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Checchia P, Benettoni M, Bettella G, Conti E, Cossutta L, Furlan M, Gonella F, Klinger J, Montecassiano F, Nebbia G, Pegoraro M, Pesente S, Rigoni Garola A, Urbani M, Viesti G, Vanini S, Zumerle G. INFN muon tomography demonstrator: past and recent results with an eye to near-future activities. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2018; 377:rsta.2018.0065. [PMID: 30530541 PMCID: PMC6335308 DOI: 10.1098/rsta.2018.0065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/27/2018] [Indexed: 06/09/2023]
Abstract
A short description of the muon tomography demonstrator at the INFN Laboratori Nazionali di Legnaro near Padua, Italy, is given and the principal achievements owing to the data collected at that experimental facility are presented. In particular, the feasibility studies for several applications based on the muon-tomographic technology, within national and European projects, are discussed. The experimental problems and the procedures used to improve the performance are underlined. In addition, new activities and the related detector optimization are illustrated.This article is part of the Theo Murphy meeting issue 'Cosmic-ray muography'.
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Hellwig K, Geissbuehler Y, Sabidó M, Popescu C, Adamo A, Klinger J, Huppke P, Ornoy A, Korhonen P, Myhr K, Montgomery S, Burkill S. Pregnancy and Infant Outcomes with Interferon Beta: Data from the European Interferon Beta Pregnancy Registry and Population Based Registries in Finland and Sweden. Mult Scler Relat Disord 2018. [DOI: 10.1016/j.msard.2018.10.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Grimmeisen F, Lehmann MF, Liesch T, Goeppert N, Klinger J, Zopfi J, Goldscheider N. Isotopic constraints on water source mixing, network leakage and contamination in an urban groundwater system. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 583:202-213. [PMID: 28104328 DOI: 10.1016/j.scitotenv.2017.01.054] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 01/07/2017] [Accepted: 01/10/2017] [Indexed: 06/06/2023]
Abstract
Water supply in developing countries is prone to large water losses due to leaky distribution networks and defective sewers, which may affect groundwater quality and quantity in urban areas and result in complex subsurface mixing dynamics. In this study, a multi-stable isotope approach was used to investigate spatiotemporal fluctuations of surface and sub-surface water source partitioning and mixing, and to assess nitrogen (N) contamination in the urban water cycle of As-Salt, Jordan. Water import from the King Abdullah Canal (KAC), mains waters from the network, and wastewater are characterized by distinct isotopic signatures, which allowed us to quantify city effluents into the groundwater. Temporal variations in isotopic signatures of polluted groundwater are explained by seasonally fluctuating inflow, and dilution by water that originates from Lake Tiberias and enters the urban water cycle via the KAC. Isotopic analysis (N and O) and comparison between groundwater nitrate and nitrate from mains water, water imports and wastewater confirmed that septic waste from leaky sewers is the main contributor of nitrate contamination. The nitrate of strongly contaminated groundwater was characterized by highest δ15NNO3 values (13.3±1.8‰), whereas lowest δ15NNO3 values were measured in unpolluted groundwater (6.9‰). Analogously, nitrate concentration and isotopic ratios were used for source partitioning and qualitatively confirmed δDH2O and δ18OH2O-based estimates. Dual water isotope endmember mixing calculations suggest that city effluents from leaky networks and sewers contribute 30-64% to the heavily polluted groundwater. Ternary mixing calculations including also chloride revealed that 5-18% of the polluted groundwater is wastewater. Up to two thirds of the groundwater originates from mains, indicating excessive water loss from the network, and calling for improved water supply management.
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Klinger J, Kudryavtsev VA. Muon-Induced Neutrons Do Not Explain the DAMA Data. PHYSICAL REVIEW LETTERS 2015; 114:151301. [PMID: 25933303 DOI: 10.1103/physrevlett.114.151301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Indexed: 06/04/2023]
Abstract
We present an accurate model of the muon-induced background in the DAMA/LIBRA experiment. Our work challenges proposed mechanisms which seek to explain the observed DAMA signal modulation with muon-induced backgrounds. Muon generation and transport are performed using the MUSIC/MUSUN code, and subsequent interactions in the vicinity of the DAMA detector cavern are simulated with Geant4. We estimate the total muon-induced neutron flux in the detector cavern to be Φ(n)(ν)=1.0 × 10(-9) cm(-2) s(-1). We predict 3.49 × 10(-5) counts/day/kg/keV, which accounts for less than 0.3% of the DAMA signal modulation amplitude.
