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Biomedical subjects

C A Joslin

Publications and source records attributed to C A Joslin.

At least 37 records · Page 2Linked to original sources
PubMed1986

Breast screening clinic versus health education session as outlets for education in breast self-examination.

A population based programme to educate women in breast self-examination (BSE) was organised as part of the UK Trial of Early Detection of Breast Cancer. Women who responded to an invitation to a meeting were educated in groups and were not routinely screened. Open access clinics offered x ray and clinical examination to all women in the study age group of 45 to 64. Women who presented for screening without prior BSE education were taught individually by clinic staff. Women taught by the two methods were surveyed by post and their BSE practice since education was compared. It was hypothesised that the women taught in clinics, who had been reassured of their breast normality, would practice BSE more regularly and correctly. Results did not confirm this hypothesis. Lower standards of practise and a higher level of anxiety at the time of survey were found in the group who presented at a free access clinic and had received individual teaching at the time of screening.

Breast↗
PubMed1985

Radiation pneumonitis in patients treated for breast cancer.

An analysis of 201 breast cancer patients having post-operative radiotherapy to the chest wall between January 1981 and May 1983 has identified those patients with chest symptoms following radiotherapy and these have been critically assessed with regard to the possibility of radiation pneumonitis being their cause. The inner contour of the anterior chest wall has been reconstructed on the radiation plan and the area of lung irradiated to a significant level in the mid-plane of the tangential fields determined. The incidence and severity of pneumonitis has been shown to rise exponentially with increase in the irradiated volume. A method of measuring the thickness of the chest wall using the simulator has been devised so that this information may be incorporated into the planning process in order to reduce the area of lung at risk.

Breast Neoplasms↗
PubMed1985

Heterogeneity of colorectal adenocarcinomas evaluated by flow cytometry and histopathology.

Flow cytometry and histopathology were utilised in evaluating 50 primary and 16 metastatic colorectal carcinomas to determine the influence of heterogeneity and proportion of dying cells on pathological assessments. A new procedure was developed for staining unfixed whole cells with acridine orange and ethidium bromide to quantify DNA and RNA content and number of dead and dying cells. Attempts were made to reduce interobserver variation in histological assessment and to determine whether flow cytometry could refine current grading and staging procedures. Interobserver variation in grading was not improved by estimating proportions of differing grades in multiple samples from individual tumours. Considerable heterogeneity was observed within tumours although this was less apparent when defining ploidy status than histological grade. No consistent differences were observed between superficial and deep parts of tumours or between primary and secondary tumours by either method of analysis. The proportion of dead and dying cells varied widely between tumours but there was no correlation with tumour grade or stage. Non-diploid tumours were not of more advanced stage or poorer histological grade than diploid tumours. Since ploidy status may be an important prognostic factor, analysis of colorectal carcinomas by flow cytometry could be of greater value than conventional grading and staging procedures.

Adenocarcinoma↗
PubMed1985

Quantitation by flow cytofluorometry of response of tumours of the uterine cervix to radiotherapy.

We are presently involved in a project to investigate the use of flow cytofluorometry in assessing, by means of serial biopsies, the response to radiotherapy of tumours of the uterine cervix. This technique enables changes in the DNA content profiles and content of proliferating cells in the tumour biopsies to be determined at intervals as therapy progresses. A means has been devised to quantitate the content of hyperdiploid cells, hypertetraploid cells, and dead and dying cells, by computer analysis of DNA vs. RNA scattergrams obtained by flow cytofluorometric analysis. Plotting of these parameters for the serial biopsies vs. time since start of tumour irradiation presents a graphical indication of the response of the tumour to irradiation. Over 100 patients (stage Ib and IIa) have been followed during intracavitary (Cathetron) therapy with parallel flow cytofluorometric analysis and histopathological assessment of serial biopsies. Patterns are beginning to emerge from these analyses which promise to indicate within 14-21 days and sometimes earlier the extent of radioresponsiveness of the tumour. These patterns may also be of assistance in planning modified dose fractionation schedules to obtain improved therapeutic ratios.

Acridine Orange↗
PubMed1984

Cervical smear histories of 500 women with invasive cervical cancer in Yorkshire.

The smear histories of 312 women with cancer of the cervix have been determined. Eighty nine women had had at least one negative smear reported in the 10 years before a diagnosis of cancer and 14 had had more than one negative smear. Fifty six of the 89 women had had a negative smear in the three years preceding the diagnosis of cancer. The highest number of negative smears (61) reported was among the 115 women aged under 45. Fifty eight slides reported as negative were submitted to independent review; 13 were subsequently reported as negative, 11 as unsatisfactory, and 34 as abnormal. These findings may in part explain why in this region there has been a disappointing reduction in the incidence of clinically invasive cervix cancer, and our findings may also apply elsewhere. Nevertheless, the confirmed negative smears chiefly occurred within three years of clinical cancer, particularly in the younger women, and this finding suggests that these women may have a short preinvasive phase.

Adult↗
PubMed1984

Flow cytofluorometric analysis of serial biopsies of tumours of the uterine cervix.

