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Biomedical subjects

K R Falchuk

Publications and source records attributed to K R Falchuk.

At least 37 records · Page 2Linked to original sources

Pericentral hepatic fibrosis and intracellular hyalin in diabetes mellitus.

Five patients with maturity-onset diabetes mellitus and hepatomegaly were studied. This group in cluded moderately obese females in whom hepatomegaly and abnormal liver studies were associated with a marked elevation in the erythrocyte sedimentation rate. Liver biopsies from all 5 showed fatty steatosis and pericentral fibrosis. In 3 of the 5, fibrous bridging between central veins and portal tracts was present. Collagen surrounded swollen hepatocytes, some of which contained intracellular hyalin indistinguishable from Mallory's hyalin. Polymorphonuclear neutrophils and regenerating nodules were not present. None of the patients had a history of alcohol use, and in 2 followed closely for 2 yr, alcohol was never detected in random blood samples. The recognition of this morphologic lesion may help to clarify the significance of this finding as an intermediate lesion between fatty steatosis and cirrhosis in diabetics.

Adult↗

Gestational choriocarcinoma and thyrotoxicosis.

A case of a 26-year-old woman with metastatic choriocarcinoma and clinical and biochemical thyrotoxicosis is described. This represents the eighth reported case of the association of choriocarcinoma and thyrotoxicosis. Serial monitoring of serum thyroxine (T4) and thyroid stimulating hormone (TSH) levels correlated precisely with the beta sub-unit human chorionic gonadotropin (hCG) level and the quantitation of host tumor burden. The development of a hypermetabolic syndrome in patients with choriocarcinoma may be due to secondary thyrotoxicosis from either the TSH-like activity of hCG or from the concomitant production of molar thyrotropin by the tumor.

Adult↗

Primary histiocytic lymphoma of the esophagus.

Squamous cell carcinoma represents the most common primary malignant lesion of the esophagus (1). The initial manifestation of lymphosarcoma infrequently occurs in the gastrointestinal tract, and in one large series, there were no lymphosarcomas presenting in the esophagus (2). In the case described below, a primary histiocytic lymphoma (large cell lymphoma) was discovered in the distal esophagus.

Esophageal Neoplasms↗

Increased frequency of HLA-DRW4 in chronic active hepatitis.

HLA-A, B, C and DRw typing was performed on peripheral blood lymphocytes of 17 adults with the diagnosis of chronic active hepatitis made by liver biopsy as the only criterion for study. An increase in the frequency of HLA-DRw4 (71 vs. 24%, p less than 0.005) was observed, but there was no increased frequency of HLA-A1, B8 or any other HLA locus specificity.

Adult↗

Effect of vitamin A on the systemic and local antibody responses to intragastrically administered bovine serum albumin.

The effects of vitamin A on the immune response to bovine serum albumin (BSA) were studied in adult mice. Treatment with vitamin A by the intragastric or parenteral routes markedly increased the local as well as the systemic antibody response to different concentrations of the antigen (BSA). In contrast, in animals given BSA alone, antigen concentrations above a certain dose resulted in a decreased or even absent anti-BSA response. These studies suggest that vitamin A may be an appropriate adjuvant in oral immunization.

Adjuvants, Immunologic↗

Tetracycline-induced pleural symphysis for recurrent hydrothorax complicating cirrhosis. A new approach to treatment.

Two patients with cirrhosis and ascites complicated by extensive unilateral pleural transudates refractory to therapy with dietary sodium restriction, diuretics, and repeated thoracentesis were successfully managed by tetracycline-induced pleural symphysis. The intrapleural instillation of this antibiotic prevented the recurrence of the effusion and substantially relieved the patients' symptoms with minimal undesirable side effects.

Female↗

The value of endoscopic retrograde pancreatography in the management of pancreatic ascites.

A case of pancreatic ascites is presented in which the preoperative use of endoscopic retrograde cannulation of ampulla of Vater (ERCP) precisely located the site of pancreatic duct disruption and thus directed the choice of operation best suited to this patients. We suggest that in this form of ascites preoperative ERCP may aid in the selection of those patients whose lesions are surgically correctable.

