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Biomedical subjects

S Holt

Publications and source records attributed to S Holt.

At least 19 recordsLinked to original sources
PubMed1992

Lack of prognostic significance of DNA ploidy and S phase fraction in breast cancer.

DNA Ploidy and S phase fraction (SPF) were measured in Stage I and II breast cancers from patients with at least 8 years of follow-up, to assess the prognostic significance of these data. Disaggregated sections of formalin-fixed, paraffin-embedded tumour were analysed by flow cytometry. SPF was calculated using a rectangular model of S phase, after subtraction of background debris using an exponential model. 64% of tumours were DNA aneuploid. The median SPF was 4.5% for DNA diploid, and 10.9% for DNA aneuploid tumours. There were small reductions in survival at 10 years for DNA aneuploid tumours, and for tumours with above median SPF, but these were not statistically significant. The relative hazard for DNA aneuploid tumours was 1.20 (95% CI 0.81-1.76), and for high SPF was 1.31 (95% CI 0.87-1.98). Neither factor was statistically correlated with survival in multivariate analysis. Technical and theoretical factors limit the accuracy and reproducibility of flow cytometric data, and may explain the lack of prognostic information given.

Breast Neoplasms↗
PubMed1992

Barrett's esophagus: observations on diagnosis and management.

Barrett's esophagus is a premalignant condition that may often pass unrecognized in clinical practice. In adults, this condition is generally believed to be caused by chronic gastroesophageal reflux resulting in a metaplastic change in the epithelium of the esophagus. Diagnosis of Barrett's esophagus is established by careful biopsy of the involved esophageal mucosa. Periodic surveillance is recommended because of the risk of carcinoma. Antireflux surgery has not been shown to result consistently in the regression of the metaplastic epithelium, but potent acid suppression offers a new therapeutic approach that leads to healing of esophagitis and the potential regression of Barrett's epithelium.

Barrett Esophagus↗
PubMed1979

Effect of gel fibre on gastric emptying and absorption of glucose and paracetamol.

To determine the part played by altered gastric emptying in the modification of glucose absorption by gel fibres, glucose tolerance tests were done in seven healthy volunteers with and without the addition of pectin to the ingested glucose solution and after pharmacological inhibition of gastric emptying with propantheline. Compared with the controls, pectin significantly reduced blood-glucose. Propantheline had a similar but more pronounced effect. Pectin and guar gum did not substantially alter glucose tolerance in a patient who had had total gastrectomy. In a further investigation, gastric emptying and paracetamol absorption were studied simultaneously in fourteen subjects. In eight of these the study was repeated after addition of guar gum and pectin to the ingested paracetamol. Both gastric emptying and paracetamol absorption were slower after gel fibre but the total absorption of the drug, reflected in urinary recovery, was not significantly reduced. The results suggest that the effects of guar gum and pectin on glucose tolerance and paracetamol absorption could be due simply to alteration in the rate of gastric emptying.

Absorption↗
PubMed1979

Pneumatosis coli and sigmoid volvulus: a report of 4 cases.

Pneumatosis coli is an uncommon disease which is frequently misdiagnosed and inappropriately treated. The condition can usually be managed conservatively but complications requiring surgical treatment are occasionally encountered. We describe 4 patients with pneumatosis coli and associated volvulus of the sigmoid colon. Some of the factors that may have contributed to pneumocyst formation in these 4 patients are discussed with reference to recent advances in our understanding of the pathogenesis of pneumatosis coli.

Adult↗
PubMed1979

Vulval tuberculosis.

A patient with chronic tuberculous ulceration of the vulva is reported. Tuberculosis of the external genitalia is unusual and primary infections are rare. Venereal transmission of the infection could not be proven in this patient, but appears the most likely origin of the disease. Complete healing of the vulval ulcer, with rapid relief of symptoms, followed antituberculosis chemotherapy. The importance of biopsy in the diagnosis of chronic genital ulcers is emphasised.

Adult↗
PubMed1979

Breath hydrogen in pneumatosis cystoides intestinalis.

Pneumatosis cystoides intestinalis (PCI) is an uncommon condition of unknown aetiology. Bacterial gas production may be an important aetiological factor, but experimental evidence in humans has been lacking. We have studied breath hydrogen excretion as an index of bacterial gas production in 12 patients with PCI and have shown that four out of five with demonstrable cysts produced unusually high levels of hydrogen while fasting. This abnormality has not been previously reported. One patient showed resolution of PCI after antibiotic treatment. These findings confirm the importance of bacterial gas production in the pathogenesis of PCI.

Adult↗
PubMed1979

High flow oxygen therapy for pneumatosis coli.

