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Biomedical subjects

A J Webb

Publications and source records attributed to A J Webb.

At least 55 records · Page 3Linked to original sources
PubMed1986

Adenolymphoma of the parotid: aetiology, diagnosis and treatment.

In order to study the changing clinical pattern, diagnosis and surgical treatment of adenolymphoma, the records of all 57 patients with a confirmed histological diagnosis, made at Bristol Royal Infirmary between 1951 and 1984, were reviewed; in 3 patients (5 per cent) bilateral lesions had been found. No characteristics emerged in a review of the history and clinical examination which would have enabled a correct preoperative diagnosis to be made. During the period of study the incidence of adenolymphoma increased 24-fold. (Parotid pleomorphic salivary adenomas increased in incidence by only 42 per cent over the same period). Before 1965 all patients were men; between 1965 and 1975 the male to female ratio was 3:1; between 1975 and 1985, 1.6:1. Of the 48 patients who had a relevant history taken 45 were smokers (93.8 per cent). It is postulated that tobacco consumption is important in the development of adenolymphoma, and has produced the changes in incidence and sex ratio. Fine needle aspiration biopsy cytology (FNAB) afforded the only method of achieving a pre-operative diagnosis. This was successful in 64.7 per cent. Superficial parotidectomy induced a 43 per cent incidence of facial nerve neurapraxia. Controlled enucleation reduced this to 8 per cent. Enucleation is the procedure of choice for adenolymphoma but can only be employed with confidence if an exact pre-operative diagnosis is made.

Adenolymphoma↗
PubMed1986

Evidence for an association between CD23 and the receptor for a low molecular weight B cell growth factor.

Low molecular weight B cell growth factor (BCGF) and a monoclonal antibody (MHM6) to the 45-kDa, B lineage-restricted, CD23 activation antigen (BLAST-2; EBVCS) were found to be indistinguishable in their biological effects. Individually, both augmented DNA synthesis in activated, but not resting, B lymphocytes while no additional enhancement resulted from using the two agonists in combination. Furthermore, by increasing the expression of Tac, both MHM6 and BCGF promoted activated B cells to respond more vigorously to the late addition of recombinant interleukin 2. The presence of BCGF during B cell activations was found to down-regulate the expression of the CD23 antigen while the coating of activated cells with MHM6 antibody diminished their capacity to absorb BCGF activity. The findings demonstrate that CD23 and a low molecular weight BCGF deliver a comparable growth-promoting signal to activated B cells. A possible relationship between CD23 and the receptor for the low molecular weight BCGF is discussed.

Antibodies, Monoclonal↗
PubMed1986

Does radiolabelled diphosphonate retention reflect bone metabolism in the elderly?

The 24-h whole-body retention of diphosphonates (WBR), a useful measure of bone metabolism in young subjects, was measured in 27 elderly subjects (19 from home and eight in-patients). WBR rose with increasing age (r = 0.55, P less than 0.01) and was negatively correlated with renal function (r = -0.60, P less than 0.01). In five subjects given vitamin D, WBR did not fall. The measurement of WBR in the elderly has to be assessed in the light of an accurate assessment of renal function and so is rarely clinically useful.

Aged↗
PubMed1985

Fine needle aspiration cytology.

Fine needle aspiration cytology is an inexpensive, atraumatic technique for the diagnosis of disease sites. This paper describes the technique and illustrates how it may be applied to the management of tumours throughout the body. The limitations of the method, the dangers of false positive reports, and the inevitability of false negative diagnoses are emphasised. In a clinical context the method has much to offer by saving patients from inappropriate operations and investigations and allowing surgeons to plan quickly and more rationally. It is an economically valuable technique and deserves greater recognition.

Abdominal Neoplasms↗
PubMed1982

The clinical syndrome of mammary duct ectasia.

Over an 11-year period in one surgeon's practice, mammary duct ectasia constituted 5.5 per cent of all breast diseases treated by operation. A total of 78 patients undergoing major duct excision for mammary duct ectasia has been studied to determine the success of the standard operative treatment. Good results were obtained when the indications for operation were nipple retraction, nipple discharge or a sub-areolar mass. By contrast, generally poor results were obtained in 9 patients in whom the indication for operation was recurrent para-areolar sepsis; two of these ultimately came to simple mastectomy.

Adult↗
PubMed1982

Ultrasonic Doppler studies of the breast.

The growth of a malignant tumour depends on vascularisation. The ultrasonic Doppler method can detect the blood flow associated with malignant breast tumours, the signals differing qualitatively from those due to benign lesions. Several descriptors of the Doppler signals were tested; benign and malignant lesions are best separated by the difference between the maximum systolic frequencies from suspect and contralateral sites. Corresponding main arterial sites are reliably coincident in normal breast pairs. Consideration of the powers and frequency spectra of Doppler signals leads to the rejection of models of tumour vascularisation giving Doppler signals based on capillary perfusion and on a single feed artery. The data are compatible with a multiple feed artery model, and this is supported by a contrast angiogram. Doppler ultrasound may be useful as a preliminary screening method, in the management of patients with radiologically dense breasts or diffuse dysplasia, and for monitoring unexcised tumours undergoing hormone therapy.

Adenocarcinoma↗
PubMed1982

Segmental lymph-node infarction after fine-needle aspiration.

Wedge-shaped lymphoid depletion and sinus distention is described in the pole of an intramammary lymph node. The origin of the lesion appears to be traumatic venous thrombosis. Topographically the lesion differs from spontaneous venous infarction of lymph nodes, and resembles segmented infarction due to small arterial lesions. The usually localised trauma of fine-needle aspiration appears to account for its distinctive microanatomical distribution.

Adult↗
PubMed1981

Bacteraemia due to a rifampicin-resistant strain of Bacteroides fragilis.

A strain of Bacteroides fragilis with high-level chromosomal resistance to rifampicin was isolated by blood culture from a patient with bacteraemia after gastrointestinal surgery. He had been receiving antituberculous therapy with rifampicin for nine months. This resistance led to some difficulty in the recognition and identification of the isolate by methods that depended upon antibiotic sensitivity patterns.

Adult↗
PubMed1980

Recent cases of trench foot.

Two cases of cold injury to the lower extremities, 'trench foot', are presented. The management is essentially conservative, but in cases of severe damage, particularly in elderly people, amputation must be advised.

Aged↗
PubMed1977

Tumour detection by ultrasonic Doppler blood-flow signals.

Ultrasonic Doppler blood-flow signals which seem to be associated with malignant tumour neovascularization have been detected in the female breast. No such signals have been detected from cysts. This discovery may lead to the development of a highspeed ultrasonic Doppler scanner which might make breast screening for cancer practicable.

Adenofibroma↗
PubMed1975

A cytological study of mammary disease.

An analysis is presented of 887 cytological biopsies performed on 610 patients with mammary disease, including 510 fine needle aspirations. Technical details of fine needle biopsy, imprints, and scrape-smears are provided, together with both histological and cytological descriptions. The case material has been classified into 6 series, the most important being a clinicocytological study in which fine needle biopsy achieved a 96.2% accuracy rate in respect of breast cancer. The status of cytology in the clinical management of mammary disease is evaluated.

Biopsy, Needle↗