Ascites↗

Circulating antibodies to bovine albumin in ulcerative colitis and Crohn's disease. Characterization of the antibody response.

The presence of antibodies against a dietary protein, bovine serum albumin (BSA), was investigated in the serum of normal subjects and patients with inflammatory bowel disease and celiac disease. Antibodies to BSA were demonstrated in 28 of 30 patients with ulcerative colities (93%), 30 of 35 with Crohn's disease (86%), 5 with untreated celiac disease and in 12 of 28 normal subjects (43%). In patients with inflammatory bowel disease, antibodies to BSA were present in greater amounts in those with severe and moderate disease than in those with mild disease. Moreover, in those patients with high titers of circulating antibody, the serum anti-BSA activity was always associated with IgG and sometimes with IgA. These findings suggest that an increased absorption of antigenic material and stimulation of antibody production may occur in association with intestinal mucosal damage, not only in ulcerative colitis and celiac disease, but also in Crohn's disease.

Animals↗

Serum lysozyme in Crohn's disease and ulcerative colitis.

Serum lysozyme (muramidase) concentrations were determined in patients with different types of inflammatory bowel disease and in normal subjects. The mean (plus or minus S.E.M.) lysozyme concentration for each group was as follows: controls, 8.8 plus or minus 0.3, ulcerative colitis, 9.3 plus or minus 0.6, Crohn's disease, 26.3 plus or minus 1.4. a and bacterial and nonbacterial enteritis, 8.9 plus or minus 0.7 mug per milliliter. Thus, mean enzyme levels were significantly greater in Crohn's disease than in ulcerative colitis (p smaller than 0.001), bacterial and nonbacterial enteritis (p smaller than 0.001) and healthy volunteers (p smaller than 0.001). The elevation of serum lysozyme in Crohn's disease may be related to tissue macrophages because no correlation was found between either the serum lysozyme concentration and the white-cell counts or the absolute numbers of circulating granulocytes or monocytes. Our findings suggest that serum lysozyme may be useful in the differential diagnosis of Crohn's disease from other types of bowel inflammation.

Adolescent↗

Selective immunoglobulin a deficiency, ulcerative colitis, and gluten-sensitive enteropathy--a unique association.

A patient with selective immunoglobulin A deficiency, severe ulcerative colitis, and malabsorption had a flat jejunal mucosa demonstrated by peroral biopsy. Treatment at different times with a gluten-free diet for the jejunal lesion and corticosteroids for the ulcerative colitis, led to improvement of the malabsorption. A repeat jejunal biopsy demonstrated histological improvement of the jejunal mucosa, even though the colitis remained active. The occurrence of immunoglobulin A deficiency in a patient with ulcerative colitis and gluten-sensitive enteropathy is uncommon.

Adrenal Cortex Hormones↗

Serum lysozyme in Crohn's disease. A useful index of disease activity.

Serum lysozyme concentrations were determined in patients with clinically active and inactive Crohn's disease as well as in healthy volunteers. The mean serum lysozyme concentrations (+/- SE) for each group were as follows: controls, 8.8 +/- 0.4; active Crohn's disease, 20.8 +/- 0.8; and inactive Crohn's disease, 10.4 +/- 0.7 mug per ml. The mean lysozyme level was significantly greater in active Crohn's disease as compared to normal subjects (P less than 0.001) and patients with inactive disease (P less than 0.001). Moreover, in patients with clinically severe Crohn's disease there seems to be a trend toward greater lysozyme levels, as opposed to those with mild to moderately active disease. In patients followed serially during the course of their disease, serum lysozyme levels increased with exacerbations of the illness and decreased with clinical improvement. These findings suggest that the serum lysozyme concentrations may serve as a useful index of the activity of Crohn's disease and aid in monitoring the clinical course of such patients.

Crohn Disease↗