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Biomedical subjects

D G Gallup

Publications and source records attributed to D G Gallup.

At least 73 records · Page 4Linked to original sources
PubMed1984

Modifications of celiotomy techniques to decrease morbidity in obese gynecologic patients.

Celiotomy techniques have been modified in an attempt to decrease the wound complication rates at our institution. During a 5-year period, 1044 patients underwent celiotomy and major surgical procedures, usually hysterectomy and bilateral salpingo-oophorectomy. Wound complications were noted in eight of 900 nonobese patients. Of obese patients not operated upon by the protocol, 42.2% had wound complications. Obese patients operated upon according to protocol had a wound complication rate of 3.1%. The difference in wound complication rate in obese, non-protocol operation patients as compared to the obese, protocol operation patients was highly significant (p less than 0.0001). The techniques used minimized wound infections in obese patients.

Adult↗
PubMed1984

Occurrence of malignant peritoneal mesothelioma after surgery and irradiation for cervical cancer.

Mesothelioma of the peritoneal cavity after irradiation is rare, and the diagnosis is sometimes difficult to establish. The following case is a report of a mesothelioma occurring 9 years after radiation therapy for carcinoma of the cervix. In this patient, who had a hysterectomy and bilateral oophorectomy 7 years prior to the mesothelioma diagnosis, the histologic, histochemical, and ultrastructural findings were all consistent with a diagnosis of malignant peritoneal mesothelioma. It is believed that this case is one of the first well-documented cases of peritoneal mesothelioma in a female who was treated by pelvic irradiation for another neoplasm.

Carcinoma, Squamous Cell↗
PubMed1984

Intraoperative antibiotic irrigation as prophylaxis in abdominal hysterectomy: a preliminary report.

A preliminary report regarding the use of an intraoperative, intraperitoneal antibiotic solution in patients having transabdominal hysterectomy reveals that the postoperative morbidity assessed by the diagnosis of cuff cellulitis or pelvic abscess was 4.7%. This morbidity represents a substantial reduction in the incidence of cuff cellulitis (27.0%) noted in a comparison group of 367 patients having abdominal hysterectomy at our institution during a two-year period. These preliminary data strongly suggest that antibiotic solutions given intraperitoneally at the time of abdominal hysterectomy reduce morbidity due to cuff cellulitis.

Abscess↗
PubMed1984

Adenocarcinoma of the endometrium in women 40 years of age or younger.

Excluding cases associated with oral sequential contraceptives, adenocarcinoma of the endometrium in young women is rare, constituting about 3% of endometrial carcinomas. The present report, based on findings from one institution, notes that women 40 years of age or younger comprised 14.4% of the 111 patients with adenocarcinoma of the endometrium. Factors analyzed in patients 40 years of age or younger (group A) as compared with those 41 years of age or older (group B) include the following: obesity 43.8% (A) versus 17.9% (B), nulliparity 44% (A) versus 10.5% (B), hypertension 31.2% (A) versus 42.1% (B), and diabetes 6.2% (A) versus 21.1% (B). Patients in group A tended to have a well-differentiated tumor, and 31.2% had polycystic ovaries. Awareness of risk factors in young women who develop endometrial adenocarcinoma leads to earlier diagnosis and will preserve the historically excellent survival rate of young women.

Adenocarcinoma↗
PubMed1984

Urinary tract evaluation of diethylstilbestrol-exposed female progeny followed in a colposcopy clinic.

Structural abnormalities of the upper genital tract in diethylstilbestrol-exposed (DES-exposed) female progeny have been noted. Since upper genital tract anomalies are often associated with upper urinary tract anomalies, intravenous pyelography was obtained in 102 DES-exposed patients at our institution to determine the incidence of upper urinary tract anomalies. Only two patients had duplication of the ureter. Since this incidence is not greater than that expected in an unexposed population, intravenous pyelogram studies are not routinely recommended for DES-exposed patients.

Abnormalities, Drug-Induced↗
PubMed1983

Recurrence of a gonadal stromal cell tumor (Sertoli Leydig cell with heterologous elements) in a teenager.

An unusual case of a moderately well-differentiated, encapsulated, Sertoli Leydig cell tumor with heterologous elements recurring 3 years after a conservative unilateral oophorectomy in a 15-year-old female is reported. This is the first case report of a metastatic Sertoli Leydig cell tumor with mucinous heterologous elements. A relative lack of uniformly accepted histological criteria of these tumors makes prognosis difficult to access. The optimal therapy for recurrent Sertoli Leydig cell tumor is unknown. Initial plans of management of this rare neoplasm, follow-up, and current concepts of treatment of recurrences will be discussed.

Adolescent↗
PubMed1982

The gynecologist and the dying cancer patient.

