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Biomedical subjects

L W Horton

Publications and source records attributed to L W Horton.

At least 19 recordsLinked to original sources
PubMed2001

Plasma cell balanitis of Zoon: response to Trimovate cream.

Our objective was to evaluate the response to Trimovate cream in patients with Zoon's balanitis. Patients attending the penile dermatosis clinic between October 1996 and October 1999 with the clinical and histological features diagnostic of Zoon's balanitis were included in this study. They were treated with Trimovate cream for a varying length of time according to clinical response, having declined circumcision as first-line treatment. All cases had photographs taken before and after treatment. Ten cases of histologically-confirmed Zoon's balanitis were treated. Clinical resolution was observed in all cases, all of whom remain on long-term follow-up. In conclusion, topical Trimovate cream is an effective treatment for Zoon's balanitis.

Adult↗
PubMed1992

Impalpable breast lesions: marking of surgical specimens for pathology.

A simple method is described to indicate the abnormal area in breast biopsy specimens excised following mammographic localization of impalpable lesions. A hypodermic needle is inserted into the specimen through the abnormality immediately following specimen radiography, removing the need to radiograph individual tissue slices. The technique has proved successful in 121 out of 122 specimens.

Biopsy↗
PubMed1990

Mucin depletion in inflammatory bowel disease.

The mucin and gland content of 26 rectal biopsy specimens--five normal specimens, 10 from patients with ulcerative colitis, and 11 from patients with Crohn's disease--were measured using a Quantimet image analyser. There was significantly less mucin in the groups with ulcerative colitis compared with either those with Crohn's disease or the normal controls. The difference in the gland content between the groups with ulcerative colitis and Crohn's disease and between the group with Crohn's disease and the normal controls did not reach significance. The results suggest that it is worth while assessing the mucin content of rectal biopsy specimens from patients with inflammatory bowel disease. In routine practice this assessment can be made by eye using a suitably stained section.

Colitis, Ulcerative↗
PubMed1989

Visualization of eosinophil chemotactic factor in abomasal tissue of cattle by immunoperoxidase staining during Ostertagia ostertagi infection.

Eosinophil chemotactic factor (ECF) was localized predominantly in the intestinal cells and lateral hypodermal cords of developing fifth stage larvae (L5) of Ostertagia ostertagi within abomasal tissue cross-sections by peroxidase in an antibody sandwich technique using monoclonal antibody to ECF. Cooperia oncophora larvae in tissue cross-sections did not stain using this technique. These experiments demonstrate that ECF is localized in Ostertagia ostertagi organelles and is probably released by the developing L5 into the abomasal tissue surrounding the parasitized gland. The presence of ECF within O. ostertagi larvae in situ and the results of previous experiments demonstrated in vitro and in vivo ECF chemotactic activity help to explain why eosinophils are observed histologically in abomasal tissues from cattle with ostertagiasis.

Abomasum↗
PubMed1986

Value of Tru-cut biopsy in the diagnosis of soft tissue tumours.

The light microscopic appearances of Tru-cut needle biopsies from 50 consecutive soft tissue tumours were assessed by three pathologists and compared with the definitive histological diagnosis. Forty-four patients had soft tissue sarcomas and six had benign soft tissue lesions. A correct predictive diagnosis of sarcoma was made on 87-98 per cent of adequate Tru-cut specimens, the accuracy varying between pathologists. Three sources of diagnostic error were recognized: false positive cores (8 per cent), false negative cores (8 per cent), and cores inadequate for diagnosis (16 per cent). The major source of confusion related to difficulties in differentiating infiltrating fibromatosis from malignant fibrous histiocytoma. The high sensitivity of Tru-cut needle biopsy suggests that it could be a valuable aid in the diagnosis of clinically suspected soft tissue sarcomas.

Adolescent↗
PubMed1985

Necrotising lymphadenitis without granulocytic infiltration (Kikuchi's disease).

Kikuchi's disease (necrotising lymphadenitis) is characterised by cervical lymphadenopathy in young patients and may be mistaken for malignant disease both clinically and histologically. Microscopically, there is a varying degree of effacement of the lymph node architecture and necrosis with an infiltrate of "histiocytic" cells and absence of polymorphs. The disease is of unknown aetiology. It was originally described in Japan, and only 27 cases have been reported elsewhere (none in the United Kingdom), although it has probably been seen but not recognised. The clinical, histopathological, electron microscopic, and immunohistological findings in four cases of the disease were evaluated.

Adolescent↗
PubMed1982

Value of plasma calcium, phosphate, and alkaline phosphatase measurements in the diagnosis of histological osteomalacia.

Plasma calcium and phosphate concentrations and alkaline phosphatase activities were examined retrospectively in 50 patients with histologically proven osteomalacia and 50 age- and sex-matched control subjects with normal bone histology. An abnormal plasma alkaline phosphatase activity was more useful than an abnormal plasma calcium or phosphate concentration in distinguishing between normal and osteomalacic subjects, producing a false-negative rate of 14% and a false-positive rate of 8%. False-negative and false-positive rates of 10% and 8% respectively were obtained when the presence of an abnormality in any one of the three biochemical measurements was used as a predictor of histological osteomalacia. When discriminant analysis was applied to plasma calcium, phosphate and alkaline phosphatase together a false-negative rate of 12% and a false-positive rate of 0% was obtained.Sixty-two patients in whom a diagnosis of osteomalacia was suspected were investigated prospectively, using both single biochemical abnormalities and the classification functions derived from the discriminant analysis of all three biochemical measurements to predict the presence or absence of histological osteomalacia. Plasma alkaline phosphatase activity gave false-negative and false-positive rates of 10% and 32% respectively but was a more reliable predictor of abnormal bone histology than were plasma calcium or plasma phosphate concentrations or the presence of an abnormality in any one of the three measurements. Discriminant analysis using plasma calcium, phosphate and alkaline phosphatase together produced a false-negative rate of 16% and a false-positive rate of 10%. We conclude that plasma alkaline phosphatase activity is the best single routine biochemical screening test for osteomalacia, although a high false-positive rate may occur. Direct discriminant analysis of plasma calcium, phosphate and alkaline phosphatase together provides a more sensitive method of detecting histological osteomalacia which should be useful in determining the prevalence of osteomalacia within high-risk populations.

