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Biomedical subjects

G Kavanagh

Publications and source records attributed to G Kavanagh.

15 recordsLinked to original sources
PubMed2002

Gluteal compartment syndrome following posterior cruciate ligament repair.

Compartment syndrome is a rare but important complication which may occur following injury or surgery to the lower limb. We present a case of contralateral gluteal compartment syndrome following arthroscopic posterior cruciate ligament repair. In order to gain a greater understanding of this complication, we undertook a limited study to investigate the effect of patient position on gluteal compartment pressures. Three volunteers were positioned in such a way as to recreate the intra-operative position of the patient described. Gluteal compartment pressures were calculated by placing weighing scales under each buttock and measuring the surface area over which the weight was distributed.Mean pressures exerted on the gluteal compartment of the non-operated leg were significantly higher (mean=44 mmHg) than those of the operated leg (mean=24 mmHg). The difference was significant with P<0.001. This limited study has shown that care should be taken when positioning patients on an operating table to reduce the risk of compartment syndrome. Factors that should be taken into account include mean diastolic pressure, length of operation and the surface area in contact with the operating table.

Adult↗
PubMed2001

Nucleotide excision repair gene XPD polymorphisms and genetic predisposition to melanoma.

The nucleotide excision repair pathway has evolved to deal with UV light-induced DNA damage. Individuals with the rare inherited nucleotide excision repair deficiency disease xeroderma pigmentosum have a 1000-fold increased incidence of skin cancer. We are interested in the possibility that more subtle changes in nucleotide excision repair genes, resulting in either a reduced capacity for repair or in altered interactions between repair proteins and components of the cell cycle control machinery, might constitute important genetic risk factors for the development of skin cancer in the general population. To investigate this hypothesis we have compared the frequency of polymorphisms in exons 6, 22 and 23 of the XPD gene in melanoma patients and a control group. For each of these two allele polymorphisms one of the alleles was over-represented in the melanoma group and there was a significant association with melanoma. Importantly, this association did not extend to markers immediately flanking the XPD gene, thus providing evidence that XPD gene polymorphisms might predispose to melanoma in the general population. There is a report that one of the polymorphic XPD alleles (exon 23 Lys), which is over-represented in the melanoma group, has reduced repair proficiency and we discuss the possibility that this is the causal change to the XPD gene that predisposes to melanoma.

Alleles↗
PubMed1999

Genetic and environmental influences in the development of multiple primary melanoma.

OBJECTIVES: To identify risk factors and the prognosis associated with the development of multiple primary melanoma (MPM). DESIGN: Case-comparison studies of subjects with MPM and single primary melanoma. Sequencing of CDKN2A in germline DNA. SETTING: Population-based study of patients with invasive melanoma in Scotland between 1979 and 1996. PATIENTS: For mortality studies, 108 patients with MPM and 216 single melanoma controls matched for age, sex, site, and tumor thickness. For risk factor studies, 48 patients with MPM and 48 single melanoma controls matched as above. For CDKN2A analysis, a sample of 23 subjects with MPM. RESULTS: The development of MPM was found not to be an independent prognostic factor. The risk of MPM was greatest in those with a family history of melanoma, with large numbers of benign nevi, and the presence of clinically or histologically atypical nevi. Germline mutations of CDKN2A were present in 6 of 23 patients with MPM and in 5 cases consisted of the base pair substitution Met53Ile. CONCLUSIONS: The importance of MPM should be addressed in melanoma follow-up protocols. Those patients at greatest risk can be identified by a family history of melanoma and their mole pattern. Germline mutations in CDKN2A occur in both familial and sporadic MPM and further studies are required to determine the value of analysis of this gene in melanoma surveillance. Patients should be informed that the development of MPM does not adversely affect their prognosis.

Disease Susceptibility↗
PubMed1998

Tonsillitis and chronic psoriasis.

Although the relationship between streptococcal tonsillitis and acute guttate psoriasis is well recognized, its relationship to chronic forms of psoriasis is less established. In order to explore this further, the authors questioned 35 patients with severe psoriasis and 35 age-matched eczema controls about their history of significant sore throats (i.e. requiring a GP visit) and any resultant worsening of the skin condition. A third of the psoriasis patients reported recurrent sore throats which worsened their skin condition. This was true of only one (3%) of the 35 eczema controls. The authors discuss these findings in the context of recent laboratory work on the association between streptococcal infection and psoriasis.

Adult↗
PubMed1997

Cutaneous pilar leiomyoma: clinicopathologic analysis of 53 lesions in 45 patients.

As cutaneous pilar leiomyomas have received little attention in the recent literature, 53 lesions from 45 patients were studied to analyze their clinicopathologic features. There was an equal distribution between both sexes; most patients were adults with a wide age distribution. Both multiple (29 lesions from 21 patients) and solitary tumors (18 patients) were included. Lesions on the extremity (29 tumors) were common in both groups, whereas truncal tumors (11) were confined largely to patients with multiple lesions. In six patients the number of lesions was not specified. The tumors were painful in 17 patients. Three patients had a positive family history of similar lesions. Histologic study revealed ill-defined bundles of well-differentiated smooth muscle cells in the reticular dermis in all cases, although nine lesions had a more nodular pattern. Overlying epidermal hyperplasia was noted in 29 cases (54.7%). Immunohistochemically there appeared to be an increased number of nerve fibers within and surrounding the tumors. Mitotic activity was observed in 15 lesions (28.3%), 13 of which had <1 mitosis per 10 high power fields (HPF); the remaining two lesions had 1-2 mitoses per 10 HPF. Follow-up was available in 10 of these mitotically active tumors and ranged from 9 months to 7 years. There was no recurrence in any of them. We have concluded tentatively that leiomyomas of arrector pili origin may exhibit a low mitotic activity of <1 per 10 HPF and that this does not adversely affect the prognosis for these patients.

