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Biomedical subjects

M D Mason

Publications and source records attributed to M D Mason.

At least 55 records · Page 3Linked to original sources

Adhesion molecules in melanoma--more than just superglue?

Malignant melanoma is increasing in incidence, and, though early lesions are readily treatable, systemic therapy for metastatic disease remains disappointing. Integrins are a family of cell-surface molecules that mediate adhesion between the cell and the extracellular matrix. One member of the integrin family, the alpha v beta 3 integrin, is associated with progression of melanomas, in that the most malignant cells express the highest levels of alpha v beta 3. Like many members of the integrin family, alpha v beta 3 recognizes the sequence Arg-Gly-Asp (RGD) in its ligands, and other molecules that contain this sequence will complete with the natural ligands (such as vitronectin) for binding. There is growing evidence that integrins function as receptors for signal transduction, and that integrin-mediated signalling can affect cell behaviour and even cell survival. Under certain circumstances, loss of integrin-mediated signalling will induce apoptosis, or programmed cell death, and we have demonstrated that melanoma cells treated with a cyclic peptide with high affinity for the alpha v beta 3 integrin will undergo apoptosis within three days. This mechanism might be exploited therapeutically.

Cell Adhesion↗

High-dose folinic acid and 5-fluorouracil bolus and continuous infusion in advanced colorectal cancer: poor response rate in unselected patients.

We have conducted a retrospective study of high-dose folinic acid and 5-fluorouracil in 96 patients with advanced colorectal cancer. Patients received 200 mg m-2 (maximum 300-350 mg) folinic acid by infusion over 2 h followed by an i.v. bolus of 5-fluorouracil 400 mg m-2 then an infusion of 5-fluorouracil 600 mg m-2 over 22 h. This was repeated over the next 24 h. The schedule was given every 2 weeks for four cycles; thereafter patients with objective response continued to a maximum of eight cycles. The overall response rate was 10.6% in 85 evaluable patients. The median duration of response was 11 months. The median survival was 6 months. Toxicity was low, only one patient experiencing toxicity greater than WHO grade II (grade IV platelet toxicity). Diarrhoea, nausea, vomiting and mucositis also occurred but were mild and infrequent. Our low response rate may be related to factors such as patient characteristics or duration of treatment.

Adult↗

A comparison of the palliative effects of strontium-89 and external beam radiotherapy in metastatic prostate cancer.

From 1988 to 1991, 284 patients with prostatic cancer and painful bone metastases were treated with either radiotherapy or strontium-89 (200 MBq). Patients were first stratified according to suitability for local or hemibody radiotherapy, then randomly allocated that form of treatment or strontium-89 (i.v. injection). After 4, 8 and 12 weeks pain sites were mapped, toxicity monitored, and all additional palliative treatments recorded. There was no significant difference in median survival (after > 80% had died); 33 weeks following strontium-89 and 28 weeks following radiotherapy (p = 0.1). All treatments provided effective pain relief; improvement was sustained to 3 months in 63.6% after hemibody radiotherapy compared with 66.1% after strontium-89, and in 61% after local radiotherapy compared with 65.9% in the comparable strontium-89 group. Fewer patients reported new pain sites after strontium-89 than after local or hemibody radiotherapy (p < 0.05). Radiotherapy to a new site was required by 12 patients in the local radiotherapy group compared with 2 after strontium-89 (p < 0.01), although there was no significant difference between hemibody radiotherapy (6 patients) and strontium-89 (9 patients) in this respect. Platelets and leukocytes fell by an average 30-40% after strontium-89 but sequelae were uncommon, and other symptoms rare.

Aged↗

Immunohistochemical and biochemical characterisation of the expression of a human embryonal carcinoma cell proteoglycan antigen in human germ cell tumours and other tissues.