Adolescent↗
PubMed1980

Vitamin D prophylaxis and osteomalacia in chronic cholestatic liver disease.

Bone histology was examined in 32 patients with chronic cholestatic liver disease, of whom just over one half were receiving high-dose parenteral vitamin D therapy. Four patients had histological evidence of osteomalacia; two of these were receiving vitamin D therapy, and showed only very mild osteomalacia, while the remaining two untreated patients had more severe bone disease. Plasma 25-hydroxyvitamin D levels were normal in all vitamin D-treated patients, and serum calcium concentrations were significantly higher in the treated group. Clinical symptoms and biochemical and radiological findings were unreliable in predicting osteomalacia. It is concluded that osteomalacia is uncommon in patients with chronic cholestatic liver disease irrespective of whether or not they are receiving vitamin D therapy. However, high-dose parenteral vitamin D prophylaxis protects against vitamin D deficiency and may also prevent the development of severe bone disease.

Adult↗
PubMed1980

Treatment of bone disease after jejunoileal bypass for obesity with oral 1 alpha-hydroxyvitamin D3.

The effects of oral 1 alpha-hydroxyvitamin D3 have been investigated in 12 patients with bone disease after jejunoileal bypass for obesity. Bone histology became normal or improved greatly after four to 12 months' treatment in eight patients but showed little change or worsened in four. There was a significant rise in plasma calcium and fall in plasma alkaline phosphatase concentration with 1 alpha-hydroxyvitamin D3 therapy in the patients with a good histological response. Administration of metronidazole and cotrimoxazole to two patients who had failed to respond to 1 alpha-hydroxyvitamin D3 resulted in clinical and biochemical improvement; in one of these patients histological improvement was also documented. It is concluded that oral 1 alpha-hydroxyvitamin D3 can be effective in healing post-bypass bone disease; the failure of some patients to respond may be related to bacterial contamination of the small intestine and in those patients antibiotics may also be indicated.

Adult↗
PubMed1980

Unusual presentation of cholangiocarcinoma.

A patient who presented with dysphagia was found to have a cholangiocarcinoma, with metastases in the para-oesophageal lymph nodes. Although dysphagia has been described as a presenting feature of some metastatic carcinomas, to the authors' knowledge, there have been no reports of it as a presenting symptom of a cholangiocarcinoma.

Adenoma, Bile Duct↗
PubMed1979

Inflammatory fibrous histiocytoma in the left upper abdomen with a leukemoid blood picture.

A case of inflammatory fibrous histiocytoma arising in the left hypochondrium, which presented with a leukemoid reaction and was initially diagnosed as chronic neutrophilic leukemia, is described. The difficulty of interpreting the hematological findings, especially as the spleen appeared to be enlarged, is discussed. The tendency of this highly malignant group of tumors to cause a systemic granulocytosis is commented upon and attention is drawn to the lack of satisfactory treatment.

Abdominal Neoplasms↗
PubMed1979

Treatment of osteomalacia associated with primary biliary cirrhosis with parenteral vitamin D2 or oral 25-hydroxyvitamin D3.

The histological and biochemical response of osteomalacia has been studied in four patients with primary biliary cirrhosis, who were treated with oral 25-hydroxyvitamin D3, 50 microgram daily, or intramuscular vitamin D2, 150,000 units once weekly, for five to 12 months. All patients showed complete histological healing of osteomalacia, despite rapidly deteriorating liver function in three. Plasma 25-hydroxyvitamin D concentrations were low in all patients before treatment, but became normal during either vitamin therapy. Serum calcium and phosphate levels, and urinary calcium excretion were not always reliable in predicting the histological response to treatment. Serum alkaline phosphatase activity decreased in all patients during vitamin D therapy. We conclude that both high-dose parenteral vitamin D2 and oral 25-hydroxyvitamin D3 may be effective in healing osteomalacia associated with primary biliary cirrhosis. Measurement of plasma 25-hydroxyvitamin D levels during vitamin D therapy provides useful information about 25-hydroxylation of the parent vitamin and intestinal absorption of orally administered 25-hydroxyvitamin D3.

Administration, Oral↗
PubMed1978

Bone disease after jejuno-ileal bypass for obesity.

Bone tissue was examined in 21 patients who had undergone jejuno-ileal bypass for obesity between 1971 and 1974. 10 patients had osteomalacia with evidence of secondary hyperparathyroidism. Clinical symptoms and biochemical and radiological investigations were often unreliable in diagnosing bone disease, although plasma-25-hydroxyvitamin-D and plasma-phosphate concentrations were significantly lower and plasma-parathyroid-hormone concentrations were significantly higher in the patients with bone disease. The presence of osteomalacia was unrelated to age, length of time since bypass, or post-bypass weight-loss, and plasma-25-hydroxyvitamin-D levels did not correlate closely with bone histological changes. It is concluded that osteomalacia is common after jejuno-ileal bypass and that factors other than simple vitamin-D deficiency may contribute to its development.

Adult↗