Arthur D. Schwabe

Prophylactic Colchicine Therapy in Familial Mediterranean Fever: A Controlled, Double-Blind Study

Abstract Chronic colchicine therapy has been advocated for suppression of the painful, febrile paroxysms of familial Mediterranean fever. To evaluate the effect of this treatment, a controlled, dou...

Estimation of Fat Absorption by Monitoring of Expired Radioactive Carbon Dioxide After Feeding a Radioactive Fat

Summary A rapid method for the diagnosis of steatorrhea based upon oral administration of radioactive glyceryl trioctanoate (RATO) and study of its oxidative decarboxylation as determined by monitoring expired C 14 -labeled CO 2 has been presented. Results based upon the testing of 20 controls and 21 patients with steatorrhea of various types clearly separated 15 of the controls from all of the patients with steatorrhea. Fourteen of 21 patients with steatorrhea fell below the lowest value encountered in 20 control subjects. Possible refinements of the technique are worthy of exploration.

The Complications of Cirrhosis of the Liver

Excerpt Dr. Marshall J. Orloff: This conference will review the natural history of cirrhosis of the liver and the treatment of the disease and its complications. A case to be presented by Dr. Lipma...

Enhanced neutrophil chemiluminescence in familial mediterranean fever

Familial Mediterranean Fever is a disorder of unknown cause characterized by recurrent, self-limited paroxysms of serosal inflammation. Although the neutrophil is the predominant cell involved, no cellular abnormalities are known. Chemiluminescence was studied in neutrophils from 20 asymptomatic patients with this disease and 21 healthy controls to evaluate the oxidative response to formyl-methionyl-leucyl-phenylalanine (f-met-leu-phe). In a subset of patients with familial Mediterranean fever, neutrophils but not monocytes were shown to have significantly enhanced chemiluminescence compared to controls. The enhanced responsiveness of neutrophils to f-met-leu-phe in this disease was found to occur at a postreceptor level. Receptor binding assays demonstrated no differences in binding affinity and receptor number between patients and controls. In addition, a similar enhancement in chemiluminescence was observed with an alternative stimulus (zymosan). In contrast to chemiluminescence, chemotaxis induced by f-met-leu-phe was not enhanced in patients with familial Mediterranean fever. The enhanced neutrophil chemiluminescence may identify a subclinical inflammatory state in attack-free patients with familial Mediterranean fever, as enhanced chemiluminescence is also observed in chronic inflammatory diseases with active inflammation.

Continuous measurement of 14C-labeled substrate oxidation to 14CO2 by isolated tissues: An lonization chamber method

Abstract The vibrating reed electrometer and ionization chamber have been adapted for the continuous measurement of 14 C-labeled substrate oxidation to 14 CO 2 by isolated tissues. Substrate oxidation curves have been described for rat renal cortex and epididymal fat pad, frog gastric mucosa, and human erythrocytes. The VRE and IC should prove to be a useful tool in the study of tissue metabolism.

Effect of long-term colchicine therapy on jejunal mucosa

Colchicine is recommended as daily prophylactic therapy in patients with familial mediterranean fever (FMF) to prevent febrile paroxysms. The drug is known to be a potent inhibitor of mitotic activity and might therefore be expected to have a significant adverse effect on tissues that undergo rapid turnover. We studied small bowel biopsies from nine patients with FMF who were receiving daily low-dose oral colchicine therapy. In each patient the lengths of 20 crypts and villi were measured and the number of mitotic figures in 20 crypts were counted. The data were compared with similar measurements from histologically normal-appearing biopsies obtained from 14 patients with a variety of mild gastrointestinal complaints. The mean crypt length was found to be significantly greater (0.197 mm vs 0.186 mm,P<0.0001) and the mean villous length significantly smaller (0.369 mm vs. 0.442 mm,P<0.0001) in the FMF patients than in the control population. In addition, the mean number of mitotic figures per crypt was significantly higher in the FMF patients (2.58 vs 1.00,P<0.001). The data reveal a pattern of mucosal injury in the colchicine-treated FMF patients characterized by a hyperplastic crypt-villous atrophy pattern with increased mitotic rate, which is indicative of an increase in cell turnover and opposite to what we anticipated based on colchicines known effect on mitotic activity.

Long-term colchicine therapy of familial mediterranean fever+

Familial Mediterranean fever is a disorder characterized by recurrent fever and polyserositis. Continuous prophylactic colchicine therapy has been effective in suppressing attacks in affected adults. From 30 children with FMF, 14 were selected for colchicine therapy. Eight children continued prophylactic colchicine therapy for 29 months (mean) and experienced a marked decrease in the frequency of attacks. Six other children did not comply with the treatment regimen. Although no deleterious side effects were noted, the safety of long-term colchicine administration in childhood is unknown.

C5a-Inhibitor Deficiency — A Role in Familial Mediterranean Fever?

The sequence of events that precipitate the recurrent febrile attacks of familial Mediterranean fever has fascinated clinicians ever since the disease became firmly established as a distinct clinic...

Progressive hepatic decompensation with terminal hepatic coma in sarcoidosis

SummaryIn a case of sarcoidosis with portal hypertension, progressive hepatic decompensation terminated in hepatic coma. The difficulties encountered in the diagnosis of sarcoidosis predominantly involving the liver and the ineffectiveness of steroids in halting the progression of the disease in this patient are emphasized.

Absorption of medium-chain lipids from the rat cecum

Summary1. Absorption of G14-labelecd octanoic acid (RAO) and glyceryl trioctanoate (RATO) from the isolated rat cecum were estimated by continuous monitoring of the expired C14O2 for 1 hr.2. After RAO administration an average of 13.6% of the administered dose of radioactivity was recovered as C14O2. Thorough washing of the cecum prior to RAO instillation did not affect the rate of C14O2 recovery.3. After intracecal administration of RATO, an average of 9.8% of the administered dose of radioactivity was recovered as C14O2. Prior washing of the cecum, however, resulted in a significant reduction in the mean C14O2 recovery, to 0.7%.4. Samples of cecal contents aspirated at 20, 40, and 60 min, after trioctanoate instillation revealed the presence of detectable amounts of mono- and diglycerides when subjected to thin-layer chromatography.5. From these results it would appear that significant amounts of octanoic acid and glyceryl trioctanoate can be absorbed from the rat cecum. While the absorption of this medium-chain fatty acid seems to proceed independently of luminal factors, the absorption of trioctanoate is preceded by luminal digestion by an active lipolytic system in the cecum.