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Biomedical subjects

R H Kaufman

Publications and source records attributed to R H Kaufman.

At least 19 recordsLinked to original sources
PubMed1992

Vulvar vestibulitis: significant clinical variables and treatment outcome.

The subject of vulvar vestibulitis was reviewed in regard to clinical variables that may be associated with this problem as well as the success of available treatment modalities. Questionnaires were returned by 71 patients diagnosed as having vulvar vestibulitis. Identical information was obtained from a comparison group of individuals with no clinical or physical findings suggesting this diagnosis. A history of recurrent candidiasis and previous condyloma acuminatum were the only variables noted more frequently in patients with vestibulitis. Among the patients treated by perineoplasty, 66% reported complete or significant alleviation of vulvar pain; 78% of the women noted a significant decrease in dyspareunia. Of the patients treated with intralesional interferon, six (50%) reported significant improvement in dyspareunia. Vulvar vestibulitis is a puzzling clinical entity whose etiology is not well understood. Perineoplasty still appears to be the treatment of choice in properly selected individuals.

Adolescent↗
PubMed1992

Advanced squamous cell carcinoma of the vulva after treatment for verrucous carcinoma. A case report.

Verrucous carcinoma of the vulva, a rare variant of squamous cell carcinoma, is a locally destructive, nonmetastasizing tumor. While controversy surrounds the choice of treatment for this lesion, which frequently recurs, it is generally accepted that a recurrence is almost always local, with histologic characteristics and biologic behavior the same as those of the primary tumor. A case of squamous cell carcinoma of the vulva with involvement of the regional lymph nodes after treatment of verrucous carcinoma is reported to increase awareness of the potential biologic behavior of this uncommon tumor.

Carcinoma, Papillary↗
PubMed1992

Herpes genitalis.

In conclusion, herpes genitalis has become one of the most common sexually transmitted diseases and has reached epidemic proportions. It presents a grave risk to immunocompromised patients and to newborns. The advent of effective therapy with acyclovir has dramatically modified the morbidity and mortality of disseminated herpesvirus infection and has helped in the therapy of primary and recurrent herpes genitalis. Current work has indicated that the disease can be transmitted by asymptomatic patients who are shedding the virus in the absence of visible lesions, which presents a diagnostic and therapeutic problem, especially significant for the pregnant patient, because infection of the neonate leads to serious consequences. Close follow-up of the pregnant woman with genital herpes therefore is imperative to minimize the risk to the newborn. At this time, no vaccines have been demonstrated to be safe and effective; therefore, prevention is of the utmost importance.

Diagnosis, Differential↗
PubMed1991

Cervical carcinoma metastatic to the skull, heart, and lungs: analysis for human papillomavirus DNA.

In this case report we present a 21-year-old patient with stage IV cervical carcinoma metastatic to the skull at the time of diagnosis. The patient had two previous negative Pap smears performed 10 months and 15 months prior to the time of diagnosis. Postmortem examination 2 months following diagnosis showed cardiac and pulmonary metastases. Human papillomavirus (HPV) DNA was detected in the primary cervical tumor and skull metastasis, but absent in the cardiac and pulmonary metastases. This study details the first report in the medical literature of a skull metastasis present at the time of diagnosis of cervical carcinoma. It also represents the first report of HPV-negative metastases arising from an HPV-positive cervical cancer.

Adult↗
PubMed1991

Increased risk of profound weight loss among women exposed to diethylstilbestrol in utero.

We surveyed 1711 women exposed to diethylstilbestrol in utero, and 919 women not exposed, concerning lifetime weight loss histories. The prevalence of a history of unexplained profoundly low body weight (weight less than or equal to 80% of expected weight for age, sex, and height) was 18.7 per 1000 in the exposed group compared to 3.3 per 1000 in the unexposed group; a 5.72 to 1 ratio of increased risk.

Adult↗
PubMed1991

Human papillomavirus DNA in tissue biopsy specimens of vulvar vestibulitis patients treated with interferon.

Thirteen women with the diagnosis of vulvar vestibulitis based on clinical symptoms, presence of vestibular tenderness on physical examination, and acetowhite changes of the vulvar vestibule were treated with intradermal injection of alpha-interferon. Biopsies of the acetowhite areas were analyzed for human papillomavirus (HPV) DNA using polymerase chain reaction amplification and dot blot hybridization. Eleven of 13 subjects harbored one of the HPV DNA types; six of these were type 16 and/or 18 and the others were unidentified. Five subjects (all HPV DNA-positive) reported resolution of symptoms with interferon therapy. Our results indicate the presence of HPV DNA in a subset of patients with vulvar vestibulitis, but its presence is not predictive of response to interferon therapy.

