Inactive Cases Research Articles

Peripheral blood neutrophil rheology measured by micropore filtration reflects Behçet's disease activity well

Activated neutrophils take a long time to pass through a narrow lumen like a micropore, and are supposed to play a deteriorating effect on microcirculation. Although the activation of neutrophils has been demonstrated in Behçet's disease, nobody analyzes the clinical activity of the disease by means of the rheological measure of neutrophils activity. Using a micropore (pore diameter 5 μm) filtration technique, we measured the filtration time of peripheral blood neutrophils, as a rheological measure of their activity, in order to determine the clinical activity of Behçet's disease. Twenty-one patients with Behçet's disease and 14 healthy control individuals were enrolled in the study. Symptoms and signs exhibited in the patients led us to distinguish the Behçet's disease into inactive and active cases. The latter were further differentiated into cases with absent symptoms and with present symptoms. Neutrophil filtration times were 11.5 ± 4.8 s in the active cases with present symptoms, which were significantly ( P < 0.05) larger than those (7.4 ± 1.9 s) in the active cases with absent symptoms. The latter filtration times were further significantly ( P < 0.001) larger than values (3.7 ± 1.3 s) in the inactive cases and also those (4.8 ± 1.2 s) in control subjects. Furthermore, increases in the filtration time obtained immediately after the exposure of cells to the chemotactic peptide formyl-methionyl-leucyl-phenylalanine (FMLP; 10 nM) were significantly ( P < 0.01) larger in the active cases with present symptoms than those in the active cases with absent symptoms. The latter were also larger, but not significantly, than those in the inactive cases, and were significantly ( P < 0.01) larger than those in control subjects. The present results demonstrate that the micropore filtration method reflects well the rheological activity of neutrophils as well as the clinical status of Behçet's disease. This method is much better than the measurement of O 2 − production to differentiate between active cases with absent symptoms and inactive patients or even control individuals. Furthermore, it is more sensitive and useful than laboratory data like the CRP value or the number of peripheral blood neutrophils.

Usefulness of PCR Study in AFB Smear Negative Patients on Admission

Background : PCR technique is useful in diagnosis of pulmonary tuberculosis. But, its sensitivity and specificity is some different among several studies. Our aim is compare our PCR results with other's previous PCR results in AFB smear negative patients. Methods : PCR were performed in patients that their disease were suspected as active pulmonary tuberculosis and that their initial serial sputum AFB smear results were negative. Total number of patients studied by PCR technique was 177. Also, we analyzed the data only in patients whose bronchial washing fluid AFB smear was negative. And the primer had been used was IS 6110. Results : In our retrograde study, the number of patients who are diagnosed as having active pulmonary tuberculosis, inactive pulmonary tuberculosis and nontuberculous pulmonary disease was 99, 28, 50, respectively. In the sputum study, the sensitivity of PCR is 41.5% (27 PCR positive cases/65 active TBc cases). And the sensitivity of TB culture is 53.8% (35 TB culture positive cases/65 active TBc cases). In the bronchial washing specimen study, the sensitivity of PCR is 53.8% (21 PCR positive cases/39 active TBc cases). And the sensitivity of TB culture is 43.6% (17 TB culture Positive cases/39 active TBc cases). The specificity of PCR in our study is 94.9%. (74 PCR negative cases/78 inactive TBc or nontubereulous cases) In the cases of patients who were never takened anti-TBc medication, the sensitivity of PCR (45.6%--25 positive cases/55 cases) is some lower than culture (58.2%--32 positive cases/55 cases). In the cases of patients who had been takened anti-TBC medication. the sensitivity of PCR (60%--18 positive cases/30 cases) is some superior than culture (50%--15 positive cases/30 cases). Conclusion : We think that PCR results in cases of sputum AFB smear negative patients is nearly same as culture. And PCR is especially useful in patients who had been takened anti-TBc medication on admission.

EM18, a New Serodiagnostic Marker for Differentiation of Active and Inactive Cases of Alveolar Hydatid Disease

We determined whether detection of antibody response against a newly detected epitope, designated Em18, among Echinococcus multilocularis antigens could be a reliable marker for differentiation of active cases of alveolar hydatid disease (AHD) from inactive cases. Fifteen Alaskan patients with either active or inactive lesions of AHD previously confirmed clinically, pathologically, and serologically by the Em2-enzyme-linked immunosorbent assay (ELISA) were used for a blind test by Western blotting. Ten and five cases were considered to be active and inactive cases, respectively. One of the 10 cases classified serologically as active was judged to be inactive based on clinical and pathologic criteria; the patient had a recognizable parasitic lesion, and following short-term treatment with albendazole, a biopsy of the liver showed a degenerated lesion that did not grow in rodents. The five cases judged to be inactive included two confirmed inactive cases with cicatrized lesions and three active cases that showed the weakest values in the Em2-ELISA. The most predominant IgG subclass responding to Em18 was IgG4. In general, there were good correlations between 1) the antibody response against Em18 and the presence of active lesions and 2) the antibody response against Em18 and the Em2-ELISA values.

