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Biomedical subjects

J D Holmes

Publications and source records attributed to J D Holmes.

At least 19 recordsLinked to original sources
PubMed2004

Salmonella Brandenburg - emergence of a new strain affecting stock and humans in the South Island of New Zealand.

AIMS: To report information on the spread of a new strain of Salmonella Brandenburg, which affected livestock and humans in the South Island of New Zealand, and a series of small case studies designed to investigate potential transmission of infection. METHODS: Information on the occurrence and spread of S. Brandenburg in livestock was gathered from laboratory diagnostic submissions, from case studies on the faecal excretion rate in ewes, carrier status of black-backed gulls (Larus dominicanus), spread of S. Brandenburg organisms in sheep yards, infection in lambs going to meat plants, and from post-abortion pathological changes in the reproductive tract of ewes. RESULTS: A newly recognised strain of S. Brandenburg was first diagnosed in aborting sheep from a flock in mid Canterbury in the South Island in 1996. Subsequently, the disease spread to other farms in mid and south Canterbury in 1997 and to Southland and Otago in the lower half of the South Island in 1998-2003. In 1999, the same strain was responsible for abortions in cattle and gastroenteritis in calves and adult cattle. The same strain of bacterium also caused disease in horses, goats, deer, pigs and humans. Spread of the disease on farms was strongly associated with aborting ewes, which resulted in considerable environmental contamination. During the abortion season, black-backed gulls appeared to spread the disease to other farms. Other potential sources of infection were carrier sheep, contaminated water sources and contaminated sheepyard dust. Damage to the reproductive tract may affect the ability of surviving ewes to conceive. CONCLUSION: Important features of this disease are its high morbidity and mortality within a flock or herd, rapid local spread and its role as an occupational, health and safety risk to farm workers and their families.

Journal Article↗
PubMed2002

Kaposiform haemangioendothelioma: case report and review of the literature.

Kaposiform haemangioendothelioma (KHE) is a rare vascular tumour, predominantly of infancy and early childhood, that has a close association with Kasabach-Merritt syndrome. Despite benign histology, this tumour frequently behaves aggressively, causing significant morbidity and mortality as a result of the compression and invasion of surrounding structures as well as from associated haematological and lymphoproliferative syndromes. There is a need for a high index of suspicion when presented with large, enlarging or abnormal vascular lesions in infancy and, less commonly, in adulthood. An early diagnosis of KHE can lead to prompt treatment, which may be life saving. To date, there have been only four reported cases of KHE occurring in patients over the age of 18 years. We report an otherwise well 26-year-old woman who presented with a KHE of the left thigh, and briefly review the literature. We believe this to be the second reported case of KHE in the UK and the first in an adult patient.

Adult↗
PubMed2002

Reducing the morbidity from extravasation injuries.

Extravasation is defined as the leakage of solutions from the vein. This may cause damage to surrounding tissue during intravenous fluid administration. Extravasation has an incidence of 5% of all cytotoxic drug administrations. In the authors' hospital, a protocol has been set up using the dilution flush-out technique. Extravasation packs containing cannulae, normal saline, hyaluronidase, and instructions on how to manage extravasation injuries, accompanied by an audit sheet to assist follow-up, have been introduced to allow the treatment of extravasation at the ward level in an attempt to reduce morbidity from the injury. Between December 1997 and December 1999, 18 adult patients were identified with extravasation injuries after the administration of cytotoxic medication. Seventeen were treated immediately according to the protocol. One, however, was not. Patients were followed-up for 6 months after injury. The 17 patients treated immediately needed no further surgical intervention, whereas the 1 patient not treated needed a split skin graft to cover the defect. The authors recommend the placement of "extravasation packs" on all wards where cytotoxic drugs are prescribed and that all staff members are familiar with this regime. These steps help to reduce the morbidity of a potentially damaging injury.

Adult↗
PubMed2001

Synthesis and characterization of dimensionally ordered semiconductor nanowires within mesoporous silica.

Semiconductor nanowires of silicon have been synthesized within the pores of mesoporous silica using a novel supercritical fluid solution-phase approach. Mesoporous silica, formed by the hydrolysis of tetramethoxysilane (TMOS) in the presence of a triblock copolymer surfactant, was employed for the nucleation and growth of quantum-confined nanowires. The filling of the silica mesopores with crystalline silicon and the anchoring of these nanowires to the sides of the pores were confirmed by several techniques including electron microscopy, powder X-ray diffraction, 29Si magic angle spinning nuclear magnetic resonance, infrared spectroscopy, and X-ray fluorescence. Effectively, the silica matrix provides a means of producing a high density of stable, well-ordered arrays of semiconductor nanowires in a low dielectric medium. The ordered arrays of silicon nanowires also exhibited discrete electronic and photoluminescence transitions that could be exploited in a number of applications, including nanodevices and interconnects.

