Coexistent regional enteritis and ulcerative colitis.
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Biomedical subjects
Publications and source records attributed to J Lough.
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Low molecular weight macroglobulinemia was observed in a patient with chronic pulmonary infection. An enlarged cervical lymph node contained many abnormal plasma cells, which were distended with immunoglobulin; this material appeared to be released into lymph spaces when the cells burst. The macroglobulin production is considered to be a non-neoplastic reactive immune response to the pulmonary infection. It is postulated that the association of constipated plasma cells and 7s-IgM can best be explained as an acquired defect in macroglobulin polymerization.
A variety of blood constituents was injected into an isolated segment of rabbit aorta to determine which elements might be involved in early endothelial injury. Test materials consisted of platelet-rich plasma (PRP) alone; PRP plus adenosine diphosphate (ADP); PRP plus tendon extract; PRP plus thrombin; ultrasonicated PRP alone; platelet-poor plasma alone; and thrombin in saline. Each experimental mixture was left in the aorta for 15 minutes, followed by reflow for 20 minutes. The vessel was then fixed by glutaraldehyde perfusion. Thick sections of the entire circumference of the aorta were taken for phase contrast microscopy and representative arease were selected for electron microscopy. In control PRP alone, platelet-poor plasma alone and with PRP plus ADP there were occasional subendothelial vesicles. When PRP plus thrombin and platelet-poor plasma plus thrombin were injected separately to form a thrombus or when thrombin in saline was used, there was extensive subendothelial vesiculation with focal ulceration and adherence of thrombus to endothelium. Severe injury was associated with the presence of thrombin initiating the polymerization of fibrinogen to fibrin. Electron micrographs demonstrate the earliest lesion as a disruption of the superficial fibrilliary elastica with separation of overlying endothelium.
Fluoride is concentrated in the bones of patients with chronic renal failure when fluoridated water is used during hemodialysis. Excessive osteoid is produced that is not normally mineralized and severe osteomalacia occurs. Electron microscopical examination of iliac crest bone biopsy specimens from four patients suggests that fluoride induces the synthesis of disarrayed collagen by the activated osteoblasts. Collagen fibers were found to be normal in size and in axial periodicity.
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At least 150 cases of mushroom poisoning occur in Canada each year, 75% in the Province of Ontario. Eighty per cent of the total are in children under the age of 9, and most do not require hospitalization. Amanita virosa poisoning is a potentially fatal medical emergency which presents as an acute gastroenteritis, progressing to hepatorenal failure. Treatment consists of elimination of undigested mushrooms, rapid rehydration, management of acute liver and renal failure, and prevention of infection during the recovery phase.
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Idiopathic neonatal hepatitis is the uncommon syndrome of prolonged obstructive jaundice associated with giant cell transformation in the liver and patent bile ducts. Either hepatitis virus or an inherited abnormality has been suggested as a likely pathogenic agent for the syndrome.Recent observation of discordance for idiopathic neonatal hepatitis in monozygotic twins is felt to be inconsistent with either an infectious or a simple genetic etiology. Immaturity of the hepatic parenchymal cell bilirubin excretory pathway is postulated as a cause of jaundice in some of these babies.
To study the possibility that susceptibility to the development of atherosclerosis during chronic renal failure is genetically determined, aortic lesion formation and changes in serum lipid levels in mice of 2 different inbred strains, C57BL/6J and A/J, were examined. Chronic uremia was induced by electrocoagulation of the right renal cortex and left nephrectomy. The mice were then fed either normal rodent chow or a saturated fat and cholesterol-enriched diet for 6 weeks. None of the A/J mice developed atherosclerosis, whereas the aortas of chow-fed uremic C57BL/6J mice were found to contain a number of fatty lesions, the severity of which was increased by a high fat diet. Uremia had different effects on serum cholesterol, triglycerides, and lipoproteins in the two strains. The results suggest that the resistance of A/J mice to uremia-induced atherosclerosis may be attributed to their ability to maintain high serum HDL-cholesterol levels and/or low serum triglyceride levels. The results further indicate that the development of atherosclerotic lesions in uremic mice is both genetically determined and affected by diet.
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Five patients with adult onset Still's disease are reported. Three had abnormal liver function tests (LFT) prior to receiving salicylates. Liver biopsy in 1 of these 3 and in another with normal LFT was abnormal. The elevated LFT returned to normal with high dose salicylate therapy coincident with remission of disease activity. It is proposed that hepatic abnormalities in Still's disease frequently reflect the underlying disease and not salicylate hepatotoxicity (SH).