Adolescent↗
PubMed1995

Urocanic acid isomers in human skin: analysis of site variation.

Urocanic acid (UCA) is found in the stratum corneum as the trans-isomer and, on ultraviolet (UV) irradiation, photoisomerization into cis-UCA takes place. Cis-UCA has been suggested to play a part in UV-induced immunosuppression. In the present study, the concentration of UCA and the percentage as cis-UCA at 10 different body sites of 20 normal volunteers were analysed. A large interindividual variation in total UCA concentration was found, but the mean UCA concentration in each site was similar, other than at the sole of the foot. There was little variation in the UCA content between sites normally exposed, and not exposed, to light, but the percentage of UCA in the cis form was clearly higher at exposed areas.

Adult↗
PubMed1994

Comparative effects of calcipotriol (MC903) solution and placebo (vehicle of MC903) in the treatment of psoriasis of the scalp.

The efficacy and safety of calcipotriol solution in the treatment of scalp psoriasis was compared with placebo (vehicle solution), in a multicentre double-blind, randomized, parallel-group study of 49 adult patients. Calcipotriol solution (50 micrograms/ml), or placebo, was applied twice daily over a 4-week period. At the end of the study period 60% of patients on calcipotriol showed clearance or marked improvement of their psoriasis compared with 17% on placebo. Overall assessment of treatment response showed that calcipotriol was superior to placebo in both investigator (P < 0.001; 95% confidence interval for difference 19.0-67.6) and patient (P < 0.001; 95% confidence interval for difference 18.3-68.0) assessments. Total sign score for psoriasis (i.e. the sum of the scores for redness, thickness and scaliness) decreased by 48.9% in the calcipotriol group, and by 18.6% in the placebo group (P = 0.005). Calcipotriol was significantly superior to placebo in reducing redness, thickness, scaliness and extent of psoriasis, and in the patients' assessment in reducing scalp flaking and itching. No statistically significant changes in blood biochemistry were detected during the study, and the solution was generally well tolerated.

Adult↗
PubMed1993

Case report: an unusual cause of epistaxis: non-traumatic intracavernous carotid aneurysm. A case report with 12 year follow-up and review of the literature.

Intracavernous carotid aneurysms are uncommon. We report the natural history and radiological appearances of a giant, non-traumatic, intracavernous carotid aneurysm which extended through the skull base to the anterior nares and caused epistaxis. The magnetic resonance imaging appearances of such an aneurysm have not been previously described. The importance of correct diagnosis is discussed.

Aged↗
PubMed1991

Complications of liver biopsy: the incidence of pneumothorax and role of post biopsy chest x-ray.

The incidence of pneumothorax and role of post biopsy chest x-ray were assessed in a prospective study of 120 consecutive patients using a standard biopsy technique. The incidence of pneumothorax was 0.8%. Post biopsy chest x-ray was not found to improve accuracy of diagnosis compared with clinical findings. Patients over the age of 60 years were at greater risk of pulmonary complications following liver biopsy.

Adolescent↗
PubMed1991

Primary fibromyalgia and the irritable bowel syndrome: different expressions of a common pathogenetic process.

Primary fibromyalgia (PFM) and the irritable bowel syndrome (IBS) are both common conditions which account for 30% or more of referrals to rheumatology and gastroenterology clinics. An association between symptoms in PFM and IBS has been suggested but the frequency with which they coexist has not been assessed. The aim of this study was to examine the prevalence of each condition in groups of patients with PFM and IBS compared to normal and disease control populations. We studied four patient groups, 20 patients in each group, with PFM, IBS, inflammatory arthritis, inflammatory bowel disease and also 20 normal controls. Using strict diagnostic criteria, each group was assessed by two investigators for symptoms and signs of PFM and IBS. Sigmoidoscopy was performed when indicated. Results indicate that 70% (14/20) of the PFM patients had IBS and 65% (13/20) of the IBS patients had PFM. This compared with the control groups where 12% (7/60) and 10% (6/60) had PFM and IBS respectively. In conclusion, these results indicate that PFM and IBS frequently coexist. A common pathogenetic mechanism for both conditions is therefore suggested.

Adult↗
PubMed1990

Chronic anaemia in an Irish gastroenterology unit: one hundred consecutive cases.

One hundred consecutive patients presenting with anaemia of at least 4 wks' duration were studied. This represents 3% of all patients seen at a medical service with a gastroenterology subspecialty interest. Forty-three men and 57 women were included; the mean age was 60 (SD 18) yr. Iron deficiency was the principal cause of anaemia in 49% of cases. Blood loss from the gastrointestinal tract was the most frequent cause of iron deficiency and was predominantly from the upper gastrointestinal tract. Patients in whom iron deficiency was the sole cause of anaemia all had a microcytic hypochromic blood profile; however, serum iron and iron binding capacity correlated poorly with the severity of anaemia. Chronic disease was the principal cause of anaemia in 39% of patients.

Adult↗