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Biomedical subjects

J W Hamer

Publications and source records attributed to J W Hamer.

At least 19 recordsLinked to original sources
PubMed1994

Primary thyroid lymphoma: clinical features, treatment and outcome: a report of 8 cases.

AIM: To assess the clinical findings and response to treatment of patients with primary thyroid lymphoma. METHODS: Patients with primary thyroid lymphoma were identified by reviewing the diagnoses of all patients with thyroid malignancies diagnosed at Christchurch Hospital between 1980-91. The records of patients with primary thyroid lymphoma were abstracted. RESULTS: During the 12 year period eight patients (6 females, 2 males) with primary thyroid lymphoma were diagnosed and treated. The median age was 78 years (range 18-90 yr). All patients presented with recent thyroid masses and obstructive symptoms were prominent. Two patients were initially referred with endocrine dysfunction--one thyrotoxic and one hypothyroid. Six patients had nonHodgkin lymphoma and two Hodgkin's disease, with all having stage IA disease. Two patients were treated by thyroidectomy, and in the remaining six patients the thyroid lymphoma masses regressed following radiotherapy with the two youngest patients also receiving chemotherapy. At follow up all five elderly patients have since died--two of disseminated lymphoma, two of concurrent cancers and one of vascular disease, and the three younger patients remain in remission after 4.5, 6.5 and 10.5 years. CONCLUSION: Primary thyroid lymphoma usually presents with obstructive symptoms, but there may be associated thyroid dysfunction. Thyroid lymphoma masses respond well to radiotherapy.

Adolescent↗
PubMed1989

Aspiration cytology in the diagnosis of head and neck masses: the early Christchurch experience.

Fine needle aspiration cytology has been performed on patients presenting with head and neck masses in Christchurch since mid-1985. The results of an initial 120 aspirations were reviewed. Histology was available to compare with the cytology result in 58% of cases. Clinical review was used to assess the accuracy of the cytology result in the remaining cases. The majority of the masses aspirated were of benign origin (72%). The cytological diagnosis was accurate in 79% of cases. Of the remaining aspirates, 13% were inaccurate and 8% nondiagnostic. The sensitivity for malignant lesions was 100%, with 86% specificity (for benign lesions). Particular diagnostic difficulty was found in the differentiation between some salivary gland tumours, and the assessment of aspirates from neck masses after combined therapy (radiotherapy and surgery). Fine needle aspiration cytology is of considerable value in the management of head and neck masses.

Adolescent↗
PubMed1983

Nonrandom cytogenetic changes in New Zealand patients with acute myeloid leukemia.

Bone marrow clones with abnormal chromosomes were observed in 56% of 66 patients with forms of acute myeloid leukemia [French-American-British (FAB) M1-M6]. Acute myeloblastic leukemia (AML, M1 and M2) was the most common form, and 65% of these patients showed chromosomal abnormalities compared with 41% of patients with acute myelomonocytic leukemia (AMMoL, M4). The recognized nonrandom chromosomal abnormalities found were trisomy 8, monosomy 5 or 7, trisomy 1q, t(6;9), t(8;21), t(15;17), and abnormalities in 17q. There was also a strong involvement of chromosome No. 11: Abnormalities were found in eight patients when their leukemia was diagnosed and in a further three patients during the course of karyotypic evolution. Six of these patients had AMMoL or AMoL. Complex or multiple clones were found in 37% of AML patients at diagnosis. Our AML patients had a reduced frequency of abnormalities in chromosome No. 5 or 7 and an increased frequency of abnormalities in chromosome No. 8 compared with studies reported in other countries (p = 0.01). This difference suggests that in New Zealand AML might be caused by factors different from those operating in more industrialized centers.

Bone Marrow↗
PubMed1981

Bone marrow transplantation for acute leukaemia and severe marrow aplasia: an analysis of five patients.

Five patients, three with severe aplasia and two with acute leukaemia have been treated by bone marrow transplantation (BMT). Four are alive and well with excellent graft function. One showed engraftment but died of acute graft-versus-host disease (GVH); this patient and his donor were hepatitis B antigen positive. Three show evidence of mild chronic GVH, two patients requiring control by immunosuppressive therapy. Bone marrow transplantation (BMT) has now become an established method of treatment in severe aplasia and in acute leukaemia and our results serve to emphasise this. The clinical and organisational problems associated with BMT are discussed.

Adolescent↗
PubMed1981

Right atrial catheters for long-term venous access.

Thirty-two Hickman central venous catheters were placed in patients suffering mainly from blood disorders. The catheters remained in situ for an average of 64 days. In 20 patients the catheters were removed either because they were no longer needed (14) or at death (6). In five patients they are still in position. Complications in seven patients led to the catheter being removed and these included four patients with catheter related sepsis. The use of these catheters allows safe long-term access to the venous circulation even in the neutropenic, immunosuppressed patient.

Bacterial Infections↗
PubMed1981

The peripheral blood picture in thyrotoxicosis.

