Biomedical subjects

J R Holman

Publications and source records attributed to J R Holman.

7 recordsLinked to original sources

PubMed1999

Adult circumcision.

Adult circumcision can be performed under local or regional anesthesia. Medical indications for this procedure include phimosis, paraphimosis, recurrent balanitis and posthitis (inflammation of the prepuce). Nonmedical reasons may be social, cultural, personal or religious. The procedure is commonly performed using either the dorsal slit or the sleeve technique. The dorsal slit is especially useful in patients who have phimosis. The sleeve technique may provide better control of bleeding in patients with large subcutaneous veins. A dorsal penile nerve block, with or without a circumferential penile block, provides adequate anesthesia. Informed consent must be obtained. Possible complications of adult circumcision include infection, bleeding, poor cosmetic results and a change in sensation during intercourse.

Adult↗

PubMed1997

Hereditary hemochromatosis.

Hereditary hemochromatosis (HHC) is an inherited disease transmitted in an autosomal recessive pattern. With homozygosity occurring in up to 0.5% of the population, HHC is the most prevalent genetic disease among the white population worldwide and has the same prevalence as the sickle cell trait in the African-American population. An asymptomatic 50-year-old white man presented at the family practice clinic and stated that HHC had been diagnosed in his mother. Laboratory findings showed markedly elevated transferrin saturation and ferritin levels. The diagnosis of HHC was made on the basis of the laboratory results and family history, and therapy was begun. Clinical manifestations of HHC occur late and include diabetes mellitus, cirrhosis, and cardiomyopathy. As end-organ damage is preventable, optimal management involves early diagnosis and lifelong phlebotomy. Diagnosis is made by an elevated transferrin saturation level and an increased serum ferritin value. Hereditary hemochromatosis is a genetic disorder of iron metabolism that has an excellent prognosis if diagnosed early.

Female↗

PubMed1995

Neonatal circumcision techniques.

Neonatal circumcision is most commonly performed using one of three techniques--the Mogen clamp, the Gomco clamp or the Plastibell device. With all three techniques, careful selection and preparation of patients is essential. Informed consent must be obtained from parents or guardians, based on an objective understanding of the medical and social implications of circumcision, including potential complications from the procedure. Measures for creating an aseptic field, anesthesia and positioning of the infant do not vary with the technique selected. Both the Mogen and Gomco clamps protect the glans while producing crush injury to the prepuce, which is then surgically removed. The Plastibell device induces necrotic tissue, which is sloughed off, along with the plastic shield, within a week or so. Although complications from neonatal circumcision are rare, hemorrhage, local infection, sepsis, meatal ulceration and poor cosmetic results have been reported.

Circumcision, Male↗

PubMed1990

Rectovaginal constriction in Jersey cattle: genetics and breed dynamics.

Data from farmer-owned herds and from experimental matings supported monofactorial recessive inheritance of rectovaginal constriction in US Jersey cattle. Kempthorne's population genetics model of a recessive trait involving only male selection was extended to include mutation and converted to selection of females only. Computer analyses with that model estimate slow decline in the frequency of the gene for rectovaginal constriction. Practical dynamics of the disorder in a breed registering 50,000 females and 2,000 males annually are given for current conditions and after 500 generations of selection.

Alleles↗

PubMed1989

Acute intermittent porphyria. More than just abdominal pain.

Acute intermittent porphyria is an unusual syndrome that may be very difficult to differentiate from acute intraabdominal processes. Diagnosis requires the documentation of increased urinary porphobilinogen. Failure to perform appropriate tests early in the attack may necessitate diagnostic laparotomy to rule out intraabdominal catastrophies. Once the diagnosis has been made, treatment with intravenous dextrose aborts most acute episodes. Patients should avoid such triggering factors as fasting and certain drugs. Screening of family members is important to identify latent carriers.

Abdomen↗

PubMed1978

Toxicological studies with mirex in bobwhite quail.

Bobwhite quail (Colinus virginianus) received dietary mirex in concentrations of 1, 20 and 40 ppm to investigate reproductive effects of long term exposure to this chemical. Residue analyses of Fo generation breeders indicated that male adipose tissue contained approximately 10 times the mirex level in the diet. Elimination of mirex in females probably was facilitated by egg laying, which reduced mirex buildup in adipose tissue to five times the dietary level. Both sexes were noted to concentrate mirex in fat and breast tissue in direct proportion to the intake of dietary mirex. Eggs collected from Fo generation breeders were not affected deleteriously by mirex as measured by embryo survival to 3 weeks, and thenumber of eggs failing to hatch. Indeed, increased rates of egg fertility and hatchability were associated with higher dietary concentrations. Chick survival data was obtained in Fp and F1 generation hatchlings from hatching through 2 weeks. No chick mortality attributable to pesticide stress was detected in either group of birds. Eggs collected from F1 generation breeders that received 1 ppm were not affected harmfully as measured by embryonation, embryo survival, and hatchability rates. Comparison of residues in wild bobwhites with residues in our experimental findings indicates mirex is apparently not affecting deleteriously reproductive success of wild quail.

Adipose Tissue↗

PubMedDate not supplied

Detection of human papillomavirus DNA in patients referred to a family practice colposcopy clinic.

BACKGROUND: Human papillomavirus (HPV) is strongly implicated in the pathogenesis of cervical neoplasia. The ability of a commercially available kit (Virapap/Viratype) to detect evidence of HPV is compared with cervical cytology, colposcopy, and directed biopsies. METHODS: During a period of 16 months, cervical samples from 241 consecutive new patients referred for a colposcopy examination were obtained for HPV-DNA hybridization typing according to the kit instructions. Samples were sent to a reference laboratory for testing. The results were compared with results of the colposcopy examination, cervical cytology, and directed cervical biopsy samples processed and evaluated by our hospital laboratory. RESULTS: HPV DNA was detected in 27 of 107 patients who had abnormal colposcopy findings for a sensitivity of 25 +/- 7.5 percent at the 90 percent confidence interval. One of 134 patients with normal findings was positive for a specificity of 99 +/- 5 percent at the 95 percent confidence interval. Based on a 75 percent probability of HPV in the population, the positive predictive value was 99 percent and the negative predictive value 30 percent. CONCLUSIONS: With the low negative predictive value and sensitivity, HPV-DNA testing by this commercial kit is not an adequate tool for screening HPV in this population.

Biopsy↗