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D H Wytock

Publications and source records attributed to D H Wytock.

10 recordsLinked to original sources
PubMed1996

Post-transfusion acquired malaria complicating orthotopic liver transplantation.

Early infectious complications within the first 3 months of orthotopic liver transplantation are common and are associated with significant morbidity and mortality. Here we report the first case of transfusion-acquired malaria in an orthotopic liver transplantation recipient. The patient was found to have Plasmodium ovale malaria during evaluation of a severe febrile illness. The infection was traced to a platelet transfusion and responded to treatment with chloroquine. Risk factors associated with the development of malaria infection are identifiable and should be reviewed from the recipient and donor when possible. Routes of infection in the liver transplant patient would include blood products, the organ itself, and resurgence of latent infection. Theoretically, immunosuppression may have an impact on the disease process. Clinicians caring for these patients need to have a high index of suspicion in order to diagnose and treat malaria effectively in the post-transplant setting. Although rare, malaria should be added to the list of pathogens that can infect organ transplant recipients.

Animals↗
PubMed1988

All yogurts are not created equal.

Because of autodigestion of lactose by its endogenous bacteria, the lactose in yogurt is better absorbed than other sources of lactose in lactase-deficient subjects. To investigate possible differences among brands of yogurt in this autodigesting capacity, we challenged eight lactose-malabsorbing subjects with 20 g oral lactose and three different brands of yogurt (Borden, Dannon, and Royal Maid). As a quantitative measure of carbohydrate absorption, end-alveolar breath samples were collected for 8 h and assayed for hydrogen gas. Symptoms were scored by questionnaire every 30 min for 8 h. The cumulative breath H2 and the area under the discontinuous curve of breath-H2 concentration decreased relative to lactose results after ingestion of Dannon and Royal Maid but not after Bordon yogurt. no correlation of symptoms with the degree of carbohydrate malabsorption was demonstrated. We conclude that the lactase activity of yogurt cultures varies among brands.

Adult↗
PubMed1988

Biopsy evaluation of chronic active hepatitis. Peritoneoscopy with directed liver biopsy versus blind percutaneous liver biopsy.

In this prospective study of chronic active liver disease, we compared the assessment of hepatic histology in samples obtained by peritoneoscopy with directed liver biopsy and blind percutaneous liver biopsy in 23 cases (22 patients, one patient studied twice). In blinded fashion, a pathologist assessed all specimens for evidence of cirrhosis and degree of necroinflammatory change. Two clinicians independently reviewed clinical and laboratory findings in both sets of biopsies. Each committed in writing recommendations regarding immunosuppressive therapy, follow-up interval, and rebiopsy date. The final diagnosis differed from that made by percutaneous and directed biopsy in 2 of 23 (9%) and 1 of 23 (4%) cases, respectively. Six cases of cirrhosis were correctly diagnosed by both biopsy methods, but only four of the six cirrhotic cases were diagnosed by gross peritoneoscopic findings. In only 2 of 23 (9%) cases was there disagreement in the degree of necroinflammatory change between the blind and directed biopsies that affected treatment recommendations. We conclude that blind percutaneous biopsy adequately diagnoses and monitors activity in viral chronic hepatitis for treatment purposes.

Adult↗
PubMed1987

Depth of colorectal biopsies with proctoscopic forceps.

It has been suggested that a barium enema may safely follow a colorectal biopsy superficial to the muscularis propria within 24 hours, but that the colon radiograph should be postponed 3 to 7 days following a biopsy including this layer. The authors prospectively studied 67 colorectal biopsies obtained with the Wolf 3-mm (grasping) and 5-mm (cutting) proctoscopic forceps from 49 patients to determine the depth of the biopsies. The 5-mm biopsies were not significantly deeper than the 3-mm biopsies (p greater than 0.5). In 18 patients biopsied with each instrument, the 3-mm biopsy was deeper in two cases (11%), the 5-mm biopsy was deeper in three cases (17%), and the biopsies were of equal depth in 13 cases (72%). None of the biopsies with either forceps reached the muscularis propria. The authors concluded that it may be unnecessary to wait longer than 24 hours before performing a barium enema after colorectal biopsy with these forceps.

Barium Sulfate↗
PubMed1985

Adaptation of the ileum in nontropical sprue: reversal of the jejunoileal fold pattern.

Seven cases of nontropical sprue (gluten enteropathy) are described in which there was an increase in the ileal fold pattern depicted on barium examination of the small bowel. In five of these patients there was a decrease in the jejunal fold pattern. This combination created a reversed appearance of the normal small-bowel radiographic pattern. This is a distinctive pattern for nontropical sprue and reflects the chronic inflammation and atrophy of the jejunum and compensatory hypertrophy (adaptation) of the ileum. This usually indicates long standing disease and should heighten awareness to potential malignant complications.

Adult↗
PubMed1984

Call to quarters.

Explore the source record for details and available documents.

Adolescent↗
PubMed1983

Digital ischemia associated with small bowel malignancy.

A 59-yr-old woman presented with digital ischemia and was found to have a small-bowel malignancy. After resection of the neoplasm, her digital ischemic symptoms resolved. Five years after the operation, she has no evidence either of recurrence of the intestinal malignancy or of the digital ischemia. This report contrasts with earlier studies, which have suggested that patients with digital ischemia associated with malignancy have a poor prognosis.

Adenocarcinoma↗