PubMed Health⌕ Search

Biomedical subjects

J R Craig

Publications and source records attributed to J R Craig.

At least 19 recordsLinked to original sources
PubMed2000

Measurement of serum hyaluronic acid in patients with chronic hepatitis C and its relationship to liver histology. Consensus Interferon Study Group.

BACKGROUND AND AIMS: Chronic hepatitis C is a slowly progressing inflammatory disease of the liver that can lead to cirrhosis and its complications. Assessment of liver damage in hepatitis C has been primarily via histological evaluation. Liver biopsy, while useful in determining the extent of liver damage, has associated costs and places patients at a small but finite risk of bleeding. Studies in small patient populations have identified serum markers shown to correlate with liver histology, including procollogen III peptide and hyaluronic acid (HA). To determine whether serum HA was a reliable predictor of cirrhosis and fibrosis, we examined serum HA concentrations from 486 chronic Hepatitis C virus (HCV) patients. METHODS AND RESULTS: Patients were anti-HCV and HCV RNA positive, with elevated alanine aminotransferase values and underwent a liver biopsy. Sera were obtained at the baseline for HA using radioimmunoassay methodology. Patients with cirrhosis had significantly higher serum HA concentrations compared with non-cirrhotic patients (382+/-31 vs 110+/-9 microg/L respectively, P< 0.001). Patients with fibrosis had significantly higher mean serum HA concentrations (179+/-11 microg/L) compared with patients without fibrosis (62+/-20 microg/L; P< 0.001). The correlation between HA concentration and the components of the Knodell histological activity index score revealed no strong associations with the exception of fibrosis, which showed moderate correlation (R=0.5421, P<0.001). The clinical value of HA measurement appears to be its ability to exclude cirrhosis. A HA value of < 60 microg/L excluded the presence of cirrhosis or significant fibrosis with a predictive value of 99 and 93%, respectively. CONCLUSIONS: Serum HA measurement may be clinically useful to non-invasively assess the degree of fibrosis and cirrhosis. Further prospective studies are warranted to determine the clinical utility of HA as a non-invasive marker of liver fibrosis.

Adult↗
PubMed1999

Efficacy of interferon treatment for patients with chronic hepatitis C: comparison of response in cirrhotics, fibrotics, or nonfibrotics.

Chronic hepatitis C patients (472 patients) were treated with consensus interferon (CIFN) or interferon (IFN) alfa-2b for 6 months in a large multicenter trial. Efficacy was assessed by clearance of hepatitis C virus (HCV) RNA using reverse transcription polymerase chain reaction (RT-PCR) (<100 copies/mL), normalization of serum alanine aminotransferase (ALT), and histological improvement. The purpose of these analyses was to compare these efficacy parameters in nonfibrotics, fibrotics, and cirrhotics. Patients with chronic HCV and cirrhosis showed the same benefit from IFN treatment as noncirrhotic patients when efficacy was assessed by clearance of serum HCV RNA or by histological benefit. Sustained HCV RNA response rates were similar when measured among nonfibrotic (11%), fibrotic (13%), and cirrhotic (11%) patients. Improvement in histologic activity index (HAI) scores was noted among all 3 groups. Cirrhotic patients had a lower sustained ALT response rate (12%) than did nonfibrotic patients (23%). Ninety percent of nonfibrotics, but only 71% of fibrotics and 67% of cirrhotics, who sustained a virological response normalized their ALT. This suggests that cirrhotic patients may clear the hepatitis C virus without normalization of ALT levels. The pattern of both HCV RNA clearance over time and ALT decrease was similar among nonfibrotics, fibrotics, and cirrhotics. Tolerability to IFN therapy was similar among the 3 groups except that more cirrhotics required dose reduction because of thrombocytopenia. In patients with cirrhosis, ALT levels may be a less appropriate endpoint in the measurement of response to therapy. We conclude that liver cirrhosis should not be a reason for excluding patients from therapy because both cirrhotic and fibrotic HCV patients benefit from IFN therapy not only by clearance of virus but by improvements in liver histology.

Adult↗
PubMed1994

Mesenchymal tumors of the liver. Diagnostic problems for the surgical pathologist.

