Biomedical subjects
Publications and source records attributed to F C Campbell.
From a multiple-regression analysis of prognostic factors and survival in a series of 387 patients with primary breast cancer, a prognostic index has been constructed, based on lymph-node stage, tumour size and pathological grade. This index is more discriminating than lymph-node stage alone, and enables a larger group of patients to be identified with a very poor prognosis.
Quantitative values if oestradiol receptor were determined in the primary breast cancer of 526 patients, 106 of whom have so far required hormonal therapy for metastatic disease (premenopausal patients-oophorectomy; postmenopausal patients-tamoxifen 20 mg twice daily). The rate of response to treatment was significantly higher in patients with receptor-positive primary cancers, and the likelihood of response further increased in proportion to the measured receptor concentration. Preliminary data also suggest that patients with high receptor values in the primary tumour will enjoy a longer remission than those with low measured values. Assays of oestradiol receptor were also carried out on biopsy specimens of accessible metastases, largely skin and lymph-node recurrences, in 24 patients who were treated mainly with local measures. Receptor status was the same in both the primary and the secondary tumour in only 18 patients.
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The oestrogen receptor (RE) status of the primary tumour has been assessed in 466 of a consecutive series of 550 patients with primary operable breast cancer. All patients were followed up (without treatment) until the development of recurrence or metastases. Distant metastases have so far occurred in 124 patients and 82 have had symptomatic local or regional recurrence. A significant correlation exists between the RE status of the primary tumour and subsequent patterns of metastasis. Symptomatic metastases to regional lymph nodes are more common with RE- cancers. There is no significant difference in either time of onset or total incidence of distant metastases between patients with RE+ and RE- tumours. Distribution of distant metastases is influenced by RE status: RE+ tumours tend to recur in bone, RE- tumours show affinity for viscera.
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A 32-year-old Black woman had a localized granulomatous mastitis. The lesion formed a discrete mass and had the clinical and radiological features of mammary carcinoma. Salmonella typhi was cultured from the lesion and also from the affected breast after excision. A rising Widal titre was demonstrated.
One hundred and eight patients were admitted to King Edward VIII Hospital, Durban, with a penetrating wound of the neck and were managed by a conservative policy. Intervention was undertaken if, and only if, there was an indication of damage to deep structures. Data were collected prospectively. Significant sequelae were seen in only 50 patients (46 per cent) and 26 underwent surgery. Three patients died from their neck injuries (2.8 per cent). 2 after operative intervention and 1 after conservative management. Morbidity was higher after surgery, though local sepsis in wound haematomas was more common in those treated conservatively. A selective policy for surgical intervention is safe and justifiable. A minimum mortality and morbidity can be obtained by adequate preoperative evaluation which includes the use of contrast radiography and angiography.
An experimental model for the primary culture and transplantation of late foetal rat small intestinal epithelium is described. Multicellular aggregates of mucosal epithelium containing pre-crypt proliferative cells were isolated from 20-day foetal rat intestine by enzymatic disaggregation. Cellular aggregates, which we refer to as "epithelial organoids," attached readily in culture, proliferated, and spread to produce coalescing colonies within 10 days. Enterocytes were maintained in culture for 3 days, removed as cell sheets, and incubated overnight with foetal mesenchyme. Fourteen recombinant preparations were then grafted to the renal subcapsular space of adult nude mice. Four of six grafts retrieved after 1 wk had developed. Histology demonstrated the formation of simple tubular structures lined by a polarized columnar epithelium. At 14 days, two of eight grafts had developed and demonstrated temporal progression of morphogenesis. Histology showed rudimentary crypts and villi lined by different epithelial cell types, including enterocytes and goblet cells. Small bowel proliferative cells within "epithelial organoids" from 20-day foetal intestine, may be maintained in primary culture for up to four days. After short term primary culture, these proliferative cells retain the capacity for progressive organotypic morphogenesis and pluripotent cytodifferentiation, after transplantation to adult recipients.
In patients with cancer circulating vascular endothelial growth factor (VEGF) may be tumor-derived and have prognostic significance. Activated platelets may also be a source of VEGF, releasing it in serum formation. Debate exists as to whether serum or plasma VEGF (S-VEGF, P-VEGF) is the most appropriate surrogate marker of tumor angiogenesis. As healing wounds produce VEGF that can spill over into the circulation, we aimed to investigate the potential confounding effects of cancer surgery on both perioperative S-VEGF and P-VEGF levels and to evaluate their relationship with platelet count. S-VEGF, P-VEGF and platelet counts were measured in 23 patients undergoing esophageal cancer resection. Samples were taken preoperatively and six weeks following surgery. Seven patients were also sampled on postoperative days 1, 5 and 10. VEGF was assayed using a commercial enzyme linked immunosorbent assay. S-VEGF and P-VEGF both rose after surgery (S-VEGF; day 5: 1017 [446-1224] pg/mL and day 10: 1231 [626-2046] pg/mL versus pre-op: 329 [189-599] pg/mL. P-VEGF; day 1: 55 [46-104] pg/mL and day 10: 58 [20-154] pg/mL versus pre-op: 23 [13-46] pg/mL), falling towards preoperative levels by six weeks. Platelet count correlated with S-VEGF (rho=0.281; p<0.05, Spearman's rank) and P-VEGF (rho=0.330; p<0.01, Spearman's rank). Platelets may contribute to VEGF levels in plasma as well as in serum. The effects of surgery on S-VEGF or P-VEGF levels are mainly transient. Care must be exercised when interpreting circulating VEGF levels in the early postoperative period.