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Biomedical subjects

H M Shingleton

Publications and source records attributed to H M Shingleton.

At least 127 records · Page 7Linked to original sources
PubMed1979

A screening system for cervical cancer cytology.

A system for screening cervical cytological preparations is described which employs the Leitz Texture Analyzer System (E. Leitz, Rockleigh, N. J.) quantitative staining with acridine orange, and a fluorescence standard. The instrumentation scans cells on microscope slides and detects objects which it interprets to be nuclei with excess total nuclear green fluorescence intensity (Previous results employing manual measurements have indicated that normal nuclei do not produce total nuclear green fluorescence greater than a specific absolute intensity level). Detected objects are identified by visual observation. Cells (102,000) from 65 patients (29 normal, 36 abnormal) have been examined. In each abnormal sample, at least one abnormal cell was detected. In over half of the samples, three or fewer other objects (e.g. clumps of polymorphonuclear leukocytes) were detected. These are easily distinguishable from single nuclei, and could be discarded by someone with minimal cytological training.

Cervix Uteri↗
PubMed1979

The Swan-Ganz catheter and management of patients undergoing pelvic exenteration.

A Swan-Ganz catheter has been used in 10 consecutive patients undergoing pelvic exenteration and has made the intraoperative and postoperative management of these patients a much easier task. Use of this catheter eliminates the guesswork involved in managing fluid and volume status by providing an accurate assessment of left ventricular end diastolic pressure. The complication rate is reported as 5% and consists mostly of ruptured balloons, infection, coiling of the catheter, and cardiac irritability. There have been no complications in the 10 patients in whom we have used the catheter. We believe that the use of the Swan-Ganz catheter in these difficult-to-manage patients is justified because of its low complication rate, easy use, and the accurate valuable information obtained.

Cardiac Catheterization↗
PubMed1979

Adenocarcinoma of the vagina in a patient with gonadal dysgenesis.

Adenocarcinoma of the vagina is an uncommon tumor. Many theories have been postulated for its etiology and tissue origin. Its occurrence in young women exposed in utero to diethylstilbestrol has pointed to estrogen influence as a possible etiologic factor. A case of adenocarcinoma of the vagina in a patient with gonadal dysgenesis is presented, and histologic and electron-microscopic observations are discussed. This patient is unique in that development of the vaginal neoplasm occurred in the absence of estrogen influence.

Adenocarcinoma↗
PubMed1978

Treatment of malignant ovarian germ cell tumors: response to vincristine, dactinomycin, and cyclophosphamide (preliminary report).

From November 1971 to November 1975, 27 patients with malignant germ cell tumors of the ovary (excluding pure dysgerminoma and tumors containing trophoblastic elements) were treated with vincristine, dactinomycin, and cyclophosphamide; 12 patients received other therapy. Fourteen tumors were pure endodermal sinus tumors, two were embryonal carcinomas, 11 were mixed germ cell tumors and 12 were immature teratomas. Of 23 patients with surgically resected disease (Stages I-IIA) only seven have failed. Median follow-up for 16 patients remaining free of disease is 24.5 months. Restaging (second-look) laparotomies were done in 15 patients. Eight were negative. Fifteen of the patients had tumors with endodermal sinus elements. Six of these have failed. Of 16 patients with advanced disease (Stage IIB, III and recurrent), eight have responded to chemotherapy, eight have failed. Median follow-up period for those remaining free of disease is 26.5 months. Six have had negative second-look surgery and one had mature teratoma. Four of eight cases which contained endodermal sinus elements responded to chemotherapy and remain disease-free. Grade 3 hematologic toxicity was seen in eight patients, dose-limiting gastrointestinal toxicity in five patients, dose-limiting neurotoxicity in five patients.

Adolescent↗
PubMed1978

Diagnostic compound B-mode ultrasound scanning in gynecology.

Diagnostic compound B-mode ultrasound scans done on gynecologic patients during the past three years were reviewed and compared with surgical findings or clinical follow-up. The 190 scans were analyzed and categorized as diagnostic, compatible (or confirmatory), equivocal, misleading, or negative. Although only 6.4% were diagnostic, the majority (66.3%) were compatible with the clinical and pathologic findings. Criteria for interpreting B-mode scans are discussed.

Diagnostic Errors↗
PubMed1978

Colposcopy or cervical conization? An economic comparison.

Costs of colposcopic evaluation of patients with abnormal Papanicolaou smears versus evaluation by conization are compared. The average colposcopic evaluation costs $106, and the average conization costs $923.70. Additional savings ensue if a colposcopic diagnosis, rather than conization of the cervix, precedes a definitive hysterectomy. All criteria for an adequate colposcopic examination and tissue diagnosis must be met to make this comparison.

Cervix Uteri↗
PubMed1978

Southern Regional Trophoblastic Disease Center, 1972--1977.

