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Biomedical subjects

J M Lawson

Publications and source records attributed to J M Lawson.

33 records · Page 2Linked to original sources
PubMed1992

Wegener's granulomatosis masquerading as pancreatic carcinoma.

A 62-year-old male presented with painless jaundice and solitary pulmonary and pancreatic masses. An extensive evaluation revealed Wegener's granulomatosis as the etiology. His pancreatic mass and jaundice responded to temporary stenting and therapy with cyclophosphamide and prednisone. While pancreatic vasculitis in Wegener's granulomatosis has been noted previously in autopsy studies, symptomatic involvement has been reported only once previously and never as a presenting feature of the disease. The antineutrophil cytoplasmic antibody (ANCA) assay proved useful in establishing the diagnosis. Necrotizing vasculidities can mimic pancreatic carcinoma and should be considered in the differential diagnosis of atypical cases.

Antibodies, Antineutrophil Cytoplasmic↗
PubMed1990

Unsuspected syphilitic hepatitis in a patient with low-grade proteinuria and abnormal liver function.

A 25-year-old patient was found to have cholestatic liver enzyme abnormalities during assessment for asymptomatic low-grade proteinuria at the US Naval Hospital in Portsmouth, Virginia. These abnormalities persisted for a 6-month period, and an extensive workup, including viral serologic studies, rapid plasma reagin test, iron studies, ceruloplasmin, antimitochondrial, antinuclear, and anti-human immunodeficiency virus antibodies, endoscopic retrograde cholangiopancreatography, and liver biopsy, was unrevealing until serologic tests for syphilis were repeated to evaluate a new onset of urethral discharge. The patient had none of the more characteristic signs of secondary syphilis. The liver enzyme abnormalities rapidly resolved after treatment with penicillin. Syphilis remains the great impostor and still must be considered in the differential diagnosis of unexplained liver enzyme abnormalities, even in a patient with no symptoms or signs of early syphilis.

Adult↗
PubMed1988

Collagenous colitis: an association with fecal leukocytes.

Collagenous colitis is an idiopathic inflammatory disorder of the colon associated with watery diarrhea, minimal to normal endoscopic findings, and a pathognomonic subepithelial band of collagen. This band is associated with a mucosal, acute and chronic inflammatory infiltrate. During the evaluation of four cases of collagenous colitis, we noted a remarkable number of acute inflammatory cells in the stool. This association has not been well recognized and carries important diagnostic significance because the mucosal appearance of the colon is frequently normal and nondiagnostic biopsies can occur early in the course of the disease or if obtained from the rectum. These cases suggest that collagenous colitis should be added to the differential diagnosis of diarrhea where fecal leukocytes are present.

Adult↗
PubMed1980

Circumsuture treatment for varicosities.

A surgical procedure that can be used either as an alternative to saphenous vein stripping or as a supplement to it has been developed and used successfully at the Straith Clinic for the past 12 years. The method avoids surgical scars and pigmentation, is simple enough to do with use of local anesthesia, and does not require hospitalization. That the patient can remain ambulatory is another desirable feature. Follow-up of 16 patients who have undergone this procedure has been very encouraging.

Aged↗
PubMedDate not supplied

Mucinous pancreatic tumors: ERCP findings.

Mucin-producing tumors of the pancreas are rare and difficult to diagnose neoplasms. To further characterize the nature of these lesions, four such cases are described here in which the diagnosis was suspected at endoscopic retrograde cholangiopancreatography by the presence of ampullary or intraductal mucus. In one patient, pancreatoscopy directly visualized the tumor. Ultrasound and computed tomography failed to suggest the presence of a neoplasm in the majority of these cases, but endoscopic ultrasound was performed in one and correctly identified the multi-cystic tumor. A high incidence of acute pancreatitis was seen in these cases and was felt to be secondary to intermittent ductal obstruction by mucus. The characteristic appearance of intra-ductal mucus provides an important clue to the presence of this type of pancreatic neoplasia.

Acute Disease↗
PubMedDate not supplied

Conducted current on guidewires in single lumen papillotomes.

An in vitro electrical circuit was designed to measure conducted current in plastic-coated guidewires and standard guidewires inserted in a single lumen papillotome. Single lumen papillotomes, which are more flexible than double lumen papillotomes, require the removal of the guidewire before electrosurgery due to concern over conducted current. In an in vitro electrical circuit, equivalent current was measured in both the papillotome wire and the standard guidewire. Plastic-coated guidewires did not allow any current flow. The advantages of flexible single lumen papillotomes and maintenance of deep biliary cannulation over a guidewire may be combined if insulated plastic-coated guidewires are used.

Ampulla of Vater↗