Biomedical subjects
Publications and source records attributed to J Westwood.
Fetal lacerations occurred in 1.5% of caesarean sections carried out in our institution. The incidence was independent of type of caesarean section, fetal presentation, cervical dilatation, presence of intact membranes or operator grade. We advocate that this complication should be included in the preoperative counselling of all patients undergoing caesarean sections.
Explore the source record for details and available documents.
Immunoperoxidase staining of LICR-LON M8, a mouse monoclonal antibody reactive with epithelial membrane antigen, showed a strong reaction with colorectal cancer. This finding prompted an immunoscintigraphic study of colorectal cancer patients using this antibody. Sixteen patients had external gamma scintigraphy after intravenous injection of indium 111-labeled M8. Positive scans were obtained in 11 of the 13 patients with primary colorectal cancers, and 2 of the 3 patients with recurrent tumors. The high indium 111 background in the liver prevented the detection of hepatic metastases in 5 patients. Twelve patients had samples taken of tumor, normal colon, and venous blood at the time of surgery. The ratio of labeled antibody uptake in tumor to that of blood was 5.1 (+/- 3.6 S.D.), which was significantly different (P = 0.001) to that of the similar ratio for normal colon (2.0 +/- 1.6 S.D.). The tumor to normal colon uptake ratio was 2.6 (+/- 1.3 S.D.). These results suggest a specific uptake of indium 111-labeled M8 by colorectal cancer.
Explore the source record for details and available documents.
The concept of tumour-specific antigens is constantly undergoing reappraisal with the development of more sensitive methods for their detection. This has resulted in the finding that the many 'new' antigens produced by human tumours or materials immunologically closely related to them are also present in non-neoplastic tissues, albeit in small amounts. However, other antigens still appear to exist almost entirely in or on tumour cells so that the antigens of human tumours may be subdivided into either tumour-associated macromolecules or tumour-specific antigens. The elucidation of the chemical nature of the tumour-specific antigens may result in important advances in cancer diagnosis and therapy. As many are organ specific, it should be possible to evolve test systems which will enable tumours to be diagnosed and located before they become apparent clinically. On the other hand the tumour-associated macromolecules, of which the oncofetal antigens are the principal examples, are found in elevated amounts in some non-neoplastic disorders. It is now clear that serial estimation of the levels of these macromolecules is of considerably more diagnostic value than single random measurements. Current work is establishing their value in the detection of recurrent and metastatic tumours before they become apparent by other methods, which is probably their most important role, and also their value as aids to monitor therapeutic efficacy. The future use of both types of antigen may unfold a new era in cancer detection and therapy but many basic chemical and immunological studies are needed before their clinical use can be fully defined.
PURPOSE: The modified peptide epitope gp100:209-217 (210M), referred to as g209-2M, of the gp100 melanocyte differentiation protein, when administered to melanoma patients by subcutaneous injection in incomplete Freund's adjuvant, is capable of generating HLA-A2-restricted CD8+ lymphocytes that specifically recognize the native gp100:209-217 (g209) peptide as well as gp100-expressing tumor cells. To evaluate the suitability of cloned lymphocytes from immunized patients for use in adoptive transfer therapy protocols, the functional and phenotypic variation of individual CD8+ T cell clones comprising the antitumor immune response was evaluated. METHODS: T-cell clones from melanoma patients who received g209-2M immunization were isolated and expanded, and their specific antitumor functional phenotypes were characterized. RESULTS: g209-specific CD8+ lymphocytes that specifically recognized gp100-expressing tumor cells were readily obtained from g209-2M-immunized patients. There was substantial variation in the absolute levels of cytokine secretion and target cell lysis by g209-specific clones from each patient. Furthermore, individual clones demonstrated discordant secretion of different proinflammatory cytokines. These clonal phenotypes were stable, even after large expansions in cell number. DISCUSSION: These results indicate that g209-2M peptide immunization of melanoma patients leads to a functionally diverse population of T cells, many of which are capable of expansion ex vivo to cell numbers appropriate for adoptive immunotherapy. However, the selection of a particular antigen-specific T-cell clone for treatment should be based on multiple functional criteria.