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Biomedical subjects

G H Warren

Publications and source records attributed to G H Warren.

At least 19 recordsLinked to original sources
PubMed1991

Collagenous colitis with involvement of terminal ileum.

We present a case of collagenous colitis with evidence of terminal ileal involvement. The patient suffered from chronic watery diarrhea of three months' duration, and colonoscopy revealed a normal endoscopic appearance. Histologic examination of biopsies revealed a broad subepithelial band of collagen, with similar histologic findings in the terminal ileum. Additionally, the patient exhibited abnormalities of d-xylose and vitamin B12 absorption, although there were no clinical signs of malabsorption. Biopsy of the proximal small intestine was normal. The significance of these findings for the definition of the clinicopathologic entity of collagenous colitis and its pathogenesis are discussed.

Colitis↗
PubMed1990

Fulminant hepatic failure associated with intravenous erythromycin lactobionate.

Fatal fulminant hepatic failure accompanied by brisk hemolysis developed in an elderly man after intravenous administration of erythromycin lactobionate for a lower respiratory infection. To our knowledge, this is the first case of fatal hepatotoxicity associated with intravenous erythromycin therapy. Erythromycin should be added to the list of drugs that can cause fulminant hepatic failure.

Aged↗
PubMed1987

The use of infrared photoplethysmography in identifying early intestinal ischemia.

Acute intestinal ischemia and infarction remain serious clinical problems despite early operative intervention. An accurate and reproducible method of assessing ischemic tissue is critical to determine the precise limits of resection. The purpose of this study was to compare the utility of infrared photoplethysmography, intravenous fluorescein, and Doppler ultrasound in assessing intestinal ischemia in an operative canine model. After five segmental mesenteric arterial ligations in each of six conditioned dogs, the detection threshold for the limits of arterial perfusion of each modality was determined and correlated with the respective histopathologic specimens. Infrared photoplethysmography proved to be 100% sensitive for ischemia when its waveform amplitudes were 50% or greater of matched reference waveforms, whereas both intravenous fluorescein and Doppler ultrasound were 88% sensitive. All were comparably specific. We conclude that infrared photoplethysmography is comparable to intravenous fluorescein and Doppler ultrasound in the assessment of ischemic intestinal segments.

Animals↗
PubMed1987

Search for a specific marker of mucosal dysplasia in chronic ulcerative colitis.

We have tried to identify a histochemical or immunohistochemical marker that would reliably detect mucosal dysplasia in chronic ulcerative colitis. Colonic biopsy specimens were taken from patients with long-standing ulcerative colitis undergoing surveillance colonoscopy. Control tissue was obtained from the margins of colonic resections performed for neoplastic or nonneoplastic diseases. Sections of the specimens were examined by periodic acid-Schiff staining, high iron diamine Alcian blue staining for sialomucins and sulfomucins, and binding of the lectins peanut agglutinin, Ulex europeus agglutinin I, and Ricinis communis I agglutinin. Sections were reacted also with anticarcinoembryonic antigen antibodies to determine whether a nonpolar surface distribution of the antigen was a feature of dysplasia. We found that changes in colonic mucin, characterized by periodic acid-Schiff-positive mucin outside of goblet cells, an increase in binding of peanut agglutinin, and an increase in the relative amount of sialylated mucin, were associated with morphologic dysplasia. However, identical alterations were observed, albeit less commonly, in colitis without dysplasia, particularly in the presence of active inflammation. No abnormality in the surface distribution of carcinoembryonic antigen or Ricinis communis I agglutinin was observed. Thus, we did not identify a reliable corollary test to the histologic diagnosis of mucosal dysplasia in ulcerative colitis. With regard to these histochemical markers, the colonic mucosa appears to respond similarly to inflammation and neoplasia.

Carcinoembryonic Antigen↗
PubMed1987

Cocaine-induced hepatotoxicity in humans.

