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Biomedical subjects

M R Robinson

Publications and source records attributed to M R Robinson.

At least 91 records · Page 5Linked to original sources
PubMed1984

Therapeutic significance and the mechanism of action of the LH-RH agonist ICI 118630 in breast and prostate cancer.

The influence of the LH-RH agonist ICI 118630 on circulating levels of the pituitary gonadotrophins LH and FSH and the gonadal steroids oestradiol, progesterone, 17-hydroxyprogesterone and testosterone has been studied in phase I clinical trials of the drug in patients with advanced breast or prostate cancer. ICI 118630 initially stimulated plasma levels of LH and FSH. On continued treatment however, the drug reversed this response and produced a rapid decline in plasma testosterone and progesterone in male and female patients respectively. Plasma oestradiol concentrations equivalent to those seen in oophorectomised or postmenopausal women were eventually produced in all 5 female patients treated with ICI 118630. In one patient however persistent follicular activity occurred until her third menstrual cycle. No appreciable side effects of the drug were observed. These data indicate that ICI 118630 initiates a castration-like endocrine response and has potential in the treatment of hormone dependent tumours of the breast and prostate.

Breast Neoplasms↗
PubMed1984

Does intravesical chemotherapy prevent invasive bladder cancer?

Intravesical chemotherapy has been shown to prolong the interval free of disease and to reduce the tumor recurrence rates in patients with superficial bladder cancer. These observations led us to consider whether a course of intravesical chemotherapy might provide a long-term decrease in the recurrent tumor rate or reduce the incidence of progression to invasive carcinoma. The records of 123 patients entered into a randomized multicenter protocol between 1975 and 1978 were examined. Patients had received a 1-year course of thiotepa or VM26, or transurethral resection alone. Mean followup was 47 months. Patients receiving thiotepa or VM26 had a lower rate of tumor recurrence, expressed as recurrences per 100 patient-months, than those undergoing transurethral resection only (5.25 versus 5.71 versus 7.98) but this was not statistically significant. However, 28 per cent of the controls required therapy besides transurethral resection to control the bladder cancer and 19 per cent died of advanced bladder cancer during followup. Only 15 per cent of the patients undergoing intravesical chemotherapy required therapy other than transurethral resection and only 3 per cent died of advanced carcinoma of the bladder. This finding suggests that intravesical chemotherapy given for 1 year is associated with a significant decrease in the incidence of tumor progression, and provides the justification to conduct future trials with extended followup.

Administration, Topical↗
PubMed1984

Treatment of invasive bladder cancer by local resection and high dose methotrexate.

Fifty-seven patients with transitional cell carcinoma of the bladder, categories pT2, pT3a and pT3b, were treated by transurethral resection of the tumour mass (54 cases) or partial cystectomy (3 cases) followed by 8 doses of methotrexate 2 g i.v. every 3 weeks with appropriate Leucovorin rescue. At completion of chemotherapy 6 months after TUR 33/57 patients were tumour-free; 5/57 had new superficial tumours; 13/57 had persistent tumour invading muscle, 3 showed tumour progression and 3 had died from treatment complications. One-year survival was 45/57 (82%); 2-year survival was 23/39. Although some patients developed metastases and others have grown new superficial tumours, of those surviving, the bladder was free of the original invasive tumour in 38/45 (84%) at 1 year and in 19/24 (79%) at 2 years. It is concluded that transurethral resection plus high dose methotrexate may offer an effective alternative to radiotherapy or cystectomy for a significant proportion of patients with invasive bladder cancer.

Adult↗
PubMed1983

Does the use of stained maggots present a risk of bladder cancer to coarse fishermen?

A case-control study in West Yorkshire has been used to investigate possible risks of bladder cancer amongst those fishermen who used azo-based dyestuffs to stain maggots or who purchased ready coloured maggots. No risks have been found, although the confidence limits of the estimates are wide. These data refer to exposures over ten years ago and it is possible recent changes in fishing practice, if they have occurred, are not yet assessable due to the long mean latency seen in bladder cancer when exposure to carcinogens is not great. This paper does not suggest the general use of these substances is without hazard, merely that no risk is associated with the study group and that the chemicals under study are not a major cause of bladder cancer.

Aged↗
PubMed1983

ABO, MNSs and rhesus blood groups in bladder cancer.

