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Biomedical subjects

D K Roberts

Publications and source records attributed to D K Roberts.

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

Scanning electron microscopy of the multifilament IUD string.

Fifteen multifilament strings on Dalkon Shield IUDs removed from patients were evaluated with scanning electron microscopy. All fifteen showed deterioration of the sheath which encloses the smaller inner filaments. The greatest area of deterioration was at the attachment knot which is usually intrauterine. Deterioration of the sheath also occurs when the device is within the uterine wall or intraperitoneal. The risk of pelvic infection may be attributed to this deterioration of the sheath and contamination from that site.

Bacterial Infections↗
PubMed1984

Fertility after metroplasty of the septate uterus.

Congenital uterine anomalies are well known to affect a woman's fertility and ability to deliver a viable infant. A retrospective chart review with recent follow-up was performed for 38 women who underwent a modified Tompkin's metroplasty. All septate uterine configurations were proven by hysterosalpingography and laparoscopy. We examined the preoperative and postoperative fertility and pregnancy salvage rates. An examination to exclude other absolute infertility and pregnancy wastage factors was completed before surgery. Of 38 women studied, 30 (78.9%) had conceived before surgery, for a 6.2% pregnancy salvage rate. Of the 36 women operated on at least one year previously, 24 (66.7%) had become pregnant, for a 77.8% pregnancy salvage rate. Fertility after metroplasty is dependent on many individual factors, and efforts must be made to maximize them. Metroplasty improves the pregnancy salvage rate in women with septate uteri.

Adult↗
PubMed1984

Malignant melanoma metastatic to the endometrium.

A case of malignant melanoma metastatic to the endometrium is presented along with a review of the literature on metastatic melanoma, showing its rarity. Malignant melanoma metastasizes to many sites, including the lung, bone, liver, skin, and pancreas. Four cases of melanoma metastatic to the endometrium have been reported. The purpose of the present report is to describe the clinical picture of another patient with malignant melanoma metastatic to the endometrium as well as the general histologic and prognostic features of the disease.

Aged↗
PubMed1983

Experience with the carbon dioxide laser in gynecologic microsurgery.

The value of the carbon dioxide laser in gynecologic microsurgery remains controversial. Initial reports on the success of the laser in infertility surgery were not supported by substantial patient data. The majority of researchers involved with laser microsurgery agree that the technique has numerous advantages, including excellent hemostasis, decreased tissue destruction, exacting precision of dissection and shortened operating time. There are, however, relatively small numbers of patients treated with this modality who have been followed up for a sufficient period of time to determine the ultimate effect the laser will have on pregnancy rates. Since our first laser microsurgical procedure in November, 1980, we have performed more than 150 such procedures. The procedures have included neosalpingostomy, tubal reanastomosis, vaporization of adhesions, and removal of endometriosis. The technique is safe as shown by the absence of any laser-related complication in our cases. We now have 69 patients who have been followed up for more than 1 year since the time of the procedure. The following work is a presentation of pregnancy data and patency rates from this patient group. These results are presented in an effort to offer some objectivity to the comparison of laser microsurgery and standard microsurgery.

Adult↗
PubMed1983

CO2 laser laparoscopy. A potential alternative to danazol in the treatment of stage I and II endometriosis.

Most clinicians currently agree that stage I and II pelvic endometriosis, as determined by the American Fertility Society classification, is best treated with danazol when there are no significant peritubal or periovarian adhesions. This therapy offers excellent pregnancy rates and avoids the risk of pelvic adhesions, which can occur after conservative laparotomy. However, the significant disadvantages of danazol include androgenic side effects, breakthrough bleeding, prolonged treatment time and high cost. It is not unheard of for a patient to choose laparotomy over danazol because of these disadvantages. An ideal form of therapy would avoid these disadvantages and be accessible at diagnostic laparoscopy, when the disease is detected. We have worked with such a treatment, the CO2 laser, for one year. With the CO2 laser adapted to the operating laparoscope we have treated stage I and II pelvic endometriosis at the time of the original diagnostic laparoscopy. Due to the precise control the operator has over the laser, implants on the peritoneum over the bladder and bowel or near the ureters can be treated safely. There is little danger of damaging adjacent structures, as one might experience with electrocautery. Ovarian endometriomas of less than 1 cm and mild adhesions can also be removed safely by tissue vaporization.

Adult↗
PubMed1975

The ultrastructural response of human endometrium to medroxyprogesterone acetate.

Medroxyprogesterone acetate is a steroid compound similar to progesterone in structure and function. Thirty women were given 150 mg. of medroxyprogesterone intramuscularly, and samples of the endometrium were examined by light and electron microscopy. The initial response of normal human endometrium was maturation and then inhibition. By 50 days after injection, the atrophic changes began to reverse, and by Day 90, after injection the tissue resembled normal proliferative endometrium. A previously undescribed nuclear inclusion body is present; however, its significance is unclear at this time. On the basis of ultrastructural changes, medroxyprogesterone appeared not to exert a significant influence on the endometrium past 90 days at this dosage.

Adult↗