Journal Article↗
PubMed2001

Highly luminescent silicon nanocrystals with discrete optical transitions.

A new synthetic method was developed to produce robust, highly crystalline, organic-monolayer passivated silicon (Si) nanocrystals in a supercritical fluid. By thermally degrading the Si precursor, diphenylsilane, in the presence of octanol at 500 degrees C and 345 bar, relatively size-monodisperse sterically stabilized Si nanocrystals ranging from 15 to 40 A in diameter could be obtained in significant quantities. Octanol binds to the Si nanocrystal surface through an alkoxide linkage and provides steric stabilization through the hydrocarbon chain. The absorbance and photoluminescence excitation (PLE) spectra of the nanocrystals exhibit a significant blue shift in optical properties from the bulk band gap energy of 1.2 eV due to quantum confinement effects. The stable Si clusters show efficient blue (15 A) or green (25-40 A) band-edge photoemission with luminescence quantum yields up to 23% at room temperature, and electronic structure characteristic of a predominantly indirect transition, despite the extremely small particle size. The smallest nanocrystals, 15 A in diameter, exhibit discrete optical transitions, characteristic of quantum confinement effects for crystalline nanocrystals with a narrow size distribution.

Journal Article↗
PubMed2001

Purification and identification of a human dermal extract component inhibitory to fibroblast proliferation.

It was previously shown that a citric acid buffer extract of human dermis (extract D) inhibited growth of human diploid fibroblasts in monolayer culture (Muir et al., 1997). Further fractionation has shown that the active principle is probably a proteoglycan, and that retention of its inhibitory activity is dependent on the use protease inhibitors throughout the extraction procedure. Elution of extract D from a DEAE-cellulose column produced four major peaks, each of which was subjected to SDS-PAGE as well as being tested for inhibitory activity on the growth of fibroblasts in culture. Peaks III and IV had no inhibitory effect, but peak I contained highly active material. Gels of this peak showed prominent bands of 120 kDa (corresponding to dermatan sulphate proteoglycan II, DS-PG II) and at 45 kDa (corresponding to the core protein). The latter band became more prominent when extract D which had been treated with chrondroitinase ABC was electrophoresed. Their identities were verified by Western blotting. Peak II also contained some slower-acting inhibitory material which has as yet to be identified, but contains little or no protein corresponding to the decorin core-protein. The data indicate that the intact decorin molecule, DS-PG II, is the main inhibitory principle in human skin.

Cell Division↗
PubMed2000

Psychiatric illness in hip fracture.

OBJECTIVE: to review the literature on the prevalence and effect on outcome of psychiatric illness in older people with hip fracture. METHODS: searching of medical databases and bibliographies to identify relevant studies. Application of predetermined quality criteria for prevalence and outcome studies. RESULTS: 19 studies met criteria for a prevalence study. Rates of psychiatric illness varied, with depression in 9-47%, delirium in 43-61% and unspecified cognitive impairment in 31-88%. Four studies met criteria for an outcome study. Psychiatric illness resulted in increased mortality and dependence and decreased activities of daily living skills. No individual study examined the prevalences and effect on outcome of depression, delirium and dementia separately. CONCLUSIONS: depression, delirium and dementia are common in older people with hip fracture. Further research is required to examine the effect on outcome of psychiatric illness, and the effect of psychiatric interventions in this setting.

Aged↗
PubMed2000

Mycobacterium tuberculosis presenting as sternal osteomyelitis.

A 54-year-old female presented with a presternal abscess and developed axillary lymphadenopathy. Imaging confirmed the presence of sternal osteomyelitis. The osteomyelitis was cured by resection and muscle flap reconstruction. Although tuberculosis was suspected, the organism was only cultured after the fourth surgical procedure. Surgeons should be aware that negative microbiology does not exclude a diagnosis of Mycobacterium tuberculosis.

Diagnosis, Differential↗
PubMed1999

Congenital rhabdomyosarcoma.

A congenital rhabdomyosarcoma presented as a partially necrotic mass on the left forearm on delivery at term. Ulceration and persistent bleeding were managed by primary curettage followed by local resection including partial excision of the muscles of the extensor compartment of the forearm. The defect was resurfaced with a split skin graft. The surgery was followed by chemotherapy according to the IVA regime. There was no recurrence at 2 years of age and the limb was fully functional. The presentation and management of rhabdomyosarcoma are discussed.