Data are presented on a group of cases of primary carcinoma of the bladder detailing their ABO, MNSs and rhesus blood antigenic phenotypes. Differences, either between all cases and controls or between particular stages of presentation and controls, have been found in the ABO red cell system as well as the MNSs red cell system. In the case of the ABO system an excess of the A gene is present but detailed study shows this to be only in patients with T1 and T2 tumours. No excess was seen in patients with carcinoma in situ or T3 or T4 stage disease. The S gene of the MNSs system is also in excess in cases of bladder cancer.

ABO Blood-Group System↗
PubMed1983

Adjuvant chemotherapy with doxorubicin (Adriamycin) and 5-fluorouracil in T3, NX, MO bladder cancer treated with radiotherapy.

Radical radiotherapy alone has been compared with radical radiotherapy followed by chemotherapy using doxorubicin (Adriamycin) and 5-fluorouracil in a randomised prospective study on 129 patients presenting with T3, NX, MO transitional cell carcinoma of the bladder. One hundred and ten patients were evaluable with a minimum follow-up of 2 years. The addition of this form of chemotherapy did not appear to influence the survival rate or the proportion of patients free from tumour. It cannot be recommended for routine use in the primary treatment of infiltrating bladder cancer.

Carcinoma, Transitional Cell↗
PubMed1983

A phase II study of intravesical mitomycin C in the treatment of superficial bladder cancer.

Twenty-three patients with histologically proven superficial bladder cancer (Tis, Ta, T1) were treated with intravesical instillations of Mitomycin C at a dose of 20 mg in 20 ml of water 3 times weekly for 21 instillations. Seventeen patients (77%) showed complete disappearance of all known disease and a further 4 showed partial responses. In 8 patients toxic effects developed (thrombocytopaenia 1, chemical cystitis 2, skin rash 3, urinary tract infection 2). All resolved rapidly on stopping the treatment but were severe enough in 5 patients to prevent them from receiving a full course of treatment.

Carcinoma in Situ↗
PubMed1983

Low-dose doxorubicin in the management of advanced carcinoma of the prostate.

Twenty-one patients with advanced metastatic carcinoma of the prostate, no longer responsive to conventional therapy, were treated with weekly low-dose doxorubicin (Adriamycin). Twelve had an impressive subjective response in terms of pain relief and improved performance status and in nine this was maintained for 3 or more months.

Doxorubicin↗
PubMed1983

Ten genetic polymorphisms in bladder cancer.

Data are presented on a group of cases of primary carcinoma of the bladder, detailing red cell surface blood group antigenic phenotypes, serum haptoglobin phenotypes, and some red cell isoenzyme phenotypes. Account is taken of the stage of the disease at presentation. The results are compared with corresponding phenotype frequencies in groups of presumed healthy persons originating either in Yorkshire or County Durham. Differences in relative incidences were found in the haptoglobin, phosphoglucomutase (PGM), and some other systems. These are both differences between all cases and controls and between particular stages at presentation and controls.

Acid Phosphatase↗
PubMed1983

Monitoring of prostatic cancer by an enzyme-linked immunosorbent assay of serum prostatic acid phosphatase.

A longitudinal study of serum prostatic acid phosphatase (sPAP) in 167 cases of carcinoma of the prostate was made using an enzyme-linked immunosorbent assay. The sensitivity of the assay was valuable in accurately exploring the low levels of sPAP achieved after treatment by orchidectomy or oestrogens. For the majority of patients with metastatic disease, treatment resulted in the level of sPAP falling to normal within 3-9 months, but in about half of these patients the level of sPAP had begun to increase again, exponentially, within 2 years. This exponentially rising level of sPAP was well correlated with evidence of progression as indicated by bone scans. The rise of sPAP in M1 disease could not be accounted for by an attenuation of the suppression of testosterone. After hormone manipulation in M0 disease the sPAP generally fell to below 1.5 ng/ml and remained at this level for the duration of the study. In untreated M0 disease there were small fluctuations in the level of sPAP, and it had a higher baseline level. In both treated and untreated patients a rising level of sPAP above normal tended to indicate tumour progression.

Acid Phosphatase↗
PubMed1983

Prognostic significance of the symptoms associated with prostatic carcinoma.

