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Biomedical subjects

A Charlton

Publications and source records attributed to A Charlton.

At least 19 recordsLinked to original sources
PubMed2005

Biphasic sarcomatoid basal cell carcinoma (carcinosarcoma): four cases with immunohistochemistry and review of the literature.

BACKGROUND: Biphasic sarcomatoid carcinoma (BSC), or carcinosarcoma, is an uncommon biphasic neoplasm that has been reported in diverse anatomical sites. The tumor is composed of a malignant epithelial component intimately associated with a malignant mesenchymal component, which may be homologous or heterologous. Twenty-three cases of primary cutaneous BSC have been reported in the English literature. In only eight of these cases was basal cell carcinoma the epithelial component. METHODS: We report a further four cases of primary cutaneous biphasic basal cell carcinoma, and include the clinical, histological and immunohistochemical features. RESULTS: The four cases showed basal cell carcinoma associated with a pleomorphic sarcomatous stroma. In addition, myofibroblastic differentiation and foci of osteoid were present in one case, and leiomyosarcomatous areas in another. The epithelial components were positive for several epithelial markers. The mesenchymal components were positive for vimentin and CD99, and negative for epithelial markers. p53 was positive with equal intensity in both epithelial and mesenchymal components. A significantly worse outcome was observed in patients with tumors measuring 40 mm or more at excision. CONCLUSIONS: The sarcomatous component of the tumor is best regarded as a metaplastic transformation of the carcinomatous component. These tumors are potentially aggressive if incompletely excised, and complete resection is recommended.

12E7 Antigen↗
PubMed2005

Chromoendoscopic surveillance in hereditary diffuse gastric cancer: an alternative to prophylactic gastrectomy?

BACKGROUND: Hereditary diffuse gastric cancer (HDGC) is defined by germline mutations in the E-cadherin gene, CDH-1. The first family in which CDH-1 mutations were identified was a large Maori kindred, where lifetime penetrance is 70%. Prophylactic gastrectomy is an unacceptable option for many mutation carriers. The results of annual chromoendoscopic surveillance using the methylene blue/congo red technique in 33 mutation carriers over a five year period are described. PATIENTS AND METHODS: Thirty three confirmed CDH-1 mutation carriers (18 males, 15 females), median age 32 years (range 14-69), were enrolled in 1999-2003. Medical records, endoscopy, and pathology were reviewed retrospectively. RESULTS: Over five years, 99 surveillance endoscopies were performed, of which 93 were chromo-dye enhanced. Sixty nine chromoendoscopies were normal. In 24 procedures, 1-6 pale areas/stomach (size 2-10 mm) were detected post chromo-dye application (totalling 56 pale lesions). One biopsy was taken from each pale lesion: 23 lesions (41%) showed signet ring cell carcinoma (10 patients), 10 lesions (18%) gastritis (four patients), and 23 (41%) normal mucosa (10 patients). No chromo-dyes were used in six procedures with macroscopic lesions (two HDGC, four ulceration). Total gastrectomies from patients with carcinoma were macroscopically normal but pathological mapping showed multiple microscopic foci of early signet ring cell carcinoma. Correlation of chromoendoscopic and gastrectomy findings showed that congo red/methylene blue detected carcinoma foci 4-10 mm in size but not foci <4 mm. CONCLUSIONS: The use of chromoendoscopy following normal white light gastroscopy facilitated detection of early gastric carcinoma foci not visible with white light gastroscopy. If these findings are validated in other HDGC kindred, chromogastroscopy represents an improved surveillance technique that can be safely considered alongside prophylactic gastrectomy.

Adolescent↗
PubMed2004

Hereditary diffuse gastric cancer: predominance of multiple foci of signet ring cell carcinoma in distal stomach and transitional zone.

