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Biomedical subjects

D I Robertson

Publications and source records attributed to D I Robertson.

31 records · Page 2Linked to original sources

Recurrent and persistent squamous cell cervical carcinoma in women under age 35.

Forty-five patients with invasive cervical squamous cell carcinoma were registered in the Tom Baker Cancer Centre from 1980 to 1985. The natural history of 22 patients (48.9%) who developed persistent or recurrent disease including 11 Stage IB, 8 Stage IIB, and 3 Stage IIIB is reported. Only one patient who had the uncommon papillary variant is alive without evidence of residual disease. The remainder are either dead (16) or alive with residual disease (5). Four patients never achieved a disease-free status and in the remainder recurrences developed on average in 8.7 months. Central or regional disease was not controlled in 20 of 22 patients. Neither radical surgery nor radiotherapy was evidently more effective in preventing persistent or recurrent disease. A reliable predictive marker for persistent or recurrent disease is required: lymph-vascular invasion in the radical hysterectomy specimens was present in 5 of 6 cases but it is subject to interpretive error. Since the disease is frequently systemic at the time of diagnosis, early adjuvant therapy and improved staging techniques are required to improve the survival.

Adult↗

Endometrial carcinoma occurring in patients under the age of 45 years.

Endometrial adenocarcinoma is frequently unsuspected in women under the age of 45 years by the gynecologist or the pathologist, but it does occur. Twenty-seven cases of endometrial adenocarcinoma in this age group, from 1980 to 1985, were reviewed clinically and pathologically. Five cases were excluded by histologic examination. Obesity and abnormal vaginal bleeding were shown to be risk factors. Endometrial screening is to be encouraged. This cancer may arise de novo rather than from a premalignant precursor. Implications of this neoplasm for the premenopausal woman are considered.

Adult↗

Influence of dietary linoleic acid on leucocyte sodium transport and blood pressure.

In a randomised double blind study to determine whether an increase in the polyunsaturated fat linoleic acid might influence leucocyte membrane sodium transport 22 normotensive volunteers received an oral supplement of linoleic acid or placebo daily for four weeks. Mean total sodium efflux rose significantly during supplementation with linoleic acid compared with placebo. In addition, all components of lying and standing blood pressure fell, though only the fall in supine systolic pressure was significant. Dietary supplementation with linoleic acid may alter ion fluxes across the cell membrane, presumably through changes in its physicochemical structure. In addition, the change in fat intake may lower blood pressure, though to only a very modest extent.

Biological Transport↗

Inguinal intranodal blue nevus: a case report.

Inguinal intranodal blue nevus is a rare lesion, but awareness of the condition will avoid a mistaken diagnosis of metastatic melanoma. The authors describe the case of a 40-year-old woman in whom an inguinal node blue nevus was discovered incidentally during radical vulvectomy for squamous cell carcinoma. They describe the characteristic light and electron microscopic features. With increased awareness of this lesion the authors believe it will be found in lymph-node chains other than the inguinal and axillary ones previously reported.

Abdominal Neoplasms↗

Development of ovarian carcinoma in a cyclosporin A immunosuppressed patient.

This is the first report of an ovarian carcinoma developing in a patient immunosuppressed by Cyclosporin A. Thirteen months before the diagnosis of malignancy, the patient received a living related donor kidney transplant whose rejection was controlled by Cyclosporin A and prednisone. The tumor was rapidly fatal five weeks from diagnosis. The literature on malignant transformation in the immunosuppressed patient is reviewed with emphasis on a gynecologic perspective.

Adult↗

Monophasic synovial sarcoma, epithelioid sarcoma and chordoid sarcoma: ultrastructural evidence for a common histogenesis, despite light microscopic diversity.

Ultrastructural examination of six rare sarcomas--four monophasic spindle cell tumours, one epithelioid sarcoma, one chordoid sarcoma--has revealed marked similarities at the electron microscopic level despite widely divergent light microscopic appearances. These features consisted of: 1 the presence of two cell types, viz. a clear cell and a cell resembling the fibroblast; 2 pseudoglandular spaces with projecting microvilli or filopodia, and with related tight junctions; 3 an amorphous intercellular ground substance with focal condensation into recognizable basement membrane. The findings suggest a common maturation of these diverse tumours to synovial-like tissue, and support the proposal of Hajdu Shiu & Fortner (1977) that these be considered variants of synovial sarcoma. Published ultrastructural studies of synovial, epithelioid and chordoid sarcoma are reviewed in the light of these findings. The ultrastructural differentiation of synovial sarcoma from extraskeletal myxoid chondrosarcoma, chordoma and the spectrum of malignant spindle cell tumours is discussed.

