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Biomedical subjects

D F Hutcheon

Publications and source records attributed to D F Hutcheon.

13 recordsLinked to original sources
PubMed1989

Lymphocytic (microscopic) colitis. Clinicopathologic study of 18 patients and comparison to collagenous colitis.

Lymphocytic colitis, formerly called microscopic colitis, is a clinicopathologic syndrome with chronic watery diarrhea and diffuse mucosal inflammatory changes with prominent intraepithelial lymphocytes. The 18 lymphocytic colitis patients studied presented with chronic watery diarrhea at a mean age of 53.8 +/- 17 years (+/- 1 SD). Roentgenographic, endoscopic, and culture data were not diagnostic. In patients tested, there was a high prevalence of arthritis (82%) and autoantibodies (50%) but no increase in frequency of histocompatibility antigens associated with well-defined autoimmune disease (DR3, B8). Lymphocytic colitis patients were compared to 21 patients with collagenous colitis. Similarities included age, symptomatology, and nondiagnostic radiographic and endoscopic studies. However, the sex distribution was statistically different, with an equal male-to-female ratio in lymphocytic colitis and female predominance (80%) in collagenous colitis. Other differences included dissimilar histocompatibility phenotypes and collagen band on biopsies of collagenous but not lymphocytic colitis. These findings suggest that lymphocytic and collagenous colitis may be related yet distinct disorders.

Adult↗
PubMed1987

Effect of therapy on bleeding rates in gastrointestinal angiodysplasia.

Sixteen patients with gastrointestinal angiodysplasia requiring transfusion were treated with surgical resection, endoscopic electrocautery, or transfusion alone. Pre- and post-therapy transfusion requirements in each group were compared to gauge the efficacy of each therapy. No superiority of any treatment could be shown statistically. The majority of patients had multiple angiodysplastic lesions throughout the gastrointestinal tract, and, accordingly, complete resolution of bleeding after therapy occurred in fewer than one-half of the patients.

Aged↗
PubMed1985

Diet and other risk factors for cancer of the pancreas.

The findings of a case - control study of cancer of the pancreas, which was conducted in the Baltimore metropolitan area, are reported. Two hundred one patients with pancreatic cancer were matched on age (+/- 5 years), race, and sex to hospital and non-hospital controls, the latter selected by random-digit-dialing (RDD). All subjects were interviewed regarding diet, beverage consumption, occupational and environmental exposures, and medical and surgical history. Significantly decreased risks were associated with consumption of raw fruits and vegetables and diet soda, and significantly increased risks were associated with consumption of white bread when cases were compared with hospital and RDD controls. A significantly reduced risk was associated with consumption of wine when cases were compared to RDD controls. Risk ratios for consumption of coffee were not significantly different from one, although there appeared to be a dose - response relationship in women. A moderate but statistically nonsignificant increase in relative odds was found for cigarette smoking, and cessation of smoking was associated with a marked reduction in risk. No significant associations were found with particular occupational exposures. Tonsillectomy was associated with a significantly reduced risk, a finding that has been observed for other cancers as well. The current evidence indicates that pancreatic cancer is likely to result from a complex interaction of factors and suggests that the study of its etiology requires a multidisciplinary approach involving both laboratory and epidemiologic components.

Aged↗
PubMed1984

Endoscopic training in the academic GI program. Program Directors Workshop, March 29 and 30, 1984, Atlanta, Georgia. How the GI pathologist can interact best with the GI trainee.

Effective collaboration between endoscopists is essential if optimal results from gastrointestinal biopsy are to be achieved. Agreed upon ways to enhance communication should be established, such as special requisition forms and regular conferences to discuss biopsy findings. Endoscopists and pathologists should know about and feel free to discuss the other specialist's procedures and techniques. Furthermore, all procedures and techniques for obtaining, handling, and reaching diagnostic conclusions from biopsy specimens need to be carefully examined and optimized. Recommended approaches are presented.

Biopsy↗
PubMed1984

Adenocarcinoma in Barrett's esophagus after elimination of gastroesophageal reflux.