A patient with hepatonecrosis associated with cocaine use is presented. Postmortem examination of the liver showed marked periportal inflammation and necrosis, and mild diffuse fatty infiltration. These pathologic findings are identical to those previously reported in a mouse model of cocaine hepatotoxicity.

Adult↗
PubMed1986

Obstructive cholangitis secondary to mucus secreted by a solitary papillary bile duct tumor.

A middle-aged woman had repeated episodes of common bile duct obstruction and cholangitis caused by profuse secretion of mucus by a solitary papillary tumor in the left hepatic duct. This complication usually occurs only with papillomatosis. The tumor initially appeared to be benign but subsequently was proven to be an invasive adenocarcinoma. Although the tumor recurred after surgical resection, her course remained uneventful without spread of the neoplasm for 3 yr.

Adenocarcinoma↗
PubMed1985

The haematopoietic response to burning: an autopsy study.

Many haematopoietic changes follow severe burn injury. Abnormalities in the production and function of granulocytes have been reported, as have changes in peripheral blood platelet counts. Anaemia invariably occurs and has a multifactorial aetiology including haemorrhage and haemolysis. To study these changes further, haematopathological materials from 22 patients who had died of burning were compared with a control group of haematologically normal people who had died suddenly and a third group of patients who had died of sepsis. Granulocytes and megakaryocytes were increase in the marrow of burned patients while erythroid tissue was reduced compared with both control groups. There was no evidence of extramedullary haematopoiesis. This study provides morphological evidence that the rate of erythropoiesis is reduced post burn and suggests that this plays a role in the anaemia seen after burn injury.

Adult↗
PubMed1985

Characterization of calcium deprivation-induced cholestasis in the perfused rat liver.

To elucidate the role of calcium in regulation of canalicular bile flow, we studied biliary sucrose permeability and the transport kinetics of taurocholate in the in situ perfused rat liver. Calcium deprivation did not adversely affect viability or ultrastructural appearances of the liver. Removal of calcium led to initial choleresis followed by cholestasis dependent on external ionized calcium concentration. Biliary recovery of [14C]sucrose relative to that of tritiated water was determined by a biliary multiple-indicator dilution technique. Analysis in terms of irreversible thermodynamics suggested that biliary permeability to sucrose increased due to a change in the sieving coefficient from 0.135 to 0.435. Biliary recovery of taurocholate was significantly (P less than 0.001) reduced in low-calcium medium (from 79.6 +/- 6.5 to 17.6 +/- 11.8%). This was not due to a defect in hepatocellular uptake of taurocholate as determined in the perfused rat liver by a multiple-indicator dilution technique and in isolated hepatocytes. We conclude that calcium deprivation-induced cholestasis is characterized by an increased biliary permeability, a defect in cellular translocation and/or canalicular secretion of bile salts, and a defect in bile salt-independent bile flow.

Animals↗
PubMed1983

A morphometric analysis of the changes with age in the skin surface wax and the sebaceous gland area of Merino sheep.

Skin samples were collected from the midside of Merino ewes at 6 weeks, one year, and 3 years of age. The thickness of the surface wax and the number and area of sebaceous glands per unit length of skin were measured with an image analyser. Three-year-old sheep had a significantly (P less than .05) thicker skin surface wax layer, (14.45 mu +/- 1.45), than they did as lambs, (7.85 mu +/- 0.88). Both the number (2.91 +/- 0.15 per mm) and area (24.27 mu2/mu +/- 1.54) of sebaceous glands per unit length of skin of 3-year-old sheep were significantly less than in lambs, which measured 4.10 +/- 0.15 per mm and 39.30 +/- 4.14 mu2/mu respectively and one-year-old sheep, which measured 3.99 +/- 0.21 per mm and 35.43 mu2/mu +/- 3.65 respectively.

Aging↗
PubMed1983

Experimental Campylobacter jejuni infection of adult mice.