BACKGROUND AND AIMS: Germline mutations in the CDH-1/E-cadherin gene are, to date, the only known cause of hereditary diffuse gastric cancer (HDGC). While two recent series of prophylactic gastrectomy described microscopic foci of signet ring cell carcinoma in sample sections from 10 macroscopically normal stomachs, whole stomach phenotype has not been mapped. We aimed to describe the size and distribution of foci in relation to mucosal zones and anatomical location. METHODS: Six patients (from three HDGC kindred) were referred for total gastrectomy via three different referral pathways. Following fixation, five stomachs were completely blocked and one extensively sampled. Histopathology was mapped to a mucosal photograph of each stomach, enabling precise localisation of carcinoma foci, benign pathology, and mucosal zones. RESULTS: There were 4-318 microscopic foci of intramucosal signet ring cell adenocarcinoma in the six macroscopically normal stomachs (foci size 0.1-10 mm in diameter). The distal third of the stomach contained 48% of total foci (range 29-75%). The body-antral transitional zone occupied 7.7% of mucosal area (range 3.6-11.8) but had 37% of foci (range 10%-75%). The largest foci were found in the transitional zone and foci density was five times greater in the transitional zone than in body or antral type mucosa. CONCLUSIONS: In germline CDH-1 mutation carriers, multiple microscopic foci of intramucosal signet ring cell carcinoma show a predilection for the distal stomach and the body-antral transitional zone. Targeting the transitional zone would maximise the likelihood of finding foci in macroscopically normal gastrectomies, and particular attention should be paid to this area during endoscopy.

Adolescent↗
PubMed2001

Changing patterns of cigarette smoking among teenagers and young adults.

In Britain at present the highest prevalence of smoking in people aged 16 years and over is among 20- to 24-year-olds. At this age, 42% of men and 39% of women smoke, compared with the overall rates of 28% and 26%. The problem is greatest in the less affluent socio-economic groups. Prevalence of regular smoking among 11- to 15-year-olds has changed little since 1982, although in 1999 it reached one of its lowest points, namely 9%. More girls than boys are smoking, e.g. 25% compared with 21% at age 15 years. Signs of developing nicotine dependence are already evident even in lighter smokers. Smoking behaviour in a country appears to follow a pattern where men start first, followed by boys, women and then girls. In most industrialised countries, prevalence for each group, except teenage girls, has peaked and reversed. Most developing countries are at an earlier stage in the pattern, which must be stopped now if millions of deaths are to be avoided.

Adolescent↗
PubMed2001

Vaginal adenosis with adenocarcinoma in situ in a woman with no recognised antecedent factors.

We present a case of vaginal adenosis with adenocarcinoma in situ in a woman with no recognised antecedent factors. This case demonstrates the importance of continuing thorough colposcopic assessment of the entire lower genital tract with repeated biopsies of all abnormal epithelium in women with persistent or recurrent cervical cytology abnormalities. Successful management requires accurate definition of the vaginal lesion.

Adenocarcinoma↗
PubMed2000

Current action for skin cancer risk reduction in English schools: a report on a survey carried out for the Department of Health.

The objective of this study was to identify current action for skin cancer risk reduction in English schools and thus set a baseline for future skin cancer risk reduction interventions. A postal questionnaire survey was sent to 1295 primary, 59 middle and 216 secondary school headteachers, a 10% sample of schools in England in 1998. Since the Health Education Authority/Department of Health/British Association of Dermatologists introduced the Sun Awareness Guidelines for Schools in 1995, seven items from the Guidelines, i.e. education, uniform, shade, outdoor activities, sunscreens, staff awareness, and parent and governor alliances were chosen as outcome measures. The results of the survey showed that most schools had taken at least one of the seven actions (mean 2.67, SD 0.88). Of the schools which addressed sun protection, the majority started to do so after the release of the Sun Awareness Guidelines in 1995. Judging from the length of time schools had been covering sun awareness issues, the proportion of schools which were just beginning to implement sun protection in 1995 was greater than those who began in the previous year. Teaching in the curriculum was the most frequent action taken, but the approach used was usually information giving. Brimmed hats and long sleeves were rarely part of summer school wear. Most schools had less than 25% of their outdoor break areas in shade, but action was being taken to increase this. Sports days were usually scheduled for the afternoon. Sunscreen use was allowed in over 80% of schools, but its application presented teachers with a dilemma. Few staff manuals contained sun awareness issues; few staff had attended in-service courses on the subject; two-thirds of headteachers would support their staff attending them. Few schools had developed parent and governor alliances. We conclude that help is needed for schools in the form of materials, courses, funds and clear Government policy if their action is to play a major role in reducing the incidence of skin cancer.

