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J C Watts

Publications and source records attributed to J C Watts.

At least 37 records · Page 2Linked to original sources
PubMed1996

Is there still a need for the general surgical pathologist?

As the work of surgical pathologists becomes increasingly complex and specialized, we must ask whether there is still a need for the generalist. The answer to this question depends on a variety of factors within a given laboratory, including laboratory setting (service versus academic), specimen volume and composition, and level of staffing. The major advantages to maintaining staff expertise in general surgical pathology include flexibility of scheduling and improvement in the overall quality of diagnostic work. However, academic teaching departments inevitably require a higher level of subspecialization to accommodate research and teaching obligations. The advantages and limitations of maintaining staff expertise in general surgical pathology are discussed in light of the system that has evolved in the author's own hospital-based laboratory, in which expertise in general surgical pathology is required of all staff pathologists in addition to the development of expertise in one or more subspecialty areas. Current trends toward managed care will demand that most of us maintain our general skills. Failure to do so may lead to consolidation of services and elimination of jobs.

Humans↗
PubMed1995

Aspergillus keratitis after radial keratotomy.

PURPOSE/METHODS: A case of severe Aspergillus keratitis after radial keratotomy manifested as a discrete midstromal infiltrate along a radial incision. Despite aggressive treatment with topical amphotericin B and oral itraconazole, the patient required a therapeutic penetrating keratoplasty. RESULTS/CONCLUSIONS: Histopathologic examination disclosed a corneal ulcer with numerous septate, branching hyphae throughout the stroma, and marked stromal necrosis. Aspergillus species should be included among the microbial pathogens responsible for infectious keratitis after radial keratotomy. If infectious keratitis is suspected, comprehensive cultures for bacteria and fungi should be obtained.

Amphotericin B↗
PubMed1994

Angiomatoid carcinoma and 'angiosarcoma' of the thyroid gland. A spectrum of endothelial differentiation.

The existence of angiosarcoma of the thyroid gland and its relation to angiomatoid carcinoma have been debated. The authors reviewed eight angiomatoid thyroid neoplasms. Controls consisted of six sarcomatoid thyroid carcinomas without angiomatoid features and an angiosarcoma metastatic to the thyroid gland. All eight angiomatoid neoplasms consisted of epithelioid cells with prominent eosinophilic cytoplasm lining vascularlike spaces. All eight expressed vimentin. Four tumors were predominantly angiosarcomalike neoplasms, based on staining for factor VIII-related antigen (three of four), CD31 (four of four), CD34 (one of four), and Ulex europaeus I lectin (four of four); they lacked epithelial markers other than cytokeratin (two of four). Four tumors were designated as angiomatoid carcinomas, based on staining for multiple epithelial markers: cytokeratin (four of four), epithelial membrane antigen (three of four), thyroglobulin (three of four). Three angiomatoid carcinomas also expressed or labeled with one or more vascular markers: CD34 (one of four), CD31 (two of four), Ulex europaeus I lectin (one of four), factor VIII-related antigen (one of four). The metastatic angiosarcoma to the thyroid gland labeled for factor VIII-related antigen, vimentin, CD31, and with Ulex europaeus I lectin. It did not express CD34. The six sarcomatoid carcinomas without angiomatoid features stained for cytokeratin (four of six), epithelial membrane antigen (one of six), and vimentin (six of six). None labeled for thyroglobulin, factor VIII-related antigen, CD31, CD34, or with Ulex europaeus I lectin. Angiomatoid carcinomas of the thyroid gland exhibit both epithelial and endothelial features. "Angiosarcoma" may represent the extreme in this spectrum of endothelial differentiation. All tumors behaved in a similar clinical fashion characterized by persistent local disease, widespread metastases and poor prognosis.

Aged↗
PubMed1990

Focal hepatic candidiasis with perihepatic adhesions: laparoscopic and immunohistologic diagnosis.

