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Biomedical subjects

J H Johnston

Publications and source records attributed to J H Johnston.

At least 19 recordsLinked to original sources
PubMed1995

Gastric syphilis: endoscopic and histological features mimicking lymphoma.

The United States is currently experiencing a syphilis epidemic. We report three cases of gastric syphilis seen during a 1-yr period. These cases were endoscopically and microscopically confused with lymphoma. Recent evidence has suggested that Helicobacter pylori has a causative role in the development of gastric carcinoma, lymphocytic gastritis, and lymphoma, as well as peptic ulcer disease and chronic gastritis. During the same period of heightened awareness for the role of H. pylori-associated gastric pathology, there has been a simultaneous rise in the incidence of syphilis throughout the United States, especially in the inner city. Gastroenterologists and pathologists must have an awareness that gastric syphilis can mimic lymphocytic gastritis and gastric lymphoma. Because of the current syphilis epidemic, gastric syphilis must be carefully considered as a diagnostic possibility in any patient with endoscopic and histological findings suggesting lymphocytic gastritis or lymphoma. This diagnosis of gastric syphilis should be weighed even when H. pylori infection is present. All three of our patients tested negative for the HIV antibody.

Adult↗
PubMed1994

Infection stones in children: a twenty-seven-year review.

OBJECTIVE: The objective of this study was to determine the relationship between urinary tract infection and pediatric urolithiasis and to characterize the pediatric infection stone former. METHODS: Two hundred seventy consecutive pediatric stone formers presenting over a twenty-seven-year period were studied. Of these, 161 children (60%) had infection-related stones. Account was taken of stone composition, anatomic location, associated anatomic lesions, and the rate of stone recurrence over a median follow-up of three years. RESULTS: The mean age of children with infection stones was 4.9 years, with two-thirds being under six years of age. Proteus mirabilis accounted for 82 percent of pure urine cultures. Seventy percent of stones were renal and 30 percent were ureteral or intravesical. One-third of patients had anatomic lesions (pelviureteric obstruction, primary obstructed megaureter, and others) contributing to stone formation. Recurrent stones occurred in 14 percent of cases. CONCLUSIONS: This study reaffirms the predominance of urinary tract infection secondary to P. mirabilis as the leading cause of pediatric urolithiasis in the United Kingdom. The significant recurrence rate suggests the importance of prophylactic antibiotics, surgical correction of congenital anomalies, and long-term follow-up of this patient population.

Adolescent↗
PubMed1990

Potential recruits in medical outpatients--an audit.

A retrospective study was made of 309 randomly selected potential service recruits seen over five years by different consultant physicians in an Army hospital. Only nine of 133 referred with a history of asthma were turned down because of an abnormality in their exercise lung function test. Only four of 92 referred for a systolic heart murmur were rejected. Only one was turned down because of a headache or migraine out of 30 referred with that diagnosis. None of nine with supposed high blood pressure nor of five with a past history of pneumothorax was rejected. Of seven referred because of epilepsy, all five with definite evidence of this were turned down. The predictability of the specialist decision in these conditions suggests that more than 80% of all potential recruits referred to hospital with medical problems (at least 800 people yearly in UK) do not need to attend.

Female↗
PubMed1989

Etiological factors in pediatric stone recurrence.

We followed 270 pediatric stone patients during a 27-year period to determine the recurrence rate of stone disease. Stone disease recurred in 42 patients (16 per cent). When these patients were categorized according to etiology of the stone disease the recurrence rates were infection 14 per cent, idiopathic 14 per cent, anatomical 27 per cent and metabolic 30 per cent. The most prolonged interval to stone recurrence in each category ranged from 7 to 13 years and, thus, long-term followup of pediatric stone patients seems to be important.

Child↗
PubMed1989

Mitral valve prolapse:--the facts.

Mitral Valve Prolapse does not cause chest pain or other symptoms and is extremely unlikely to give rise to complications. In practice it is difficult to differentiate a 'prolapsing' valve from one that is 'normal' no matter what methods are used. Since diagnosing 'heart disease' is itself a well known cause of ill health, the most stringent criteria must be adopted before the mitral valve is labelled as being abnormal. The need for the diagnosis at all is, in most cases, doubtful.

Electrocardiography↗
PubMed1989

TB in Gurkhas.

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Cross-Sectional Studies↗
PubMed1987

Experimental comparison of endoscopic yttrium-aluminum-garnet laser, electrosurgery, and heater probe for canine gut arterial coagulation. Importance of compression and avoidance of erosion.

We compared five endoscopic thermal devices that have been used clinically for control of arterial bleeding in the gastrointestinal tract: neodymium:yttrium-aluminum-garnet (YAG) laser, electrofulguration, monopolar and bipolar electrocoagulation, and heater probe. In canine models we determined the ability to coagulate arteries of varying size and depth. The most effective method for coagulation of medium size arteries was first to occlude the vessel by compression, then to apply heat to seal it (coaptive coagulation). For the contact probes (monopolar, bipolar, and heater probes), the depth of tissue coagulation was controlled by varying probe appositional force and energy, and coagulation of deep arteries was possible. Undesirable erosion of tissue and vessels was noted with electrical sparking from the monopolar electrode and with YAG laser at high power density. In contrast, heater probe and bipolar electrocoagulation did not produce tissue erosion at any instrument setting. In this comparative study of arterial coagulation, overall ranking was as follows: heater probe = bipolar electrocoagulation greater than monopolar electrocoagulation greater than neodymium:YAG laser greater than electrofulguration greater than control. In our opinion these data should assist the clinician or investigator who plans to coagulate arterial bleeding lesions such as peptic ulcers, although further clinical research will be needed to verify these experimental results.

Animals↗
PubMed1987

Palliative bipolar electrocoagulation therapy of obstructing esophageal cancer.

In a multicenter pilot study, a prototype bipolar electrocoagulation tumor probe was employed for palliation of obstructing circumferential esophageal cancer in 20 patients. Mean number of initial treatment sessions was 1.7. Dysphagia and tumor channel size improved significantly after treatment. Mean treatment interval before repeat treatment was 7.6 weeks. Major complications included delayed hemorrhage (two patients) and esophageal-pulmonary fistula (two patients). This new device may provide a less expensive alternative to laser or surgery for palliation of malignant esophageal obstruction.

Adenocarcinoma↗
PubMed1987

Obesity bubbles.

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Catheterization↗
PubMed1985

Comparison of heater probe and YAG laser in endoscopic treatment of major bleeding from peptic ulcers.

In our experience using the YAG laser and the heater probe in endoscopic treatment of major hemorrhage from peptic ulcers, ultimate hemostatic success was achieved in 19 of 20 (95%) ulcers treated with the heater probe, versus 24 of 35 (69%) YAG laser-treated ulcers (p less than 0.05). The heater probe was considerably faster, more convenient to use, and safer than YAG laser. We presently consider the heater probe to be the preferred endoscopic hemostatic device.

Electrocoagulation↗
PubMed1983

Leptospirosis--an occupational disease of soldiers.

Two cases of leptospirosis are described in soldiers who fell into a river together. One developed Weil's disease due to icterohaemorrhagiae serogroup and the other "Mud-Fever" due to grippotyphosa serogroup. The organisms were initially cultured in standard blood culture media. There were six cases of leptospirosis in BAOR in the 10 years to 1980 giving an incidence 10 times greater than in the civil population of UK and West Germany. Leptospirosis is an occupational disease of soldiers in BAOR and the health risks of fresh water immersion should be publicised.

Adult↗