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Showing papers by "Wishaw General Hospital published in 2008"


Journal ArticleDOI
TL;DR: Among tumour-based inflammatory factors, only tumour microvessel density was independently associated with poorer cancer-specific survival, and the host inflammatory responses are closely associated with poor tumour differentiation, proliferation and malignant disease progression in breast cancer.
Abstract: The significance of the inter-relationship between tumour and host local/systemic inflammatory responses in primary operable invasive breast cancer is limited. The inter-relationship between the systemic inflammatory response (pre-operative white cell count, C-reactive protein and albumin concentrations), standard clinicopathological factors, tumour T-lymphocytic (CD4+ and CD8+) and macrophage (CD68+) infiltration, proliferative (Ki-67) index and microvessel density (CD34+) was examined using immunohistochemistry and slide-counting techniques, and their prognostic values were examined in 168 patients with potentially curative resection of early-stage invasive breast cancer. Increased tumour grade and proliferative activity were associated with greater tumour T-lymphocyte (P<0.05) and macrophage (P<0.05) infiltration and microvessel density (P<0.01). The median follow-up of survivors was 72 months. During this period, 31 patients died; 18 died of their cancer. On univariate analysis, increased lymph-node involvement (P<0.01), negative hormonal receptor (P<0.10), lower albumin concentrations (P<0.01), increased tumour proliferation (P<0.05), increased tumour microvessel density (P<0.05), the extent of locoregional control (P<0.0001) and limited systemic treatment (P⩽0.01) were associated with cancer-specific survival. On multivariate analysis of these significant covariates, albumin (HR 4.77, 95% CI 1.35–16.85, P=0.015), locoregional treatment (HR 3.64, 95% CI 1.04–12.72, P=0.043) and systemic treatment (HR 2.29, 95% CI 1.23–4.27, P=0.009) were significant independent predictors of cancer-specific survival. Among tumour-based inflammatory factors, only tumour microvessel density (P<0.05) was independently associated with poorer cancer-specific survival. The host inflammatory responses are closely associated with poor tumour differentiation, proliferation and malignant disease progression in breast cancer.

87 citations


Journal ArticleDOI
TL;DR: LVSI-H&E in early stage cervical cancer remains an important predictive factor of recurrent disease and reduced disease-free interval and LVSI-IHC was found to be associated with no pathological factors, and survival analysis revealed no statistically significant association with recurrence or survival.
Abstract: Background This study investigates the clinical significance of lymphovascular space invasion (LVSI) as detected by hematoxylin and eosin (LVSI-H&E) and immunohistochemistry (LVSI-IHC) in early stage cervical carcinoma.

34 citations


Journal ArticleDOI
TL;DR: Intense multi-agent neo-adjuvant chemotherapy including ifosfamide followed by wide excision and postoperative radiation are recommended and should not take precedence over or interfere with systemic chemotherapy.
Abstract: Purpose. To review various treatment modalities on outcome of patients with pelvic Ewing’s sarcoma. Methods. Between January 1948 and December 2004, 18 male and 15 female patients aged 3 to 48 (mean, 20) years with pelvic Ewing’s sarcoma were retrospectively reviewed from the Scottish Bone Tumour Registry. Results. The commonest site involved was the ilium. The main presenting symptom was pain, followed by swelling and restricted hip movements. Treatments included surgery, radiotherapy, chemotherapy, or any of them in combination. Patients who had no metastasis at presentation (p<0.01) and underwent chemotherapy with ifosfamide (p<0.01) had significantly longer survival. Age (p=0.09), gender (p=0.95), delay in presentation (p=0.31), tumour site (p=0.9), surgery (p=0.73), and radiotherapy (p=0.23) were not predictive of survival in the univariate analysis. The 5-year event-free survival rate in patients with no metastasis at presentation was 35%.

23 citations


Journal ArticleDOI
TL;DR: Diagnostic laparoscopy is the most accurate method for excluding the pathology related with chronic pelvic pain and endometriosis seems to be responsible for the majority of pathological cases.
Abstract: The objectives of this study were to determine the importance of diagnostic laparoscopy for the accurate diagnosis of endometriosis and to correlate the findings with infertility. Participants in this study included 336 women who were 18–45 years old, had no past medical history of abdominal operations, and complained of chronic symptoms of pelvic pain. In all these cases there were no pathological pelvic ultrasound findings. Also, nongynaecological diseases where excluded. Diagnostic laparoscopy was performed in all patients. In 191 women (56.8%) no pathology was found during the diagnostic laparoscopy, and 89 women (26.4%) actually reported improvement or even complete cure from their symptoms after the operation. In the majority of pathological cases the laparoscopy revealed various stages of endometriosis (n = 101; 30%). Other gynecological causes which were diagnosed during the laparoscopy where pelvic adhesions due to inflammatory disease (n = 37; 11%), ovarian cysts (n = 5; 1.5%), and uterine fibroids (n = 2; 0.5%). Diagnostic laparoscopy is the most accurate method for excluding the pathology related with chronic pelvic pain. Endometriosis seems to be responsible for the majority of pathological cases. Almost 60% of women have no pathology when examined with laparoscopy. A high percentage of symptoms can be phycogenic.

6 citations


Journal ArticleDOI
TL;DR: A 33-year-old, 34-week gestation patient with metformin treated gestational diabetes presented with lactic acidosis and subsequent examination and ultrasound confirmed foetal death, providing evidence of ethanol and cocaine use on the day prior to admission.
Abstract: A 33-year-old, 34-week gestation patient with metformin treated gestational diabetes presented with lactic acidosis Subsequent examination and ultrasound confirmed foetal death Examination of the blood and urine provided evidence of ethanol and cocaine use on the day prior to admission Lactic acidosis has been reported after the use of metformin, but it is exceptionally rare Precipitants such as ethanol and cocaine create a biochemically favourable environment in which lactic acidosis can occur Therefore, in patients receiving metformin who have ingested such agents, lactic acidosis should be considered Copyright © 2008 John Wiley & Sons

1 citations