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Biomedical subjects

J E Bridges

Publications and source records attributed to J E Bridges.

9 recordsLinked to original sources
PubMed2004

The gynaecological management of women on tamoxifen: a national questionnaire survey.

Tamoxifen is the standard adjuvant treatment for women with breast carcinoma, decreasing the incidence of contralateral disease. However, the risk of endometrial cancer is increased. To establish current gynaecological management of women receiving tamoxifen in the United Kingdom we conducted a postal questionnaire of consultant gynaecologists, enquiring about frequency of, and methods used to investigate women on tamoxifen. Ninety-five per cent investigate women on tamoxifen only if they are symptomatic. Pelvic ultrasound and endometrial sampling are used for first-line investigation by 68.7%. Interpreting ultrasound findings, endometrial thickness is the parameter regarded as most important. An endometrial thickness of greater than 5 mm is regarded abnormal by 47.8% of respondents and of 4 mm by 23.6%. As there is no consensus of opinion regarding normal values for endometrial thickness, further data are required to ensure consistency when interpreting ultrasound reports of women on tamoxifen.

Biopsy↗
PubMed1998

Two-dimensional FDTD analysis of a pulsed microwave confocal system for breast cancer detection: fixed-focus and antenna-array sensors.

A novel focused active microwave system is investigated for detecting tumors in the breast. In contrast to X-ray and ultrasound modalities, the method reviewed here exploits the breast-tissue physical properties unique to the microwave spectrum, namely, the translucent nature of normal breast tissues and the high dielectric contrast between malignant tumors and surrounding lesion-free normal breast tissues. The system uses a pulsed confocal technique and time-gating to enhance the detection of tumors while suppressing the effects of tissue heterogeneity and absorption. Using published data for the dielectric properties of normal breast tissues and malignant tumors, we have conducted a two-dimensional (2-D) finite-difference time-domain (FDTD) computational electromagnetics analysis of the system. The FDTD simulations showed that tumors as small as 2 mm in diameter could be robustly detected in the presence of the background clutter generated by the heterogeneity of the surrounding normal tissue. Lateral spatial resolution of the tumor location was found to be about 0.5 cm.

Breast↗
PubMed1997

Abdominal radical trachelectomy: a new surgical technique for the conservative management of cervical carcinoma.

Traditionally radical hysterectomy has formed the mainstay of treatment for early stage cervical carcinoma. More recently radical trachelectomy and laparoscopic lymphadenectomy have been introduced to allow preservation of fertility. We present a new approach to fertility-sparing surgery, namely abdominal radical trachelectomy. The technique is similar to a standard radical hysterectomy and lymphadenectomy. In our technique the ovarian vessels are not ligated and, following lymphadenectomy and skeletonisation of the uterine arteries, the cervix, parametrium and vaginal cuff are excised. The residuum of the cervix is then sutured to the vagina and the uterine ateries re-anastomosed.

Anastomosis, Surgical↗
PubMed1994

Expression of integrin adhesion molecules in endometrium and endometriosis.

OBJECTIVE: To compare the expression of cell adhesion molecules by endometrium and endometriosis. DESIGN: A comparative study of integrin expression, determined immunohistochemically, in eutopic and ectopic endometrium biopsied synchronously from patients with endometriosis diagnosed at laparoscopy or laparotomy. SETTING: University Departments of Obstetrics and Gynaecology, and Pathology, Southampton; Department of Obstetrics and Gynaecology, Newcastle upon Tyne. SAMPLES: Eighteen paired samples of endometria and endometriosis. RESULTS: A wide distribution of collagen-laminin receptor proteins was demonstrated. alpha 1 integrin expression was limited to secretory endometrium. beta 3 expression was only demonstrated on proliferative endometrium. CONCLUSIONS: Expressions of the integrin proteins differed between the various elements of the endometrium. Cyclical changes in integrin expression also were demonstrated. No difference in cell adhesion molecule expression was seen when comparing endometrial and endometriosis samples.

Cell Adhesion Molecules↗
PubMed1988

The distribution of CA 125 in the reproductive tract of pregnant and non-pregnant women.