HA-ICR adult mice were studied to develop an animal model for Campylobacter jejuni enteritis in humans. Fecal and ileal cultures made by selective and nonselective methods showed that C. jejuni and related organisms are not bowel commensals. Intragastric feeding of 10(8) CFU of three different strains of C. jejuni produced infection in 100% of the animals, and infection rates were dose dependent. Pretreatment with antibiotics or opiates was not necessary to induce infection. Fresh isolates and strains passed on artificial media yielded similar infection rates. Infected mice did not show signs of illness, but transient bacteremia within 10 min of oral infection was observed in nearly 100%. The small intestine was the principal target organ, with epithelial inflammation seen 48 h after infection. Control mice of four species had undetectable serum immunoglobulin G antibody specific for the infecting strain, but infected mice showed peak titers at 1 week with rapid decline. Immunoglobulin M titers rose minimally, and immunoglobulin A titers did not rise. Infected mice uniformly became chronic asymptomatic excretors, shedding 10(4) to 10(6) CFU/g of feces; a minority were biliary carriers. Intestine carriage was most pronounced in the stomach and proximal small intestine. Because this experimental infection led to bacteremia, transient pathological changes, and immunoglobulin G titer rises, this model may be useful for evaluating the effects of prophylactic and therapeutic interventions.

Animals↗
PubMed1983

Endoscopic sclerotherapy for bleeding esophageal varices: effects and complications.

Endoscopic esophageal vein sclerosis recently has been revived as a treatment for bleeding varices because long-term results with portacaval shunts have been poorer than suggested by initial short-term studies. Esophageal vein thrombosis secondary to endothelial damage has been considered the result of the activity of the sclerosing agents, but until 1981 there had been little pathologic documentation. Autopsy findings in ten patients who died after variceal sclerosis suggest that variceal obliteration is achieved by mural necrosis followed by fibrosis, and that thrombosis is only a transient phenomenon. Complications of sclerotherapy that were found included ulceration, hemorrhage, perforation, and stricture.

Adult↗
PubMed1983

Inflammatory polyposis in an ileal blind loop.

A case of inflammatory polyposis of the ileum after ileosigmoid anastomosis is reported. Two features are noteworthy. First, the polyps were localized in a blind ileal loop. Second, while rare ileal inflammatory polyps related to enteroenteric anastomosis have been reported, to our knowledge this is the first instance of approximately 50 polyps to be described at such a site. The etiology of these lesions is unknown but may be related to fecal irritation, stasis, bacterial overgrowth, or bacterial toxin. These polyps may ulcerate and bleed, causing iron deficiency anemia, and they must be distinguished from neoplastic polyps. Since side-to-side and end-to-side anastomoses have become more common with use of the surgical stapler, inflammatory polyps may be encountered more frequently.

Aged↗
PubMed1983

The biliary tract in inflammatory bowel disease.

In summary, the biliary tract seems particularly vulnerable to damage in patients with chronic inflammatory bowel diseases. The intrahepatic histological features of the common entity, pericholangitis, and the uncommon lesion, sclerosing cholangitis, overlap and, some feel, may be different manifestations of the same hepatobiliary insult. The potentially important role for cholangiography in distinguishing between usually banal and frequently serious disease is evident. Not knowing the cause of either lesion, appropriate preventive measures or treatment are not available. The role of the inflammatory disease in the potential development of cholangiocarcinoma is not clear. Cholelithiasis secondary to ileal dysfunction is usually independent of the other three processes.

Adult↗
PubMed1982

Granulomatous Torulopsis glabrata cholecystitis in a diabetic.

A 53-year-old man who was a healthy, diet-controlled adult-onset diabetic underwent elective cholecystectomy eight weeks after an episode of acute cholecystitis. The gallbladder showed granulomatous inflammation and a single, mixed gallstone. Torulopsis glabrata was isolated from bile. This yeast of low pathogenicity is usually of clinical significance only in patients with serious associated illness. The patient remains well, and no reservoir for the organism has been identified in him. This is the first report of this organism causing cholecystitis confirmed by both culture and histologic examination. Supporting one report and conflicting with several others, the inflammatory reaction of T. glabrata may be granulomatous.

Candida↗