The characteristics of epilepsy in a largely untreated population in rural Ecuador.

A house-to-house survey of epileptic seizures covering a population of 72,121 persons was carried out in a rural area of northern Ecuador. A cascade system of diagnosis was used to identify all cases of epileptic seizures in this population. 1029 cases were found, of whom 881 were considered to be definite cases and 148 were possible cases. Of the 1029 cases, 56% had active epilepsy. The lifetime prevalence rate was found to lie between 12.2 and 19.5/1000 and the prevalence of active cases between 6.7 and 8.0/1000. An annual incidence rate of between 122/100,000 and 190/100,000 was estimated. Seizure type was classified without EEG data and almost half of the cases had partial seizures. In 27% of cases an aetiology was proposed on clinical grounds. This is one of few reported studies of a population that has been largely unexposed to antiepileptic drugs, providing an opportunity to study the natural history of the untreated condition. It has been suggested that treatment in newly developing epilepsy will prevent its development to a chronic condition. Only 37% of the 1029 cases had ever received antiepileptic drugs, and only 12% of the cases were taking them at the time of the survey. Despite this, a high rate of inactivity was observed, with 44% of all cases free of seizures. Nearly two thirds of the inactive cases identified had never received treatment with antiepileptic drugs. In a subgroup of untreated cases with an active condition, treatment with antiepileptic drugs was initiated and was highly effective even in cases with a long previous history. Thus the findings from this study suggest that the development of epilepsy resistant to therapy is not always associated with a long duration of untreated epilepsy.

Role of monocytes in cryoglobulinemia-associated nephritis

Several monocyte-macrophage functions were found to be defective in cryoglobulinemic patients. Nevertheless, monocytes actively phagocytizing cryoglobulins have been frequently found in kidney specimens from these patients. Whether subsequent degradation of the ingested immune material is effective, however, is still unknown. Monocytes from eight cryoglobulinemic patients (4 with active disease and associated nephritis and 4 inactive cases without nephritis) and eight normal controls of same sex and similar age were analyzed. Monocytes from patients with active cryoglobulinemia and associated nephritis were found to be able to ingest, but unable to catabolize, cryoglobulins, as shown by electron microscopy using gold-labeled goat IgG to human IgG and IgM in 18-hour cultured suspensions. Synthesis and maturation of monocyte cathepsin D, one of the most important lysosomal proteases, were analyzed in the same subjects. Purified monocytes were cultured in presence or absence of cryoglobulins for 18 hours at 37 degrees C in RPMI medium and labeled with 35S-methionine. The various forms of cathepsin D were separated by electrophoresis and visualized by fluorography. Results from cultures of monocytes from clinically active cryoglobulinemic patients with nephritis suggest that intracellular transport of newly synthesized cathepsin D was impaired and the release into the medium of precursor polypeptides of the enzyme enhanced in each experimental condition. Since procathepsin D is susceptible to activation in pathologic conditions lowering local pH (such as in inflamed tissues), these data suggest that monocytes from patients with active cryoglobulinemia and associated nephritis have a propensity to exert phlogistic effects via secretion of procathepsin D in tissues.

Tuberculosis in recent Asian immigrants to British Columbia, Canada: 1982–1985

The prevalence and incidence of active tuberculosis among 21 959 recently arrived (1982–1985) immigrants from 7 selected Asian countries into British Columbia (BC), Canada, were reviewed. Among these newly arrived immigrants, 1173 (5.3%) were judged to have inactive tuberculosis at the immigration examination in their country of origin. In this subgroup, 14 of 932 (1.5%) were found to have active tuberculosis at the initial examination after arrival in Canada. Subsequently, 7 further cases arose in this group of inactive cases giving an average annual incidence rate of 0.33% over the 4-year period of study. Only 3 of these 21 cases had previous antituberculosis chemotherapy. The remaining 20 786 recent immigrants with normal X-rays at the immigration examination contributed 30 cases during the next 4 years — an average annual incidence rate of 0.08% or 8 times the comparable rate for BC (0.01%). The limitations of the immigration screening process are illustrated and the value of early surveillance of immigrants designated as having inactive tuberculosis is underlined. The apparent failure to exclude active disease prior to the arrival of these immigrants is one factor elevating the incidence of active tuberculosis in the first few years after arrival in the host country. Other factors include the relatively high prevalence of inactive tuberculosis among the immigrants from certain countries and their high rate of early relapse after entry, especially in those not previously treated. Such immigrants should be considered for chemoprophylaxis immediately after entry.

