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Biomedical subjects

A J Webb

Publications and source records attributed to A J Webb.

At least 37 records · Page 2Linked to original sources
PubMed1994

Scrape cytology in the diagnosis of Paget's disease of the breast.

Eczema of the nipple is an important symptom presenting to the general surgeon in the out-patient department. The diagnosis of Paget's disease of the nipple has traditionally been made by incision biopsy necessitating at least a local anaesthetic. We present 14 patients with nipple skin change, in whom the technique of scrape cytology was used to identify patients with Paget's disease. In our series eight cases of Paget's disease were successfully identified by scrape cytology with no false negatives or positives. We suggest that this is a quick, easy, non-invasive method of screening eczema of the nipple in the out-patient clinic.

Breast Diseases↗
PubMed1994

Primary breast lymphoma with skin involvement arising in lymphocytic lobulitis.

Primary breast lymphoma is a rare tumour which has recently been associated with pre-existing lymphocytic lobulitis. We report a patient with lymphocytic lobulitis in whom the lymphoma recurred in the contra-lateral breast 5 years after the initial presentation, to be followed shortly afterwards by skin involvement. This progression illustrates the relationship between extra-nodal lymphomas and underlying autoimmune disease and the homing of lymphomas to related sites.

Breast Neoplasms↗
PubMed1993

Will screening for breast cancer reduce mortality? Evidence from the first year of screening in Avon.

In the first year of screening in Avon, 93 malignant lesions were detected of which one-half were impalpable. Of the impalpable lesions, one-half were in situ or showed areas of microinvasion only. One-fifth of the malignant lesions were invasive tumours of special histological type which are known to carry a good prognosis even when not detected by screening. One-quarter of the lesions had clinical or pathological features which would be expected to confer a poor prognosis. Only 16 invasive ductal carcinomas measuring 1 cm or less in diameter were detected--a small proportion of the total number of malignant lesions. Although these early figures suggest that the effect of screening on mortality from breast cancer may be small, continued high-quality screening and careful detailed analysis are essential to determine the effect of screening on the mortality from breast cancer and the effect on the population as a whole.

Breast Neoplasms↗
PubMed1992

Diagnostic and therapeutic aspects of fine-wire localization biopsy for impalpable breast cancer.

During the first 2 years (July 1989 to July 1991) of the Avon Breast Screening Service, fine-wire localization biopsy was indicated in 213 impalpable breast lesions. A total of 144 lesions were benign and 69 malignant. Only four of 213 lesions (1.9 per cent) were not excised at the first localization. Factors influencing reoperation in the 69 patients with malignant impalpable lesions were examined. There was a significant association (P < 0.001) between parenchymal disturbances on mammography and invasive carcinoma, and between non-invasive carcinoma and microcalcification (P < 0.001). In 31 patients the localization biopsy was the only surgical procedure. Thirty-eight patients required further surgery: 12 underwent further local excision and 26 mastectomy. Reoperation was more frequent in patients with calcification than in those with parenchymal disturbance (P < 0.001). The most frequent indications for mastectomy were inadequate excision of widespread comedo ductal carcinoma in situ or invasive ductal carcinoma combined with extensive ductal carcinoma in situ. Fine-wire localization biopsy was a combined therapeutic and diagnostic procedure in 31 of 69 women with impalpable screen-detected lesions. The majority of patients required further surgery because radiological abnormalities underestimated the extent of disease.

Biopsy, Needle↗
PubMed1991

Florid papillomatosis of the nipple: a clinico-pathological surgical problem.

Adenoma or florid papillomatosis of the nipple is a rare, benign condition which resembles the clinical appearances of Paget's disease of the nipple and the histological appearances of papillary carcinoma of the breast. We describe a case which illustrates the pitfalls in diagnosis and proposes a safe management procedure for breast and nipple lesions.

Breast Neoplasms↗
PubMed1989

Management of high grade parotid carcinomas.

Thirty-four patients admitted to the Bristol Royal Infirmary during the 20-year period 1966-85 and diagnosed as suffering from high grade parotid carcinoma were studied. The male:female ratio was 2.4:1, with a mean age at presentation of 68 years. Facial swelling was present in all patients with a mean duration of 9.9 months before treatment. Pain, deep fixation, facial nerve involvement, ulceration and distal metastases were all associated with a poor prognosis. Diagnosis was made either at operation or by fine needle biopsy. All 34 patients received radiotherapy. Fourteen patients (41 per cent) underwent a definitive surgical procedure. The local recurrence rates for the non-surgical and surgically treated groups were 30 per cent (six patients) and 36 per cent (five patients) respectively; twelve patients (60 per cent) in the non-surgical group developed distant metastases as opposed to six patients (43 per cent) in the surgical group. Both local and distant recurrent disease are indicators of poor prognosis, with only one patient alive at 104 months. Seven patients (21 per cent) remain recurrence free. Definitive surgery, combined with radiotherapy, improved survival in those with amenable localized disease.

