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Biomedical subjects

A H Patterson

Publications and source records attributed to A H Patterson.

18 recordsLinked to original sources
PubMed2002

Increased nm23 immunoreactivity is associated with selective inhibition of systemic tumour cell dissemination.

AIMS: In vitro transfection experiments show that the nm23 gene suppresses metastasis, although the evidence from clinical studies is contradictory. The purpose of this study was to investigate whether nm23 selectively influences systemic, pleural, and lymphatic metastasis in non-small cell lung cancer (NSCLC). METHODS: Forty two patients undergoing resection of NSCLC and lymph node sampling were enrolled prospectively. In each case, a bone marrow aspirate, pleural lavage, and lymph nodes were assessed using immunohistochemistry for epithelial antigens and morphology. The intensity of nm23-H1 immunoreactivity of the primary tumour was compared with the internal control of normal bronchial epithelium in 32 cases where available. The microvessel count (MVC) of each tumour was determined using immunohistochemistry for the endothelial cell marker CD34. RESULTS: Tumour cell dissemination was detected in the bone marrow in 18 patients, in the pleura in seven, and in the lymph nodes in 21. Increased immunoreactivity for nm23 was found in the primary tumour in six patients, with none having tumour cells in the bone marrow, compared with 12 of 26 patients who showed nm23 immunoreactivity equal to or less than the control (Fisher's exact test: p = 0.043). This effect was confirmed to be independent of the MVC on multivariate analysis. There was no significant difference in the incidence of pleural or lymphatic tumour cell dissemination between the two groups. CONCLUSION: nm23 appears to be a suppressor of systemic, but not lymphatic, metastasis in primary NSCLC.

Aged↗
PubMed1999

Interphase cytogenetics of chromosomes 11 and 17 in fine needle aspirates of breast cancer.

The aims of this investigation were to compare quantitative with qualitative analysis of fluorescent in situ hybridization (FISH) centromere signals in interphase breast cancer cell nuclei and to evaluate the possible clinical utility of detecting numerical abnormalities of chromosomes 11 and 17 by FISH in the preoperative prediction of breast cancer histological grade. Commercial digoxigenin-labeled centromere probes to chromosomes 11 and 17 were hybridized to 69 malignant aspirates with histological follow-up. Aspirates were categorized as disomic or aneusomic for chromosomes 11 and 17 qualitatively; a subset of aspirates was also analyzed quantitatively. The quantitative and qualitative approaches resulted in almost identical categorisation. There was a significant association between the qualitative categorization of aspirates as aneusomic or disomic, the histological grade of the excised tumours (P = .0695, n = 69), and the cytological grade of the clinical aspirates (P = .006, n = 35). Although histological grade III tumors were almost invariably polysomic for one or both chromosomes, polysomy was also detected in grade I and II tumors. Qualitative FISH analysis was shown to be more sensitive than cytological grading in predicting histological grade III but was of lower specificity and was therefore not clinically useful.

Adult↗
PubMed1999

Use of alcohol fixed cytospins protected by 10% polyethylene glycol in immunocytology external quality assurance.

AIMS: To provide cytospins as a means of external quality assurance (EQA), while maintaining antigen expression integrity and achieving uniformity of material for all participating laboratories. METHODS: Cells were collected from two adenocarcinoma and one reactive pleural effusion specimens. Lymphoid cells were also collected through aspiration of a resected tonsil specimen. All cells were collected in Hanks balanced salt solution (HBSS); cytospins were made and fixed in methanol or acetone alone or protected using a layer of 10% polyethylene glycol (PEG) in 50% methanol. Two laboratories participated (RGHT and UCL). RESULTS: Cytokeratin expression detected using either CAM5.2 or AE1/AE3 antibodies was sensitive to temperature. Without PEG, unacceptable or negative staining was seen within six weeks of preparation. LCA was not sensitive to temperature, with good staining scores being achieved after eight weeks following preparation. CONCLUSIONS: It is possible to send alcohol fixed, air dried cytospins to laboratories participating as part of an EQA scheme for immunocytology. Some antigens will require protection from temperature variations during transit. A layer of 10% PEG in 50% methanol, allowed to air dry, is suitable for this purpose. Participating laboratories will only have to remove this layer using methanol before their localisation technique for assessment.

Adenocarcinoma↗
PubMed1999

Fluorescence in situ hybridisation detection of erbB2 amplification in breast cancer fine needle aspirates.

AIM: To develop a method for the detection of amplification of the erbB2 oncogene in breast cancer fine needle aspirates using fluorescence in situ hybridisation (FISH) and to compare amplification with immunohistochemical detection of the erbB2 protein. METHODS: A digoxigenin labelled probe to the erbB2 gene was hybridised to 15 aspirates prepared from operative breast cancer specimens. A chromosome 17 centromere probe was also hybridised to the aspirates either separately or in combination with the erbB2 probe. The aspirates were scored for erbB2 amplification and chromosome 17 centromere number. Subsequently, paraffin wax embedded sections of the tumours were stained with the antibody CB11 and scored for the presence of membrane staining. RESULTS: Three of the 15 tumour aspirates showed high level amplification of erbB2 detected by FISH. These three tumours also showed chromosome 17 polysomy and diffuse membrane staining by immunohistochemistry. CONCLUSIONS: FISH can be used to detect erbB2 amplification in fine needle aspirates and results correlate with conventional immunohistochemical staining. Difficulties were encountered in the visualisation of the signals in non-amplified cases without the use of specialised digital imaging.