It has been speculated that obstetricians and gynecologists may have relatively more problems in dealing with death and dying than do some other physicians. A questionnaire was sent to 3,229 Board-eligible or Board-certified obstetrician-gynecologists in rural and urban areas in the Southeast. Only 11% of those who responded had had any emphasis placed on the care of dying patients during their training. Only 6% had not seen any new cases of invasive cancer of the female genital tract in a 5-year period. Sixty-two percent hospitalized their terminally ill patients; 21% managed their terminal patients at home; and only 1% indicated that they used a hospice. Our data support the concept that, despite the increase in hospices and dying teams (available to 19% of respondents), gynecologists will continue to be asked to care for the dying. Suggestions for improving the training of residents in caring for the dying are presented.

Attitude to Death↗
PubMed1982

Postoperative morbidity in cases of cervical conization followed by vaginal hysterectomy.

In an attempt to define a group of patients at risk for relatively increased morbidity who have had vaginal hysterectomy after conization, we retrospectively analyzed patients who had hysterectomy for cervical intraepithelial neoplasia. Patients who had hysterectomy within 24 hours of conization had an overall morbidity rate of 42% and are compared to a second group of patients who had hysterectomy six weeks or more after conization, with a morbidity rate of 24%. A third group of patients who had hysterectomy without conization had an overall morbidity of 19%. These data suggest that a period of less than 24 hours from conization to hysterectomy, particularly in large teaching hospitals, leads to relatively greater morbidity.

Cervix Uteri↗
PubMed1979

Leiomyosarcoma of the uterus: case reports and a review.

Eight patients with leiomyosarcoma (LMS) of the uterus recently treated at our institution are reported. Modes of initial therapy in these patients included surgery alone, radiation therapy alone, or surgery plus radiation therapy. Mitotic counts were greater than 10 per 10 high power fields in the tumors of all of these patients. Only two patients are currently alive, and both have been treated for metastatic neoplasm to the lungs. A comparison of the histological material of these patients with criteria outlined in the recent literature for a diagnosis of uterine LMS is made. The possible role of a hormonal influence on this neoplasm is discussed. It would appear that a more aggressive initial therapy plan may improve survival in patients with this lethal malignancy.

Adult↗
PubMed1979

Childhood lichen sclerosus.

Presented is a case of a 6-year-old girl with biopsy-proved lichen sclerosus et atrophicus (LSA) localized to the anogenital region. She was seen approximately 3 months after the development of vulvar pruritus and burning on micturition. Following vulvar biopsies the patient was treated with hydrocortisone cream. Four months postbiopsy the patient is asymptomatic but with the coalesced white plaques remaining. Although cases benefiting from such various regimens as estrogen creams have been reported in the literature, the major benefit of therapy is relief of symptoms. This may be more safely accomplished with treatment of any vaginal discharge and the use of topical hydrocortisone cream. In children with regression of lichen sclerosus, complete resolution is common. No definite relationship to the menarche is documented.

Child↗
PubMed1979

Management of abnormal Papanicolaou smears in pregnancy.

All pregnant patients with abnormal cervical cytologic smears were evaluated as outpatients in the colposcopy clinic. Of the 131 patients, 84% had colposcopically directed biosies. Initial biopsy diagnosis of severe dysplasia/carcinoma in situ was noted in 16% of patients with class II smears and 43% of patients with class III smears. Two patients underwent conization and 2 had modified conizations because they failed to meet our criteria for adequate colposcopic evaluation. Of the 110 patients available for postpartum follow-up, all had either the same or a lesser degree of cervical intraepithelial neoplasia. Invasive carcinoma was not detected in any patient who underwent subsequent hysterectomy or conization. No abortions or premature labors could be directly attributed to the procedure.

Biopsy↗
PubMed1979

Current concepts of management of rupture of the gravid uterus.

Fifteen cases are reported of spontaneous rupture of the gravid uterus occurring at the Naval Regional Medical Center (NRMC), Portsmouth, Virginia, over a 21-year period. Forty-seven percent of the patients had previously undergone a cesarean section. Thirteen percent of the patients had received oxytocin prior to the rupture. Fetal mortality associated with these ruptures was 13%. No maternal deaths occurred. Forty percent of the patients had repair of the defect, with 60% undergoing some type of hysterectomy. Preventive measures, early diagnosis, and prompt treatment are emphasized.

Adult↗
PubMed1979

Adenocarcinoma in situ of the cervix during pregnancy.

A case of adenocarcinoma in situ of the cervix during pregnancy, appropriately diagnosed by conization, is reported. A review of the literature reveals that this neoplasm is rarely encountered during pregnancy. Guidelines for diagnosis and treatment of this unusual lesion are suggested.

Adenocarcinoma↗