In the embryonal carcinoma (EC) cell line GCT 27, monoclonal antibody GCTM-2 recognises an epitope on a 200 kD pericellular matrix keratan sulphate proteoglycan. Immunohistochemical analyses demonstrated staining of tissue sections from 21 out of 22 human non-seminomatous germ cell tumours, and from 22 out of 28 sections of seminomas. In normal human fetal tissues gut epithelium and muscle stained strongly, and certain other epithelia stained moderately. In adult tissues, the distribution of the epitope was similar, but staining intensity was weaker. Neoplastic tissues showed reactivity with embryonal rhabdomyosarcoma and colorectal carcinoma, but no other non-germ cell tumours. Immunofluorescence microscopy showed that GCTM-2 also stained cell lines from human colorectal carcinoma, embryonal rhabdomyosarcoma and choriocarcinoma. In contrast to EC cells the epitope in these other cell types required permeabilization of the cells to be visualised, and the protein bands in immunoblots lacked extensive modification with keratan sulphate and were smaller. Thus, GCTM-2 reacts with an epitope which has a previously unrecognised tissue distribution; its expression as a pericellular matrix proteoglycan is predominantly a characteristic of human EC cells.

Antibodies, Monoclonal↗

Non-Hodgkin's lymphoma of the bladder--CT and MRI appearances.

Computed tomography (CT) appearances of two patients with primary bladder non-Hodgkin's lymphoma are presented with magnetic resonance imaging (MRI) correlation in one. The differences between primary and secondary bladder lymphoma with respect to their clinical presentation, course and prognosis are described. Bladder lymphoma is a rare tumour which often presents as a large multilobular submucosal mass, and such an appearance may suggest the diagnosis. Bladder lymphoma, however, cannot be differentiated from the more common transitional cell carcinoma on the basis of CT attenuation values or enhancement patterns, or MRI signal characteristics. The diagnosis must, therefore, be made by histology. Other differential diagnoses and the role of various imaging techniques in the diagnosis and management of bladder lymphoma are considered.

Adult↗

Inguinal and iliac lymph node involvement in germ cell tumours of the testis: implications for radiological investigation and for therapy.

The clinical details of 1191 patients with primary germ cell tumours of the testis seen at the Royal Marsden Hospital between 1977 and 1989 were reviewed in order to determine the incidence of inguinal or iliac node metastases. This was detected in 22 patients, 11 with inguinal and 11 with iliac lymphadenopathy. Seven of these patients had a history of maldescent and orchidopexy, and one patient had congenitally fused testes. Of the remaining 14 patients, eight had bulky para-aortic lymphadenopathy (5 cm or greater in diameter), one had histological evidence of breach of the tunica vaginalis by tumour, and in five patients no predisposing factors were identified. Eight patients had a seminoma, 11 a non-seminoma, and two a combined tumour. Inguinal or iliac nodes were significantly more common in the group of patients defined by bulky para-aortic disease or a history of maldescent and orchidopexy (15/267) than those without either factor (7/924, P less than 0.0004). Patients with a history of maldescent, congenital anomalies of the genitourinary system, or with bulky para-aortic disease, should routinely have the pelvis and inguinal regions included in a staging or follow-up CT scan. These factors should also influence the extent of the radiation field or of surgical dissection when these modalities are employed.

Cryptorchidism↗

The effect of carboplatin on renal function in patients with metastatic germ cell tumours.

Renal function was determined before and at varying times after chemotherapy in 62 patients with metastatic germ cell tumours treated with carboplatin. Eighteen patients were excluded because of urinary tract obstruction, leaving 44 evaluable patients treated with carboplatin either as a single agent (13 patients) or in combination with other agents (31 patients). No significant differences were observed in mean 51Cr-labelled Ethylenediamine tetraacetic acid (EDTA) clearances before and after carboplatin in either the group as a whole (P = 0.58), or when assessment at 1 month or less (P = 0.4), 3 months or less (P = 0.91), or later than 3 months (P = 0.38) were analysed. Carboplatin does not have significant renal toxicity when used at conventional dosage in patients with germ cell tumours.

Adolescent↗

Management of the contralateral testis in patients with testicular germ cell cancer.

Patients with testicular germ cell tumours (TGCT) are at increased risk of developing a tumour in the contralateral testis. Such a tumour may be preceded by carcinoma in situ (CIS), which is more common in patients with infertility, atrophic testis or a history of cryptorchism. Of 1219 patients with TGCT seen at the Royal Marsden Hospital between 1962 and 1984 in whom the contralateral testis was managed by surveillance, 38 (3.1%) developed a second tumour and 8 died of germ cell tumours. Seventeen of 26 assessable patients (65%) exhibited at least one of the known aetiological risk factors for carcinoma in situ. Diagnosis of carcinoma in situ may lead to more appropriate management of the contralateral testis.

Carcinoma in Situ↗