (fatty liver, chr. hepatitis, cirrhosis) (37% and 30%), acute viral hepatitis (15%) and toxic liver injury (14%) respectively. The causes of e.c. were: choledocholithiasis (44%), cancer of the pancreatic head (15%), cancer of gallbladder and extrahepatic ducts (12%) and cancer of liver (10%). The causes of c. were benigne, in 78.2%, while malignant neoplasms were present in 21.8%. Out of the multitude of laboratory tests two appeared particularly significant: glut, transpeptidase was pathologic in 81% of alcoholic liver disease, in 62% of the cases with obstructive jaundice and in 27.7% of malignant neoplasms. LX-lipoprotein examined in 52 patients was positive in 24% of i.c., and 60% of e.c. Proliferation of bile ducts was the most frequent finding in surgical liver biopsies in choledocholithiasis cases.

[Morphological study of 2 cases of congenital toxoplasmosis]. / Morfoloska studija dva slucaja kongenitalne toksoplazmoze

A morphological study of two cases of acute generalized congenital toxoplasmosis has shown that in one case the most heavily involved organ was the heart (focal necrotic myocarditis), in addition to some changes in the central nervous system (leptomeningitis), and in the other case, the most affected organ was the cerebrum (focal necrotic encephalitis). In both cases, in almost all organs, there were degenerative and reactive changes. Toxoplasma was found in necrotic foci of the myocardium and the brain. Some basic views concerning a special vulnerability of the central nervous system in toxoplasmosis are put forward. The basic fact is that the explanation for the infection of exposed fetuses lies in the condition of the immune system (in the degree of its development and activity), especially regarding certain localizations of changes in the organs with a less developed activity of the local immune system.

[Diagnostic and prognostic criteria in acute non-A, non-B viral hepatitis with a prolonged course]. / Dijagnosticki i prognosticki kriterijumi u akutnom virusnom hepatitisu "ni-A-ni-Be" produzenog toka.

In a prospective three-year-long study of Non-A, Non-B infections carried out in the Institute of Infectious and Tropical Diseases in Belgrade, by a method of exclusion and in about 30% of patients' liver biopsies, 75 cases of acute viral hepatitis Non-A, Non-B were discovered. It makes only 2.29% of all cases of acute viral hepatitis diagnosed and treated in the same period in this institution. In prolonged forms of the disease (24 cases) the chronicity was shown by epidemiological data (posttransfusion hepatitis), fluctuation of transaminase and rise of gamma globulins in acute phase of the disease. Liver biopsies performed in the first four months of the disease were of no prognostic value.