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Biomedical subjects

D Cavanagh

Publications and source records attributed to D Cavanagh.

At least 127 records · Page 7Linked to original sources
PubMed1991

Upper-body fat distribution and endometrial cancer risk.

STUDY OBJECTIVE: --To determine if body fat distribution affected endometrial cancer risk. DESIGN: --Case-control study. SETTING: --This study was carried out at the H. Lee Moffitt Cancer Center at the University of South Florida, Tampa, where all patients in the case group received their diagnoses and histological confirmations. PATIENTS: --Forty consecutive women newly diagnosed with endometrial cancer and 40 controls matched for age and Quetelet index. MAIN OUTCOME MEASURES: --Anthropometric measurements were taken for the abdomen, thigh, suprailiac, subscapular, biceps, and triceps skin fold thicknesses; waist and hip circumferences, weight, and height. Relative risks for endometrial cancer were calculated according to these anthropometric measurements. RESULTS: --Case patients with endometrial cancer had significantly greater waist-to-hip circumference ratios (P less than .001), abdomen-to-thigh skin fold ratios (P less than .01), and suprailiac-to-thigh skin fold ratios (P = .02) compared with control subjects matched for age and Quetelet index. The relative risk for endometrial cancer increased with an increasing waist-to-hip circumference ratio (less than or equal to 1.14 = 1.0; greater than 1.14 = 15.0), with an increasing abdomen-to-thigh skin fold ratio (less than or equal to 0.82 = 1.0; greater than 0.82 = 5.0), and with an increasing suprailiac to-thigh skin fold thickness ratio (less than or equal to 0.67 = 1.0; greater than 0.67 = 3.50). CONCLUSION: --Upper-body fat localization is a significant risk factor for endometrial cancer in women matched for age and Quetelet index.

Adult↗
PubMed1991

Laser vaporization of grade 3 vaginal intraepithelial neoplasia.

Between March 1, 1984, and May 23, 1990, 26 patients underwent laser vaporization for grade 3 vaginal intraepithelial neoplasia. Twenty of these patients had prior hysterectomy, 12 of them because of cervical neoplasia. Ten patients had undergone prior treatment for vaginal intraepithelial neoplasia. Eleven (42%) developed recurrence of vaginal neoplasia with a mean time to recurrence of 22 weeks. Three of the 11 patients had invasive cancer at the time of recurrence. One patient had invasive cancer on biopsy at the time of laser vaporization and subsequently underwent radiation therapy. The remaining 14 patients remain alive with no evidence of recurrent disease at a mean follow-up interval of 117 weeks. In our hands, laser vaporizaiton did not appear to be efficacious treatment for grade 3 vaginal intraepithelial neoplasia, especially when diagnosed in the region of a vaginal cuff scar.

Adult↗
PubMed1991

The use of the Cytobrush cervical sampler in patients with cervical stenosis.

In 37 of 43 patients (86%) with cervical stenosis (inability to undergo passage of the cotton-tipped applicator), the Cytobrush cervical sampler was successfully passed into the endocervical canal. The use of the Cytobrush sampler for cervical cytologic screening appears to be valuable in patients with cervical stenosis.

Adolescent↗
PubMed1991

Management of radionecrosis of the vulva and distal vagina.

Twelve patients were seen between January 1983 and June 1989 with the clinical diagnosis of radionecrosis of the vulva or distal vagina. Seven patients received radiation for vulvar cancer, three for distal vaginal cancer, and two for recurrent endometrial cancer. No patient healed spontaneously and the mean delay in surgical therapy was 8.5 months. The radionecrotic site was treated with local therapy, radical local excision (with or without colostomy), or exenteration. The operative defect was closed primarily in three patients and covered with local flaps or myocutaneous flaps in seven patients. The two patients with local care still have radionecrotic ulcers. One of three patients who were closed primarily continues to have an ulcer. All other patients have healed satisfactorily except one who died after two attempts to correct the problem. Radionecrosis of the vulva and distal vagina should generally be treated surgically.

Adult↗
PubMed1991

A polycistronic mRNA specified by the coronavirus infectious bronchitis virus.

The third largest of the nested set of subgenomic mRNAs (mRNA3) from the coronavirus infectious bronchitis virus (IBV) contains three separate open reading frames (3a, 3b, and 3c) which are not present on the next smallest of the mRNAs, suggesting that this mRNA may be functionally polycistronic. However, although a protein product has been identified from the 3c open reading frame, to date the coding function of 3a and 3b has not been established. We present nucleotide sequence data suggesting that each of the three open reading frames is conserved in a variety of different IBV strains and further show, through the preparation of monospecific antisera against bacterial fusion proteins, that IBV-infected cells contain small amounts of the products of these ORFs. In vitro translation studies using synthetic mRNAs containing the 3a, 3b, and 3c open reading frames suggest strongly that all three proteins can be translated from a single molecular species, and expression studies carried out in intact cells support this conclusion. Thus mRNA3 of IBV appears to be functionally tricistronic.

