Congestive (dilated) cardiomyopathy in association with solvent abuse.
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Biomedical subjects
Publications and source records attributed to A S Mee.
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The effect of endotoxin and immune complexes on monocyte lysosomal enzyme activity has been studied in patients with Crohn's disease and ulcerative colitis. Immune complexes made at equivalence or in antigen excess caused a rapid fall in intracellular activity of the enzyme N'acetyl-beta-D-glucosaminidase which was significantly greater than that seen when cells were incubated with medium alone. Endotoxin had no effect on intracellular enzyme activity but there was a significant elevation of activity in the supernatants. Cells from patients with inflammatory bowel disease were no different to cells from healthy control subjects in their response to either endotoxin or immune complexes.
A chronic colitis has been induced in rabbits having many of the histological features of human ulcerative colitis. Animals were first immunised with the common enterobacterial antigen of Kunin and haemagglutinating antibodies demonstrated in high titre. An immune complex colitis was then established by the injection of soluble immune complexes following mild irritation of the rectum with dilute formalin as previously described. The rabbits developed an acute colitis within the first week but, in contrast with unsensitised rabbits, the inflammation persisted and was still present at six months as assessed by proctoscopy and rectal biopsy. Kunin-sensitised rabbits receiving intravenous saline, antigen, or antibody alone did not develop a chronic colitis. It is suggested that hypersensitivity to colonic bacterial antigens may be one mechanism whereby an acute colitis becomes chronic.
The metabolism of pure radioiodine labelled Clq has been observed in five patients with ulcerative colitis, five patients with Crohn's disease, and in five control subjects. Both the fractional catabolic rate and the synthesis rate of Clq were increased in the five patients with Crohn's disease and in four of the five patients with ulcerative colitis. The fifth patient was in remission and had a normal synthesis rate. These results support the hypothesis that complement activation plays a role in the pathogenesis of these disease states and that the increased complement activation is primarily via the classical pathway.
Thirty-nine patients with ulcerative colitis and 35 with Crohn's disease have been investigated for evidence of reaginic hypersensitivity and compared with control subjects. There was no difference in the frequency of a personal or family history of atopy or in serum IgE levels. Similarly, no overall difference was noted in prick test responses to 21 allergens. However, further analysis of prick test responses showed that patients with inflammatory bowel disease responded more frequently to food allergens. This was highly significant when compared with healthy controls (p less than 0.001). The relevance of this finding to the aetiology of inflammatory bowel disease is discussed.
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Thirty-six cases of herpes zoster complicated by facial paralysis (the Ramsay Hunt syndrome) seen over 10 years were reviewed to determine the subjective degree of recovery (ascertained by questionnaire) and residual disability (ascertained by re-examination). Eighteen patients made a full recovery, most within three months; 14 patients were left with only mild residual signs. In only four patients was the final result regarded as unsatisfactory. Outcome was not adversely influenced by age. The facial paralysis of the Ramsay Hunt syndrome thus carries a generally favourable prognosis.
Pulmonary function has been assessed in patients with ulcerative colitis and Crohn's disease and compared with a healthy population. No statistically significant differences were found in the measurements observed within the three groups.
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