Immunohistochemical detection of transforming growth factor-β1 in fibrotic liver diseases

Transforming growth factor-β1 was localized by means of immunohistochemical reaction in liver biopsy specimens taken from patients having different chronic liver diseases with extending fibrosis. Two polyclonal antibodies that were produced in rabbits were directed against the amino terminal of transforming growth factor-β1. Staining by anti-CC(1–30) was primarily extracellular and located in the portal and periportal fibrotic areas of all seven cases with chronic active hepatitis. No staining was noted in the four chronic persistent cases studied. A strong reaction was seen with the antibody in nine of the ten cirrhotic samples, whereas it was negative in one inactive cirrhosis case and in all five cases with normal liver histological findings. No positive staining could be detected by the anti-LC(1–30) in any of the liver tissues. Detection of transforming growth factor-β1 in active liver diseases at the site of fibrosis suggests that transforming growth factor-β1 might have a role in the process and progression of fibrosis during the development of the disease. (HEPATOLOGY 1991;14:269–273.)

Immunohistochemical detection of transforming growth factor-β1 in fibrotic liver diseases

Transforming growth factor-beta 1 was localized by means of immunohistochemical reaction in liver biopsy specimens taken from patients having different chronic liver diseases with extending fibrosis. Two polyclonal antibodies that were produced in rabbits were directed against the amino terminal of transforming growth factor-beta 1. Staining by anti-CC(1-30) was primarily extracellular and located in the portal and periportal fibrotic areas of all seven cases with chronic active hepatitis. No staining was noted in the four chronic persistent cases studied. A strong reaction was seen with the antibody in nine of the ten cirrhotic samples, whereas it was negative in one inactive cirrhosis case and in all five cases with normal liver histological findings. No positive staining could be detected by the anti-LC(1-30) in any of the liver tissues. Detection of transforming growth factor-beta 1 in active liver diseases at the site of fibrosis suggests that transforming growth factor-beta 1 might have a role in the process and progression of fibrosis during the development of the disease.

Macrophage histology in paraffin-embedded multiple sclerosis plaques is demonstrated by the monoclonal pan-macrophage marker HAM-56: correlation with chronicity of the lesion

Using the monoclonal antibody HAM-56 with the avidin-biotin method on recent or archival paraffin-embedded tissue from multiple sclerosis brains, we have been able to distinguish between acute, chronic active and inactive lesions. HAM-56 stains all macrophages, monocytes and at least some microglia; it is the only pan-macrophage marker to our knowledge that can be satisfactorily used on conventional paraffin sections. A much narrower range of mainly perivascular macrophages in acute plaques of multiple sclerosis is stained with MAC-387, anti-muramidase and anti-alpha1-anti-trypsin. The acute plaques show HAM-56-stained macrophages throughout the lesion, and these macrophages exhibit profiles of phospholipid-rich myelinic bodies, which are also usually stainable with Luxol fast blue. Active ongoing lesions show a rim of macrophages at the edge of the lesion. These macrophages show profiles of large vacuoles, thought to represent the sudanophilic esterified cholesterol formed during demyelination. Inactive cases show none of these features; the few perivascular macrophages present often contain the end product of lipid peroxidation, ceroidlipofuscin.

Spindle cell tumors resected from male patients with germ cell tumors. A clinicopathologic study of 14 cases

We identified 14 male germ cell tumor patients (13 of whom had received prior chemotherapy) in whom distinctive neoplasms composed of spindle to stellate cells set in a myxoid to collagenous stroma containing numerous blood vessels developed. These neoplasms were cytokeratin-positive and vimentin-positive and alpha-fetoprotein (AFP)-negative. Ten patients with neoplasms of low cellularity and no mitoses have not had tumor recurrences, whereas four patients with more cellular and mitotically active tumors have experienced either recurrences or death. We recommend simple surgical excision, without additional chemotherapy, for the hypocellular, mitotically inactive cases. The transition from mitotically active spindle cell tumors to frankly sarcomatous areas in three cases indicates that these lesions may be the substratum for the development of sarcomas in some patients with germ cell tumors. Based on their histologic appearance and immunohistochemical profile, as well as preceding evidence of yolk sac tumor (YST) in 11 patients (data incomplete in 3 cases), we speculate that many of these cases represent overgrowth of a spindle cell component of YST that is selected for by chemotherapy.

