Biomedical subjects

J P Micha

Publications and source records attributed to J P Micha.

26 records · Page 2Linked to original sources

PubMed1985

Semipermanent right atrial catheter in gynecologic cancer patients.

The indications for insertion of semipermanent right atrial silicone catheters and immediate and long-term complications in patients admitted to a gynecologic oncology service, are described. Eight-five catheters were inserted in 79 patients for a variety of indications. Most catheters were placed under local anesthesia, in the patient's hospital room. Immediate morbidity caused by damage to the pleura was limited to three patients (3.5%). Infectious morbidity related to catheter use was seen in five patients (5.9%). Two patients were unable to administer daily heparin boluses through the catheter, and in both of these patients catheter thrombosis was seen (2.4%). A right atrial catheter can easily be inserted at the patient's bedside or in an outpatient setting. This device should be offered to any patient in whom intermediate or long-term vascular access is desired for nutritional support, chemotherapy, pain control, or similar indications.

Aged↗

PubMed1985

The potential of digitally inserted tampons to induce vaginal lesions.

To determine the incidence of vaginal mucosal alterations associated with the use of digitally inserted tampons, 100 women were prospectively evaluated colposcopically for three consecutive menstrual cycles. Three groups of 20 women each used the regular, super, and super-plus sizes of a digitally inserted rayon and cotton tampon; two additional groups of 20 each used external sanitary protection or an applicator-inserted rayon polyacrylate tampon. Vaginal mucosal drying and layering were significantly more common in all tampon users than in pad users; vaginal mucosal ulceration was a more rare event, seen only in tampon users, and statistically more commonly in the rayon polyacrylate group. The incidence of these alterations was not related to the presence of Staphylococcus aureus. All ulcerations healed without treatment. The common occurrence and relatively benign nature of these changes are discussed in view of the concern that these changes might predispose a woman to developing toxic shock syndrome.

Adolescent↗

PubMed1984

Chemosensitivity testing of nonsolid tumors by the subrenal-capsule implant assay.

A procedure to test chemosensitivity of nonsolid tumors using the subrenal-capsule xenograft assay has been developed. This technique is applicable to the study of malignant effusions and hematopoietic tumors. The tumor cells are centrifuged to form a pellet and the pellet is resuspended in the presence of bovine fibrinogen to form a jelled clot. This clot is cut into fragments which are implanted beneath the renal capsule of normal mice. The growth of the tumor cells from ovarian adenocarcinoma obtained from ascitic fluid is better than that of tumor fragments from the solid tumors. This is probably a reflection of the greater viability of tumor cells from ascitic fluids. The sensitivity to chemotherapy was the same for the solid tumor and its malignant effusions.

Adenocarcinoma↗

PubMed1984

The subrenal capsule tumor implant assay as a predictor of clinical response to chemotherapy: 3 years of experience.

The clinical response to chemotherapy of a series of female patients with advanced pelvic malignancies was compared to the response of their tumors to the same agents in the murine subrenal capsule implant assay. A total of 194 different patients were studied in 242 different assays; 89.3% of the assays were evaluable. There were 83 prospective assays (assays performed before the patient received the chemotherapy) of 66 different patients for which clinical correlations were available. In these assays the sensitivity (frequency of positive test results in responding patients) was 85.0%, the specificity (frequency of negative test results in nonresponding patients) was 57.1%, and the efficiency (percentage correctly classified) was 63.9%. There were 100 retrospective assays (assays performed after the patient had been treated with the chemotherapy) of 69 different patients for which clinical correlations were available. In these assays the sensitivity was 66.7%, the specificity 70.7%, and the efficiency 70.0%. Thirty-one of the patients had both prospective and retrospective assays. There were 59 patients for whom the clinical response to chemotherapy could not be determined. It is believed that the clinical utility of the SRC assay has been validated by the good prospective sensitivity of the assay.

Animals↗

PubMed1984

Baboon cervical colposcopy, histology, and cytology.

Colposcopic cervical/vaginal examinations were performed on 10 healthy adult baboons. Five of the ten baboons had a "satisfactory" colposcopic cervical examination with columnar epithelium visible on the exocervix. However, only three of five with "satisfactory" colposcopic exams had large visible transformation zones. The colposcopic findings were confirmed by histologic study. Probable squamous metaplasia was seen in one of the four animals who underwent cervical biopsies. The histologic and cytologic similarities of the human and baboon cervical transformation zones were noted. Only the three animals with the large visible cervical transformation zones were considered suitable for colposcopic studies of the transformation zone. Thus only 30% of the baboons examined were considered suitable subjects for studies involving colposcopy. Screening colposcopic exams would be necessary to find this subpopulation of baboons with large transformation zones visible on the exocervix. The implications of this study relative to the use of baboons as an animal model for studies of intraepithelial neoplasia are discussed.

