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Biomedical subjects

I Taylor

Publications and source records attributed to I Taylor.

At least 235 records · Page 13Linked to original sources
PubMed1988

Wide excision of primary breast cancer: the incidence of residual carcinoma at the site of excision.

Fifty-one consecutive women with early breast cancer underwent wide excision and axillary clearance. After wide excision five biopsies were taken from the walls of the cavity. On histological examination tumour was present in the cavity biopsies in 13 cases (25%). The presence of ductal carcinoma in situ in the primary tumour was not associated with an increased number of positive cavity biopsies. In nine cases incomplete excision was due to separate foci of invasive or in situ carcinoma, in two cases tumour was contiguous with the primary carcinoma and in two, separate foci and contiguous disease both occurred. The high incidence of residual local tumour after wide excision of breast cancer demands the need for postoperative irradiation to the breast and frequent review.

Adult↗
PubMed1987

Predictive power of progesterone receptor status in early breast carcinoma.

Progesterone receptor status (PgR) and oestrogen receptor status (ER) were examined in 332 women with stage I-II breast carcinoma treated at a single centre either by simple mastectomy with (n = 283) or without (n = 6) axillary clearance, or by segmental mastectomy with (n = 18) or without (n = 25) axillary clearance and radiotherapy; median follow-up time was 40 (range 10-60) months. Neither the concentration nor the presence of PgR related to either disease-free interval or survival. However both the presence and the concentration of ER were found to be associated with a longer disease-free interval amongst patients with stage II tumours (P less than 0.01). From this study it appears that progesterone receptor status does not predict outcome in early breast carcinoma.

Adult↗
PubMed1987

Exfoliated cells and in vitro growth in colorectal cancer.

Cells exfoliated from colorectal cancers may only be implicated in local recurrence if they are proven to be viable and capable of growth. Thirty patients with primary colorectal cancer were studied. Cells were obtained from primary tumour, uninvolved mucosa, mesorectum, lumen of the bowel, luminal mucus, serosal surface of the bowel and from washings of the tumour bed after dissection. Colonies grew in vitro in monolayer culture from 21/30 primary tumours; 11/41 mesorectum specimens; 11/27 luminal washings; 14/29 luminal mucus specimens; 1/27 serosal surface washings and 3/13 post-dissection washes. Colonies stained positively for the epithelial markers cytokeratin and desmosomes and also for carcinoembryonic antigen. Cells capable of in vitro growth are present in these various sites and, if spilled at operation, may well be implicated as one of the factors leading to local recurrence.

Adult↗
PubMed1987

Factor X-activating activity in patients with colorectal carcinoma.

The ability of malignant tissue from 50 patients with colorectal carcinoma to activate blood coagulation factor X directly was compared with samples of adjacent, macroscopically normal colonic mucosa from the same patients, and tissue from four patients with non-malignant bowel disease. The resected tissue was homogenized and incubated with purified factor X and calcium ions. The subsequent generation of activated factor X was measured spectrophotometrically with a chromogenic substrate. Results were expressed as absorbance units, and as the ratio of tumour and normal activities. Factor X-activating activity (FXAA) was present in all normal and malignant tissues tested. FXAA was significantly greater (P less than 0.001) in the tumour homogenates than in the uninvolved tissue. The tumour:normal ratio was significantly (greater than 1.2) elevated in 38 patients (76 per cent). FXAA was not correlated with the degree of differentiation of the tumour, the Dukes' classification of the disease or the exact site of the tumour. There was no difference between the FXAA content of non-involved tissue from the colorectal cancer group and colonic mucosa from patients with non-malignant bowel disease. It is concluded that colorectal carcinomas contain significantly more FXAA than adjacent, non-malignant colonic mucosa from the same subject, but there is no direct evidence for a relationship between procoagulant levels and the extent of malignancy in these patients.

Adenocarcinoma↗
PubMed1987

Liver tumour blood flow and responses to arterial embolization measured by dynamic hepatic scintigraphy.

Liver and tumour blood flow has been studied in 30 patients with multiple liver metastases and in 14 patients with solitary liver tumours by means of dynamic hepatic scintigraphy. Observations were compared with those of a group of 33 control subjects. Haemodynamic changes were also measured in 10 patients who underwent hepatic arterial embolization (HAE). The mesenteric fraction (MF) to tumour regions in 32 subjects showed a wide range compared with control subjects. In 9 patients the MF to the tumour region was within the normal range suggesting that some tumours may possess a portal venous supply. The MF to the uninvolved liver regions was below the normal range in 25% of patients, indicating that HAE could be hazardous in this group. Following HAE the MF rose in all 4 tumour regions and fell in 4 non-embolized uninvolved liver regions. No increase in colloid clearance rate (k) was seen though a significant decrease occurred in 4 patients. These changes may well represent increased portal venous flow into tumours.

Adult↗
PubMed1987

Severe sodium restriction alone and with potassium supplementation does not alter blood lipoproteins in essential hypertension.

