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Biomedical subjects

J K Kelly

Publications and source records attributed to J K Kelly.

At least 73 records · Page 4Linked to original sources
PubMed1986

Fatal Aspergillus pneumonia in chronic granulomatous disease.

A 20-year-old man died from Aspergillus pneumonia three weeks after heavy exposure to grain dust. Lung biopsy and autopsy demonstrated a distinctive form of suppurating granulomatous bronchopneumonia caused by Aspergillus fumigatus, which was the sole agent cultured from the tissue. The liver and lymph nodes contained pigmented lipid histiocytes characteristic of chronic granulomatous disease, and subsequently both of the patient's brothers were found to have X-linked chronic granulomatous disease. The authors suggest that this morphologic expression of Aspergillus pneumonia should raise a suspicion of neutrophil dysfunction or chronic granulomatous disease.

Adult↗
PubMed1986

Giant and symptomatic inflammatory polyps of the colon in idiopathic inflammatory bowel disease.

Four cases of giant inflammatory polyps were found in a series of 86 consecutive colectomies for inflammatory bowel disease. Two presented a distinctive clinical syndrome of abdominal pain and chronic iron-deficiency anemia due to blood loss. Secondary ulceration of the heads of the polyps accounted for the bleeding and anemia, and the size of the polyps accounted for the abdominal pain. In both cases unusually long portions of colon were involved by the giant polyps. The third and fourth cases had rare complications--reactivation of an enterocutaneous fistula and perforation of an acquired diverticulum. These cases demonstrate that giant inflammatory polyps may produce symptoms independently of the underlying inflammatory bowel disease. In reported cases of giant inflammatory polyps, approximately two-thirds had Crohn's disease and one-third had ulcerative colitis. The transverse colon was the commonest location, pain was the commonest symptom, and the polyps were localized to a short segment of colon in the majority of cases. More than 50% of cases mimicked neoplasm on barium enema. Giant inflammatory polyps may produce a variety of distinctive signs and symptoms and deserve independent recognition.

Adult↗
PubMed1986

The strictures, sinuses, and fissures of Crohn's disease.

One hundred forty-six consecutive specimens of excised bowel from patients with Crohn's disease were studied to determine the relationships between strictures, sinuses, and "fissures." A significant coincidence of sinuses and strictures was observed and sinuses tended to arise proximal to the point of maximal stricture. "Fissures," defined as blind-ending inflammatory tracts that did not penetrate through the full thickness of the muscle coat, were of two types. One type was associated with submucosal fibromuscular hyperplasia and repair and appeared to be an early sinus. The second type was in dilated ileum or colon in the bases of ulcers and is designated an "acute fissure." The anatomic findings suggest that both sinuses and fissures may be due to mechanical factors including intraluminal pressure rather than to any intrinsic quality of the inflammatory process in Crohn's disease.

Colon↗
PubMed1986

Experimental infection of infant rabbits with verotoxin-producing Escherichia coli.

To study the pathogenesis of diarrheal disease due to verotoxin (VT)-producing Escherichia coli, 3-day-old rabbits were inoculated intragastrically with live E. coli O157:H7 (high VT producer), E. coli O113:K75:H21 (low VT producer), or O157:H45 (VT negative) and were examined for clinical symptoms, bacterial colonization, presence of detectable free VT in the intestines, and histological changes. Diarrhea developed consistently with 10(8) bacteria of E. coli O157:H7 but was observed only infrequently with even a higher dose of E. coli O113:K75:H21. VT-negative strains failed to cause diarrhea under the same experimental conditions. E. coli O157:H7 was recovered from the colon of infected animals in a significantly higher concentration than from the small intestine, and the clinical symptoms correlated with the presence of detectable free VT in the colon. Histological changes were seen mainly in the mid- and distal colon; these changes were characterized by a vast increase in apoptosis in the surface epithelium, increased mitotic activity in the crypts, mucin depletion, and a mild to moderate infiltration of neutrophils in the lamina propria and epithelium. Multiple foci of attached bacteria were seen on the surface epithelium of the gut-associated lymphoid tissue, cecum, and colon. Bacteria were never seen in epithelial cells or the lamina propria. These mucosal abnormalities as well as clinical symptoms were reproduced in infant rabbits by the intragastric administration of VT alone. These results are consistent with the hypothesis that VT plays a major role in the pathogenesis of diarrhea caused by E. coli O157:H7 and other VT-producing E. coli.

