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Biomedical subjects

G Delgado

Publications and source records attributed to G Delgado.

At least 91 records · Page 5Linked to original sources
PubMed1990

Vulvar condylomas and squamous vestibular micropapilloma. Differences in appearance and response to treatment.

A study of 37 women with typical condylomas and so-called squamous micropapilloma was undertaken to determine their response to systemic interferon and/or podophyllin treatment. Thirty lesions were classified as condylomas and 9 as squamous micropapillomas; two women had both lesions. Twenty-six (87%) of 30 condylomas responded, whereas only 1 (11%) of the 9 cases of micropapillomatosis showed a partial response (P less than .001) to podophyllin and/or interferon. Twenty-six biopsies from condylomas in which sufficient DNA was available for analysis contained human papillomavirus (HPV) DNA sequences that hybridized to an HPV 6 + 16 probe mix under nonstringent conditions. In contrast, HPV DNA sequences could not be detected in any of the nine cases of micropapillomatosis. Immunoperoxidase studies performed on these lesions failed to demonstrate viral capsid antigen. Thus, despite certain similarities in the clinical presentation and microscopic features of condylomas and squamous micropapillomas, it is not clear at present whether micropapillomas are HPV-related lesions.

Condylomata Acuminata↗
PubMed1989

Postoperative adjuvant external-beam radiotherapy in surgical stage I endometrial carcinoma.

A combined surgical and radiotherapeutic approach is widely in Stage I endometrial adenocarcinoma. The technique and timing of the radiotherapy varies from center to center. Postoperative external-beam (EB) radiotherapy has the advantage of patient selection based upon surgical findings, comprehensive treatment of the pelvic nodal and vaginal cuff areas, and elimination of the need for an intracavitary procedure. Although frequently utilized, this technique is surprisingly poorly described in the medical literature. From 1979 to 1986, 46 surgical Stage I patients received adjuvant postoperative EB therapy at Georgetown University Hospital (GUH) (Washington, DC). Indications for treatment were Grade greater than or equal to 2 and/or depth of myometrial invasion of greater than 33%. The 5-year actuarial survival was 90% with a disease-free survival of 82%. The failure rate within the irradiated field was 6.5% with a distant failure rate of 8.7%. The rate of significant long-term complications was acceptable at 6.5%. The authors conclude that postoperative EB radiotherapy is an effective adjuvant therapy with results comparable to other available radiotherapeutic techniques.

Adenocarcinoma↗
PubMed1989

A phase I/II study of intraperitoneally administered doxorubicin entrapped in cardiolipin liposomes in patients with ovarian cancer.

A phase I and II clinical trial of intraperitoneally administered liposome-encapsulated doxorubicin in patients with advanced ovarian cancer is being evaluated. Doxyrubicin liposomes were prepared with cardiolipin, phosphatidyl choline, cholesterol, and sterarylamine and sized by flow cytometry before administration. Fifteen patients have been treated with 42 cycles of intraperitoneal liposome-encapsulated doxrubicin. Liposome-encapsulated doxorubicin in 2 L of normal saline solution was infused over 1 hour through an infusaport into the peritoneal cavity with a dwell time of 4 hours every 21 days. Liposome-encapsulated doxorubicin has been administered at escalating doses up to 100 mg/2 L and has been well tolerated. Increased bowel motility with mild-to-moderate abdominal distress has been encountered during the first 24 hours after administration. There has been one patient with presumed chemically induced peritonitis after a temperature elevation to 39.5 degrees C. There has been no myelosuppression, abnormalities of liver function tests, or alopecia. Nausea and vomiting were minimal. Liposome-encapsulated doxorubicin was extravasated in two patients without sequelae. Drug levels were measured after completion of infusion. At a dose of 70 mg, the peak intraperitoneal concentration was 28.6 micrograms/microliter, which was reduced to 23.6 micrograms/microliter by 2 hours. Concurrent plasma levels were in the range of 0.2 to 0.5 micrograms/microliter. A similar pattern was observed at other doses. The maximum tolerable dose has not yet been obtained. There were three responders in the 10 evaluable patients. The preliminary experience with intraperitoneal liposome-encapsulated doxorubicin is encouraging.

Adult↗
PubMed1989

Determination of cellular oncogene rearrangement or amplification in ovarian adenocarcinomas.