Animals↗

PubMed1982

Plasma levels of oxytocin and 13, 14-dihydro-15-keto prostaglandin F2 alpha in preterm labor and the effect of ethanol and ritodrine.

We have measured the concentrations of circulating oxytocin and the 13, 14-dihydro, 15-keto-metabolite of prostaglandin F2 alpha (PGFM) in women during preterm labor. Twelve women were given intravenous ethanol and 11 women received intravenous ritodrine for the prevention of preterm birth. Blood samples were obtained before and 1/2, 1, 2, 4, 12, and/or 24 hours after treatment began. On admission, the plasma concentrations of both oxytocin and PGFM were raised over levels observed in women with normal pregnancies of similar gestational age, 25 to 36 weeks. The initial oxytocin level was 58.5 +/- 8.2 pg/ml (mean +/- SE, n = 23) and the mean initial PGFM level was 264 +/ 33.1 pg/ml (n = 15); both values were significantly higher than in 10 control subjects (17.4 +/- 4.8 and 156 +/- 21.8 pg/ml, respectively). During infusion of ethanol, the plasma oxytocin level fell rapidly, the levels at 1/2 and 1 hour after infusion being significantly lower than before the infusion (29.0 +/- 5.5 and 27.8 +/- 3.5 pg/ml, respectively). The plasma oxytocin level remained low in women in whom the treatment arrested labor and prevented preterm birth (n = 8) but rose 2 to 4 hours after the infusion began in women in whom the treatment failed to arrest labor (n = 4). Ritodrine, on the other hand, had no significant effect on circulating oxytocin levels. The plasma PGFM level decreased significantly during ritodrine treatment only in the successfully treated patients. Ethanol had no consistent effect on plasma PGFM levels in the four patients in whom PGFM levels were measured. In the ritodrine-treated patients, the plasma PGFM level was positively correlated with the frequency of uterine contractions whereas in the ethanol-treated patients a correlation of plasma oxytocin to the frequency of contractions was observed. Thus, oxytocin secretion is increased during preterm labor, and the release of prostaglandin F is also increased. While it is not possible to determine whether any or both of these oxytocic agents actually trigger preterm labor, both seem to play a role in its mechanism.

Dinoprost↗

PubMedDate not supplied

Spontaneous bacterial peritonitis following treatment for cervical carcinoma.

Spontaneous bacterial peritonitis (SBP) is an acute bacterial infection usually associated with ascites and cirrhosis or is a complication of peritoneal dialysis. There are very few case reports of cancer patients who developed this disease. Furthermore, there have been no published case reports of successfully treated gynecological cancer patients who later developed SBP. We present a case involving a 41-year-old woman who was treated for cervical carcinoma in 1992. She underwent radical surgery and adjuvant chemoradiation therapy. Two years later, the patient presented with streptococcal group B cellulitis associated with left leg lymphedema. She recovered following antibiotic treatment but had recurrent episodes of streptococcal cellulitis in her leg over the past 10 years. In 2003, the patient was admitted to the hospital because of sepsis, acute renal failure, and SBP. She was treated and recovered following treatment. SBP is usually associated with cirrhosis. Although SBP is rarely seen in successfully treated gynecological cancer patients, oncologists should be aware of this clinical entity. Timely treatment is essential to maximize chances of survival.

Adult↗

PubMedDate not supplied

Surgery alone or surgery with a combination radiation or chemoradiation for management of patients with bulky-stage IB2 cervical carcinoma.

The management of stage IB2 cervical carcinoma remains controversial. This retrospective review evaluates 47 IB2 cervical carcinoma patients treated with surgery alone (S), surgery plus postoperative radiotherapy (SR), or surgery plus postoperative chemoradiation (SRC). Median progression-free interval (PFI) was 70.3 months for the SR group (n= 21), 73.3 months for the SRC group (n= 15), and 33.5 months for the S group (n= 11). The survival rate was 76% for the SR group, 87% for the SRC group, and 55% for the S group. Overall 5-year survival rate for the three groups was 75%. Median follow-up for the patient population was 61.3 months. The number of the patient and the nonrandomized nature of this study preclude any definitive conclusions, but interestingly, the SRC and SR groups exhibited a substantially better PFI and overall survival compared to the S group. Selection bias does not appear to be a factor since patients in SR or SRC group were at greater risk for recurrence (eg, higher incidence of deep stromal invasion, parametrial involvement) than patients in the S group; yet, they still experienced superior PFI and overall survival. Further studies comparing postoperative irradiation and chemoradiation with these patients in a randomized phase 3 trial may be warranted.

Adenocarcinoma↗