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Biomedical subjects

J S Simpson

Publications and source records attributed to J S Simpson.

At least 19 recordsLinked to original sources
PubMed1993

Fine-needle aspiration cytodiagnosis of breast masses in pregnant and lactating women and its impact on management.

We reviewed our experience with 9,726 cases of fine-needle aspiration cytology of the breast that were done from January 1983 to February 1992. During our review, we found that 214 aspirates had been submitted from pregnant and lactating women for the investigation of breast mass(es). Despite a variable clinical presentation and spectrum of cytologic findings, we considered the application of aspiration cytology in these women as useful as in the nonpregnant-nonlactating women for management decision. A team approach between the clinician and cytopathologist was always maintained; with this approach, the false-positive or -negative diagnoses were reduced to almost nil. In all cases in which the cytodiagnosis of carcinoma of breast was made, the findings corresponded with subsequent cell blocks from the aspirate and tissue examination. Benign lesions were diagnosed cytologically with minimal difficulty, and all aspirates that were less than optimal for cytodiagnosis were repeated to minimize the chance of missing an abnormality. All the benign lesions were followed throughout pregnancy, postpartum, and thereafter; if the mass persisted, the aspiration was repeated. With this protocol of follow-up, the need for a customary liberal surgical biopsy was reduced to a minimum.

Adolescent↗
PubMed1992

Needle aspiration cytology, immunocytochemistry, and electron microscopy in a rare case of secretory carcinoma of the breast in an elderly woman.

Needle aspiration was performed on a breast mass in a 91-year-old woman. The cytologic features in the aspirate were a diffuse, prominent, intracytoplasmic vacuolization and secretion in malignant cells and occasional signet ring-like forms. This was confirmed in a subsequent cell block which was made from the aspirate. Immunocytochemical studies showed a positivity for mucin by alcian blue stain in the vacuolated cells which was periodic acid-Schiff positive and resistant to diastase digestion. Oil-red-O staining was negative and on Colloidal iron stain the tumour cells were positive. Immunopositivity to carcinoembryonic antigen, cytokeratin, and epithelial membrane antigen was found in the malignant cells, while on electron microscopy the tumour cells contained a significant amount of intracytoplasmic secretory material. Secretory carcinoma of the breast is a rare tumour and can be diagnosed and differentiated from other breast carcinomas in view of its characteristic cytologic features.

Aged↗
PubMed1992

Coexpression of vimentin, cytokeratin and S-100 in monomorphic adenoma of salivary gland; value of marker studies in the differential diagnosis of salivary gland tumours.

An unusual coexpression of glial fibrillary acid protein (GFAP), keratin and vimentin occurs in pleomorphic adenoma of salivary gland. We designed this study to see if coexpression of the markers was also present in monomorphic adenoma of the salivary gland and whether monomorphic adenoma could be distinguished from other salivary gland tumours by marker studies. Immunocytochemical markers were used on fine needle aspiration samples from four cases of monomorphic adenoma, two cases of oncocytic adenoma, three cases of adenoid cystic carcinoma and four cases of pleomorphic adenoma. While positivity for cytokeratin, vimentin and S-100 was consistently found in all cases of monomorphic adenoma, only cytokeratin was expressed in adenoid cystic carcinoma. In pleomorphic adenoma, GFAP, cytokeratin and vimentin were coexpressed while in cases of oncocytic adenoma none of the markers was localized. Thus, it appears that by using a combination of GFAP, cytokeratin, vimentin and S-100 a distinction between these neoplasms may be possible. However, a larger study is needed to establish the usefulness of this approach.

Adenoma↗
PubMed1992

Fine needle aspiration cytodiagnosis of apocrine carcinoma of the breast.

The cytopathological appearances of 14 cases of apocrine breast carcinoma diagnosed by fine needle aspiration cytology are described and the features compared to those seen in apocrine cells aspirated from benign cystic and solid lesions. Significant atypia must be observed before a diagnosis of apocrine carcinoma can be entertained.

Biopsy, Needle↗
PubMed1992

Fine needle aspiration cytodiagnosis of a carcinoid tumour of the male breast.

The diagnosis of a primary carcinoid tumour of the breast in a 38-year-old male was initially made from a fine needle aspiration sample. The cytodiagnosis was supported by the histochemical demonstration of Grimelius-positive granules in tumour cells which were also found in tissue removed in a subsequent biopsy. An immunocytochemical study using markers for neuron-specific enolase and chromagranin in the aspirated sample and tissue was found to be negative. A total mastectomy with axillary node dissection was performed which showed no residual or metastatic tumour. No primary tumour was found elsewhere.

Adult↗
PubMed1991

The diagnostic impact of needle aspiration cytology of the breast on clinical decision making with an emphasis on the aspiration cytodiagnosis of male breast masses.

Our experience with a total of 7,231 needle aspirates of the breast was reviewed. Ninety-nine cases from the total of 7,231 aspirates studied were from male patients. While an aspiration cytodiagnosis of gynecomastia was made in most of these cases, carcinoma was diagnosed in four cases. Although a clinical distinction between male breast cancer and gynecomastia is often difficult, we found needle aspiration cytology a very useful initial investigation for making this distinction.

Adolescent↗
PubMed1990

Directional atherectomy. New approaches for treatment of obstructive coronary and peripheral vascular disease.

