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Biomedical subjects

R W Holt

Publications and source records attributed to R W Holt.

At least 37 records · Page 2Linked to original sources
PubMed1987

Intraoperative single-dose radiotherapy. Observations on staging and interstitial treatment of unresectable liver metastases.

Fourteen patients with a history of colonic cancer were evaluated for metastatic disease and were thought to have unresectable disease confined to the liver. Exploratory surgery revealed that two patients had extensive extrahepatic disease, and the procedure was terminated. In 12 patients, closed-end needles (diameter, 2.1 mm) were introduced into each nodule and connected to a 370-MBq (10-Ci) afterloading iridium source. Radiation doses were dependent on nodule size, providing minimum doses of 20 Gy (2000 rad) to the lesion's periphery with rapid radiation falloff avoiding toxic effects to adjacent normal tissue. The maximum number of nodules treated in one patient was 11. The largest nodule treated measured 9 x 6.5 x 6 cm. Cholecystectomy in four patients allowed precise implantation and obviated biliary fistula. Preoperative computed tomography underestimated the number of hepatic metastases in all cases but one, and treatment-induced computed tomographic alterations further limited its utility. Radiation treatment was well tolerated, and the median hospitalization was eight days. Of ten patients whose preoperative carcinoembryonic antigen values exceeded 10 ng/dL, the values in six patients decreased postoperatively.

Adult↗
PubMed1987

Coexpression of distinct eye- and liver-specific LDH isozymes in cichlid fish.

In a recent electrophoretic survey of lactate dehydrogenase (LDH) in neotropical cichlid fishes (Perciformes, Cichlidae) we have discovered several species in which a cathodal liver-specific isozyme is expressed along with the highly-anodal eye-specific isozyme (LDH-C4) typically encountered in perciform fishes. We believe this fourth, liver-specific LDH isozyme to be real and not artifactual since homogenization of fresh liver from one of these species, the Basketmouth cichlid (Acaronia nassa), in either of two nondenaturing detergents or in the presence of the protease inhibitor phenylmethylsulfonylfluoride affects neither the presence nor mobility of this cathodal band. Moreover, it continues to be expressed in the captively bred F1 of these same wild fish. The discovery of several fish species, like the Basketmouth, in which biochemically distinct eye- and liver-specific LDH isozymes are coexpressed, is discussed in light of the currently accepted hypothesis that these two isozymes are encoded by a single locus (LDH-C) which has undergone divergent tissue expression in several other major teleost groups. Preliminary characterization of the liver-specific isozyme relative to the eye-specific LDH-C4 in the Basketmouth cichlid with respect to thermolability and NADH-induced binding to oxamate-sepharose columns suggests that the eye- and liver-specific LDH isozymes are biochemically quite distinct in this fish and that they are probably encoded by two distinct loci.

Animals↗
PubMed1987

Conversion from regional to systemic chemotherapy.

Hepatic artery chemotherapy for the ambulatory patient using the Infusaid pump has been advocated for the management of malignant hepatic disease. Catheter related complications remain a potential source of morbidity particularly when the transaxillary approach is used. Should hepatic artery catheter related complications arise, the possibility of conversion to a systemic route offers the opportunity to salvage the Infusaid pump.

Antineoplastic Agents↗
PubMed1986

Interstitial radiation therapy for hepatic metastases: sonographic guidance for applicator placement.

A new technique is reported for the treatment of hepatic metastases using sonography-directed percutaneous placement of a 14-gauge needle applicator and a high-intensity "remote afterloading" iridium-192 (Ir-192) source for interstitial radiation therapy. The results with six patients show that the procedure is easily performed, patient tolerance is good, and there is minimal disruption of the patient's lifestyle. Hospitalizations have been less than 24 hr. Partial response or stable disease in the liver was observed in all six patients. Tumoricidal doses up to 5000 rad (cGy) in a single treatment with durations from 7 to 41 min were achieved in small volumes (less than 25 cm3) with no clinically significant toxicity on follow-up evaluations from 2-6 months. The technique appears to ablate discrete metastatic tumor deposits in the liver.

Brachytherapy↗
PubMed1986

Chronic venous access in the elderly.

The use of chronic venous catheters has become routine in the management of neoplastic disease. If an anticipated result of diagnosis related grouping (DRG) reimbursement to hospitals is earlier patient discharge and reliance on more intensive outpatient management, concern about the safety and maintenance of such catheters in the outpatient elderly will become a more common issue. With careful patient selection and emphasis on catheter care, insertion of these catheters in the elderly is safe and reliable.

Aged↗
PubMed1984

Adhesional obstruction of the colon.

Adhesional colonic obstruction, although unusual, must be included in the differential diagnosis of mechanical intestinal obstruction. A series of four patients is reported, including a case of large-bowel necrosis secondary to adhesions. Observations are made regarding this disease process and circumstances that may increase patient vulnerability.

Adult↗
PubMed1980

Flexible fiberoptic sigmoidoscopy in a surgeon's office.

The use of the flexible fiberoptic sigmoidoscopy in an office setting in 116 consecutive patients detected 18 polyps beyond the reach of the rigid sigmoidoscope. Three of these polyps were Dukes' A lesions. Cancer surveillance and resolution of questionable x-ray findings were improved with this new instrument. Anastomoses, diverticula and inflammatory bowel disease were more easily surveyed. With the use of proper technique, the procedure is safe and well tolerated by the patient.

Adult↗
PubMed1979

Ultrasonic evaluation of the gallbladder in sickle cell disease.

The gallbladder is frequently diseased in sickle cell anemia. The distinction between cholecystitis and the abdominal crisis of sickle cell disease is difficult to make. Ultrasonography permits a rapid evaluation of the gallbladder in sickle cell disease.

Adult↗