Female↗
PubMed1996

Cranial desmoid tumor associated with homozygous inactivation of the adenomatous polyposis coli gene in a 2-year-old girl with familial adenomatous polyposis.

BACKGROUND: Familial adenomatous polyposis (FAP) is a dominantly inherited disorder characterized by the presence of more than 100 adenomatous polyps in the colon and rectum starting in the second decade of life. FAP is associated with extra colonic manifestations, including desmoid tumors. METHODS: A 2-year-old girl presented with a rapidly enlarging tumor of the forehead and a family history of FAP. The tumor was cultured for cytogenetic studies. A DNA linkage study using flanking and intragenic polymorphisms of the adenomatous polyposis coli (APC) gene was performed to identify the allele loss in the tumor. Germline mutation identification was by single strand conformation polymorphism analysis of exon 15 of the APC gene, with subsequent double stranded sequencing of fragments with conformational changes. A mutation-induced loss of a restriction site was used to confirm allele loss in the tumor. RESULTS: Microscopically, the tumor had desmoid features. Cytogenetic analysis of the tumor demonstrated loss of chromosome region 5(q21q22). A truncating adenomatous polyposis coli (APC) gene mutation was identified in the leukocyte DNA from the child and her affected father. Linked DNA markers suggested that the tumor had lost the maternal, wild-type allele. A mutation-induced restriction endonuclease site alteration demonstrated hemizygosity of the mutant sequence in the tumor DNA. CONCLUSIONS: These findings are compatible with the presence of a "second hit" inactivation of the APC gene and implicate this gene in the pathogenesis of desmoid tumors.

Adenomatous Polyposis Coli↗
PubMed1996

Differing injury patterns in snowboarding and alpine skiing.

This is a study of all people presenting to ski patrollers with ski and snowboard injuries during the 1995 season. There were 476 casualties of whom 396 were skiers and 57 were snowboarders. Information was collected retrospectively on the mechanism, region and injury, and also personal details of the casualties. The information was compared with the numbers of ski and snowboard injuries for the 1994 season. Injuries due to snowboarding increased in frequency, from 4 per cent in 1994 to 11 per cent in 1995. Snowboarders were younger, predominantly male, and were more often beginners than were skiers. They most commonly sustained ligament strains, dislocations and fractures, with the hand and forearm and shoulder most affected. Skiers sustained more ligament strains and soft tissue bruising, particularly of the knee and thumb. Snowboarders sustain a different pattern of injuries compared with skiers, and this has important implications for preventing accidents in the instruction of novices.

Adolescent↗
PubMed1996

Hand trauma and herpes infection.

A herpes simplex type 2 infection of the hand after injury is described in a 26-year-old man. The management and implications of such an unusual hand infection are discussed.

Adult↗
PubMed1995

Energy-dispersive X-ray analysis of the extracellular cadmium sulfide crystallites of Klebsiella aerogenes.

Klebsiella aerogenes forms electron-dense particles on the cell surface in response to the presence of cadmium ions in the growth medium. These particles ranged from 20 to 200 nm in size, and quantitative energy dispersive X-ray analysis established that they comprise cadmium and sulfur in a 1:1 ratio. This observation leads to the conclusion that the particles are cadmium sulfide crystallites. A combination of atomic absorption spectroscopy, inductively coupled plasma mass spectrometry, and acid-labile sulfide analysis revealed that the total intracellular and bound extracellular cadmium:sulfur ratio is also 1:1, which suggests tha the bulk of the cadmium is fixed as extracellular cadmium sulfide. The tolerance of K. aerogenes to cadmium ions and the formation of the cadmium sulfide crystallites were dependent on the buffer composition of the growth medium. The addition of cadmium ions to phosphate-buffered media resulted in cadmium phosphate precipitates that remove the potentially toxic cadmium ions from the growth medium. Electron-dense particles formed on the surfaces of bacteria grown under these conditions were a combination of cadmium sulfide and cadmium phosphates. The specific bacterial growth rate in the exponential phase of batch cultures was not affected by up to 2mM cadmium in Tricine-buffered medium, but formation of cadmium sulfide crystallites was maximal during the stationary phase of batch culture. Cadmium tolerance was much lower (10 to 150 microM) in growth media buffered with Tris, Bistris propane, Bes, Tes, or Hepes. These results illustrate the importance of considering medium composition when comparing levels of bacterial cadmium tolerance.

Cadmium↗