冬季の熱帯の対流活動と日本の天候

The relationship among tropical convection, the weather over Japan and the atmospheric circulation in the Northern Hemisphere during winter was statistically examined with the use of monthly mean temperature data over Japan, outgoing longwave radiation (OLR), 500mb geopotential heights and the sea level pressure. It was found that the temperature over Japan is highly correlated with convective activity around the Philippines, i.e., when the convection around the Plilippines is active, the temperature over Japan is lower than normal. Conversely, when the convection is inactive, temperatures over Japan are above normal.Convective activity around the Philippines is also correlated with the Northern Hemisphere 500 mb geopotential heights, especially in the region of east Asia. When convective activity around the Philippines is strong, the 500mb heights around Japan are lower while those around Siberia are higher. Weak convection means higher 500mb heights over Japan and low heights over Siberia. Sea level pressure in the northwest Pacific east of Japan is lower while that in Siberia is higher for active convection cases. The converse is true for inactive conviction. Conclusions from these results indicate that for active convection the strength of the east Asia winter monsoon becomes stronger resulting in a cold winter over Japan. Inactive convection weakens the east Asian winter monsoon creating a warm Japanese winter.The results of composite analyses show that the global height anomaly patterns such as the Eurasian and Pacific/North American patterns can be found more clearly in the active convection cases than in the inactive cases.

57. A NEW METHOD FOR DETECTING ANTI LIVER CELL MEMBRANE ANTIBODY USING A HUMAN HEPATOMA CELL LINE

A simple technique for detection of serum autoantibodies that bind to liver membrane antigens on the surface of liver cells has been developed using Alexander cells[PLC/PRF/5]. Alexander cells were incubated with test serum(1:160), washed then adherent antibodies were detected by incubating with 125I-proCein A. Specific binding to cell surface was calculated as the ratio between the counts with patient's serum divided by 2SD above the mean count obtained with serum from controls. The ratio was significantly higher in those with active autoimmune chronic active hepatitis (aCAH)[median 4.5, range 1.1-23.1] when compared to inactive cases [1.5, 0.3-4.1; p<0.01], to alpha-1 antitrypsin deficiency [1.2, 0.3-2.3; p<0.01], and to Wilson's disease[1.7, 0.3-2.9;p<0.01]. The ratio in primary sclerosing cholangitis was similar to active aCAH[4.2, 0.8-6.7]which would support recent evidence implicating autoimmune mechanisms in PSC. In 11 aCAH cases tested for anti-LSP [liver specific lipoprotein] antibody a positive correlation was found between Alexander cellbinding assay & anti-LSP titres( r= 0.56 p<0.02). In 4 aCAH tested @ diagnosis [4.8,3-23.1] the ratio fell after effective immunosuppresive therapy [0.9, 0.6-4.5]. Alexander cell binding assay provides a simple, rapid & sensitive technique to detect specific antibody to liver cell membrane which may help in the management of autoimmune liver disease.

Pathological Studies on the Peripheral Nerve Involements of Leprosy in the Extremities

