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H A Carpenter

Publications and source records attributed to H A Carpenter.

87 records · Page 5Linked to original sources
PubMed1987

Collagenous colitis: a clinicopathologic correlation.

Collagenous colitis is an unusual cause of chronic, watery diarrhea. To characterize this disease, we reviewed biopsy specimens and the clinical records of 17 patients (9 women and 8 men) with this diagnosis. Intermittent diarrhea with symptom-free intervals lasting years was found in 7 of the 17 patients. Two patients had incapacitating arthralgias, and nine had a mild weight loss. Collagen deposition beneath the surface epithelium formed a continuous layer in 11 but was discontinuous in 5 of the 16 patients who had undergone rectal or colonic biopsies at our institution. The thickness of the collagen band was variable (maximum, 93 microns). The symptoms of the patients did not correlate with the thickness of the collagen layer. Variability in collagen thickness may be related to disease phase and increases the need to obtain multiple biopsy specimens from the sigmoid colon and rectum. The optimal treatment for collagenous colitis is difficult to determine because three of six patients treated only symptomatically in our study had resolution of their diarrhea.

Adult↗
PubMed1987

Pulmonary alveolar phospholipoproteinosis: experience with 34 cases and a review.

A retrospective review of Mayo Clinic records through 1983 revealed 84 patients (24 male and 10 female; mean age, 41 years) with the diagnosis of pulmonary alveolar phospholipoproteinosis. The major clinical features were dyspnea, cough, fever, and chest pain. Chest roentgenograms usually showed bilateral symmetric alveolar infiltrates, but asymmetric, unilateral, and chronic patchy patterns were also noted. Diagnosis was established by thoracotomy-lung biopsy in 26 patients. Histologic analysis revealed uniform filling of the alveoli by periodic acid-Schiff-positive material and maintenance of normal alveolar architecture. Electron microscopy showed enlarged alveolar macrophages with lamellar osmiophilic inclusions, dense granules, and myeloid bodies. Of the 21 patients who underwent therapeutic bronchoalveolar lavage, 13 had no recurrence of the disease during a mean follow-up of 8.8 years. In patients who underwent pulmonary function testing both before and after lavage, significant restrictive dysfunctions present before the procedure were alleviated afterward. Three deaths occurred among the 34 patients. Pulmonary alveolar phospholipoproteinosis may result from defective clearance of phospholipids by the alveolar macrophages, excessive production of phospholipids by type II pneumocytes, or both. It is likely a nonspecific response to a variety of injuries to the alveolar macrophage or type II pneumocyte or both, including exposure to certain dusts and chemicals and occurrence of hematologic diseases or infections. The uncommon occurrence of this disorder suggests individual susceptibility.

Adolescent↗
PubMed1987

Allergic Aspergillus sinusitis.

The condition of allergic aspergillosis of the paranasal sinuses is presented. Two cases are added to the seven previously described in the world literature. The clinical, radiologic, and pathologic features are outlined, and a careful follow-up regime is advised.

Adult↗
PubMed1987

Radiographic appearance of mucosal dysplasia associated with ulcerative colitis.

The radiographic appearance of dysplasia, a precancerous histologic change that is frequently present in colitic colons at high risk for cancer, was analyzed. Over a 5-year period, 170 patients with long-standing ulcerative colitis participated in a cancer surveillance program at our institution. On entry, all patients underwent radiography with a double-contrast barium enema and colonoscopy with multiple random biopsies. All radiographs were reviewed retrospectively and were correlated with the colonoscopic and histologic findings. Dysplasia, ranging from mild to severe, was found in the biopsy specimens from 26 (15%) of these patients (in 59 different regions). Thirteen of the 26 patients with dysplasia had colectomies, and the specimens were available for review. Most dysplasia is not radiographically visible, as was the case in 40 (68%) of the 59 regions found histologically to have dysplasia. In the 19 regions in which dysplasia was visible radiographically, it appeared as a solitary nodule or as several separate nodules in 11 (19%) of the 59 regions or as a close grouping of multiple adjacent nodules with apposed, flattened edges in 8 (14%) of the 59 regions. The radiographic finding of a nodule or of several separate nodules was not specific because these nodules were indistinguishable from the inflammatory nodules often present in colitic colons. On the other hand, the radiographic finding of a close grouping of adjacent nodules with apposed, flattened edges was associated with dysplasia 50% of the time. This radiographic appearance was seen in five of our 26 patients who had dysplasia. Our study shows that barium examinations are useful in some patients with chronic ulcerative colitis by suggesting the presence of dysplasia and directing the endoscopist to specific locations for biopsy.

Colitis, Ulcerative↗
PubMed1987

Diffuse pulmonary hemorrhage. An uncommon manifestation of Wegener's granulomatosis.

We report two cases of Wegener's granulomatosis with the unusual manifestation of diffuse alveolar hemorrahge. One patient with well-documented Wegener's granulomatosis developed alveolar hemorrhage 4 weeks after leukopenia necessitated the discontinuation of cyclophosphamide. The second patient presented with pulmonary hemorrhage and died 10 days after an open-lung biopsy in which histologic features of Wegener's granulomatosis were overshadowed by alveolar hemorrhage. Lung biopsies in both cases showed marked alveolar hemorrhage and pulmonary capillaritis. The importance of recognizing capillaritis and other subtle histologic features of Wegener's granulomatosis are emphasized.

Aged↗
PubMed1986

Usual interstitial pneumonitis is a T-cell alveolitis.

