PubMed Health⌕ Search

Biomedical subjects

C D Holman

Publications and source records attributed to C D Holman.

At least 109 records · Page 6Linked to original sources
PubMed1984

Relationship of solar keratosis and history of skin cancer to objective measures of actinic skin damage.

Two methods for the assessment of severity of actinic skin damage were evaluated in a population-based survey of 1216 subjects. After controlling for the effects of age, skin texture changes graded by cutaneous microtopography were found to be associated strongly with the presence of solar keratoses and a past history of non-melanotic skin cancer. Changes in skin condition graded by paraocular photography had a weaker relationship with the presence of keratoses and showed no association with non-melanotic skin cancer. These results, together with a higher level of agreement between observers in grading cutaneous microtopographs, support the use of cutaneous microtopography as an index of actinic skin damage in epidemiological research.

Adolescent↗
PubMed1984

Inter-observer variation between pathologists in the classification of cutaneous malignant melanoma in western Australia.

Inter-observer variation between six pathologists in their application of histological classifications during a survey of cutaneous malignant melanoma was analysed using kappa statistics. The highest levels of adjusted agreement were attained for tumour thickness and the presence of ulceration; intermediate levels were achieved on cross-sectional profile, level of invasion, histogenetic type, solar elastosis and the presence of an associated benign melanocytic lesion; agreement on other histological features of melanoma tended to be relatively poor. The problems experienced in the interpretation of these classifications are discussed and suggestions for their improvement are offered.

Australia↗
PubMed1984

Pigmentary traits, ethnic origin, benign nevi, and family history as risk factors for cutaneous malignant melanoma.

The roles of constitutional factors and benign nevi in causation of malignant melanoma were examined in a case-control study of 511 patients and 511 matched controls in Western Australia. The strongest risk factor was the number of palpable benign nevi on a subject's arms. Compared to the risk of melanomas for persons having no palpable nevi on the arms, the relative risk of melanoma was 2.0 for persons with 1-4 nevi, 4.0 for persons with 5-9 nevi, and 11.3 for persons with 10 or more nevi (P less than .0001). Of the several pigmentary traits known to have associations with melanoma, inability to tan was the most important. Susceptibility to sunburn and hair color also had significant effects that were independent of tanning ability; however, after these traits were controlled, measured skin color and eye color had no additional effects. A reduced risk of melanoma was observed in persons having two or more Southern European grandparents [odds ratio (OR) = 0.39; P = .025]. Persons of Celtic origin did not have a significantly increased risk (OR = 1.18). Possession of one or more affected blood relatives was related to an increased risk of melanoma (OR = 2.69; P less than .0001). The effects of pigmentary traits, benign nevi, ethnic origin, and family history as risk factors were largely independent of one another.

Australia↗
PubMed1984

Cutaneous malignant melanoma and indicators of total accumulated exposure to the sun: an analysis separating histogenetic types.

Evidence associating malignant melanoma with semiquantitative and questionnaire indicators of past sunlight exposure is presented from a case-control study of 511 patients and 511 matched control subjects in Western Australia. That melanoma is related to sun exposure was supported by associations with actinic skin damage graded by cutaneous microtopography, history of nonmelanotic skin cancer, duration of residence of migrants to Australia, and mean annual hours of bright sunshine received at locations where the subjects had resided. Separate analyses of histogenetic subtypes revealed that Hutchinson's melanotic freckle melanoma had the strongest associations with indicators of sunlight exposure. For superficial spreading melanoma, a specific relationship was observed with age at arrival as against duration of residence in Australia. Migrants arriving before age 10 years appeared to have a risk similar to that of native-born Australians, whereas the estimated incidence in those arriving after age 15 years was around one-quarter of the native-born rate, with arrival at later ages giving no additional advantage. Control subjects arriving in Australia before age 10 years had an increased number of nevi on their arms, suggesting that sun exposure in early life may be a factor in nevus production and, therefore, a determinant of later potential to develop superficial spreading melanoma.

Adolescent↗
PubMed1983

Possible infectious etiology of six cases of Ewing's sarcoma in Western Australia.

Six cases of Ewing's sarcoma occurring in Western Australia during a 2-year period are reported. All six patients lived in rural habitats and reported exposure to farm animals. There was evidence of direct contact between two patients over a 3-year period preceding the diagnosis of their tumors. These features raise the possibility that Ewing's sarcoma has an infectious etiology.

Adolescent↗
PubMed1983

Survival from preinvasive and invasive malignant melanoma in Western Australia.

The crude and relative survival rates from malignant melanoma of the skin were evaluated in 528 patients diagnosed in Western Australia in 1975-1976. Follow-up of patients to December 31, 1980 was 96% complete. For invasive malignant melanoma the relative five-year survival rates were 85% in men and 89% in women, while in cases of preinvasive melanoma both sexes experienced 100% relative five-year survival. The effects on prognosis of sex, anatomic site, clinical stage, level of invasion and tumor thickness were examined. Invasive melanomas of less than 0.76 mm in thickness also were associated with 100% relative survival. The variation in survival of melanoma patients with geographic location and the relative contributions of early diagnosis and biologic nature to the favorable outcome of melanoma in Australia are discussed.