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Al-Taiy H, Wenzel N, Preußler S, Klinger J, Schneider T. Ultra-narrow linewidth, stable and tunable laser source for optical communication systems and spectroscopy. OPTICS LETTERS 2014; 39:5826-5829. [PMID: 25361095 DOI: 10.1364/ol.39.005826] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A novel ultra-narrow linewidth, stable and tunable single-line laser source is demonstrated and experimentally performed. The single spectral line laser is achieved by selecting and amplifying one spectral comb line of a femtosecond-fiber laser via polarization pulling assisted stimulated Brillouin scattering. Stabilization and tuning is performed by additional modulation. First proof of concept results show possible linewidths below 1 Hz and an SNR of 47 dB with a tunability of more than 100 nm and a relative stability of ±160 mHz over 5 h. Such a laser source gives high potential for many different applications like spectroscopy and optical communications.
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Scheidle M, Dittrich B, Klinger J, Meißner L, Klee D, Büchs J. pH-Kontrolle in Schüttelkolben mithilfe neuartiger Controlled-Release-Systeme. CHEM-ING-TECH 2009. [DOI: 10.1002/cite.200950085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Barker R, Hinkson P, Klinger J, Davidson D. P795 Tolevamer, a novel toxin-binding polymer, neutralises the large clostridial toxins from the B1/027 epidemic strain of Clostridium difficile. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)70636-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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33
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Wolf L, Klinger J, Held I, Hötzl H. Integrating groundwater into urban water management. WATER SCIENCE AND TECHNOLOGY : A JOURNAL OF THE INTERNATIONAL ASSOCIATION ON WATER POLLUTION RESEARCH 2006; 54:395-403. [PMID: 17120674 DOI: 10.2166/wst.2006.614] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The management of urban groundwater resources is directly linked to urban water supply and drainage concepts. A proper integration of groundwater into urban water management plans is recommended for long-term planning. The paper describes the development of a new modelling suite which addresses the urban water and solute balance in a holistic way. Special focus has been placed on the assessment of the impact of sewer leakage on groundwater in four case study cities. Tools for the prediction of sewer leakage including the assessment of uncertainties are now available. Field investigations in four European case study cities were able to trace the influence of sewer leakage on urban groundwater using microbiological indicators and pharmaceutical residues.
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Ocampo J, Klinger J. Modification of the surface structure of ice during ageing. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100244a038] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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35
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Ocampo J, Klinger J. Proton mobility in the bulk and the surface of hexagonal ice. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100244a067] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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de la Motte S, Klinger J, Kefer G, King T, Harrison F. Pharmacokinetics of human growth hormone administered subcutaneously with two different injection systems. ARZNEIMITTEL-FORSCHUNG 2001; 51:613-7. [PMID: 11505794 DOI: 10.1055/s-0031-1300089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The bioavailability of recombinant human growth hormone (somatropin, CAS 12629-01-5) was compared between a transcutaneous jet injection device and subcutaneous cannula injection. Thirteen healthy male subjects received 8.64 IU somatropin once with jet and once with cannula injection in a randomized cross-over study. Baseline-corrected somatropin serum concentrations were evaluated with non-compartmental and compartmental methods. The 90% confidence intervals with two one-sided t-tests around the ratios of injection devices were 91-120% for maximum concentration, 94-110% for area-under-curve until 14 h, and 92-103% for area-under-curve to infinity. Somatropin has a known metabolic half-life of ca. 20-30 min while the observed terminal half-lives were 2-4 h. Absorption and elimination rate constants were similar. Times of maximum concentrations, terminal half-lives and lag times to start of absorption appeared to be shorter and the absorption rate constant appeared to be larger for jet than for cannula injection. In conclusion, the kinetics of somatropin from subcutaneous tissue had a "flip-flop" characteristic. Bioavailability of somatropin after jet injection was equivalent to cannula injection.