Age Factors↗
PubMed1980

Indian childhood cirrhosis in the United Kingdom.

Two young brothers with cirrhosis are reported. They are the issue of a first-cousin marriage between Bangladeshi parents. The older boy was born in Bangladesh, the younger in England. A diagnosis of Indian childhood cirrhosis (ICC) was made on the basis of the clinical features and the liver histology. The younger brother represents the first example of this disease in a patient born in the United Kingdom.

Bangladesh↗
PubMed1979

Alpha-1-antitrypsin deficiency and hepatocellular carcinoma.

Forty-two cases of hepatocellular carcinoma (HCC) were examined for the presence of the inclusions of alpha-1-antitrypsin (AAT), which indicate a carrier state for the Pi Z gene. These were found in the non-neoplastic liver tissue of two cases of HCC and in one of the 98 control livers, a difference that is not statistically significant. Typical globules of AAT deficiency were not found in HCC cells. One-quarter of HCCs, however, contained cells which showed diffuse cytoplasmic staining for AAT, a pattern seen also in the non-neoplastic livers.

Carcinoma, Hepatocellular↗
PubMed1979

Alpha-1-antitrypsin Pi S phenotype and liver cell inclusion bodies in alcoholic hepatitis.

Typical liver cell inclusions of alpha-1-antitrypsin deficiency were found in a patient with the Pi S phenotype and acute alcoholic hepatitis. It is suggested that the inclusions resulted from the combined effects of the S phenotype and alcohol and, on the basis of the known chemistry of the variant antitrypsins, that the lowered serum concentration of antitrypsin associated with the S allele may be due to hepatic holdup.

Hepatitis, Alcoholic↗
PubMedDate not supplied

Vitamin A hepatotoxicity in multiple family members.

Three of five family members experienced symptoms and biochemical evidence of hepatitis that could not be explained on the basis of infectious, metabolic or immunologic disorders of the liver. A history of prolonged ingestion of moderate amounts of vitamin A (20,000 to 45,000 IU per day for 7 to 10 years) was obtained in each of the three family members and was absent in the remaining two unaffected individuals. A liver biopsy performed in one family member confirmed the diagnosis of vitamin A toxicity. This report emphasizes the finding that even moderate amounts of vitamin A, when ingested over a prolonged period of time, can cause significant hepatocellular injury.

Adult↗
PubMedDate not supplied

The local immunological defence system of the human endometrium.

The distribution of immunoglobulins and secretory component (SC) in the human endometrium has been studied by an immunoperoxidase technique. SC is present in a proportion of the epithelial cells and the amount of this substance is increased during the secretory phase of the cycle. A variety of immunoglobulins are present, in low concentrations, in the stromal interstitium during the secretory phase of the cycle and these are thought to diffuse passively from the plasma as a non-specific accompaniment of stomal oedema. Only IgA is found in the epithelial cells and this appears solely in those cells containing SC. No immunoglobuln-containing lymphoid cells are present in the endometrium. It is suggested that the endometrium lacks a true local secretory immune system but is able, because of its content of SC, to compensate for this by extracting polymeric IgA from the plasma. This system presumably helps to protect the endometrium against infection but the biological significance of its apparent control by progesterone is uncertain.

Animals↗
PubMedDate not supplied

MR imaging of compressive myelomalacia.

The authors studied retrospectively 42 patients with the magnetic resonance (MR) diagnosis of myelomalacia. Depending on MR findings, the patients were grouped into early, intermediate, and late stages of myelomalacia. Early stage myelomalacia patients presented with high intensity signal changes on T2-weighted images involving the width of the affected cord. The intermediate stage patients were characterized by varying degrees of cystic necrosis of the central gray matter, better seen on T2-weighted images. Central cystic degeneration, syrinx formation, and atrophy were prominent features of the late stage of myelomalacia. Ten patients had follow-up MR examinations within 6 months of initial imaging. Two of the four early stage myelomalacia patients showed improvement in the repeat studies. The follow-up scans of the six intermediate and late stage myelomalacia patients showed either no change or progression of disease. Early stage myelomalacia may be reversible, depending on the severity of the initial spinal cord injury. Magnetic resonance can serve as a useful tool in the assessment and management of myelomalacia patients.

Adolescent↗