Australia↗
PubMed1983

Seasonal variation in the junctional component of pigmented naevi.

From an assessment of the presence of a junctional component in 8,380 pigmented naevi, and histological review of its extent and the presence of inflammation and regression in a sample of 216 junctional and compound naevi, it was determined that naevi excised in summer were more likely to have a junctional component and evidence of inflammatory response than those excised in winter. It is suggested that a short-term promotional effect of sunlight on cells in the junctional zone of pigmented naevi may, in addition to increased case ascertainment in summer, explain reported seasonal variation in the incidence of malignant melanoma.

Biopsy↗
PubMed1983

Adjuvant immunotherapy with BCG in stage II malignant melanoma.

Forty-one patients were treated with BCG immunotherapy following block dissection of lymph nodes involved with malignant melanoma. A control group of similar patients who received no immunotherapy was drawn from a population consisting of all patients with malignant melanoma diagnosed in Western Australia in the period from January 1, 1975 to December 31, 1976. The disease-free survival and overall survival of BCG-treated patients were not different from that of the control group, who received no immunotherapy. The findings do not support the use of this type of immunotherapy as an adjuvant to surgery in the treatment of patients with stage II malignant melanoma.

Adult↗
PubMed1983

Inter-observer variation in the histopathological reporting of Hodgkin's disease: an analysis of diagnostic subcomponents using kappa statistics.

Levels of agreement between nine pathologists on the Rye classification of Hodgkin's disease and on diagnostic subcomponents used in applying the classification, were analysed by kappa statistics. Pathologists experienced comparatively little difficulty in agreeing on the presence of nodules and lacunar cells and hence best agreement was achieved on the nodular sclerosis category. Poorer agreement levels on the lymphocytic predominance, mixed cellularity and lymphocytic depletion categories were explained mainly by problems in the assessment of numbers of lymphocytes and abnormal reticulum cells other than Reed-Sternberg cells. Identification of the Reed-Sternberg cell, although of paramount importance to a diagnosis of Hodgkin's disease, appeared to have no great practical relevance to use of the Rye classification in this series of cases.

Cell Count↗
PubMed1983

Survival from invasive cutaneous malignant melanoma in Western Australia and the Oxford Region: a comparative histological study of high and low incidence populations.

A detailed histological review of 196 cases of invasive cutaneous malignant melanoma diagnosed in Western Australia, a high incidence area, during 1975-76 and of 226 cases during the period 1972-76 from the Oxford Region, a low incidence area, was made by one pathologist using the same parameters for each series. Five-year survival rates were analysed with respect to histological features, sex and site, with and without correction for tumour thickness. The results showed higher overall survival rates in Western Australia, with marked differences in prognosis between males and females in the Oxford Region, and between Oxford males and patients of both sexes in Western Australia. These findings were in accord with the corresponding differences in tumour thickness, and they support the theory that survival rates from cutaneous malignant melanoma are higher in areas of high incidence because they are diagnosed and treated earlier.

Actuarial Analysis↗
PubMed1982

An improved method of analysis of observer variation between pathologists.

An improved method of analysing interobserver variation in histopathological studies is described and illustrated, by use of data from a congruence survey of malignant melanoma. The method provides, between any number of pathologists, an assessment of overall agreement and of agreement on each individual category of a classification system. Adjustment for differences in chance agreement due to varying numbers of categories or an altered composition of cases is included in the analysis. A generalization of the procedure designed to measure the strength of associations between different categories is formulated and explained with the use of an example.

Humans↗
PubMed1982

A histological comparison of cutaneous malignant melanoma between the Oxford Region and Western Australia.

Two series of cutaneous malignant melanoma (CMM), one from a low incidence area (the Oxford Region) and one from a high incidence area (Western Australia), were compared by one pathologist using the same histological criteria. The findings included similarities in the distributions of histogenetic type of CMM, predominant cell type, and the degree and pattern of inflammatory reaction. Differences were found in other features including tumour profile, the presence of ulceration, mitotic activity, evidence of regression and level of invasion. The most important, and consistent morphological difference was the greater thickness of tumours from the Oxford Region, which is thought to be consistent with the theory that CMM is diagnosed at an earlier stage in high incidence areas because of greater medical and public awareness of the condition. Some problems in the use of accepted classifications of CMM are discussed.

Adult↗
PubMed1981

Cervical cytology histories of 100 women with invasive carcinoma of the cervix.

We reviewed the cytological histories of 100 women diagnosed as having invasive carcinoma of the cervix in Western Australia in 1977-80. Sixty-one women had never had a cervical smear test before the diagnosis of cancer. Among the remaining 39 patients, nine had one or more dyskaryotic cervical smears taken, up to eight years before the diagnosis of invasive cancer was made. Another patient had two smears, suspicious of malignancy, taken 15 years before diagnosis. Wider use of colposcopy and selective biopsy in the management of patients with abnormal smear test results is recommended.

Adult↗