Publications (9)25.47 Total impact
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Article: Breast 03
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ABSTRACT: Background: Breast cancer affects one in 10 women in the UK. No link has been demonstrated between angiogenesis and regional metastasis in breast cancer. Many cancers spread primarily via the lymphatics, yet research into lymphangiogenesis and metastasis has been limited. Using all known lymphatic markers, we quantified lymphangiogenesis by measuring mRNA expression of lymphatic markers, using quantitative polymerase chain reaction (QPCR) techniques. Furthermore, the relationship between lymphangiogenesis and axillary lymph node status was examined.Methods: RNA was extracted and cDNA synthesized from 120 archival breast cancers and 33 background breast samples. Plasmids containing human sequences from the following markers were constructed and used as internal standards: LYVE-1, Prox1, Podoplanin, VEGF-C, VEGF-D, VEGFR-3 and VEGFR-2. The first six are lymphatic markers, whereas VEGFR-2 is a blood vessel marker. QPCR was performed on the breast cDNA and plasmids. The original concentration of each marker was quantified by reference to the plasmid standards' concentrations.Results: Mean values for node positive, negative and background tissue for each marker (all values in copies µL−1): LYVE-1: 128, 12.1, 0.3; Prox1: 6140, 4466, 1270; podoplanin: 23306, 7764, 4973; VEGF-C: 3989, 613, 270; VEGF-D: 115, 32, 12; VEGFR-3: 129, 117, 66. Most differences were statistically significant (Mann–Whitney U-test, P < 0.05). No differences were found between the three groups with VEGFR-2.Conclusions: This first quantitation of lymphangiogenesis has demonstrated that lymphangiogenesis is higher in node-positive than in node-negative tumours, and the lowest in normal breast. This suggests that those cancers which overexpress lymphatic markers are more likely to metastasise to the lymphatics.British Journal of Surgery 01/2009; 89(S1):48 - 48. · 4.61 Impact Factor -
Article: Groin pain in sportsmen is not always musculotendinous in origin.
British Journal of Sports Medicine 01/2003; 36(6):470-2. · 4.14 Impact Factor -
Article: From PCR to RCA: a surgical trainee's guide to the techniques of genetic amplification.
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ABSTRACT: With the advent of evidence-based medicine and the Calman-Hine Report, more and more surgical trainees are undertaking a period of research, either before entering or during their Specialist Registrar training. Many will encounter concepts in science uncommon in daily clinical settings. This paper will elucidate the techniques of genetic amplification available today with their potential for usage in clinical research.European Journal of Surgical Oncology 09/2002; 28(5):554-9. · 2.50 Impact Factor -
Article: Nurse-led direct access endoscopy clinics: the future?
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ABSTRACT: Many studies have shown that rectal bleeding is a good indicator of underlying colorectal pathology, and that ost of the lesions in patients presenting with rectal bleeding lie in the left side of the colon [1, 5, 9, 12, 23, 26]. The recent acceptance of the nurse-practitioner by the National Health Service may allow the use of nurse-endoscopists to develop throughout the United Kingdom. This study aimed to audit a unique nurse-led direct-access nurse-endoscopy service with regard to its efficacy and cost effectiveness, and to monitor patient satisfaction and direct referrals from the primary health sector. A nurse-led open-access flexible sigmoidoscopy (OAFS) service for patients reporting fresh rectal bleeding was established at our center in February 1996. A prospective audit of sigmoidoscopic findings and a retrospective analysis of referral patterns from local general practitioners were conducted. A questionnaire survey of both patient and general practitioner satisfaction also was conducted at the same time. Since February 1996, 706 patients have been referred to our service. Rectal bleeding was by far the most common cause for referral, representing the dominant symptom in 92% of the referrals received. Although 99% of the patients underwent a complete sigmoidoscopic examination, 16% of these examinations were limited because of several factors combined. A cause for bleeding was identified in 91% of the patients, with 24% of them experiencing subsequent significant pathology. Of the patients surveyed, 99% were satisfied with the service provided. The results also show nurse-led OAFS to be a more effective use of financial resources, costing $90 less per patient than general practitioner referrals sent to a consultant for further action. Rectal bleeding is a good indicator of underlying colorectal disease. Most of the significant lesions presenting with this symptom are found in the left side of the colon. A nurse-led OAFS is safe, effective, and acceptable to patients. It also is more cost effective than a consultant-led service.Surgical Endoscopy 02/2002; 16(1):166-9. · 4.01 Impact Factor -
Article: Lymphangiogenesis and breast cancer metastasis.
