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Biomedical subjects

R C Nuss

Publications and source records attributed to R C Nuss.

At least 19 recordsLinked to original sources
PubMed1989

Clinical correlation of hormone receptor status in epithelial ovarian cancer.

Cytoplasmic estrogen receptor (ER) and progesterone receptor (PR) levels were measured in ovarian epithelial carcinomas from 37 patients using a dextran-coated charcoal assay prior to any treatment. Sixty-eight percent of the tumors were ER positive, forty-nine percent were PR positive, forty-one percent were positive for both receptors, and twenty-seven percent were negative for both receptors. Receptor status in epithelial ovarian carcinomas was found to have no clinical significance when correlated with age, parity, race, cigarette smoking, surgical stage, histologic type, histologic grade, progression-free interval, or patient survival.

Adult↗
PubMed1988

Infrared laser bone ablation.

The bone ablation characteristics of five infrared lasers, including three pulsed lasers (Nd:YAG, lambda = 1,064 micron; Hol:YSGG, lambda = 2.10 micron; and Erb:YAG, lambda = 2.94 micron) and two continuous-wave lasers (Nd:YAG, lambda = 1.064 micron; and CO2, lambda = 10.6 micron), were studied. All laser ablations were performed in vitro, using moist, freshly dissected calvarium of guinea pig skulls. Quantitative etch rates of the three pulsed lasers were calculated. Light microscopy of histologic sections of ablated bone revealed a zone of tissue damage of 10 to 15 micron adjacent to the lesion edge in the case of the pulsed Nd:YAG and the Erb:YAG lasers, from 20 to 90 micron zone of tissue damage for bone ablated by the Hol:YSGG laser, and 60 to 135 micron zone of tissue damage in the case of the two continuous-wave lasers. Possible mechanisms of bone ablation and tissue damage are discussed.

Animals↗
PubMed1988

Successful pregnancy after previous conservative treatment of an advanced cervical pregnancy.

Cervical pregnancy was diagnosed at 12 weeks' gestation in a young nulliparous woman presenting with vaginal bleeding. Initial treatment with methotrexate was unsuccessful. The patient was ultimately treated by internal iliac artery ligation, hysterotomy, and intracervical balloon tamponade. Nineteen months after surgery, the patient delivered a healthy infant at 36 weeks' gestation by cesarean section.

Abortion, Induced↗
PubMed1988

An evaluation of the clinical staging of endometrial cancer.

Therapeutic approaches to endometrial cancer have traditionally been based on preoperative clinical staging. We conducted a retrospective review of 56 women with diagnoses of stage I and II endometrial cancer in order to compare preoperative clinical staging with postoperative staging based on pathologic data. We found a change in stage based on surgical findings in 41.1% of the cases. Endocervical curettage was falsely positive in 92.8% of cases. In addition, an overall change in tumor grade occurred in 39.3% of patients. Preoperative clinical staging of endometrial cancer is associated with a large margin of error when compared to surgical pathologic data.

Curettage↗
PubMed1987

Positive results of endocervical curettage as an indication for conization of the cervix.

At University Hospital of Jacksonville (Fla) during the years 1981 through 1984, 37 patients had conization of the uterine cervix for the sole indication of dysplastic cells found on endocervical curettage. Eighteen of the 37 (48.7%) were found to have a more dysplastic lesion than that diagnosed by colposcopic biopsy. In two of the 37 (5.4%) a previously undiagnosed invasive cancer was found. We conclude that dysplastic cells found on endocervical curettage must be further evaluated with cold conization of the cervix.

Cervix Uteri↗
PubMed1987

Vulvar and vaginal hematomas: a retrospective study of conservative versus operative management.

We reviewed 32 cases of vulvar and vaginal hematomas treated at three hospitals in Jacksonville, Florida, from March 1975 to March 1985. Patients ranged in age from 14 to 37 years. In 29 patients the hematomas resulted from obstetric trauma and in three from other causes. We found that patients managed conservatively had more subsequent operative intervention and more complications requiring antibiotics and transfusion, and they required more days of hospitalization than patients managed operatively. We also found an increased risk of complications and increased hospitalization for patients with conservatively managed hematomas when the product of the longitudinal diameter and the transverse diameter was 15 or greater.

Adolescent↗
PubMed1987

Management of gynecologic oncology emergencies.

