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Biomedical subjects

J F Robertson

Publications and source records attributed to J F Robertson.

At least 163 records · Page 9Linked to original sources
PubMed1989

Ki67 immunostaining in primary breast cancer: pathological and clinical associations.

Ki67 immunostaining has been performed on 136 primary breast cancers and related to various clinical and pathological features of the disease. Staining was most frequently seen in poorly differentiated tumours showing high rates of mitotic activity, but was independent of tumour size, lymph-node status and ER expression. A high level of Ki67 immunostaining was often associated with early recurrence of breast cancer after mastectomy. These data are consistent with the concept of the Ki67 antibody detecting an antigen that is closely related to cell proliferation and thus provides a clinically useful marker for this important characteristic of the tumour.

Adult↗
PubMed1989

Mitoxantrone--a useful palliative therapy in advanced breast cancer.

We have treated 76 patients with advanced breast cancer with single-agent mitoxantrone: all had previously received hormone therapy and 30 patients had also received prior chemotherapy. The overall response rate at 6 months was 15%, with a further 22% having static disease. Responding and static patients had similar survival curves and were grouped together as patients with "stable disease." Patients with stable disease had a significantly longer survival than patients with progressive disease (p less than 0.001); the median difference in survival was 9 months.

Breast Neoplasms↗
PubMed1989

Granulomatous lobular mastitis.

The clinical and histological features of six cases of granulomatous lobular mastitis are presented. All six patients were parous. 1-6 years after their last pregnancy with a mean age of 34 years; all had unilateral disease and presented with an extra-areolar breast lump. Histologically, all demonstrated a non-caseating granulomatous inflammatory condition centered on breast lobules; in four women there was an acute inflammatory process with micro-abscess formation. Five of the six cases had persistent or recurrent disease despite wide local excision: surgery might not be the best treatment for recurrent disease.

Adolescent↗
PubMed1989

Review of the endocrine actions of luteinising hormone-releasing hormone analogues in premenopausal women with breast cancer.

The endocrinological actions of the luteinising hormone-releasing hormone (LHRH) analogue, Zoladex (goserelin) in premenopausal women with advanced breast cancer are reviewed. LHRH analogues are an interesting addition to the currently available treatments for hormone-sensitive breast cancer in premenopausal women. Their modest side effects and ease of administration are in contrast to the risks and morbidity of surgical endocrine therapy.

Adult↗
PubMed1989

Zoladex in advanced breast cancer.

In the treatment of 53 premenopausal patients with advanced breast cancer, the LHRH analogue, Zoladex (goserelin), produced a response rate similar to that of surgical oophorectomy. Endocrinologically, Zoladex caused castrate levels of serum oestradiol and progesterone except in a small number of patients, where intermittent, suppressed peaks of oestradiol persisted. Treatment of 34 premenopausal patients with Zoladex combined with the anti-oestrogen tamoxifen (Nolvadex) produced significantly lower levels of serum oestradiol; all patients had castrate serum oestradiol levels. It is suggested that a prospective randomised study is necessary to determine any clinical advantage from such a combination.

Breast Neoplasms↗
PubMed1988

Effect of LHRH agonist, Zoladex, on ovarian histology.

In a phase I clinical trial Zoladex was used as first line hormonal therapy in premenopausal women with advanced breast cancer. Patients on progression of their disease underwent surgical oöphorectomy. The histology of ovaries from 23 women treated with Zoladex has been compared with the ovaries from 34 patients who, before the clinical trial of Zoladex, underwent surgical oöphorectomy as primary therapy. Both groups show similar follicular phase development. Only 13 per cent of the Zoladex group developed corpora lutea while 58 per cent showed evidence of luteinization in the primary oöphorectomy group (P less than 0.01). Non-neoplastic follicular cysts were seen more often in the ovaries of the Zoladex treated patients than in the primary oöphorectomy group (P less than 0.05). Zoladex appears to arrest not folliculogenesis but follicular maturation with inhibition of ovulation, the follicles subsequently undergoing atresia with follicular cyst formation.