Adult↗

Sclerosing stromal tumor of the ovary.

This case study of a sclerosing stromal tumor of the ovary in a 29-year-old woman demonstrates that the tumor was a functioning lesion that secreted estradiol, progesterone, and testosterone. Clinically, there was anovulation with resultant infertility, which was resistant to therapy with clomiphene citrate. Removal of the tumor was followed by reversal of these abnormalities.

Adult↗

Hypertrophic osteoarthropathy complicating metastatic ovarian adenocarcinoma.

This report documents for the first time the association of hypertrophic osteoarthropathy with ovarian adenocarcinoma metastatic to the lung, in a 47-year-old woman who became totally incapacitated by her joint pain. Surgical removal of the lung metastases resulted in prompt relief of her pain. Theories of the pathogenesis of this clinical syndrome are reviewed. They include neurovascular, humoral and estrogenic mechanisms. Pulmonary arteriovenous shunting has also been considered in the pathogenesis. Operation should be considered in all patients who area incapacitated by joint pain associated with metastatic disease in the lungs.

Adenocarcinoma↗

Malignant carotid body paraganglioma: light and electron microscopic study of the tumor and its metastases.

A right carotid body paraganglioma (CBP) was removed from a 30-year-old female after finding metastases to cervical lymph nodes. The tumor and its metastases were studied by light and electron microscopy to determine the neoplastic cell type. Light microscopy confirmed the presence of chief cells but was inadequate alone to exclude sustentacular cells. By electron microscopy, only chief cells were found in both the primary and secondary tumors. This is the first report of an ultrastructural study of a metastasis from a malignant CBP. From our observation, we suggest that CBP be defined as a proliferation of chief and sustentacular cells. Electron microscopy is essential to determine the cell types present and thereby help classify the lesion as a tumor or hyperplasia of the carotid body.

Adult↗

Chordoid sarcoma: ultrastructural evidence supporting a synovial origin.

A case of chordoid sarcoma which presented as a painful mass on the dorsum of the right hand in a 72-year-old man was studied by light and electron microscopy. The tumor was composed of lobules separated by thin connective-tissue bands. At the periphery of the lobules, the cells were epithelioid in appearacne and there were numerous nests of clear cells. From the periphery, stellate and spindle shaped cells were radially oriented and formed a loose cobweb arrangement in an abundant loose ground substance. Distinctive ultrastructural features included pseudoacinar formation, microvilli, long cytoplasmic filopodia (often with complex interdigitations), numerous desmosomes, partial basal lamina, scanty endoplasmic reticula, and numerous intracytoplasmic filaments 80--100 A in width. We believe these ultrastructural features indicate a synovial origin of this uncommon neoplasm.

Aged↗

Postmastectomy lymphangiosarcoma: experience with three patients and electron microscopic observations in one.

The clinical features are presented of three patients in whom lymphangiosarcoma developed after radical mastectomy followed by local irradiation. The median time between radical mastectomy and the diagnosis by biopsy of lymphangiosarcoma was 9.9 years. No form of therapy, including high-dose combination chemotherapy, appeared able to control the disease. All three patients died with residual lymphangiosarcoma and in two it was the direct cause of death. These results stress that prevention of postmastectomy lymphangiosarcoma is vital. This can be accomplished by avoiding radical mastectomy followed by local irradiation. Ultrastructural observations in one case suggest that the tumour has a primitive vasoformative origin.

Adult↗

Cervico-vaginal screening in an STD clinic.

From May 1986 to March 1988, there were 3,622 "new" female clients at the Calgary Sexually Transmitted Disease (STD) Clinic of whom 2,278 registered for the first time. A cervico-vaginal (Pap) smear was obtained from those who had not had one in the previous 6 to 12 months and any history of venereal warts (VW) was recorded. 621 smears were accessed of which 611 were suitable for inclusion in this study. 65 (10.6%) smears revealed human papillomavirus (HPV) and/or cervical intraepithelial neoplasia (CIN). Any history of VW increased the likelihood of an abnormal smear by 5.3 times. Those with currently visible VW were more likely (8.8 times) to have an abnormal smear than those with a past history (3.5 times). These data re-affirm the recommendation of the first "Walton Report" that Pap smears should be obtained in STD Clinics.

Canada↗