The involvements of peripheral nerve in both extremities were histopathologically classified into five grades by changes of nerve tissue elements based on the demyelination, axonal degeneration and nerve thickening as shown in Fig. 1.The nerve change grade could be correlated with the clinical course of leprosy. Except Grade 1 from infection to early stage, in general, Grade 2 corresponding to the early stage, Grade 3 to the developing stage, Grade 4 to the resorbing stage and Grade 5 to the terminal stage respectively.Pathological and histopathological investigation was made from active, early resorbing and inactive (reactional) BL of 3 autopsy cases. Each autopsy case could be said to be very rare in Japan.The active case of BL was of 92 yrs. old, male, who died at the short period of about 6 months from onset. It was during chemotherapy of CIBA for 3 months after admission. Leprous lesions of skin and peripheral nerves of this case were demonstrated BL lesion as shown in Fig. 8 to Fig. 15. The histopathological findings of peripheral nerves in common with skin were characterized by less leprosy bacilli than that of LL lesion and lymphocytic infiltration in the leprous lesion. And the nerve fibers were markedly affected by the invasion of the leprous lesion developed in the intrafunicular interstice. In these nerve tissues Schwann cells contained leprosy bacilli which were short rod and/or granulated less in number as compared with those of regular LL lesion.The BL case of an early resorting stage was of 31 yrs. old, male, hospitalized for a long duration of 16 years. The chemotherapy of promin was continued for 6 years. The leprous lesions in skin as well as peripheral nerves represeented the characteristic feature of BL. The nerve changes showed considerable remains of scattered leprosy bacilli in the nerve bundles, while, the infiltration of lymphocytes was more markedly proliferated. It was also characteristic of the early resorbing stage that homogenized and elongated acid-fast substances were demonstrated in the Schwann cells as shown in Fig. 19, and more proliferated lymphocytes, some rupture and collagenous-fibrotic proliferation of nerve fibers were found.The inactive and reactional BL case was of 27 yrs. old, male, admitted about 6 years ago and committed suicide during chemotherapy of Promin for one year. It was considered that a reversal reaction occurred in this case judzing from marked edema, obious dilatation of blood-capillaries and some lymphocytic infiltration in the nerve interstice, Atrophy and fragmentation was seen in the nerve fibers. Also, as another finding, foreign body giant cells containing acid-fast substances char-acteristically appeared in the nerve interstice in this reactional case

Population dynamics of the badger (Meles meles) and the epidemiology of bovine tuberculosis (Mycobacterium bovis).

A survey and analysis is presented of the population biology of the badger ( Meles meles ) and the epidemiology of bovine tuberculosis ( Mycobacterium bovis ) within badger populations. Simple mathematical models are used to further our understanding of Special attention is given to the identification of areas in which current knowledge is inadequate, and to future research needs. The badger is shown to have a low intrinsic population growth rate, a not insignificant maturation delay to first breeding, to produce small litters of cubs which experience high rates of mortality in their first year of life but low rates thereafter, and to exhibit limited powers of dispersal. Population abundance is largely determined by habitat type and long term stability appears to arise primarily as a consequence of density-dependent constraints on fecundity. Such constraints are thought to only operate at densities close to the carrying capacity of the habitat. Cyclic fluctuations in abundance, with a period of between six and eight years, may occur in areas of moderate to poor habitat. Such fluctuations will be most apparent with respect to cub abundance as opposed to adult density. Bovine tuberculosis is endemic within many badger populations throughout regions of Britain but is particularly prevalent in areas of good badger habitat in the southwest of England. Current evidence suggests that badgers play a significant role in disease transmission to cattle. It is argued that the infection is able to persist in high, moderate and low density badger populations. The observed stability of the disease appears to be a consequence of ‘pseudo-vertical’ transmission (from parent to new born offspring), the long duration of infectiousness of infected animals (low disease-induced mortality rate), the presence of carriers and inactive cases and the social organization and behaviour of the host species. Disease prevalence is likely to be related to badger density although in a nonlinear manner. Control measures based on the removal of infected social groups of badgers in the southwest of England appear to have reduced the force of infection within badger populations by approximately 50%. The disease, however, remains endemic but at low levels of prevalence. The reduction in the force of infection has reduced the frequency of disease transmission to cattle herds. Eradication of the infection within badger populations may not be necessary for the short-term control of the infection in cattle. The persistence of low levels of infection in low density badger populations (suppressed by control measures), in areas of intensive cattle farming activity, however, presents a continual threat to cattle health in the long term . The ability of badger populations to recover from substantive reductions in density is poor, with a return time (to the pre-control state) of approximately five years. Small reductions in abundance, however, are likely to enhance net population growth rates as a consequence of the relaxation of density-dependent constraints on fecundity (the natural population regulatory mechanism). As such, rapid population growth to precontrol levels is predicted, following small reductions in density. As a consequence of the requirement for continual and substantive suppression of badger abundance (a renewable resource) in areas of intensive cattle farming it is suggested that alternative methods of disease control should be actively sought with a view to the design of more effective long-term control policies.

A clinical evaluation of the diagnostic usefulness of an early dermal reaction to tuserculin: a failure to distinguish between tuberculosis and other respiratory disease

An early (6–8 hour) reaction to RT23 tuberculin which was previously found to distinguish between patients with active tuberculosis and healthy tuberculin positive individuals failed to distinguish between such patients and those with other respiratory diseases. It also failed to distinguish between radiologically active and inactive cases of tuberculosis. Such early reactions were frequent among healthy hospital workers but not among other healthy subjects.

