Biomedical subjects

A Marchbank

Publications and source records attributed to A Marchbank.

4 recordsLinked to original sources

PubMed2002

Implementation of the British Thoracic Society recommendations for organising the care of patients with lung cancer: the surgeon's perspective.

BACKGROUND: The British Thoracic Society (BTS) recognises that it is of paramount importance to ensure that all patients with a working diagnosis of lung cancer have access to first class care [The Lung Cancer Working Party of the British Thoracic Society Standards of Care Committee. BTS recommendations to respiratory physicians for organising the care of patients with lung cancer. Thorax 1998; 53 (Suppl 1): S1-81. METHODS: A retrospective audit of the time involved in the management of patients with lung cancer referred for consideration of surgery at the Royal Brompton Hospital was carried out. Our performance was compared with the BTS recommendations. RESULTS: The notes from 194 patients were analysed, accounting for 93.7% of patients referred with lung cancer in a 1-year period. A total of 90 patients fulfilled the criteria for analysis as they had potentially resectable disease at referral; 59 (65.5%) underwent thoracotomy, and 31 (34.5%) were considered inoperable. The median interval between the onset of symptoms and their first chest radiograph was 39 days, and between the onset of symptoms and referral to a surgeon by a chest physician was 112 days. The median interval between referral by a respiratory physician and surgical out-patient attendance was 14 days, and between referral by a respiratory physician and the surgical procedure was 32.5 days. The median length of time from surgical out-patient attendance to the surgical procedure was 17 days. There was no association between the interval between the onset of symptoms and the surgical procedure with advanced tumour stage at surgery. CONCLUSIONS: There are a number of sources of delay in the referral process for a patient with potentially resectable lung cancer. Most patients referred to our unit were treated within the time scale recommended by the BTS. Our survey has shown that there are cumulative delays in the overall investigation and management of lung cancer patients, which are not covered by the BTS guidelines, and which result in unacceptable delays for most patients.

Adult↗

PubMed2001

CUSP/p63 expression in rat and human tissues.

The human homolog of KET, p63, bears strong homology to the tumor suppressor p53 and plays an essential role in epithelial development. CUSP, the most abundant cutaneous product of p63, has been identified as an autoantigen in chronic ulcerative stomatitis (CUS). The original report of KET expression at least partially contradicts p63 expression subsequently reported by many different groups. We have examined p63 expression by Northern analysis of RNA from multiple human tissues and by indirect immunofluorescence of rat tissue with CUS patient sera. Northern analysis reveals p63 RNA in skin, thymus, placenta, skeletal muscle, kidney, and lung, with non-transactivating p63 RNA in skin, thymus, and placenta. Reverse transcriptase polymerase chain reaction (rtPCR) assays show abundant non-transactivating p63 RNA, and little to no transactivating p63 RNA, in human basal cell carcinoma as well as in normal skin adjacent to the tumors. p63 RNA expression was not detected in brain, heart, colon, spleen, liver, or small intestine. Immunofluorescence reveals p63 expression in skin, oral epithelium, tongue, kidney, and trachea, but not in liver, large intestine, testis, skeletal muscle, or heart. Focal p63 expression within tissues, the complex array of isoforms encoded by the gene, and the specificity of the probes and antibodies utilized, may all contribute to contradictory accounts of CUSP/p63 expression.

Animals↗

PubMed1999

Characterization of an autoantigen associated with chronic ulcerative stomatitis: the CUSP autoantigen is a member of the p53 family.

A unique clinical syndrome has been described in which patients have chronic oral ulceration and autoantibodies to nuclei of stratified squamous epithelium. We have characterized the autoantibodies from patients sera and found that the major autoantigen is a 70 kDa epithelial nuclear protein. Sequencing of the cDNA for this protein, chronic ulcerative stomatitis protein, revealed it to be homologous to the p53 tumor suppressor and to the p73 putative tumor suppressor, and to be a splicing variant of the KET gene. The p53-like genes, p73 and the several KET splicing variants, are recently described genes of uncertain biologic and pathologic significance. This study provides the first clear association of a p53-like protein with a disease process.

Autoantigens↗

PubMed1995

Fluorocarbon emulsions.

Perfluorocarbon emulsions have been the topic of intense investigation for many years and presently there are still no absolute indications for their use in clinical practice. The relatively disappointing results of the early clinical studies, as a consequence of using low concentrations of a relatively underdeveloped emulsion, have been responsible for a largely negative impression and it is now essential that the newer second generation emulsions should be judged individually with regard to their efficacy and toxicity under different circumstances. Technological advancement in the fields of chemistry and detergent/emulsifier research will continue and new formulations are being developed which which will require to be tested in models in the laboratory. In the future, this class of drugs will continue to be the topic of intense investigation and their mechanisms of action, which are undoubtedly more complex than the simple carriage of dissolved gases in solution, will be clarified. However, whether fluorocarbon emulsions will ever be used as a 'blood substitute' as was originally anticipated is doubtful.

Anemia↗