The technique of flow cytofluorometry has been employed to assess, by means of cell suspensions prepared from serial biopsies, the radioresponsiveness of tumours of the uterine cervix. This enables DNA profiles and content of proliferating cells to be determined prior to treatment and during external beam and intracavitary therapy. Results show that elimination of hyperdiploid and hypertetraploid cells and reduction in the proliferating fraction of cells can readily be monitored by this method during therapy. This information, quickly available during treatment, may assist in estimating radioresponsiveness of the tumour and possible prognosis for the patient. Dose fractionation schedules may also be adjusted according to tumour response to therapy. Our results, however, show no relationship between histopathological classification of a tumour (WHO) and its ploidy state. The advanced stages of the disease (II and III) do, however, show an increased content of hypertetraploid cells in the tumour biopsies.

Brachytherapy↗
PubMed1984

Breast self-examination: clinical results from a population-based prospective study.

As part of the Department of Health's National Breast Screening Trial a seven year study is in progress in Huddersfield to assess the effect of an educational programme in Breast Self Examination (BSE) on the mortality due to breast cancer among women aged 45-64. The initial cohort of 22,484 women have completed 3 years in the study and show a higher than expected annual incidence rate of breast cancer. There is no significant difference in the incidence rates between those who attended meetings for BSE instruction and those who did not. Similarly there is no difference in stages of presentation of cancers between attenders and non-attenders at these meetings and also between cancers detected in the first, second and third years. Those who discovered abnormalities during self examination, however, presented with smaller lumps compared to other women. Assessment of prognostic factors do not at this time provide sufficient evidence to show that a community-base BSE campaign will result in a significant improvement in the stage of breast cancer presentation.

Breast Neoplasms↗
PubMed1980

Lymphocyte supernatants and the electrophoretic mobility of erythrocytes: further experience of cancer diagnosis.

A double-blind trial of the tanned-erythrocyte electrophoretic mobility test for cancer has been carried out. This included 70 normal subjects as controls, 61 subjects with disease other than cancer, and 229 cancer patients. Slowing values generally increased in the order given, with certain diseases having values within the range positive for cancer. Exposure to viral infection also tended to produce false positives. Slowing values above 50%, however, appear to be definitely associated with cancer. For the middle range of slowing values (25-50%) there is some overlap between the 3 groups, so that a statistical probability of the presence of malignancy is available from the test. With slowing values below 25% there is little likelhood of cancer. Tumour type influences the test result, as does, to a lesser extent, tumour bulk.

Adult↗
PubMed1977

Pre-treatment 3H-TdR labelling of cervical biopsies: histology, staging and tumour response to radiotherapy.

Pre-treatment data from tumour biopsies labelled in vitro with tritiated thymidine are reported for 54 patients undergoing radical radiotherapy by 137Cs or Cathetron 60Co intracavitary insertions plus external irradiation for carcinoma of the uterine cervix. Labelling indices were obtained ranging from 1.8 to 27.8%. No correlation was observed between mean labelling indices and the histological type of tumour or its degree of differentiation. Comparison of data obtained in this study with previously reported data for carcinoma in situ and invasive carcinoma indicate that with increasing clinical stage of the disease, a considerable lengthening of the potential doubling time of the tumour cells, from less than 1 to 8 days, occurs. The degree of vaginal spread of the tumour was directly related to the degree of parametrial involvement. The mean time taken for the vaginal component of the tumour to resolve following radiotherapy was related to its initial spread and the pre-treatment labelling index. The greater the spread of the tumour, the lower the labelling index and the longer the time taken for resolution. Up to 1 year following radiotherapy the incidence of locally recurrent, or metastatic disease was unrelated to the pre-treatment labelling index.

Autoradiography↗
PubMed1977

The treatment of early cancer of the corpus uteri.

This paper analyses the results of post-operative radiotherapy in 256 cases of cancer of the corpus uteri. Myometrial invasion by tumour was shown to be significantly related to histological grading (p less than 0.001) as it was to recurrence rates (p less than 0.025). By placing patients into one of three subsets according to the depth of myometrial invasion, survival was sufficiently different for each subset to validate their use, not only for prognostic purposes but to determine the type of radiotherapy indicated. Radiotherapy was given as either local intravaginal treatment using an obturator loaded with 60Co or by a combination of this and external beam teletherapy. The value of using radiotherapy to treat the whole pelvis as opposed to treating only the vaginal tissues was significant (p less than 0.01) in terms of local disease control for the deep myometrial invasive group. In terms of survival, external beam therapy was of benefit for all three subsets, i.e. superficial, not more than half and more than half myometrial invasion. A planned approach to post-operative radiotherapy was significantly better for the series as a whole compared to previous ad hoc approaches (p less than 0.01). The treatment methods used did not produce unacceptable morbidity.

Adult↗
PubMed1976

Clinical assessment of the MOD-MEM cancer test in controls with non-malignant diseases.

A control series of 105 patients in hospital with non-malignant diseases was used in a limited clinical assessment of the MOD-MEM test. Twenty-seven positive results could be explained on the basis of destruction of nervous parenchyma, tissue necrosis, tuberculosis, malignant disease, etc. The remaining 13 unexplained positives showed a sex and age distribution in agreement with that predicted from cancer registration statistics if the MOD-MEM test detects cancer about 16 years before the clinical appearance of the disease.

Evaluation Studies as Topic↗
PubMed1973

Evaluation and development of the macrophage electrophoretic mobility (MEM) test for malignant disease.

A preliminary announcement of a new in vitro blood test for cancer by Field and Caspary appeared in the Lancet of 26 December 1970. The test depends on sensitization of the patient's lymphocytes to a common antigen apparently present in human tumours. We now offer independent confirmation of these findings, together with methods for improving the test towards its future clinical use.

Animals↗