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Biomedical subjects

J K Kelly

Publications and source records attributed to J K Kelly.

At least 37 records · Page 2Linked to original sources
PubMed1993

Hepatic and gastric cytoprotective effects of long-term prostaglandin E1 administration in cirrhotic rats.

BACKGROUND: Acute administration of prostaglandin E (PGE) may be cytoprotective for hepatocytes in acute hepatitis and for gastric mucosa in cirrhotic rats. We examined the effects of long-term PGE treatment on liver and stomach in cirrhotic rats. METHODS: Cirrhosis was induced by bile duct ligation. Controls had a sham operation. Half the rats received a PGE1 analogue, misoprostol (PGE1) (10 micrograms orally, daily) on days 1-29 postsurgery, and the others received vehicle only. On day 31, all rats underwent ex vivo gastric chamber procedures. Liver chemistry, portal pressures, and hepatic and gastric tissue levels of prostaglandin E2, leukotriene B4, myeloperoxidase, and collagen were determined. RESULTS: PGE1-treated cirrhotic rats had less hepatosplenomegaly, lower serum alanine aminotransferase levels, and portal pressures and higher arterial pressure than vehicle-treated cirrhotic rats. Hepatic and gastric leukotriene B4, myeloperoxidase and collagen levels were significantly lower in the PGE1-treated compared with vehicle-treated cirrhotic rats. Vehicle-treated cirrhotic rats had greater spontaneous and ethanol-induced gastric damage and failed to show a gastric hyperemic response to ethanol, whereas PGE1-pretreated rats did. PGE1 did not significantly affect sham-operated rats. CONCLUSIONS: Long-term PGE1 administration was cytoprotective for both the liver and gastric mucosa in cirrhotic rats. Clinical trials of PGE in human cirrhosis or portal hypertensive gastropathy may be warranted.

Alprostadil↗
PubMed1992

Kin selection in density regulated populations.

The process of kin selection has both intra- and inter-group components (Hamilton, 1975, in: Biosocial Anthropology Wade, 1980). Group advantageous characteristics can evolve when inter-group differences in fertility are sufficiently great to overcome any within-group disadvantage of the trait. The potential magnitude of inter-group differences in fertility is determined largely by the way a population is regulated. Inter-group differences decrease as the spatial scale over which a population is regulated becomes increasingly localized. The present paper extends previous work by Boyd (1982, Anim. Behav. 30, 972-982) on the quantitative relation between kin selection and density regulation. A simple genetic model is employed to examine the conditions under which the interaction of local density regulation and kin selection can maintain a stable polymorphism. The ecological factors determining the spatial and temporal scale of density regulation are discussed. Finally, the results are applied to two biological cases in which local density regulation may be influencing the direction of phenotypic plasticity in group advantageous characters.

Animals↗
PubMed1992

Carcinoid tumors and inflammatory bowel disease.

Three cases are described in which carcinoid tumors arose in previously established inflammatory bowel disease: two were in the ileum in cases of Crohn's disease, and one was in the rectum in a case of ulcerative colitis. Review of this association in the literature suggests that it may be more than fortuitous.

Adult↗
PubMed1992

Absence of an association between enteric parasites in the manifestations and pathogenesis of HIV enteropathy in gay men. The GI/HIV Study Group.

49 gay men confirmed to be infected with the human immunodeficiency virus (HIV) and 9 HIV seronegative gay men participated in a pilot study comparing clinical status and enteric parasite load with gastrointestinal structure, function and symptomatology. Cases included 16/49 (33%) men who were CDC stage II, 7/49 (14%) who were CDC stage III, and 26/49 (53%) who were CDC stage IV. The mean CD4-lymphocyte count was 476 +/- 199 (SD)/microliter. The prevalence of enteric parasitic flora was similar in HIV seropositive patients and controls. Seven cases had enteric infection with pathogenic agents including 3 patients with Entamoeba histolytica, and 4 patients with Giardia lamblia, one of whom also had cryptosporidiosis. Other cases were most frequently colonized with Blastocystis hominis (44%) and Endolimax nana (41%) regardless of the HIV clinical status. HIV seropositive patients with enteric parasitic colonization tended to have lower mean levels of serum IgA than cases without parasites. Duodenal morphometric mucosal changes demonstrated a significant decrease in the mean villous height (p < 0.01) with no elongation of the crypt depth in HIV-infected patients with and without diarrhea compared to controls. Despite gastrointestinal symptoms including diarrhea and weight loss being more prevalent in HIV infected individuals than controls, no correlations were found between the presence of particular enteric parasites, gastrointestinal symptomatology, the clinical HIV status of the CD4-lymphocyte count, the malabsorption of D-xylose or morphometric changes in the duodenum.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Polypoid prolapsing mucosal folds in diverticular disease.

