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Biomedical subjects

V Humeniuk

Publications and source records attributed to V Humeniuk.

15 recordsLinked to original sources
PubMed2005

Arteriovenous malformations in Cowden syndrome.

Cowden syndrome (OMIM No 158350) is a pleomorphic, autosomal dominant syndrome characterised by hamartomas in tissues derived from the endoderm, mesoderm, and ectoderm. It is caused by germline mutations in the PTEN gene and is allelic to the Bannayan-Riley-Ruvalcaba and Lhermitte-Duclos syndromes. The three syndromes are defined on clinical grounds but there is overlap in their definitions. The clinical features include trichilemmomas, verrucose lesions of the skin, macrocephaly, intellectual disability, cerebellar gangliocytoma, thyroid adenomas, fibroadenomas of the breast, and hamartomatous colonic polyps. Cutaneous haemangiomas are occasionally noted. Malignancies often arise in the affected tissues. Visceral arteriovenous malformations are a recognised component of the Bannayan-Riley-Ruvalcaba syndrome but have been reported rarely in Cowden syndrome. A family is described with a clinical diagnosis of Cowden syndrome, a familial frameshift mutation in the PTEN gene, and large visceral arteriovenous malformations. The association of these pleomorphic syndromes with arteriovenous malformations can be explained by the putative role of the PTEN gene in suppressing angiogenesis. Recognition of arteriovenous malformations as a clinical feature of Cowden syndrome has implications for the clinical management of patients with this disorder.

Adult↗
PubMed2001

Successful treatment of radiation induced breast ulcer with hyperbaric oxygen.

The purpose of this report was to investigate the efficacy of hyperbaric oxygen treatment in the management of a persisting radiation induced ulcer following standard breast irradiation. A 57-year-old Caucasian patient was referred following partial mastectomy and axillary node clearance for a T2N0 grade 3 infiltrating ductal carcinoma of the left breast. She received 45 Gy in 25 fractions at 1.8 Gy per fraction to the isocentre to the whole breast using tangential fields and 4 MV photons, in conjunction with intravenous chemotherapy (cyclophosphamide, methotrexate and 5 fluorouracil). Treatment was interrupted for 3.5 weeks because of a grade 4 skin and subcutaneous reaction. Treatment resumed to the tumour bed alone. Chemotherapy was abandoned. The tumour bed received 14 Gy in 7 fractions at 2 Gy per fraction prescribed to the 100% using 10 MeV electrons and a direct field, completing treatment on 7 July 1998. The radiation induced a painful 8x4 cm ulcer which persisted in spite of rigorous treatment including Gentian Violet, Silvazine Cream, Duoderm and antibiotics. The patient received 30 hyperbaric treatments, six times a week, completing treatment on 15 December 1998. The patient required insertion of bilateral ear grommets under local anaesthetic. The breast ulcer showed a response to treatment with early healing after 7-8 days and clinical evidence of re-epithelization. At completion of 30 treatments the patient was left with a small shallow faintly discharging multilocular 3-4 cm ulcer. The ulcer had completely healed by 14 January 1999. The patient has been symptom free since completion of treatment. This report highlights the efficacy of hyperbaric oxygen therapy in the management of persisting radiation-induced ulcers.

Journal Article↗
PubMed1995

Locally advanced breast cancer: is surgery warranted following chemotherapy?

Various methods of management of locally advanced breast cancer have been proposed, including combinations of chemotherapy, surgery, radiotherapy, immunotherapy and hormone manipulation. This retrospective study evaluated the effectiveness of chemotherapy in the management of locally advanced breast cancer in pre- and perimenopausal women by examining the pathology of the mastectomy specimens. Sixteen women who on initial clinical examination had breast cancers measuring 5 cm or greater underwent chemotherapy prior to surgery. Four women were also treated with radiotherapy prior to surgery. All 16 women underwent mastectomy and axillary clearance. All specimens showed residual tumour in the mastectomy specimen or the regional lymph nodes. Chemotherapy is useful in reducing tumour burden to allow surgical resection, but does not produce centripetal shrinkage of tumour, nor sterilize the breast of cancer. In this small series, the addition of radiotherapy also failed to clear the patient of tumour. Wide surgical excision including the original tumour margins is thus required to achieve locoregional control. Until chemotherapy and radiotherapy regimens can be proved to sterilize the breast of tumour, we caution against the use of any surgery less than total mastectomy if optimal local control is to be achieved for locally advanced breast cancer in pre- and perimenopausal women.

Adult↗
PubMed1993

Benign breast disease. A practical guide.

A concise working guide to the syndrome of benign breast disorder is given for the busy general practitioner. An outline of the symptoms, current thoughts on pathophysiology and recommendations for treatment are discussed.

Female↗
PubMed1989

Mammographic hook wire localization--a step by step guide.

A practical approach to hook wire localization of impalpable mammographic lesions is described, together with hints and potential pitfalls. A standard set of five radiographic projections is outlined. This consists of: 1. The "Right Angle" View 2. The "Needle Placement" View 3. The "Depth Adjustment" View 4. & 5. The "Hook Check" Views Modifications of the technique for more experienced operators are also described. The technique is simple and accurate in many circumstances.

