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Biomedical subjects

D E Townsend

Publications and source records attributed to D E Townsend.

At least 73 records · Page 4Linked to original sources
PubMed1983

Gentamicin resistance in methicillin-resistant Staphylococcus aureus.

Gentamicin resistance has been studied in methicillin-resistant Staphylococcus aureus (MRSA) strains, from Royal Melbourne Hospital (RMH) and Sydney. Gentamicin resistance was transferred in mixed cultures to a plasmid free strain, and the determinants were examined. The Sydney strain had high level resistance to gentamicin, tobramycin, kanamycin and neomycin which was carried on a c.34 megadalton plasmid. The gentamicin resistant RMH isolates all had a determinant which conferred low level resistance to gentamicin, tobramycin and kanamycin and appeared to be chromosomal in one isolate, on a plasmid of c.28.5 megadaltons in another and on a plasmid of c.18 megadaltons in the other isolates. It is suggested that a gentamicin resistance transposon is being transferred in the MRSA at RMH.

DNA Transposable Elements↗
PubMed1983

Cryotherapy and carbon dioxide laser management of cervical intraepithelial neoplasia: a controlled comparison.

Two hundred patients with cervical intraepithelial neoplasia were treated alternately by cryotherapy and carbon dioxide laser therapy on an outpatient basis after appropriate triage with colposcopy, cervical biopsy, and endocervical curettage. Results of treatment were not significantly different from one another, with failure occurring in 7% of patients treated with cryotherapy and 11% of those treated with carbon dioxide laser therapy. The cryotherapeutically treated patients had less pain but more discharge than those treated by the carbon dioxide laser. The laser patients' cervices healed more rapidly than did the cervices treated with cryotherapy. There appears to be no advantage in replacing cryotherapy with carbon dioxide laser therapy.

Carbon Dioxide↗
PubMed1983

Vulvar carcinoma in situ.

Sixty-five patients with carcinoma in situ of the vulva were reviewed. Attention was focused upon the epidemiology, duration of symptoms, and location of lesions. The vulva and perineum were divided diagrammatically into 16 geographic compartments; lesion location and percentage of occurrence in each area were calculated. The most common site was the inferior border of the right labium majus. Eighty-four percent of patients under the age of 40 had multifocal disease. Sixty-five percent of patients over 40 had unifocal disease.

Adult↗
PubMed1982

Intraepithelial squamous lesions of the vulva: biologic and histologic criteria for the distinction of condylomas from vulvar intraepithelial neoplasia.

We reviewed 65 intraepithelial lesions of the vulva and distal vagina and compared the presence of koilocytosis, abnormal mitoses, and parabasal or basal nuclear enlargement with DNA microspectrophotometric distribution patterns and the presence of human papillomavirus antigen as determined by immunoperoxidase. Abnormal mitoses and cytologically atypical nuclear enlargement were specific predictors of aneuploidy and were reliable for distinguishing vulvar intraepithelial neoplasia (VIN) from condylomas. Koilocytosis was present in 100% of condylomas and 71% of aneuploid (VIN) lesions, but there were qualitative and quantitative differences in the distribution of koilocytic cells in the two classes of lesions. On the basis of these findings, criteria for distinguishing between VIN and condyloma are proposed.

Antigens, Viral↗
PubMed1982

Treatment of vaginal carcinoma in situ with the carbon dioxide laser.

Thirty-six patients with vaginal intraepithelial neoplasia were treated with the carbon dioxide laser. More than half of the patients had grade 3 vaginal intraepithelial neoplasia (carcinoma in situ). The majority of patients were treated in a single session; six patients were treated twice, and two patients were treated three times. In 92% of the patients, the lesions were completely removed by the laser without significant side effects.

Adult↗
PubMed1982

Vulvar intraepithelial neoplasia: correlation of nuclear DNA content and the presence of a human papilloma virus (HPV) structural antigen.

Immunoperoxidase localization of a human papilloma virus structural antigen (HPV) was attempted in 68 intraepithelial lesions of the vulva, 39 of which were analyzed for nuclear DNA content by microspectrophotometry. Overall, 5.9% (4/68) stained positive for HPV. Ninety percent (35/39) of the cases tested were aneuploid, and, of these, 2.8% (1/35) stained positive for HPV. In contrast, 50% (2/4) of the polyploid lesions were positive. Hence DNA microspectrophotometry and immunoperoxidase localization of HPV are useful coparameters for distinguishing wart virus infection (condylomata) from vulvar intraepithelial neoplasia. HPV is detected infrequently within aneuploid lesions, in keeping with the concept that epithelial maturation is required for virion assembly. Whether the HPV genome exists in a nonreplicative state within the aneuploid cell population is unknown.