Adult↗
PubMed1991

Fungal vulvovaginitis.

Fungal vulvovaginitis remains one of the most frequent conditions affecting the lower genital tract. Recent advances in the understanding of the pathophysiology of the condition have improved our ability to treat recurrent or persistent cases. More clinical data have become available on the optimal duration of treatment with some of the newer antifungal agents.

Antifungal Agents↗
PubMed1991

Vulvar malignancy.

Treatment of invasive vulvar malignancy has become more individualized during the past decade. In the past, radical vulvectomy with bilateral inguinofemoral lymphadenectomy was the standard therapy for invasive squamous cell carcinoma and melanoma of the vulva. This is no longer always the case. The treatment of stage I and stage II invasive squamous cell carcinoma of the vulva has become more individualized. Less radical surgery appears to produce the same results as ultraradical surgery. Wide local excision of early lesions associated with ipsilateral lymph node dissection appears to be adequate therapy in many cases. Likewise, treatment of early melanoma (0.75 mm in thickness) can be managed by wide local excision with or without groin dissection of the ipsilateral side. This more conservative approach has resulted in significantly fewer postoperative complications and has improved the self-image of many women undergoing treatment for vulvar malignancy.

Female↗
PubMed1979

Cervical cancer cell lines containing herpesvirus markers.

Five epithelioid cell lines were established from invasive cervical carcinoma tissue and were examined for herpes simplex virus (HSV) antigens or virus-induced changes. Immunofluorescence studies with antiserum to an HSV type 2 nonstructural polypeptide detected perinuclear antigens. In these cell lines, concentrations of a membrane fucopeptide that is regularly present in normal cells were reduced to levels similar to those previously observed in virus-transformed cells. One of the cell lines inoculated into athymic mice produced tumors.

Animals↗
PubMed1979

Persistence of virus shedding in asymptomatic women after recovery from herpes genitalis.

One hundred seventeen women were reexamined within 6 months after presenting with genital herpes. Swabs for virus isolation were taken from the cervix whether or not lesions were observed. Herpesvirus type II was isolated from 30 of 67 patients with recurrent disease, but also from 5 of 50 women during periods when there were no signs or symptoms of illness. The epidemiologic importance of virus shedding from asymptomatic women is discussed.

Adult↗
PubMed1979

Vaginal epithelial changes in young women enrolled in the National Cooperative Diethylstilbestrol Adenosis (DESAD) project.

Initial clinical findings are reported for the 3339 young women enrolled in the Diethylstilbestrol Adenosis (DESAD) project. Changes in the vaginal mucosa (VEC--vaginal epithelial changes), which were detected by colposcopy or iodine staining, occurred in 34% of 1275 participants identified by review of prenatal records 59% of participants who themselves requested entry into the project, and 65% of participants referred by a physician. Analysis of data on the 298 women who were identified by record review and whose prenatal records contained complete information about drug exposure indicated that VEC is most closely associated with the timing of the onset of intrauterine exposure to diethylstilbestrol (DES), total dose, and length of exposure. Frequency of VEC was also found to decrease with age. No instances of severe dysplasia, carcinoma in situ, invasive squamous cell adenocarcinoma, or clear cell carcinoma were observed among the women identified by record review.

Adenocarcinoma↗
PubMed1979

Dermatomyositis and female malignancy.

All cases of dermatomyositis-polymyositis in women seen between 1970 and 1977 at Baylor Affiliated Hospitals were reviewed. Twenty-five patients were identified with this diagnosis. Of these women, 5 were found to have a malignant tumor: 3 ovarian carcinomas, 1 cervical intraepithelial carcinoma, and 1 colon carcinoma. Pertinent histologic and clinical findings in patients with dermatomyositis-polymyositis are discussed. The high prevalence of malignancy in these patients, previously recognized, is discussed. A case report is presented.

Adult↗
PubMed1978

Treatment of genital herpes simplex virus infection with photodynamic inactivation.

A double-blind randomized study to evaluate the effect of proflavine in the treatment of genital herpesvirus infection was conducted. One hundred fifty-seven women were studied, of whom 75 were treated with proflavine (treated women) and 82 were treated with placebo (control group). There were 62 women with primary disease and 95 with recurrent infection. Under the conditions by which this study was conducted, there was no apparent difference in the time of healing of lesions, development of recurrences, or virus isolation following treatment in the proflavine-treated and control groups.

Acridines↗