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Biomedical subjects

J B Kirsner

Publications and source records attributed to J B Kirsner.

At least 19 recordsLinked to original sources

Inflammatory tissue reaction in rabbit bowel injected with Crohn's homogenates.

Homogenates from the terminal ileum of a patient with Crohn's disease with granulomas were prepared as snap-frozen or fresh and were injected into the ascending colonic walls of New Zealand white rabbits. Control animals were injected with 1 per cent bovine serum albumin alone. The rabbit bowel was examined after 1 year, and lesions were noted in each of the rabbits injected with Crohn's disease homogenate, irrespective of the type of tissue preparation. The observed lesions were diffuse and occurred both at the injection site and in the terminal ileum. These changes were not noted in the control group. This work confirms earlier results in the same animal model and suggests that either fresh or snap-frozen homogenates will produce the intestinal lesion but that bovine albumin alone will not.

Animals

Antibodies to synthetic polyribonucleotides in spouses of patients with inflammatory bowel disease.

Serum from patients with inflammatory bowel disease (I.B.D.) and their unaffected spouses bound significantly more synthetic single-stranded (poly.rA) and double-stranded (poly.rA.poly.rU) R.N.A. but not KB cell D.N.A. than did serum from age-matched controls and their spouses. Binding activity resided in Ig fractions and was predominantly of IgM class. A significant corelation was observed between the amount of double-stranded but not single-stranded R.N.A. bound by serum from patients and from their respective spouses. These findings provide indirect support for the presence of R.N.A. viruses in patients with I.B.D. and the transmission of such agents to their close personal contacts.

Antibodies, Viral

Inherited deficiency of second component of complement and HLA haplotype A10,B18 associated with inflammatory bowel disease.

A patient with inflammatory bowel disease and sacroiliitis had haplotypes A10,B18 and Aw32,b18 at the major histocompatibility locus. Serum total complement and C2 hemolytic complement activities were undetectable; levels of the remaining C1-C9 components were normal. The parents, both siblings, and a child each had half-normal levels of C2 and either the A10,B18 or the Aw32,b18 hla haplotype. In a second unrelated family, an only child and both parents developed inflammatory bowel disease. The father and child had HLA haplotype A10,B18, but, along with the mother, each had normal serum levels of hemolytic C and C2. Homozygous C2 deficiency, often in association with the A10,B18 haplotype, has previously been linked with various autoimmune diseases and with propensity to infection. Our findings suggest that C2 deficiency or this haplotype also may predispose to inflammatory diseases of the intestine.

Adult

Convulsions complicating colectomy in inflammatory bowel disease.

Convulsions have complicated the surgical management of life-threatening inflammatory bowel disease in five patients. These patients experienced a transient, generalized convulsive disorder and toxic ambylopia. Results of neurological examination were unremarkable. Treatment included metabolic stabilization along with the administration of oxygen and anticonvulsive medication. Various factors, such as hypoxia, fluid overload, cerebral edema, steroid administration, and deficits in calcium, magnesium, and potassium, may have contributed to the cause of this complication.

Adolescent

Multicentric colonic lymphoma complicating ulcerative colitis.

A 72-year-old female with ulcerative colitis of 30 years duration underwent total proctocolectomy for a cecal mass thought to be an adenocarcinoma. Pathologic examination of the colon revealed 22 tumors, all of which proved to be malignant lymphoma, histiocytic type. Thirteen cases of non-Hodgkins malignant lymphoma and 2 cases of Hodgkins disease of the colon arising in ulcerative colitis are reviewed and discussed.

Aged

Carcinoma of the colon in the adolescent: a report of survival and an analysis of the literature.

A case of adenocarcinoma of the transverse colon in a fourteen year old girl is presented. Five years after radical resection of this Dukes' C2 lesion, the patient is alive and well without recurrent disease. The incidence of large bowel carcinoma in adolescents remains low, but there is an increasing tendency toward neoplasia in younger patients. Factors that affect patient survival included late stage at presentation, delay in treatment, paucity of symptoms, and a higher incidence of tumors of the transverse colon. An increased incidence of colloid carcinoma is noted. The etiology and pathogenesis of large bowel cancer as it pertains to childhood are reviewed.

Adenocarcinoma

Lymphocytotoxic antibodies in patients with inflammatory bowel disease and their spouses--evidence for a transmissible agent.

Serum lymphocytotoxic antibodies (LCA) were detected in twenty-seven out of fifty-three (51%) patients with inflammatory bowel disease (IBD) and in twenty-three out of their fifty-three (43%) unaffected spouses. The prevalence of LCA in both groups was significantly increased (P less than 0.001) compared to that in age- and sex-matched controls (11%) or in control spouses (6%). Concordant expression of LCA occurred in sixteen out of the fifty-three (30%) patient-spouse pairs compared to only one out of the fifty-three (2%) control-spouse pairs (P less than 0.001). In contrast to the LCA results, heterophile antibody titres were similarly distributed in all four study groups. It is suggested that LCA may represent markers of infectious agents in IBD and that their occurrence in unaffected close contacts of patients may indicate transmission of such agents to these subjects.

Antibodies

Usefulness of rectal biopsy in inflammatory bowel disease.

With careful "standardized" technique and proper handling, rectal biopsies can be useful diagnostic and therapeutic adjuncts in the initial evaluation and then long term observation of patients with chronic inflammatory bowel disease.

Biopsy

The production of an unusual tissue reaction in rabbit bowel injected with Crohn's disease homogenates.

Recent reports have suggested a transmissible factor in the etiology of Crohn's disease, which had yet to be confirmed. The specificity of the transmission was tested with a disease control of ulcerative colitis as well as normal bowel. Twenty New Zealand White rabbits received inoculum of tissue homogenates from the terminal ileum of normal, ulcerative colitic, and Crohn's disease patients. This inoculum was injected into the wall of the ascending colon and the animals were examined after one year. Changes were noted consistently only in those animals receiving the Crohn's disease inoculum. These changes consisted of thickened bowel wall with increased mucosal folds, thickened mesenteric fat with some creeping, irregular areas of thin colonic mucosa, and hyperplastic mesenteric lymph nodes. The terminal ileum distant from the inoculum site was smooth with atrophic changes only in the Crohn's inoculated group of animals. These animals also had discrete collections of macrophages in colon or sacculus, mucosal and submucosal edema, and chronic inflammation of the colon. However, the characteristic features of Crohn's disease were not reproduced.

Animals