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Klinger J, Klinger J. [Irritable bowel syndrome]. Rev Med Chil 2001; 129:576-80. [PMID: 11464542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Irritable bowel syndrome is a functional disease with highly variable symptoms and difficult to diagnose. The clinical picture is fundamental to reach a correct diagnosis and discard other gastrointestinal diseases. It etiology is not well known; psychological problems and stress probably play an important role in the development of the disease. Irritable bowel syndrome impairs the quality of life of patients and is a frequent cause of consultation in primary care. Its therapy is basically symptomatic and requires psychological support. The physician must warn his/her patients that immediate results are rarely obtained and that a prolonged clinical follow up may be necessary.
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Klinger J, Martin H, Chen Z. Experiments on induced modulational instability of an incoherent optical beam. OPTICS LETTERS 2001; 26:271-273. [PMID: 18040298 DOI: 10.1364/ol.26.000271] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
We report the observation of modulational instability (MI) of a partially spatially incoherent beam induced by seeding noise through cross-phase modulation. We show experimentally that a threshold exists for such induced incoherent MI to occur that depends on the degree of spatial coherence as well as on the strength of the nonlinearity. Above threshold, the induced MI leads to the formation of ordered and disordered patterns of incoherent light.
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41
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Klinger J, Rochas G. Anisotropic heat conduction of fresh hexagonal ice single crystals at low temperature. ACTA ACUST UNITED AC 2000. [DOI: 10.1088/0022-3719/15/21/014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Maggiolo P, Klinger J, Arellano L. [Collagenous sprue. Clinical case]. Rev Med Chil 1998; 126:1100-2. [PMID: 9922514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
A 47 years old female, treated in 1984 for a non Hodgkin lymphoma, presented in 1993 with diarrhea with features of steatorrhea. The initial assessment concluded that the patient had a gluten induced enteropathy and she had a good clinical response to a gluten free diet. In 1996, while still on gluten free diet, steatorrhea appeared. A new intestinal biopsy showed sub epithelial collagen deposition. After an empiric treatment with prednisone and sulphasalazine, steatorrhea abated but subepithelial collagen deposition persisted in intestinal biopsies.
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Colice GL, Hill N, Lee YJ, Du H, Klinger J, Leiter JC, Ou LC. Exaggerated pulmonary hypertension with monocrotaline in rats susceptible to chronic mountain sickness. J Appl Physiol (1985) 1997; 83:25-31. [PMID: 9216940 DOI: 10.1152/jappl.1997.83.1.25] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Hilltop (H) strain Sprague-Dawley rats are more susceptible to chronic mountain sickness than are the Madison (M) strain rats. It is unclear what role pulmonary vascular remodeling, polycythemia, and hypoxia-induced vasoconstriction play in mediating the more severe pulmonary hypertension that develops in the H rats during chronic hypoxia. It is also unclear whether the increased sensitivity of the H rats to chronic mountain sickness is specific for a hypoxia effect or, instead, reflects a general propensity toward the development of pulmonary hypertension. Monocrotaline (MCT) causes pulmonary vascular remodeling and pulmonary hypertension. We hypothesized that the difference in the pulmonary vascular response to chronic hypoxia between H and M rats reflects an increased sensitivity of the H rats to any pulmonary hypertensive stimuli. Consequently, we expected the two strains to also differ in their susceptibility to MCT-induced pulmonary hypertension. Pulmonary arterial pressures in conscious H and M rats were measured 3 wk after a single dose of MCT, exposure to a simulated high altitude of 18,000 ft (barometric pressure = 380 mmHg), and administration of a single dose of saline as a placebo. The H rats had significantly higher pulmonary arterial pressures and right ventricular weights after MCT and chronic hypoxia than did the M rats. The H rats also had more pulmonary vascular remodeling, i.e., greater wall thickness as a percentage of vessel diameter, after MCT and chronic hypoxia than did the M rats. The H rats had significantly lower arterial PO2 than did the M rats after MCT, but the degree of hypoxemia was mild [arterial PO2 of 72.5 +/- 0.8 (SE) Torr for H rats vs. 77.4 +/- 0.8 Torr for M rats after MCT]. The H rats had lower arterial PCO2 and larger minute ventilation values than did the M rats after MCT. These ventilatory differences suggest that MCT caused more severe pulmonary vascular damage in the H rats than in the M rats. These data support the hypothesis that the H rats have a general propensity to develop pulmonary hypertension and suggest that differences in pulmonary vascular remodeling account for the increased susceptibility of H rats, compared with M rats, to both MCT and chronic hypoxia-induced pulmonary hypertension.
