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Peter Campbell

Publications and source records attributed to Peter Campbell.

21 records · Page 2Linked to original sources

Optimal position for a cervical collar incision: a prospective study.

BACKGROUND: The descriptions of the optimal method for placing a cervical collar incision for thyroidectomy or parathyroidectomy are varied. It has been our impression that a collar incision marked in the neutral upright neck, migrates superiorly relative to the sternal notch when the patient is placed in the supine position. The aim of this study was to investigate the validity of this impression and to assess whether this is influenced by patient factors and/or pathology. METHODS: Fifty patients undergoing either thyroid or parathyroid surgery had a planned incision marked 1 finger-breadth (17 mm) above the sternal notch when sitting in the upright position. When placed in the supine position, with neck extended, the distance from the sternal notch to the marked incision was remeasured. Patient variables such as body mass index, height, weight and neck circumference were documented prospectively and data were recorded on operative details and tumour pathology. RESULTS: The collar incision marked in the neutral upright neck, migrated on average 21 mm superiorly once the patient was placed supine with the neck extended (P=0. 0001 ).The extent of migration was independent of all patient factors, type of operation and thyroid or parathyroid pathology. CONCLUSIONS: Migration of a proposed cervical collar incision does occur. An inappropriately placed incision may lead to excessive scarring if it is too low, or unusual prominence if it is too high. We believe a good position for marking such an incision is 1 fingerbreadth above the sternal notch with the patient in a neutral, upright position.

Cicatrix↗

Comparative genomic hybridization analysis of adrenocortical tumors.

Comparative genomic hybridization (CGH) is a molecular cytogenetic technique that allows the entire genome of a tumor to be surveyed for gains and losses of DNA copy sequences. A limited number of studies reporting the use of this technique in adult adrenocortical tumors have yielded conflicting results. In this study we performed CGH analysis on 13 malignant, 18 benign, and 1 tumor of indeterminate malignant potential with the aim of identifying genetic loci consistently implicated in the development and progression of adrenocortical tumors. Tissue samples from 32 patients with histologically proven adrenocortical tumors were available for CGH analysis. CGH changes were seen in all cancers, 11 of 18 (61%) adenomas, and the 1 tumor of indeterminate malignant potential. Of the adrenal cancers, the most common gains were seen on chromosomes 5 (46%), 12 (38%), 19 (31%), and 4 (31%). Losses were most frequently seen at 1p (62%), 17p (54%), 22 (38%), 2q (31%), and 11q (31%). Of the benign adenomas, the most common change was gain of 4q (22%). Mann-Whitney analysis showed a highly significant difference between the cancer group (mean changes, 7.6) and the adenoma group (mean changes, 1.1) for the number of observed CGH changes (P < 0.01). Logistic regression analysis showed that the number of CGH changes was highly predictive of tumor type (P < 0.01). This study has identified several chromosomal loci implicated in adrenocortical tumorigenesis. Activation of a protooncogene(s) on chromosome 4 may be an early event, with progression from adenoma to carcinoma involving activation of oncogenes on chromosomes 5 and 12 and inactivation of tumor suppressor genes on chromosome arms 1p and 17p.

Adenoma↗