Antigens, Viral↗
PubMed1982

Management of vulvar intraepithelial neoplasia by carbon dioxide laser.

Thirty-three patients with vulvar intraepithelial neoplasia were treated with the carbon dioxide (CO2) laser. In 31 of these patients the lesion was completely eradicated by the laser treatment. All patients experienced moderate pain following the procedure, and 2 had severe pain. The only other complications were 1 case of bleeding and 1 of infection. The CO2 laser appears to be an acceptable treatment modality for vulvar cancer precursors provided patients are carefully evaluated prior to treatment and invasive carcinoma is ruled out.

Adult↗
PubMed1982

Primary carcinoma of the Bartholin gland: a report of 14 cases and review of the literature.

Fourteen cases of primary carcinoma of the Bartholin gland were treated between 1955 and 1980. Follow-up information was available on all patients. Ten patients have survived free of disease for 5 or more years. Three patients with positive inguinal lymph nodes have survived 5 years. Histological patterns and lymph node involvement are analyzed. The authors' data and a review of the literature support the concept that radical vulvectomy with bilateral inguinal-femoral lymphadenectomy is required for all histologic types of Bartholin gland carcinoma. Routine pelvic lymph node dissection is not necessary when the inguinal-femoral nodes are negative for metastases.

Adenocarcinoma↗
PubMed1981

Cryosurgery and the CO2 laser.

Over the past decade, the management of intraepithelial lesions of the visible portion of the female genital tract has substantially changed with the introduction of cryosurgery and the carbon dioxide laser. Although cryosurgery and the carbon dioxide laser are very effective in eradicating preinvasive disease, the selection of patients by colposcopy and appropriate biopsies is more important than the treatment techniques. Failure to properly evaluate women with genital tract neoplasia can result in disastrous consequences for the patient. The CO2 laser shows considerable promise in managing dysplasia and carcinoma in situ of the vagina and vulva. The laser combines the accuracy of the operating microscope and the precision and control of the photon beam. Posttreatment sequelae are minimal, and scarring is absent.

Adult↗
PubMed1981

The relation between uterine cervix temperature differentials and epithelial abnormalities.

Temperature measurements of the human cervix uteri were made at various locations by a direct-contact thermistor probe. These measurements were compared to both colposcopic findings and histologic examination of tissue biopsies. A correlation between loci of temperature elevation and tissue abnormality was found; however, the measurements were not able to predict the severity of this abnormality.

Body Temperature↗
PubMed1981

Nuclear DNA study of vulvar intraepithelial and invasive squamous neoplasms.

In this study, 59 vulvar intraepithelial squamous neoplasms (8 atypia and 51 carcinoma in situ) and 33 invasive squamous carcinomas were analyzed for their nuclear DNA content using Feulgen microspectrophotometry. Four cases of atypia had a polyploid DNA distribution. The remaining 4 cases of atypia and all cases of carcinoma in situ had an aneuploid pattern, and nearly two thirds of these had high ploidy stem cells (greater than 3N). This is in contrast to the low ploidy stem cells (less than 3N) seen in 70% of the invasive carcinomas and in 82% of the intraepithelial neoplasms in the vicinity of invasive carcinomas. This observation suggests that not all vulvar intraepithelial neoplasms have the same propensity to become invasive. Invasive carcinomas of comparable size and depth of invasion with low ploidy stem cells had a higher frequency of lymph node metastasis than those having high ploidy stem cells. The significance of nuclear DNA findings related to gynecologic neoplasms is discussed.

Aneuploidy↗
PubMed1981

Invasive cancer following outpatient evaluation and therapy for cervical disease.

Factors relating to the inappropriate therapy of 66 cases of cervical cancer are reviewed. The patients are divided into 2 major categories: 1) 33 who underwent cryosurgery or hot cautery without colposcopy; 2) 9 who underwent colposcopy without outpatient therapy; and 3) 24 who underwent colposcopy followed by outpatient therapy. Of the patients who had outpatient therapy without colposcopy, the major indication for treatment was "cervicitis," and all had a normal Papanicolaou smear. Of the 33 patients who underwent colposcopy because of an abnormal Papanicolaou smear, the proper treatment evaluation was carried out in only 5. The endocervical curettage (ECC) was omitted in 17 patients; no biopsies were taken in 8 patients; and conization of the cervix was omitted in 3 patients who had a positive ECC. Recommendations are made to minimize the inappropriate use of the outpatient approach in patients with cervical disease.

Adult↗