Adolescent↗
PubMed1999

Saying "no" to cigarettes: a reappraisal of adolescent refusal skills.

The principles of social inoculation developed in the late 1940s and later presented as a theory combined with Bandura's self-efficacy construct in the 1970s led to a series of smoking-prevention programmes for young people based on refusal skills. The present study examines refusal skills developed by young people who have not been taught such a programme. The survey was carried out by self-completed questionnaires administered to whole classes of 11-15-year-olds in two secondary schools in northern England. Harter's Self-Perception Profile for Children was used. Responses from 743 (365 boys and 378 girls) were analysed. Smoking prevalence reflected the national prevalence pattern for the age group at the time of the survey. Girls were at greater risk than boys of being repeatedly offered a cigarette and more likely than boys to accept it after more than two offers. Girls with high self-perception scores for all domains except social competence were at lowest risk of being offered a cigarette. For boys this only applied in the context of behavioural conduct. However, the factor most strongly related to multiple offers of cigarettes was having a best friend who smoked. Never smokers were most likely to have simply said "No, thank you" to proffered cigarettes but most had used several responses, boys generally using more refusal mechanisms than girls did. Cigarette refusal among young people is a complex process and programmes must be variable in order to meet specific circumstances, such as refusing a cigarette from one's best friend.

Adolescent↗
PubMed1999

Determination of metaldehyde in suspected cases of animal poisoning using gas chromatography-ion trap mass spectrometry.

A method was developed to detect the molluscicide metaldehyde in samples of stomach contents for forensic toxicology investigations. Gas chromatography-ion trap mass spectrometry in full-scan mode was used to identify and quantify metaldehyde. The limit of detection based on mass chromatograms for the m/z 89 ion was 3 microg/g. Mean recoveries from six different spiked samples were 74% at 25 microg/g and 94% at 500 microg/g. The relative standard deviation of six replicate determinations of a sample containing 632 microg/g metaldehyde was 7.3%.

Acetaldehyde↗
PubMed1997

Evaluation of a cancer-based coping and caring course used in three different settings.

Cancer in the family may affect the psycho-social adjustment of the children involved. Children who have survived childhood cancer or with a parent or sibling with cancer, may find protection from the risk of emotional and behavioural difficulties from effective external support systems. A training course was developed by the Cancer Research Campaign to help professionals who make up potential external support systems, cope with children experiencing cancer-related life crises. The course was offered to, and evaluated with, practising teachers, student teachers and Cancer Aid and Listening Line workers. Results from interviews and pre and post course questionnaires indicated that after the course all three groups felt more confident in dealing with children under stress. Participants felt that specific skills such as 'attentive listening' had increased as a result of the course. Of the three groups the practising teachers have found the course the most useful in their work and have been able to disseminate their newly acquired skills throughout their schools. Teachers are expected to cope with students' various life crises as they arise in schools. Basic counselling skills training for teachers could help them cope with these in a more confident manner, thereby reducing the risk of emotional and behavioural difficulties and contributing towards a Health Promoting School ethos.

Adaptation, Psychological↗
PubMed1996

Identification of pesticide poisoning in wildlife.

The Wildlife Incident Investigation Scheme investigates incidents of suspected poisoning of wildlife (also honey bees and companion animals) by pesticides in the United Kingdom. The approach to these investigations has evolved over the past 30 years. Field investigations, post-mortem examinations, toxicological data and experience of previous poisoning incidents assist in the selection and interpretation of appropriate chemical analyses. Several 'multi-residue' and several 'individual compound' analytical methods for pesticides in wildlife are currently in use; these are described.

Animals↗