Symptomatic and radiological resolution of pneumatosis coli was achieved by intermittent high flow oxygen therapy in five patients. In each case the extent of the disease was defined by colonoscopy and contrast radiography before treatment. Despite the confirmation of pneumocyst resolution, recurrence of colonic gas cysts was noted in two patients at six months and one year after treatment. Bacteriological studies indicated that resolution of the disease, induced by oxygen therapy, was not associated with eradication of anerobic bacteria from stool and colonic mucosa. The clinical features and response to treatment of this group of patients are discussed, with particular reference to previously reported methods of oxygen administration.

Aged↗
PubMed1979

Grey scale ultrasound in Crohn's disease.

Grey scale ultrasound examination was performed in 20 patients with Crohn's disease of varying extent and severity. In 15 of the 20 patients studied, thickening of the wall of the terminal ileum and caecum, with adjoining inflammatory changes in the mesentery, produced recognisable patterns on longitudinal and transverse ultrasonographs. Grey scale ultrasound, although not providing the specificity or detail of conventional radiology, can be helpful in the assessment of ileocaecal Crohn's disease, particularly in younger patients where the radiation hazards of repeated x-ray examinations are undesirable.

Adult↗
PubMed1979

Interatrial abscess.

A large abscess of the interatrial septum developed during the course of acute bacterial endocarditis affecting the aortic valve. Septic involvement of the cardiac conducting system produced atrioventricular dissociation, and subsequent abscess rupture resulted in an aorto-right atrial communication. The clinical presentation of this rare complication of acute bacterial endocarditis is correlated with the post-mortem findings.

Abscess↗
PubMed1979

Hazards of hepatic artery infusion of streptozocin.

Three patients with metastatic malignancy received streptozocin by hepatic artery infusion through a percutaneous transfemoral catheter. Two patients developed major arterial thrombosis, from which one died. The other suffered renal damage following displacement of the catheter tip. Possible avoidable risk factors are identified.

Adenoma, Islet Cell↗
PubMed1979

Myocardial infarction and marijuana.

Myocardial infarction in the virtual absence of risk factors occurred in a 25-year old man shortly after smoking a cigarette containing marijuana. Subsequent coronary arteriography was normal.

Adult↗
PubMed1979

A single scan technique for estimating acid output.

A single scan technique using 99mTc has been developed for the measurement of gastric acid output. After an overnight fast, pentagastrin (6 microgram/kg S.C.) was given 15 min before 99mTc (1 mCi i.v.), and a scan of the abdomen was performed 15 min later using a double-headed scanner. Accumulation of isotope within the stomach was then calculated from the scan and expressed as a percentage of the injected dose. Pentagastrin-stimulated intragastric activity correlated with acid output measured conventionally on a separate occasion (r = 0.87, P less than 0.0001). The test is rapidly performed with minimal inconvenience and discomfort to the patient, and the dose of irradiation used is small. The advantages of the method compared with intubation and gastric aspiration are discussed.

Gastric Acidity Determination↗
PubMed1978

Multiple concentric ring sign in the ultrasonographic diagnosis of intussusception.

Gray scale ultrasound examination of two patients with abdominal space-occupying lesions demonstrated characteristic ring shadows on longitudinal scans. In one case a multiple concentric ring shadow resulted from an ileocolic intussusception, and in the other a "bull's eye" image was due to an infiltrating carcinoma of the pyloric antrum. A study of these patients confirms the suspicion [1] that there is a characteristic ultrasonic appearance of intussusception in bowel loops.

Adenocarcinoma↗
PubMed1978

Fluorouracil cardiotoxicity.

Our of 140 patients treated with intravenous 5-fluorouracil, four developed ischaemic chest pain within 18 hours of either the second or third dose. In three of these patients the pain recurred after subsequent doses. Predose electrocardiograms in two cases were normal. None of the four patients had a history of ischaemic heart disease, although all had received left ventricular irradiation. Although cardiotoxicity is a rare complication of fluorouracil treatment, it merits wider recognition.

Adult↗
PubMed1978

A teratoma of the lung containing thymic tissue.

A case of a benign, cystic intrapulmonary teratoma occurring in the left lobe of a 63-yr-old female is described and the typical clinical symptoms and distinguishing X-ray appearances which may be helpful in diagnosing this rare tumour are mentioned. The connection between the tumor and the segmental bronchus clearly established the true intrapulmonary nature of the lesion in this case and the unusual finding of thymic tissue within the wall supports previous speculation regarding the possible thymic origin of these neoplasms.

Choristoma↗
PubMed1978

Spontaneous mid-oesophageal rupture.

The clinical presentation and management of spontaneous rupture of the middle third of the oesophagus is described in two patients. Early presentation and treatment in one case led to uncomplicated recovery. In the other patient late presentation and diagnosis resulted in delayed surgical intervention with an unsuccessful outcome. The nature of this rare lesion is discussed and nine previously described cases are reviewed.

Adult↗