The haematological results of 200 patients with uncomplicated thyrotoxicosis is reviewed. Although more than half of the patients showed a normal blood picture, several abnormalities were detected. In 37 percent of patients the erythrocytes showed microcytosis, and 8.5 percent were mildly anaemic. An absolute lymphocytosis was found in 11 percent and neutropenia was present in 2.5 percent of patients. The prevalence of treated pernicious anaemia was 1.5 percent.

Adolescent↗
PubMed1981

Acute promyelocytic leukemia: cytogenetics and bone-marrow culture.

Six patients were diagnosed as having acute promyelocytic leukemia (APL) according to FAB criteria. One patient conformed to the M3 variant. Informative cytogenetic results (G-banding) on five of the patients showed that three of them, including the M3 variant, had the 15;17 translocation in bone-marrow or blood cells. Cells with the translocation were accompanied by cells with a normal karyotype in all patients and no other chromosomal abnormality was present. This first report of the 15;17 translocation from the South Pacific region is relevant to the uneven geographical distribution of APL patients with the translocation. Five of the six patients including the M3 variant, showed a distinctive pattern of cell growth in agar culture characterized by a profusion of small, uniform clusters containing 6-20 cells with the appearance of promyelocytes. The remaining patient had a pattern of cell growth more typical of M2 acute leukemia. This cell growth pattern may be useful in diagnosing and monitoring the course of APL.

Aged↗
PubMed1980

Richter's syndrome with identification of marker chromosomes.

A case is presented of a man with Richter's syndrome with diffuse histiocytic lymphoma following a ten-year history of untreated chronic lymphatic leukemia. He did not respond to therapy. The lymphoma cells had 61 chromosomes with aneuploidy of 13 chromosomes and 11 structurally altered chromosomes. Only chromosomes 8, 9, 12, 14, and 18 were diploid and without abnormality. Significantly, part of chromsome 1q was duplicated as in the partial trisomy of 1q reported to characterize a number of hematologic neoplasms. A large marker chromosome with subterminal centromere was a tandem duplication of chromosome 4q.

Aneuploidy↗
PubMed1980

Bone marrow transplantation for severe aplastic anaemia.

An eight-year-old girl with severe acquired aplastic anaemia received a bone marrow transplant from her 11-year-old brother. The bone marrow graft is firmly established, but the patient has mild chronic graft versus host disease affecting liver and skin. The indications for bone marrow transplantation in aplastic anaemia are discussed.

Anemia, Aplastic↗
PubMed1980

Acute onset of folate deficiency in patients under intensive care.

Four patients with ruptured abdominal aortic aneurysm developed thrombocytopenia and marked megaloblastic changes within 3-10 days of surgery. In 2 patients, direct evidence of folate deficiency within marrow cells was obtained by measuring deoxyuridine suppression in short-term bone marrow cultures. The results suggest that folate deficiency was limited to marrow tissue. Folate deficiency localized to the bone marrow offers an explanation for the extremely rapid onset of thrombocytopenia in these patients. The significance of these findings with regard to folate metabolism is discussed. The importance of recognizing this potentially fatal complication of critical illness is emphasized, because it should be readily prevented by folic acid therapy.

Acute Disease↗
PubMed1980

An electrophoretic and quantitative analysis of coagulation factor XIII in normal and deficient subjects.

Previous electrophoretic studies of the A and B subunits of factor XIII have revealed considerably genetic heterogeneity. The present work investigates the electrophoretic forms and quantitates the A and B subunits in a family with inherited factor XIII deficiency. The data indicate that the deficiency in this family is due to a null allele at the locus controlling the A subunit. All family members were found to have decreased levels of B subunit. The data also indicate that there is no difference in thrombin activated transamidase activity between normal individuals with the three commonly occurring electrophoretic phenotypes of the A subunit.

Alleles↗
PubMed1979

Pregancy complicated by acute myeloid leukaemia.

Combination cytotoxic chemotherapy was used to treat a case of acute myeloid leukaemia presenting in the 25th week of pregnancy with a sustained complete remission of the leukaemia and the successful delivery of a normal infant. The management of leukaemia presenting in pregnancy is discussed.

Adult↗
PubMed1979

Jogger's heat stroke.

Two patients developed heat stroke following jogging. Transient disturbance of cerebral function was the most dramatic clinical feature. Although haemorrhagic complications were not seen, marked changes in the haemostatic system occurred with both thrombocytopenia and a reduction of clotting factors synthesised by the liver. No evidence of disseminated intravascular coagulation was found. Heat stroke must now be added to the list of jogging hazards.

Adult↗
PubMed1979

Familial relative polycythaemia due to haemoglobin Heathrow.

Eleven affected members of a New Zealand family carrying the high oxygen affinity haemoglobin Heathrow are described. The detection of high oxygen affinity abnormal haemoglobins may be difficult as haemoglobin and red cell mass may both fall within the normal range and no abnormality may be detected on haemoglobin electrophoresis or by haemoglobin stability tests. The importance of oxygen affinity studies to establish the diagnosis is emphasized.

Adult↗