Amino Acid Sequence↗
PubMed1991

Further experience with radiation therapy and concomitant intravenous chemotherapy in advanced carcinoma of the lower female genital tract.

Sixty-seven patients with advanced carcinoma of the lower female genital tract (cervix, vagina, and vulva) were treated with radiation and concomitant intravenous cisplatin and/or 5-fluorouracil. Fifty-seven patients (85%) responded completely clinically. Thirty-five (61%) complete responders recurred with a median time to recurrence of 6 months. Twenty-six of the thirty-five patients who recurred had some component of local failure. The 22 complete responders who have not recurred have been followed a median of 13 months. Acute toxicity was minimal, with only 6 patients requiring interruption of therapy. Nine (13%) patients developed severe late complications and eight required surgery. The actuarial 5-year survival is 22%. This treatment regimen is disappointing in terms of both survival and local control.

Adult↗
PubMed1991

Concentrated albumin infusion as an aid to postoperative recovery after pelvic exenteration.

Twenty-eight patients underwent pelvic exenterations for gynecologic malignancies between June 1986 and June 1989. The postoperative fluid and electrolytes were managed by one of two regimens. One group of 10 patients was given concentrated 25% albumin infusion for the first 16 hr after surgery in addition to maintenance intravenous crystalloid solution according to ideal body weight. The second group of 18 patients received only a standard crystalloid solution. The albumin infusion group was found to have a more stable postoperative course as evidenced by less fluid boluses (P less than 0.01), fewer electrolyte bolus requirements (P less than 0.01), and easier management of blood pressure and urine output. There was a 50% decrease in total fluid requirement, a higher mean right atrial pressure (P less than 0.05), and a lower maintenance intravenous fluid rate (P less than 0.01). As a consequence, central hyperalimentation was started earlier (P less than 0.01) and the albumin infusion group left the Intensive Care Unit sooner than the non-albumin infusion group. There was not a single instance of clinical fluid overload with this slow infusion technique. Thus, concentrated albumin infusion was beneficial in the acute fluid management of these difficult patients.

Aged↗
PubMed1991

A phase II evaluation of cisplatin, bleomycin, and mitomycin-C in patients with recurrent squamous cell carcinoma of the cervix.

Cisplatin, bleomycin, and mitomycin-C were used to treat 25 patients with recurrent squamous cell carcinoma of the cervix. Six patients had a partial response, yielding a total response rate of 27%. Nine patients had stable disease. The median survival for the whole group was 30 weeks. The median survival for responders was 32 weeks. The median progression free interval for the whole group was 12 weeks and the median progression-free free interval for responders was 14 weeks. The toxicities noted were primarily nausea, vomiting, and myelosuppression. The combination of cisplatin, bleomycin, and mitomycin-C has modest effectiveness in the treatment of recurrent squamous cell carcinoma of the cervix, but represents no improvement over single-agent chemotherapy.

Adult↗
PubMed1991

Femoral vessel coverage with dura mater after inguinofemoral lymphadenectomy.

Twenty patients undergoing inguinofemoral lymphadenectomy for vulvar malignancy had the femoral vessels covered with freeze-dried human cadaver dura mater; 5 patients had a radical vulvectomy and 15 had a modified radical vulvectomy, and a total of 38 groins were explored. The dura mater was sutured to the inguinal ligament, sartorius muscle fascia, and adductor longus muscle fascia. Three of the thirty-eight wounds had wound breakdown uncovering the dura mater; each of the groins healed satisfactorily by secondary intention without exposing the femoral vessels. Three patients developed cellulitis without wound breakdown and three patients developed lymphocysts. All groin wounds have healed completely and there have been no delayed complications. The mean follow up was 12.5 months (range, 2-30 months). Coverage of the femoral vessels with dura mater after inguinofemoral lymphadenectomy appears to be a safe and effective alternative to the technically more difficult and more time-consuming sartorius muscle transplant.

Adult↗
PubMed1991

Management of locally advanced squamous cell carcinoma of the vulva.

Carcinoma of the vulva is an uncommon malignancy, accounting for 5% of gynecologic cancers. Patients who have locally advanced disease often cannot be managed locally by a radical vulvar resection. Current approaches to the treatment of locally advanced vulvar cancer include ultraradical surgery, radiotherapy, or a combination of treatment modalities. Ultraradical surgery has been used for patients with clinically resectable vulvar lesions and generally has consisted of a radical vulvar operation combined with a partial or total pelvic exenterative type procedure. The use of primary radiotherapy for carcinoma of the vulva remains controversial but may be the only option available when the patient has unresectable disease. Data have accumulated to confirm that megavoltage radiotherapy can cause marked regression of even locally advanced vulvar carcinoma to the point where a more limited resection can then be undertaken, often with an improved resection margin, with sparing of organ function, and improved quality of life. As with preoperative radiotherapy, combined chemoradiotherapy with or without resection has been used increasingly, with some promising results in several squamous cell carcinomas. There are few data on this type of treatment for carcinoma of the vulva.

Carcinoma, Squamous Cell↗
PubMed1991

Use of the cytobrush in postmenopausal women.

