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Biomedical subjects

D R Kent

Publications and source records attributed to D R Kent.

At least 19 recordsLinked to original sources
PubMed1986

Effect of oral contraceptives on leukocyte phagocytic activity and plasma levels of prostaglandin E2 and thromboxane B2 in normal menstruating women.

Mononuclear and polymorphonuclear cells were isolated from the peripheral blood of normal menstruating women. Four of the subjects were not using oral contraceptives and five were taking various formulations. The women were tested once a week for 12 consecutive weeks. Plasma levels of 6-keto-prostaglandin F2 alpha (6-KF), prostaglandin E2 (PGE2), thromboxane B2 (TxB2), estrogen, and progesterone were measured by specific radioimmunoassays. The phagocytic activity of the mononuclear and polymorphonuclear cells isolated from the peripheral blood was measured with a bacterial phagocytosis and killing assay. The phagocytic activity of both types of cells was depressed perimenstrually in both groups of women. However, examination of individuals showed that those subjects not taking oral contraceptives had a worsening of phagocytic activities with approaching menses while the oral contraceptive subjects generally had an improving of these activities at this time. We were unable to correlate the phagocytic activities with either hormone or prostaglandin levels in the plasma of these subjects. However, the subjects on oral contraceptives had significantly lower levels of PGE2 and TxB2 than those women who were not using oral contraceptives.

Contraceptives, Oral↗
PubMed1985

Experience with a cost-effective crossmatch protocol.

Pretransfusion blood samples were routinely tested for ABO group, Rh type, and the presence of unexpected red blood cell antibodies. Patients who had unexpected red blood cell antibodies received transfusions of blood that was crossmatched using an immediate spin test, a 37 degrees C incubation step, and an indirect antiglobulin test. Patients who did not have unexpected red blood cell antibodies received transfusions with blood that was crossmatched by an immediate spin crossmatch only. Because the average immediate spin crossmatch required only 3.25 minutes to be performed, crossmatches were not done for patients without unexpected antibodies until blood was actually requested to be issued for transfusion. During the first 8 1/2 months this protocol was used, 27,742 crossmatches were performed and 46,959 unnecessary crossmatches were avoided, thus reducing direct costs by at least +49,300. This protocol also allowed for optimal blood inventory control and minimized the outdating of units of blood to only 0.19%.

Blood Banks↗
PubMed1984

Experience with the routine use of an abbreviated crossmatch.

Three years' experience with the routine use of an abbreviated crossmatch procedure is reported. If a patient had no known history of and/or no currently demonstrable unexpected antibodies, ABO and Rh type specific blood was crossmatched at the time of need by using an immediate spin saline abbreviated crossmatch. Once blood was issued, both a 37 degrees C incubation and an antiglobulin crossmatch were done using the same tube employed for the abbreviated crossmatch. This served as a check that clinically significant antibodies were not overlooked. None of the 19,818 patients transfused following an abbreviated crossmatch suffered an acute hemolytic transfusion reaction as a result of this strategy; however, two patients may have manifested asymptomatic hemolysis. This approach to compatibility testing might be appealing to hospitals faced with fiscal limitations and new regulations affecting hospital reimbursement.

Adult↗
PubMed1984

Depressed mononuclear cell phagocytic activity associated with menstruation.

The peak of the normal distribution curve for pelvic inflammatory disease occurs near the onset of menses. This study was undertaken to determine if there were changes in the cell-mediated immunity of normal menstruating women which could explain the increase in inflammatory disease. The cellular immune response of 8 normal women, measured by number of T- and B-cells and response of mononuclear cells to stimulation with mitogen, was not dependent on the menstrual cycle. However, there was a significant decrease in phagocytic activity of mononuclear cells early in the cycle. The depressed phagocytic activity was not altered by treating the subjects with ibuprofen.

Female↗
PubMed1984

Safety and efficacy of vaginal prostaglandin E2 suppositories in the management of third-trimester fetal demise.

Prostaglandin E2 vaginal suppositories are well established in the management of intrauterine fetal demise in the second trimester of pregnancy. However, approval for their use in the third trimester has been withheld pending evaluation of safety and efficacy. In this study 46 patients with intrauterine fetal demise in the third trimester were managed in a similar fashion except that only a 10-mg dose of prostaglandin E2 was employed. Forty-four of the 46 patients were delivered successfully. One patient experienced a cervical laceration that necessitated a hysterectomy; in her, oxytocin was used to supplement the prostaglandin. It appears that prostaglandin E2 vaginal suppositories can be used safely in the management of fetal demise in the third trimester of pregnancy. Use of a lower dose of the medication as well as tocodynamometry is recommended because the absorption of and sensitivity to this medication vary from patient to patient. The frequency of administering the medication should depend on the patient's response rather than on any given formula.

Adolescent↗
PubMed1984

Effects of prostaglandin E2 analogue suppository on blood loss in suction abortion.

The purpose of the present clinical investigation was to determine the effect of preoperative treatment with a long-acting prostaglandin suppository containing 9-deoxo-16,16-dimethyl-9-methylene prostaglandin E2 on uterine blood loss in patients undergoing preoperative cervical dilatation before transcervical abortion. Ninety-five young women in the ninth to 14th week of gestation were randomly assigned to one of two groups. Patients in group 1 were treated with a long-acting prostaglandin suppository and group 2 patients acted as control subjects. At the end of three hours, patients in both groups underwent abortion with careful intraoperative measurement of blood loss in both groups. The blood loss in the prostaglandin-treated group was significantly lower than that in the control group (69.0 +/- 14.1 mL versus 151.1 +/- 26.6 mL). The difference in intraoperative blood loss was observed at all gestations between nine and 14 weeks. There was significantly greater dilation of the cervix after prostaglandin treatment (mean difference, 4.58 mm; P less than .005).