Redundant or polypoid mucosal folds were found in eight surgically resected sigmoid colons with diverticular disease. Grossly, they were either swellings of mucosal folds or larger, leaflike, smooth-surfaced polyps with broad bases arising from mucosal folds. The number of lesions ranged from one to 11, and when multiple they formed two rows between diverticula. Swollen mucosal folds showed submucosal and mucosal vascular congestion, scanty thrombi, edema, hemorrhage, and hemosiderin deposition. Some were markedly inflamed. Polypoid lesions also showed crypt elongation and fission, upgrowth of muscle from the muscularis mucosae, and hyperplastic-metaplastic change typical of mucosal prolapse. One polyp showed evidence of an inverted diverticulum. Two cases displayed diffuse mucosal inflammation resembling inflammatory bowel disease in the region of the polyps. We speculate that these lesions result from a combination of venous congestion and mucosal redundancy secondary to spastic contraction of the muscle coat.

Colonic Diseases↗
PubMed1990

DNA sequences required for yeast actin gene transcription do not include conserved CCAAT motifs.

Sequences required for Saccharomyces cerevisiae actin gene transcription were mapped and compared to the regulatory region of the actin gene from a thermophilic fungus, Thermomyces lanuginosus. Two CCAAT motifs conserved in position in these two species could be mutated without affecting promoter activity, regardless of whether the yeast were grown in fermentable or non-fermentable carbon sources. Two TATA-like sequences and an upstream activation sequence (UAS) composed of multiple elements were identified. The contribution of sequence motifs within these elements to UAS activity varied depending on the carbon source. The Thermomyces gene contains sequences highly homologous to this UAS, but in the opposite orientation.

Actins↗
PubMed1990

Gastrointestinal function and structure in HIV-positive patients.

We examined 19 patients (17 men) with human immunodeficiency virus (HIV) infection and gastrointestinal symptoms to determine whether those symptoms were due to either a gastrointestinal tract infection or a defect in mucosal absorption because of an enteropathy. The erythrocyte folate and serum vitamin B12 levels were within normal limits in all of the patients. The serum ferritin level was elevated in 12. The xylose absorption test results were abnormal in 8 of the 13 patients able to complete the study. None of the duodenal aspirates yielded a pathogen. Light microscopy revealed nonspecific lymphocytic inflammation without infection in the stomach (in seven patients), the esophagus (in five), the duodenum (in two) and the rectum (in two). However, biopsy specimens were positive for Candida albicans in the esophagus (four patients), cytomegalovirus in the esophagus (one) and the rectum (two), Helicobacter pylori in the antrum (two), Treponema infection in the rectum (two) and Mycobacterium avium-intracellulare in the small intestine (one). Only three patients had a normal series of biopsy specimens. All of the patients had similar ultrastructural changes at the epithelial-stromal junction of the antral glands and in the intestinal crypts. We conclude that abnormal biochemical and endoscopic findings are common in HIV-positive patients with gastrointestinal symptoms. Defects in carbohydrate absorption and ultrastructural changes may be responsible for some aspects of HIV enteropathy.

Bacterial Infections↗
PubMed1990

Pseudotumor appearance in chronic hepatitis.

