PubMed Health⌕ Search

Biomedical subjects

J E Fitzwater

Publications and source records attributed to J E Fitzwater.

14 recordsLinked to original sources
PubMed1984

Quality assurance of histopathologic diagnoses: a prospective audit of three thousand cases.

The purpose of this study was to examine a system of quality assurance in which microscopic slides from all surgical cases were subject to peer review before completion of the final pathology report. Three thousand surgical pathology cases were evaluated and the diagnoses entered on preliminary diagnosis sheets. Microscopic slides were reviewed and coded reviewer opinions entered on photostatic copies of preliminary diagnosis sheets. Reviewer comments were incorporated into the final pathology reports at the discretion of the responsible pathologist. Two hundred thirty-three (7.8%) cases were identified in which at least one reviewer disagreed with the preliminary diagnosis; in 67 of the 233 cases (2.2%) the final diagnosis was modified as a result of the review process. Changes in final diagnoses were judged to be significant in 29 (0.96%) cases. These results suggest that systematic review of surgical pathology diagnoses prior to preparation of final pathology reports may be a useful tool in assuring quality and consistency in diagnoses.

Diagnostic Errors↗
PubMed1982

Treatment of hypopigmented sarcoidosis with 8-methoxypsoralen and long wave ultraviolet light.

A patient with hypopigmented sarcoidosis involving the face was treated with topical 8-methoxypsoralen and long wave ultraviolet light. Satisfactory repigmentation occurred within eight months of tri-weekly therapy. Electron microscopic study of involved, untreated skin showed abnormalities of melanocytes, including cytoplasmic vacuolization and the presence of melanosome complexes. Treated skin showed sparsity of melanosomes within the central portions of some melanocytes and large numbers of melanosomes within melanocytic dendrites. The clinical and ultrastructural findings suggest the possibility of toxic damage to melanocytes, perhaps with abnormalities of melanosome transfer, in lesions of hypopigmented sarcoidosis. These abnormalities appear to be responsive to psoralen-UVA therapy.

Adult↗
PubMed1982

Diffuse cutaneous reticulohistiocytosis.

A 65-year-old man had a diffuse, asymptomatic, cutaneous eruption of 5- to 15-mm reddish-brown, nonscaling papules in arcuate, annular, and serpiginous patterns for one year. The morphologic, light microscopic, and ultrastructural features of the skin lesions were typical of multicentric reticulohistiocytosis; however, the patient had no historic, clinical, laboratory, or roentgenographic evidence of arthritis. Spontaneous involution of the eruption occurred 17 months after onset. Several weeks later subacute myelogenous leukemia developed. The reported occurrence of isolated and multiple reticulohistiocytomas, diffuse cutaneous reticulohistiocytosis without systemic involvement, and multicentric reticulohistiocytosis with identical light microscopic and ultrastructural findings suggests that these conditions probably represent a spectrum of clinical expressions of similar etiologic and pathogenetic mechanisms.

Aged↗
PubMed1979

Localized tick bite reaction.

A woman presented with a localized tick bite reaction. The tick (Amblyomma americanum, the "lone star" tick) was still attached to the erythematous, indurated skin of the upper back. After several unsuccessful attempts at removal, a punch biopsy was performed, and the resultant histologic sections incorporated both tick and involved skin. The various systemic and localized tick bite reactions are discussed, as are the diagnostic dilemmas which may arise when the organism is no longer present. Punch biopsy is suggested as an effective means of removing the organism.

Aged↗
PubMed1975

Septic endocarditis and indwelling pulmonary artery catheters.

A pulmonary artery catheter removed from a man with idiopathic cardiomyopathy yielded Staphylococcus aureus in culture, as did blood and sputum. Septic endocarditis of the right side of the heart was found at autopsy. A review of 438 autopsy reports in which an indwelling pulmonary catheter had been used and of another 493 reports preceding its use at our medical center suggests no association between the use of indwelling catheters in the right side of the heart and endocarditis in the left, although there is a risk of thrombotic endocardial vegetation formation in the right side of the heart, with possible infection or embolization.

Adult↗
PubMedDate not supplied

Nasal hemangioma of pregnancy.

The nasal hemangioma of pregnancy is an uncommon but impressive cause of epistaxis. One patient with this condition recently treated at the Keller Army Hospital, West Point, exemplifies the problems encountered in the diagnosis and treatment of this puzzling disorder.

Adult↗
PubMedDate not supplied

Medical meniscus repairs. An experimental and morphologic study.

In an effort to determine the healing potential of medial meniscus tears, 20 canine and 12 rhesus knee joints were subjected to transverse medial meniscus laceration and repair with a single Dexon suture (Davis & Geck, Pearl River, NY). At four months, 12 out of 32 (38%) had healed completely with restoration of the inner meniscal rim and 18 (56%) showed partial healing sufficient to protect the underlying articular cartilage. Only 2 (6%) of the menisci failed to heal. Histologic evaluation showed that the scar tissue present in the menisci was composed of unorganized collagen without common ground substance components. As a result of these studies, we believe that certain meniscal tears, particularly those involving the vascular periphery, can heal and may be repaired rather than treated by meniscectomy.

Animals↗