Breast Neoplasms↗
PubMed1988

Choledochal cyst: a 33-year review.

We present 13 patients who were seen at Glasgow hospitals over a 33-year period. Only five (38 per cent) were children. Of the eight adults, two had complications of the cyst at presentation, namely biliary cirrhosis and cholangiocarcinoma respectively. Another adult patient developed a carcinoma in the cyst 9 years after internal drainage. The incidence of malignant change in the series was therefore 15 per cent. Only five patients have remained well after surgery: three had complete excision and two internal drainage. Of the eight other patients, one had complete excision, five had internal drainage, one had partial excision and one had cholecystectomy and (years later) sphincterotomy. We believe that excision of the cyst is the treatment of choice.

Adult↗
PubMed1988

Cholelithiasis in childhood: a follow-up study.

Fifteen children with cholelithiasis who were treated at the Royal Hospital for Sick Children, Glasgow between 1973 and 1985 are reviewed. Ten patients had idiopathic gallstones and five had gallstones in association with hereditary spherocytosis. All patients have been followed up for between 4 months and 12 years (mean 4.1 years): ultrasonography has been carried out on 13. Fourteen patients underwent surgery of whom only seven had symptoms from their gallstones. Nine patients had cholecystostomy and removal of gallstones, four patients had cholecystectomy (one had negative exploration of the common bile duct in addition) and one patient with choledocholithiasis underwent choledochotomy with transduodenal sphincterotomy. One patient did not have surgery; she has remained asymptomatic and ultrasound examination confirms that she still has a solitary gallstone in her gallbladder. Clinical review with ultrasonography shows that cholecystostomy with removal of gallstones appears to be an acceptable alternative to cholecystectomy.

Adolescent↗
PubMed1988

Assent to ascent of the testis.

We report 13 boys in whom the testis ascended from the normal scrotal position to an undescended position. A patent processus vaginalis was identified in 10 patients at orchidopexy and is believed to have contributed to testicular ascent. The other three patients had retractile testes which were held in the high position by surrounding adhesions.

Child↗
PubMed1987

Surgery for necrotizing enterocolitis.

Thirty-seven patients who had necrotizing enterocolitis and required emergency surgical intervention are reviewed. The indications for surgery were intestinal perforation (28), intestinal obstruction (7), clinical deterioration (1) and persistent rectal bleeding (1). The initial procedure was percutaneous peritoneal catheter drainage (13), intestinal diversion alone (8), intestinal resection (14), laparotomy and biopsy (1) and laparotomy alone (1). Twelve patients developed late intestinal strictures. The overall mortality rate was 35 per cent.

Age Factors↗
PubMed1987

Acute pancreatitis associated with carcinoma of the ampulla of Vater.

Acute pancreatitis associated with pancreatic carcinoma or tumour metastases in the pancreas is well documented. In this paper we show a similar association between acute pancreatitis and ampullary carcinoma. Of 41 patients with ampullary carcinoma seen at a single centre over a 25 year period (1959-83), 6 developed acute pancreatitis. Three other patients with a history of obstructive jaundice were noted to show mild transient hyperamylasaemia. Endoscopic retrograde choledochopancreatography is mandatory in the investigation of such patients.

Acute Disease↗
PubMed1987

Management of periampullary carcinoma.

Forty-one patients presented to our hospital between 1959 and 1983 with periampullary carcinoma. Twenty-six (63 per cent) underwent radical surgery, eight (20 per cent) local excision of the tumour, six (15 per cent) had bypass procedures and one was treated by endoscopic sphincterotomy (2 per cent). Potentially curative resection was performed in 83 per cent of the 41 patients. The operative mortalities for radical, local and bypass surgery were 7.7 per cent, 25 per cent and 16.6 per cent respectively. The degree of tumour differentiation significantly affected survival while local spread did not significantly affect survival in patients treated radically. The 5 year survival rates (calculated actuarially) for radical, local and bypass surgery were 34, 44 and 0 per cent respectively.

Adenocarcinoma↗