Usual interstitial pneumonitis (UIP) is an idiopathic inflammatory disorder that produces scarring of the lung parenchyma. We studied open-lung biopsies of 13 patients with UIP using immunohistological staining and monoclonal antibodies. T lymphocytes (Leu 4+) accounted for 59% of cells in the alveolar septal infiltrates in UIP and OKT8+ cells accounted for the majority of T lymphocytes in most cases. OKM1+ granulocytes comprised a smaller percentage (14%) of the alveolar infiltrates. Granulocytes were most frequent within cystic airspaces and inflamed small airways. Class II HLA (Ia) antigens were expressed on lymphocytes, macrophages, endothelial cells, and alveolar type II cells in lungs with UIP. This study demonstrates that altered immunoregulatory subsets are present in the lungs of patients with UIP and suggests the possibility that activated T cells may play a role in the pathogenesis of this disorder.

Adult↗
PubMed1986

Follicular carcinoma of the thyroid presenting with hematuria: a case report.

A 59-year-old woman presented with hematuria in which a subsequent workup showed follicular carcinoma of the thyroid metastatic to the urinary bladder. Soft tissue metastasis from such a carcinoma is seen most commonly in the lungs and occasionally in the liver and kidneys. This case illustrates that follicular carcinoma of the thyroid may have a variable presentation, including hematuria.

Adenocarcinoma↗
PubMed1985

Open lung biopsy in immunocompromised patients.

From January 1978 through December 1980, ninety-five immunocompromised patients underwent diagnostic open lung biopsy (OLB) at the Mayo Clinic, Rochester, Minn. A specific causative diagnosis was made in 77 patients (81%); 12 patients (13%) had more than one specific causative diagnosis. Of the 77 patients with a specific causative diagnosis, 52 patients (68%) had infections, 19 patients (24%) had malignant pulmonary disease, 12 patients (15%) had cytotoxic lung disease, ten patients (13%) had interstitial fibrosis (not related to cytotoxins), and one patient (1%) had vasculitis. In 36 (47%) of the 77 patients with a specific causative diagnosis, the diagnosis was made, by frozen sections or stains, within three hours of OLB. In 35 additional patients (45%), the diagnosis was established within 24 hours. Twelve patients (13%) had minor complications of OLB; no deaths were attributed to the OLB procedure.

Adolescent↗
PubMed1982

Abdominal angina and neurofibromatosis.

A young man with severe abdominal pain and weight loss due to intestinal ischemia was examined. At operation, the origins of the celiac and superior mesenteric arteries were found to be compressed by plexiform neurofibromatosis. Symptoms were relieved by reconstructive arterial surgery.

Abdomen↗
PubMed1982

Multilocular cysts of the peritoneum.

Multilocular cysts of the peritoneum diagnosed at the Mayo Clinic from 1907 through 1981 were examined and divided, on the basis of their light microscopic features, into two groups--cystic mesotheliomas and cystic lymphangiomas. There are apparent clinical differences between the two groups. Cystic mesotheliomas tend to occur in adult females and often recur. Cystic lymphangiomas occur most often in males, often develop in children, and rarely recur, if at all. The distinguishing histologic features are the cytologic characteristics of the cells lining the cysts and the presence or absence of smooth muscle in the wall of the cysts.

Adolescent↗
PubMed1981

Hypothyroidism after thyroidectomy for Graves' disease.

In 100 patients who underwent subtotal thyroidectomy for Graves' disease in 1970 through 1975, postoperative hypothyroidism developed in 75 patients an average of 4.6 months after operation. One patient had permanent hypocalcemia. Unilateral vocal cord function was abnormal postoperatively in three patients. Thyroidectomy for Graves' disease is used at our institution much less frequently than in the past and its use is being restricted to a younger population. The low recurrence rates of thyrotoxicosis (1 percent) was obtained at the expense of a high rate of postoperative hypothyroidism.

Adolescent↗
PubMed1979

Congenital absence of the portal vein.

A 4 1/2-year-old girl is described in whom the portal vein is absent and the venous return from the gastrointestinal tract, spleen, and pancreas is through the left renal vein into the inferior vena cava. She had a hepatoblastoma, which was treated surgically by right hepatic lobectomy. Regeneration occurred in the remaining left lobe within 3 months after surgery. This is the second such case documented in the literature.

Carcinoma, Hepatocellular↗
PubMed1976

Extraskeletal myxoid chondrosarcoma: a clinicopathological study.

Extraskeletal myxoid chondrosarcoma is a rare tumor of cartilagenous origin, with only 41 previously reported cases. It has a distinctive histologic pattern and should be distinguished from chondrosarcoma of bone because of its different behavioral pattern. The light microscopic, histo-chemical and electron microscopic features of such a tumor are reported.

Adult↗
PubMed1974

Bronchial venular leakage during endotoxin shock.

The pulmonary effects of endotoxin shock were investigated in dogs by a combination of anatomic and physiologic technics. Shock was produced in 14 dogs by injecting Escherichia coli lipopolysaccharide intravenously. Three dogs in hypovolemic shock and 6 untreated dogs served as controls. Colloidal carbon was injected intravenously to detect sites of pathologic increase in vascular permeability. During the first hour of endotoxin shock, bronchial venules allowed carbon and blood elements to traverse their walls, whereas no leakage of these large particles or ultrastructural changes could be detected in the alveolar walls. Only after the first hour was bronchial venular leakage accompanied by focal degenerative changes in the alveolar endothelium, focal interstitial edema in the alveolar septum and sequestration of damaged leukocytes in the alveolar capillaries. In contrast to these observations in endotoxin shock, control dogs in hypovolemic shock did not show bronchial venous leakage. Our findings suggest that the leakage of bronchial venules may be involved in the pathogenesis of pulmonary interstitial edema caused by endotoxin shock.

Animals↗