Four cellular oncogenes, fos, myc, Ha-ras, and Ki-ras, are routinely expressed in ovarian adenocarcinomas. To determine whether the molecular lesion in ovarian carcinoma was a genetic rearrangement or amplification of expressed oncogenes, we examined the myc, Ha-ras, Ki-ras, and fos oncogenes in 14 serous adenocarcinomas of the ovary using molecular hybridization techniques. Using a series of diagnostic restriction endonucleases and gene-specific deoxyribonucleic acid probes, we found no evidence of rearrangement of these genes. In addition, we found no evidence of amplification of the cellular oncogenes analyzed in this series of ovarian tumors. Therefore genetic rearrangement or amplification of these cellular oncogenes is not the primary molecular lesion leading to their expression in ovarian carcinomas.

Adenocarcinoma↗
PubMed1989

A prospective surgical pathological study of stage I squamous carcinoma of the cervix: a Gynecologic Oncology Group Study.

Thirty-three institutions collaborating in the Gynecologic Oncology Group gathered surgical and pathological data on 1125 patients with primary, previously untreated, histologically confirmed stage I cervical carcinoma with more than 3 mm of invasion who were selected to undergo radical hysterectomy and paraaortic and pelvic lymphadenectomy. Of the 940 eligible, evaluable patients, 732 had squamous carcinoma. Of the study group, 87 (12%) did not undergo radical hysterectomy because of gross disease beyond the uterus or microscopic aortic node involvement documented at exploratory laparotomy. Among the 645 patients undergoing pelvic and paraaortic lymphadenectomy and radical hysterectomy, five risk factors were significantly associated with microscopic pelvic lymph node metastasis: depth of invasion (P = 0.0001), parametrial involvement (P = 0.0001), capillary-lymphatic space invasion (P = 0.0001), tumor grade (P = 0.01), and gross versus occult primary tumor (P = 0.009). The factors identified as independent risk factors for pelvic lymph node metastasis by multivariate analysis were capillary-lymphatic space involvement (P less than 0.0001), depth of invasion (P less than 0.0001), parametrial involvement (P = 0.0005), and age (P = 0.02). The model was used to predict the chance of a patient having nodal metastasis for any combination of risk factors.

Adult↗
PubMed1989

Randomized trial of cyclophosphamide plus cisplatin with or without doxorubicin in ovarian carcinoma: a Gynecologic Oncology Group Study.

A randomized clinical trial was conducted in women with stage III ovarian carcinoma (less than or equal to 1 cm residual lesions), using cyclophosphamide plus cisplatin (CP) with or without doxorubicin. There were 349 evaluable patients, of whom 176 received CP while 173 patients received CP plus doxorubicin (CAP). Hematologic toxicity was almost identical. There was no significant difference in progression-free interval (PFI) (median, 22.7 months and 24.6 months), frequency of negative second-look laparotomy (30.2% and 32.8%), or survival (median, 31.2 months and 38.9 months) between CP and CAP, respectively. Thus, doxorubicin in the dose schedule employed does not improve combination chemotherapy of optimal stage III ovarian carcinoma. Several other findings, independent of treatment arm, were of interest. There was a significant difference in PFI and survival by residual disease category (yes v no) and by grade of differentiation (1 v 2 + 3). In multivariate analysis, age, residual disease at entry, cell type (clear cell carcinoma), and time from surgery to initiation of chemotherapy were significant predictors of survival. There was no difference in outcome comparing those who refused second-look with those who had a second-look.

Adult↗
PubMed1989

Carcinoma of the vulva. Significance of surgical margin involvement in assessing prognosis.

Repeat pathologic analysis was completed in order to independently assign surgical margin status in a group of 61 patients from the Ohio State University gynecologic oncology tumor registry. Patients were entered into the study group after having undergone simple or radical vulvectomy for squamous carcinoma of the vulva. A statement regarding margin status was made following a detailed pathologic review, and parameters--including stage, grade and lymph node involvement--were assigned without regard to outcome. There was no statistically significant difference in the survival or recurrence rate with involved margins. Mean lesion size was significantly larger with involved margins (P less than .05). The survival and recurrence data support a primary surgical attempt at complete excision regardless of the microscopic margin status.

Carcinoma, Squamous Cell↗
PubMed1989

Surgical staging of carcinoma of the ovaries.

One hundred and eighty-seven patients with stages I, II and III optimal (metastatic lesions of less than 3 centimeters) epithelial carcinoma of the ovaries were evaluated preoperatively and had standardized exploration and biopsy. The protocol called for examination and biopsy of the peritoneum, diaphragm, omentum, pelvic and para-aortic lymph nodes and aspiration of ascites or peritoneal washings for cytologic examination. Of those patients with metastases to the omentum, the clinical impression did not correlate with pathologic findings in 45 per cent. The findings were similar for diaphragmatic lymph nodes (50 per cent), pelvic lymph nodes (71 per cent) and para-aortic lymph nodes (96 per cent). Nine of 97 patients clinically thought to have stage I disease had the stage elevated to II and III based on pathologic findings. Similarly, 15 patients thought to have stage II were found to have stage III based on histopathologic findings. There were 74 complications in 54 patients, with 29 having at least one complication. Surgical exploration for early stage carcinoma of the ovary should include biopsy of the retroperitoneal pelvic and para-aortic lymph nodes, excision of the infracolic omentum, biopsies of pelvic and abdominal peritoneum, including the right diaphragm, and peritoneal cytologic studies.