A pseudotumor appearance of the liver has not been previously described in chronic hepatitis. We reviewed 81 charts with a biopsy diagnosis of "chronic hepatitis" and at least one radiologic liver scan, and found four cases with a pseudotumor appearance. They all had features on radiologic scans suggestive of space-occupying lesions. Histology showed chronic hepatitis in all four. Two were cirrhotic, one due to alcohol and the other due to hepatitis B. The other two patients had chronic active hepatitis with regenerative nodules but only limited fibrosis, one due to hepatitis B, the other probable non-A, non-B. None had any evidence of hepatic malignancy. We conclude that some patients with chronic hepatitis may present with a pseudotumor appearance on radiological scans, due to the presence of regenerative nodules. Space-occupying lesions on liver scans in chronic hepatitis may represent non-neoplastic liver disease.

Adult↗
PubMed1990

Protein-losing enteropathy in systemic lupus erythematosus associated with intestinal lymphangiectasia.

This case report concerns a young woman with systemic lupus erythematosus who presented with a protein-losing enteropathy. Intestinal biopsy revealed lymphangiectasia. Mesenteric lymph nodes showed paracortical lymphoid depletion and multiple small sinusoids. Elevated cholesterol levels and normal lymphocyte counts characterized the peripheral blood samples. Lymph nodes, though enlarged, showed no evidence of obstructive pathology. No secondary cause of lymphangiectasia could be identified. The patient exhibited antinuclear antibodies and antibodies to dsDNA at the onset, and then, 5 yr later, the classic features of systemic lupus erythematosus (SLE). The lymphocytopenia and hypolipidemia that characterizes lymphangiectasia is not a feature of the SLE cases reported to date. Furthermore, the mechanism for the dilated lymphatics and villous edema is more likely immunological than mechanical disruption of lymphatics.

Adolescent↗
PubMed1990

Chronic right upper quadrant pain without gallstones: does HIDA scan predict outcome after cholecystectomy?

Patients with chronic right upper quadrant pain who do not have gallstones on ultrasound or cholecystography are often referred for surgery for presumed acalculous chronic cholecystitis. We followed 26 patients who had cholecystokinin (CCK) cholescintigraphy for evaluation of chronic right upper quadrant pain without demonstrable gallstones on ultrasound who underwent cholecystectomy so that it could be determined whether there was any relation between a low ejection fraction (EF), morphological features of chronic cholecystitis, and clinical outcome. Eighteen patients (69%) were considered therapeutic successes, whereas eight (31%) were failures after an average 2-yr follow-up. Both patient groups had significantly reduced EF: the successful group at 0.39 and the failures at 0.25. Thus, a low EF did not predict clinical outcome, since the failure group had an even lower EF than the success group. Seven gallbladders demonstrated chronic acalculous cholecystitis; the average EF of this group was 0.35. The remaining 19 gallbladders were normal, yet also had an EF of 0.35. Thus, decreased EF does not predict the histologic features of chronic cholecystitis without gallstones. The diagnostic value of cholescintigraphy in patients with acalculous right upper quadrant pain is low, probably because this entity represents a variety of processes, including inflammation, gallbladder dysmotility, and the irritable bowel syndrome.

Abdominal Pain↗
PubMed1989

Idiopathic retractile (sclerosing) mesenteritis and its differential diagnosis.

We report a case of retractile mesenteritis presenting as an abdominal mass with incomplete small-bowel obstruction. Histological features included fat necrosis, fibrosis, elastosis, dystrophic calcification, and chronic inflammation. Lymphatic obstruction resulted in the accumulation of lipid-laden macrophages in the ileal mucosa. Ultrastructurally, myofibroblasts were the principal cells present. The differential diagnosis of retractile mesenteritis is discussed with particular attention to myofibroblastic disorders such as inflammatory pseudotumors, desmoids, retroperitoneal fibrosis, and other uncommon conditions that appear to be morphologically or clinically distinguishable although the etiology and pathogenesis are obscure.

Abdominal Neoplasms↗
PubMed1989

Origin of fistulas in Crohn's disease.