Adult↗
PubMed1989

Beta-adrenergic responsiveness in stress-sensitive and stress-resistant pigs.

This study investigated whether enhanced metabolic responsiveness to beta-adrenergic stimulation might explain the liability of the stress-sensitive pig to develop an acidosis during stressful situations. Blood lactate, pH, PCO2 and heart rate response to an intravenous infusion of isoprenaline were examined in three lines of pentobarbitone anaesthetized, atropinized pigs. The lines were Pietrain X Hampshire which had been selected over eight generations for a positive reaction to the halothane test (stress-sensitive); Pietrain X Hampshire which had been selected over eight generations for no reaction to the halothane test (stress-resistant) and British Landrace which had been selected over four generations for a positive halothane reaction (stress-sensitive). The metabolic responses to isoprenaline were greater in the stress-sensitive Pietrain X Hampshire line than the stress-resistant line. The stress-sensitive Landrace pigs, however, had smaller changes in pH and PCO2 in response to isoprenaline than the stress-resistant Pietrain X Hampshire pigs. This inconsistent trend across the three lines led to the conclusion that enhanced beta-adrenergic responsiveness was not the likely cause of stress sensitivity.

Animals↗
PubMed1989

Impressions.

Explore the source record for details and available documents.

General Surgery↗
PubMed1987

Fine-needle aspiration biopsy and the diagnosis of thyroid cancer.

Conventional criteria for the evaluation of thyroid nodules are inaccurate in identifying the small proportion of malignant neoplasms. The diagnostic accuracy of fine-needle aspiration biopsy (FNAB) for cytology was therefore assessed in 562 patients with nodular thyroid disease, 373 of whom (66.4 per cent) had histological confirmation of the cytological diagnosis. Sixty-one aspiration biopsies were positive for malignancy, and the diagnosis was confirmed histologically in 59 of these (96.7 per cent). Thus, there were two false positive cytology results among 310 patients with proven benign disease (0.6 per cent). Four of sixty-three patients with proven carcinoma had a benign cytological diagnosis, a false negative rate of 6.3 per cent. In 57 of the 59 malignancies (96.6 per cent) correctly diagnosed by FNAB the histological type of tumour was successfully identified. Overall 367 of 373 patients received correct cytological discrimination between benign and malignant nodules, an overall accuracy of 98.4 per cent for FNAB. The sensitivity of the test was 93.7 per cent and the specificity 99.4 per cent. Besides being safe, cost-effective and reliable, FNAB directs the appropriate selection of patients for surgery and enables the correct operation to be performed for each type of tumour.

Adolescent↗
PubMed1987

Triggering of B lymphocytes through CD23: epitope mapping and studies using antibody derivatives indicate an allosteric mechanism of signalling.

By using five monoclonal antibodies in reciprocal cross-locking studies, a minimum of three epitope clusters have been defined for the B-cell restricted, activation-associated CD23 antigen. Two of the five antibodies were capable of replacing low molecular weight B-cell growth factor (BCGF) in B-cell co-stimulation assays. These two antibodies belonged to the same epitope group, while non-stimulatory antibodies fell outside this cluster. By prior coating of activated B lymphocytes at 4 degrees, all five CD23 antibodies interfered with the subsequent uptake of BCGF activity onto the cells. However, only the two stimulatory antibodies were capable of inhibiting the absorption of BCGF completely. From one of these antibodies, F(ab')2 and Fab fragments were generated and both were found to be equivalent to whole antibody in their ability to mimic BCGF. Immobilized antibody, however, failed to stimulate over a wide range of concentrations. These findings demonstrate that the ability of certain CD23 antibodies to deliver a growth-promoting signal to activated B cells is independent not only of the Fc portion of the molecule but also of receptor cross-linking. The latter observation is indicative of an allosteric mechanism of triggering, a notion supported by the epitope specificity of activation through CD23. The findings are discussed in relation to the putative natural ligands for CD23 and the way they may influence B-cell function through this receptor.

Antibodies, Monoclonal↗