Biomedical subjects
Publications and source records attributed to J N Webb.
The clinicopathological features of a basaloid carcinoma of the prostate gland are described in a 28-year-old man, and the management and prognosis discussed. Basaloid tumours of the prostate are very rare and only a few cases have been described in detail. Those cases which have been reported as adenoid cystic carcinoma, adenoid cystic-like carcinoma and adenoid basal cell tumour are reviewed.
A total of 277 patients with apparently localised prostatic cancer (T2-T4 NXMO) were allocated at random to receive radiotherapy alone (88), orchiectomy alone (90) and combined therapy (99) between 1980 and 1985. The main outcome measures were survival, time to appearance of metastases and treatment of local disease progression by further transurethral resection. Orchiectomy, whether alone or with radiotherapy, produced a significant delay in detection of metastases when compared with radiotherapy alone. There were no statistically significant differences between the 3 treatment groups in local disease control or in overall survival.
A non-computerised method of accurate prospective analysis of the quantitative aspects of the work of a general histopathology laboratory was devised. The method entails monitoring the progress of all biopsy and cytology specimens through the laboratory during selected monthly periods of study. The data collected include details of specimen type, block/section/stain details for each specimen, and information about the timed progress through technical, medical, and secretarial stages of specimen/report handling. The results give a detailed breakdown of the biopsy and cytology workload of this department. They give information about the rate of passage of specimens through the system and identify reasons for delay in the reporting of some cases. The method is easy to operate and will allow for the analysis of specific effects--for example, staff changes--on the efficiency of the department. The data will also provide some of the information required for the costing of histopathology laboratory services, and the type of information obtained will probably become a necessary requirement for laboratory accreditation.
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A total of 76 patients with advanced epithelial ovarian carcinoma were randomised to receive 6 months of treatment with either a combination of hexamethylmelamine, 5-fluorouracil, cisplatin and prednimustine or prednimustine alone following initial surgery. Pathologically confirmed response rates were 35% for combination chemotherapy and 28% for prednimustine, and the overall survival was identical for the two groups. Seven patients achieved a pathologically defined complete response, one of whom relapsed at 8 months; the others remain disease-free 18-36 months (median, 23 months) after presentation. The extent of initial surgery significantly affected the survival of patients receiving prednimustine but not of those receiving combination chemotherapy. Prednimustine can produce durable responses in advanced ovarian cancer using a schedule that results in negligible toxicity.
We report our experience in the treatment of carcinoma in situ of the urinary bladder using Evans strain Bacille Calmette-Guérin (BCG). The mean period of follow-up was 30 months; 18 patients received intravesical therapy and 16 of these were evaluable. They received 8 weekly instillations of 60 mg Evans strain BCG in 50 ml of saline. No intradermal BCG was given. The response rate was 93.75% at 3 months; this declined to 57% at 2 years. The complications of therapy were frequent but mild. Seven patients failed to complete the course. These results were comparable to those obtained with other strains of Bacille Calmette-Guérin.
The role of muscle function in the aetiology of recurrent dislocation of the patella has been examined. Eleven of the 12 patients we studied had joint hypermobility. Muscle biopsies from eight of nine patients treated by surgery had a predominance of abnormal Type 2C fibres, and three of six patients whose quadriceps muscles were studied by electromyography also had abnormal results. Our preliminary findings suggest that there may be a primary muscular defect in many cases of recurrent dislocation of the patella.
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The case is described of a 71-yr-old female with a tumour in the pulp of the left index finger. The histology was that of a myxoma of nerve sheath or Pacinian neurofibroma. Electron microscopy of the tumour provides convincing evidence for an origin from the perineural cells. The location of these tumours, suggestive histology and perineural origin provides support for the belief that they arise from sensory nerve endings.
Virus-like particles (VLP) have been identified by electronmicroscopy in the skeletal muscles (paraxials) of six cases of idiopathic scoliosis. These particles closely resembled VLP reported in the skeletal muscles in other conditions, e.g. Reye's syndrome, polymyositis, malignant hyperthermia, and chronic myopathy. We have shown by specific staining that these structures are composed of glycogen in a crystalline form. Using Coxsackie B infected tissue culture cells as a control we have shown that these viruses, which are of similar shape and size to the VLP, were unstained using this specific staining method.
The results of multiple biopsies from apparently non-tumour bearing bladder mucosa were studied in 154 patients with bladder cancer; 33% of the biopsies from apparently normal mucosa showed histological abnormalities including 4.5% with carcinoma. When the mucosa appeared red but flat, 52% of the biopsies showed histological abnormalities including 14% with carcinoma. Biopsies from mucosa that had a granular or mossy appearance showed carcinoma in 42%. A more aggressive management policy was adopted in 12 patients (8%) as a direct result of the biopsy findings.
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The clinical and pathological features of 52 adenocarcinomas invading the oesophagus and the oesophagogastric junction are reviewed. The relationship of these tumours to the presence of a concomitant hiatal hernia and the histogenesis of primary oesophageal adenocarcinomas are discussed. Adenocarcinomas of the cardio-oesophageal junction appear to have distinctive prognostic and pathological features and there may be a case for their classification into a separate category of alimentary neoplasms.
To determine whether it is the amount or the duration of the force applied manually by the tester, or both, that determines the tester's perception of the strength of the hip flexor or abductor muscles, an electromechanical device was designed which was placed between the tester's hand and the subject's limb. With the device we measured the force applied to the limb, the time interval during which it was applied, and the angular position of the limb during the entire test. In 240 such tests, the testers' ratings of the differences in strength between the right and left sides were correlated with seven variables involving force and time. It was found statistically that the impluse--that is, the duration of the tester's effort multiplied by the average applied force during each test--was the factor that most influenced the tester in the ratings.
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The histological, histochemical and ultrastructural features of cell death in the normal human foetus are described. The age range of the foetuses was 7 to 16 wk. Cell death was observed in all foetuses between 10 and 16 wk. On the basis of these findings it is suggested that disintegration of cell membrane may be a crucial factor in this process. Acid phosphatase activity and phagocytosis of cell debris are evidently not the main means of disposal of degenerate cell products. The possible relevance of cell death in embryogenesis for dystrophic processes is discussed.