Bleeding at the gastroesophageal junction.
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Biomedical subjects
Publications and source records attributed to D Katz.
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The bacterial flora intimately associated with the intestinal mucosa of patients with Crohn's disease has been examined and compared with the mucosal flora of a control group. Specimens were obtained at operation from patients undergoing intestinal surgery. Whole thickness intestinal sections were taken from the diseased segment and from a portion of uninvolved intestine from patients with Crohn's disease as well as from a control group. A section of each specimen was examined histologically. Twenty-two specimens of Crohn's tissue (12 ileum, 10 colon) and 46 control samples from small and large bowel were examined using strictly anaerobic bacteriological techniques in an anaerobic chamber. Organisms were grown under both aerobic and anaerobic conditions. A mucosal flora was found to exist in all the large bowel samples and in three-quarters of the small bowel samples. It was qualitatively similar in all the samples, consisting mainly of Gram positive bacteria, aerobic Gram negative rods and bacteroides. Greater numbers of bacteria were associated with colonic tissue (10(7) - 10(8) per g) than with tissue from the jejunum (10(3) - 10(4) per g). This difference was statistically significant (p<0.03). Samples from the terminal ileum were quantitatively intermediate between jejunum and colon. There was no statistical difference in the numbers of bacteria associated with Crohn's tissue compared with histologically normal tissue from the same patients and from the control group of patients. Among the bacterial isolates, however, Enterobacteria were more commonly associated with Crohn's tissue.
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The normal anatomy of the pancreas is demonstrated by computed tomography (CT) (EMI) in 50 patients with no known pancreatic disease and in 15 comparable postmortem studies. The problems of optimal demonstration of the pancreas in CT and the possible causes of misinterpretation of the pancreatic axial tomography are considered. The size of the normal pancreas was found to be up to 3.0 cm for the head, 2.5 cm for the neck and body, and 2.0 cm for the tail. In assessing these values, it is important to be sure that adjacent structures such as the portal vein, splenic vein, and duodenum are not included in the measurement, that the measurements are taken on scans of maximum resolution with no movements, and that the measurements are strictly related to the anteroposterior diameter. It is considered that gantry tilt will also distort these figures. The reasons for these statements are presented and discussed.
A 2-year-old boy had a fatal disseminated BCG infection. Immunologic assessment showed a normal humoral response and normal numbers of E rosettes, normal thymus weight and histological features, but an abnormal response of lymphocytes in vitro and negative skin tests. Histological examination showed the presence of Gram-negative acid-fast bacilli within the macrophages. The possible mechanisms of immunodeficiency in this patient are discussed.
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Using the microtiter system, titration of Newcastle disease virus infectivity and neutralizing antibodies was carried out in chicken embryo fibroblasts grown in "U" or flat-bottomed plates. Infectivity was detected by a combined hemadsorption-hemagglutination method. Inhibition of that reaction indicated the presence of neutralizing antibodies. A 24-h microneutralization test was developed and compared to the plaque neutralization and microhemagglutination inhibition test. Reproducibility of the microneutralization test was statistically analyzed.
An unusual association of pancarditis due to Streptococcus viridans is described. The pathologic findings appear to indicate that the myocardial infection and pericarditis were blood borne.
Parathyroid hormone increased the incorporation of Na2H32PO4 into phosphatidic acid and phosphatidylinositol in cat renal cortical slices. Incorporation was not observed into any other phospholipid. The effects were seen as early as one minute for phosphatidic acid and ten minutes for phosphatidylinositol. 8-Bromoadnosine 3',5'-monophosphate did not mimic the effects of parathyroid hormone. Concentrations of parathyroid hormone, 1 x 10(-8)M to 1 x 10(-7)M, which increased the incorporation of 32p into phosphatidic acid and phosphatidylinositol maximally, did not alter tissue cyclic AMP levels suggesting that the incorporation of 32p was independent of cyclic AMP.
A group of 76 polycythemia vera patients was followed prospectively with bone marrow examinations at regular intervals. Six terminated in acute leukemia, preceded by an indolent preleukemic phase succeeded by a very fulminant leukemia. At autopsy, all patients had extramedullary hematopoiesis. In one of them, only the bone marrow was leukemic, suggesting that it was the primary site of this transformation. In three with leukemic involvement of nonhematopoietic organs, the infiltrate consisted of myelo- or myelomonoblasts and normoblasts. The preleukemic phase was characterized by a rapidly evolving spontaneous pancytopenia, with a drop from polycythemic blood counts within 2 mo. In the bone marrow, megaloblastoid erythropoiesis with ring sideroblasts was prominent. A similar preleukemic phase evolving in other potentially leukemic conditions, has been described. Therefore, in patients at risk, the appearance of ring sideroblasts may be regarded as an early indicator of imminent acute leukemic transformation.
In mammals the antibody activity in secretions is associated with the secretory IgA. This unique immunoglobulin plays a major role in immunity against infectious diseases of the alimentary and the respiratory tracts. We found a similar system of local immunity against Newcastle disease virus (NDV) in the fowl. Airway washings and bile globulins of chickens were examined by immunodiffusion and immunoelectrophoretic methods. No antigenic differences were found between the serum IgA and the secretory IgA of airway washings and of bile. The chicken IgA differs from mammalian IgA by lacking secretory component. Antibodies in the airway washings and in tears of chickens immunized by aerosol ir i.m. NDV vaccine (attenuated or inactive) were compared to serum antibodies produced by similar methods of administration. HI antibodies in secretions reached higher levels after aerosol vaccination than after i.m. administration, whereas in serum the situation was reversed. The antibody activity in airway washings and in tears is associated with IgA, while in serum the main antibody is IgG.
Thirty-nine patients with myelofibrosis and myeloid metaplasia were diagnosed and followed during the period 1955-74. Twenty-eight suffered from agnogenic myeloid metaplasia and 11 from myeloid metaplasia following polycythemia vera. In an attempt to compare the two groups and to define prognostic guidelines, an analysis of survival with respect to various clinical parameters was made. The median survival time of patients with agnogenic myeloid metaplasia was seven years as opposed to only 28 months for the poltpolycythemic group. Older age at diagnosis, a large spleen, or its rapid enlargement, anemia and leukocytosis, but not thrombocytopenia, had a marked negative effect on survival. The clinical condition of most patients was remarkably stable during the entire course of their disease. If a significant drop in hemoglobin occurred, it was sudden, and caused by gastrointestinal hemorrhage or the development of acute leukemia. No demonstrable effect of therapy on survival was found.
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The effects of cefazolin were studied in 15 hospital patients (average age, 67) with respiratory-tract infections. The infections were chiefly bronchopneumonia caused by organisms such as D. pneumoniae, Staph. aureus, or E. coli. In 13 of the 15 patients the results were excellent to good (eradication of the primary pathogen and clinical improvement); in the other 2 patients the response was fair. Intramuscular injection was well tolerated and only one patient complained of pain at the site of injection; no other adverse clinical effects were observed. In the laboratory determinations, including liver and kidney function tests, the only abnormalities were 2 cases in which the Coombs' test gave positive results without hemolysis. Cefazolin seems to be a safe and effective antibiotic for the treatment of respiratory-tract infections caused by cefazolin-susceptible organisms.
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