This paper discusses the prognostic significance of the symptoms of prostatic carcinoma. In a series of 123 patients, 72 presented with prostatism, of which 11% died with progressive malignant disease. Of 36 patients with retention of urine, 30% died with progressive malignant disease, and of 15 patients with a combination of skeletal pain and prostatism, 53% died of progressive malignant disease. Skeletal pain is a very poor prognostic factor.

Aged↗
PubMed1983

The protein composition of the ocular zonules.

Bovine and human zonules were found to be composed of noncollagenous acidic glycoprotein with a high cysteine content, double that previously reported. In reduced zonular fractions the most prominent peptide had a molecular weight (MW) of approximately 70,000. Lesser quantities of 170,000, 50,000, and 35,000 dalton peptides were also present and a variable number of lower MW bands, depending upon the degree of reduction and denaturation. A fraction of bovine zonules soluble in low ionic strength buffers contained primarily a peptide of approximately 50,000 daltons, often present as a doublet. Amino acid and hexosamine content of these two fractions was consistent with the presence of at least two different glycoconjugates, one a proteoglycan. Carbohydrate analysis of whole zonules suggested that these glycoconjugates include a sialofucose-containing glycoprotein and a lesser quantity of xylose-containing proteoglycan. The amino acid profile and peptide content of the zonules resembled that of elastic tissue microfibrils, increasing further the possibility of a close relationship between these two fibrils.

Adult↗
PubMed1982

Histological features of skin reactions to human lymphoid cell line lymphokine in patients with advanced cancer.

Lymphokines (LCL-LK) prepared from the human lymphoid cell line RPMI 1788 were injected intradermally into tumour-bearing patients. Biopsies of skin reactions were obtained for histological study from 30 min. to 72 hr, and for comparison, biopsies were taken at similar times of tuberculin reactions in tuberculin-positive patients. The early response to LCL-LK consisted of polymorph adherence to vascular endothelium (at 30 min.) followed by polymorph exudation, oedema and haemorrhage (1-2 hr); mononuclear and eosinophilic leucocyte emigration began at 4 hr; and by 12 hr, when the reaction was maximal clinically, there was widespread pleomorphic leucocytic infiltration of the dermis. At later times (48-72 hr) skin reactions to LCL-LK showed predominantly mononuclear cell infiltration and hypertrophy of vascular endothelium. Electron microscopy at 48 hr revealed perivascular lymphocytes and macrophages. The skin reaction to LCL-LK appeared to superimpose an early component of marked polymorph infiltration, oedema and haemorrhage upon a mononuclear cell exudation similar to that seen in the tuberculin reaction. It was concluded that the later phase of the skin reaction to lymphoid cell line lymphokine in the human bore a close histological similarity to the established tuberculin reaction. The LCL-LK reaction occurred in patients anergic to recall antigens. Its intensity was mainly related to dose and did not vary substantially between different batches of lymphokines.

Dose-Response Relationship, Immunologic↗
PubMed1982

Serum protein profiles in carcinoma of the kidney.

The levels of serum acute phase reactant proteins (APRPs) have been examined in untreated kidney carcinoma and during the evolution of metastases. These proteins can provide a warning of the likelihood of extensive local or metastatic spread at first presentation. The levels of APRPs rise with increasing tumour burden but the system is insensitive to small tumour burdens. beta 2-Microglobulin levels do not contribute additional information. Serum phosphohexose isomerase tends to be elevated when there is a large tumour burden but its change does not accurately mirror the rate of expansion of the tumour. The APRPs and phosphohexose isomerase are useful in alerting the clinician to the probability of metastases or large local masses in kidney cancer, but have a limited use in monitoring.

Blood Proteins↗
PubMed1981

The evaluation of a new enzyme immunoassay for the measurement of prostatic acid phosphatase.

An enzyme immunoassay for prostatic acid phosphatase (PAP) has been assessed. An upper limit normal is set at 1.8 microgram/1. There is a very low incidence of raised levels in chronic diseases or cancers other than those of the prostate. Patients with well-controlled prostatic cancer have levels less than 1.8 microgram/1 and show little variation about their own mean. PAP can rise exponentially with a doubling time of 1-5 months. This assay is unlikely to increase the detection of asymptomatic prostatic cancer as 66% of T0-2NXM0 cases had PAP less than 1.8 microgram/1. The main advantages over routine enzyme assays are its sensitivity and accuracy in the lower range.

Acid Phosphatase↗