In 236 resection specimens of Crohn's disease (127 first excisions and 109 reexcisions) there were 60 specimens with fistulas (excluding anal fistulas): 44 in first excisions and 16 in reexcisions. In primary excisions, 36 fistulas arose in the ileum, three in the colon and five in the ileocecal valve. The majority were located either at the proximal end of a stricture (62%) or within a stricture (31%); four cases (7%) were not associated with strictures. In reexcision specimens, ten fistulas arose at the bowel anastomosis, four arose in the ileum in association with strictures, and two were of doubtful origin. Only four fistulas in primary excisions drained to the skin whereas seven did so in reexcisions.

Colitis↗
PubMed1989

A novel enteropathy with partial villous atrophy, microscopic colitis, and pemphigoid change.

Microscopic colitis associated with gluten-resistant partial villous atrophy was documented in a 21-year-old woman with chronic nonbloody diarrhea. Electron microscopic examination of the colonic and duodenal biopsies showed focal separations of basal lamina from cryptal epithelial cells forming subepithelial blebs in which were mast cells and fibroblasts. These morphologic features have not been previously described in any inflammatory bowel disease and are reminiscent of bullous pemphigoid of the skin. The findings suggest that not all cases of microscopic colitis lie within the spectrum of collagenous colitis.

Adult↗
PubMed1989

Cocaine abuse: neurovascular complications.

In a review of the records of 3,712 drug abusers, 13 patients were identified with neurologic deficits attributable to the use of cocaine. Ischemic manifestations were the most frequent, occurring in seven (54%) patients, with a mean age of 34.2 years. Three (23%) patients had subarachnoid hemorrhage, and three (23%) had intracerebral hemorrhage. Three patients from other institutions were included in the analysis, for a total of 16 patients, (eight with cerebral ischemia, four with subarachnoid hemorrhage, and four with intracerebral hemorrhage). Of the six patients with head computed tomographic findings of cerebral infarction, five had subcortical infarcts. Two of the four patients who presented with a subarachnoid hemorrhage had a congenital intracranial aneurysm. One of the four patients with an intracerebral hemorrhage had an underlying arteriovenous malformation. The mechanism through which these complications occur is not completely understood. Factors that may play a role include the acute hypertensive response that occurs with cocaine use as well as disordered neurovascular control.

Adult↗
PubMed1989

Genetic markers and inflammatory bowel disease: immunoglobulin allotypes (GM, KM) and protease inhibitor.

We have studied immunoglobulin allotypes (GM and KM) in 101 patients with Crohn's disease, 51 patients with ulcerative colitis, and 99 healthy local blood donor controls. In addition, protease inhibitor (PI) types were examined in a random subset of patients and in all controls. No significant differences were found between Crohn's disease patients and controls, or between ulcerative colitis patients and controls, in the frequencies of GM phenotypes, GM haplotypes, KM phenotypes, or PI phenotypes.

Colitis, Ulcerative↗
PubMed1989

Collagenous colitis and microscopic colitis: the watery diarrhea-colitis syndrome.

Nine patients (seven females, two males) with chronic watery diarrhea and nonspecific colonic mucosal inflammation followed for 1-5 yr are presented. Eight were diagnosed as having collagenous colitis on the basis of marked thickening of the subepithelial collagen layer in at least one set of biopsies. The thickness of the collagen table varied with time in all eight cases. When thickening was minimal, morphological features were indistinguishable from microscopic colitis, signifying that, in most cases, collagenous colitis and microscopic colitis are part of the same spectrum of colonic mucosal response. One of the eight patients had documented collagenous colitis and gluten-associated enteropathy for 12 yr. The colitis and duodenal histology improved synchronously when a gluten-free diet and corticosteroids were administered. The ninth patient had microscopic colitis and enteropathy which did not respond to gluten withdrawal. This patient never exhibited thickening of subepithelial collagen in repeated biopsies over 5 yr, suggesting that an entity of microscopic colitis may exist independent of collagenous colitis. Duodenal mucosal biopsies showed normal histology in four other patients with collagenous colitis. The histological variability of collagenization and inflammation during the course of collagenous colitis and microscopic colitis and the clinical feature of watery diarrhea suggest that these two entities be grouped together as the watery diarrhea-colitis syndrome.

Adult↗