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Biomedical subjects

M G Berry

Publications and source records attributed to M G Berry.

At least 19 recordsLinked to original sources
PubMed2006

Digitisation of the total burn surface area.

The assessment of surface area of the body affected by a burn (TBSA) has long been estimated with manual charts. Initial assessment of burned patients is made frequently by clinicians with limited experience producing significant errors. Paper copies of burn charts are unwieldy, subject to loss and tend towards overestimation. Thus, a simple method of calculation, recording and transmission via email or telemedicine may produce benefits in both initial treatment and data recording. Although computer-based systems have been reported previously none have entered routine clinical practice in the UK. We devised a PC-based program, "Burn Calculator", whereby digital transcription of the burn allows automatic area calculation allowing not only a rapid, accurate figure for determination of fluid resuscitation, but also the potential for rapid electronic transmission. It also calculates fluid requirements to minimise errors during resuscitation. This initial pilot study compared figures from 50 paper charts with those from Burn Calculator to determine its accuracy and reproducibility. Previously reported variations in TBSA estimation were confirmed, as was the tendency towards TBSA underestimation resulting from transcription of a three-dimensional clinical situation to a two-dimensional representation. Burn Calculator showed high correlation (r=0.9850; p<0.0001) and reproducibility (R=0.9957) that would simplify assessment and referral plus facilitate data collection, interpretation and research.

Adolescent↗
PubMed2004

Integrin expression and survival in human breast cancer.

BACKGROUND: Integrin cell adhesion molecules are fundamental to numerous cellular functions including anchorage, differentiation and proliferation. Reduced expression of certain alpha and beta integrin subunits in primary breast cancer cells has been correlated with increased invasion and metastasis. Conversely, over-expression of the alpha6 subunit has been linked to poorer survival. The objective of this study was to measure the survival of a cohort with breast carcinoma in relation to integrin expression and to evaluate their potential as prognostic indicators. METHOD: Integrin expression on samples from 99 consecutive patients with breast cancer was assayed using monoclonal antibodies to the subunits alpha(1,2,3,6,V) and beta(1,3,4,5). This cohort has now been followed prospectively for almost five years allowing for early assessment of survival in relation to integrin expression. RESULTS: Whilst analysis of the data confirmed the relation of survival to proven predictors of tumour grade, tumour size and vascular invasion, statistical significance was not demonstrated with regard to both lymph node status and all integrin subunits studied. CONCLUSION: Previous research correlating certain integrin subunits with survival has not been confirmed in this study. Despite proven molecular importance in tumour cell adhesion, invasion and metastasis, integrin expression would appear not to translate clinically as independent indicators of prognosis, at least in the short-term.

Adult↗
PubMed2003

Integrin beta1-mediated invasion of human breast cancer cells: an ex vivo assay for invasiveness.

BACKGROUND: The integrin cell adhesion molecule (CAM) family is intimately involved in cell adhesion and invasion through tissue basement membranes (BM). As a consequence of the short survival of patient-derived human breast cancer cells, the invasion of such cells has not been previously reported. Our aims were to optimise culture conditions in order to establish a reliable invasion assay and to assess the effect on invasion of perturbations of the beta1 integrin receptors. METHODS: Pure suspensions of viable carcinoma cells were isolated immunomagnetically from human breast cancer (HBC) samples and introduced onto a replicated glycoprotein BM within an invasion chamber. Degree of invasion was compared to both beta1 integrin expression and tumour grade. Additionally, the effect of beta1 receptor blockade with monoclonal antibody (mAb) was assessed. RESULTS: Invasion was significantly greater in grade II than grade III tumour cells (p=0.0012). Anti-integrin beta1 monoclonal antibody inhibited cancer cell invasion by a mean of 83.96 +/- 4.80%. CONCLUSIONS: The invasion assay confirmed the fundamental importance of beta1 integrin receptors to transmembrane invasion and reports this for the first time in cells isolated from primary breast cancer. It represents a potent research tool for investigation of the tumour biology of invasion at the integrin beta1-mediated cell-basement membrane interface. This assay has the potential clinical application of improved stratification of patients for adjuvant therapy on a more individual basis than currently available.

Adult↗
PubMed2003

Bifid median nerve: anatomical variant at the carpal tunnel.