Although some mesenchymal lesions include readily diagnosable entities, some patients have difficult presentations and unusual radiographic results. This review of mesenchymal tumors covers hemangioma, infantile hemangioendothelioma, angiomyolipoma, angiosarcoma, epitheloid hemangioendothelioma, fibroma, malignant fibrous histiocytoma, inflammatory pseudotumor, mesenchymal hamartoma, embryonal sarcoma, and sarcomatoid hepatocellular carcinoma.

Humans↗
PubMed1992

Effect of aspirin on photodynamic therapy utilizing chloroaluminum sulfonated phthalocyanine (CASP).

The efficacy of photodynamic therapy (PDT) is mediated through a direct vascular effect. Interference with platelet function and resulting vascular stasis have been recently demonstrated utilizing the photosensitizer dihematoporphyrin ether (DHE). We examined the effect of aspirin, a known inhibitor of both cyclooxygenase and platelet activity, on PDT using chloroaluminum sulfonated phthalocyanine (CASP). Thirty-six rats implanted with a window chamber were given either 0.1 mg/kg (low dose) or 10 mg/kg (high dose) aspirin immediately before, immediately after, or 6 hours after the completion of CASP-PDT. Aspirin in either dosage did not appear to have any effect on the window vasculature when given immediately after light exposure. A moderate inhibition of vascular response was seen in animals treated with aspirin pre-PDT, whereas high-dose aspirin completely abrogated the CASP-PDT vascular response when given 6 hours post-PDT. These data indicate that aspirin can effect CASP-PDT in both time-dependent and dose-dependent fashions.

Animals↗
PubMed1988

Clonal origin of hepatitis B virus-associated hepatocellular carcinoma.

The clonal origin of tumors was studied in two multifocal hepatocellular carcinomas arising from hepatitis B viral cirrhosis. DNA extracted from several tumor nodules was analyzed for the presence of hepatitis B virus genome by the Southern blot technique. Unique clonal integration of the viral DNA sequences occurred in both cases. In each case, identical integration bands occurred among multiple nodules of liver tumor. These results are strong evidence of a unicentric origin of these tumors, although the tumors' gross appearance is suggestive of multifocal origin.

Carcinoma, Hepatocellular↗
PubMed1988

Hepatic epithelioid hemangioendothelioma.

Epithelioid hemangioendothelioma (EHE) is a rare, malignant neoplasm of vascular origin arising in soft tissues, lung, and liver. Four cases of hepatic EHE are reported, and 49 previously reported cases are reviewed. The tumor occurs in adults of all ages; 66% of patients are women. The prognosis is variable. Computed tomographic findings suggest the tumor begins as multiple hepatic nodules that grow and coalesce, forming large confluent masses preferentially involving the liver periphery. Extensive hepatic involvement is associated with enlargement of uninvolved portions of the liver and splenomegaly. Awareness of the radiologic features is helpful because clinical findings are nonspecific, and biopsy specimens may be misinterpreted as carcinoma or venoocclusive disease.

Adult↗
PubMed1986

Delta viral hepatitis. Histopathology and course.

Delta viral hepatitis is important to recognize on hepatic tissue as its presence may explain severe or fulminant acute viral hepatitis, "relapse" of acute viral hepatitis, fulminant acute viral hepatitis in a chronic hepatitis B carrier, exacerbation of previously silent chronic active hepatitis, and the change in course of persistent viral hepatitis to progressive chronic active hepatitis. Histologic clues to support delta infection are primarily the severity of hepatocellular necrosis and inflammatory response. Specific immunologic procedures are required for diagnosis and include serum testing (antigen, antibody for IgG and IgM types) and antigen detection in tissue by immunofluorescence or immunoperoxidase staining. This agent is currently important as a cause of hepatitis in IV drug users, male homosexual patients, and recipients of blood products. Further studies are needed with careful accurate classification of hepatitis B patients in order to recognize the pattern of spread, severity, and outcome of delta hepatitis in other populations.

Carcinoma, Hepatocellular↗
PubMed1980

Fibrolamellar carcinoma of the liver: a tumor of adolescents and young adults with distinctive clinico-pathologic features.