Patients who were postmenopausal were identified, and the results of a standard Papanicolaou smear using a cotton-tipped applicator were compared with those using a cytobrush. One hundred one postmenopausal women were evaluated between August 1, 1987, and April 9, 1990. The standard Papanicolaou smear with a moistened cotton-tipped applicator yielded endocervical cells in 59 (58%) of the 101 patients, whereas the cytobrush yielded endocervical cells in 90% of the patients. The use of the cytobrush for cervical cytologic screening appears to be of value in postmenopausal women.

Adult↗
PubMed1991

Williams' vulvovaginoplasty after supralevator total pelvic exenteration.

Seven patients had delayed Williams' vulvovaginoplasty after supralevator total pelvic exenteration. Of the three patients who died of carcinoma of the cervix (at 2, 5, and 15 months after vulvovaginoplasty), the first died before having a chance to attempt intercourse, but the other two had reported intercourse on at least two occasions after the reconstruction. One of the patients described the experiences as neither pleasant nor unpleasant but stated that her husband seemed satisfied. The other patient described the experience as satisfactory to both herself and her husband. The remaining four patients are alive with no evidence of recurrent disease at 28, 42, 56, and 106 months after operation. Two of these patients have reported entirely satisfactory sexual relations approximating pre-exenteration frequency, but the remaining two have not had sexual relations since surgery. Both give the main reason for this as lack of opportunity. The Williams' vulvovaginoplasty appears to be a reasonable alternative for vaginal reconstruction in patients who will have and especially who have had exenteration. To improve results, other methods of vaginal reconstruction should continue to be evaluated.

Adult↗
PubMed1991

Deduced amino acid sequence of the fusion glycoprotein of turkey rhinotracheitis virus has greater identity with that of human respiratory syncytial virus, a pneumovirus, than that of paramyxoviruses and morbilliviruses.

The sequence of the fusion (F) glycoprotein of turkey rhinotracheitis virus (TRTV) has been deduced from cDNA clones derived from oligo(dT)-selected infected cell RNA. The protein consists of 538 amino acids, the F2 and F1 subunits containing 102 (including the F2-F1 connecting peptide RRRR) and 436 residues, respectively. Each subunit has one potential N-linked glycosylation site. The protein has 38 to 39% amino acid identity with the F protein of respiratory syncytial virus (Pneumovirus genus) but only about half that with members of the other two genera (Paramyxovirus and Morbillivirus) in the Paramyxoviridae family. This is the first sequence evidence to support the view that TRTV is a pneumovirus, the first avian member of the genus to be described.

Amino Acid Sequence↗
PubMed1991

Comparing the yield of the standard Papanicolaou and endocervical brush smears.

To compare the endocervical cell yield of the standard Papanicolaou smear and endocervical brush (Cytobrush) smear, cervical cytology smears using both techniques were obtained separately from each of 491 women between Aug 1, 1987, and Jan 31, 1990. The smear provided endocervical cells from 97% of the patients, while the Papanicolaou smear provided them from 64%. The brush was unsatisfactory (no endocervical cells) in 3% of the patients. In nine patients (2%) no endocervical cells were found on either specimen. In six patients (1%) the brush smear was unsatisfactory, while endocervical cells were found on the Papanicolaou smear. The study design precluded an adequate assessment of the sensitivity for detecting abnormal cells with the addition of the brush. The addition of an endocervical brush smear to the routine Papanicolaou smear appears to provide better sampling of the endocervical canal than does the standard Papanicolaou smear alone, using a cotton-tipped applicator.

Adolescent↗
PubMed1991

Advanced actinomycotic pelvic inflammatory disease simulating gynecologic malignancy. A report of two cases.

Two women had large, solid, fixed pelvic masses simulating advanced ovarian cancer in one case and advanced cervical cancer in the other. Both patients had had plastic intrauterine contraceptive devices in situ for 7 and 17 years, respectively. Both patients required laparotomy to make the diagnosis. In both the surgery was markedly difficult because of the total absence of tissue planes. Both had obvious actinomycotic disease on routine histologic examination of the ovary and were treated with prolonged penicillin, with some, but not total, resolution of the pelvic fibrosis. The diagnosis of advanced actinomycotic pelvic inflammatory disease should be entertained in patients with a large, solid pelvic mass and an intrauterine device in situ or a recent history of intrauterine device use.

Actinomycosis↗
PubMed1991

Mass closure of the abdominal wound with delayed absorbable suture in surgery for gynecologic cancer.

There has been a resurgence of interest recently in the optimal method of closure of the midline abdominal wound. The focus has been on the high-risk patient in particular. The controversy centers on interrupted versus continuous fascial closure and the choice of suture material. For three years on a gynecologic cancer service, running mass closure with delayed absorbable suture (Polyglactin) was used. Two hundred fifty-six patients were evaluable for analysis. The minimum follow-up time was two years. There was no wound dehiscence. Fourteen patients (5.5%) developed incisional hernias. The mass closure technique using delayed absorbable suture was effective in very-high-risk patients.

Female↗