Seventeen 50-year-old men, previously untreated and all with mild to moderate essential hypertension, were given a low sodium diet for 2 weeks. During the second week, the diet was supplemented with potassium. Urinary excretion of Na+ decreased from 201 +/- 11 to 24 +/- 5 and 19 +/- 4 mmol 24 h-1, respectively, after 1 and 2 weeks (means +/- SE) while the urinary Na+: K+ ratio changed from 2:1 to 1:4 and 1:11. Despite significant changes in blood pressure, body weight, serum electrolytes, sympathetic noradrenergic tone, haemoglobin concentration and haematocrit, no significant change appeared in serum total cholesterol, HDL-cholesterol or triglycerides. Thus, low sodium diet alone and combined with potassium supplementation seems neutral to blood lipoproteins in the treatment of essential hypertension.

Adult↗
PubMed1987

Temporary blood flow stasis with degradable starch microspheres (DSM) for liver metastases in a rat model.

A reliable liver metastasis model using intraportal injections of sarcoma cells was established in syngeneic hooded Lister rats to study the blood supply of the tumours and to evaluate the role of degradable starch microspheres (DSM) in conjunction with selective hepatic arterial and portal venous chemotherapy. The tumour/normal liver (T/L) ratio after intra-arterial and intraportal injection of 113Sn microspheres was 1.04 (range: 0.38-1.15) and 0.03 (range: 0.006-0.22), respectively. After intravenous 14C-iodoantipyrine quantitative autoradiography of tumour and normal regions demonstrated a mean T/L ratio of 0.74 +/- 0.05. After hepatic artery ligation (HAL) and portal vein ligation (PVL) the values were 0.32 +/- 0.05 and 0.42 +/- 0.05, respectively. These results confirm that the vascularity of the tumours in this model is similar to human colorectal cancer metastases. Radiolabelled 14C 5-Fluorouracil (5-FU) was given intravenously, via the hepatic artery and via the portal vein (the latter two routes with and without DSM). Quantitative autoradiography of tumour regions showed that selective hepatic arterial administration with DSM resulted in a significantly increased concentration of 14C-5-FU within the tumours. These results suggest that DSM may enhance the therapeutic benefit of hepatic arterial 5-FU by increasing its uptake into tumours.

Animals↗
PubMed1987

Changes in blood flow, portal pressure and shunting during the development of cirrhosis in response to beta-blockade.

An experimental model of cirrhosis was developed in the rat to assess the effect of disease and pharmacological manipulation on blood flow, shunting and portal pressure. With progression in the severity of histological cirrhosis there was a steady fall in effective liver blood flow as measured with radioisotope labelled colloid. This corresponded to a rise in portal pressure and shunting with a close correlation between the two (r = 0.7, p less than 0.01). In control animals and when portal hypertension was caused by extrahepatic obstruction, beta-blockade with propranolol, but not selective beta 2 blockade, significantly decreased liver blood flow. With cirrhosis there was a variable response to propranolol depending on the histological severity of disease, the height of portal pressure and degree of shunting. There is a possibility therefore that a potential may exist for lowering portal pressure by manipulating intrahepatic shunting.

Adrenergic beta-Antagonists↗
PubMed1987

Management of acute lower gastrointestinal haemorrhage in a surgical unit over a 4-year period.

Over a 4-year period 107 patients, 5% of all emergency admissions, were admitted to one surgical unit with significant lower gastrointestinal haemorrhage (requiring more than a 2-unit transfusion of blood). Twenty-three individuals required more than 3 units of blood, and 7 life-saving surgery. All subjects undergoing surgery required more than 3 units of blood in the first 24 hours of admission. Arteriography was diagnostic in 5 of the 9 subjects in whom it was performed. Arteriography was positive if performed in the first 24 hours of admission. A flow chart of the management of patients with lower gastrointestinal haemorrhage is presented.

Blood Transfusion↗
PubMed1987

X-ray and ultrasound localization of non-palpable breast lesions and difficulties in management.

Seventy-four patients who have had biopsy of a non-palpable breast lesion are reviewed. A double-dye localization technique was used in 88% while in 12% localization of the lesion was best achieved by ultrasound mammography. Biopsy was successful in 70 patients (95%) at the first attempt. The overall incidence of malignancy was 20%, being greater in asymptomatic patients (32%) than in patients with mastalagia (16%). Re-excision of the biopsy site in these patients showed residual cancer in 33%. It is suggested that both careful examination of the operative specimen and postoperative mammography may be necessary to ensure that the original lesion has been removed. Re-excision of the biopsy site appears to be necessary when the histology is malignant.

Adult↗
PubMed1987

Fine needle aspiration cytology of breast masses: an evaluation of its accuracy and reasons for diagnostic failure.

