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Biomedical subjects

J M Monaghan

Publications and source records attributed to J M Monaghan.

At least 73 records · Page 4Linked to original sources
PubMed1991

Vaginal epithelial abnormalities in patients with CIN: clinical and pathological features and management.

Of 4147 women who had CIN treated by laser at the Regional Gynaecological Oncology Centre, Queen Elizabeth Hospital, Gateshead, 103 (2.5%) had co-existing vaginal epithelial abnormalities. CIN 3 was the histological diagnosis most often associated with vaginal lesions. The upper vagina was almost always involved. In 67% the lesion in the cervix appeared to be confluent with that in the vagina. Even when the lesions were confluent, biopsies form the cervical and vaginal components did not always show the same grade of intraepithelial neoplasia and in some biopsies they showed different lesions. Laser treatment appears to be effective for the vaginal lesions and is therefore recommended although, in selected patients, careful follow up alone may suffice.

Carcinoma in Situ↗
PubMed1990

Immature presacral teratoma in an adult female.

A case of immature presacral teratoma in an adult female presenting in pregnancy is described. She remains free of disease 12 months following treatment with a combination of chemotherapy, radiotherapy, and surgery. Serum alpha-fetoprotein levels appeared to correlate more with tumor "aggression" than with tumor growth.

Adult↗
PubMed1990

Role of centralization of surgery in Stage IB carcinoma of the cervix: a review of 498 cases.

A review was undertaken of 498 patients with stage IB carcinoma of the cervix managed over a 15-year period in the Regional Gynaecological Oncology Centre, Gateshead. All but 4 were treated by radical hysterectomy, with adjuvant radiotherapy and/or chemotherapy for those with involved pelvic nodes. The overall 5-year survival in those with negative nodes was 91.4% compared with 50.5% in those with positive nodes (P less than 0.05). Of those dying from the disease, 7 patients only (1.4%) developed central recurrence, the remainder experiencing pelvic side-wall or distant recurrence. There was no difference in survival related to patient age. There were three deaths related to surgery and a fistula rate of only 1.2%. Bladder hypotonia and lymphocyst affected a minority of patients in the long term. The data support the case for radical surgery in stage IB carcinoma of the cervix, managed on a centralized referral basis.

Adult↗
PubMed1990

Is routine colposcopic assessment necessary following laser ablation of cervical intraepithelial neoplasia?

The colposcopic and cytological findings at follow-up of 1000 women treated by laser ablation for cervical intraepithelial neoplasia or human papillomavirus infection at the Regional Department of Gynaecological Oncology, Gateshead, were reviewed. Colposcopy detected six of 27 patients with residual disease compared with cytology which was abnormal in 26 of the 27 and detected 21 as abnormal on the first visit after laser treatment. In our unit invasive disease after laser treatment was never detected solely on initial colposcopic review.

Adolescent↗
PubMed1990

Loop diathermy cone biopsy.

A technique for cone biopsy using loop diathermy is presented. The diathermy loop consists of an insulated shaft attached to an insulated transverse or U-shaped arm, to which the loop wire is attached. The diathermy power is supplied by an electrosurgical unit. Among the first 50 cases, the mean age was 41.6 years; 72% of the cases were reported as cervical intraepithelial neoplasia III and 6% as microinvasive carcinoma. The mean length of the cone was 20.2 mm and the mean weight 3.9 g. Only 10% of the cones were reported as incompletely excised. No major complications were observed, and minor complications were reported in four patients (8%). We found this technique to be quick, simple, and economical. It provides a good histologic specimen with a low incidence of short-term morbidity.

Adult↗
PubMed1989

Cytokeratin expression in cervical epithelium: an immunohistological study of normal, wart virus-infected and neoplastic tissue.

In this study using a panel of anticytokeratin antibodies and an indirect immunoperoxidase method, we examined cervical squamous epithelia including mature stratified epithelium, immature squamous metaplasia, CIN 1, 2 and 3, wart virus infection and squamous carcinoma. Changes from the normal patterns of staining were inconsistently seen in CIN 1 and 2, but in CIN 3 the changes were more marked, and consisted of a loss of stratification of the staining pattern and a patchy reduction in staining. Invasive carcinomas showed a similar staining pattern to CIN 3 lesions.

Carcinoma, Squamous Cell↗
PubMed1989

Morphometric analysis of nuclear/cytoplasmic ratios in normal and perineoplastic vulvar skin.

Analysis of vulvar skin adjacent to squamous carcinoma has demonstrated abnormal deoxyribonucleic acid (DNA) content in histologically unremarkable specimens. Analysis of DNA by microdensitometry is time-consuming. Morphometric analysis by point counting was used to compare the nuclear/cytoplasmic ratios of normal vulvar skin and skin adjacent to malignancy. This showed elevated ratios in the latter specimens although there was no linear relationship to increasing ploidy.

Adolescent↗
PubMed1989

Invasive cancer of the cervix after laser treatment.

Over a period of 8 years and 6 months, 1979-1988, 4222 women were treated with laser ablation for cervical intraepithelial neoplasia (CIN) with or without papillomavirus infection of the cervix. Of 3738 patients followed up, nine were diagnosed as having invasive cancers of the cervix, four of which were microinvasive. It is stressed that each woman treated with laser must have frequent, long-term cytological follow-up.

