Search PubMed⌕ Search

Biomedical subjects

R E Sedlack

Publications and source records attributed to R E Sedlack.

8 recordsLinked to original sources
PubMed1999

Eradication of Helicobacter pylori normalizes elevated mucosal levels of epidermal growth factor and its receptor.

OBJECTIVE: Helicobacter pylori (H. pylori) infection has been linked to gastric cancer. The factors that promote carcinogenesis remain unknown. Epidermal growth factor (EGF) has been shown to be a potent epithelial mitogen and oncoprotein when sustained over expression occurs. Our aim was to compare gastric mucosal levels of EGF and its receptor (EGFR) among controls, H. pylori infected subjects, and subjects following H. pylori eradication using quantitative flow cytometric analysis. METHODS: Patients referred for evaluation of dyspepsia underwent EGD and six antral biopsies were performed (two each for rapid urease testing (RUT), histopathology, and flow cytometry). Controls were those found to be H. pylori negative while subjects had confirmed infection. The study patients were treated, then had repeat EGD with biopsies. RESULTS: There were 17 controls and 28 cases. Mean EGF and EGFR values were 2.69 and 2.46 for controls and 4.67 and 4.64 for subjects. Subjects' mean EGF was 73% higher (p = .035) and EGFR was 88% higher (p = 0.029) than controls. After treatment, the subjects' mean values declined 55% (p = 0.0001) for EGF and 40% (p = 0.002) for EGFR. Three subjects had persistent infection and showed no change in their EGF/EGFR levels. No difference was found among factor levels with respect to endoscopic findings. CONCLUSIONS: Both EGF and EGFR from gastric antral biopsies are increased nearly 2-fold in infection with H. pylori. Infection eradication reduces levels of both factors to those of controls. One major pathogenic mechanism for gastric mucosal hyperproliferation and possibly carcinogenesis related to H. pylori may be the over expression of EGF and increased receptor density of EGFR on gastric mucosal cells.

Adult↗
PubMed1990

Unsuspected syphilitic hepatitis in a patient with low-grade proteinuria and abnormal liver function.

A 25-year-old patient was found to have cholestatic liver enzyme abnormalities during assessment for asymptomatic low-grade proteinuria at the US Naval Hospital in Portsmouth, Virginia. These abnormalities persisted for a 6-month period, and an extensive workup, including viral serologic studies, rapid plasma reagin test, iron studies, ceruloplasmin, antimitochondrial, antinuclear, and anti-human immunodeficiency virus antibodies, endoscopic retrograde cholangiopancreatography, and liver biopsy, was unrevealing until serologic tests for syphilis were repeated to evaluate a new onset of urethral discharge. The patient had none of the more characteristic signs of secondary syphilis. The liver enzyme abnormalities rapidly resolved after treatment with penicillin. Syphilis remains the great impostor and still must be considered in the differential diagnosis of unexplained liver enzyme abnormalities, even in a patient with no symptoms or signs of early syphilis.

Adult↗
PubMed1983

A decline in carcinoma of the stomach. A diagnostic artifact?

During the past 50 years or more, a dramatic decline in the mortality from gastric carcinoma has been observed in virtually every country in the world, including the United States. Some investigators suspect that this decline is due to refinements in the diagnosis and classification of abdominal malignancies rather than being a true decline in the incidence of gastric cancer. Because the record system in Rochester, Minnesota, ensures the identification of virtually every patient in the local population with a serious illness, and the level of diagnosis is high, it seemed appropriate to study the incidence and long-term trends of gastric cancer in this community. Trend analysis for the period 1935 through 1979 revealed a consistent decline in the incidence of gastric carcinoma whether death certificates as the sole source of cases were included or not. Analysis of either all clinically confirmed or only tissue-confirmed cases revealed a statistically significant decrease in stomach carcinoma throughout the study period. These declines were observed even if only the more recent periods (1955 through 1979) were examined. The reasons for this finding remain obscure, but the study suggests that improvements in diagnostic accuracy alone cannot account for this remarkable downward trend in gastric malignancy.

Adolescent↗
PubMed1980

Incidence of Crohn's disease in Olmsted County, Minnesota, 1935-1975.

The incidence, trend over a 41-year period, prevalence, familial aggregation, and survivorship of Crohn's disease in the population of Olmsted County, Minnesota, are described. During the period 1935-1975, there were 103 incidence cases; the age-adjusted incidence rate per 100,000 rose from 1.9 (1935-1954) to 4.0 (1955-1964) and to 6.6 in the most recent period (1965-1975). The increase of the rate over the last 11 years is due largely to the increase among persons 20 to 29 years old. No difference in the rates by sex was found. The urban rates were higher than the rural for both sexes and in each interval of the study. The prevalence of Crohn's disease among the residents of Olmsted County on Jan. 1, 1976, was found to be 105.7 per 100,000 population. The relatively high prevalence rate reflects the chronic nature of the disease, the recent increase of incidence, the completeness of case ascertainment, and the high survival rate among these patients.

Adult↗