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Biomedical subjects

M Penalver

Publications and source records attributed to M Penalver.

45 records · Page 3Linked to original sources
PubMed1989

Recurrent vulvar carcinoma in the intervening tissue bridge in early invasive stage I disease treated by radical vulvectomy and bilateral groin dissection through separate incisions.

Early invasive stage I squamous cell carcinoma of the vulva treated with radical vulvectomy and bilateral inguinofemoral lymphadenectomy rarely recurs, particularly when the lymph nodes contain no metastatic tumor. Primary radical surgery in this patient utilized separate groin incisions, and recurrent tumor developed in the tissue bridge between the groin scar and the vulva. Reexploration showed numerous inguinofemoral nodes to subseqently contain recurrent carcinoma. Literature regarding early, "microinvasive," squamous cell carcinoma of the vulva is reviewed.

Aged↗
PubMed1989

Nontunneled ureterocolonic anastomosis: an alternate to the tunneled implantation.

A nontunneled, nonrefluxing ureterocolonic implantation was performed in 32 patients who underwent construction of a continent colonic reservoir with a tapered distal ileum, and in 6 who underwent bladder replacement or urinary unidiversion with an ileocolonic segment. Between January 1986 and June 1988, 76 ureterocolonic anastomoses were performed with a success rate of 96%. Our preliminary report shows that this technique is a valuable alternative to the tunneled ureterocolonic anastomosis for various reconstructive procedures.

Anastomosis, Surgical↗
PubMed1989

Lymphangioma circumscriptum of the vulva: case report and review of the literature.

Lymphangioma circumscriptum is a benign disorder of lymphatic channels. The pathology consists of a collection of subcutaneous lymphatic cisterns communicating through dilated channels with superficial clusters of vesicles. The most common symptom is recurrent oozing of clear fluid. Management consists of wide excision, assuring free lateral and deep margins by frozen-section analysis. Involved margins have been shown to increase the recurrence rate. Laser vaporization has been used recently with relatively good results. The etiology of this lesion is unclear; however, lymphatic obstruction has been suggested as a possible cause in occasional cases. Two cases of vulvar lymphangioma circumscriptum have been reported previously in the literature, both arising in elderly women after radiation therapy for squamous cell carcinoma of the cervix. We present the third case, arising in a 42-year-old woman with no previous surgery or radiation.

Adult↗
PubMed1988

Application of an ATP-bioluminescence assay in human tumor chemosensitivity testing.

Intracellular adenosine triphosphate (ATP) is the primary energy unit of living cells, and can be quantitated by measuring the light generated with luciferase-luciferin reagent in a luminometer. The use of an ATP-bioluminescence assay, to determine tumor cell viability after exposure to chemotherapeutic agents, has been adapted to test tumor chemosensitivity in vitro. This presentation will illustrate the method of the ATP-chemosensitivity assay (ATP-CSA) using an ovarian cancer cell line NIHL:OVCAR-3 as an example and present preliminary data on 54/56 successful in vitro ATP-CSA's from 46 patients with pelvic malignancies. Fresh human tumor specimens were generally tested for single and combined drug effects at two drug concentrations (0.2 X and 1 X peak plasma concentrations). Correlation of in vitro drug sensitivity and in vivo patient response was obtained for 23 treatment regimens in 22 patients with ovarian carcinoma. The true positive rate was 100% and the true negative rate 66.7%. Our data demonstrate (a) that the ATP-CSA, measuring total cell viability, is a feasible in vitro assay for human tumor drug testing and (b) that specific criteria of in vitro chemosensitivity for this assay need to be defined by further studies, for single and combined drug exposure at different concentrations, to permit a meaningful correlation with in vivo clinical response.

Adenosine Triphosphate↗
PubMed1987

Gastrointestinal surgery in gynecologic oncology: evaluation of surgical techniques.

In recent years, the use of surgical staples has become popular in all subspecialties of surgery. The advantages proposed have been a decrease in operative time and morbidity. This paper reviews the University of Miami/Jackson Memorial Medical Center, Division of Gynecologic Oncology experience with the use of surgical staples in gastrointestinal surgery on patients with a diagnosis of a gynecologic malignancy. Between January 1, 1979 and July 1, 1985, a total of 152 procedures were done, 81 by stapler and 71 by suture anastomosis. Ninety-one patients had received previous radiation or chemotherapy. The average age of the patients was 52 years. The results show a decrease in operating time, blood loss, and postoperative hospital stay in those patients where the stapler anastomosis was used. The postoperative morbidity and mortality were not increased. Twenty-seven total pelvic exenterations were performed during the period of study and they were evaluated separately. The hospital stay and blood loss as well as the operative time were significantly less using staplers. This report includes a detailed evaluation of the results. From this study, we concluded that surgical staples are a safe alternative in gastrointestinal surgery in patients with a gynecologic malignancy.

Adult↗
PubMed1986

Small bowel complications after supravesical urinary diversion in pelvic exenteration.

Between June, 1966, and June, 1984, 102 pelvic exenterations were performed at Jackson Memorial Hospital/University of Miami Medical Center and all patients had some type of supravesical urinary diversion. Of these patients, 23 were reexplored for a gastrointestinal complication and 15 of those had a small bowel complication. Small bowel fistula occurred in 15 instances and 9 patients were reexplored. The fistula associated mortality was 53.3%. All the fistulas occurred in previously radiated patients who had undergone an enteroenteroanastomosis. The recent use of enterocolostomies after the construction of an ileal conduit in 21 patients has not produced any postoperative small bowel fistula, while in 43 patients who underwent enteroenterostomies, 13 fistulas occurred (P less than 0.01). Patients who did not undergo pelvic floor closure had a higher incidence of fistula and small bowel obstruction, while there were no fistulas in patients with previous enterocolostomies, regardless of the pelvic closure.

Colon, Sigmoid↗
PubMed1986

Major surgical procedures for gynecologic malignancy in elderly women.

We review 89 patients more than 75 years old who had major operations for various gynecologic malignancies. The recent routine use of perioperative intensive care decreased hospital mortality from 8.9% to 3.2%, and helped in decreasing and anticipating intraoperative and postoperative cardiorespiratory complications. Availability of visiting nurses since 1980 decreased the mean hospital stay from 30.2 to 24.4 days in patients who had radical vulvectomy. There were no deaths among 11 patients who subsequently had surgical reexploration for recurrent or new disease. Fifty-two of the 89 patients survived more than three years with no limitations resulting from the operations. When indicated, major surgical procedures for gynecologic malignancy in elderly women can be done safely, especially when the patient is evaluated and managed in a well staffed surgical intensive care unit.

Aged↗