Cervix Uteri↗
PubMed1989

Is it time for a reconsideration of the criteria for cone biopsy?

Between August 1985 and November 1988, 475 laser cone biopsies were performed at the Regional Gynaecological Oncology Unit in Gateshead. Of these, 332 were performed for abnormal cervical cytology and unsatisfactory colposcopy. The negative cone rate in this group was 34%. In those with cytological abnormalities up to and including mild dyskaryosis the figure was 64% and there were no cases of invasive disease. In this group the authors have reconsidered the criteria for cone biopsy and suggested biopsy of the visible ectocervical lesion combined with endocervical curettage or brushing. Those with negative histology or cytological abnormalities less than moderate dyskaryosis should be managed conservatively.

Adult↗
PubMed1988

Pelvic lymphocyst--a 10-year experience.

Pelvic lymphocysts occur infrequently after radical surgery for cervical cancer. The problem is one of recognition. In a retrospective analysis of patients seen over 10 years in this department, the incidence was 25.3%. All were diagnosed by bimanual, clinical examination only. The only factor that appears to relate to the formation of lymphocysts is the presence of poorly differentiated tumors; 70.8% of patients developing lymphocysts had poorly differentiated tumors. All the lymphocysts in this series resolved spontaneously and did not produce any major complications.

Adenocarcinoma↗
PubMed1988

Management decision making using clinical and operative staging in cervical cancer.

Clinical staging has serious limitations. Operative staging, although invasive, has significant advantages in identifying patients with metastatic disease; identification of this group will allow the extension of normal pelvic treatment methods and the more appropriate targeting of studies to assess therapy protocols for this difficult management group. This chapter has served to introduce contributions from the world's leading authorities in gynaecological oncology. Each chapter deals in great detail with the specific experience of each contributor.

Decision Making↗
PubMed1988

The management of the patient with abnormal vaginal cytology following hysterectomy.

Thirty-two patients presenting with abnormal vaginal cytology following hysterectomy were studied. Seven (21.8%) had had hysterectomy for benign conditions whilst 25 (78.1%) had cervical intraepithelial neoplasia (CIN) or invasive cervical carcinoma. Twenty-five patients had partial or total vaginectomy (15 as the primary procedure), and one required laser treatment following vaginectomy. Of 11 (34.3%) patients treated primarily by laser, five subsequently required vaginectomy because of persistent or recurrent cytological abnormality. All four patients treated with topical 5-fluorouracil or dinitrochlorobenzene subsequently required surgery. Nine of the 32 patients (28.1%) proved to have invasive carcinoma of the vagina on histological examination of the vaginectomy specimen. At the time of writing all patients in the study are well with no evidence of disease.

Adult↗
PubMed1988

Inflammatory cell infiltration and survival in squamous cell carcinoma of the vulva.

The prognostic significance of tumour infiltration by inflammatory cells in squamous cell carcinoma of the vulva was examined in a cohort of 34 patients surviving without recurrence for at least 5 years after radical surgery, and a comparative cohort of 35 patients who died of their diseases. Overall, heavy inflammatory infiltration correlated with a good prognosis and light infiltration with a poor one, independent of other indices such as differentiation, tumour size and nodal status. IgA-containing cell infiltration also correlated with a good prognosis but the presence of IgA-containing cells did not alone account for all the inflammation in the good prognosis group. An immunological response to the tumour may be influencing prognosis. At a practical level, the extent of inflammation appears, at least in this material, to be as useful a prognostic index as many more conventional ones.

Aged↗
PubMed1987

Mucin production in cervical intraepithelial neoplasia and in stage 1b carcinoma of cervix with pelvic lymph node metastases.

Sections from cervical intraepithelial neoplasia (CIN 3) and stage 1b carcinoma of the cervix were stained with periodic acid-Schiff (PAS) and alcian blue to identify the presence of intracellular mucin. One out of seven specimens of CIN 3 demonstrated intracellular mucin. In a series of 33 patients with stage 1b carcinoma of the cervix with pelvic lymph node metastases, PAS demonstrated intracellular mucin staining patterns that were similar in both tumour and lymph node in most patients. In the subgroup of 23 patients classified as having squamous carcinoma, 8 (35%) demonstrated intracellular mucin to some degree and only 2 (25%) of those 8 were alive after 3 years compared with 13 of the other 15 (87%) who did not show any mucin staining (P less than 0.01).

Adenocarcinoma↗
PubMed1987

A nuclear deoxyribonucleic acid analysis of normal and abnormal vulvar epithelium.

Vulvar and groin skin from 21 women with clinical squamous cell carcinoma of the vulva was compared with that from nine patients with vulvar intraepithelial neoplasia. Feulgen-stained nuclear densitometry showed a constancy of Feulgen-deoxyribonucleic acid (DNA) density in normal epithelium and all subepithelial connective tissue nuclei. At three sites--tumor edge, opposite labia, and perineum--there were significant differences in nuclear chromatin content between the two groups and also as compared with normal epithelium.

Biopsy↗