A 56-yr-old man with severe reflux esophagitis, Barrett's esophagus, and a peptic lower esophageal stricture underwent subtotal resection of the Barrett's esophagus with colonic interposition. After the interposition procedure, gastroesophageal reflux was eliminated, as evidenced by absence of clinical and radiographic findings and by the results of a later continuous pH probe recording. Despite the absence of reflux, 8 yr after the colonic interposition the patient was found to have adenocarcinoma in the remnant of the Barrett's esophagus. This case indicates that elimination of gastroesophageal reflux does not necessarily lead to regression of Barrett's mucosa, nor does it prevent development of adenocarcinoma. As a result, patients with Barrett's esophagus should remain under long-term surveillance for dysplasia and adenocarcinoma, even after successful antireflux therapy. If esophagectomy is performed, every attempt should be made to resect all of the esophagus lined by Barrett's mucosa.

Adenocarcinoma↗
PubMed1982

Cutaneous immunoglobulin deposition in primary biliary cirrhosis.

We studied the skin of six patients with primary biliary cirrhosis (PBC) to determine if there is cutaneous deposition of complement and immunoglobulins in PBC. We also investigated serum samples from these patients for the presence of circulating antibodies against nuclear and cytoplasmic antigens. Three of five patients demonstrated immunoglobulins (IgM or IgG) or complement (C3) deposition at the dermoepidermal junction (DEJ) in clinically normal, light-protected skin. Two of six patients had 2- to 5-mm papular-pustular skin lesions as a manifestation of PBC. Serological studies in these patients disclosed low antinuclear antibody titers in three patients and anti-single-stranded DNA antibody titers in the two patients with skin lesions. These histological, immunofluorescent, and serological findings offer further evidence of the occurrence of circulating immune complexes in at least some patients with PBC.

Adult↗
PubMed1979

Postcholecystectomy diarrhea.

Diarrhea developed in three patients following cholecystectomy. Fecal bile-acid excretion was elevated in the two patients for whom it was measured. All three patients' diarrhea resolved with cholestyramine resin therapy. This experience suggests that gallbladder removal may lead to a bile-acid-mediated diarrhea in some patients, and that this condition appears to respond to cholestyramine therapy.

Bile Acids and Salts↗
PubMed1979

Cryptosporidiosis in an immunosuppressed renal-transplant recipient with IgA deficiency.

Cryptosporidia are sporozoan parasites that infect epithelial cells of the gastrointestinal tract. Infection with cryptosporidia has been found most commonly in a variety of animal species and only rarely in man. The authors report a case of an immunosuppressed renal-transplant recipient with IgA deficiency who experienced diarrhea and fever and was found to have cryptosporidia in a jejunal biopsy specimen and in air-dried smears of the specimen. By electron microscopy, trophozoite, schizont, and macrogamete forms were identified, and these forms ahd morphologic features similar to those of cryptosporidia previously found in guinea pigs. Treatment of the cryptosporidial infection in this case was with trisulfapyrimidines. The efficacy of this treatment could not be evaluated because of complications.

Apicomplexa↗
PubMed1979

Hormone-mediated watery diarrhea in a family with multiple endocrine neoplasms.

A father and son each presented with severe watery diarrhea. The son was found to have a pancreatic islet-cell tumor associated with the pancreatic cholera syndrome, as well as a parathyroid adenoma. The father was found to have multiple islet-cell adenomas and the Zollinger-Ellison syndrome. Pancreatic tumor tissue from each patient contained detectable gastrin and vasoactive intestinal peptide; however, a much higher gastrin concentration was found in the tumor tissue from the father and a much higher vasoactive intestinal peptide content in the tumor tissue from the son. Thus, watery diarrhea may be mediated by different hormones in families having multiple endocrine neoplasia; the precise cause of the diarrheal syndrome should be defined to ensure the proper therapy.

Adenoma↗
PubMed1977

Esophageal reflux. Diagnosis and therapy.

Diagnosis of esophageal reflux often can be made on the basis of the characteristic symptoms of heartburn and regurgitation. When the picture is not so typical, acid reflux testing and esophageal biopsy appear to be the best indicators of esophageal reflux. Medical management is directed toward preventing reflux, neutralizing refluxed gastric contents, and enhancing clearance of refluxed material. Antacids are a mainstay of therapy, along with restrictions on diet and certain types of activity. If conservative therapy fails to control symptoms and stricture is likely to develop, surgery may be indicated.

Esophagogastric Junction↗