Clinical and pathologic features of 23 patients with a distinctive histologic and clinical variant of hepatocellular carcinoma are summarized. The variant pattern of hepatocellular carcinoma is most common in the age group 5--35 years and occurs equally in either sex. The distinctive histologic features include 1) deeply eosinophilic neoplastic hepatocytes, many of which contain intracytoplasmic hyaline globules and distinct pale bodies and 2) fibrosis arranged in a lamellar fashion around the neoplastic hepatocytes. The histologic and gross features of the tumor have been confused both with focal nodular hyperplasia and with hepatocellular adenoma. The average survival of 32 months and the high operability rate of 48% far exceed the survival or operability for ordinary hepatocellular carcinoma. Thus, this tumor type must be recognized and considered separately when evaluating therapeutic results in large series of patients with hepatocellular carcinoma.

Adolescent↗
PubMed1980

An autopsy survey of clinical and anatomic diagnoses associated with alcoholism.

Alcoholism, a major cause of hospitalization and death in the United States, has been associated with multiple organ system dysfunctions. A systematic search by computer was made of the diagnoses in 35,579 autopsies performed from 1949 to 1972 at the Los Angeles County-University of Southern California Medical Center. Alcoholic and control cases (total, 8,186) were matched by age, sex, race, and appropriate date of death. Many major differences in diagnosis between the two groups were found. A fourfold increase in the annual frequency of alcoholism at autopsy was noted during the period under study. The mean age at death was ten years less in the alcoholism group compared with the total population submitted to autopsy. This survey supports the hypothesis that the clinical and autopsy diagnosis in alcoholic and nonalcoholic patients are significantly different in frequency.

Adult↗
PubMed1979

Extragenital adenomatoid tumor: Evidence for the mesothelial theory of origin.

The histogenesis of so-called adenomatoid tumors has been contested. Doubts as to a mesothelial derivation often have been based on the belief that adenomatoid tumors originate exclusively in or nearby genital tract organs. This report documents a histologically typical adenomatoid tumor which developed in the mesentery of the small intestine. Extensive clinical investigations and an uneventful 3-year postoperative follow-up interval confirmed that the tumor was not a metastatic adenocarcinoma or malignant mesothelioma. The extragenital site of origin of this neoplasm provides additional corroborative evidence for the mesothelial origin of adenomatoid tumors. Regardless of their anatomic location, these distinctive neoplasms should be classified as benign adenomatoid mesotheliomas.

Adenoma↗
PubMed1978

Rhabdomyosarcomas of the uterus.

The authors report the clinicopathologic findings in four cases of adult women with rhabdomyosarcomas that originated in the endometrium or cervix, or both. All tumors were pure sarcomas and not components of carcinosarcomas or malignant mixed mesodermal tumors. In two patients, the tumors were typical botryoid embryonal rhabdomyosarcomas. Both patients were alive and well following combined treatments with surgery and chemotherapy or irradiation 3.0 and 2.7 years after operation, respectively, although one had a solitary pulmonary metastasis resected. The other two women had pleomorphic rhabdomyosarcomas, and both died rapidly of widespread tumor. Combination therapy rather than surgery alone probably should be used initially for patients with rhabdomyosarcomas of the uterus.

Adult↗
PubMed1978

Splenic epidermoid cysts.

Four patients with splenic masses were operated upon and found to have epidermoid cysts of the spleen, a rare lesion comprising less than 10% of benign, nonparasitic splenic cysts. The patients were young and had vague, non-specific symptoms which were related to the size of the slowly enlarging splenic mass. Three patients had palpable masses. Contrast gastrointestinal studies and intravenous urography will help exclude mass lesions of the gastrointestinal or genitourinary tract. Sonar scan may confirm the cystic nature of the lesion and localize it to the spleen. A review of 42,327 autopsy records at the Los Angeles County--University of Southern California Medical Center revealed 32 benign splenic cysts found incidentally at autopsy. Hemorrhage, infection, rupture, and rarely, malignant change are complications of splenic cysts. Splenectomy is recommended to eliminate the symptoms produced by the cyst and prevent the potential complications.

Adolescent↗