Adenocarcinoma↗
PubMed1988

Possible prognostic significance of human papillomavirus type in cervical cancer.

While several different human papillomaviruses (HPV) have been associated with cancer of the cervix, it is yet to be determined if specific HPV types have clinical or prognostic significance. To address this question, 30 cases of invasive carcinoma (squamous carcinoma, adenosquamous carcinoma, and adenocarcinoma) with HPV DNA sequences detectable in the tissue were analyzed. HPV type was determined by Southern blot DNA hybridization. Clinical information was obtained by chart review, and all biopsy and surgical specimens were reviewed microscopically without knowledge of HPV type. HPV 16 was detected in 14 cases, HPV 18 in 6, and HPV 31 in 2. In eight samples there were distinctly different, but as yet uncharacterized, HPV DNAs. Of the factors evaluated, tumor grade was found to have a statistically significant relationship to HPV type. Eighty-three percent of HPV 18-associated tumors were grade 3 tumors (5 of 6) as compared to only 7% of HPV 16-associated tumors (1 of 14) (P = 0.002). Age at diagnosis and nodal status in relation to HPV type exhibited a trend but were not statistically significant. The mean age of the HPV 18 group was 37 years, compared to 49 years for the HPV 16 group. Similarly, among Stage IB cancers, nodal involvement was associated with 60% of HPV 18 cases (3 of 5) as compared with 36% of HPV 16 cases (4 of 11). These observations suggest that HPV 18 may be associated with a more aggressive form of cervical cancer than other HPV types.

Adenocarcinoma↗
PubMed1987

An alternative approach to the vertical midline abdominal incision for staging in ovarian carcinoma.

The case report describes a situation that required staging laparotomy for ovarian cancer but the patient refused vertical incision for cosmetic reasons. The technique employed a low transverse skin incision with development of a skin flap and horizontal transection of the midabdominal wall near the level of the umbilicus. Operative exposure was adequate for standard staging procedures and the cosmetic requirements of the patient were satisfied.

Abdominal Muscles↗
PubMed1987

Necrotising haemorrhagic encephalomyelopathy in an adult: Leigh's disease.

A 21 year old male, well-nourished and non-alcoholic, died after five weeks illness. He had suffered epileptic fits, bilateral internuclear ophthalmoplegia, bulbar and pontine paralysis, tetraparesia, ataxia and dystonia. A CT brain scan showed low density lesions of the striatum bilaterally. Post-mortem studies revealed pathological anomalies compatible with Leigh's disease, although the presence of haemorrhages and involvement of the mamillary bodies could also suggest Wernicke's encephalopathy.

Adult↗
PubMed1986

Increased pancreatic acinar content and secretion of cationic trypsinogen following 30-day continuous ethanol intoxication in rats.

The effects of sustained, high blood alcohol levels (216 +/- 120 mg/100 ml, S.D.) for 30 days on cholecystokinin (CCK)-mediated pancreatic exocrine function were studied in a rat model that achieves both maximally controlled, optimal nutrition and high alcohol intake (approximately 40.5% of total calories). In alcohol-fed rats, basal plasma levels of immunoreactive cationic trypsinogen (ICT) were reduced by 50% (P less than 0.05), but intravenous doses (0-30 IDU/kg/hr; 1 IDU = approximately 62.5 ng CCK-8) of cholecystokinin octapeptide (CCK-8) resulted in a 3-fold greater maximal concentration of ICT and an 80% steeper slope of the dose-response curve compared to those of pair-fed control animals. Basal plasma levels of amylase were not different in the two groups at basal conditions and did not change significantly following CCK-8 administration. In vitro studies with isolated pancreatic acini have shown that basal secretion of ICT into the media was similar in the two groups. However, ICT secretion in response to CCK-8 (30-3000 pM) was 2-fold greater in alcohol-fed rats than in pair-fed controls, resulting in a CCK-8 EC50 which was about half that of controls. On the contrary, the basal and maximal amylase secretion from acini isolated from alcohol-fed rats was reduced by 67 and 43%, respectively, causing a reduction in the magnitude of the response curve with almost identical EC50 and slopes. Despite the marked alterations in CCK-stimulated enzyme secretion, radioiodinated CCK-33 binding to receptors on acini isolated from both control and alcohol-fed rats was similar. Cellular concentrations of ICT and amylase, however, revealed similar patterns of alterations: 2 to 3-fold increase in ICT and 70% reduction in amylase in alcoholic acini compared to controls. These results indicate that the inverse changes in amylase and ICT secretions following continuous ethanol administration are probably due to differential effects on enzyme synthesis.