16,16-Dimethylprostaglandin E2↗
PubMed1983

Preoperative cervical dilatation with a single long-acting prostaglandin analog suppository. An alternative to traumatic mechanical dilatation before surgical evacuation.

A single vaginal suppository containing 1 mg of 15-methyl prostaglandin F2 alpha methyl ester induced cervical dilatation in 60 patients requesting surgical termination of pregnancy. Forty-two percent of the patients required no further dilatation. Even when further dilatation was required, it was performed with considerable ease due to the softening effects of the prostaglandin on the cervix. The use of this agent may be of value in preventing complications resulting from mechanical dilatation of the cervix.

Abortion, Induced↗
PubMed1978

Intraepithelial neoplasia of the uterine cervix in the teenager.

One hundred and seventeen teenagers with abnormal cervical cytology were evaluated using colposcopy and directed biopsies. Eighty-eight cases of cervical intraepithelial neoplasia were discovered including 24 cases of severe dysplasia or carcinoma in situ. Erradication of these lesions is essential as a preventative measure. The importance of routine cytologic screening and early evaluation of abnormal Papanicolaou smears in the teenager is emphasized.

Adolescent↗
PubMed1978

Effect of pregnancy on liver tumor associated with oral contraceptives.

Four cases of liver adenoma associated with oral contraceptives complicating pregnancy are reported. All patients were symptomatic during pregnancy and 2 were admitted with rupture of the adenoma. One subsequently died. Increased growth and vascularity of adenomas during pregnancy is highly likely. The potential for development of lethal complications is considerable.

Adenoma↗
PubMed1977

Etiologic factors in the pathogenesis of liver tumors associated with oral contraceptives.

Within the last several years, previously rare liver tumors have been seen in young women using oral contraceptive steroids. The Registry for Liver Tumors Associated with Oral Contraceptives at the University of California, Irvine, has clearly identified 27 cases. The recent literature contains 44 case reports. Common to these 71 cases has been a histopathologic diagnosis of focal nodular hyperplasia, adenoma, hamartoma, and hepatoma. Significant statistical etiologic factors include prolonged uninterrupted usage of oral contraceptive steroids. Eight deaths and liver rupture in 18 patients attest to the seriousness of this new potentially lethal adverse phenomenon.

Adenoma↗
PubMed1977

Live tumors and oral contraceptives.

Data on 78 cases of benign hepatic neoplasia among women with a history of oral contraceptive (OC) use are analyzed. Data for the study were collected by the Liver Tumor Registry of the University of California Irvine Medical Center. Factors considered in the analyses include the patient's age and duration of OC therapy, histopathology of the tumors, and their symptoms, findings, and prognosis. The pathogenesis and treatment of the tumors are also discussed.

Adenoma↗
PubMed1977

Unilateral tuboovarian autoamputation.

Six cases of unilateral tuboovarian absence are reviewed. In four, the peritoneal cavity contained a separate ovoid structure. In two of these, the pathologist could identify the remnant as a phagocytized ovary. In a third patient, the ovoid body was seen fixed to the contralateral ovary during laparoscopy. Subsequently, it was identified radiologically as a calcific density. In the fourth case, an intact ovary was separated from the uterus and engulfed by omentum. If a total embryogenic error or selective dysgenesis of the urogenital fold occurs, ipsilateral anomalies usually involve adjacent structures of both the urinary and genital systems. Howerver, no anomalies of the uterus and urinary structures appeared evident in any reviewed case. Therefore, adnexal torsion with subsequent infarction necrosis and autoamputation represents the most likely explanation for this phenomenon.

Adult↗
PubMed1976

Abnormal cervical cytology in the teen-ager: a continuing problem.

Abnormal cervical cytology is being discovered in an alarming number of sexually active teen-agers. Over an 18 month period, cytology consistent with mild dysplasia or worse was noted in 188 of 2,655 teen-agers screened. This represents a rate of 70.8 per thousand. Colposcopically directed biopsies in 65 patients revealed 15 cases of severe dysplasia-carcinoma in situ. Cryosurgery was the principle method of treatment and, combined with colposcopy, is a safe and effective means of managing these patients.

Adolescent↗
PubMed1976

The making of a colposcopist. A safe and sensible approach.

A program was established to determine the accuracy of colposcopy at our institution. Forty-three patients with cytologic or histologic evidence of severe dysplasia or worse underwent diagnostic conization following satisfactory colposcopy. Thirty patients subsequently had either therapeutic conization or hysterectomy preceded by biopsy only. In all 73 cases, the surgical specimen did not reveal a more advanced lesion. However, when the colposcopy was unsatisfactory, the rate of error was 20.8%. It is our opinion that colposcopy is a safe and valuable technique as long as one recognizes the need for training and understands the indications for further diagnostic studies. The use of the colposcope for the evaluation of abnormal cervical cytology has increased steadily over the last few years, and several excellent courses are now offered throughout the United States. Armed with a certificate from such a course, many gynecologists then become self-proclaimed colposcopists in spite of warnings to the contrary by the instructors. In addition, supervision by experienced personnel is not always available. How, then, does one indeed become an accomplished colposcopist to the point that he or she can safely spare the patient the risk, inconvenience and expense of diagnostic cervical conization? Although several recent publications 2,5,6,9,11 document the diagnostic accuracy of colposcopically directly biopsies, we feel each individual should develop and evaluate his or her own skill before altering or abandoning conventional methods of diagnosis and management. The purpose of this report is to present our experience with colposcopy utilizing a program which can perhaps serve as a model to other clinicians.

Biopsy↗