The chemotactic function of neutrophils in ulcerative colitis.

Neutrophil chemotactic function was investigated in 30 patients with ulcerative colitis (UC) in an active (no. = 15) or an inactive (no. = 15) stage. Peripheral blood neutrophils from active cases had a significantly decreased stimulated migration in modified Boyden chambers. Simultaneously done investigations of neutrophil migration into skin window chambers showed normal results in both active and inactive cases of UC. Thus, the defective chemotaxis during in vitro conditions was not reflected in a quantifiable neutrophil dysfunction in experimental acute inflammation.

Syntax und semantik der fundamentalrelation: Das Guarani als Sprache des aktiven typus

Resume Linguistic postulates about ergativity and the like imply two different kinds of hypothesis: inductive hypotheses concerning morphosyntactic case forms and deductive hypotheses concerning semantic case roles. On the morphosyntactic level, we observe some implicational universals and an accumulation principle based on the economy of linguistic expression. On the semantic level, the distinction of an ACTIVE and an INACTIVE case role is considered as fundamental. The result is a new typology where the traditional ergative-accusative dichotomy is replaced by a fivefold distinction, including in addition the active, the neutral and the nonaccumulated types. Only the ergative, the accusative and the active types can constitute whole language systems. The essential features of the so-called active type, which has only recently come to be known, are illustrated by a detailed analysis of the verbal system of Guarani.

LABORATORY SUPPORT IN THE MANAGEMENT OF SYPHILIS

Recent developments in syphilis serology are set down. The approach today is more rational as it has some basis in immunological understandings. In spite of improvements, syphilis serology continues to have limitations, and differentiating active from inactive cases remains taxing. In primary and secondary syphilis, dark-ground microscopy is still the quickest and surest way to make the diagnosis. In latent syphilis and in late and congenital cases, as well as in instances of other treponemal infections, serological evidence of disease needs to be considered along with each patient's medical, social and sexual history, when and why they may have been given antibiotic treatment, and the results of radiological studies and cerebrospinal fluid examination. For some syphilitics, the decision to treat or not to treat remains a matter of art rather than science.

Bronchial findings in pulmonary tuberculosis

A total of 297 bronchoscopies were performed on 238 patients with pulmonary tuberculosis at the Paivarinne Chest Hospital during the period 1967--1973. The tuberculous process was deemed active in 172 patients and inactive in 66. Active endobronchial tuberculosis was diagnosed in 20 patients, 11.6% of the active cases, whereas inactive sequelae of endobronchial tuberculosis appeared in 7% of the total material. Bronchography was performed on 163 patients; a normal bronchogram was obtained in 54% of the cases with minimal changes, 35% of the moderately advanced cases, 13% of the far advanced and 23% of the inactive cases. Sputum samples were more often positive for tubercle bacilli than the bronchial aspirates, and bacterial cultures from sputum samples were less reliable indicators of infection than were cultures from bronchial aspirates. Cytological smears revealed no difference between these two sampling methods.

The Clinical Significance of Classifications of Cirrhosis. A Comparison between Conventional Criteria and Numerical Taxonomy

Classification of patients with cirrhosis serves the clinical purpose of selecting patients for adequate therapy. A material of 441 patients from a randomized clinical trial of prednisone treatment were classified according to different criteria, and the effect of this therapy was assessed by comparing the survival curves of controls and treated patients in the groups. Six classifications based on single criteria were studied, viz. females vs. males, alcoholics vs. non-alcoholics, compensated vs. decompensated cases, active vs. inactive cases, manifest vs. latent cases, and non-primary biliary vs. primary biliary cirrhosis. The latter group was too small for further analysis. Furthermore, the material was classified by numerical taxonomy, based on 56 clinical symptoms and signs and histological and serological changes. The taxonomical classification showed interdependence with all the clinical classifications, except that of primary biliary cirrhosis. Three clinical classifications, viz. those based on sex, alcoholism, and compensation, and one taxonomic class showed a significant therapeutic relevance. Combination of these criteria revealed that female patients with compensated non-alcoholic cirrhosis, previously demonstrated to benefit from prednisone treatment, showed a markedly greater prednisone effect if they belonged to the taxonomic group than if they did not. According to clinical, histologic, and laboratory data, the latter group was characterized as less severe cases than the former one. Whereas this discrepancy between clinical severity and therapeutic effect cannot be fully explained, the data do suggest that clinical criteria may not be ideal for selection of patients with cirrhosis for steroid therapy, and that numerical taxonomy may provide clues for more clinically significant classifications.