Alcoholism↗
PubMed1986

Ovarian carcinoma. The significance of restaging laparotomies with negative outcomes.

The role of restaging laparotomy in the treatment of ovarian carcinoma is currently being reevaluated. This study was initiated to examine the predictive value of a negative outcome. Between November 1974 and October 1983, sixty-three patients with no clinical evidence of disease underwent 70 restaging laparotomies for ovarian carcinoma. The findings of 34 (49%) of these procedures were negative for residual disease. Patient follow-up ranged from 30 to 137 months. Twenty-eight patients are alive with no evidence of disease with a median follow-up of 62 months. Four patients have died of a second primary tumor. Only two patients had recurrence of their ovarian carcinoma following restaging laparotomy with negative findings (recurrence rate, 5.9%; 13.3% for patients with advanced disease). Patients with negative findings at restaging laparotomy have an excellent prognosis and a good chance of being cured of their disease.

Adult↗
PubMed1986

Human papillomavirus deoxyribonucleic acid in cervical carcinoma from primary and metastatic sites.

Tissue from 13 cervical cancers and pelvic or para-aortic lymph nodes from the same patient were evaluated by deoxyribonucleic acid hybridization with a human papillomavirus type 16 deoxyribonucleic acid probe for the presence of human papillomavirus-related deoxyribonucleic acid sequences. Twelve of the primary malignancies were squamous cancers and one was an adenocarcinoma. Eight of the primary tumors contained human papillomavirus type 16 deoxyribonucleic acid sequences, and five contained viral sequences closely related to human papillomavirus type 16. Histopathologic diagnosis confirmed malignant cells in six of 13 lymph nodes; three of these specimens contained human papillomavirus type 16 sequences while three had human papillomavirus type 16-related sequences. One lymph node that failed to show malignant cells also contained human papillomavirus type 16 deoxyribonucleic acid. The remaining lymph nodes did not contain malignant cells by either histologic examination or deoxyribonucleic acid hybridization. The human papillomavirus deoxyribonucleic acid sequences in the lymph nodes were similar to those in the matched primary cancer in all cases. These data provide further evidence implicating human papillomavirus in the etiology of cervical cancer.

Adenocarcinoma↗
PubMed1986

The significance of paraaortic node status in carcinoma of the cervix and endometrium.

Survival in 115 women with cervical carcinoma and 55 patients with carcinoma of the endometrium was correlated with the status of paraaortic lymph nodes and the clinical stage of disease. The survival probability at 48 months for patients with cervical cancer who had negative paraaortic lymph nodes was 86% for stage IB in comparison to 67% for those with advanced disease (clinical stages II, III, and IV). The difference of 19% between these two groups was not statistically significant nor was there a statistical difference in survival between early and advanced disease groups when paraaortic nodes contained tumor (37 vs 20%). For all stages of cervical cancer, survival was 80% with negative nodes and 20% with positive nodes at 48 months. In patients with endometrial carcinoma and negative paraaortic lymph nodes, projected survival at 48 months was 72% for stage I and 77% for stages II and III. When paraaortic lymph nodes demonstrated metastatic disease, survival uniformly decreased to 27% of patients with stage I cancer and 25% of those with stage II and III disease. For all stages of endometrial cancer, survival was 76% with negative nodes and 26% with positive nodes at 48 months. The presence or absence of metastatic disease in the paraaortic lymph nodes is an important prognostic factor that appears to be more useful in predicting survival than clinical stage of disease in patients with cervical and endometrial cancer.

Adenocarcinoma↗
PubMed1986

Focal dystonia of the jaw and the differential diagnosis of unilateral jaw and masticatory spasm.

The clinical features, differential diagnosis and treatment of unilateral spasms of the jaw and masticatory muscles are discussed and illustrated by eight cases of unilateral jaw spasms of various aetiologies. These include focal dystonia of the jaw, hemimasticatory spasm with and without facial hemiatrophy, paroxysmal events in multiple sclerosis and tetany. Attention is particularly drawn to four cases of unilateral dystonia of the jaw which has not been described before.

Adult↗