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ABSTRACT: Breast cancer is one of the commonest malignancies in women in the western world. It spreads predominantly via the lymphatic system. However, the understanding of the formation of lymphatics, lymphangiogenesis, has been limited. This has been largely due to the previous lack of lymphatic specific markers. The most specific marker used in humans has been the vascular endothelial growth factor receptor 3 (VEGFR-3). However, this is also found on blood vessel endothelium. The other vascular endothelial factor receptors (VEGFR-1 and -2) are primarily blood vessel receptors. More recently, novel, specific markers for lymphatics have been discovered, such as LYVE-1, prox I and podoplanin, enabling further research into this new field. Each of these new markers is described in detail. The article also outlines the current understanding in breast cancer metastasis, with an emphasis on the more recent research into lymphangiogenesis. Since these specific markers are now available, quantitation of lymphangiogenesis is now possible by using either immunohistochemistry or quantitative PCR approaches. In addition, to breast cancer, research into many other cancers is now possible using these methods and new markers. With this in mind, possible therapeutic strategies for the future are discussed.Histology and histopathology 02/2002; 17(3):863-70. · 2.48 Impact Factor -
Article: Nurse-led direct access endoscopy clinics: the future?
[show abstract] [hide abstract]
ABSTRACT: Background: Many studies have shown that rectal bleeding is a good indicator of underlying colorectal pathology, and that ost of the lesions in patients presenting with rectal bleeding lie in the left side of the colon [1, 5, 9, 12, 23, 26]. The recent acceptance of the nurse-practitioner by the National Health Service may allow the use of nurse-endoscopists to develop throughout the United Kingdom. This study aimed to audit a unique nurse-led direct-access nurse-endoscopy service with regard to its efficacy and cost effectiveness, and to monitor patient satisfaction and direct referrals from the primary health sector. Methods: A nurse-led open-access flexible sigmoidoscopy (OAFS) service for patients reporting fresh rectal bleeding was established at our center in February 1996. A prospective audit of sigmoidoscopic findings and a retrospective analysis of referral patterns from local general practitioners were conducted. A questionnaire survey of both patient and general practitioner satisfaction also was conducted at the same time. Results: Since February 1996, 706 patients have been referred to our service. Rectal bleeding was by far the most common cause for referral, representing the dominant symptom in 92% of the referrals received. Although 99% of the patients underwent a complete sigmoidoscopic examination, 16% of these examinations were limited because of several factors combined. A cause for bleeding was identified in 91% of the patients, with 24% of them experiencing subsequent significant pathology. Of the patients surveyed, 99% were satisfied with the service provided. The results also show nurse-led OAFS to be a more effective use of financial resources, costing $90 less per patient than general practitioner referrals sent to a consultant for further action. Conclusions: Rectal bleeding is a good indicator of underlying colorectal disease. Most of the significant lesions presenting with this symptom are found in the left side of the colon. A nurse-led OAFS is safe, effective, and acceptable to patients. It also is more cost effective than a consultant-led service.Surgical Endoscopy 12/2001; 16(1):166-169. · 4.01 Impact Factor -
Article: Lymphangiogenesis quantification using quantitative PCR and breast cancer as a model.
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ABSTRACT: The detection of lymphangiogenesis (formation of new lymphatics) has previously been difficult to measure, primarily due to the lack of specific markers for lymphatic endothelium. Using conventional PCR (polymerase chain reaction), DNA sequencing, plasmid synthesis, and real-time quantitative PCR (RTQPCR), we report a new approach to enable the measurement of lymphangiogenesis using LYVE-1, a novel, specific lymphatic marker in breast cancer tissue. By using a Scorpion-based probe system with the RTQPCR analyser, a highly sensitive and specific detection and quantitation of LYVE-1 was possible. It was found that lymphangiogenesis occurred in all breast specimens and that higher levels were found in tumours which had spread to the lymph nodes.Biochemical and Biophysical Research Communications 12/2001; 288(4):1043-6. · 2.48 Impact Factor -
Article: 'Fast track' carotid duplex scanning in a district general hospital.
Annals of The Royal College of Surgeons of England 04/2001; 83(2):145-6. · 1.23 Impact Factor -
Article: Lymphangiogenesis Quantification Using Quantitative PCR and Breast Cancer as a Model
[show abstract] [hide abstract]
ABSTRACT: The detection of lymphangiogenesis (formation of new lymphatics) has previously been difficult to measure, primarily due to the lack of specific markers for lymphatic endothelium. Using conventional PCR (polymerase chain reaction), DNA sequencing, plasmid synthesis, and real-time quantitative PCR (RTQPCR), we report a new approach to enable the measurement of lymphangiogenesis using LYVE-1, a novel, specific lymphatic marker in breast cancer tissue. By using a Scorpion-based probe system with the RTQPCR analyser, a highly sensitive and specific detection and quantitation of LYVE-1 was possible. It was found that lymphangiogenesis occurred in all breast specimens and that higher levels were found in tumours which had spread to the lymph nodes.Biochemical and Biophysical Research Communications.
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Institutions
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2001–2009
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University of Wales
- College of Medicine
Cardiff, WLS, United Kingdom
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