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Klinger J, Sacher F, Brauch HJ, Maier D. Determination of Organic Phosphonates in Aqueous Samples Using Liquid Chromatography/Particle-beam Mass Spectrometry. ACTA ACUST UNITED AC 1997. [DOI: 10.1002/aheh.19970250205] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Barnett SW, Legg HS, Sun Y, Klinger J, Blackbourn DJ, Locher CP, Levy JA. Molecular cloning of the human immunodeficiency virus subtype 2 strain HIV-2UC2. Virology 1996; 222:257-61. [PMID: 8806506 DOI: 10.1006/viro.1996.0417] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
An infectious molecular clone was derived from the HIV-2UC2 isolate that previously was found to persistently infect and induce an AIDS-like disease syndrome in baboons. The molecularly cloned virus (HIV-2UC2mc) showed in vitro properties similar to those of the parental isolate with regard to T-cell tropism, cytopathicity, and the ability to infect primary baboon PBMC. Nevertheless, when inoculated into two baboons, the cloned virus showed a limited ability to replicate in these animals. DNA sequence analysis revealed a defective vpr gene in the UC2mc as well as in the pathogenic parental UC2 strain. Thus, the vpr gene is not required for the induction of disease in baboons. The attenuated infectious molecular clone of UC2 should be useful for future studies designed to map the genetic determinants of HIV-2 pathogenesis in the baboon model and to evaluate vaccine strategies.
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Unkauf M, Rehn D, Klinger J, de la Motte S, Grossmann K. Investigation of the efficacy of oxerutins compared to placebo in patients with chronic venous insufficiency treated with compression stockings. ARZNEIMITTEL-FORSCHUNG 1996; 46:478-82. [PMID: 8737630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The aim of this study was to investigate, if the the combined treatment of compression stockings and drug treatment with oxerutins (O-(beta-hydroxyethyl)-rutosides, Venoruton) provides additional benefit for patients with chronic venous insufficiency (CVI) compared to compression treatment alone. Oxerutins belong to the group of oedema protective agents and possess anti-exudative and membrane protective activity. A total of 133 female patients with CVI grade II participated in this double-blind, randomised, multi-centre, parallel-group study with two treatment groups. The whole study lasted for 19 weeks, and consisted of a one week placebo run-in phase, 12 weeks treatment phase, followed by a 6 weeks treatment-free follow-up period. All patients received a basis compression therapy that consisted of standard compression stockings. In order to standardise initial fitting of stockings in this multi-centre setting, stockings were fitted after one week of standard diuretics starting at baseline and then stockings were worn for the following 11 weeks. Patients were randomised to receive oxerutins (2 x 500 mg daily) or matching placebo. Leg volumes (water displacement) and associated subjective symptoms (visula analogue scale) were measured during a placebo run-in period at enrolment (week - 1) and half a week later (week - 1/2), at baseline week 0), at 4, 8, 12 weeks on treatment, and again after a 3- and 6-weeks treatment-free follow-up. The primary efficacy criterion, the area under the baseline from week 0 to week 18 (AUB0-18) of leg volume changes, as measurement of the global change of leg oedema during the study, resulted in a superior reduction of -5589 ml.d for the combined treatment with oxerutins compared to -2101 ml.d for placebo (p = 0.012). The mean change of leg volume compared to baseline after 12 weeks of treatment was -63.9 ml for stockings and oxerutins, and -32.9 ml for the patients who received stockings and placebo (p < 0.05). Oxerutins showed a prolonged effect in the follow-up phase compared to placebo, with mean AUB values for week 12 to week 18 of -1769 ml.d versus -133 ml.d (p < 0.01). The study demonstrated that the combined therapy of compression stockings and drug treatment with oxerutins is significantly superior in reducing leg oedema resulting from chronic venous insufficiency compared to compression treatment alone.