We describe a rare case of a bifid median nerve in the wrist of a 4-year-old girl who presented with a laceration of her right hand. In addition to the nerve, the carpal tunnel was duplicated with a separate tunnel for each branch.

Child, Preschool↗
PubMed2001

The influence of body mass index on burn surface area estimated from the area of the hand.

It is well recognised that initial estimates of the area involved in a burn injury by inexperienced clinicians are frequently excessive. In Britain the palmar surface area of the hand is taught to approximate 1% of the total body surface area (TBSA), but no allowance is made for variations in individual body weight. This study aimed to evaluate the relationship between hand surface area (HSA) and body mass index (BMI) using healthy volunteers. We found that mean HSA diminished significantly as BMI increased in both sexes (P<0.001). This effect was, however, more pronounced in women, particularly those with a BMI greater than 31 kg/m(2) in whom the HSA represented only 0.64%. Awareness of the potential for over-estimation of burn surface area using this method alone may improve the accuracy of burn area estimation and consequent need for commencing resuscitation.

Adult↗
PubMed2001

Acute facial-nerve paralysis with parotid adenolymphoma.

An 82-year-old woman presented with acute facial paralysis in association with parotid swelling following fine-needle aspiration cytology of a parotid adenolymphoma. Evacuation of a tense haematoma decompressed the nerve and led to complete recovery within 6 months. Additionally, the tumour is no longer evident, either clinically or radiologically, and fine-needle aspiration cytology appears to have been both diagnostic and, inadvertently, therapeutic in this case.

Adenolymphoma↗
PubMed2000

Audit of a one-stop breast clinic--revisited.

BACKGROUND: A one-stop diagnostic service has been available for women with symptomatic breast disease at St Bartholomew's Hospital for 5 years and was originally audited in May 1993. In re-auditing the one-stop service our aim was to see if our practice had improved following the original audit and to look at the impact which these changes in practice had made to the service offered to the patient. METHODS: A prospective audit of 4 consecutive clinics was undertaken in November 1997. A total of 300 patients (59 new and 241 follow up) were seen in clinic in this time. The primary outcome measure concerned the completeness of triple assessment in the 40 patients who required one stop investigations, including mammography, ultrasonography and fine-needle aspiration cytology. In addition, mean time to initial consultation and level of awareness of the one-stop facility and its attendant time delay were measured. RESULTS: Of the 300 clinic attendees 40 (38 new, 2 follow-up) had one-stop investigations. As a result of the one-stop service being in practice, 36 patients (90%) had a definitive management decision made at their first outpatient visit. Of these 2 were symptomatic cancers, forming 5% of the workload. A total of 86% of the workload was benign. Four patients (10%) had equivocal results. The mean waiting time from designated appointment until surgical consultation was 36.7 minutes and was disappointingly unchanged from that of the previous audit. However this does not take into account the significant reduction in staffing levels which has occurred between the two periods of assessment. CONCLUSIONS: The initial audit identified a significant problem with time constraints, necessitating that a large number of patients with carcinomas return at a later date for further investigations. Booking only new patients at the beginning of clinic has provided a solution. Disappointingly, our figures do not show a significant improvement in mean waiting time compared with the previous audit, despite allowing GPs greater access of referral. Encouragingly, we have been able to maintain a similar standard of provision of care despite lower staffing levels and to implement the changes suggested by the original audit (thereby closing the audit loop).

Adolescent↗
PubMed2000

Integrin beta1 upregulation in MCF-7 breast cancer cells by angiotensin II.

AIMS: Integrins are a major family of cell adhesion molecules whose function is perturbed in tumour invasion and metastasis. Angiotensin II (A II) is well-known in the systemic control of water and electrolyte homeostasis and haemodynamics, but recent evidence points to an additional local renin-angiotensin system (RAS) with possible long-term trophic effects including carcinogenesis. METHODS: The effect of angiotensin II on MCF-7 human breast cancer cell line integrin expression was evaluated with immunocytochemistry (ICC) and immunoprecipitation (IP). RESULTS: The experiments demonstrated a 1.40 +/- 0.14-fold increase in beta, integrin expression on MCF-7 cells following treatment with A II. CONCLUSIONS: These findings report the first evidence of an association between integrins and the RAS in human breast cancer cells and suggest a novel research avenue for future anti-metastatic strategies, through the manipulation of cell adhesion mechanics, in the management of invasive human breast cancer.

Angiotensin II↗