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Biomedical subjects

G Holmes

Publications and source records attributed to G Holmes.

At least 55 records · Page 3Linked to original sources
PubMed1991

Anomalous systemic venous to left atrial connection in tricuspid atresia with severely restrictive interatrial communication.

An adequate interatrial communication is necessary to accommodate right atrial output in patients with tricuspid atresia. We report a patient with a tiny opening in the midportion of the atrial septum, who was found to have an anomalous systemic venous to left atrial communication. This channel was not evident on noninvasive testing, but would likely have caused persistent desaturation following a Fontan procedure had it not been detected. In patients with restrictive interatrial communications, an angiogram of the right atrium may reveal similar anomalous channels.

Abnormalities, Multiple↗
PubMed1988

Anal cancer in women.

We studied predisposing factors in 56 women with anal cancer, comparing them with 56 matched controls drawn from the population. A detailed pretested questionnaire was administered to each study subject in a structured interview and blood was drawn for detection of herpes simplex virus antibodies by radioimmunoassay. Pathologic material from cases was obtained and evidence of human papilloma virus infection was sought. By univariate analyses we found associations between anal cancer and positive herpes simplex virus 2 titer (p = 0.0017), cigarette smoking (p = 0.0028), previous positive or questionable cervical Papanicolaou smear (p = 0.0124), and increasing number of sexual partners (p = 0.0224). By the multivariate technique of logistic regression there were independent and significant associations with cigarette smoking (p = 0.0126), previous use of hemorrhoid preparations (p = 0.0149), and history of disturbed bowel habits for greater than 1 mo (p = 0.0273). Anal cancer in women is a rare disease associated with cigarette smoking and sexual experience. Its association with previous anorectal disease is unclear and deserving of further study.

Adult↗
PubMed1988

Balloon dilatation for cardiac obstructive lesions in infants and children.

PBD has been used to relieve a wide variety of cardiac obstructive lesions in infancy and childhood. However, it has been most frequently used for semilunar valve stenosis, particularly PS. Results of pulmonic PBD are almost uniformly satisfactory for relief of typical PS, and the low rate of significant complications show that it is a safe procedure in practiced hands. It is now considered the treatment of choice for typical PS. Recently reported results of PBD for critical neonatal PS are also encouraging. New generations of balloon catheters better suited for neonatal balloon valvuloplasty will probably facilitate the procedure. In contrast, results for dysplastic valves are poor, suggesting that this condition is not amenable to PBD. Aortic stenosis also responds well to PBD in infancy and childhood when the valve is not dysplastic. The procedure in general is technically more difficult than pulmonary valvuloplasty, with a higher rate of complications, especially in neonates.

Catheterization↗
PubMed1986

Infantile spasms. Comparative trial of nitrazepam and corticotropin.

Fifty-two patients were enrolled in a four-week randomized multicenter study comparing nitrazepam and corticotropin in the treatment of infantile spasms. The drugs' efficacy was evaluated in 48 patients, all less than 2 years of age. Both treatments resulted in a statistically significant reduction in spasm frequency from that at baseline, but the difference between treatments was not significant. The number of patients who experienced side effects was similar in the two treatment groups, but the adverse effects encountered among the patients treated with corticotropin were qualitatively more severe and required the discontinuation of treatment in six patients.

Adrenocorticotropic Hormone↗
PubMed1985

Juvenile papillomatosis and breast carcinoma.

Juvenile papillomatosis (JP) is a breast tumor of young women featuring atypical papillary duct hyperplasia and numerous cysts, first described as a clinicopathologic entity in 1980. The disease is of interest because of the youth of these patients and the fact that the pathologic elements resemble those considered to be precancerous in older women. This report summarizes the findings in 180 patients enrolled in the Juvenile Papillomatosis Registry. The mean age at diagnosis was 23 years (range, 12-48 years; median, 21 years; mode, 18 years). No relationship was found with parity, age of menarche, or use of birth control pills. Fifty patients (28%) reported that one or more relatives had had breast cancer. Twelve (7%) patients reported a first degree relative (mother, 10; sister, 2), whereas in 38 (21%) breast cancer was limited to one or more secondary relatives, most often maternal (23/39 or 59%). Persistent (or recurrent) JP was found in 25 patients who had a subsequent biopsy, and 8 patients had bilateral JP. Pathologic analysis revealed focal epithelial necrosis, a feature often associated with carcinoma, in 30 (17%) cases predominantly in those with the most severe cytologic atypia of hyperplastic duct lesions (77%). Positive family history was reported by 33% (10/30) of women with epithelial necrosis and 27% (40/150) without this finding. Seven patients (4%) had breast carcinoma diagnosed concurrent with JP (ipsilateral, 5 cases; contralateral, 2 cases). A previously unreported finding is the diagnosis of carcinoma subsequent to JP in two cases (contralateral intraductal and ipsilateral microinvasive duct, respectively) with intervals of 8 and 9 years, respectively. The nine patients with carcinoma and JP tended to be slightly older at the time JP was diagnosed (mean, 27 years) and had a higher frequency of positive family history (56%) than those without breast cancer (mean age, 23 years; positive family history, 26%). These findings confirm earlier evidence that JP is a marker for families at risk and now indicate that the patient with JP may herself be in jeopardy of developing breast cancer coincidentally or at a later date. Wide local excision is adequate to control the lesion in most cases. Careful clinical surveillance is indicated for any woman who has juvenile papillomatosis and for her female relatives. The early age of onset of this unusually florid proliferative disease, and family history association, suggest there may be an underlying hormonal disturbance or genetic abnormality.