The experience of the Southern Regional Trophoblastic Disease Center includes 222 patients who were referred from January 1972 to October 1977. The initial tissue diagnosis was hydatidiform mole in 212 patients and choriocarcinoma in ten. There was spontaneous remission of 142 (69%) of the moles and one of the choriocarcinomas, and 77 patients developed persistent trophoblastic disease. Of these, 58 had no evidence of metastasis, and all achieved remission with single-drug therapy. Nineteen patients developed metastases; 13 were in the "good prognosis" category, and all achieved remission with single-drug therapy. Five (83%) of the six patients with metastases in the "poor prognosis" group achieved remission with triple chemotherapy; one died of her disease.

Cancer Care Facilities↗
PubMed1977

Cervical carcinoma with adenoid cystic pattern: a light and electron microscopic study.

Three cases of cervical carcinoma with an adenoid cystic pattern were studied by light and electron microscopy. All were found to be compatible with the histologic picture of adenoid cystic carcinoma in other body sites. Although there was some variability in the pattern among the tumors, areas of each exhibited a cribriform appearance characterized by small cells with sparse cytoplasm arranged around cystic gland-like lumina. Only one tumor displayed cylindromatous formations similar to those described by Billroth. Two of the tumors were associated with foci of squamous cell carcinoma while the third contained areas suggestive of such a component. Electron microscopic examination showed varied morphology of the cysts, manifested by true glandlike lumina, extracellular spaces containing replicated basement membrane or enclosed stroma. In view of the observed diversity in the light and electron microscopic morphology of adenoid cystic carcinomas of the cervix, it is apparent that this tumor is not a distinct histologic entity. Accordingly, it is recommended that the terminology "cervical carcinoma with adenoid cystic pattern" be utilized.

Adenocarcinoma↗
PubMed1977

The significance of age in the colposcopic evaluation of women with atypical apanicolaou smears.

As women age, atypical Papanicolaou smears are associated with more advanced cervical neoplasia. The woman under age 30 had less than one chance in a hundred of having invasive carcinoma if she has an atypical Papanicolaou smear, while the woman over age 60 has one chance in six of this finding. An atypical Papanicolaou smear does not necessarily mean neoplasia is present; 23% of the women evaluated for atypical smears had a negative evaluation, and this included women over age 60. Endocervical currettings containing neoplastic tissue frequently are seen after age 30 and may contribute significant information to the final diagnosis; stenosis of the endocervix, however, may prevent curettage in postmenopausal women. Diagnostic conizations of the cervix rarely are necessary prior to age 30 if colposcopic technics are used. The need for conizations increases by decade of age and is required in at least one-third of postmenopausal women evaluated initially by colposcopy.

Adolescent↗
PubMed1976

Outpatient evaluation of patients with atypical Papanicolaou smears: contribution of endocervical curettage.

A series of 603 patients referred with atypical Papanicolaou smears was evaluated by repeat smears, colposcopically directed cervical biopsies, and endocervical curettage. These techniques as a unit can establish an accurate outpatient diagnosis superior to any of these modalities used alone and comparable with findings in conization and hysterectomy specimens. Endocervical curettage has made a unique contribution to the evaluation of such patients; these curettings have allowed examination of tissue fragments and are more reliable in diagnosing neoplasia than are endocervical smears. Invasive carcinoma and its precursors confined to the anatomic endocervical canal can be recognized by this technique, and conversely the absence of neoplastic epithelium in adequate endocervical curettings rules out occult carcinoma. Indications for conization of the cervix are discussed in reference to the other biopsy and cytologic findings, and guidelines are presented for patient management, stressing clinicopathologic correlation and cooperation.

Biopsy↗
PubMed1976

Quantitative fluorescence spectrophotometry of acridine orange-stained unfixed cells. Potential for automated detection of human uterine cancer.

After staining with acridine orange (AO), the nuclei of unfixed cells from the human female genital tract exhibited the same fluorescence behavior previously observed for human and murine leukocytes and mouse ascites tumor cells. With staining conditions chosen to assure saturation of the green-fluorescing AO-nucleic acid complex in normal cells, corrected fluorescence emission spectra were recorded from the entire nucleus of 341 cells taken from 32 normal and 28 abnormal patients. Intensity of the recorded spectra was expressed in phosphor particle units, a fixed arbitrary unit of fluorescence intensity, to display intensity differences among the spectra from the various cell types. In all abnormal samples, one or more cells were found with 530-nm nuclear fluorescence intensity considerably greater than the maximum intensity recorded from normal cells. Determination of the adequacy of 530-nm nuclear fluorescence intensity as a criterion for cancer detection requires additional investigation. Additional criteria, if needed, may be supplied by the metachromasy of AO-stained unfixed cells.

Acridines↗