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Fahrmeir L, Klinger J. Estimating and testing generalized linear models under inequality restrictions. Stat Pap (Berl) 1994. [DOI: 10.1007/bf02926415] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bunnett NW, Wu V, Sternini C, Klinger J, Shimomaya E, Payan D, Kobayashi R, Walsh JH. Distribution and abundance of neutral endopeptidase (EC 3.4.24.11) in the alimentary tract of the rat. THE AMERICAN JOURNAL OF PHYSIOLOGY 1993; 264:G497-508. [PMID: 8460703 DOI: 10.1152/ajpgi.1993.264.3.g497] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The distribution of neutral endopeptidase (NEP; EC 3.4.24.11) was examined in the alimentary tract of the rat. Immunoreactive NEP and NEP mRNA were localized to epithelial cells of the small intestine and to muscle cells in the stomach, small intestine, and colon by immunohistochemistry and in situ hybridization histochemistry. NEP antisera recognized a protein on Western blots of membranes from gastric, jejunal, and colonic mucosa and gastric muscle with an electrophoretic mobility identical to that of recombinant human NEP (approximately 95 kDa). An antisense cRNA probe to NEP hybridized to RNA of approximately 3.5 kb and approximately 6.5 kb, corresponding to the primary transcripts of rat NEP, on Northern blots of total RNA from the jejunal mucosa. NEP message was detected in mRNA from jejunal and colonic mucosa and gastric, jejunal, and colonic muscle using a ribonuclease protection assay. NEP enzymatic activity, assessed by DL-thiorphan-inhibitable degradation of glutaryl-Ala-Ala-Phe-4-methoxy-2-naphthylamine, was highest in homogenates of jejunal mucosa (868 +/- 98 pmol.h-1 x micrograms protein-1) and was between 49- and 413-fold lower in other gastrointestinal tissues. The cellular origin of NEP in the gastric and colonic mucosa could not be determined.
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Hoffenberg P, Reyes V, Palma J, Ossa P, Maggiolo P, Klinger J. [Treatment of gastric ulcer with sucralfate and famotidine]. Rev Med Chil 1991; 119:45-9. [PMID: 1824143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
We conducted a double blind random study on 79 patients with gastric ulcer: 39 received sucralfate, 1 g 4 times a day (Group 1) and 40 received a single evening dose of famotidine, 40 mg (Group 2). At 4 weeks, endoscopy revealed healing of the ulcer in 46% of patients in Group 1 and 40% in Group 2 (NS). At 8 weeks, corresponding figures were 90% and 75% (NS). All patients were able to complete treatment and minor side effects were reported from all patients, 36% with sucralfate and 28% with famotidine. Thus, sucralfate and famotidine are equally effective for therapy of gastric ulcer. The higher percentage of healing with sucralfate observed in this study was not statistically significant.
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González M, Ribalta J, Reyes H, Klinger J, Maggiolo P, Varleta P, Hernández I, Delgado M, Donoso S. [Primary biliary cirrhosis. The clinical experience in 31 patients]. Rev Med Chil 1990; 118:1350-4. [PMID: 2152667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
We analyzed 31 patients with a diagnosis of primary biliary cirrhosis, 29 of them males, aged 23 to 72 years. Liver biopsy was diagnostic in all showing initial findings of the disease in 5. Echotomography and cholangiography demonstrated a patent biliary, tract. Anti-mitochondrial antibodies were present in 94% of patients. Alkaline phosphatase and biliary acid levels were useful for diagnosis. Pruritus was present with varying intensity in all patients, with premenstrual exacerbations in 5 females who had cholestasis of pregnancy or hepatitis caused by progestin drugs before developing cirrhosis. Recurrent urinary tract infection was present in 8 patients, osteoporosis in 24, Sjogren's syndrome in 24 and Crest syndrome in 4. Survival ranged from 1 to 12 years, death being caused by ruptured esophageal varices in 12 patients and by liver failure in 7. Persistence of pruritus and altered liver function tests after cholestasis of pregnancy or hepatitis caused by progestins should lead to investigation of biliary cirrhosis.
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