Investigation of serum and tissue homogenates obtained from first, second and third trimester pregnancies, and from non-pregnant women, has provided further insight into the possible origin of the CA 125 antigen. Serum CA 125 levels were higher in the first trimester (median 53.6 U/ml, range 15.6-268.3 U/ml) than in non-pregnant women (median 19.3 U/ml, range 7.2-27.0 U/ml) and later in pregnancy (second trimester: median 18.5 U/ml, range 12.0-25.1 U/ml, third trimester: median 19.2 U/ml, range 16.8-43.8 U/ml) (P less than 0.05) but were two orders of magnitude less than in second trimester amniotic fluid (median 4825 U/ml, range 3200-9300 U/ml). Fetal serum CA 125 activity was consistently less than 20 U/ml. The highest tissue levels of CA 125 were detected in first trimester decidual homogenate (median 4547 U/100 mg, range 340.4-20 851 U/100 mg) and were greater than in non-pregnant endometrium (median 388 U/100 mg, range 100.9-3341 U/100 mg) (P less than 0.01) and term decidua (median 116 U/100 mg, range 32.7-449.9 U/100 mg) (P less than 0.01). These observations suggest that CA 125 is synthesized by normal endometrium and decidua and that increased CA 125 activity during pregnancy is of decidual origin.

Antigens, Tumor-Associated, Carbohydrate↗
PubMedDate not supplied

Preoperative predictors of suboptimal primary surgical cytoreduction in women with clinical evidence of advanced primary epithelial ovarian cancer.

INTRODUCTION: Women with epithelial ovarian cancer (EOC) are conventionally treated with primary cytoreductive surgery. For those with a low probability of optimal primary surgical debulking, an alternative management option is primary chemotherapy with delayed primary surgery. Selection criteria are required to identify women who may benefit from this approach. PATIENTS AND METHODS: Patient age, presence of ascites, preoperative serum CA-125 level, surgical procedures performed, postoperative residual disease, FIGO stage, and histology data were collected on 97 women with preoperative clinical evidence of advanced EOC. Univariate and multivariate analysis was performed to identify which preoperative factors predict disease that will be suboptimally debulked. Receiver-operator curves were constructed for CA-125 level as a predictor for residual disease. RESULTS: The best predictor of disease suboptimally cytoreduced was serum CA-125 level (OR = 22.76, 95% CI = 7.13-72.69). Other predictive factors included age over 60 years (OR = 3.16, 95% CI = 1.04-9.56) and clinical evidence of ascites (OR = 3.30, 95% CI = 1.03-10.62). The optimal cut-off for serum CA-125 as a predictor of suboptimal debulking was 586 IU (sensitivity 80.0%, specificity 88.5%, PPV 85.7%). CONCLUSION: Serum CA-125 level is a reliable component of the preoperative assessment of women with EOC.

Adult↗
PubMedDate not supplied

Routine computerized tomography scanning, groin ultrasound with or without fine needle aspiration cytology in the surgical management of primary squamous cell carcinoma of the vulva.

We set out to study whether computerized tomography (CT) scanning of the vulva and the groin and groin ultrasound scanning (USS) alone or with fine needle aspiration cytology (FNAC) (USS/FNAC) influenced or could influence the surgical management of primary squamous cell carcinoma of the vulva (SCCaV). Forty-four patients underwent surgery for primary SCCaV following radiologic imaging by one or more modalities. Patient details included the clinical assessment of the carcinoma, radiologic findings, the operation performed, and whether the decision regarding the type and extent of surgery for the vulval carcinoma and, in particular, for the groin node dissection was or could be influenced by the radiologic findings. The age range was 38-87 years, with a median of 74 years. A total of 75 groin dissections were performed. Twenty-five of the 44 patients (56.8%) did not have groin node metastasis, 14 had unilateral metastasis (31.8%), and 5 (11.4%) had bilateral metastasis. All cases with histologically proven nodal status were analyzed to compare the preoperative imaging status with the histology. The calculated sensitivity, specificity, negative predictive value, and positive predictive value for CT were 58%, 75%, 75%, and 58%, for USS alone-87%, 69%, 94%, and 48%, and for USS-guided FNAC-80%, 100%, 93%, and 100%, respectively. There was no patient in whom surgical planning for the vulval carcinoma or the groin nodes was or could be altered by the CT findings. The data do not support the routine use of CT scanning in patients with primary SCCaV, either in assessment of the primary vulval carcinoma or in detecting groin nodal metastases. For the groin nodes, USS/FNAC is superior to CT in assessing disease status. In contrast to CT, USS/FNAC may have a useful clinical role in the management of the groin nodes in vulval carcinoma.

Adult↗