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Biomedical subjects

R J Rand

Publications and source records attributed to R J Rand.

13 recordsLinked to original sources
PubMed1993

The incomplete cone biopsy: a comparison of conservative and surgical management.

OBJECTIVE: to determine the reliability of conservative management of cone biopsies showing apparently incomplete excision of cervical intraepithelial neoplasia (CIN) by comparing surgical and conservative management. DESIGN: a retrospective study. SUBJECTS: 74 consecutive cone biopsies with a histology report of apparently incomplete excision of CIN 2 or CIN 3 from a series of 738 cone biopsies. MAIN OUTCOME MEASURES: the presence of CIN at hysterectomy against the pick up rate in conservatively managed patients. RESULTS: where excision appeared incomplete at the ectocervix this was confirmed in 1 of 6 (16.7%) of patients managed surgically and 2 of 17 (11.8%) of patients managed conservatively (P = 0.40). Where excision appeared incomplete at both endo- and ectocervix, 5 of 6 (83.3%) were confirmed to have incomplete excision in the surgical group, and 3 of 5 (60%) had further proven CIN in the conservative group (P = 0.34). Where excision appeared incomplete at the endocervix only, this was confirmed in 7 of 22 (32%) of cases managed surgically, but only 2 of 18 (11.1%) of cases managed conservatively had further proven CIN (P = 0.14). Combining all patients with incomplete excision at the endocervix irrespective of the ectocervix status revealed confirmation of residual CIN in 12 of 28 (42.9%) patients managed surgically and in 5 of 23 (21.7%) patients managed conservatively (P = 0.097). CONCLUSIONS: management should depend on the site of the apparent incomplete excision. Where excision appears incomplete at the ectocervix only, cytological follow up should be employed. If the endocervix is involved, further excisional surgery may be more appropriate.

Biopsy↗
PubMed1990

General practitioner obstetrics in Bradford.

The standard of obstetrics care by general practitioners in Bradford was assessed by reviewing the case records of all women who in 1988 were booked for delivery under their general practitioner but subsequently required transfer to consultant care. A total of 5885 women were delivered in Bradford during 1988. Of 1289 booked under their general practitioner, 637 required transfer to consultant care. In 259 cases transfer occurred during labour; only 37 of these women were visited by their general practitioner. Many of the problems that precipitated transfer were predictable and some were considered preventable: 263 of the women transferred were considered unsuitable for booking by general practitioners. The perinatal mortality among women booked under their general practitioner was 10.1/1000 and the stillbirth rate 7.8/1000. These figures are high and suggest a need for tighter controls over the qualifications and experience of doctors participating in a fully integrated system of obstetric care.

Consultants↗
PubMed1985

Cryotherapy in the management of cervical ectopy.

Sixty-five patients with benign ectopy of the uterine cervix were treated by cryosurgery in the departments of genitourinary medicine at St Luke's Hospital, Bradford, and the Airedale General Hospital, West Yorkshire, without analgesia or anaesthesia. A symptomatic cure rate of 98% was achieved. There were no serious complications. This treatment is considered to be appropriate in genitourinary clinics in the United Kingdom as these have routine screening procedures for various genital infections.

Adolescent↗
PubMed1983

Genital herpes.

Explore the source record for details and available documents.

Female↗
PubMed1978

T- and B-lymphocyte subpopulations following radiotherapy for invasive squamous cell carcinoma of the uterine cervix.

Lymphocyte subpopulations in patients with cervical carcinoma were studied before and after radiotherapy. T lymphocytes were recognized by their ability to form spontaneous rosettes with sheep erythrocytes (E rosettes). Two surface marker characteristics were used to detect B lymphocytes: receptors for activated complement responsible for erythrocyte--antibody--complement (EAC) rosette formation, and surface membrane immunoglobulin (SmIg), readily stainable by immunofluorescence. We have demonstrated a significant depression of total lymphocytes after radiotherapy which persists for more than 5 years. This reduction in lymphocytes is due to a loss of E rosette-forming T cells, SmIg-bearing B cells and null cells. Absolute numbers of EAC rosette-forming B cells are not altered by treatment, and there is a rise in this cell type when the results are expressed as percentages of the total lymphocyte count. The possible functional immunological significance of these changes is discussed.

Adult↗
PubMed1977

T- and B-lymphocyte subpopulations in pre-invasive and invasive carcinoma of the cervix.

Lymphocyte subpopulations in patients with pre-invasive and invasive cervical carcinoma, other gynaecological malignancies and controls were studied. T lymphocytes were recognized by their ability to form spontaneous rosettes with sheep red blood cells (E rosettes). Two surface marker characteristics were used to detect B lymphocytes: the receptors for activated complement responsible for erythrocyte-antibody-complement (EAC) rosette formation, and surface membrane immunoglobulin (SMIg), which is readily stainable by immunofluorescence. There was a significant depression in T cells in association with invasive but not pre-invasive cervical carcinoma. The results for B cells varied according to the method used for their detection. EAC rosette-forming (EAC-RFC) were significantly raised in patients with invasive cancers but not in patients with pre-invasive cancer. SMIg-bearing cells were not significantly altered by the presence of malignant disease. The changes in E-RFC and EAC-RFC numbers were more marked in patients with extensive cancers. Possible functional implications of these findings are discussed.

Adolescent↗
PubMed1975

Maternal cardiomyopathy of pregnancy causing stillbirth.

Cardiomyopathy of pregnancy developed in a healthy primigravida at 34 weeks gestation and was followed two weeks later by the spontaneous delivery of a fresh stillbirth. An immunological basis underlying both the mother's condition and the fetal death was suggested by the presence of myocardial antibodies in maternal and cord blood. Reference is made to two other cases in which a similar pathological process may have occurred.

Adult↗