Adolescent↗
PubMed1982

Prognostic value of the electroencephalogram in neonatal asphyxia.

In order to determine whether an EEG early in the course of asphyxia neonatorum is of any more value than the neurological examination in predicting outcome we reviewed case histories of 38 infants with asphyxia neonatorum. The EEG background activity was valuable in predicting outcome. Normal and maturationally delayed EEGs were associated with normal outcomes while low voltage, electrocerebral inactivity and burst suppression EEGs were highly correlated with severe neurological sequelae. Epileptiform activity was not as predictive of outcome as background activity. Although initial normal neurological examinations were associated with normal developmental and neurological outcomes, moderately and severely abnormal infants had more variable courses. A single EEG done early in the course of asphyxia neonatorum is a more sensitive predictor of outcome than the neurological examination.

Asphyxia Neonatorum↗
PubMed1982

On the functional heterogeneity of UDP-glucuronyl transferase of mouse liver microsomes.

Fractionation of sodium cholate solubilized microsomes from mouse liver on Sepharose CL-48 yielded three protein peaks with UDP-glucuronyltransferase activities. Of these three peaks, only peak II contained activities towards all the substrates tested: p-nitrophenol, 1-naphthol, morphine, testosterone and estrone. These glucuronyltransferase activities could not be dissociated by further chromatography on DEAE-Sepharose CL-6B and isoelectric focusing. The results show the presence of a functional form of glucuronyltransferase with a wide substrate specificity, and indicate that in addition, other forms with narrower studied specificities may also be present in mouse liver microsomes.

Animals↗
PubMed1981

Substrate specificity of human UDP-glucuronyltransferase in cultured lymphocytes.

1. This study establishes the presence of UDP-glucuronyltransferase activity for non-steroidal as well as steroidal substrates, in cultured human B-lymphocytes. Glucuronidation of alpha-naphthol and testosterone was demonstrated in homogenates of two cell lines, SN1006 and RPMI-1788, and that of phenolphthalein, 4-methylumbelliferone, p-nitrophenol and estradiol in the cell line with the higher glucuronyltransferase activity, SN1006. 2. Kinetic studies of testosterone glucuronidation in homogenates of both cell lines revealed a similarity in the behaviour of glucuronyltransferase of these cells. Thus, comparable apparent Km values for UDPGA (0.63 mM) and for testosterone (14 microgram) were observed, although apparent maximal velocities, Vmax, differed several-fold (3.0 versus 0.55 pmol/10(6) cells per min, in SN1006 and RPMI-1788 cells, respectively). 3. Kinetic studies of glucuronidation of testosterone, estradiol, phenolphthalein, alpha-naphthol, 4-methylumbelliferone, and p-nitrophenol yielded comparable apparent Km values for UDPGA (0.56-0.67 mM), suggesting that the same, or similar, glucuronyltransferase(s) catalyse(s) glucuronidation of this wide range of substrates in lymphocytes. This was reinforced by the observation of competitive inhibition of testosterone glucuronidation by alpha-naphthol (Ki 0.25mM), 4-methylumbelliferone (Ki 0.8mM) and p-nitrophenol (Ki 0.8 mM). Thus, lymphocyte glucuronyltransferase activity with a broad substrate specificity, for steroidal and non-steroidal aglycones, is indicated.

Cell Line↗
PubMed1977

Coexisting childhood schizophrenia and myasthenia gravis treated successfully with neostigmine bromide.

A 12-year-old boy who had suffered from severe schizophrenia for 8 years developed myasthenia gravis. Both disorders were treated simultaneously and successfully with neostigmine bromide. The authors suggest that these two disorders may in some cases be part of the same disease process and urge that physicians consider this possibility in patients with severe emotional problems and muscle weakness.

Acetylcholine↗
PubMed1976

Further studies on the "curry kidney".

The Fijian Indian is a prolific renal stone former, whereas the native Fijian living in the same climate is not. An excessive intake of curry has previously been suggested as the cause of this extensive stone formation in the Fijian Indian. Metabolic studies in these patients have not revealed any other biochemical abnormality which might cause nephrolithiasis. Nearly half of the Fijian Indians who meet violent and sudden deaths have evidence of nephrocalcinosis. These findings add further weight to the theory that an excessive intake of curry is nephrotoxic.

Adolescent↗
PubMed1976

Contribution of a nurse clinician to office practice productivity: comparison of two solo primary care practices.

A comparison of two solo primary care practices with similar patient populations reveals a significant difference in productivity. A nurse clinician was employed in the more productive practice. She independently managed 1,848 patient visits a year that would otherwise have required the time and attention of a physician. She contributed to the productivity of the physician by performing some tasks he would normally have performed during visits they managed jointly. It was primarily because of the assistance he received from the nurse clinician that the physician in practice II was 12 percent more productive than the physician in practice I. The nurse clinician and physician managed 31 percent more patient visits during a standard day than the physician in practice I, or a difference of 2,856 patient visits a year. This annual difference is based on a work schedule that could be matched in other practices: an eight-hour day and a 240-day work year.

Humans↗