Two patients developed fever, cholestasis, and neutropenia following chemotherapy for acute leukemia. Computed tomographic scans of the liver were nondiagnostic, but peritoneoscopy in each case showed diffuse studding of the liver surface with white plaques. Microbiological cultures of the biopsy specimens were negative, but direct immunofluorescence stains of deparaffinized sections of the biopsies confirmed candidiasis. Follow-up laparoscopy in 1 patient after 2 mo of treatment with amphotericin B showed development of diffuse perihepatic adhesions. Peritoneoscopy is valuable in the diagnosis and management of focal hepatic candidiasis, and an etiologic diagnosis can be provided by immunohistology when microbiological culture of the biopsy specimen is negative or unavailable.

Adult↗
PubMed1990

Giant forms of Blastomyces dermatitidis in the pulmonary lesions of blastomycosis. Potential confusion with Coccidioides immitis.

Typical yeast-phase cells of Blastomyces dermatitidis have a characteristic appearance in tissue sections. Fungal morphologic variation occurs infrequently in the lesions of blastomycosis, yet it can complicate the differential diagnosis, particularly if fresh tissue is not available for microbiologic culture. The authors report a case of pulmonary blastomycosis, confirmed by culture and direct immunofluorescence, in which some of the yeast-like cells were abnormally large. These giant yeast-like cells exceeded the size range accepted for the tissue forms of B. dermatitidis; therefore, coccidioidomycosis was considered initially in the differential diagnosis. Otherwise characteristic morphologic features of these cells, in particular multinucleation and the production of broad-based blastoconidia, helped resolve the differential diagnosis. The diagnosis can be confirmed by direct immunofluorescence or microbiologic culture.

Blastomyces↗
PubMed1988

Nephrogenic adenoma of the bladder: report of 10 cases.

Nephrogenic adenoma is an uncommon metaplastic lesion of the lower urinary tract that usually is associated with antecedent inflammation or surgical procedures. We report 10 new cases, 8 of which followed renal transplantation and 1 of which followed partial cystectomy for squamous cell carcinoma of the bladder. No predisposing factors could be identified in 1 patient. The nephrogenic adenomas, all of which were located in the bladder, were treated by either biopsy with fulguration or transurethral resection. The lesion recurred locally in 1 patient.

Adult↗
PubMed1988

Immunofluorescence as an adjunct to the histopathologic diagnosis of Chagas' disease.

We have developed a new indirect immunofluorescence procedure for identifying Trypanosoma cruzi amastigotes in sections of Formalin-fixed, paraffin-embedded tissue pretreated with a 0.25% trypsin solution to enhance immunofluorescence. In sections of human and mouse myocardia infected with T. cruzi and stained by this procedure, both intact amastigotes and phagocytosed amorphous antigen were intensely fluorescent and easily detected; nonspecific background fluorescence was absent or minimal. No staining occurred in similarly treated sections of Formalin-fixed, paraffin-embedded tissue that contained Histoplasma capsulatum var. capsulatum, Toxoplasma gondii, or Leishmania donovani to control specificity. Because pathology laboratories usually receive Formalin-fixed tissues for evaluation, this rapid and reliable procedure can be used to extend the diagnostic capability of conventional histopathology.

Animals↗
PubMed1988

Echo-planar pediatric imager.

Practical constraints make it difficult to build large-aperture echo-planar magnetic resonance (MR) imagers. The implementation of a pediatric imager and its performance are described. Spatial resolution and signal-to-noise levels comparable to those of 1982 state-of-the-art MR imagers have been achieved in imaging times of 0.05-0.15 seconds. T1 and T2 information are obtainable in the echo-planar mode. A major issue is that of chemical-shift displacements.

Child↗
PubMed1986

Disseminated cryptococcosis presenting as cellulitis with necrotizing vasculitis.

Patients with disseminated cryptococcosis infrequently present with cutaneous involvement. Skin lesions, when present, are usually multiple and polymorphous in appearance. Cellulitis caused by Cryptococcus neoformans is rare, and necrotizing vasculitis associated with cryptococcal vascular invasion has not to our knowledge been reported. We report here a case of disseminated cryptococcosis in a renal transplant recipient who had cellulitis and necrotizing vasculitis and in whom a diagnostic skin biopsy allowed for early therapy with cure and salvage of the renal allograft.

Cellulitis↗