Breast Neoplasms↗
PubMed1983

Elastosis and primary breast cancer.

One hundred sixty-five patients with primary operable breast cancer were followed for up to 60 months. Each patient had the amount of focal elastosis and the estrogen-receptor activity within the tumor determined, as well as the tumor size, axillary nodal palpability, and nodal involvement. The risks of recurrence and death were compared by constructing life tables and assessing differences in various subgroups. There was no demonstrated association between tumor elastosis and the patients' age, menstrual status, the palpability of axillary lymph nodes, or the pathological states of these nodes at mastectomy. A tendency for larger tumors to have less elastosis was noticed. A significant association between the grade of elastosis and the presence, or absence, of estrogen-receptor activity was seen. The degree of focal elastosis in the primary tumor, alone, was disappointing as a prognostic factor. A strong suggestion that estrogen-receptor activity is a better indicator of prognosis was present.

Axilla↗
PubMed1983

Localization and excision of occult breast lesions.

Between 1976 and 1982, 190 non-palpable mammographic abnormalities considered to be suspicious of malignancy were excised using a needle localization technique. The indications for biopsy, technique for localization, method for confirmation of excision and histopathological preparation are presented. The histopathological diagnosis of these lesions were 150 benign and 40 malignant. There was no clear correlation between the mammographic appearances and the occurrence of cancer. Compared with 100 consecutive women with palpable breast cancer the impalpable and mammographically detected tumours were smaller, more often non-invasive and associated with negative axillary nodes.

Adult↗
PubMed1982

Oestrogen receptors and primary breast cancer.

Oestrogen receptor activity has been determined in the primary tumours from 243 patients with breast cancer and the subsequent clinical course of the disease has been followed for one to five years. Patients with oestrogen receptor-negative tumours had significantly shorter disease free intervals and survival times than those with receptor-positive tumours. Patients with large tumours, or with palpable axillary lymph nodes, or with histopathologically proven involvement of axillary lymph nodes also had a poorer prognosis than those with small tumours, impalpable nodes or histopathologically noninvaded nodes. The prognostic value of oestrogen receptor status was independent of these other three indices so that combination of receptor status and node status permitted definition of groups of patients with particularly good and particularly bad prognosis. The independence of these prognostic indices may relate to the possibility that whilst oestrogen receptor status is an index of the intrinsic biological behaviour of the tumour, nodal involvement and tumour size are more likely to reflect the chronological stage in the course of the disease at which the patient presents.

Breast Neoplasms↗
PubMed1982

Breast localization biopsy.

Nineteen localization biopsies were performed on eighteen women, where routine mammography revealed impalpable abnormalities. These abnormalities are described and the results of biopsy given. Six carcinomas were detected, all of which were shown to have no evidence of metastatic disease.

Biopsy↗
PubMed1981

Factors affecting dehydroepiandrosterone sulphate levels in human breast secretions.

Human breast secretions as collected by nipple aspiration have been analysed for dehydroepiandrosterone sulphate by radioimmunoassay. All secretions collected from non-lactating normal women contained remarkably high levels of dehydroepiandrosterone sulphate as compared with plasma taken at the same time. Although there was a large range of concentrations, levels were of a similar magnitude in different ducts from the same breast and in different breasts from the same individual. No significant difference was detected between secretions from pre and postmenopausal women. Sequential sampling of breast secretions through the menstrual cycle in two normal premenopausal women showed no cyclic variation in dehydroepiandrosterone sulphate concentration. There was also no significant difference between levels in breast secretions obtained from normal women and patients with either malignant or benign breast disease. Analysis of secretions from tumour and non-tumour bearing breasts in cancer patients failed to show consistent differences although, in contrast to normal women, the variation between breasts in individual patients was often marked.

Adult↗
PubMed1981

Milk protein concentrations in the mammary secretions of non-lactating women.

Milk protein concentrations were determined either by double antibody radioimmunoassay (IgA and IgG) or single radial immunodiffusion (lactoferrin) in the mammary secretions of seven healthy non-lactating subjects and eight patients with breast disease. IgA and IgG were detected in all samples of breast secretion (whether from normal or diseased breasts) and the concentrations observed were very similar to those in post-partum colostrum and milk. However, because the volume of secretion obtained was very small compared with colostrum and milk, total IgA synthesis by the non-lactating breast is very much less than in the lactating breast. The IgA detected in the mammary secretions was demonstrated to be secretory IgA by gel filtration and it is therefore suggested that the secretory immune system is functional in the non-lactating breast.

Adult↗
PubMed1980

Preoperative assessment and staging of breast cancer: preliminary communication.

A prospective study has been carried out in 172 women to determine the sensitivity of methods to detect occult metastatic disease in the skeleton and liver. With the exception of bone scintiscans, the results of these tests bore little relationship to recurrence rates. On the other hand, knowledge of the histopathology of the lower axillary (pectoral) lymph nodes is of value in this respect.A follow-up study is also reported which confirms the importance of accurate measurements of the primary tumour clinical node status and oestrogen receptor contact of the tumour in defining prognostic groups. Elastosis (estimated in 165 tumours) did not prove to be a useful prognostic index.

Bone Neoplasms↗