Biopsy, Needle↗
PubMed1998

Detection of chromosomal numerical abnormalities in clinical breast tumour fine-needle aspirations by fluorescence in situ hybridisation (FISH): refinement of a method.

This study sought to refine a fluorescence in situ hybridisation (FISH) technique for the study of numerical chromosome aberrations in cells recovered from breast tumours by fine-needle aspiration (FNA). Such techniques have been used to study numerical aberrations of chromosomes from tumours from many sites. This technique is intended for use in a routine cytopathology laboratory, and no specialised cytogenetics knowledge is necessary. Slide preparation, slide and probe denaturation, and stringency conditions were investigated. We found that the simplest slide preparation technique (direct smears) gave the best results. No difference was seen when slide and probe were denatured together or separately. Stringency conditions must be adapted to suit particular probes. Study of numerical chromosomal changes may help determine their significance in the clinical progression of the disease. Such changes may prove to have prognostic significance and therefore influence treatment of breast cancer. FISH on interphase cells is a technically straightforward, reproducible technique, suited to the study of numerical chromosome aberrations in tumour cells. The method has the potential for use in the study of malignant cells from sites other than breast, including ovary, prostate, lung and bladder.

Biopsy, Needle↗
PubMed1990

The medical liability crisis: the New York experience.

The past 15 years have not been easy for the doctors who manage Medical Liability Mutual. There have been many frustrations and setbacks, and at times the predictors of doom for MLMIC seemed to be correct. Despite all the difficulties, the board of directors has never deviated from its original basic principles: (1) to attempt to settle meritorious claims rapidly and to resist totally those claims without merit; (2) to invest funds with caution and prudence, while achieving the best possible return on that investment; (3) to reduce medical injury and enhance patient safety; and (4) to make every effort to change a system that does not serve the public and threatens our health care system. The next five years may well be even more hectic than the past 15 have been. We do not know the reasons for the recent apparent improvement, and the situation may well deteriorate again. It is to be hoped that major changes that will benefit the public as a whole will occur, and that in the future the concerns of professional liability will not consume as much of our time and resources as they do at present.

General Surgery↗
PubMed1980

The anterior impingement syndrome of the ankle.

Four cases in professional athletes and a ballet dancer of what we would like to term the anterior impingement syndrome of the ankle are described. A brief review of the very sparse literature is presented. The cause is felt to be the repeated pull of the anterior ankle joint capsule and the impingement of the talus against the tibia in running and jumping leading to calcific deposits along the lines of the capsular fibers. We feel that any athlete who has pain or limitation of motion secondary to the anterior impingement syndrome should be considered for surgical removal of the offending spurs. The four patients were able to return to their previous activity levels.

Adult↗
PubMed1976

Decreasing fuel-oil consumption through feedback and social commendation.

The energy crisis of the winter of 1973-74 led to severe shortages of fuel oil for home heating and a government request for voluntary conservation by the oil consumer. This experiment tested two methods of facilitating fuel-oil conservation. Home fuel-oil consumers were randomly assigned to one of three experimental groups: feedback of information on rate of oil use, feedback plus commendation for reduced consumption, or a no-treatment control. The consumption rate for the feedback plus commendation group was significantly lower than that of either the informational feedback group or the control group. The informational feedback group did not differ from the control group. The results suggest that feedback alone may not result in oil conservation, but that feedback combined with commendation can produce socially significant savings.

Journal Article↗
PubMed1976

Ruptures of the tendo achillis. An objective assessment of surgical and non-surgical treatment.

A comparative study is presented of seventy-nine patients with rupture of the tendo achillis, forty-eight of whom were treated surgically and thirty-one, non-surgically. With one exception, all were healthy, athletic individuals. Twenty-two per cent of the patients had an initial misdiagnosis. The patients treated surgically were more satisfied with the results of their treatment. Strength, power, and endurance as measured on the Cybex II dynamometer revealed that the patients treated non-surgically attained only 72 per cent of normal strength and 70 per cent of normal power and endurance as compared with the surgically treated patients. Wound complications occurred in only two patients and no reruptures occurred in the surgically treated group, whereas there were nine rereptures in the group not treated surgically.

Achilles Tendon↗
PubMed1975

Ten years' experience with femoral shaft fractures.

One hundred one patients with femoral shaft fractures treated by open reduction and intramedullary fixation have been presented. The results demonstrated no nonunions in nonpathologic bone; less than 2% infection; clinical union in 4 to 6 months; radiologic union at 6 to 8 months; excellent range of knee motion in more than 90% of patients; unsupported full weight-bearing usually present by the eighth postoperative week, and an average hospital stay of 6 to 7 weeks. The advantages and disadvantages of the most common methods of treatment of femoral shaft fractures have been reviewed. The non-operative approach of cast-bracing has yielded encouraging results in the hands of those well-trained in its application. Weighing the advantages and disadvantages of the operative and nonoperative techniques, as described, we feel that open reduction and internal fixation with an intramedullary rod is still the treatment of choice for most femoral shaft fractures, in the hands of most orthopaedic surgeons.

Adolescent↗