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Biomedical subjects

L G Bartholomew

Publications and source records attributed to L G Bartholomew.

At least 19 recordsLinked to original sources
PubMed1987

Macroenzyme as a cause of unexplained elevation of aspartate aminotransferase.

Aspartate aminotransferase (AST) can exist as a macroenzyme by forming a complex with an immunoglobulin. This immunoglobulin-complexed macromolecule can cause an elevation in serum AST activity, which may be detected on routine blood chemistry analysis and erroneously considered to indicate the presence of liver disease. Clinicians should be aware of this phenomenon so patients are not subjected to unnecessary procedures. In patients with unexplained AST elevation, liver and muscle disease can be biochemically excluded by the finding of normal serum levels of alanine aminotransferase and creatine kinase. The presence of macro-AST can be determined by exclusion chromatography, electrophoresis, and activation assays with pyridoxal 5-phosphate. The elevated AST values can persist for many years.

Aged↗
PubMed1983

Adenocarcinoma of the rectum arising in a hamartomatous polyp in a patient with Peutz-Jeghers syndrome.

The malignant potential of the hamartomatous polyps in Peutz-Jeghers syndrome has been debated. Although this is a very rare event, these polyps can undergo carcinomatous transformation, as demonstrated by this report of a 37-year-old man with well-documented Peutz-Jeghers syndrome who developed an invasive grade 2 adenocarcinoma on the surface of a hamartomatous polyp in the rectum.

Adenocarcinoma↗
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↗
PubMed1981

Does Peutz-Jeghers syndrome predispose to gastrointestinal malignancy? A later look.

Several reports have recently suggested an association between the development of intestinal carcinoma and the presence of Peutz-Jeghers syndrome. During the 45-year period between 1935 and 1979, 48 patients with Peutz-Jeghers syndrome were seen at the Mayo Clinic, Rochester, Minn, and followed up for a median period of 33 years. Carcinoma of the small or large intestine did not develop in any patient, with possibly one exception. Survival of patients with Peutz-Jeghers syndrome also was found to be similar to that of the general population. Therefore, skepticism continues about the premalignant potential of this rare syndrome, especially in the small intestine, and surgical conservatism should be practiced in its management.

Adult↗
PubMed1981

Clinicopathologic study of nonspecific ulcers of the small intestine.

Fifty-nine cases (31 men and 28 women) of nonspecific small bowel ulceration, representing the Mayo Clinic experience from 1956 to 1979, are reviewed. The average age was 51 years. Presenting symptoms or signs were those of intermittent small bowel obstruction (63%), blood loss (25%), and acute abdomen (12%). Whereas 78% of the ulcers were located in the ileum, 15% in the jejunum, and 7% in the jejunoileum, perforation was by far more common in the jejunum (78%) as compared with the ileum (11%). Diagnosis was rarely made preoperatively, although abnormalities were noted roentgenographically in 66%. Treatment was surgical and was usually curative. Operative mortality was 8.5%. No single cause was implicated.

Adolescent↗
PubMed1979

Severe pancreatic involvement in three generations in von Hippel-Lindau disease.

Von Hippel-Lindau disease is a hereditary neoplastic disorder that is most commonly manifested as vascular tumors of the retina and cerebellum. Although visceral involvement is uncommon and is almost always clinically silent, we have encountered three closely related patients with extensive symptomatic pancreatic involvement. One patient had pronounced exocrine pancreatic insufficiency.

Adult↗
PubMed1978

Radionuclide image patterns of hepatic metastasis and pyogenic abscess: difficulties in differential diagnosis.

A case of hepatic metastasis with a clinical differential diagnosis of amebic and bacterial abscess is presented. Hepatic scanning with 67Ga-citrate did not diagnostically differentiate the lesion. Hepatic arteriography combined with a therapeutic trial of metronidazole proved useful in defining the lesion. An understanding of the pathophysiologic process involved in 67Ga scanning of hepatic lesions suggests a non-invasive method of discriminating among these clinical diagnostic possibilities.

Adenocarcinoma↗
PubMed1978

Fatal disseminated intravascular coagulation after peritoneovenous shunt for intractable ascites.

Peritoneovenous shunt for intractable ascites was complicated by disseminated intravascular coagulation, which resulted in the death of the patient. Attention is called to this potentially serious complication. The cause of disseminated intravascular coagulation occurring after peritoneovenous shunt is uncertain. Patients at risk for this complication need to be identified if this shunt is being considered.

Ascites↗
PubMed1977

Menetrier's disease. Effect of medical and surgical vagotomy.

A 62-year-old woman with incapacitating atherosclerotic vascular occlusive disease was found to have severe hypoproteinemia as a result of Menetrier's disease. That diagnosis was suspected on roentgenographic and gastroscopic examinations and confirmed by examination of full-thickness surgical gastric biopsy specimens. The protein loss from the stomach was significantly decreased by treatment with trimethaphan and atropine and led us to perform proximal gastric vagotomy at the time of endarterectomy. Subsequent protein turnover studies suggest that there has been a significant decrease in protein loss by the stomach. Further evaluation of the possible role of medical and surgical vagotomy in this disease seems warranted.

Atropine↗
PubMed1975

Diabetic microangiopathy in patients with pancreatitic diabetes mellitus.

Clinically evident diabetic microangiopathy (retinopathy and nephropathy) occurred in 18% of diabetic patients with acute pancreatitis and 14% of diabetic patients with chronic pancreatitis. The presence of diabetic retinopathy and nephropathy in patients with pancreatitic diabetes without a family history of diabetes mellitus suggests that these patients have "primary" diabetes mellitus unmasked by the pancreatitis. The occurrence of diabetic microangiopathy is significantly correlated with the duration of diabetes. The frequency of these diabetic complications seems to increase when there is a family history of diabetes in patients whose pancreatitis is simultaneous with or precedes the onset of diabetes. The majority of patients with diabetic microangiopathy were on insulin therapy, but the need for insulin treatment is an indication of the severity of the diabetes, rather than the insulin being a causative factor of the microangiopathy. The degree of steatorrhea in diabetic patients with chronic pancreatitis did not protect against the development of microangiopathy.

Acute Disease↗