Gynecologic malignancies are the third most common cancer among women in the United States. Because of often subtle early findings, the diagnosis may not be made before the widespread dissemination of the disease. The Emergency Department physician will commonly encounter a woman with vaginal bleeding, pelvic pain, or a symptomatic abdominal mass. In this article, we have described the epidemiology, recognized patterns of spread, and associated findings of gynecologic tumors. The proper Emergency Department evaluation and management of these problems is emphasized with guidelines for the timing of referrals and consultation with the gynecologic oncologist. The treatment of gynecologic malignancies is often complicated and responsible for Emergency Department visits. The various modalities are addressed according to the organ systems affected and include sections on postoperative problems, gastrointestinal complaints, urologic complications of therapy, radiation therapy and its complications, with an emphasis on the most serious complications necessitating either careful outpatient management or hospital admission. As cost-containment pressure grows, we have included sections on chemotherapy and total parenteral nutrition, both of which are becoming common outpatient events for the cancer patient.

Antineoplastic Agents↗
PubMed1987

Cefonicid vs. cefoxitin for cesarean section prophylaxis.

A randomized, prospective study compared a long-acting, second-generation cephalosporin, cefonicid (Monocid), with a short-acting, second-generation cephalosporin, cefoxitin (Mefoxin), for cesarean section prophylaxis. One hundred thirty-nine patients were enrolled, with 81 receiving a 1-g intravenous dose of cefonicid after cord clamping and 58 receiving a 2-g dose of intravenous cefoxitin after cord clamping and at 6, 12 and 18 hours postpartum. In those patients receiving cefonicid prophylaxis, endometritis incidence was 17.3% (14 of 81). This finding was not statistically significant (P less than .397) when compared to the 12.1% incidence of endometritis (7 of 58) with cefoxitin. In addition, the febrile morbidity incidence for cefonicid prophylaxis was 23.5% (19 of 81) as compared to 15.5% (9 of 58) for cefoxitin (P less than .25). Because the two drugs appear to be equally efficacious, cefonicid may be the better choice because of its markedly lower cost.

Adult↗
PubMed1986

Diethylstilbestrol-associated vaginal adenosis followed by clear cell adenocarcinoma.

A young woman was examined because of a history of in utero exposure to diethylstilbestrol and was identified as having vaginal adenosis. Fourteen months later, on routine follow-up, a small vaginal clear cell adenocarcinoma was recognized. She refused any therapy other than wide local excision. She was seen intermittently for several years with no recurrence. Five and one-half years after initial diagnosis she was found to have multiple sites of clear cell adenocarcinoma in the upper third of the lateral and anterior vaginal walls. Cases of vaginal adenosis followed later by the development of clear cell adenocarcinoma (metachronous cases) are distinctly unusual. The authors have collected the other recorded cases in the literature or in the Registry for Research on Hormonal Transplacental Carcinogenesis and have attempted to compare these cases with the larger group of patients who present with clear cell adenocarcinoma and have associated vaginal adenosis (synchronous cases). The authors have found few differences between the two groups. Most of the differences can be accounted for by the close follow-up of patients with known vaginal adenosis. However, it has been noted that the location of the clear cell adenocarcinoma is apparently different in the two groups. The reasons for this apparent difference are briefly discussed.

Adenocarcinoma↗
PubMed1985

Keratoacanthoma of the vulva.

A 65-year-old white woman noted a "pea-sized" lump of the right labium majus. At the initial examination a few weeks later, the mass was 1.5 cm in maximum diameter. An excisional biopsy was interpreted as well-differentiated squamous cell carcinoma. The biopsy material was subsequently reviewed prior to recommended radical surgery. Upon review, the lesion was interpreted as a keratoacanthoma. No further surgery was performed and the patient has remained free of recurrent disease for over 2 years. This case is presented in an effort to alert gynecologic oncologists and pathologists of the possibility of this lesion occurring on the vulva.

Aged↗
PubMed1985

The use of methylprednisolone and metoclopramide in control of emesis in patients receiving cis-platinum.

cis-Platinum is a chemotherapeutic agent with benefits often limited by the severe gastrointestinal reactions it produces in nearly all patients. Persistent anorexia, nausea, and vomiting may continue for days after therapy and are poorly controlled by conventional antiemetics. Patients at times refuse continuation of cis-platinum chemotherapy because of these severe gastrointestinal side effects. Intravenous methylprednisolone (Solu-medrol) as well as intravenous metoclopramide (Reglan) have been shown effective in the treatment of chemotherapy-induced nausea and vomiting. This randomized, double-blind study is a comparison of the efficacy of Solu-medrol vs Reglan, as well as, the combination of Solu-medrol and Reglan in the prevention of cis-platinum-induced nausea and vomiting. In this study patients receiving Reglan had better protection from vomiting than patients receiving Solu-medrol (P = 0.0564). Patients receiving the combination of Reglan and Solu-medrol had better protection from vomiting than patients receiving Reglan alone (P = 0.0332), or patients receiving Solu-medrol alone (P = 0.0010). Finally, older patients experienced less vomiting than younger patients, regardless of the anti-emetic drugs used (P = 0.0730).

Adult↗