Atherectomy is defined as the controlled removal of atherosclerotic tissue from vessel walls. The directional atherectomy catheter consists of a cup-shaped cutter within a housing unit and a small balloon. It was developed to perform transluminal atherectomy for the treatment of atherosclerotic vascular disease. This new procedure was performed on 195 lesions in peripheral arteries of lower limbs in 134 procedures, and 52 lesions in coronary arteries in 50 procedures. A successful angiographic outcome was obtained in 89% of procedures and 90% of lesions in peripheral experience, and 60% of procedures and 62% of lesions in coronary experience. A higher success rate (81%) was achieved in our more recent experience with coronary atherectomy, as compared with a 42% success rate in our earlier experience. The incidence of major complications was infrequent in both peripheral and coronary experiences. In the peripheral experience, one patient had delayed occlusion that required bypass surgery, and two patients had distal embolization. In the coronary experience, one patient had acute occlusion that required emergency bypass surgery. There were no vessel perforations. Conclusively, transluminal atherectomy is a feasible, predictable, and safe procedure for the treatment of peripheral and coronary artery disease. Further studies, however, are necessary to evaluate the long-term efficacy of this new procedure.

Aged↗
PubMed1989

Percutaneous nephrostomy in short-term management of ureterolithiasis and renal dysfunction in a filly.

Percutaneous nephrostomy was used to provide urine output in a 3-year-old Thoroughbred filly with azotemia and obstructive ureterolithiasis. Previous left ureteral surgery had failed to provide clinical improvement, and the filly became more azotemic. Nephrostomy was performed in the standing patient, with ultrasonographic guidance and local anesthesia. Continuing IV fluid therapy and diuresis through the nephrostomy tube resulted in a decrease in clinical signs of azotemia. However, the filly developed a cecal impaction, which ruptured during surgery because of colic, and was euthanatized.

Animals↗
PubMed1988

Undergraduate education about cancer: a survey in Australian medical schools.

The goals of undergraduate medical education are to provide a core of basic knowledge, and a framework to permit further development of that knowledge. The structure of teaching and experience in cancer medicine should reflect the increasing importance of cancer in the community. Undergraduate teaching of oncology and its scientific bases is currently fragmented, and in some cases may be deficient. Until now, there have few analyses of what is being taught about cancer at different medical schools. We have undertaken a survey of final year medical students or recently qualified doctors in Australia enquiring about their cancer education. The results indicated that substantial differences existed between the medical schools, and we therefore surveyed the teaching faculty in the schools to determine their view of the validity of the questions we used. Together these surveys showed that significant disparities existed between what the faculty felt should be taught and what students had actually experienced.

Australia↗
PubMed1987

A simple surgical audit.

A simple microcomputer based surgical audit system, written by one of the authors and implemented on a Tandy model IV microcomputer, is described. The system allows data from 2000 patients to be stored on a single disc. Data stored can be easily analysed and used to audit clinical activity.

Computers↗
PubMed1986

Breast self-examination in an urban population: estimates of prevalence and quality of performance.

Interview data from 434 women (aged greater than or equal to 20 years) in two Wellington suburban areas were used to estimate the prevalence and quality of performance of breast self-examination. Although 98% of women were familiar with breast self-examination, and 73% had performed it at least once, only 39% did so at least monthly. Its practice was significantly more common in the middle years (30-59), among Europeans, and in women with tertiary education. Thoroughness or quality of performance was assessed by comparison with Cancer Society recommendations. Scores for examination technique were generally high (mean = 73%) compared with those assessing timing (mean = 47.5%) and conditions under which breast self-examination was performed (mean = 43.3%). Results from this study were compared with 1975-76 New Zealand survey data which produced lower estimates of the prevalence of monthly breast self-examination. Both studies found that more than a quarter of women have never practiced it. Future research and intervention efforts should be directed toward this group of women.

Adult↗
PubMed1986

Comparison of histochemical and biochemical assays for oestrogen receptor in breast tumour tissue.

Oestrogen receptors were measured by a histochemical technique in tumour tissue from 45 patients with breast cancer, and the results compared with receptor levels measured by a standard biochemical dextran-charcoal assay. Histochemical measurements were made by incubating frozen sections of tumour tissue with 17-fluoresceinated oestrone, using dithiothreitol to inhibit uptake by low affinity binding sites, and estimating receptor content by the extent of fluorescence seen microscopically. Results from the two assays gave varying estimates of receptor concentration, with 66% of patients classed as receptor-positive by the biochemical assay, and 44% of patients classed as receptor-positive using the histochemical technique. Because of these discrepancies the histochemical assay cannot be considered a direct substitute for biochemical receptor measurements. Progesterone receptor was detected by biochemical measurement in 80% of the subgroup of patients who were positive for oestrogen receptor in both assays. The histochemical assay may thus identify a subset of those patients considered oestrogen receptor-positive by conventional receptor assays, and this group may be more likely to respond to hormonal therapy. However, whether the histochemical method provides a predictive measurement for endocrine responsiveness which is superior to standard progesterone receptor assay remains to be determined.

Adult↗
PubMed1986

Frozen section evaluation of cervical conization specimens.

Frozen section evaluation was done on 96 conization specimens. One patient had invasive carcinoma, which was correctly diagnosed on frozen section. No patient received inappropriate therapy on the basis of an erroneous diagnosis made from the evaluation of frozen sections. The mean time from initiation of surgery to the surgeon's receipt of the frozen section diagnosis was 0.9 hours. There was no significant increase in the blood loss or intraoperative complication rate when frozen conization was added to either abdominal or vaginal hysterectomy.

Biopsy↗