A study of 1458 patients who had undergone breast aspiration cytology was conducted to determine the diagnostic accuracy of the technique. The effect of tumour histology and size on the unsatisfactory aspirate and false negative rate was examined. Seven hundred and thirty one patients (50%) had histological diagnoses. The sensitivity of aspiration cytology for malignancy was 64% for the first aspiration, but was 91% in patients who had had 3 aspirates. The specificity was 56%, this low figure was almost entirely due to inadequate or unsatisfactory cytological preparations. The positive and negative predictive values of aspiration cytology were 99.4% and 85% respectively demonstrating high diagnostic accuracy given a satisfactory aspirate. Invasive lobular carcinoma yielded a significantly higher unsatisfactory rate than invasive ductal carcinoma (P less than 0.001) and fibroadenoma yielded a significantly lower unsatisfactory rate than fibroadenosis (P less than 0.001). Mass size influenced the unsatisfactory rate for invasive ductal carcinoma (P less than 0.05) and fibroadenoma, but not for invasive lobular carcinoma or fibroadenosis. Only 2 of the 32 false negatives were due to misinterpretation, the remainder resulted from the aspiration needle missing the mass. We conclude that aspiration cytology is an accurate preoperative diagnostic procedure for the evaluation of breast masses. Unsatisfactory or negative aspirates should be regarded as 'non-results' if there is clinical or radiological suspicion of malignancy.

Adolescent↗
PubMed1986

Seat belt injury to the female breast.

Six women who sustained injury to a breast from seatbelt straps during road traffic accidents are presented. In three the breast contained a carcinoma. In view of the overlap of the appearance of fat necrosis and carcinoma by clinical and radiological examination all such lesions should be biopsied to exclude carcinoma as the history of the lesion can be dangerously misleading.

Accidents, Traffic↗
PubMed1986

Effect of warfarin on formation and growth of pre-neoplastic lesions in chemically induced colorectal cancer in the rat.

Anticoagulant drugs are known to have an effect on tumour growth. However, the mechanisms by which they act are poorly understood, and have therefore been investigated in this study. Wistar rats were given eight weekly subcutaneous injections of azoxymethane, at a dose of 10 mg kg-1 week-1. Following this they were randomized into two groups: a control group, which received no further treatment, and a warfarin treated group, which received warfarin at 'non-therapeutic' doses in their drinking water, for a further 8 weeks. Pairs of rats from each group were killed at 5-weekly intervals from 10 to 35 weeks after the first azoxymethane injection. At 40 weeks all remaining rats were killed. Samples of colonic mucosa from the descending colon and rectum were taken for scanning electron microscopy. The number of microadenomas per low power field was determined in both groups at each time interval. Tumour incidence and distribution were noted in animals killed at 40 weeks. The median number of microadenomas was significantly lower in warfarin treated animals than in controls at all time intervals. Tumour number was also significantly decreased by warfarin treatment (27 in azoxymethane treated animals, 10 in animals receiving azoxymethane and warfarin, P less than 0.05). The distribution of tumours along the colon was similar to that seen previously, following 12 weeks of azoxymethane. These effects occurred despite the non-concurrent administration of azoxymethane and warfarin.

Adenoma↗
PubMed1986

Pattern of spread of bloodborne tumour.

The pattern of bloodborne tumour spread has been studied experimentally in syngeneic rats. A variety of tumour types has been injected intravenously, intraportally and also intra-arterially via the left ventricle. Tumour cell arrest as a factor in the localization of metastases in the lung following intravenous injection of cells, and in the liver following intraportal injection, is emphasized. Once tumour cells have entered the arterial circulation they disseminate to almost all organs in similar proportions to the distribution of cardiac output. The dissemination and arrest of cells is not found to correlate with the later distribution of metastases. For example, certain organs (especially the adrenals) which receive only low fractions of injected cells, are always preferred sites for bloodborne metastasis. A strikingly similar pattern of 'arterial metastasis' is also seen for all the tumours used despite their very different histological and biological natures.

Animals↗
PubMed1986

Depression and social stress among patients with benign breast disease.

One hundred and forty women referred to the Southampton breast clinic had a psychiatric interview at home, before their first clinic attendance. The 107 subsequently diagnosed as having benign breast disease had a high rate of depressive symptomatology in comparison with women in published surveys of the general population. In the year before referral, 25 (23 per cent) had had definite depression and 19 (18 per cent) had had borderline depression: at the time of interview 9 (8 per cent) had major depression and 22 (21 per cent) had minor depression. Depression in these patients was associated with recent life events and social difficulties. Mood disturbance and psychosocial stress may lead to medical consultation about benign breast disease, or even contribute to its development. Severe depression was less common in the 33 patients who turned out to have breast cancer, though more of them had minor depression, and they reported fewer recent life events.

Adult↗
PubMed1986

Direct contact B-scan ultrasound in the diagnosis of solid breast masses.

Our experience of breast ultrasound in the differentiation of benign and solid malignant breast masses indicates a specificity of 93% for carcinoma; 7% of cancers were regarded as benign. Eight of 89 proven fibroadenomas were considered possibly malignant. Typical, and overlapping, features are described, and the world literature is discussed. Whereas most previous workers have used a water-path technique, we employ direct contact B-scanning, which is quick, simple, and apparently at least as successful. The small group of solid masses where there is overlap between fibroadenoma and carcinoma needs further study; this might be helped by histological correlation with the ultrasound appearances of malignancy, the causes of which are still debated. The exclusion of a focal solid mass in a patient with a breast lump can reduce the biopsy rate.

Adenofibroma↗